Submarine medicine: An overview of the unique challenges, medical concerns, and gaps.

Submariners face many challenges. For example, they "live where they work" and can be called to duty anytime. They have limited access to open space, natural settings, fresh air, fresh food, sunlight, privacy, exercise, and outside communication. They support a wider range of missions than occur aboard most other Navy vessels. At sea or on shore, submariners work long hours under conditions with little margin for error. They may traverse remote or disputed areas of the ocean far from rescue assets, and must remain vigilant for potential encounters with hostile forces, onboard fires, anomalies in the breathing atmosphere, leaks, undersea collisions, or radiation exposures. If any of these factors cause casualties, the Independent Duty Corpsman (with intermittent advice from shore-based medical personnel), must be ready to provide aid as long as necessary. The challenges of submarine service led to the growth of the unique field of submarine medicine, which has maintained an excellent record of health and safety. This review introduces the field of submarine medicine as practiced in the U.S. Navy, describing its major concerns, giving an overview of the operation of a submarine medical department, and identifying several medical gaps that researchers are working to fill. Submarine medicine already has a stellar record in terms of radiation and atmospheric safety and has made strides in fatigue management. Ongoing work will deliver improved psychological screening and support tools. This report summarizes developments in these and other areas of submarine medicine.

Initial review of the U.S. Navy's pressurized submarine escape training outcomes.

The U.S. Navy reinstituted pressurized submarine escape training (PSET) for submarine sailors in 2009 after a nearly 30-year absence. This training addresses escape from a disabled submarine at depth with the use of the Beaufort, Ltd. Mk 10 Submarine Escape and Immersion Equipment (SEIE) suit. Training is classified as "high-risk" due to previous U.S. and foreign navy experience with training-associated morbidity and mortality, particularly from diving-related illness. To reduce risk, medical screening procedures are performed. During the first 39 months of training, 7,025 students screened for PSET with 32% completing all phases, including two pressurized ascents. The most common reason for screening disqualification was presence of upper respiratory congestion. During training, middle ear barotrauma was responsible for 53% of attrition, primarily during the test of pressure.

Development of underwater and hyperbaric medicine as a medical specialty in Turkey.

Underwater and hyperbaric medicine focuses on diving physiology, prevention and treatment of health problems related to the exposure to high ambient pressure and therapeutic use of hyperbaric oxygen for several medical conditions. Adequate educational standards should be developed for physicians working in the field of underwater and hyperbaric medicine. In Turkey, underwater and hyperbaric medicine is one of the medical specialties. The history of underwater and hyperbaric medicine as a medical specialty is dated back to the 1960s. In this paper, we review standards and the development of underwater and hyperbaric medicine as a medical specialty in Turkey.

Overseas SpR4th year subspeciality training report August 2001 to August 2002.

These two attachments were in highly specialised fields of medicine and only loosely connected with anaesthesia. However, as a military anaesthetist, both of these areas are highly relevant. The jobs were of high quality from an educational and training perspective and were also allied with an increased amount of autonomy and responsibility appropriate to this stage of training.