Real risk for Thai team in cave: Physical and psychological toll of scuba escape

The stranded Thai soccer players (Photo: ROYAL THAI ARMY via EPA-EFE) Photo: ROYAL THAI ARMY via EPA-EFE

Real risk for Thai team in cave: Physical and psychological toll of scuba escape

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Real risk for Thai team in cave: Physical and psychological toll of scuba escape


Just because military search groups were able to find a group of 12 stranded Thai soccer players and their coach alive in an underwater cave doesn’t mean they’re safe. In fact, the most difficult part in getting them out safely likely still lies ahead.

RELATED: ‘Life-or-death situation’: Rescuers face huge obstacles | Thai soccer team found alive after 10 days lost in caves

As noted by USA TODAY’s John Bacon, the precarious passageways that the team will need to traverse, amidst rising water and potential rainfall that would increase those water levels, means it will be essential for all to use scuba gear during portions of their escape,

That escape would be harrowing even without diving gear, with narrow passageways and rope leads, but some portions have water that can’t be pumped out, which necessitates a diving escape. That’s true of all 12 players, some of whom are as young as 11 and others who can’t swim.

“The evacuation must speed up,” Interior Minister Anupong Paojinda told the Bangkok Post. “Diving gear will be used. If the water rises, the task will be difficult. We must bring the kids out before then.”

If that sounds daunting enough, it gets even more precarious. The safety of scuba diving for children under 15 is questionable, at best. That’s due to both emotional and physiological issues; even if teenagers and children have the discipline, responsibility and general fearlessness needed to be a successful diver, they could suffer ear injuries or, in some cases among younger divers, putting themselves at higher issue of decompression illness.

Here’s how Thought Company described a pair of significant additional health risks for children 15 or younger:

  1. Patent Foramen Ovale (PFO): While in the womb, all infants’ hearts have a passageway that allows blood to bypass the lungs. After birth, this hole gradually closes as the child matures. Young, or slowly developing children may still have a partially open PFO by the age of 10. Research is ongoing, but initial findings suggest that PFOs may increase the risk of decompression illness.
  2. Equalization Issues: A scuba diver must add air to his middle ear via the eustachian tube to equalize the air pressure as he or she descends. Most adults can easily equalize their ears. However, the physiology of a child’s ears can make equalization difficult or impossible. Young children have flattened, small eustachian tubes that may not allow air to flow to the middle ear effectively. For many children under the age of 12 (and some older ones), it is physically impossible to equalize the ears because the eustachian tubes are not sufficiently developed. Failure to equalize the ears can lead to severe pain and ruptured ear drums.

Add on the additional physical stress each of these young bodies is under after 10 malnourished days without food in a cave, and it would seem to be a miracle if any could make it out of the cave safely. All of the players are considered to be in stable condition, but stable condition does not necessarily mean that they are dive fit.

Given the urgency being put on evacuating the teens from the cave there is no current timetable for when the dive escapes are likely to be attempted. One thing does seem certain: There won’t be enough time to make all of the players comfortable, confident and fully healthy before they have to attempt their escape.


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