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Immersionary Pulmonary Oedema (IPO) – INM Guidance

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
  • Do not dive again until medically assessed.



AT Diving Medical Referrals

The Institute of Naval Medicine (INM) have released 2016DIN01-133 which replaces 2015DIN01-191.

This DIN explains that INM only has a single consultant in diving medicine and is therefore unable to accept referrals for AT diving fitness medicals.

Issued in Oct 15, the DIN expects this position to continue for at least another six months.

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Changes to AT Diving Medicals

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.