Medical aspects of diving

Hrvatska kao pomorska zemlja ima dugu tradiciju ronilaštva. Ronjenje kao oblik sportske, profesionalne i rekreativne aktivnosti u posljednje vrijeme sve se više popularizira. Ono što ronjenje čini posebnim u odnosu na većinu ostalih sportskih aktivnosti uvjeti su u kojima se odvija. Dubina, tj. visoki tlak u vodi, za čovjeka je neprirodno okruženje i zahtijeva izuzetnu fizičku spremnost, bez obzira je li riječ o roniocu rekreativcu ili profesionalcu. Ovaj rad ukazuje na moguće posljedice štetnog djelovanja ronjenja na ljudsko tijelo. Pomnije je obrađeno djelovanje pojedinih plinova (kisika, ugljikova dioksida i dušika) koji su u atmosferskim uvjetima koji vladaju na razini mora bezopasni. Međutim, pod utjecajem dubine njihov parcijalni tlak raste i izaziva mnoge štetne učinke u tijelu kao što su: dekompresijska bolest, neruotoksičnost dušika, tzv. dubinska opijenost te neurotoksičnost kisika i njegovih slobodnih radikala. Spomenuta je i problematika hipoksije, stanja smanjenog parcijalnog kiska u krvi, kao izuzetno opasne pojave koja može rezultirati smrtnim ishodom u samo par minuta. Opisane su i moguće štetne posljedice visokog tlaka vode na sinuse i srednje uho, jedne od češćih patologija ronjenja. Za sva navedena stanja potrebno je biti upoznat s patofiziologijom ronjenja i prepoznati rane znakove štetnih zbivanja. To je važno jer zahtjevni uvjeti ronjenja često usporavaju i onemogućavaju pravovremeno pružanje medicinske pomoći, što nerijetko za posljedicu ima smrtne ishode. Upravo iz ovoga razloga i za što uspješniju prevenciju, važno je prije samoga ronjenja upoznati i medicinske aspekte ove aktivnosti.Croatia as a maritime country has a long tradition in diving. Popularity of diving, as a form of sports, professional and recreational activity has recently significantly increased. What makes diving so special compared to most other sports activities, are the conditions in which it is performed. Depth, i.e. high pressure of water, is unnatural environment for men and it requires extreme physical fitness, both for professional and recreational divers. This paper stresses possible consequences of harmful effects diving might have on human body and with more details it deals with effect of some gasses (oxygen, carbon dioxide and nitrogen), which are harmless in the atmospheric conditions at sea level, but however, with the influence of depth their partial pressure increases and causes many harmful effects in a diver’s body like: decompression sickness, neurotoxicity of nitrogen, so called deep sea intoxication, neurotoxicity of oxygen and its free radicals. The paper also deals with hypoxia, condition of reduced partial oxygen in blood, as an extremely dangerous occurrence which may have lethal consequence in only a few minutes. Possible harmful effect of high water pressure on sinuses and middle ear are also described in this paper, as one of pathologies of diving which occur rather often. Because of all the described conditions it is necessary to be well informed about the pathophysiology of diving in order to be able to recognize early signs of harmful effects. That is important because demanding diving conditions often make impossible for medical care to be provided on time or to be provided at all which often results in death. It is because of this reason and because of a more successful prevention that it is necessary to be well informed about medical aspects of this activity before going to dive