Divers and Ears: a question of equalizing

Equalizing your ears is one of the first skills that new divers learn and that we practice on every single dive. While building up dives, equalization becomes almost instinctive for many divers. For some divers equalizing remains difficult, frustrating and even painful.

Let’s have a look into the process, the techniques and what can make equalizing problematic.

The anatomy of the human ear

Without going in too many details, the human ear can be segmented in 3 major parts: the outer ear, the middle ear and the inner ear.

The outer ear is at the surface filled with air. When being submerged, our outer ear fills with water and does not cause any issues. The inner ear is filled with body fluids. As a liquid is almost non-compressible, the inner does seldom cause an issue when diving. The middle ear is a dead air space filled with air. When diving the air in the middle ear is getting compressed and puts the ear drum and the inner soft tissues under pressure. It are these pressure changes you experience during scuba diving. As we descend, the surrounding pressure increases, while the pressure in your middle ear remains the same. The imbalance can cause extreme discomfort.

Through equalization we re-balance the pressure in our middle ear by increasing or decreasing the gas pressure in order to match the pressure at depth. We do this though the Eustachian tube which connects the middle ear with our nose.

Inner Ear

The Eustachian tube

The Eustachian tube makes the connection between our middle ear and our nose. As we are breathing gas at depth, our nose contains air at the same pressure as the environment. The Eustachian tube is made of and surrounded by soft tissue. You can look at it as a balloon. When the pressure in the balloon is higher that the surrounding pressure, the excess air will easily come out. This is what typically happens when you are ascending during the dive. When descending, the balloon holds gas at a lower pressure, pushing the sides to each other thus blocking air flowing into it. In order to equalize the pressure, you must force the sites to open up and let air flow into the balloon.

Equalization techniques

The Valsalva Maneuver is the most common method and the one you probably learned during your certification. This involves pinching your nose and blowing gently (like blowing your nose in a handkerchief), thereby forcing air to move along the Eustachian tubes and into your middle ear. The excess pressure from the lower part of the Eustachian tube is forced open and allows air to flow in the middle ear. It is effective as long as you use it in a timely fashion. However, if you wait until discomfort occurs to try equalizing this way, it often doesn’t work. If the outside pressure becomes too great, the Eustachian cushions become “locked” shut – and no amount of air will open them. Instead, if you blow too hard, you risk causing damage to your inner ear tissues.

An alternative is to try pinching your nose and swallowing (a method known as the Toynbee Maneuver), or moving your jaw as if you’re about to yawn. These techniques use the throat muscles rather than air pressure to open the Eustachian cushion and are usually more effective if the valves are already locked shut. Of course, the easiest way to avoid this problem in the first place is to equalize before the pressure becomes too great, i.e. every meter of your descent, or before experiencing discomfort.

Checklist for effective equalization

  • Listen for the “pop”
    Before going for a dive, make sure that when you swallow you hear a “pop” in both ears. This tells you both Eustachian tubes are opening.
  • Take  it slowly
    Never continue to dive if you feel pain in your ears. Take it slow and attempt to equalize. Don’t let your buddy or your dive guide put you under pressure.
  • Start early
    Before the dive, begin gently equalizing your ears every few minutes. Chewing gum seems to help because it makes you swallow often.
  • Equalize at the surface
    Pre-pressurizing at the surface helps most divers get past the critical first few meter of descent. It may also inflate your Eustachian tubes so they are slightly bigger. Although not proven to be the most efficient,  it’s worth trying it out to see if it helps you.
  • Descend feet first
    Studies have shown a Valsalva Maneuver requires 50 percent more force when you’re in a head-down position than head-up.
  • Look up
    Extending your neck tends to open your Eustachian tubes.
  • Use a descent line
    Pulling yourself down an anchor line helps control your descent rate. It also helps you stop your descent if you feel pressure.
  • Stay ahead
    Equalize often, trying to maintain a slight positive pressure in your middle ears. Don’t wait until you feel pressure or pain.
  • Stop if it hurts
    Your Eustachian tubes are probably locked shut by pressure differential. Ascend a little bit and try equalizing again.
  • Avoid milk
    Some foods, including milk, can increase your mucus production.
  • Avoid tobacco and alcohol
    Both tobacco smoke and alcohol irritate your mucus membranes, promoting more mucus that can block your Eustachian tubes.
  • Keep your mask clear
    Water up your nose can irritate your mucus membranes, which then produce more of the stuff that clogs.

 

Refresh your diving skills

Why would I need a scuba refresh?

Everybody has experienced it. You are on a diving excursion and one of your fellow divers is not at the level expected. It typically starts with the preparation of the dive kit. It takes ages to get prepared, requires the full attention of the dive centre staff and the person is obviously very nervous. Once ready, limited attention is given to the dive briefing. You now upfront this is going to be a hard one.

Having a good up to date knowledge and practice, handling of dive gear and understanding of diving procedures is key to fully enjoy your dives. Nevertheless we see divers in our centre regularly that are lacking at least one of these as they have not been diving for a while, regardless of the reasons, or do not feel confident. Besides the fact these divers increase the risks when taking them diving, they typically spoil the dives of the regular divers.

The same quite often applies for active divers that decided recently to make major changes to their dive equipment. Not sure how to use the new equipment or lacking practice with it, they easily shift the focus to the new kit as opposed to the diving while being under water.

When you recognize yourself in any of the above statement, it might be wise to talk to the dive centre and agree on a refresher course.

What’s in it for me?

Get back into it

Over time unused scuba knowledge fades. We as dive centre expect certified divers to safely plan and execute dives in accordance with their qualification. Planning a dive, controlling your bottom time, master your buoyancy and performing a correct safety stop are key to any dive. Understanding in-water safety procedures such as correct buddy procedures and what to do in case of diver separation are mandatory to conduct dives in a safe and controlled manner. During a refresher course we will go through all the steps of a dive and help to bring you back up to speed on all these aspects.

Understand and manage your own dive gear

Most dive centres require certified divers to assemble and disassemble their own dive gear, check and adjust your weights and make sure all is functioning correctly. A lot of attention on getting your dive equipment sorted out is given during the refresher session in order for you to fully master it.

Refreshing skills and routine

Any dive professional is ready to help you rehears the required scuba skills. Believe us, quite often small, forgotten things can cause major issues during a dive, ruining the dive for everybody. Sometimes they can even cause dangerous situations. Doing a refresher course allows you to rehears all the required skills thus reducing the risks of major issues afterwards. After the skill rehearsal you will start thinking as a diver again!

For the diver having changed his dive gear, these sessions allow you to build confidence in the use of your newly acquired gear while practicing with your instructor. He will be happy to help you out with any issue and even demonstrate how to use the equipment correctly.

Practice in a controlled environment

Scuba diving is not risk free and if something goes wrong, there is a risk attached. It’s critical for the safety of you and your dive buddy to know what to do if you find yourself in a low-on-air emergency situation. Strangely though, certified divers rarely practice these skills. Running through the skills under the supervision of an instructor allows you to practice them in a safe, risk-free environment so that they become more instinctive in the unlikely event something does go wrong.

Build confidence

As a certified diver you understand that being stressed for a dive is not the best option. When not having been diving for a while or you made some major changes in your dive gear, you will get nervous as you get closer to hitting the water. The higher your heart-rate gets, the more the stress will build up. This will have a negative impact not only on your air consumption, but might cause you not to react correctly on events during the dive. Practicing in a confined and controlled environment under the direct guidance of a pro will give you the confidence required and reduce the pre-dive stress. You will be able to fully enjoy the dive and reduce the risks for you and your fellow divers.

Get to know your guides

Quite often the pros assisting you during the refresher course are also the divers that will guide the dives. Getting to know each other and building report during the refresher course will help for the real dives. In addition these pros have tons of dives and know the environment you will be diving in by heart. Enjoy the refresher course to gather valuable information and get fully prepared to discover the underwater world at 100%.

Some final thoughts

All divers learn during their basic diving course, regardless from the agency, that a refresher is required when you did not dive for somewhere between 6 to 12 months. Experience teaches us that the person asking for a refresher course is often the least needing it. Quite some divers over estimate themselves and are confident a refresher course or even just a refresher dive is not required. Once they come into the centre and are requested to start preparing their gear we know how late it is. Please think twice before joining a dive and be critical on yourself, it will increase the safety for yourself, your fellow divers and your guides.

Regardless of the recommendations of the dive associations, each diver should make a critical evaluation of his ability to manage a dive end-to-end. Some divers may need some assistance to safely re-enter the water way sooner as others. The recommendations are just a rule of thumb but each should in the first place do an honest self-assessment. Believe us, as dive professionals we will not judge anybody requesting assistance to re-enter, just the opposite. At the end it is all about making sure dives are fun and enjoyable and can be conducted in the safest way possible.

Where is my buddy?

The buddy system

As recreational divers we learned it is advised to always dive with a buddy. Diving with a buddy makes diving more fun, safer and is in some countries even a legal requirement. The idea behind it is based on the fact that with two it is easier and less stressful to manage difficult situations or emergencies during the dive. We also learned the correct functioning of the buddy system is a mutual responsibility.

Despite our training, incidents of divers becoming separated are not unusual. Whether consciously or by accident, divers can end up alone underwater during various phases of a dive and sometimes it results in potentially dangerous situations.

The buddy system described

“The buddy system is the situation which occurs when two divers of similar interest and equal experience and ability share a dive, continuously monitoring each other throughout the entry, the dive and the exit, and remaining within such distance that they could render immediate assistance to each other if required.”

—  Definition by Bob Halstead, Line dancing and the buddy system

From the definition we learn that the divers within a buddy team share similar experience, interest and skills and they monitor each other throughout the dive. When an emergency occurs they are ready to help each other in order to avoid major issue.

A good buddy team agree on a dive planning, roles during the dive, signals to be used and a realistic objective prior to the dive. Each buddy members familiarizes with and checks his partners dive equipment in order to be able to deal with unforeseen events such as an out-of-air scenario.

When diving in a group, the group leader should make sure all divers are aware of their buddy and that the group dive plan matches the plans of the individual buddy teams. It is good practice for a dive leader to re-emphasis each diver’s responsibility for his buddy team.

Why does it go wrong?

Divers become separated for many reasons. Dive buddies are dealing with things that absorb their attention, and as a result fail to properly monitor each other. When divers are only focused on their underwater task like underwater photography, a separation from their buddy system is likely. Despite a good agreement prior to the dive, environmental conditions, visibility, equipment problems and diver attitude can all lead to separated buddies.

Buddy Separation Procedure

Stop, Think and Act

Stop swimming and remain where you are. Panic is your worst adviser. Look around for about 1 minute to see if you can find your buddy. Do this by rotating 360° slowly. Things to look for are bubbles (remember, only humans make bubbles under water), unusual colours under water (yellow fins, dive lights, …). While doing your search, make sure your buddy can see you. Slowly moving your own diving torch up and down will make you more visible for your buddy. Also making a sound (banging your knife on your tank for example) will give him some idea of direction.

Ascend, Safety Stop, Surface.

After you spend a minute of looking for your buddy, your next step is to ascend slowly to the depth of about 5m. When you reach the 5m, deploy your surface marker buoy (SMB) to help your buddy who may already be at the surface know where you are while doing your safety stop. If you do not have an SMB (which should not be the case as an SMB is a standard equipment for each diver) you might consider skipping your safety stop.
Also during your safety stop, keep looking out for your buddy doing slow 360° surveys.

Surface – Bubbles

When you reach the surface, look for nearby bubbles and look below you. Call out to your buddy several times. If you and your buddy had a dive plan, your buddy will be doing the same procedure as you and will appear at the surface close to where you are. If water conditions are not favorable return to the dive boat and report your missing buddy.

Return to the dive boat or shore.

In your dive plan with your buddy, you would know how long to wait at the surface, if the time exceeds that limit (it should only be a couple of minutes), make your way back to the dive boat and report your buddy as missing.

How to prevent buddy separation?

The buddy system is important in recreational diving and when it fails risks are imminent. Following guidelines can help to avoid losing your buddy:

  • Include buddy separation risks when planning dives, and make certain that the dive objective, the used equipment and the dive conditions do not increase the risk of separation.
  • Remember the dive begins once you step in the water. As such you both go down together!
  • When diving in a group, don’t assume that everyone is looking out for each another. Each diver should have a buddy and conscientiously monitor that person.
  • Avoid dive plans that are inherent in buddies to separate. In case of a Search and Recovery for example, make sure buddies can communicate using a line when distance between them increases.
  • Distraction leads to separation. In case it’s part of the dive objective (e.g. one is doing underwater photography) the non-acting buddy will stay in close contact.
  • When one diver leads and the other follows, the “lead” diver should never assume that the “follower” is following. Maintain visual or body contact throughout the dive.
  • Don’t assume the dive has ended once you reach the safety stop. It doesn’t end until all divers are out of the water.

 

Why do you want to work in the diving industry?

Most people are convinced that becoming a dive instructor and work in the industry is only about the adventure in your life, working in exotic destinations and earning lots of money. Well, the truth is a bit different.

Not sure we were the only ones being convinced this was not the only thing, we have been talked to a lot of dive instructors and divemasters, both experienced and just certified ones. Indeed we came up with a bit of a different story. It’s true that the adventurous life and the exotic locations play a role when going for a career in the diving industry, but it just does not stop there. Most guys and girls we talked to all agreed that sharing and transferring your passion for diving is much more important than the adventure.

The smile on the student’s faces, the great feedback at certification, the compliments from divers and the great stories told at the end of the holidays, that’s what makes our days.

Just to give you a small story illustrating the feeling….

In the center we organise try-dives in the pool on a daily basis. The aim is to let non-divers experience the feeling of freedom under the water, breathing, finning and the sense of being weightless. In order to make this often first time experience something special, we organise some show around it involving friends and family.

A few weeks ago, we were quite busy with a large group of youngsters wanting to give it a try. Whilst the dive instructors were in the water, we had a chat with a somewhat older man who seemed nervous but interested in trying. The 70-year old was a swimmer but never in his life tried snorkelling or scuba diving. Seen his age he was quite nervous about trying. In the first go we explained exactly what was going to happen and assured him that we take all necessary measures to make it a fun but safe experience. Finally he decided to hit the water and guess…. He came out with the biggest smile on his face ever seen. At the end of his holidays he came to see us, thank us again and asked for the possibilities of going for the PADI Scuba Diver certification. Finally he left from the island giving us all a big hug and Anita even got some kisses!

This small anecdote exactly illustrates why we want to make diving our way of life!