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Need
for Medical Fitness Examinations?*
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Why A Medical Exam?
The only real reason for recreational
divers
to have an examination is to "maximize personal in-water safety". Other
reasons possibly include the safety of others, limiting the progression
of diseases (skin diseases), and prevention of long-term sequelae.
Edmonds
reported on 100 fatalities: 25 had known disqualifying factors --9 had
been told not to dive.
Working divers have a need to
anticipate the
progression of natural disease, detect any long-term consequences of
diving,
check for other occupational requirements and protect the employers by
ascertaining expected effective performance.
What is Fitness to Dive?
Australia and Malta
- Insist that recreational divers
have
an exam by
a doctor trained in diving medicine before taking any diving courses.
BSAC (British Subaqua Club)
- Family practitioner assists
filling
out a special
form and suggests referral to a BSAC "medical referee' who charges no
fee.
France
North America
"Advisory" only. Physicians
associated with hyperbaric
chambers, emergency room doctors and DAN doctor members are usually
knowledgeable
about diving medicine and may give opinions and advice.
Links
NOAA Fitness to Dive
NOAA Diving Program
NOAA
Working Diver Minimum Fitness Requirements
NOAA
Diving Program Medical Standards
NOAA Diving Programs
Forms
Navy Diver Screening
Questionnaire
Navy Diving Physical
Fitness to Dive? When?
Exams
- Before training
- Periodically
- After surgery, diving accident,
other
illness or
accident
Medical assessment is enhanced by a
physician who
has any diving knowledge or is himself a diver.
Diving
Medical History and Physical Exams
Fitness Problems
- The novice diver
- The asthmatic diver
- The diabetic diver
- Questions to ask the diabetic
diver:
- Any changes in insulin
requirement over the past
year?
- Any hypoglycemia in the
past
year?
- Any hospitalizations in
the
past year?
- Is control well managed?
- The physically handicapped
- The aging diver
- After head injury
- The diver who has had CAGE or DCS
with residual
damage
*Adapted from David Elliott, Medical
Seminars
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