Knowledge of Immersionary Pulmonary Oedema has been increasing in recent years. The Institute of Naval Medicine (INM) has published the following information that all divers should be aware of:
IPO is a life-threatening condition that can develop during a dive and all divers should be aware of the potential for this to affect them
In IPO fluid accumulates in the lung tissues leading to shortness of breath, coughing up of sputum, and/or chest pain
The risk is increased in people with high blood pressure, over-hydrating before a dive, diving in cold water, exertion and breathing against a negative pressure when diving.
First aid measures include removal from the water, call the DDMO/Coastguard/Ambulance, sit the casualty upright, place them on 100% oxygen, take them to a warm place if possible or re-warm on site, do not give any fluids and prepare for evacuation to hospital.
If the symptoms occur during the dive, the casualty should be closely accompanied to the surface
Consider IPO in anyone who reports equipment difficulties after a dive or switches to bail out due to perceived equipment difficulties
Diving Safety Memorandum 09/18 has just been released and provides information on the impact Over The Counter (OTC) medication can have on fitness to dive. In particular there are issues with Sidenafil (Viagra) and other drugs, which cause a similar effect as PDE-5-inhibitors. These have been shown to promote the onset and severity of neurological decompression illness (DCI).
We’re aware that members of the reserves have been struggling to obtain service diving medicals through service sources. This seems to particularly be a problem with members of University Officer Training Corps (UOTCs).
Following a discussion with SO1 Reserves in Defence Primary HealthCare Services (DPHC) the position has now been clarified. The bottom line is that all reservists are fully entitled to have their service diving medicals completed through service Occupation Health (OH) resources.
We’ve just received advanced notification that the Institute of Naval Medicine (INM) intends to make changes to the policy for AT service diving medicals. This is likely to appear in the next version of BR1750A which should be published in Autumn 2014.
The change has been driven by the Health and Safety Executive (HSE) and will bring AT service diving medicals fully into line with the Diving at Work Regulations (DWR). Specifically it will remove the exemption that currently exists for some AT divers to have an annual health surveillance check rather than a full physical examination.
The INM intend to allow grandfather rights, i.e divers will only need the full medical when their current medical expires.
Final point is that this is advanced warning and not current policy as the revised BR1750A has not yet been published. We’ll notify everyone when it comes online.
The INM is aware of the difficulties some medical centres have in conducting service medicals for all those who need them. One piece of good news is that the HSE have allowed the MoD to use locum doctors who are in date for the standard underwater medicine course to conduct military AT medicals. This will increase the pool of doctors who are able to conduct medicals and should reduce the difficulties that medical centres face. Once again this change will be promulgated in the revised version of BR1750A.