Fit to Dive Dr Clare Peddie

1
Fit to Dive?Dr Clare Peddie

• British Sub-Aqua Club
• National Diving Officer
• National Governing Body for Underwater Swimming

2
Fit to dive?

• History of fitness tests in the BSAC
• BSAC Incident report analysis
• Trends in recreational diving
• BSAC role as educators on fitness to dive

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History

• BSAC Diver Training Programme comprised a number
  of fitness tests
• Medical performed by local GP

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Learning to dive- the A test

• Swim 200 metres freestyle (not backstroke)
  without a stop.
• Swim 100 metres backstroke without a stop.
• Swim 50 metres wearing a 5kg weight belt
• Float on back for 5 minutes (hand and leg
  movement permitted).
• Tread water with hands above head for one minute
• Recover 6 objects from the deep end of training
  pool (one object per dive).

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National Instructor Exam- history

• Packed full of stamina tests
• The long swim..
• Examiners pose rescue scenarios

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Justification

• Needed to be fit to dive
• Required in rescue situations
• Poor performance of demand valves required a high
  level of fitness
• Diving often involved long snorkels to wreck
  sites
• Shore dives with demanding entries and exits
• Diving an extreme sport

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Is lack of medical fitness to dive a burning
issue?
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Data on fatalities

• Date drawn from the last 9 years
• Total UK fatalities in this time 147
• Bodies still not recovered 25
• Leaving 122
• Medical cause 20
• Nearly all of these are heart attacks

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Age factor

• Average age of 20 subjects 48 (67-29)
• Average age in incident database 38
• Probably an age trend in medical fatalities
• Divers are currently an ageing population!

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Gender factor

• Males 17
• Females 3
• Males in incident database 78
• Females in incident database 22
• No gender bias

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Seasonality

• All bar one (March) occurred in the months of May
  to Oct, with a peak in July
• Most of the diving takes place May to Oct
• Winter months are where the stresses on divers
  are greater
• Perhaps older divers steer clear of the winter
  months

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Fatalities due to medical reasons

• Not increasing

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Current situation

• Self-declaration for medical fitness
• Referral to diving medical referees
• Movement away from tough fitness tests
• Diving a sport for all
• Simple swimming test to learn to dive
• Advanced Lifesaver required for First Class
• National exam - an exam of instructional technique

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BSAC perspective

• New trainee divers
• Seasonal peaks
• New trends in diving
• Fitness to dive on the day..

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New trainee divers

• Additional stresses
• Normally shore diving
• Weight of equipment
• Buoyancy issues
• Lack of familiarity with equipment
• Anxiousness failure to ventilate properly
• Dive fitness muscles to do the work
• From 2007 - BSAC will be training these trainee
  divers to use Nitrox - option to minimise risk

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Seasonal divers

• Seasonal peaks in incidents
• Easter (if the weather is good)
• May bank holiday weekend
• Divers try to begin diving season where they left
  off in September

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Trends in Recreational Diving

• Deeper longer dives more frequent
• Cylinder numbers and equipment has developed

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Ladders to tail-lifts

• Minimisation of exertion during diving

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Trends in Recreational Diving

• Closed circuit rebreathers improving
  decompression
• 60 branches in BSAC have 2 or more rebreather
  divers
• New physiological problems
• Oxygen toxicity
• CO2 toxicity

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Fitness to dive on the day

• Previous dive history
• unreported or unrecognised decompression illness
• Recent dives
• missed stops
• fast ascents
• repetitive deep diving over several days
• Fatigue
• Infection ears, sinuses, chest.
• Body core temperature
• Dehydration
• Blood alcohol levels

21
Education

• BSAC role as NGB to improve education and
  therefore prevention
• Awareness of factors contributing to diving
  incidents very much improved
• Early treatment with oxygen much more prevalent

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Fit to dive?

• Fit to dive on the day?
• Fit to dive in the conditions?
• BSAC role to educate divers to make informed
  decisions
• Medically fit to dive?
• In your capable hands.