A2 Initial Assessment Of Diving Injuries

When using the form in Figure 5A-1a, the initial assessment must gather the necessary information for proper evaluation of the accident.

When a diver reports with a medical complaint, a history of the case shall be compiled. This history should include facts ranging from the dive profile to progression of the medical problem. If available, review the diver's Health Record and completed Diving Chart or Diving Log to aid in the examination. A few key questions can help determine a preliminary diagnosis and any immediate treatment needed. If the preliminary diagnosis shows the need for immediate recompression, proceed with recompression. Complete the examination when the patient stabilizes at treatment depth. Typical questions should include the following:

1. What is the problem/symptom? If the only symptom is pain:

a. Describe the pain:

Throbbing b. Is the pain localized, or hard to pinpoint?

2. Has the patient made a dive recently?

3. What was the dive profile?

a. What was the depth of the dive?

b. What was the bottom time?

c. What dive rig was used?

d. What type of work was performed?

e. Did anything unusual occur during the dive?

4. How many dives has the patient made in the last 24 hours? a. Chart profile(s) of any other dive(s).

5. Were the symptoms first noted before, during. or after the dive? If after the dive, how long after surfacing?

6. If during the dive, did the patient notice the symptom while descending, on the bottom, or during ascent?

7. Has the symptom either increased or decreased in intensity since first noticed?

8. Have any additional symptoms developed since the first one?

9. Has the patient ever had a similar symptom?

10. Has the patient ever suffered from decompression sickness or gas embolism in the past?

a. Describe this symptom in relation to the prior incident if applicable.

11. Does the patient have any concurrent medical conditions that might explain the symptoms?

To aid in the evaluation, review the diver's Health Record, including a baseline neurological examination, if available, and completed Diving Chart or Diving Log, if they are readily available.

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