Méliet J L
Institut de Médecine Navale du Service de Santé des Armées, Toulon Naval.
Bull Acad Natl Med. 1996 May;180(5):985-97; discussion 997-1002.
Underwater diving is a very closely medically managed activity. Performing it, the human organism is under the physical laws of pressure and following consequences. The expiratory flows are significatively reduced, enhancing the risk of alveolar hypoventilation at exertion, the central nervous system is the privileged target during inopportune tissue degassing related accidents (leaving 20% of sequellae), barotraumatic injuries threaten middle and inner ear or lung (pulmonary barotrauma is the most severe accident), the toxicity of gas under pressure (i.e. oxygen, nitrogen) exposes to specific risks of loss of consciousness. Lastly, the adaptative mechanisms to immersion can be overflown, leading to pulmonary oedema. Facing these constraints, the practitioner's role begins just before the diver's activity starts by looking for contraindications to diving. It continues during tuition time by teaching him the physiopathology of accidents, their prevention and first cares. Finally, in case of accident, a specialized medical team acts in diagnosis and treatment. From these points of view, diving medicine is a multispecialty medical matter.
水下潜水是一项受到严格医学管理的活动。在进行水下潜水时，人体会受到压力物理定律及相关后果的影响。呼气流量会显著降低，增加了运动时肺泡通气不足的风险；在不当的组织脱气相关事故中，中枢神经系统是主要的受损目标（会留下20%的后遗症）；气压伤会威胁中耳、内耳或肺部（肺气压伤是最严重的事故）；加压气体的毒性（如氧气、氮气）会带来意识丧失的特定风险。最后，对浸入的适应性机制可能会不堪重负，导致肺水肿。面对这些限制，从业者的职责在潜水员活动开始前就已开始，即寻找潜水的禁忌症。在培训期间，要教导潜水员事故的病理生理学、预防方法和急救措施。最后，在发生事故时，由专业医疗团队进行诊断和治疗。从这些角度来看，潜水医学是一个多专业的医学领域。
