Acute lung conditions are some of the most dramatic and life-threatening diving injuries and it’s vital for dive professionals to be able to quickly recognize and react to them. Acute pulmonary conditions can have long-lasting and serious effects, and require prompt care. Here are some of the most common lung conditions faced by divers:
Immersion pulmonary edema (IPE)
IPE is one of several lung conditions that could affect divers. Common symptoms of IPE are chest pain, frothy pink sputum and dyspnea (labored breathing) in divers who are or were recently submerged.
IPE is an accumulation of fluid in the lungs caused in part by immersion in water. IPE occurs because the opposing pressures of fluid surrounding the lungs are forced out of equilibrium, and excess fluid is allowed to build up in pulmonary tissues. Immersion in water can increase the fluid pressure in the capillaries surrounding the lungs, and this pressure differential can be exacerbated by a number of risk factors, leading to an increased risk of edema (swelling). You can minimize your risk of IPE by addressing common risk factors like overhydration, overexertion and hypertension, as well as obesity.
Pulmonary overinflation syndrome
Pulmonary overinflation syndrome is typically the result of air trapped in the lungs due to an obstructed airway, or breathholding, expanding during ascent and inflating the lungs beyond their maximum capacity. This can result with a lung barotrauma which may manifest in a, pneumothorax, subcutaneous or mediastinal emphysema, or an arterial gas embolism. Lung expansion injuries can be prevented by ensuring that you are medically fit to dive, never holding you breath while on scuba and by avoiding rapid ascents.
Pulmonary embolism (PE) 
A PE is another dangerous pulmonary condition which can occur unrelated to diving but may mimic dive injuries. A PE involves the blockage of blood flow in the vasculature of the pulmonary system by fat buildups or blood clots. Common symptoms of a pulmonary embolism are chest pain, distension of the neck veins, and an altered level of consciousness or fainting.
Pulmonary embolisms typically result in a significant drop in blood pressure and cardiac output. Acute PE often results in symptoms noticeable to the individual, but the slow onset of chronic PE may go unnoticed. Risk factors include heart disease, obesity, smoking, and hypertension. Conditions like deep vein thrombosis (DVT), which can occur during long periods of non-movement like air travel, can contribute to PE as clots from the DVT migrate through the pulmonary system and increase the risk of blockages.
If you suspect a diver has any of these conditions, remove the individual from the water, provide oxygen, and seek immediate medical attention. It’s important that all cases receive a thorough medical evaluation because of the risk of after-accident complications.
For more information on lung health and diving, visit: DAN.org/Health.
