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The article presents a study which examines the connection of severity of decompression illness (DCI) assessed by diving medicine specialist through telephone with clinical findings in the treatment facility. The study analyzes the standard telephone protocols received by diving medical hotline and categorises symptoms and signs according to description and terminology of DCI. Result shows that specialist-based telephone hotline can provide a reliable assessment of the severity of DCI.

The article analyzes problems with a preclinical treatment algorithm for diving accidents based on hyperbaric situation in Switzerland. It offers a brief historical perspective of the development of deep diving physiology and practice in the country. It discusses the availability of hyperbaric chambers for assessment and recompression treatment (HBOT) and helicopter-based medevacuation in the country. It also offers a look at international recommendations for decompression illness.

The article presents diving accident guidelines of the German Society for Diving and Hyperbaric Medicine. The Society considers diving accidents as decompression accident or decompression injury, which are characterized by the formation of gas bubbles in blood and tissues. Dive partners provide first aid in most cases. Mild symptoms call for protection against hypothermia as well as hyperthermia. The pathogenesis and symptoms of diving accidents are also discussed.

A letter to the editor is presented about the fitness-to-dive certifications needed by European divers to be allowed to dive in the Great Barrier Reef.

A certificate for divers should be based on expertise and risk assessment. The doctor needs knowledge of the divers history, diving technique, motivation and risk exposure.

Introduction: The object of this study was to evaluate to what extend the severity of decompression illness (DCI) assessed by a diving medicine specialist over the phone correlates with actual clinical findings., Methods: The phone protocols of calls received by a diving medical hotline between January 2008 and December 2009 were analysed. Each case was followed up after completion of the treatment and categorized into one out of four severity groups according to the same standard protocol used for categorisation at the time of the initial hotline call., Results: In 47 of 151 calls, DCI was suspected by the hotline experts. The initial estimation was coherent with the clinical findings in 37 cases, 9 were overestimated and one was underestimated. With the 95% bootstrap confidence interval 0.551 to 0.864 and computed weighted Cohen's κ coefficient = 0,721, the coherence between hotline assessment and clinical assessment can be considered as good. The five divers with minimal symptoms who were categorised as "no DCI possible" could not be followed up., Conclusion: We conclude that, despite some limitations to the study, particularly the limited sample size, a reliable assessment of the severity of DCI can be provided by a specialist-based telephone hotline.