The growing popularity of recreational scuba (self-contained underwater breathing apparatus) diving leads a proportionately large number of pediatric patients of all ages to physicians' offices for physical examinations to determine qualification for diving courses and active diving. It is estimated that over 200 000 persons of all ages complete such courses each year (W. Hendricks, oral communication, May 1984), including approximately 2000 participants 15 years of age or younger.
Practitioners should realize that for all its beauty and fascination, the underwater world also subjects the diver to sudden changes in ambient pressure, the physical demands of swimming in currents, adapting to temperature extremes, and situations that require maintaining composure and using sound judgment. In addition, when diving medical problems supervene at sea, the diver is isolated from emergency services routinely available on land.
It is important for pediatricians in marine and aquatic locations to