Scuba diving is an exhilarating adventure, offering a glimpse into an underwater world full of vibrant marine life and breathtaking landscapes. However, just like any outdoor activity, it comes with its set of risks and potential injuries. That’s why knowing first aid tailored specifically for scuba diving emergencies is crucial. Whether you’re a novice diver or a seasoned pro, being ready to handle common diving injuries and emergencies can make all the difference. In this article, we’ll dive deep into the essential first aid skills every scuba diver should have, from managing decompression sickness to treating barotrauma, ensuring your underwater excursions stay safe and enjoyable.
Introduction to First Aid in Scuba Diving
First aid in scuba diving is a specialized set of skills and knowledge applied to handle injuries and medical emergencies related to underwater activities. Unlike general first aid, scuba diving first aid focuses on conditions resulting from pressure changes, marine life encounters, and environmental exposures unique to diving. A timely and appropriate response to diving-related incidents not only prevents complications but can also be lifesaving. As such, understanding the nature of diving injuries and how to manage them with first aid is a must-have skill for every diver.
Common Injuries and Conditions in Diving
Before learning how to administer first aid, it is important to recognize the most common injuries and conditions divers encounter. These include:
- Decompression sickness (DCS): Caused by nitrogen bubbles forming in the blood or tissues when a diver ascends too quickly.
- Barotrauma: Injury resulting from pressure changes affecting air-filled spaces like ears, sinuses, and lungs.
- Cuts and lacerations: Often sustained from sharp corals, rocks, or marine creatures.
- Marine stings and bites: From jellyfish, sea urchins, or other aquatic life.
- Hypothermia and heat exhaustion: Resulting from prolonged exposure to cold or hot environments.
Knowing these helps divers anticipate potential problems and respond appropriately when emergencies arise.
How to Manage Decompression Sickness First Aid
Decompression sickness (DCS), sometimes called “the bends,” is one of the most serious diving emergencies. It develops when nitrogen absorbed during the dive forms bubbles in tissues or bloodstream due to rapid ascent. Early recognition and immediate action are vital.
Signs and symptoms of DCS can include joint pain, dizziness, fatigue, difficulty breathing, skin rashes, and neurological issues such as numbness or paralysis. If you suspect DCS:
- Stop diving immediately: Do not dive further or ascend again.
- Administer 100% oxygen: Providing pure oxygen helps to reduce nitrogen bubbles and improve tissue oxygenation.
- Keep the diver hydrated and rested: Encourage fluids and keep them lying flat, avoiding sudden movements.
- Arrange prompt evacuation: Transport the diver to the nearest medical facility equipped with a hyperbaric chamber for recompression therapy.
Remember, timely administration of oxygen and rapid access to medical care significantly improve outcomes for DCS patients.
Treating Cuts, Stings, and Barotrauma
Cuts and Lacerations
Divers may encounter sharp objects underwater, risking cuts or scrapes. It’s important to:
- Clean the wound with fresh water to remove any debris or saltwater bacteria.
- Apply pressure with a sterile dressing to control bleeding.
- Use antiseptic if available to prevent infection.
- Cover the wound with a waterproof bandage if continuing the dive is necessary, but it’s usually best to abort and seek medical attention for deeper wounds.
Marine Stings
Stings from jellyfish, sea urchins, or other marine creatures can cause pain, swelling, or even allergic reactions.
- Rinse the area with vinegar or saltwater (not freshwater, which may trigger nematocyst discharge).
- Remove any visible tentacles with tweezers or a gloved hand.
- Apply heat to the affected area to reduce pain if applicable.
- Use antihistamines or painkillers if symptoms persist, and monitor for signs of anaphylaxis — which requires immediate emergency care.
Barotrauma
Barotrauma arises from pressure-related injuries, often affecting the ears, sinuses, or lungs. Symptoms include ear pain, dizziness, hearing loss, or chest pain.
- For ear barotrauma, try gentle equalizing techniques but never force it if pain persists.
- If lung barotrauma or severe symptoms like coughing blood occur, seek immediate medical assistance.
- Divers with barotrauma should avoid diving until fully healed and cleared by a medical professional.
CPR and Rescue Breathing for Divers
Cardiopulmonary resuscitation (CPR) and rescue breathing are critical skills for assisting divers who have lost consciousness or stopped breathing, particularly after near-drowning or severe injury.
- Check responsiveness: Gently tap and shout to see if the diver responds.
- Call for emergency help: Prompt communication with rescue services is essential.
- Open airway: Tilt the head back and lift the chin.
- Perform rescue breaths: Deliver two slow breaths if the diver is unresponsive but has a pulse.
- Begin chest compressions: If there is no pulse, start chest compressions at a rate of 100-120 per minute and a depth of about 2 inches (5 cm) for adults.
- Maintain CPR until emergency medical personnel arrive or the diver regains consciousness.
Many diving organizations include CPR and rescue breathing training as part of their certification courses.
Handling Hypothermia and Heat Exhaustion
Divers are exposed to varying water and weather temperatures, making hypothermia and heat exhaustion potential risks.
Hypothermia
Signs include shivering, numbness, confusion, and slurred speech.
- Remove the diver from cold environments immediately.
- Dry and insulate them using blankets or dry clothing.
- Provide warm (not hot) fluids if they’re conscious and can swallow.
- Avoid rapid rewarming and do not give alcohol or caffeine.
- Seek urgent medical care if symptoms are severe or worsening.
Heat Exhaustion
This can occur when divers are exposed to prolonged heat, especially out of water during surface intervals.
- Move the diver to a shaded, cool area.
- Encourage rest and hydration with cool water or electrolyte drinks.
- Loosen tight clothing and cool the skin with wet cloths or fans.
- Monitor closely for progression to heat stroke, which is a medical emergency.
Emergency Oxygen Administration
Administering emergency oxygen is one of the most effective first aid treatments for diving injuries, particularly decompression sickness and arterial gas embolism.
- Oxygen should be provided at the highest possible concentration, ideally from a portable oxygen kit specifically designed for diving emergencies.
- Begin administration as soon as diving-related symptoms are observed.
- Continue oxygen until the diver is evaluated by medical personnel or a hyperbaric specialist.
- Proper training in oxygen delivery techniques, including how to use masks and regulators, is essential.
Many dive shops and liveaboards carry emergency oxygen kits and have staff trained to administer it.
Preparing a First Aid Kit for Diving Trips
A well-equipped first aid kit tailored for scuba diving can make managing injuries more effective. Essential items to include are:
- Sterile gauze pads, adhesive bandages, and waterproof dressings
- Antiseptic wipes and antibiotic ointment
- Tweezers and scissors
- Elastic bandages for sprains or strains
- Emergency oxygen kit with delivery masks
- CPR mask or face shield
- Pain relievers (such as ibuprofen or acetaminophen)
- Antihistamines for allergic reactions
- Thermal blankets for hypothermia
- Burn gel or topical analgesics
Ensure that the kit is stored in a waterproof container, checked periodically, and replenished after each trip.
Training and Certification Recommendations
Knowledge alone isn’t enough; practical training and certification are critical for effective first aid response in scuba diving. Organizations like PADI, NAUI, and SSI offer specialized first aid and emergency oxygen provider courses designed for divers, including:
- Emergency First Response (EFR): Covers CPR, rescue breathing, and basic first aid skills.
- Divers Emergency Management Provider: Focuses on managing diving-specific emergencies.
- Oxygen Provider Courses: Teach how to safely administer emergency oxygen.
Regular refresher courses are recommended to keep skills sharp and updated with the latest protocols.
Empowering Divers with First Aid Skills
Scuba diving opens the door to breathtaking underwater experiences, but it also demands respect for the environment and the risks involved. Equipping yourself with scuba diving first aid knowledge and skills isn’t just about responding to emergencies — it’s about expanding your confidence and safety awareness both underwater and on the surface. By understanding common diving injuries, practicing key first aid techniques, including oxygen administration and CPR, and maintaining a well-prepared first aid kit, you become an invaluable asset to your diving community. Remember, preparedness and calm action during emergencies truly save lives, so invest in your training and stay safe every time you dive.
