DIVING
ACCIDEN
TS
PRESENTED BY: ARCEMIE AGUAVIVA
DIVINGDiving is a sport or activity in which you jump into water head-first with
your arms held straight above your head, usually from a diving board. It is also
an activity of working or looking around underwater, using special breathing
equipment.
DIVING
ACCIDENT
Diving accidents can be fatal and are often characterized by organ dysfunction,
especially neurological deficits. They have become comparatively rare among professional
divers and workers. However, since recreational diving is gaining more and more
popularity there is an increasing likelihood of severe diving accidents.
COMPETITI
VE
DIVING
ACCIDENTS
STATISTICAL
RECORDS
Diving injuries vary depending on whether the sport is performed at a recreational or elite level, and the
level of competition. Common diving injuries are strains to the shoulder and trunk. During the 2012 Summer
Olympic Games, 8% of diving athletes sustained an injury.
Lack of knowledge of the water depth and surroundings pose a significant risk of injury among
unstructured and unsupervised divers.
ACCORDING TO BC INJURY RESEARCH AND PREVENTION UNIT IT IS ESTIMATED THAT
Shoulder
Injuries
Shoulder injuries typically occur during
water entry when arms extended overhead get
forced back. Athletes usually feel the shoulder
pop out of joint when their shoulders are
dislocated. Most of the time the shoulder goes
back into the joint on its own; this is called a
subluxation (partial dislocation). If the athlete
requires help to get it back in, it is called a
dislocation.
Neck injuries
Repetitive extension of the neck on
water entry can cause an irritation of the
neck joints. This results in muscle spasms
and stiffness when rotating the neck or
looking up. Athletes with tingling or burning
down the arm may have a cervical disc
herniation or “stinger” and should see a
doctor.
Spinal Injury
Spondylolysis, stress fractures of the
bones in the lower spine, is due to overuse
from arching or extending of the back.
Symptoms include low back pain that feels
worse with back extension activities. Back
or reverse dives are often more painful. Disc
injury may cause low back pain that occurs
with flexion—including pike and tuck dives .
Other medical issues
Divers are at risk for a variety of medical
concerns as well, including
• Swimmer’s ear and sinusitis from too much
water in the ear
• Ruptured eardrums from impact in the water
and acute pressure changes
• Cuts, scrapes, bruises, fractures, and head or
facial injuries from hitting the board,
platform, or pool deck
• Sunburn or rashes from the sun
First Aid for shoulder injuries
The recommended treatment for most acute injuries is referred to as the PRICE principle.
This is an acronym for protection, rest, ice, compression, and elevation. The goal of this
treatment is to:
• Reduce pain and swelling
• Lay the foundation for a good rehabilitation
Protection
In this context, it means to remove the athlete from play to protect against further injury. This
is especially important in the first 48 hours after the injury occurred. It is often advised to rest
the arm in a sling. Ideally you should always have a sling available in the first aid kit. If not,
then you can always make one with a scarf or a towel.
Rest
The player should not play his or her sport for up to 48 hours. The length of this period depends on the
type and severity of the injury. This process should be evaluated in consultation with a doctor or
physiotherapist.
Ice
The aim of applying ice is to relieve pain. 20 minutes with an ice pack every other hour for a day or two
generally has a good effect.
Compression
This is not that important in acute shoulder injuries, because it is difficult to apply compression using an
elastic bandage around the shoulder.
Elevation
Luckily the shoulder is already above the heart, so no need to think about that.
First Aid for neck injuries
If you find the victim face down in the water, you must carefully rotate the victim to an
upward facing ( supine) position.
Rotate to Supine Position
You must be careful to avoid any bending or twisting the victim’s neck and torso to avoid
aggravating existing injuries.
Place one forearm along the length of the victim’s sternum with the hand of that arm
supporting the bony structure of the victim’s lower jaw. Simultaneously place your other
forearm along the length of the victim’s spine, supporting the victim’s head at the base of the
skull with your hand. Then support the victim’s head and torso with your forearms and hands
with an inward and upward pressure.
Maintain Neck Alignment
Once the victim is facing upwards, you must then continue to support the victim from the side
by placing one hand behind the neck and the other hand along the victim’s back. This
technique will maintain proper spinal alignment of the victim and will keep him/her in a
supine, upward facing, position. Additional rescuers should bring the necessary equipment
(i.e. SID, straps, lateral head/neck restraint, and so forth) and position a cervical collar around
the victim’s neck.
Head and Neck Immobilization
Place head and neck lateral immobilization restraints along both sides of the victim’s head in
order to reduce the risk of any lateral movement.
First Aid for Spinal
Injuries
Reassure the casualty
Do not move them and tell them not to move, unless they are in immediate danger. Call 999 or 112
for emergency help or ask someone else to call for you.
Steady and support their head, so that their head, neck, and spine are in a straight line to try
and prevent further damage.
To do this, kneel or lie behind their head, resting your elbows on the ground or on your knees to
keep your arms steady. Hold each side of their head, spreading your fingers so that you do not cover
their ears as they need to be able to hear you. Support their head in this neutral position.
If there is someone who can help you, ask them to put rolled-up blankets, towels, or clothes on
either side of the head while you keep the casualty’s head in the neutral position.
Continue to support their head until emergency help arrives and can take over, no matter how long it
takes for them to come.
If unresponsive
Open their airway using the jaw-thrust technique.
To do this, put your fingertips at the angles of the jaw and gently lift the jaw to open the airway. Do not
tilt their neck.
PREVENTION
Strength Training and
Neuromuscular Training Managing Concussion
Program
Concussions are a common injury in diving,
Educate divers on proper techniques, safety
so it is important to be aware of concussion signs
protocols, and training load. Risk of head and neck
and symptoms and know what to do if concussion
injury is reduced when the hands are held together,
is suspected. The Concussion Awareness Training
thumbs locked, and arms extended beyond the
Tool (CATT) is an online resource for coaches and
head. Diving with more air time (maximized flight
teachers to learn more about how to recognize,
distance), a low entry angle, and steering technique
prevent, and manage a concussion.
are important.
PREVENTION
Sport-related Physicals Facilities
The American Red Cross Swimming and
Competitive diving is physically demanding
Diving guidelines require a minimum depth of 9
and some pre-existing conditions may increase the
feet of water below the tip of the diving board in a
risk of injury. An annual sport-related physical
standard public pool. Most diving-related spinal
evaluation ensuring fitness to participate can help
cord injuries occur in residential pools where the
to reduce risk of injury.
maximum depth is less than 9 feet.
RECREATIO
NAL DIVING
ACCIDENTS
STATISTICAL
RECORDS
According to the Sports and Fitness Industry Association 2015 report, there are approximately three
million people who engage in scuba diving-related activities in the United States every year, and more than nine
million people identify themselves as recreational divers. The incidence of diving-related accidents has
increased steadily with the increase in divers.
ACCORDING TO BC INJURY RESEARCH AND PREVENTION UNIT IT IS ESTIMATED THAT
Barotrauma
Barotrauma is an injury to soft tissues
resulting from a pressure differential between
an airspace in the body and the ambient
pressure. The resultant expansion or
contraction of that space can cause injury..
Ear and Sinus
The most common injury in divers is ear barotrauma. As the middle ear tissues swell with edema—a
consequence of the increased pressure—the pressure difference across the eardrum pushes it into the
middle ear space causing it to bleed and possibly rupture.
Paranasal sinuses, because of their relatively narrow connecting passageways, are especially susceptible
to barotrauma, generally on descent. With small changes in pressure (depth), symptoms are usually mild
and subacute but can be exacerbated by continued diving. Larger pressure changes can be more
injurious, especially with forceful attempts at equilibration (such as the Valsalva maneuver)
Symptoms of Ear Barotrauma
01 02 03 04 05
Pain Decreased Vertigo (dizziness or Tinnitus Sense of “water” in the ear
hearing sensation of (ringing in (serous fluid/blood
accumulation in the
spinning) the ears)
middle ear)
Rapid Ascent
A rapid ascent is the largest cause of
injury and death in scuba diving. DCI
(decompression illness) and air embolisms are
the largest two groups of injuries. Rapid ascent
is the main factor in DCI when a cause is
known. In an estimated 36% of all the
incidents, the rapid ascent was the result of a
panic reaction.
Decompression
Illness
Decompression illness (DCI) usually
refers to one of 2 related conditions and both
are most commonly associated with scuba and
deep sea divers.
When underwater, divers breathe compressed
air that contains nitrogen gas at the same
pressure as the surrounding water. This
accumulates in the diver's body tissue, and is
breathed out on ascent, providing that ascent
occurs at a safe rate.
ARTERIAL GAS EMBOLISM
Gas entering the arterial blood through ruptured pulmonary vessels can distribute bubbles into the body
tissues, including the heart and brain, where they can disrupt circulation or damage vessel walls. The
presentation of AGE ranges from minimal neurologic findings to dramatic symptoms requiring urgent and
aggressive treatment.
DECOMPRESSION SICKNESS
Breathing air under pressure causes excess inert gas (usually nitrogen) to dissolve in and saturate body tissues.
The amount of gas dissolved is proportional to—and increases with—the total depth and time a diver is below
the surface. As the diver ascends, the excess dissolved gas must be cleared through respiration.
Decompression illness syndromes—
clinical findings
ARTERIAL GAS EMBOLISM
01 02 03 04 05
Chest pain or Loss of Paralysis Blurred vision Personality change,
bloody sputum conscious- difficulty thinking, or
confusion
ness
Decompression illness syndromes—
clinical findings
DECOMPRESSION SICKNESS
01 02 03 04 05
Coughing spasms Loss of bowel Joint aches or pain Dizziness Staggering, loss of
or shortness of or bladder coordination, or tremors
breath function
Other Conditions Related to Diving Accident
Drowning
Any incapacitation while underwater can result in drowning.
Nitrogen narcosis
At increasing depths, the partial pressure of nitrogen increases, causing narcosis in all divers. The impairment can
be life threatening. This narcosis quickly clears on ascent and is not seen on the surface after a dive, which helps
differentiate this condition from AGE.
Hazardous marine life
Oceans and waterways are filled with marine animals, most of which are generally harmless unless threatened.
Most injuries are the result of chance encounters or defensive maneuvers. Resulting wounds have many common
characteristics: bacterial contamination, foreign bodies, and occasionally venom.
RISK FACTOS
HEALTH
CONDITIONS
AGE
The presence of underlying health conditions
There is a higher risk for decompression illness
and diving-related fatality among older divers. The risk
can place scuba divers at increased risk for injury.
of arterial gas embolism, asphyxia, or disabling cardiac Divers with asthma, diabetes mellitus, right-to-left
injury during a dive is greater for those older than 49- shunt (a cardiac abnormality) and spinal stenosis
years-old as compared to younger divers.. (narrowing of the spinal canal) are at increased risk
of injury.
RISK FACTORS
SEX
EXPERIENCE
When comparing male and female divers 25
Divers in their first year of certification, years of age, males were found to be at 6 times
particularly divers on their first dive, are at increased higher risk of suffering a diving-related fatality as
risk of injury. compared to females. This difference in risk lessens
with increased age, with similar fatality rates
among males and females at 65 years of age.
First Aid for Barotrauma
Most cases of ear barotrauma generally heal without medical intervention. There are
some self-care steps you can take for immediate relief. You may help relieve the effects of air
pressure on your ears by:
• Yawning
• chewing gum
• practicing breathing exercises
• taking antihistamines or decongestants
If the case is severe
• Call the emergency hotline
• Doctor will prescribed an antibiotic or a steroid to help in cases of infection or inflammation.
• In some cases, ear barotrauma results in a ruptured eardrum. A ruptured eardrum can take up to two
months to heal and may require surgery.
Prevention for Barotrauma
You can decrease your risk of experiencing barotrauma by taking antihistamines or
decongestants before scuba diving .However, you should always check with your doctor and
be aware of possible side effects before taking new medications.
Other steps you can take to prevent or lessen barotrauma include:
• descend slowly while diving
• swallow, yawn, and chew when you feel symptoms of barotrauma, which can relieve
symptoms
• exhale through your nose during an ascent in altitude
• avoid wearing earplugs while diving
First Aid for Decompression
Illness
Initial treatment for all suspected cases of decompression illness, whether thought to be
DCS or CAGE, should be the same. Firstly, the accepted practice of “Danger, ABC” should
be used.
• If unconscious, place the casualty in the recovery position and ensure airway is open.
• Administer high concentration oxygen if available.
• Monitor the person’s level of response, breathing and circulation until Emergency
response arrives.
• If the person becomes unresponsive with abnormal breathing after resurfacing, CPR
should be administered with rescue breaths. See Unresponsive and abnormal breathing
In addition, ensure the following:
• Lay the casualty down and keep them horizontal.
• Encourage the diver to remain calm and still.
• Protect against hypothermia
• Monitor for deterioration and record observations
• Notify the appropriate emergency service of any deterioration.
Prevention for Decompression
Illness
Decompression sickness can be a dangerous condition, and it needs to be treated immediately.
Luckily, it’s preventable in most cases by following safety measures.
Do your safety stops
To prevent decompression sickness, most divers make a safety stop for a few minutes before
ascending to the surface. This is usually done around 15 feet (4.5 meters) below the surface.
Talk to a dive master
If you’re not an experienced diver, you’ll want to go with a dive master who is familiar with safe
ascents. They may follow the guidelines for air compression as outlined by the United States
Navy.
Use a dive computer
Dive computers were invented for a reason. They are the most accurate account of your dive
and calculate your decompression times based on you and you alone.
For scuba divers, there’s protocol in place to prevent decompression sickness. That’s why it’s important to
always dive with a group led by an experienced dive master.
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