title: Diving medicine in clinical practice.
abstract: BACKGROUND
  Diving is a popular sport, and some recreational divers have medical risk factors. Their health can be endangered by high extracorporeal (ambient) pressure and its many systemic effects.
  
  
  METHODS
  We review relevant publications on free (breath-hold) diving, scuba diving, medical evaluation for diving, barotrauma, decompression sickness, and diving with medical risk factors, which were retrieved by a selective search of PubMed.
  
  
  RESULTS
  Free diving or scuba diving, even at seemingly innocuous depths, puts considerable stress on the cardio - vascular system, ears, and lungs. Unexpected events while diving, diminished functional reserve, and pre-existing medical illnesses increase the risk of a diving accident. An international survey revealed that minor incidents occur in 1.3% of all dives, and decompression accidents in 2 of every 10 000 dives. A properly conducted medical examination to determine diving fitness, followed by appropriate counseling, can make a life-threatening diving accident less likely.
  
  
  CONCLUSIONS
  To be able to certify diving fitness and give competent medical advice about diving, physicians must be well informed about the physical and physiological changes of diving and the associated risks to health, and they need to know how to perform a medical evaluation of prospective divers. In Germany, any licensed physician may judge a person fit to dive. It is recommended that this be done in adherence to the relevant evaluation standards and recommendations of the medical specialty associations. Randomized controlled trials on the effect of preventive behavior would be desirable, as would a central registry of diving accidents.
authors: Department of Anesthesiology and Intensive Care Medicine, University of Bonn, Central Institute of the German Armed Forces' Medical Service, Department IV-Military Ergonomics and Exercise Physiology-Koblenz, Research Group Epidemiology of Performance, Institute for Physiology and Anatomy, German Sport University Cologne.
authors: Lars
authors: L
authors: Eichhorn
authors: Dieter
authors: D
authors: Leyk
mesh_terms: D003665:Decompression Sickness / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D004242:Diving / Q000293:injuries* / Q000502:physiology*; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D010808:Physical Examination / Q000379:methods*