Guidelines for Examining Doctors
MEDICAL GUIDELINES
These notes are included for the guidance of doctors who may be unfamiliar
with requirements for diving. If in doubt, please discuss with your nearest Medical Referee
| SYSTEM | DISQUALIFYING FACTORS | ALLOWABLE FACTORS | OTHER POINTS |
| General |
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Diving is not advised during pregnancy. Those who have dived before discovering they were pregnant are advised to contact a Medical Referee. | |
| ENT | Perforated eardrum in new entrants, chronic vestibular disease in new entrants, | Perforated eardrum known to have been present during several years of diving, Healed perforation, including ?paper thing" scars. Unilateral nasal block, Sinusitis if not adversely affected by diving. | Valsalva test of drum mobility should be carried out and if doubtful, practical diving test in pool should be advised. For this purpose any wax obscuring a good view of the drum should be removed. Deafness - at discretion of Medical Referee the candidate may be restricted to diving with a fit companion. Sinusitis may benefit from diving! |
| Oral Cavity | Dentures must be retained in place on fully opening the mouth and not be dislodged by placing jaws together in any position, or by movement of one denture against the other. They should extend to the muco-buccal fold. If dentures do not satisfy these requirements, they should not be worn while diving. Cleft palate not acceptable without Referee?s opinion. | Applicants to be advised about bad teeth and fillings but these should not normally disqualify. | |
| RS | Suspicion of active tuberculosis. Tuberculosis scars other than healed primary focus in new entrants, History of spontaneous pneumothorax, lung cysts or bullae normally disqualifies. Possible surgical treatment should be discussed with a Medical Referee. Old spontaneous pneumothorax in candidates over thirty may be allowable. Refer to Medical Referee. | TB. scars in established diver subject to Referee?s opinion, Traumatic pneumothorax not necessarily a disqualifying factor. Any surgical removal of lung tissue or any serious lung complaint to be referred to Medical Referee, Asthma in childhood with full remission by time of examination, | A chest X-ray is not required on entry or at repeat medical examination unless there is a history of significant cardiovascular disease, respiratory disease or occupational exposure (since the last medical in the case of a repeat medical) or if the physical examination reveals an abnormality in the cardiovascular or respiratory systems. Doctors must see film or report before signing certificate. Asthma (except as under "Allowable"), surgical removal of lung tissue, chronic bronchitis or any other serious chest condition should always be referred to a Medical Referee. |
| CVS | Clinical or where appropriate EGG evidence of ischaemic heart disease, aortic valve disease. Evidence of heart disease other than lone systolic murmur, should be referred. Symptomatic or pathological arrhythmias, systolic pressure over 160 mm Mg, diastolic pressure over 100 mm Hg in established divers and 90 mm Hg in new entrants, or other evidence of hypertensive disease. End organ damage from hypertension | Minor asymptomatic heart disease other than ischaemic (subject to more frequent medical checks). Persons with well controlled hypertension without evidence of end organ damage may be permitted to dive. Intracardiac shunts should be referred to Medical Referee. |
Post-exercise EGG recommended in the case of individuals with a poor family history of coronary disease or hyperlipidaemia, particularly if they smoke but needs to be interpreted with caution. Pacemaker to be referred to Medical Referee. |
| Haematology | Haemophilia, sickle cell disease and polycythaemia will disqualify. | Mild anaemia but advise treatment. Tumours and leukaemia may be allowable but should be referred to Medical Referee. Sickle cell trait. |
Sickle cell test only where clinically indicated. |
| Abdomen / UGS | Significant proteinuria, until the cause has been established. | Peptic ulcer, unless unduly active or troublesome. Abdominal hernias (but advise repair). |
|
| Nervous System and Vision | History of confirmed epilepsy including post-traumatic fits, refer to Referee. Any serious head injury in past three months. Currently symptomatic psychiatric or personality disorders. Any disease of CNS (MS. Polio Petit Mal, etc.) refer to Medical Referee. |
Febrile convulsions but no other type of fit allowable. Multiple Sclerosis - only stable patients acceptable. | A single isolated fit or severe head injury to be referred to Medical Referee. Severe visual impairment to be reported to Referee. A long fit free period off anticonvulsants may be allowable. Referee to Medical Referee. |
| Endocrine | Diabetes with diabetic complications. | Referral to Medical Referee is required for diabetics and for all other endocrine disorders. | For diabetics, an annual medical is mandatory. |
| Drugs | The use of the following disqualifies: Oral sympthomimetics (other than proprietary nasal decongestants), oral steriods, muscle relaxants, digoxin, Psychotropic drugs - see comments in Other Points column. Alcohol, drug or narcotic abuse to disqualify. |
Antihistamines and analgesics should only be used with caution. Oral contraceptives and diuretics are allowable. Smoking is allowable but reduces fitness and predisposes to air embolism, pneumothorax and coronary thrombosis. Inhaled sympathomimetics, such as salbutamol, should not be used therapeutically within 24 hours of diving but may be used as a prophylactic measure by symptomless divers. |
If any psychotropic drug (including tranquillisers, sedatives and hypnotics) have been used, the candidate should not dive for at least 3 months after complete cessation of therapy without the consent of the Referee. |
| Decompression Illness since last Medical |
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Referee to Medical Referee or Medical Consultant. |
| Disabilities | Disease, amputation or deformity excessively limiting ability to swim. (May be issued with a restricted certificate at discretion of referee). Learning disability sufficient to produce problems in understanding and remembering the theory and techniques of diving. |
Arthritis, amputation or arthrodesis not severely limiting ability to swim. | Anyone with a significant disability should be assessed by a Medical Referee. Suitable organisations to contact are "Dolphin" (Tel. No 01752 408093) or the Headquarters of the Diving Associations who have jointly published this form. |
Page last modified: 17th Nov 2006 - 16:55:27