First Aid basics are for when you inadvertently touch or brush against something underwater. Usually when that happens you are left with a burn, an abrasion or poisonous sting. You need to know what to do about it

There are so many ways you can be injured underwater while Scuba Diving. First Aid basics knowledge is a must so you know what to do about it, or indeed whether you need to do something about what has happened.

What we will deal with here are First Aid basics dealing with relatively minor injuries and recognition of more serious injuries which require you to seek help.

A lot of the time, unless you are lucky enough to live close to a dive location, you will be travelling to an exotic location to dive and that may require that you carry with you some basic First Aid kit.

Contents of a First Aid basics kit

  • White vinegar (for sea creature stings)
  • Sunscreen
  • Hydrogen Peroxide
  • Isopropyl alcohol (70% solution)
  • Alcohol wipes or pads
  • Anti-bacterial soap
  • Antiseptic cream or spray
  • Adhesive Bandages
  • Compress pads
  • Gauze pads
  • Adhesive tape
  • Cotton swabs
  • Aspirin or other analgesic
  • Scissors
  • Tweezers
  • Baking soda
  • Seasick pills
  • Ear drops

Injuries and symptoms and what to do about them

Cuts & Abrasions



What to do

First Aid basics

  • Control bleeding
  • Scrub inside and around wound with soap and water
  • Remove any visible debris
  • Apply topical antiseptic, cover with sterile dressing and bandage
  • Watch for allergic reaction, like swelling, and infection
  • For deep cuts/puncture wound, press a clean cloth directly on the wound and get medical attention

Cuts from coral reefs can be a problem – even the mildest of abrasions can develop into an infected sore because of the calcareous matter and animal proteins which remains within the flesh of the abrasion. Applying First Aid basics is a necessity in avoiding further problems developing.

Warm tropical waters can host numerous bacteria – cleaning the injury as soon as possible, and thoroughly, can minimize the possibility of infection. This is almost always one of the First Aid basics you can rely on.

The wound needs to be well cleaned using soap and water then by applying alcohol or peroxide and other antiseptic ointments. These are fundamental First Aid basics.



Swelling, redness, pus, foul smell, swollen glands, fever

What to do

First Aid basics aren't appropriate - See a Doctor

Swimmers ear (Otitis Externa)

Otitis externa is caused by constant moisture in the ear canal. This moisture will eventually begin to break down the ear canal lining, which makes this sensitive area more susceptible to infection. The continuous moisture will begin to dislodge and break down earwax, which actually acts as a moisture barrier and protects the ear canal. Once water becomes trapped in the canal, bacterial and fungal growths can occur, causing infection.


Ear fullness, itching, pain, fever, swollen lymph nodes

What to do

The First Aid basics -

  • Add several eardrops into ear canal for 5 min. to inhibit bacterial growth
  • Seek medical attention for severe infection or if ear remains sore/tender

Divers Ear Drop Solution Home Brew: 50:50 white wine vinegar and isopropyl alcohol

Also use Burows solution which is available over the counter.

Burow's solution is a pharmacological preparation made of aluminium acetate dissolved in water.

It was invented in the mid-1800s by Karl August Burow, an ophthalmologist.

The preparation has astringent and antibacterial properties and is used to treat a number of skin conditions such as insect bites, rashes caused by poison ivy and poison sumac, swelling, allergies and bruises.
Burow's solution is traditionally applied in cold compresses over the affected area. In otology, it is applied as ear drops of a 13% solution.
Burow's solution is available over the counter as a generic preparation. Bayer also manufactures a modified form of the preparation under the commercial name Domeboro

Typical ear drops used for otitis externa contain antibiotics to fight infection, and corticosteroids to reduce itching and inflammation.

The vinegar lowers the Ph level of your ear and inhibits bacterial growth while the alcohol dries your ear canal out.

These First Aid basics will go a long way to making sure your scuba dive vacation is a pleasant one - there is little worse than suffering needless ear troubles - needless because it is so easily preventable.

Corals or Barnacle Cuts

What to do
Would you believe some more First Aid basics?

  • Control bleeding
  • Scrub with soap and water
  • Remove any visible debris
  • Cover with sterile dressing and bandage
  • Monitor for allergic reaction and infection
  • Seek medical attention if necessary
  • Fire Coral, hydroids, Jellyfish, sea wasps, sea anemones


    Redness/rash, burning, blisters, swelling

    What to do ......... First Aid basics....

    • Flush with vinegar (mild acetic acid, baking soda or rubbing alcohol)
    • Flush with saline or sea water (NO FRESH WATER)
    • Remove tentacles with tweezers or adhesive tape
    • Shave area and apply hydrocortisone lotion or cream
    • Monitor for infection/ allergic reaction
    • Seek medical attention if necessary

    Spine Punctures: Urchin / Crown-of-Thorn Sea star (starfish) / Fish

    What to do

    • Irrigate with water and then scrub with soup and water
    • Apply topical antiseptic and a cover with a sterile dressing or bandage
    • Monitor for infection/ allergic reaction

    Lionfish Aliwal Shoal Dec 09

    Lionfish, Scorpionfish and Stonefish (possess spines that transport venom)


    Redness, swelling, blistering (lionfish) and extreme pain What to do

    • Similar to spine punctures noted above
    • Soaking in hot water may dramatic relieve pain from lionfish
    • Seek medical attention if necessary
    • Antivenom may be available for stonefish and wound may take weeks to heal

    Scorpion fish can be almost invisible on the reef

    Cone Shells

    Never pick up a cone shell on the narrow end (It really is safest just to leave them alone!)


    Pain, numbness, swelling, redness, respiratory distress or arrests, cardiac arrest.

    What to do

    • Immobilize, clean puncture site and apply pressure dressing.
    • Place diver in recovery position, transport to nearest medical facility
    • If safely possible, bring the stinging snail to the emergency room

    I must mention there are 30 recorded human deaths from cone snails, and from what is recorded about these, they are exceptionally dangerous - one named the cigarette snail - so named because it is said you will only have time to smoke a cigarette before you die.....

    Sea Snake Bite


    Small bite pattern visible, stiffness/aching, respiratory distress, weakness, vomiting

    What to do

    • Ensure ABC's (Airway, Breathing and Circulation)
    • Control bleeding
    • Monitor for shock and/or allergic reaction
    • Seek immediate medical attention

    Seafood Poisoning

    Natural occurring chemicals (marine toxins) can cause illness. One type – ciguatera poisoning, is caused by eating contaminated tropical reef fish: Barracuda, grouper etc. Fish absorb and build up the poison occurring in their prey – the older or bigger the fish, logically the more poison (obviously depending on what the fish is eating (see page on morays) Symptoms (onset 15-30min)

    Abdominal pain, numbness around mouth, tooth pain, headache, dizziness, diarrhoea, vomiting, nausea, paralysis, muscle/joint aches, chills and fever, itching.

    What to do

    First Aid basics are only the beginning and may only serve to stabilise while waiting for professional medical assistance.

    • Ensure ABC's
    • if responsive induce vomiting and save for analysis.
    • Administer Oxygen
    • Seek medical attention
    • Notify all who may have eaten the same food

    Diver's ear

    Diver's ear, also known as ear squeeze, occurs when the eustachian tube malfunctions and does not open as a diver swims deeper into the water. Pressure builds and causes pain and possible eardrum rupture. Treat diver's ear by not diving any deeper if you experience ear pain or pressure. Seek medical attention if the pain does not subside when you reach the surface of the water.

    • Nasal spray
    • Oral decongestants
    • Pain medication
    • Antibiotics

    Stop your dive immediately if you experience ear pain or pressure. Attempt to clear your ears by plugging your nose, closing your mouth and blowing. Return to the surface if the ear pain or pressure does not stop. Make all necessary decompression stops along the way.

    Open your Eustachian tube by using nasal spray and taking oral decongestants once you reach the surface. Take antihistamines if you have a known allergy that contributes to diver's ear.

    Take pain medication if needed.

    Contact a doctor if the ear pain or pressure does not stop soon after reaching the surface. Ask if you need to seek immediate medical attention. If immediate medical attention is not advised, visit your doctor after you return home to check for any ear damage.

    if you experience nausea, vomiting, hearing loss, continued ear pain, disorientation or fluid seeping from your ear. These are all signs of a ruptured eardrum. Drive to the nearest emergency room and have your eardrum examined by the attending doctor. Take any antibiotics prescribed by the doctor to prevent infection. Have your ear checked by a doctor before you dive again.

    Prevention of Divers ear

    • Stay out of the water if you already have ear pain of any kind. As much of a disappointment as it is, the smartest choice is to postpone your dive until your ear pain has subsided.
    • Equalize your ears often when you dive. – but GENTLY!
    • Rinse your ears with a drying agent after each dive. To make your own solution, combine equal parts of rubbing alcohol, hydrogen peroxide and white vinegar. The combination dries moisture and kills bacteria.
    • Never use a cotton swab inside your ear. A cotton swab causes tiny abrasions in your ear canal, removes the protective layer of wax and pushes ear wax further into the ear canal.
    • When you dive, you introduce water into a warm environment. When you pair that bacteria-friendly factor with open abrasions, impacted ear wax and unprotected skin, you have recipe for infection.
    • Keep yourself healthy in the days before your dive. Colds and allergies can create inflammation of the ears. Alcohol can lead to dehydration. Drink lots of water, don't smoke and eliminate or limit alcohol consumption.

    Dealing with an Unconscious Scuba diver

    • Bump, or slightly nudge the unconscious diver to ensure that he is indeed unconscious. You want to make sure they are not simply playing a joke on you.
    • Approach the diver from the left side and slide your right arm under his left arm. This step is assuming they are at the bottom of the body of water.
    • Reach for his regulator (diver's breathing device) and hold it in place while also supporting his head and neck. His head and neck should be held in a normal position. This enables expanding air to escape the diver's lungs, and could help him regain consciousness. This step is assuming the regulator is not in the diver's mouth.
    • Inflate your BC (buoyancy compensator) and ascend at a regular rate to the surface. Normal rate of ascension for a diver is 30 feet a minute. Ascending any faster could result in too much pressure building in the veins and has the potential for causing air clots in the body.
    • Begin CPR on the unconscious victim once you have them on the boat and have determined that they are not breathing.
    • Also contact the Coast Guard or emergency personnel like NSRI as soon as possible.

    Scuba diving, is only as safe as the scuba diver's experience and awareness allows.
    The dangers of scuba diving are numerous and after all, it is an environment where you are exposed to creatures with which you are basically unfamiliar.

    There are significant dangers from both the sea, equipment failure, the sea life (which is usually coming into contact with a human by accident and defending itself).

    It is also rare that a scuba diver is subjected to an unprovoked attack.

    Your knowing the First Aid basics is a fundamental part of being a safe scuba diver.
    Your knowledge may save your own life if not your companion's, even if it is only knowing where the dangers lie.

    First Aid basics are now covered - click here to go back to recreational diving page

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