PHONE : 022 527 2822
Meet The Team
Director & Instructor
I was born in 1972 and was fortunate to be brought up by the ocean. I grew up living at Eastern Beach and attended Bucklands Beach Primary, Intermediate, and Macleans College. I have always loved to swim, fish, windsurf, sail, and surf from a young age. I have been able to explore the Coromandel, including snorkelling and scuba diving as we have had a family batch (Holiday home) in Whangamata for about 40 years. I have extensive knowledge of diving in the Hauraki Gulf and its outer Islands as well. I have explored other parts of the world, but really loved Huntington Beach CA where I met my wife. I enjoyed running my business there, but like a salmon, I felt the need to migrate back to my birth place. I am now back in NZ with my wife and four kids and love teaching my passion to anyone interested.
Heya ! I'm Kaiya and am a 2000's baby who has been in love with the ocean since day one. Originally, I am from California and initially grew up in Huntington Beach but then moved to my Dad's home country of NZ in 2011. Even still the beach was only ever a few minutes away. I received my PADI professional scuba instruction in 2018 which was the best year of my life! I was able to dive some of New Zealand's best dive spots and I learnt so much while exploring this amazing industry. The ocean is an element very close to my heart and everyday I strive to find new ways protect it and the funky creatures within.
I started working for Epic Scuba in 2018 and it has truly been a pretty cool time.My favorite thing about this job is getting to know my students and help them on their journey to becoming certified. I also love hearing their stories after they've been diving overseas! Not to forget, its always a privileged to show the students the wonders of the local blue backyards of Aotearoa. Being able to share my passion for the ocean as a part of my job is so rewarding, can't wait to do more dives and enable more people to get up close and personal with the sick as underwater world!
Hi, My Name is Robert baker I was born in 1990 in New Zealand I have been a Scuba Instructor since October 2014. I have dived in various sites throughout New Zealand, the pacific islands and Asia., I first learnt to dive in Thailand while on holiday with my family. When I got back to New Zealand from that holiday I enjoyed it so much that I made it my job by becoming an instructor. My favorite places in New Zealand to dive are the Poor Knights, Marine Reserve and the HMNZS Waikato Ship Wreck. I started working with Elmesie Scuba in August 2015. We work within schools and have enjoyed teaching the students how to dive and seeing the satisfaction on their faces with learning to dive and the unique experience that they get to have diving places like Goat Island and the Poor knight Islands etc.
Epic Scuba Ltd was formally known as Elmesie Scuba which was established in 2000, In Los Angeles (LA), Huntington Beach, California, USA by the owner Robert Elmes. Elmesie Scuba is a NAUI (National Association of Underwater Instructors) which is an internationally recognized Snorkeling & Scuba diving facility. We are one of the biggest training facilities in Auckland New Zealand, that teaches youth within primary, intermediate, and High/College Schools. ES also teaches classes to the General Public. In 2011 Rob moved with his family back to his Native country of New Zealand and is now operating in Auckland. Since the time of establishment, Epic Scuba has successfully been teaching a variety of snorkeling and scuba classes. Epic Scuba has also been approved by Work Safe New Zealand as a Safe Adventure Activity/outdoor provider for snorkeling and scuba diving activities. We pride ourselves in safety, flexibility, good communication, and our happy nature. Robert Elmes believes that this is the main reasons why Epic Scuba is still in business today. We teach snorkeling and scuba diving courses / classes in Auckland, New Zealand. We are a referral dive facility and a guided (Discovery) dive center.
Since establishment here in NZ Epic Scuba has Aligned themselves with NCEA (NZQA) and has helped modify and develop rubrics for Level 1, 2, 3 year levels. ES has also done sessions for Camp Quality, Top Catch, New Zealand Underwater Association (NZUA) contributing to their Mini Dippers Program.
WHO WE WORK WITH
Epic Scuba currently teaches snorkeling & scuba programs at Kings College, Diocesan School for girls College, Saint Kentigern College, Kristin College, Sacred Heart College, Glendowie College, Sancta Maria College, Takapuna Grammar, Northcote College, Rosehill College, Pakuranga College, Alfriston College, Mt Albert Grammar, Lynfield College, Aorere College, Edge Water College, Botany College, just to name a few.
We teach PADI and NAUI snorkeling and scuba diving courses in Auckland, 2012,
We are a referral dive center and a guided discovery dive shop.
ADDITIONAL TEAM MEMBERS
Tania Barnes (Shop Hand)
Hi there! My name is Tania. I work in the Epic Scuba shop. I am from America, but moved to New Zealand two years ago to follow my passion for marine life in the most beautiful country in the world!
I love seeing the people that come in and be a welcoming smile to our wonderful abode here in Half Moon Bay. I love the water and want to make it a safe and comfortable place that everyone can enjoy, and I also know how having the right equipment for each individual can make an experience of a lifetime even more amazing!
I love the satisfaction knowing someone has walked away with gear that is perfectly suited for their unique needs and wants, and are ready to begin exploring more of the amazing waters Kiwis are lucky enough to have in their own backyard and hopefully beyond.
"Rob and his team at Epic SCUBA have given my student the opportunity to gain a qualification that they could have only done outside of school. Over 100+ students have gained their NAUI and PADI certification over the past four + years and this is something they will have for the rest of their lives.
Rob and his team are excellent at what they do. They have a relaxed attitude which the students respond to but they makes sure everything is done impeccably well. The students have all enjoyed the experience and Rob has made them all feel at ease in the water. Rob has the qualities that make him an excellent teacher, calm, approachable, and knowledgeable which therefore make him well respected by students and staff"
PE Department, Kings College
"We have worked with Rob Elmes and Elmesie Scuba for the last three years. Rob is enthusiastic and passionate about diving and that has rubbed off on the students. He has a very professional approach, communicating effectively with the school and clearly outlining all safety aspects. He has gone out of his way to ring parents to explain procedures and safety practices so they will feel confident about their childs dive.
Rob is always willing to tailor a program to our needs and time frame, and has come up with some great ways to link diving to assessment practices. I have no hesitation in recommending Elmsie Scuba to either schools or individuals wanting to learn to dive"
Director of Sport, Rosehill College
"Rob has worked with Sacred Heart College for the last 3 years and in that time has provided an exceptional course for our Sports Leadership students. His friendly nature, expert knowledge and experience with Scuba & Snorkelling along with an exemplary safety record has given the students & staff the confidence & experience to make these courses a “real life experience”. In my dealings with Rob he is very flexible & happy to accommodate changes and work with the sometimes challenging nature of schools. Along with this is Rob’s ability to give the boys confidence in the water & a clear understanding of what he wants the boys to achieve. He does this with humour but always in a calm manner that tells the boys that this is fun but common sense and safety are not comprised. Rob has a clear understanding of what the Achievement Standards are assessing and always submits valid assessment data accurately.
I would have no hesitation in recommending Rob & his business to any school, business or group"
Assistant HOD Physical Education, Sacred Heart College
"We have worked with Elmesie Dive School for the past 3 years. Through their expertise 180 NCEA L2 Physical Education students have learnt to scuba and snorkel dive while learning risk management procedures inherent in diving (7 NCEA L2 credits). Elmesie and his instructors have good knowledge of NCEA criteria, is flexible with teaching programmes, have a great rapport with students and have very high safety standard. I like the way that students are dealt with as individuals with different needs, anxieties and abilities - as a consequence nearly all students make the dives at Goat Island to complete the course. Elmesie Dive School has helped provide an exiting, real outdoor experience at an affordable cost to the student"
Assistant HOD Physical Education, Northcote College
MEDICAL STATEMENTParticipant Record (Confidential Information) This is a statement in which you are informed of some potential risks involved in scuba diving and of the conduct required of you during the scuba training program. Your signature on this statement is required for you to participate in the scuba training program offeredby ____ and Instructor _ located in the Facility city of_, state/province of _Read this statement prior to signing it. You must complete this Medical Statement, which includes the medical questionnaire section, to enroll in the scuba training program. If you are a minor, you must have this Statement signed by a parent or guardian. Diving is an exciting and demanding activity. When performed correctly, applying correct techniques, it is relatively safe. When established safety procedures are not followed, however, there are increased risks. To scuba dive safely, you should not be extremely overweight or out of condition. Diving can be strenuous under certain conditions. Your respiratory and circulatory systems must be in good health. All body air spaces must be normal and healthy. A person with coronary disease, a current cold or congestion, epilepsy, a severe medical problem or who is under the influence of alcohol or drugs should not dive. If you have asthma, heart disease, other chronic medical conditions or you are taking medications on a regular basis, you should consult your doctor and the instructor before participating in this program, and on a regular basis thereafter upon completion. You will also learn from the instructor the important safety rules regarding breathing and equalization while scuba diving. Improper use of scuba equipment can result in serious injury. You must be thoroughly instructed in its use under direct supervision of a qualified instructor to use it safely. If you have any additional questions regarding this Medical Statement or the Medical Questionnaire section, review them with your instructor before signing. Please read carefully before signing. The purpose of this Medical Questionnaire is to find out if you should be examined by your doctor before participating in recreational diver training. A positive response to a question does not necessarily disqualify you from diving. A positive response means that there is a preexisting condition that may affect your safety while diving and you must seek the advice of your physician prior to engaging in dive activities.Please answer the following questions on your past or present medical history with a YES or NO. If you are not sure, answer YES. If any of these items apply to you, we must request that you consult with a physician prior to participating in scuba diving. Your instructor will supply you with an RSTC Medical Statement and Guidelines for Recreational ScubaDiver’s Physical Examination to take to your physician._ Could you be pregnant, or are you attempting to become pregnant?_____ Are you presently taking prescription medications? (with the exception of birth control or anti-malarial)_ Are you over 45 years of age and can answer YES to one or more of the following?• currently smoke a pipe, cigars or cigarettes• have a high cholesterol level• have a family history of heart attack or stroke• are currently receiving medical care• high blood pressure
• diabetes mellitus, even if controlled by diet alone.Have you ever had or do you currently have…_____ Asthma, or wheezing with breathing, or wheezing with exercise? _____ Frequent or severe attacks of hayfever or allergy?_____ Frequent colds, sinusitis or bronchitis?_____ Any form of lung disease?_____ Pneumothorax (collapsed lung)?_ Other chest disease or chest surgery?___ Behavioral health, mental or psychological problems (Panic attack, fear of closed or open spaces)?___ Epilepsy, seizures, convulsions or take medications to prevent them? Recurring complicated migraine headaches or take medications to prevent them?_____ Blackouts or fainting (full/partial loss of consciousness)?_ Frequent or severe suffering from motion sickness (seasick, carsick, etc.)?__ Dysentery or dehydration requiring medical intervention?_____ Any dive accidents or decompression sickness?_____ Inability to perform moderate exercise (example: wal 1.6 km/one mile within 12 mins.)? Head injury with loss of consciousness in the past five years?_____ Recurrent back problems? Back or spinal surgery?__ Diabetes?__ Back, arm or leg problems following surgery, injury or fracture? _____ High blood pressure or take medicine to control blood pressure? _____ Heart disease? Heart attack?_ Angina, heart surgery or blood vessel surgery?
_____ Sinus surgery?_ Ear disease or surgery, hearing loss or problems with balance? _____ Recurrent ear problems?_____ Bleeding or other blood disorders?_____ Hernia?__ Ulcers or ulcer surgery ?
_____ A colostomy or ileostomy?___ Recreational drug use or treatment for, or alcoholism in the past five years?ivers Medical Questionnaire To the Participant:
The information I have provided about my medical history is accurate to the best of my knowledge. I agree to accept responsibility for omissions regarding my failure to disclose any existing or past health condition. _ Signature Date Signature of Parent or Guardian DatePRODUCT NO. 10063 (Rev. 06/07) Ver. 2.01 © PADI 1989, 1990, 1998, 2001, 2007 © Recreational Scuba Training Council, Inc. 1989, 1990, 1998, 2001, 2007 Page 1 of 6 STUDENT Please print legibly. Name____PHYSICIAN This person applying for training or is presently certified to engage in scuba (self-contained underwater breathing apparatus) diving. Your opinion of the applicant’s medical fitness for scuba diving is requested. There are guidelines attached for your information and reference. Physician’s Impression I find no medical conditions that I consider incompatible with diving. I am unable to recommend this individual for diving.
RemarksDay/Month/YearPhysician____Recreational SCUBA (Self-Contained Underwater Breathing Apparatus) can provide recreational divers with an enjoyable sport safer than many other activities. The risk of diving is increased by certain physical conditions, which the relationship to diving may not be readily obvious. Thus, it is important to screen divers for such conditions. The RECREATIONAL SCUBA DIVER’S PHYSICAL EXAMINATION focuses on conditions that may put a diver at increased risk for decompression sickness, pulmonary overinflation syndrome with subsequent arterial gas embolization and other conditions such as loss of consciousness, which could lead to drowning. Additionally, the diver must be able to withstand some degree of cold stress, the physiological effects of immersion and the optical effects of water and have sufficient physical and mental reserves to deal with possible emergencies. The history, review of systems and physical examination should include as a minimum the points listed below. The list of conditions that might adversely affect the diver is not all-inclusive, but contains the most commonly encountered medical problems. The brief introductions should serve as an alert to the nature of the risk posed by each medical problem. The potential diver and his or her physician must weigh the pleasures to be had by diving against an increased risk of death or injury due to the individual’s medical condition. As with any recreational activity, there are no data for diving enabling the calculation of an accurate mathematical probability of injury. Experience and physiological principles only permit a qualitative assessment of relative risk. For the purposes of this document, Severe Risk implies that an individual is believed to be at substantially elevated risk of decompression sickness, pulmonary or otic barotrauma or altered consciousness with subsequent drowning, compared with the general population. The consultants involved in drafting this document would generally discourage a student with such medical problems from diving. Relative Risk refers to a moderate increase in risk, which in some instances may be acceptable. To make a decision as to whether diving is contraindicated for this category of medical problems, physicians must base their judgement on an assessment of the individual patient. Some medical problems which may preclude diving are temporary in nature or responsive to treatment, allowing the student to dive safely after they have resolved. Diagnostic studies and specialty consultations should be obtained as indicated to determine the diver’s status. A list of references is included to aid in clarifying issues that arise. Physicians and other medical professionals of the Divers Alert Network (DAN) associated with Duke University Health System are available for consultation by phone +1 919 684 2948 during normal business hours. For emergency calls, 24 hours 7 days a week, call +1 919 684 8111 or +1 919 684 4DAN (collect). Related organizations exist in other parts of the world – DAN Europe in Italy +39 039 605 7858, DAN S.E.A.P. in Australia +61 3 9886 9166 and Divers Emergency Service (DES) in Australia +61 8 8212 9242, DAN Japan +81 33590 6501 and DAN Southern Africa +27 11 242 0380. There are also a number of informative websites offering similar advice. NEUROLOGICAL Neurological abnormalities affecting a diver’s ability to perform exercise should be assessed according to the degree of compromise. Some diving physicians feel that conditions in which there can be a waxing and waning of neurological symptoms and signs, such as migraine or demyelinating disease, contraindicate diving because an exacerbation or attack of the preexisting disease (e.g.: a migraine with aura) may be difficult to distinguish from neurological decompression sickness. A history of head injury resulting in unconsciousness should be evaluated for risk of seizure. Relative Risk Conditions • Complicated Migraine Headaches whose symptoms or severity impair motor or cognitive function, neurologic manifestations • History of Head Injury with sequelae other than seizure • Herniated Nucleus Pulposus • Intracranial Tumor or Aneurysm • Peripheral Neuropathy • Multiple Sclerosis • Trigeminal Neuralgia • History of spinal cord or brain injury Temporary Risk Condition History of cerebral gas embolism without residual where pulmonary air trapping has been excluded and for which there is a satisfactory explanation and some reason to believe that the probability of recurrence is low. Severe Risk Conditions Any abnormalities where there is a significant probability of unconsciousness, hence putting the diver at increased risk of drowning. Divers with spinal cord or brain abnormalities where perfusion is impaired may be at increased risk of decompression sickness. Some conditions are as follows: • History of seizures other than childhood febrile seizures • History of Transient Ischemic Attack (TIA) or Cerebrovascular Accident (CVA) • History of Serious (Central Nervous System, Cerebral or Inner Ear) Decompression Sickness with residual deficits CARDIOVASCULAR SYSTEMS Relative Risk Conditions The diagnoses listed below potentially render the diver unable to meet the exertional performance requirements likely to be encountered in recreational diving. These conditions may lead the diver to experience cardiac ischemia and its consequences. Formalized stress testing is encouraged if there is any doubt regarding physical performance capability. The suggested minimum criteria for stress testing in such cases is at least 13 METS.* Failure to meet the exercise criteria would be of significant concern. Conditioning and retesting may make later qualification possible. Immersion in water causes a redistribution of blood from the periphery into the central compartment, an effect that is greatest in cold water. The marked increase in cardiac preload during immersion can precipitate pulmonary edema in patients with impaired left ventricular function or significant valvular disease. The effects of immersion can mostly be gauged by an assessment of the diver’s performance while swimming on the surface. A large proportion of scuba diving deaths in North America are due to coronary artery disease. Before being approved to scuba dive, individuals older than 40 years are recommended to undergo risk assessment for coronary artery disease. Formal exercise testing may be needed to assess the risk. * METS is a term used to describe the metabolic cost. The MET at rest is one, two METS is two times the resting level, three METS is three times the resting level, and so on. The resting energy cost (net oxygen requirement) is thus standardized. (Exercise Physiology; Clark, Prentice Hall, 1975.) Guidelines for Recreational Scuba Diver’s Physical Examination Instructions to the Physician: Page 3 of 6 Relative Risk Conditions • History of Coronary Artery Bypass Grafting (CABG) • Percutaneous Balloon Angioplasty (PCTA) or Coronary Artery Disease (CAD) • History of Myocardial Infarction • Congestive Heart Failure • Hypertension • History of dysrythmias requiring medication for suppression • Valvular Regurgitation Pacemakers The pathologic process that necessitated should be addressed regarding the diver’s fitness to dive. In those instances where the problem necessitating pacing does not preclude diving, will the diver be able to meet the performance criteria? * NOTE: Pacemakers must be certified by the manufacturer as able to withstand the pressure changes involved in recreational diving. Severe Risks Venous emboli, commonly produced during decompression, may cross major intracardiac right-to-left shunts and enter the cerebral or spinal cord circulations causing neurological decompression illness. Hypertrophic cardiomyopathy and valvular stenosis may lead to the sudden onset of unconsciousness during exercise. PULMONARY Any process or lesion that impedes airflow from the lungs places the diver at risk for pulmonary overinflation with alveolar rupture and the possibility of cerebral air embolization. Many interstitial diseases predispose to spontaneous pneumothorax: Asthma (reactive airway disease), Chronic Obstructive Pulmonary Disease (COPD), cystic or cavitating lung diseases may all cause air trapping. The 1996 Undersea and Hyperbaric Medical Society (UHMS) consensus on diving and asthma indicates that for the risk of pulmonary barotrauma and decompression illness to be acceptably low, the asthmatic diver should be asymptomatic and have normal spirometry before and after an exercise test. Inhalation challenge tests (e.g.: using histamine, hypertonic saline or methacholine) are not sufficiently standardized to be interpreted in the context of scuba diving. A pneumothorax that occurs or reoccurs while diving may be catastrophic. As the diver ascends, air trapped in the cavity expands and could produce a tension pneumothorax. In addition to the risk of pulmonary barotrauma, respiratory disease due to either structural disorders of the lung or chest wall or neuromuscular disease may impair exercise performance. Structural disorders of the chest or abdominal wall (e.g.: prune belly), or neuromuscular disorders, may impair cough, which could be life threatening if water is aspirated. Respiratory limitation due to disease is compounded by the combined effects of immersion (causing a restrictive deficit) and the increase in gas density, which increases in proportion to the ambient pressure (causing increased airway resistance). Formal exercise testing may be helpful. Relative Risk Conditions • History of Asthma or Reactive Airway Disease (RAD)* • History of Exercise Induced Bronchospasm (EIB)* • History of solid, cystic or cavitating lesion* • Pneumothorax secondary to: -Thoracic Surgery -Trauma or Pleural Penetration* -Previous Overinflation Injury* • Obesity • History of Immersion Pulmonary Edema Restrictive Disease* • Interstitial lung disease: May increase the risk of pneumothorax * Spirometry should be normal before and after exercise Active Reactive Airway Disease, Active Asthma, Exercise Induced Bronchospasm, Chronic Obstructive Pulmonary Disease or history of same with abnormal PFTs or a positive exercise challenge are concerns for diving. Severe Risk Conditions • History of spontaneous pneumothorax. Individuals who have experienced spontaneous pneumothorax should avoid diving, even after a surgical procedure designed to prevent recurrence (such as pleurodesis). Surgical procedures either do not correct the underlying lung abnormality (e.g.: pleurodesis, apical pleurectomy) or may not totally correct it (e.g.: resection of blebs or bullae). • Impaired exercise performance due to respiratory disease. GASTROINTESTINAL Temporary Risks As with other organ systems and disease states, a process which chronically debilitates the diver may impair exercise performance. Additionally, dive activities may take place in areas remote from medical care. The possibility of acute recurrences of disability or lethal symptoms must be considered. Temporary Risk Conditions • Peptic Ulcer Disease associated with pyloric obstruction or severe reflux • Unrepaired hernias of the abdominal wall large enough to contain bowel within the hernia sac could incarcerate. Relative Risk Conditions • Inflammatory Bowel Disease • Functional Bowel Disorders Severe Risks Altered anatomical relationships secondary to surgery or malformations that lead to gas trapping may cause serious problems. Gas trapped in a hollow viscous expands as the divers surfaces and can lead to rupture or, in the case of the upper GI tract, emesis. Emesis underwater may lead to drowning. Severe Risk Conditions • Gastric outlet obstruction of a degree sufficient to produce recurrent vomiting • Chronic or recurrent small bowel obstruction • Severe gastroesophageal reflux • Achalasia • Paraesophageal Hernia ORTHOPAEDIC Relative impairment of mobility, particularly in a boat or ashore with equipment weighing up to 18 kgs/40 pounds must be assessed. Orthopaedic conditions of a degree sufficient to impair exercise performance may increase the risk. Relative Risk Conditions • Amputation • Scoliosis must also assess impact on respiratory function and exercise performance. • Aseptic Necrosis possible risk of progression due to effects of decompression (evaluate the underlying medical Page 4 of 6 cause of decompression may accelerate/escalate the progression). Temporary Risk Conditions • Back pain HEMATOLOGICAL Abnormalities resulting in altered rheological properties may theoretically increase the risk of decompression sickness. Bleeding disorders could worsen the effects of otic or sinus barotrauma, and exacerbate the injury associated with inner ear or spinal cord decompression sickness. Spontaneous bleeding into the joints (e.g.: in hemophilia) may be difficult to distinguish from decompression illness. Relative Risk Conditions • Sickle Cell Disease • Polycythemia Vera • Leukemia • Hemophilia/Impaired Coagulation METABOLIC AND ENDOCRINOLOGICAL With the exception of diabetes mellitus, states of altered hormonal or metabolic function should be assessed according to their impact on the individual’s ability to tolerate the moderate exercise requirement and environmental stress of sport diving. Obesity may predispose the individual to decompression sickness, can impair exercise tolerance and is a risk factor for coronary artery disease. Relative Risk Conditions • Hormonal Excess or Deficiency • Obesity • Renal Insufficiency Severe Risk Conditions The potentially rapid change in level of consciousness associated with hypoglycemia in diabetics on insulin therapy or certain oral hypoglycemic medications can result in drowning. Diving is therefore generally contraindicated, unless associated with a specialized program that addresses these issues. [See “Guidelines for Recreational Diving with Diabetes” at www/wrstc.com and www.diversalertnetwork.org.] Pregnancy: The effect of venous emboli formed during decompression on the fetus has not been thoroughly investigated. Diving is therefore not recommended during any stage of pregnancy or for women actively seeking to become pregnant. BEHAVIORAL HEALTH Behavioral: The diver’s mental capacity and emotional make-up are important to safe diving. The student diver must have sufficient learning abilities to grasp information presented to him by his instructors, be able to safely plan and execute his own dives and react to changes around him in the underwater environment. The student’s motivation to learn and his ability to deal with potentially dangerous situations are also crucial to safe scuba diving. Relative Risk Conditions • Developmental delay • History of drug or alcohol abuse • History of previous psychotic episodes • Use of psychotropic medications Severe Risk Conditions • Inappropriate motivation to dive – solely to please spouse, partner or family member, to prove oneself in the face of personal fears • Claustrophobia and agoraphobia • Active psychosis • History of untreated panic disorder • Drug or alcohol abuse OTOLARYNGOLOGICAL Equalisation of pressure must take place during ascent and descent between ambient water pressure and the external auditory canal, middle ear and paranasal sinuses. Failure of this to occur results at least in pain and in the worst case rupture of the occluded space with disabling and possible lethal consequences. The inner ear is fluid filled and therefore noncompressible. The flexible interfaces between the middle and inner ear, the round and oval windows are, however, subject to pressure changes. Previously ruptured but healed round or oval window membranes are at increased risk of rupture due to failure to equalise pressure or due to marked overpressurisation during vigorous or explosive Valsalva manoeuvres. The larynx and pharynx must be free of an obstruction to airflow. The laryngeal and epiglotic structure must function normally to prevent aspiration. Mandibular and maxillary function must be capable of allowing the patient to hold a scuba mouthpiece. Individuals who have had mid-face fractures may be prone to barotrauma and rupture of the air filled cavities involved. Relative Risk Conditions • Recurrent otitis externa • Significant obstruction of external auditory canal • History of significant cold injury to pinna • Eustachian tube dysfunction • Recurrent otitis media or sinusitis • History of TM perforation • History of tympanoplasty • History of mastoidectomy • Significant conductive or sensorineural hearing impairment • Facial nerve paralysis not associated with barotrauma • Full prosthedontic devices • History of mid-face fracture • Unhealed oral surgery sites • History of head and/or neck therapeutic radiation • History of temperomandibular joint dysfunction • History of round window rupture Severe Risk Conditions • Monomeric TM • Open TM perforation • Tube myringotomy • History of stapedectomy • History of ossicular chain surgery • History of inner ear surgery • Facial nerve paralysis secondary to barotrauma • Inner ear disease other than presbycusis • Uncorrected upper airway obstruction • Laryngectomy or status post partial laryngectomy • Tracheostomy • Uncorrected laryngocele • History of vestibular decompression sickness Page 5 of 6 1. Bennett, P. & Elliott, D (eds.)(1993). The Physiology and Medicine of Diving. 4th Ed., W.B. Saunders Company Ltd., London, England. 2. Bove, A., & Davis, J. (1990). Diving Medicine. 2nd Edition, W.B. Saunders Company, Philadelphia, PA. 3. Davis, J., & Bove, A. (1986). “Medical Examination of Sport Scuba Divers, Medical Seminars, Inc.,” San Antonio, TX 4. Dembert, M. & Keith, J. (1986). “Evaluating the Potential Pediatric Scuba Diver.” AJDC, Vol. 140, November. 5. Edmonds, C., Lowry, C., & Pennefether, J. (1992) .3rd ed., Diving and Subaquatic Medicine. Butterworth & Heineman Ltd., Oxford, England. 6. Elliott, D. (Ed) (1994). “Medical Assessment of Fitness to Dive.” Proceedings of an International Conference at the Edinburgh Conference Centre, Biomedical Seminars, Surry, England. 7. “Fitness to Dive,” Proceedings of the 34th Underwater & Hyperbaric Medical Society Workshop (1987) UHMS Publication Number 70(WS-FD) Bethesda, MD. Paul A. Thombs, M.D., Medical Director Hyperbaric Medical Center St. Luke’s Hospital, Denver, CO, USA Peter Bennett, Ph.D., D.Sc. Professor, Anesthesiology Duke University Medical Center Durham, NC, USA Richard E. Moon, M.D., F.A.C.P., F.C.C.P. Departments of Anesthesiology and Pulmonary Medicine Duke University Medical Center Durham, NC, USA Roy A. Myers, M.D. MIEMS Baltimore, MD, USA William Clem, M.D., Hyperbaric Consultant Division Presbyterian/St. Luke’s Medical Center Denver, CO, USA John M. Alexander, M.D. Northridge Hospital Los Angeles, CA, USA Des Gorman, B.Sc., M.B.Ch.B., F.A.C.O.M., F.A.F.O.M., Ph.D. Professor of Medicine University of Auckland, Auckland, NZ Alf O. Brubakk, M.D., Ph.D. Norwegian University of Science and Technology Trondheim, Norway Alessandro Marroni, M.D. Director, DAN Europe Roseto, Italy Hugh Greer, M.D. Santa Barbara, CA, USA BIBLIOGRAPHY/REFERENCE ENDORSERS Page 6 of 6 8. Neuman, T. & Bove, A. (1994). “Asthma and Diving.” Ann. Allergy, Vol. 73, October, O’Conner & Kelsen. 9. Shilling, C. & Carlston, D. & Mathias, R. (eds) (1984). The Physician’s Guide to Diving Medicine. Plennum Press, New York, NY. 10. Undersea and Hyperbaric Medical Society (UHMS) 11. Divers Alert Network (DAN) United States, 6 West Colony Place, Durham, NC 12. Divers Alert Network Europe, P.O. Box 64026 Roseto, Italy, telephone non-emergency line: weekdays office hours +39-085-893- 0333, emergency line 24 hours: +39-039-605-7858 13. Divers Alert Network S.E.A.P., P. O. Box 384, Ashburton, Australia, telephone 61-3-9886-9166 14. Divers Emergency Service, Australia, telephone 61-8-8212-9242 15. South Pacific Underwater Medicine Society (SPUMS), P.O. Box 190, Red Hill South, Victoria, Australia, 16. European Underwater and Baromedical Society, Christopher J. Acott, M.B.B.S., Dip. D.H.M., F.A.N.Z.C.A. Physician in Charge, Diving Medicine Royal Adelaide Hospital Adelaide, SA 5000, Australia Chris Edge, M.A., Ph.D., M.B.B.S., A.F.O.M. Nuffield Department of Anaesthetics Radcliffe Infirmary Oxford, United Kingdom Richard Vann, Ph.D. Duke University Medical Center Durham, NC, USA Keith Van Meter, M.D., F.A.C.E.P. Assistant Clinical Professor of Surgery Tulane University School of Medicine New Orleans, LA, USA Robert W. Goldmann, M.D. St. Luke’s Hospital Milwaukee, WI, USA Paul G. Linaweaver, M.D., F.A.C.P. Santa Barbara Medical Clinic Undersea Medical Specialist Santa Barbara, CA, USA James Vorosmarti, M.D. 6 Orchard Way South Rockville, MD, USA Tom S. Neuman, M.D., F.A.C.P., F.A.C.P.M. Associate Director, Emergency Medical Services Professor of Medicine and Surgery University of California at San Diego San Diego, CA, USA Yoshihiro Mano, M.D. Professor Tokyo Medical and Dental University Tokyo, Japan Simon Mitchell, MB.ChB., DipDHM, Ph.D. Wesley Centre for Hyperbaric Medicine Medical Director Sandford Jackson Bldg., 30 Chasely Street Auchenflower, QLD 4066 Australia Jan Risberg, M.D., Ph.D. NUI, Norway Karen B.Van Hoesen, M.D. Associate Clinical Professor UCSD Diving Medicine Center University of California at San Diego San Diego, CA, USA Edmond Kay, M.D., F.A.A.F.P. Dive Physician & Asst. Clinical Prof. of Family Medicine University of Washington Seattle, WA, USA Christopher W. Dueker, TWS, M.D. Atherton, CA, USA Charles E. Lehner, Ph.D. Department of Surgical Sciences University of Wisconsin Madison, WI, USA Undersea & Hyperbaric Medical Society 10531 Metropolitan Avenue Kensington, MD 20895, USA Diver’s Alert Network (DAN) 6 West Colony Place Durham, NC 27705