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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.