Children and Diving

Is the child a small adult when it comes to diving ?
Definitely not Participation of children in Scuba diving is growing every year. Instructors ,dive masters and parents and pediatricians are all in growing need to understand the physiological differences between children and adults that relate specifically to scuba diving.
I-Respiratory tract
Lung maturation and alveolar multiplication are progressive all along the growth period. It is very fast till the age of four, then gradually slows to stop at the age of eight. The elastic tissue is rare at birth, and then it increases gradually to reach complete development at 18 years. These facts: relatively small lung capacity + less elasticity + Scuba diving (Breathing compressed air) = Possibility of air trapping even in a healthy lung.
II- Heart and blood vessels 40% of 7-8 years old children have patent foramen ovale (PFO), this hole between the 2 atria of the heart may allow bubbles formed in the venous side to go into the arterial circulation in case of increased intrathoracic pressures during ascent from a scuba dive, in this situation, the risk of cerebral air embolism is considerable.
III Ear, nose and throat
Middle ear barotraumas is the main clinical incident in children diving, this comes from the following reasons :
1. Eustachian opening is not as patent as adults.
2. Frequency of nose and throat infections in children is definitely more than adults.
3. Misunderstanding and of equalization technique.


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IV-Thermobiology and children diving

This is considered the major limiting factor for children diving. So a well fitted suit is important.
Head and neck are the main areas of heat loss in children, protection with a hood is considered mandatory.
The draw back of less adipose tissue in relation to body surface is not actually very important as this is compensated by
• faster vasoconstrictive reaction.
• Faster thermo genesis (heat production) due to higher basal metabolic rate.
V-Psychological aspects
Emotional liability are characteristic of 7-8 years old child, in the presence of danger (real or imaginative) the reaction is unpredictable.
So, panic situation can lead to lung barotrauma.
Visual reference (bottom, coral reef, or pool walls) are important, as the dependence in this age on the visual field is very high.
VI-Locomotor Apparatus
Carrying heavy loads can lead to injury of ossification nuclei in children with consequent growth disorders, also decompressive risk of the growth cartilage is probable as its desaturation period is shorter than in adult bone due to its higher metabolic activity.
Conclusion
*Before age of 7-8 years, many respiratory risks are present such as breathlessness, hypoxia, and air pressure trapping leading to a risk of pulmonary barotrauma, even a localized one.
Meaning that respiratory functions in a child less than 7-8 years do not allow Scuba diving without risk.
After age of 7-8 years, pulmonary function is developed enough to allow for safe scuba diving except for:
1. Limiting maximum depth.
2. Using depth and tank pressure compensated air regulator.
3. Adapted snorkel with little dead space.
*Stop diving when child suffers from cold or sore throat.
*Be sure that that the child understands what equalization proper technique is and how often he must do it underwater.
*Stop diving on the first signs of feeling cold.
*Take care of dehydration and hyperthermia in summer.
* Visual reference and feeling comfortable, warm, and secure are very important for children during their Scuba diving experience.
*Loads must be lightened by using special back packs.
Diving doctors has to stress in their pre dive medical release for children on the cardiopulmonary check and ENT problems.
Instructors and dive masters have to ensure good understanding and suitable dive conditions, for their young divers.
Parents( divers ) have not to overestimate the capabilities of their children.
Finally, diving is still a new activity for children, so it is difficult to understand all the risks in the present time.
Dive professionals, diving doctors and parents have to work together to ensure that young divers will grow healthy to become old divers