Nick Pelios
Freediver, Creator
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Nick Pelios
Freediver, Creator
Every descent asks for trust in one’s body, mind, and partner. But no matter how experienced you are, nature has a way of humbling even the best of us. That’s why first aid knowledge isn’t a nice-to-have in this sport. It’s non-negotiable. Understanding how to respond to emergencies can be the dividing line between a story to tell and a tragedy to mourn.
Let’s start with what can go wrong. Freediving, by nature, involves breath-holding and pressure changes. The most well-known and feared risk is shallow water blackout. It occurs when the brain becomes deprived of oxygen, usually during ascent. A diver can appear fine and suddenly lose consciousness within a few meters of the surface. Knowing how to recognize the signs-subtle slowing of movement, twitching, unresponsiveness-is crucial. But recognizing it is only step one. The immediate response should be to secure the diver’s airway, remove their mask, and provide rescue breaths while keeping their head above water. Once on land or a boat, CPR may be necessary if breathing hasn’t resumed.
Barotrauma is another risk, especially in the ears, sinuses, and lungs. While proper equalization techniques prevent most issues, sometimes descent happens too quickly or forcefully. A ruptured eardrum or sinus squeeze isn’t just painful-it can disorient a diver, making ascent dangerous. Lung barotrauma, while less common, can be life-threatening. It typically happens when a diver holds their breath too forcefully while ascending, leading to a lung over-expansion injury. This requires immediate evacuation and oxygen administration.
Then there’s hypothermia. Even in tropical waters, the body can lose heat faster than it can generate it. A diver shivering uncontrollably, appearing pale or sluggish, might be in the early stages. If left unchecked, hypothermia can impair motor control, judgement, and breathing. The right response is to get the diver out of the water, dry them off, remove any wet gear, and slowly rewarm them using dry clothing, blankets, or body heat. Never place them in hot water or expose them to direct heat-it’s dangerous and can shock the system.
Marine life injuries, while rare, do occur. A brush with a jellyfish, a sting from a sea urchin, or an accidental encounter with a venomous fish can all cause pain, inflammation, and allergic reactions. The treatment depends on the creature involved. Vinegar may help with jellyfish stings, while hot water immersion is effective for many marine stings. Antihistamines and pain relievers can ease symptoms, but in the case of systemic reactions-difficulty breathing, swelling of the face, or rapid heartbeat-epinephrine may be required, and emergency services must be contacted.
Physical injuries are another consideration. Coral cuts, scrapes from rocky entries, or fin mishaps can break the skin and expose divers to infections. All wounds, no matter how small, should be cleaned thoroughly with fresh water and antiseptic. Apply sterile dressings, monitor for signs of infection, and avoid diving again until the wound has properly sealed.
Carrying a first aid kit that is both compact and comprehensive is a must for every freediving trip. It should include sterile gauze, medical tape, bandages, antiseptic wipes, a thermal blanket, antihistamines, pain relievers, and if possible, an emergency oxygen kit. But more important than owning these items is knowing how to use them. A kit is only as useful as the training behind it.
That’s why taking a certified first aid course, ideally one that focuses on diving scenarios, is one of the most valuable investments a freediver can make. The Divers Alert Network (DAN) and other recognized bodies offer programs that teach CPR, oxygen administration, wound care, and emergency management in aquatic settings. Practicing these skills regularly ensures that they become second nature under pressure.
The buddy system in freediving isn’t a formality. It’s a lifeline. A trained partner who can recognize early warning signs and respond decisively is essential. This is not just about avoiding solo dives-it’s about having someone who’s prepared to act when seconds count. Communication, trust, and shared knowledge are what turn a pair of divers into a functional safety unit.
Environmental awareness is also part of first aid readiness. Knowing the specifics of the dive site-currents, depth changes, marine life, entry and exit points-helps in both prevention and response. Always check the weather and sea conditions before diving. Ensure that someone on shore or on a boat is aware of the dive plan and has a way to contact emergency services if needed.
No piece of gear, no level of experience, and no amount of physical training can replace preparedness. Freediving strips you down to your most human elements. You face nature with nothing but your breath and your mind. In that kind of exposure, first aid knowledge isn’t just smart-it’s respectful. It honors the risks, acknowledges the unexpected, and protects the community.
Diving deeper starts with knowing how to come back up. And sometimes, the most powerful thing you can carry with you isn’t found on your belt or in your bag-it’s the confidence to handle the worst, calmly, when it counts the most.