Medical concerns about professional (commercial, scientific, rescue, etc.) as well as recreational diving safety derives from two major shortcomings: scanty knowledge of diving physiology and lack of monitoring of vital parameters during diving. Both deficiencies are virtually related to the total absence of instrumentation suitable for underwater measurements of simple but crucial physiological parameters such as heart rate, blood pressure, cardiac function, blood oxygen saturation etc. Actually, none of the available clinical devices used in everyday clinical practice for assessing health status can be used underwater because of a variety of problems related to the liquid environment, its salinity and the high hydrostatic pressure. Thus, with regard to performance of physiological measurements, underwater medicine is back to centuries ago.
In the lack of direct measurements, the results of series of ‘models’ of underwater diving are considered as valid surrogate and inferences from the clinical world are commonly adopted. Unfortunately, both processes are intrinsically uncertain and scientifically incorrect. Thus, the transfer to the underwater environment of routine clinical instruments would represent a great advancement, both in terms of knowledge and safety, just as it already occurred in space medicine.
This task requires designing novel underwater diagnostic and monitoring instrumentation and developing ad hoc support infrastructure. Beyond the design of waterproof instruments, special attention must be paid to selecting, placing and protecting the sensors and transducers especially for long term monitoring.
In the present articles we will briefly describe some of the devices we were able to realize for the underwater assessment of physiological parameters considered crucial for the advancement of knowledge in underwater physiology and for the implementation of measures, able to improve diving related safety:
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