Les médecins et chercheurs de DAN répondent à vos questions sur la médecine de la plongée
Q : Is it possible to dive after having a tracheostomy?
R: : A tracheostomy is a surgically created opening in the front of the neck that leads directly into the trachea to facilitate breathing by allowing air to reach the lungs. The opening allows a person to breathe when the normal airway above the opening is blocked or inadequate due to various conditions.
Dive medical authorities, including the Undersea and Hyperbaric Medical Society, consider a tracheostomy to be a high-risk condition and a contraindication to scuba diving. Important issues include the following:
• Risk of aspiration and drowning: Since the trach tube bypasses the natural protective mechanisms of the airway — such as the mouth, nose, larynx, and epiglottis — preventing water from directly entering the lungs is difficult. Water can enter the lungs during immersion or even at the surface, where a splash of water from wave action could enter the stoma (opening). Even if the stoma is covered with a speaking valve or cap, submersion could increase the risk of aspiration, which could lead to choking, coughing, rapid ascent, or drowning.
• Interface: Standard recreational dive equipment is not made for a tracheostomy interface. A standard scuba regulator is sealed by the mouth and held in place by the teeth using a regulator bite tab. This connection is not possible with a tracheostomy.
• Possible barotrauma: There may be a risk of pressure-related (barotrauma) complications, especially with individually crafted regulator modifications. The difficulty of maintaining a sealed airway under pressure cannot be overstated. There is a risk of pulmonary barotrauma (lung overexpansion injury) if air trapping or unequal pressure occurs as the diver descends or ascends in the water column. The trach stoma and surrounding tissues may not tolerate pressure changes well, increasing the risk of lung overexpansion injury such as pneumothorax or subcutaneous emphysema.
• Infection risk: All water, including chlorinated pools, contains opportunistic pathogens. An open stoma or one that is only partially breached provides a direct pathway for bacteria to enter the lower respiratory tract, increasing the risk of serious infections such as pneumonia and tracheobronchitis.
• Airway management difficulty: In an emergency, clearing and managing the airway may be more difficult for first responders who may be unfamiliar with a tracheostomy. Vomiting, regurgitation, or managing simple secretions pose additional considerations for rescue breathing or CPR.
• Underlying condition and therapies and medications: Conditions such as chronic lung disease, neuromuscular disorders, or prior airway surgery may also affect fitness to dive. Coughing or clearing secretions underwater is next to impossible and would negatively impact a dive. Coughing, especially while ascending, has been associated with lung overexpansion injuries, like those caused by accidentally holding one’s breath on ascent. Radiation therapy or medications may have affected surrounding tissue or vital organs such as the lungs or heart.
In summary, a tracheostomy is a contraindication to diving because of multiple factors — including drowning risk from aspiration, equipment incompatibility, infection risk, pressure-related complications, underlying medical conditions, and therapies and medications.
— Jim Chimiak, MD, DAN Chief Medical Officer
© Alert Diver – Q4 2026