The evaluation and management of medical problems related to diving used to be strictly under the aegis of a limited number of physicians involved in military or occupational medicine. The influences of technology and affluence, however, have contributed to increased diving activities in science, industry, and especially recreation. Recent estimates place the number of sport divers in the United States at approximately 5 million, with another several hundred thousand new divers being trained annually. Accordingly, the incidence of diving-related disorders has increased. The Divers' Alert Network (DAN) recorded 1164 diving-related injuries treated in 1994 alone, in addition to 97 fatalities. These numbers do not reflect injuries not reported to DAN.<sup>19   Divers Alert Network Report on 1988 Diving Accidents Durham: Duke University (1989). 

Cliquez ici pour aller à la section Références</sup> Furthermore, the proliferation of hotel-hosted dive courses in tropical vacation spots has greatly increased the number of rapidly trained, relatively unsophisticated divers who then fly home again, often shortly after completing their last dive. Therefore, treatment of diving-related problems may be encountered by emergency physicians in diverse geographic locations.

The medical problems associated with diving are all related to the fact that divers are exposed to environments for which humans are poorly adapted and which contain potentially hazardous life. Some common problems involve exposure-related illness and traumatic injuries, but medical management does not significantly differ compared with the nonaquatic environment. Dermatitides, infections, and envenomations related to marine flora and fauna can be banal or exotic, but an appropriately detailed discussion exceeds the scope of this article. The vast majority of dangerous diving-related medical conditions, however, are caused by the effects of changes in pressure underwater and the necessity for a source of breathable air, usually supplied by a self-contained underwater breathing apparatus (SCUBA). This article focuses on these concerns.