Scuba4fun

04/05/2022

https://www.fittodive.org/certificates/gxn5cszaoe
It has been estimated that panic contributes to 40-60% of scuba diving deaths. Therefore, those with a history of anxiety and panic attacks need to be cautious about participating in scuba diving. There are many that are promoting recreational scuba diving as a therapy for mental health disorders. Whilst there is no doubt in my mind that scuba diving can be relaxing and potentially therapeutic, there are clearly increased risks and both the diver and their buddy or instructor needs to be aware and have mitigating strategies in place.
Dr Laura Walton has created an excellent course – Preventing Panic in Scuba Diving, which I have just completed. Laura provides an excellent analysis of panic, what causes it, and suggests strategies of how to manage it. The course is a mixture of presentations, case studies and discussions. There is excellent advice on getting ‘fit to dive.’
I thoroughly recommend this course to all divers with a tendency to panic, instructors who may have students experiencing panic underwater and basically everyone who wishes to enjoy the underwater world in the safest manner possible.
A great course that has taught me a lot.

Helping scuba divers towards mental, emotional & physical wellbeing for diving.

08/02/2022

Is a Covid-19 infection still relevant for diving?
Since relatively early days in the Covid pandemic we have been concerned about the possible consequences of Covid damage for scuba diving. Many diving authorities issued guidance that suggested that divers who had contracted Covid-19 should be medically assessed before resuming diving. The general theme seemed to be a delay before returning to diving and then most having lung function tests and probably some form of exercise test with oxygen saturation monitoring and only if within normal limits be cleared for diving.
Many of the recreational diving training agencies collaborated to form the updated RSTC medical statement in 2020, which was further updated at the last minute to include a question about Covid-19 infection. In the UK there have now been nearly 18 million confirmed cases of Covid-19, with the likely true number being much higher, so potentially well over 50% of the population have had Covid-19. This should mean that over 50% of divers may need medical assessment before diving.
So what has recently changed?
This ‘RSTC’ committee released an updated version of the medical statement on 17th January 2022 which now only asked for ‘a diagnosis of Covid-19 since I last had a diving medical’ in Box A requiring a doctor’s clearance to dive. This would result in any diver who has had a Covid infection needing medical assessment, but at least not needing ongoing annual medicals. However, they have quickly replaced this with version 2022-02-01 which drops all mention of Covid-19. I suspect that the committee’s view was that anyone who had significant covid-19 infection would be picked up through other questions.
Dive operators are notoriously slow at updating their paperwork and websites, so their clients are likely to be given a previous version of the RSTC medical form. This means that some divers will require medical assessment and others not for the same medical status, depending on which version that they are given.
The UKDMC which advises BSAC, SAA & SSAC still publish advice that even those with asymptomatic or mild infection have an increased risk of lung damage which may lead to lung barotrauma when diving. Any of their divers who have had Covid-19 infection will need review by one of their medical referees.
So there is undoubtedly going to be confusion about the need for medical assessment depending on which medical screening questionnaire is being used by the dive operators and schools. Many who get given the latest RSTC form may believe that mild Covid-19 illness is of no concern for diving. Only time will tell if this is a reasonable view. If their dive operator uses an older version of the RSTC form, or the UKDMC medical statement, then any Covid-19 infection will lead to a medical review. It may well be up to each individual dive operator to decide what their policy will be about asking their divers for medical review or not after Covid-19, and choosing which version of the medical statement form that they use.

24/02/2021

Recreational diving will soon be able to resume in the UK. For many divers it will have been a long time since their last dive and the enthusiasm to get back into the water is understandable. There are many postings about getting your kit serviced, doing check out dives etc before resuming the type of diving that you previously did. This return to diving has another issue to consider – have you been infected with Covid-19 and what if any damage has it done to you?
It is now well known that even mild, and even asymptomatic Covid-19 infection can have long lasting effects on many parts of the body. Divers need to be concerned about potential lung and heart damage. Some will attribute their lethargy or shortness of breath on exercise to those extra lockdown pounds put on with boredom eating or not being able to get to the gym. Whilst this may be true for many, unfortunately for some it will indicate underlying lung or heart damage.
When we immerse ourselves in water there are significant changes to the cardiovascular system and the changing gas volumes in our lungs may well trigger problems that we desperately don’t want - cardiac problems or lung barotrauma! Both of which have high fatality rates in divers.
Official statistics show that there have been over 4 million, and rising, Covid-19 cases in the UK. This is known to be an underestimate as testing was not widely available for the first wave of the pandemic and even now if people aren’t getting much in the way of symptoms they may not bother to get tested. So a large number of recreational divers are likely to have been infected.
Depending on which dive agency you dive with you will probably need to complete either the RSTC medical statement (commercial agencies such as PADI) or the UKDMC medical form (club based such as BSAC.) Both have been updated to include questions on Covid-19 infection and a positive response requiring an assessment by a doctor.
Those required to complete the UKDMC form will need to see a UKDMC medical referee, those using the RSTC medical form can technically be assessed by any doctor, although in reality most UK GPs no longer provide recreational diving medicals. There are not many approved diving doctors in the UK and most have other posts within the NHS keeping them very busy dealing with the pandemic. It is not likely to be easy to access diving medical consultations for the foreseeable future and even harder to access lung and heart investigations if needed.
All divers should be encouraged to complete medical screening forms honestly and accurately. If indicated medical assessment should be completed before any in water activity. Remember that a diving accident can have serious effects on family members, rescuers and bystanders as well.
Safe diving.

13/06/2020

Recreational Diving Medicals.
I will be resuming a recreational diving medical service on Monday 15th June.

Diving medicals require close contact and touching. Undertaking spirometry and exercise testing are high risk for blasting thousands of viral particles into the air. Even though people may be asymptomatic we now know that many may nevertheless be infected / contagious. Hence these medicals are categorised as high risk.

There will be a screening process when booking the appointment and again on arrival, along with a temperature check. PPE will be provided and be required to be used wherever possible in the consultation. Hand washing and sanitiser will be available. Viral filters will be attached to the spirometer. Social distancing will need to be maintained as far as possible. Equipment and surfaces will be disinfected before and after the consultation.

Despite these measures there will remain a risk of transmission of any virus present in either the diver or myself and this risk will need to be accepted by the diver. More information is available on my website at http://www.ukoffshoremedicals.co.uk/Covid-19%20protocol.htm.

Anyone who has had symptoms suggestive of coronavirus will need to be screened for lung and heart damage, currently thought to be best done by CT chest scans and echocardiograms or stress exercise tests. These are costly. This should be discussed before booking the appointment.

The recommencement of this service is not an endorsement that it is safe to dive, you should only resume diving if your risk assessment is satisfactory and acceptable to all concerned.

Safe Diving.

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31/05/2020

The validity, extension & renewal of MA2 certificates.
The recreational diving industry in the UK is beginning to resume (prematurely in my opinion!) Those professional level divers e.g. instructors, divemasters and rescue divers on commercial courses will need to review the validity of their HSE diving medical certificates (MA2) and seek to renew or extend them if necessary. As these medicals are considered high risk for the transmission of coronavirus (close contact, forced exhalations for spirometry and heavy breathing during the exercise test,) they can only be conducted after a satisfactory risk assessment. PPE and appropriate decontamination protocols will be needed, the cost of which will need to be added to the price of the medical. The HSE issued guidance on the 24th March 2020 and further guidance on the 27th May 2020. This chart summarises the position relating to the required medical certificates.
Safe Diving.

29/05/2020

Following the BDSG’s announcement last week that recreational diving may recommence in the UK I have had many enquiries about the safety of this decision and how to get medically assessed. I do not support the BDSG’s decision and am not currently offering recreational diving medicals and neither are many UK based diving doctors.
It is clear that a significant number of Covid-19 patients are experiencing significant lung and heart damage which would make diving dangerous. What we do not know is how long this damage will last for or if it will be permanent.
Guidance on the medical assessment of divers is beginning to appear and my advice is based on the Belgium Society of Diving, The UC San Diego and the European Underwater and Baromedical Society’s publications, along with the case reports from Dr Frank Hartig.
If you are a BSAC club diver then you will need to consult a UKDMC medical referee, if you are a RSTC Diving Training Agency diver (e.g. PADI, RAID, SDI, TDI, SSI) then in theory you may consult any doctor, although in reality very few UK GPs are now offering sport diving medicals. Sport diving medicals are not included in the NHS and these will need to be accessed privately and some of the needed investigations will be costly.
Safe Diving.

18/05/2020

DAN Europe’s advice on diving post Covid-19
DAN Europe have just published an additional medical form for dive schools / operators to use to specifically enquire about Covid-19 illness, possible illness and exposure. Interestingly they only recommend that those who were admitted to hospital with lung symptoms will need full respiratory and cardiac investigation prior to diving. They seem to have discounted Dr Frank Hartig’s observations that of 6 divers who developed Covid-19, who did not need hospitalization, most had signs of significant lung damage at the 6 week review. I personally feel that longer follow up is required to establish if this damage is temporary or permanent, as most patients who may have had Covid-19 will not have been hospitalized. Diving with lung damage could be fatal.
Anyway, well done to DAN for issuing this guidance.

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22/04/2020

Covid-19 and recreational diving.
I hope that you are all remaining well and looking forward to getting back to diving. Unfortunately by then, many of you will either know that you have had Covid-19 or be unaware that you have had a mild, in terms of symptoms, infection. Preliminary analysis of cases has shown that the lungs and heart can be significantly affected and this will have serious consequences for diving, even at recreational depths.
The Belgian Society for Diving have published their current evaluation and guidance on the European Underwater and Baromedical Society’s website at: http://www.eubs.org/wp-content/uploads/2020/04/2020-0412-Position-of-the-BVOOG.pdf.
This is well worth reading. I suspect that the British advice will be along the same lines.
This will mean that costly investigations may be required before medical clearance to resume diving can be given. As diving medicine is generally not available on the NHS these tests will probably need to be arranged in the private sector.
The UKDMC do not support recreational diving at this time and for the foreseeable future recreational diving medicals are unlikely to be available.
You will need to bear this in mind before booking your next diving holiday or even getting wet in British waters.
Stay safe everyone.

22/10/2019

This is a must read for all recreational diving professionals. It covers a vast amount about identifying hazards and how to mitigate them. You will be a better pro after reading it and your students will be much safer for it.

The DAN Risk Assessment Guide for Dive Operators and Dive Professionals is the industry’s most comprehensive guide for refining the safety of your recreational dive operation, and the most recent edition is now available FOR FREE as a downloadable PDF. Download your copy now at https://apps.dan.org/Publication-Library/ and select "HIRA Guide 2nd Edition 2019".

Whether you are starting a new dive operation or just working to make yours even safer, this guide will make things easier. It outlines the minimum safety recommendations for recreational diving operations and alerts you to risks and hazards that occur in all facets of a dive business or operation, helping you to completely avoid or effectively manage incidents and accidents. The DAN Risk Assessment Guide for Dive Operators and Dive Professionals gives the professionals who put divers in the water every day the insight they need to make their operations as safe as possible.