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From Divers Alert Network

From simple cases of swimmer’s ear to the serious and sometimes lasting damage of barotrauma, divers are vulnerable to ear problems because the delicate mechanisms that govern our hearing and balance just aren’t designed for the rapid pressure changes that result from diving.

Fortunately, ear injuries are preventable.

Your middle ears are dead air spaces, connected to the outer world only by the Eustachian tubes running to the back of your throat.

If you fail to increase the pressure in your middle ears to match the pressure in your outer and inner ears, the result is painful middle ear barotrauma, the most common pressure-related ear injury.

The key to safe equalizing is opening the normally closed Eustachian tubes. Each has a kind of one way valve at its lower end called the “Eustachian cushion,” which prevents contaminants in your nose from migrating up to your middle ears. Opening the tubes, to allow higher-pressure air from your throat to enter your middle ears, normally requires a conscious act. Swallowing usually does it.

You equalize your ears many times a day without realizing it, by swallowing. Oxygen is constantly absorbed by the tissues of your middle ear, lowering the air pressure in those spaces. When you swallow, your soft palate muscles pull your Eustachian tubes open, allowing air to rush from your throat to your middle ears and equalize the pressure. That’s the faint “pop” or “click” you hear about every other swallow.

Scuba diving, however, subjects this equalization system to much greater and faster pressure changes than it’s designed to handle. You need to give it help.

All methods for equalizing your ears are simply ways to open the lower ends of your Eustachian tubes, so air can enter.

Methods Used:

-Passive
requires no effort
Typically occurs during ascent.

-Voluntary Tubal Opening
Tense Your Throat and Push Your Jaw Forward
Tense the muscles of the soft palate and the throat while pushing the jaw forward and down as if starting to yawn. These muscles pull the Eustachian tubes open. This requires a lot of practice, but some divers can learn to control those muscles and hold their tubes open for continuous equalization.

-Toynbee Maneuver
Pinch Your Nose and Swallow
With your nostrils pinched or blocked against your mask skirt, swallow. Swallowing pulls open your Eustachian tubes while the movement of your tongue, with your nose closed, compresses air against them.

-Frenzel Maneuver
Pinch Your Nose and Make the Sound of the Letter “K”
Close your nostrils, and close the back of your throat as if straining to lift a weight. Then make the sound of the letter “K.” This forces the back of your tongue upward, compressing air against the openings of your Eustachian tubes.

-Lowry Technique
Pinch Your Nose, Blow and Swallow
A combination of Valsalva and Toynbee: while closing your nostrils, blow and swallow at the same time.

-Edmonds Technique
Pinch Your Nose and Blow and Push Your Jaw Forward
While tensing the soft palate (the soft tissue at the back of the roof of your mouth) and throat muscles and pushing the jaw forward and down, do a Valsalva maneuver.

-Valsalva Maneuver
Pinch Your Nose and Blow
 This is the method most divers learn: Pinch your nostrils (or close them against your mask skirt) and blow through your nose. The resulting overpressure in your throat usually forces air up your Eustachian tubes.

But the Valsalva maneuver has three problems:

1. It does not activate muscles which open the Eustachian tubes, so it may not work if the tubes are already locked by a pressure differential.

2. It’s too easy to blow hard enough to damage something.

3. Blowing against a blocked nose raises your internal fluid pressure, including the fluid pressure in your inner ear, which may rupture your “round windows.” So don’t blow too hard, and don’t maintain pressure for more than five seconds.

Swallowing—and various methods of equalizing—are all ways of opening the normally closed Eustachian tubes, reducing the pressure differential between the outer ear and inner ear. The safest clearing methods utilize the muscles of the throat to open the tubes. Unfortunately, the Valsalva maneuver that most divers are taught does not activate these muscles, but forces air from the throat into the Eustachian tubes.

That’s fine as long as the diver keeps the tubes open ahead of the exterior pressure changes. However, if a diver does not equalize early or often enough, the pressure differential can force the soft tissues together, closing the ends of the tubes. Forcing air against these soft tissues just locks them shut. No air gets to the middle ears, which do not equalize, so barotrauma results. Even worse, blowing too hard during a Valsalva maneuver can rupture the round and oval windows of the inner ear.

To learn more, please visit www.DAN.org/Health to view the Smart Guide on Ears.

From PADI

Descending and ascending are often overlooked as critical diving skills, usually outshone by the need for perfect trim and buoyancy once the dive is underway. However, being able to descend and ascend slowly and safely, while maintaining good positioning, is something that new divers can struggle with, and should be practiced just like any other skill.

Use your logbook to keep track of how much weight you’re using on each dive, and whether it was salt or freshwater. It will also help to keep an exact record of the kind of equipment you used: steel or aluminium tank? 10 litre, 12 litre, or 15? Short or long wetsuit? 3mm, 5mm, or 7mm? All of these things contribute to accurately estimating the amount of lead you’ll need on your next dive. Make sure you’re writing down as many details as you can, as this will help you and your next dive professional to add or subtract some weight based on your previous dives. 

Many divers don’t realise that it should actually be an effort to get down. If you’re dropping like a lead balloon on your descents, chances are you’re over weighted. It’s always good to carry as little weight as possible, particularly for shore dives or challenging diving environments (who wants to carry an extra 10kg up a beach, when they could be carrying eight? or six?) Descending slowly and then maintaining your buoyancy throughout the entire dive – safety stop and all – are serious skills to master, but once you have, you’ll find yourself shedding the pounds.

If anything has changed since your last dive – such as diving environment, exposure suit, or even body mass – conduct a proper weight check before your dive. Properly weighted, you should float at eye level holding a normal lungful of air with an empty BCD. Take care not to kick or scull while you do your check; this will only keep you near the surface. Let yourself hang vertically in the water column with minimal movement, and then exhale fully. If you drop like a sack of bricks, you need to take some weight off. Ideally, you’ll start to sink slowly, giving yourself plenty of time to equalise early and often on the way down.

Your descent should look similar to your weight check as you fully deflate your BCD and hold still and vertical- no kicking! Empty your lungs completely. Make any inhales as small as possible, and emphasise the exhales, so that your out-breaths are much longer and stronger than your in-breaths. As you feel yourself start to freefall, use your abs to bring your upper body into a face down, horizontal position so that the weight of the tank can’t pull you over backwards. Squeeze your glutes and push your belly out to bring your hips and legs up behind you, and add some air back into your BCD to avoid contacting the bottom.

It takes time in the water to really get comfortable and realise what works for you, so it’s worth experimenting not just with the amount of weight you carry, but how you carry it too. Take time to get good at ascents and descents, and you’ll find that the rest of your dive gets easier too! Take out Peak Performance Buoyancy course to further improve your buoyancy skills.

If you have your Open Water Diver certification but had forgotten some of the skills associated with ascending and descending, it may be time to ReActivate your diving skills.

About the Author

Originally from the UK, Liz Wilkie has been working, writing, and diving her way around Asia, Australia, and Europe since 2010, and is currently a PADI MSDT in Cyprus. She’s trained in Thailand, the Philippines, and Indonesia, and teaches English Language during the off-seasons.

From Divers Alert Network April 2020

COVID-19 symptoms range from mild to severe. Some people have no symptoms at all while others require complicated stays in ICUs with ventilatory support to recover. In addition to the impact of the primary viral infection, factors such as underlying medical conditions, age, secondary complications and more will affect recovery.

COVID-19 shares many features with other serious viral pneumonias and requires a period of convalescence before returning to normal activities. The amount of time needed to recover will vary, as will the long-term effects of COVID-19 such as pulmonary function. As information becomes available it will be incorporated into COVID-19 prevention, treatment and follow-up guidelines.

Determination of your fitness to return to diving after a COVID-19 infection will require assessment by your physician team confirming your full recovery and ability to safely perform unrestricted vigorous activity.

If your doctor needs to consult with a dive medicine specialist, DAN doctors are here to help. We also have a database of dive medicine doctors and can provide referral information. Call us at +1 (919) 684-2948, 9am-5pm ET, Monday thru Friday.

In addition, we urge all divers who have recovered from COVID-19 infection to call DAN for up-to-date information. As always, continue to follow all recommended precautions and stay safe!

We all know how incredible the ocean can be to explore underwater, but wouldn’t it be even more amazing to share these moments with your family? Children as young as 8 years old can be introduced to scuba diving through the PADI Bubblemaker program. While those aged 10 years or older can embark on their PADI Junior Open Water Diver course. It’s never too late to get scuba certified and start living the dream as a scuba family. Not convinced? Check out these 5 reasons why you should get your family certified.

If you’re a parent you would know the struggle of trying to find a weekend family activity that everyone enjoys and agrees on. However, if your family becomes scuba certified you will always have a new dive site to explore, new skills to learn and new marine animals to spot underwater – no two dives are ever the same. Scuba diving is the perfect activity to show your family the beauty of the underwater world, inspire ocean conservation and create memories that will last a lifetime.

In this day and age, technology has become an integral part of our daily regime (whether we like it or not). From answering emails to playing games, watching YouTube or going on social media, technology is everywhere. Scuba diving allows your family to be immersed in nature and the outdoors, while also eliminating the possibility of anyone being able to check their phones. Who else knows a family member that could do with a scuba diving technology detox?

If you’re a diver you would already know how hard it is to scuba on a family holiday. From finding spare time outside of activities to organising babysitters or even destination choices – fitting in just one dive can be hard, let alone a few! Instead of watching your family snorkel above you or leaving them on the dive boat, why not show them the oceans beauty from another view? Not only will you be able to experience incredible adventures underwater, but your family will also be bursting with conversation topics for years to come – who doesn’t love a good diving story!

Deciding on what destination you should choose for your next holiday should be exciting not challenging. For some families this decision can erupt in chaos with disagreements over what destination to choose – hot or cold, history or scenery, ocean or no ocean. However, when you share a common interest these discussions become easier and arguments begin to dissipate among family members. With a scuba family your holiday planning becomes simplified to ‘what diving destination do you want to cross off your bucket list? Thailand, Mexico, Indonesia or maybe Egypt?’ Once you have chosen your holiday destination you can then start planning some diving activities that the whole family can enjoy together.

Are you someone who loves sharing photos on social media or maybe you love putting together a photo album after your holiday? Imagine the phenomenal photos and videos you will be able to capture while diving on a family holiday – we bet none of your friends will have family photos quite like yours! Not only will you have beautiful photos and videos to share from your trip, but you will have many diving stories to share. Diving with your family is an incredible experience that will leave you with many treasured memories (and photos) for years to come.

Want to start living the dream as a scuba family? 

Are you a scuba diver looking for a new challenge? Or maybe you’re wanting to explore underwater places deeper than 30 meters or that nobody has ever seen before? Then the PADI Tec 40 course might just be for you. Not only is this course a great place to start your technical diving journey, but you will also have the chance to build on and advance your recreational skills.

You may have looked at or heard about technical diving and thought, is this for me? As a Tec Deep Instructor Trainer, I would conduct a casual interview over a coffee with anyone who expressed interest in technical diving. It is important to discuss the aspects of the course and the general attitude required to take this kind of challenge on. It takes discipline and commitment to really get stuck into technical diving, as well as an adventurous mind set. Most of all I like divers having a good reason to get started, not just “I want to go deep”. I prefer hearing that someone has a goal that they’re wanting to achieve using the technical diving system.

To start your technical journey with the Tec 40 course, you must first be a PADI Advanced Open Water Diver, Enriched Air Diver with at least 10 dives logged using enriched air deeper than 18 meters/60 feet, Deep Diver with at least 10 dives logged at 30 meters/100 feet and you must be at least 18 years of age with a minimum of 30 logged dives. Completing the Tec 40 course will allow you to extend your deep bottom time while exploring wrecks or deep reefs, for longer. The Tec 40 course is also the stepping stone to PADI Tec 45 and PADI Tec 50 courses which extend your depth, capabilities, skills and bottom time even further.

The PADI Tec 40 course is your first step into technical diving. It is a basic level of decompression diving that will allow you to dive with redundancy of gases, higher mixes of Enriched Air of up to 50%, decompression on EANX 50% for conservatism and up to 10 minutes of decompression. With the Tec 40 certification under your belt, you will certified to make limited decompression dives to 40 meters/130 feet.

This is one of the coolest things about technical diving – it can be completed almost everywhere! PADI has over 366 TecRec Centres in over 64 different countries, worldwide. This diversity allows you the freedom to pick from the top diving destinations with the most skilled technical instructors, worldwide. Whether you want to dive in search of 40 meter wrecks in Malta or if you want to cruise with hammerhead sharks 40 meters down in Borneo, you will be able to find a PADI TecRec Centre to achieve your goal.

The simple answer – when you’re ready. This could be when you’re an Advanced Open Water Diver with 40 logged dives or when you’re a Master Scuba Instructor with over 500 logged dives. Despite if you have been diving for 6 months or 10 years, it’s all down to the individual’s skill level and attitude. A quick discussion with a PADI Tec Instructor will help you answer this question. Our main aim is to keep everyone safe, so we don’t let anyone expose themselves to this level of diving before they’re ready. But when you’re ready, you will know and so will your instructor!

For so many reasons! You will enhance your skills learnt from your experience as a recreational diver, you will learn gas planning, buoyancy control, you will become a problem solving master, and much more. With guidance from your PADI Tec Instructor and the use of the technical syllabus, you will learn a range of extra skills that will take your diving skills from being advanced to expert.

Are you interested in having more time to explore places that others have never seen before? Or maybe you just want to advance your diving skills?

  As certified divers, we should already have a pretty good understanding of how to dive safely. But many of us have found ourselves in unsafe diving situations such as diving beyond our training or diving despite apprehension or discomfort. Many of these dangerous situations result from poor decisions made before a dive, but why do divers make bad decisions when we know better?

I have found myself in several unsafe situations in diving. Once a dive operator encouraged me to go on a dive that was deeper than I was trained to go. Another time one put together my equipment for me, and when I went to double check it he told me not to bother, saying they had "been doing this for years." Many divers give in to this sort of pressure, but why does this happen despite all the training we've undergone?

We could say these dive operators have an unsafe dive culture, but I think we must examine how such cultures arise. Many factors contribute to unsafe diving. One is pluralistic ignorance, which is when people act as if nothing is wrong because nobody else is acting like anything is wrong. In diving, this can occur when someone suggests something unsafe and nobody speaks out against it. When this happens we tend to look around, notice that nobody else seems to be concerned, and think something like "Well, nobody seems concerned, so maybe I'm paranoid; it must be OK." We must not take the inaction of others to mean that everything is as it should be.

Another factor is known as diffusion of responsibility. This occurs when a person's sense of responsibility diminishes in the presence of other people. In diving, we might see something that is inappropriate but say nothing because we assume it is someone else's responsibility to say something. It is particularly easy for novice divers to fall into this trap since they tend to assume that everyone else is better suited than they are to take responsibility for the dive. Remember, you are the best advocate for your own safety.

Deindividuation is another factor that can lead to unsafe diving. This phenomenon is often called "being lost in the crowd," but it doesn't necessarily require a large group. We feel fewer constraints on our actions when many people are around us, as might be the case on a full dive boat. When we are lost in the crowd, we tend to act more impulsively and may thus be more prone to making errors.

Close-knit groups of friends can be particularly prone to groupthink, which is when everyone in a group agrees with each other without thinking things through. Someone might suggest an unsafe dive, and everyone gives their assent without much thought.

On the other hand, diving with people you don't know can also be problematic. We tend to want to be liked by others, so we sometimes do things we normally wouldn't to get along or for others to like us. Often called normative social influence, it can encourage us to make an unsafe dive in an attempt to be liked by others. If someone suggests diving deeper than you are trained to, you might feel pressure to say yes if you want to be liked by that person. Although putting your life in danger just to be liked might seem strange, normative social influence is powerful and should be taken seriously.

Informative social influence is a bit different. This is when we do as others do because we think they know what is best. We learn from them and follow their lead. This is a good thing as long as the person we are learning from is doing things properly. Unfortunately, novices often look toward anyone with more experience, but not every diver is a worthy role model.

The good news is that we can counter these unwanted influences in many ways, including reading articles like this one. The simple act of learning about these influences can be enough to weaken them. We can also do the following:

· Take control. Don't assume somebody else will say something is amiss. Review your training, and stick to it. If someone suggests doing something outside of your training, say you aren't comfortable doing it. Chances are that someone else in the group is similarly concerned but is too shy or uncomfortable to say so.

· Slow down. We tend to act impulsively around other people, so slow down and think. Rarely do we have to make split-second decisions before we dive. Taking a minute or even just a few seconds to think things through can effectively counter errors due to impulsiveness.

· Play devil's advocate. It's natural to blindly go along with the crowd at times. To counter this, think about what might go wrong. We won't always identify plausible concerns when we play devil's advocate, but sometimes we may notice potential problems.

· Rely on your training. Part of safe diving is recognizing unsafe diving. If you are unsure, consult your manual or ask a diver with knowledge, experience and a commitment to safe diving. You can often tell who these people are: They tend to talk about safety, have advanced training and help novices before dives.

· Model good behavior. If you are an experienced diver, lead by example. Don't be afraid to go out of your way to make it clear you are a safe diver. For example, you might invite novices to plan their dives with you. This helps create a climate that benefits everyone.

· Role-play. Practice with a friend what you would do if someone pressured you to make an unsafe dive. We often make poor decisions because we are put on the spot and don't have time to think things through properly. Practicing what you would say and who you would say it to can make it considerably easier to make the safe decision. Prior to doing something exciting like diving, we tend to respond with our dominant response, but a beginner's dominant response is not always the correct one. Through role-playing and practice you can make your dominant response one that supports safety.

Most of us understand, intellectually at least, the risks associated with cutting corners, rushing dives and not being fully prepared.

By learning to recognize factors that lead to unsafe decisions, we can help keep ourselves out of dangerous situations.