Dive Medicals

[sheeper]

I don't necessarily disagree with some of the comments here. Scuba is a self-regulating industry. But i voted "yes".

A medical form is required by our training agencies for every class. If certain things are checked as a "yes", a physician approval is required. Some classes (divemaster and instructor) require a physician sign-off. Even beyond that, i will sometimes require a student to provide a physician sign-off if i am unsure about their physical abilities. I very often do this for tech students. I require the medical from students to protect both myself AND the student. As I am also a paramedic, my threshold for medical tends to be a bit different than many other instructors.

 

[scubadada]

I am also a physician and I side with my colleague, @rsingler, no.

I am 70 years old. I have several yes answers on both page 1 and page 2 of the Participant Questionaire. I have also exercised nearly every day of my adult life.

I have no problem with the requirement for me to return the Medical Examiner's Evaluation Form in order to participate in training. I did exactly that just last December when I took the Recreational Avelo Diver course from Dive Friends in Bonaire. So far, I have never been required to have medical clearance to dive with a land based or liveaboard operator. I'm back to the Revillagigedos in June.

 

[OMyMyOHellYes]

No.

No no.

No no NO.

Nope.

Virtue signaling measure in real terms with no appreciable return WRT safety.

It's hard enough to get in to see a doctor now anyway, even with "good" insurance. And how many docs even understand, really understand, the risks and nuances of diver health issues and how they will impact things underwater.

And who would get to enforce this? Scuba police pulling up divers and barking "SHOW ME YOUR PAPERS!!!" ?

LAST thing we need is more required bureaucratic input and expense to an activity that is expensive and already throws up barriers to entry/continuity. Anyone noticed that this has become an old man's sport already?

 

[DiveLikeAMuppet]

What would you include in the dive medical? How much can a doctor actually diagnose during the appointment? Would you tailor the medical to the type of diving a person might perform?

Unless you have you tick a "yes" on the medical questionnaire or suffer from a major medical problem, a dive medical is unlikely to uncover much. A recreational (as opposed to HSE diving at work medical) includes:

• urine test for diabetes
• quick spirometry test and stetoscope lung check
• weight, height and waist circumference
• ear function - ottoscope check of an ear canal, ear drum and ability to equalize and a test checks for inner ear balance issues
• discussion of any previous medical exams

You might get sent for further checks if you suffered from e.g. asthma. There might even be some time to ask few questions too but that's about all you can do in 30 minutes. It's absolutely worth the money if you had a problem that might impact your diving but probably pointless otherwise.

If you make the medicals mandatory, doctors, especially in the US, would need to assume a lot of responsibility for certifying that you are medically fit. So I would assume that medicals would get into philosophical territory and essentilly kill the sport:

• Should divers get routinely checked for PFO? And if a PFO is found (what size?) with no prior decompression problems - does that mean a diving ban? A limit to your diving? 10 meters no deco no more than 2 dives per day? Or you need to dive a different GF? Fixing a PFO is pretty pricey.
• Should fat divers be allowed to dive? If so, what's the cuttoff in terms of BMI or some body fat measurement? 27 or 28? Or even 29 as that's very fat to participate in a dangeous sport? Should very obese divers be allowed to dive at all? Maybe fat divers should not dive rebreathers or participate in technical diving? Maybe they should only be allowed to dive with a 1:1 oversight of a professional guide?
• Should out of shape divers be allowed to dive? If you believe in buddy system, it's a lot of hard work to rescue someone. Getting back on a boat in swell is hard work too, especially with multiple cylinders. How would you test fitness and what's the benchmark? Maybe we could adopt a swim test for lifeguards as that's an existing standard - 400 metres in 8 minutes? That's by the way significantly stricter than e.g. GUE swim tests that worry so many divers. Obviously the fitness test would not be adjusted for age.

Looking around UK dive boats, two thirds of divers including myself would fail at least one of the 3 bullet points above...

I think it's safer to keep diving a niche, overlooked sport. Any regulation makes our life much more difficult.

 

[lowwall]

All you have to do is look at FAA medicals for the unintended side effects if you make these mandatory. Do you really want divers to avoid seeking therapy for physical and psychological conditions just to keep a clean medical history? How about divers spending months or years fighting through bureaucracies to get their medical back when something gets flagged that shouldn't have been or after necessary treatment is successfully completed?

The process is likely a necessary evil for pilots flying commercial passengers. But that's a very different situation from the recreational diver.

OTOH, I could support some sort of recurring skills and fitness check. Maybe every 5 years require a demonstration of basic skills including a timed underwater swim in full gear and surface swim with no gear. The times and distances should be moderate, something less than the original test.

Failure to complete the test could temporarily revert the diver's cert from OW to Scuba/Supervised Diver, which means the diver would be restricted to diving with a certified DM or Instructor.

 

[scubadada]

...I could support some sort of recurring skills and fitness check. Maybe every 5 years require a demonstration of basic skills including a timed underwater swim in full gear and surface swim with no gear. The times and distances should be moderate, something less than the original test.

Failure to complete the test could temporarily revert the diver's cert from OW to Scuba/Supervised Diver, which means the diver would be restricted to diving with a certified DM or Instructor.

Who would administer, supervise, and report this testing? When and where would this testing be done, it would likely interfere with many regular diving activities? Would the cost be borne by the diver? Would all operators be obliged to ensure current certification or turn down the diver for unrestricted diving? US or international?

 

[boulderjohn]

I am going to give the experience of someone I know very well. He has a cardiac history that has some issues, and....

1. His cardiologist is an avid and highly experienced diver who has no problem with him diving. He is also friends with one of the most famous diving cardiologists in the country. This person knows all about his cardiac issues and has not only said he is good to dive, he has dived with him.
2. Another physician who was in the past extremely active on ScubaBoard told him that his condition was an absolute contraindication for diving and he should quit diving immediately.

So which one does he go to for his medical evaluation?

 

[Germie]

No. As long as people who are really healthy and sportive fall dead during football, running, etc, a dive medical will not help. Is it your time, it is your time.
A self check list with some risk factors is not bad. The list you have now already.

 

[lowwall]

Who would administer, supervise, and report this testing? When and where would this testing be done, it would likely interfere with many regular diving activities? Would the cost be borne by the diver? Would all operators be obliged to ensure current certification or turn down the diver for unrestricted diving? US or international?

Here's the answers the way I imagine it:

Who would administer, supervise, and report this testing?
Any instructor and agency that can sign off on OW certs. This would either be a separate e-card or a notation on your existing cert. Issuance of an advanced cert that has an in-water fitness component would also reset the 5-year clock.

When and where would this testing be done, it would likely interfere with many regular diving activities?
Pool/confined water normally with OW at the discretion of the instructor. Ideally you'd do it at an LDS or maybe when checking in the day before you start diving. It should only take 20-30 minutes to do the swim tests and a couple of basic skills. For the skills, I think it would be enough to demonstrate, while neutrally bouyant, a mask flood and clear and switch from primary to secondary regulator and back.

Would the cost be borne by the diver?
I don't see who else would volunteer to pay for it . But it shouldn't be expensive. 30 minutes of an instructor's time in a pool. You could run a few people at a time to get the cost even lower.

Would all operators be obliged to ensure current certification or turn down the diver for unrestricted diving? US or international?
Yes, that's the whole point. Note that it wouldn't make a difference for most vacation diving since that's supervised anyway, i.e., has a DM and depth limits. The idea would be to directly save the lives of at least a few of the grossly physically unfit bug hunters who succumb to cardiac issues every year, but more importantly to make it clear that a certain level of physical fitness and a very basic set of skills is necessary to dive safely. The hope is that it would encourage the occasional diver to be more active. Because the swim test time and distance would be known, it would give divers a concrete goal to shoot for in their fitness regimes. I'm also OK if it discourages those in really poor shape who aren't interested in getting fitter from attempting to dive.

 

[OMyMyOHellYes]

OTOH, I could support some sort of recurring skills and fitness check. Maybe every 5 years require a demonstration of basic skills including a timed underwater swim in full gear and surface swim with no gear. The times and distances should be moderate, something less than the original test.

Failure to complete the test could temporarily revert the diver's cert from OW to Scuba/Supervised Diver, which means the diver would be restricted to diving with a certified DM or Instructor.

No.

No no.

No no NO.

Nope.

Virtue signaling measure in real terms with no appreciable return WRT safety for the general population. If VIPs created the perception of a money grab (to which I don't subscribe) when it only impacts cylinder owners, think about the outcry for a far more expensive recurrent requirement hung around the neck of ALL divers.

That 90-year-old in front of me doing 45 in the passing lane. Turning left out of the right-hand lane. Culling those kinds of drivers would significantly improve safety for a much much larger population. They did a driver test 65 years back and yet we don't require new approval to drive (or make them drive with a licensed driver over 18 years of age in the front seat (presumably supervising)if they fail the new driver test).

Some things like scuba DO NOT need to be regulated to death.

If I am destined to die of a massive internal fart (heart attack), I'd kind of like it to be on a good dive, in bed with a really hot 20-something female, back on the ground after setting the brakes after a great flight, or maybe on the firing range. Not in a nursing home wheel chair with drool on my bib and a fully loaded diaper.