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DIVING MEDICINE
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ATTENTION DEFICIT DISORDER AND DIVING
distractibility, and impulsivity. For the Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD) as it is
also called, is a relatively common difficulty in children that continues to present problems in
symptoms have to be relatively severe.
30% - 70% of these children when they are adults. Individuals who suffer from this disorder
frequently have symptoms that make it dangerous for them to dive and they often need to
To be able to dive safely, a person has to take medications that also make diving risky.
be able to keep track of several things at effects that are incompatible with diving AttentionDeficitDisorderisvery disruptatleasttwoofschool,familyor diagnosisofADDcanbeaccurately orientation, tank pressure, time required one other psychiatric diagnosis and their peer relationships. Everyone suffers from to complete the dive, gas supply required ‘other’ problem may make it unsafe for result it is very difficult to decide who of buddy, other divers, boat or shore, etc.
headache, nausea, dizziness, insomnia > Antisocial personality features are found can easily result in death due to arterial well controlled with medication, so is it are in children. Treatment often requires DAVID SAWATZKY, S.C., C.D.,
To be able to dive safely, a
B.Med.Sc., M.D., M.Sc., is a diving
controlled drugs. To further complicate the person has to be able to keep
medical specialist who was on contract at
track of several things at the
Defence Research and Development Toronto
present to their physician believing they same time. People with ADD
from 1998 to 2005. Previously he was the
Canadian Forces Staff Officer in Hyperbaric
often make careless mistakes.
partial complex seizures, hearing deficits, Medicine at DCIEM (1986-1993) and later
In diving they not only put
the Senior Medical
themselves at risk but their
Officer at Garrison
actions might result in the
Support Unit
some evidence that they are less effective A central feature of ADD is ‘disinhibition’.
death of their dive partner.
Toronto (1993-
and 5.0% of adults experience difficulties This can be seen as poor self-regulation, injury can also suffer from problems with 1998). He’s written
a monthly column
inability to prevent immediate responses, attention, concentration and memory.
on diving medicine
difficulty with focused attention and goal- in Canada’s Diver
There is relatively little data available on Magazine since
hyperactivity in children is often seen as 1993, has been on
restlessness, difficulty relaxing and feeling children, treatment is primarily drugs.
their actions might result in the death of the Board of
chronically ‘on edge’ in adults. Adults Advisors for the
International
kinds of drugs that seem most effective in Impulsivity is a common feature of ADD.
Association of
while failing to complete important tasks.
Nitrox and Technical Divers (IANTD) since
They blurt out inappropriate thoughts that 2000, and is an active cave, trimix and
closed circuit rebreather
diver/instructor/instructor trainer. David’s
for life. Stimulants are highly addictive first love is cave diving exploration and he’s
been exploring and surveying underwater
norepinephrine activity is increased.
pain, rashes, pruritus, urticaria, fever, passages in Canada since 1985. David was
suggest antidepressants be tried first.
arthralgias, and scalp hair loss. They also responsible for the exploration and
ADD but no clear link has been identified mapping of almost 11 kilometres of
counselling, and life skills training are underwater passages in the Ottawa River
Cave System. In 1995, he executed the first
identical to those of ADD. In the field of successful rescue of a missing trained cave
diver. David received the Canadian Star of
Courage for this rescue which took place in
with ADD may be at increased risk if they higher doses of stimulants than children.
the chilly Canadian waters of Tobermory,
Ontario. He still dives as much as possible,
with substance abuse is so difficult that converted into the active chemical inside but admits his six year old son Lukas, five
can function effectively in life they most year old daughter Emeline and wife (Dr
because of the slower onset of action.
Debbie Pestell) are currently higher
priorities than diving!
s p o r t d i v i n g m a g a z i n e d e c e m b e r / j a n u a r y 2 0 1 0 / 1 1
and others. It also has stimulant effects.
controlled drug in the USA approved forthe treatment of ADD but it can cause The bottom line is that most adults with a dyspepsia, sleep disturbance, and others.
medications to help control the symptoms, for the rest of their lives. They should not because virtually all of the medicationsused to treat ADD are incompatible with effects are incompatible with diving. Inaddition, many of them cause sedation.
Nitrogen narcosis also causes CNSdepression and it is highly likely that thesedation caused by any drug will bemade much worse by nitrogen narcosis.
Most of these drugs also cause CNSstimulation and as a result can beexpected to dramatically increase the riskof an oxygen convulsion if a diver isexposed to elevated partial pressures of s p o r t d i v i n g m a g a z i n e d e c e m b e r / j a n u a r y 2 0 1 0 / 1 1

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