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140213-N-CG436-031 PANAMA CITY, Fla. (Feb. 13, 2014) Students at Naval Diving and Salvage Training Center (NDSTC) conduct training operations in the center's 40-foot-deep Aquatic Training Facility. NDSTC, the largest diving facility in the world, trains more than 1,200 military divers from every branch of service each year. (U.S. Navy photo by Mass Communication Specialist 2nd Class Michael Scichilone)
Each case is evaluated individually. Every possible effort is made to prevent injuries while participating in high risk training. If an injury does occur, the NDSTC medical staff acts aggressively to return the candidate to diving duty as soon as possible. If an injury requires extensive medical therapy, each case is individually evaluated and a medical recommendation is made to the training officer at NDSTC. The training officer takes the medical input and makes a recommendation to the commanding officer via the chain of command. The commanding officer ultimately makes the decision of whether or not a candidate is retained at NDSTC while he or she recovers from an injury. Many factors are considered in this decision and cannot be detailed fully here.

Dental disease, particularly cavities, can lead to severe pain and permanent damage to one’s teeth when combined with changes in pressure. Proper dental hygiene, frequent exams and periodic dental  cleanings will help reduce the risk of having a diving related dental problem.

A NAVPERS 1200/6, also known as U.S. Military Diving Medical Screening Questionnaire is a tool for Undersea Medical Officers to evaluate a candidate’s suitability for diving duty. This screening tool is used in conjunction with the medical history and medical examination (DD 2807 and DD 2808). It is designed to catch new medical conditions that have occurred since the DD 2807 and DD 2808 were performed.

There are many reasons that a person might fail a pressure test. The Valsalva Maneuver is very easy for some people to learn while others have a very difficult time learning how to perform this maneuver. If the Valsalva Maneuver is difficult for you, seek out the help and guidance of divers or aviation personnel that frequently have to use this maneuver. A second very common reason for inability to successfully pass a pressure test is congestion or cold symptoms. You should attempt a pressure test only when you feel healthy and do not have any signs or symptoms of a cold or upper respiratory tract infection. Another common reason you may not be able to pass a pressure test is related to your anatomy. Some people’s anatomic structures allow them to be successful divers without any difficulty, whereas other people will always have a difficult time with pressure changes. The most common cause for this is a condition known as Eustachian Tube Dysfunction. Eustachian Tube Dysfunction does not respond well to medication or surgery therefore this is a disqualifying condition for diving duty. If you are concerned about having Eustachian Tube Dysfunction, you should seek out an evaluation by your primary care provider. Your primary care provider will perform an examination and then determine if you need to be seen by an ENT physician (Ear, Nose, and Throat Specialist). If a diagnosis of Eustachian Tube Dysfunction is made, this condition is permanently disqualifying for diving duty.

Typically, all U.S. Navy and other military diving units (SEALS, Army Engineering Divers, Marine Reconnaissance, Seabee Underwater Construction Teams, Army Special Forces Divers, and Air Force Combat Controllers and PJ’s) have hyperbaric chambers. Additionally, many aviation facilities within the military have hyperbaric chambers in order to treat altitude DCS cases. Any certified U.S. military chamber with adequate staffing can perform diving candidate pressure tests. All possible efforts should be made to complete this pressure test prior to arriving at the Naval Diving and Salvage Training Center (NDSTC). If all efforts to obtain a pressure test have been exhausted, it is possible to complete the pressure test once you arrive at NDSTC; however all other requirements for initial dive training must be met.

In regard to diving duty, a Special Duty Abstract serves two purposes. The first purpose states that a diving candidate has been thoroughly evaluated by an Undersea Medical Officer and that the candidate is physically qualified (PQ) for diving duty. The second purpose is that it provides documentation for the successful completion of a pressure test which is required prior to initiating initial dive training.

An Undersea Medical Officer is a Navy Medical Officer that has been trained in diving medicine, submarine medicine, and radiation health. All qualified Navy Undersea Medical Officers (UMO’s) are also Diving Medical Officers (DMO’s). The Army and Air Force often send physicians through the NDSTC Diving Medical Officer course. These physicians are considered Diving Medical Officers; however they do not have an expertise in submarine medicine or radiation health. Additionally, only a qualified Undersea Medical Officer (UMO) has the authority to make a recommendation for changing standard U.S. Navy Treatment Tables during the treatment of a diving casualty to his or her respective Commanding Officer.

Any physician, physician assistant, or nurse practitioner can perform a dive physical.  However, an Undersea Medical Officer must review and approve it for accuracy and completeness.  It is possible to electronically send a copy of all medical documentation to the nearest UMO to you in geographical location and request that they sign the physical exam and special duty abstract. This should be done only as a last resort

A dive physical must be less than 24 months old prior to beginning initial dive training. Once a diver has completed dive training at NDSTC, a dive physical is required every five years prior to age 50, every 2 years prior to age 60, and then every year beyond age 60. This requirement is in addition to the yearly Preventive Health Assessment (PHA).

Any physician, physician assistant, or nurse practitioner can perform a dive physical. Once the physical is complete, an Undersea Medical Officer (often referred as a DMO or Diving Medical Officer) must review the physical examination and recommend a status of physically qualified (PQ) for diving duty.

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