Can people with asthma become a DM?

[The Iceni]

Saturation once bubbled...
Not a good idea, in general.

DMs have responsibilities to students and to divers in an organized dive. In a worse case scenario, a group of inexperienced divers in a deep drift dive with limited visibility, more that just a DM may die should the DM experience an asthma attack at depth. . . .

In standard diving practice, the most an asthmatic diver may be responsible for is a buddy, and vice versa.

Readers,

I entirely agree with Saturation and he highlights the dangers in diving as a group "Starburst" fashion. In the UK diving is mostly club based and whenever possible we dive in buddy pairs, particularly when taking novices. I have, reluctantly, dived as a threesome on occassion and did not enjoy the dive as much. It is much easier to communicate with, and keep your eye on, one other diver but it is almost impossible to keep one's eye on a group of three or more, regardless of the conditions. This is particularly worrisome if the group consists of inexperienced divers. Asthma is certainly not the only thing than can affect the DM as I know only too well. Indeed the dive does not have to be in any way demanding for a tragedy to occur.

Even the most competent diver can only ever perform a rescue on one other. I have read of incidents where the dive leader/master has been required to assist one of the divers in a group and, by necessity, has left the others to fend for themselves with a less than ideal outcome.

I worry that financial imperatives oblige instructors employed by certain commercial operations to ignore the one-to-one buddy system with the least experienced divers.

In consequence it is my opinion that reversible obstuctive airways disease is an absolute contraindication to all diving if that person is unable to demonstrate to a diving medical authority that he would always be able to perform a rescue despite his medical condition. While the attitudes to asthma have changed for the better this must never be forgotten.

 

[SubMariner]

I worry that commercial imperatives require PADI instructors to ignore the one-to-one buddy system with the least experienced divers.

Can you please elaborate on what you mean by this?

~SubMariner~

 

[The Iceni]

SubMariner once bubbled...
Can you please elaborate on what you mean by this?

~SubMariner~

Hi Submariner,

I think the point I made was (knowing what I now know about the numerous hazzards inherent in all diving) is that if I were a novice diver I would not feel comfortable if I (or one of my relatives) were expected to do the majority of their first open water dives with a group of novices and only one experienced diver.

I gather, in certain parts of the world, particularly the Middle and Far East, some dive centres offer diving holiday/group courses from scratch, where the student:instructor ratio is in excess of 5:1.

I understand the majority of the instructors employed by these centres are PADI accredited.

As Saturation posted earlier

In a worse case scenario, in a group of inexperienced divers in a deep drift dive with limited visibility, more that just a DM may die should the DM experience an asthma attack at depth.

Delete "deep drift dive with limited visibility" and for "an asthma attack" substitute "serious problems" and I think you will more fully understand my concerns; -

In a worse case scenario, in a group of inexperienced divers, more that just a DM may die should the DM experience serious problems at depth.

You cannot deny that a lot of pressure is put on instructors employed by these operators to certify as many students as possible. However, I take your point and have edited my post to more accurately reflect the correct position.

 

[Saturation]

Nessie once bubbled...
Hi,
to become a PADI DM it just depends on whether you find a doctor who gives you a certificate which says that you are fit to dive without any restrictions.

That is what the standards say, and then it is up to the Instructor whether he will certifiy you.

At least in the USA, you are quite right, Nessie. Its likely a doc can be found somewhere to sign a diving health certificate, it then falls on the Instructor or the IDC to choose to take the DM candidate.

However, I foresee the practical limit in these types of problems are risk of suits the employers of the DM may face.

While the possibility of an accident or a life threatening asthma attack are likely low, despite what the theoretical risks are [ and published on this thread as a quote from the UHMS study], as the Peter Hughes Belize tragedy demonstrates, one needs but one accident of any size for lawyers of the victims to look deeply into the qualifications of the professional staff in a dive operation.

Once labeled an asthmatic, even if the DM no longer suffers from the disease, the DM carries a stigma that won't be erased until dive medicine states that certain types of asthmatics, of which the DM is part of, are not a concern in diving OR in the DM health certificate, a statement is made by a doc that the candidate no longer has the disease [asthma can suddenly dissappear the " I had asthma as a child but not anymore story," remain unchanged or worsen with age.]

 

[DeputyDan]

has asthma.

Her doctor also dives and has asthma.

Based on my hearing the Doctor talk to my daughter the answer is no. It would not be a good ideal.

Cold water diving is not allowed for my daughter.............

The Doctor also recommends the OW depth recommendation of 60 feet.

 

[The Iceni]

DeputyDan once bubbled...
The Doctor also recommends the OW depth recommendation of 60 feet.

Hi Deputy Dan,

Any rational behind the 60 feet limit?

The levels of expertise required for shallower dives are less, particularly if they are always conducted within "no-stop-limits". However, to me, it seems axiomatic that an asthma attack during any open water dive is equally hazardous since the single major risk factor - pulmonary barotrauma - is greatest during the very rapid pressure changes close to the surface.

May I quote from a related post of mine?

Certification is like a driving licence, there are no half measures, such as driving on country roads alone. In practice a certified diver is legally entitled to excercise the rights inherent in his level of qualification.

So ***, while you may indeed be medically fit to dive this does not mean that you may ever satisfy your instructor that you will ever be safe to dive. That's his call and in this litiginous society, and regardless of any doctor's opinion, if your instructor has any doubts, whatsover, about your abilities he has a duty to fail you.

It seems very odd to me that any individual could be certified as medically fit to dive but medically unfit to be a dive master.

 

[AquaTec]

I would think it would depend on what triggers an attack, is it an allergen or exertion.

and I agree that the shallow water pressure changes are more of a concern than the deeper ones.

I suggest a very slow ascent

 

[rcohn]

If you can satisfy the YMCA asthma protocols you can be certified as a DM, which I have done. My understanding is that SSI now accepts the same protocols.

Ralph

 

[SubMariner]

I think the point I made was (knowing what I now know about the numerous hazzards inherent in all diving) is that if I were a novice diver I would not feel comfortable if I (or one of my relatives) were expected to do the majority of their first open water dives with a group of novices and only one experienced diver.

I gather, in certain parts of the world, particularly the Middle and Far East, some dive centres offer diving holiday/group courses from scratch, where the student:instructor ratio is in excess of 5:1.

I understand the majority of the instructors employed by these centres are PADI accredited.

I cannot speak to any other agency, but PADI Standards indicate the following Instructor to student ratios in Open Water:

These ratios are maximums. It is often appropriate to use judgment and lower ratios depending on a variety of factors. During all open water dives, student divers must remain under the supervision of a Teaching status PADI Instructor.
Student divers may not be left unattended either at the surface or underwater.
.....The maximum ratio of student divers to instructor during the open water dives for this course is 8 students to 1 instructor, with a certified assistant for each two additional students, to a maximum of 12 student divers. You may use more than two certified assistant, but the maximum number of student divers remains at 12.
Note: If conducting the Open Water Dive for Discover Scuba Diving participants,the maximum ratio is 4 to 1,with 2 additional
participants allowed with the use of a certified assistant. You may use more than one certified assistant, however, the maximum number of participants is 6.
During any open water training dive that includes children aged 10-11, the maximum instructor-to-student diver ratio is 4:1. No more than two children aged 10-11 may be included in the group of four student divers. You may not increase this ratio with the use of certified assistants.

As mentioned in the Standards, the aforementioned ratios are MAXIMUMS. Prudent Instructors downscale in less-than-perfect conditions. They will also have Certified Assistants and/or additional Instructors. If an Instructor does NOT make allowances, then they are not a good Instructor. Agency has nothing to do with it.

Speaking of Agencies, since PADI is the largest certifying agency in the world, it is only logical that the majority of Instructors may well belong to PADI. However, beyond that.... ????

Frankly, on most check-out dives for Open Water students you have nothing BUT novices. Remember, although there will also be a touring portion of the dive afterwards, the main reason for these dives is to put Open Water students through exercises in order to verify their skills for certification. Having other divers along would actually be detrimental, as it would split the focus of the Dive Leaders from the novices who were doing their check-out dives.

Meanwhile, what would you deem to be an acceptable Instructor to student ratio? What ratios do you use as an Instructor?

~SubMariner~

 

[Nessie]

Saturation once bubbled...



At least in the USA, you are quite right, Nessie. Its likely a doc can be found somewhere to sign a diving health certificate, it then falls on the Instructor or the IDC to choose to take the DM candidate.

However, I foresee the practical limit in these types of problems are risk of suits the employers of the DM may face.

While the possibility of an accident or a life threatening asthma attack are likely low, despite what the theoretical risks are [ and published on this thread as a quote from the UHMS study], as the Peter Hughes Belize tragedy demonstrates, one needs but one accident of any size for lawyers of the victims to look deeply into the qualifications of the professional staff in a dive operation.

Once labeled an asthmatic, even if the DM no longer suffers from the disease, the DM carries a stigma that won't be erased until dive medicine states that certain types of asthmatics, of which the DM is part of, are not a concern in diving OR in the DM health certificate, a statement is made by a doc that the candidate no longer has the disease [asthma can suddenly dissappear the " I had asthma as a child but not anymore story," remain unchanged or worsen with age.]

Yep, I agree. I started to write my opinion about these PADI standards, but couldn´t really express what I wanted to say, so I just answered the question whether it would be against PADI.

I am working regularly with a DM who has allergic asthma.
I think it is important do differ whether it is allergic or non-allergic asthma. At those times when he is has no problems on land I feel safe and enjoy working with him because I think it it very unlikely that he would get problems at the surface and that he´s even safer underwater. At those seasons he is feeling allergic effects he is taking a break. In my opinion this is safe, what is your opinion?