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Stefan Thiesen, (c) Hawaii, 1994 Now: Werner Str. 203 D-59379 Selm / Germany email:email@example.com
SCUBA diving nowadays allows easy access to the underwater realm for almost everybody who can afford to buy or rent the equipment, and the theory behind the underlying principles of recreational diving is relatively well understood. Diving is a safe sport if divers are properly trained and stay within safe limits. The problems already begin with the definition of these limits. One of the main dangers is the possibility of a medical condition called decompression sickness or "caisson disease" after the French word for box. It was first observed in 19th century France when underwater constructions were carried out by workers in boxes on the ground of rivers. As implied by the name, decompression sickness is a pressure related condition caused by the rapid lowering of ambient pressure, in the case of SCUBA diving during a fast ascent, usually after a deep dive. The behavior of liquids and gaseous substances with changing pressure and temperature are very well understood, while our understandings of the physiological effects are still incomplete. Under surface norm pressure of one bar only about 4% of the Oxygen of each inhalation are metabolized and exhaled as Carbon Dioxide while the atmospheric Nitrogen does not contribute to any physiological function since it is an inert gas. Under water the situation changes. In a water depth of 20m for example we find a surrounding pressure of three bars, that means although the air still consists out of 78% Nitrogen, the Nitrogen partial pressure tripled to 0.78 bar * 3 = 2.34 bar, so that there is a higher partial pressure of Nitrogen in the Lungs than in the bodies' tissues which according to the normal human environment are only saturated with Nitrogen at a partial pressure of approximately 0.78 bar. While diving, an equalization of the lung and the tissue partial pressures progresses during which Nitrogen continually flows from the Lungs into the bloodstream and is distributed to all cells and tissue compartments. The Nitrogen Molecules are transported from the region of higher partial pressure to the region of lower pressure until a state of equilibrium is reached and the pressure gradient disappears. The reason why only the Nitrogen has to be taken into consideration is because the Oxygen does not accumulate in tissues since it is metabolized continuously. The amount of Nitrogen saturated in the blood and tissues depend on the surrounding pressure, that means the depth of the dive and 1
but it will surely result in severe problems to directly shoot up to the surface from the same depth at the end of the dive. Bert did major research work and his work "La Pression Barometrique" as well as his practical recommendation concerning slow ascents and treatment of decompression sickness remained valid for a long time. cartilage. The gas molecules follow Henry's law and "pearl out" from the surrounding liquid due to the sudden drop of pressure." During the ascent this situation is reversed so that after ending the dive the Nitrogen partial pressure in the human tissue is higher than in the breathed surrounding air. that is the blood in the major blood vessels as well as capillaries. "The amount of gas that will dissolve into a liquid at a given temperature is proportional to the partial pressure of that gas. The time needed for saturation on the other hand depends on the circulation and blood supply to the tissue area in question. Although observed as early as 1854. although it did not yet include a systematic understanding of the behavior and connection of different tissue types and parts of the human body. In the terminology used blood. in the case of the human body it is Nitrogen that is in physical solution up to the saturation limit under surface pressure and although the saturation limit usually is not reached at the maximum diving depth during a dive. Nitrogen is highly soluble in fat tissues -. so a distinction can be made between "fast" and "slow" tissues. the harmless desaturation goes hand in hand with a maximum pressure reduction rate per time. joints and bones. muscles and the neural system are considered as fast "tissues" and bones. The next important factor is the "solubility coefficient". On the basis of empirical and experimental data the first decompression tables were developed by J. While the ongoing saturation of body tissues during descents and deep diving does not have any known negative effects. This means that a fast ascent leads to the formation of bubbles in the human body liquids. The same phenomenon can be observed as seen when a can of soda is suddenly opened after it has been shaken. Haldane later used goats for pressurizing experiments to determine how much nitrogen can be dissolved in tissues and where the limits for decompression times and 2 . it is easily exceeded when ascending again even from moderate depths.five times as high as in diluted tissues. In other words: it is not dangerous at all in terms of decompression problems. tissues. is how long the diver has been breathing air under increased pressure. decompression sickness wasn't systematically explained before the French researcher P. to immediately descent to for example 40m.is based on Henry's law stating that. The single most important factor for the probability of developing decompression sickness is the time. In the case of the soda the gas is Carbon Dioxide. sinews. joints and articular capsules are slow tissues. since the different tissue compartments have different saturation coefficients and characteristic saturation/desaturation times (from only minutes to several hours at a given pressure). Haldane and all later developments are based on this fundamental research. Bert figured out that the "caisson disease" or "The Bends" called medical condition has its origin in the bubbles formed in human tissue by nitrogen during de pressurization.
Diving within the conservative limits of decompression sickness is normally safe. Tables used for recreational diving are more conservative. and there are different models used for achieving these goals.pressures/depths are. burning chest pain and shock due to lack of Oxygen. His experiments were successful. the results verified by human divers and concluded in the first usable dive tables and largely increased diving safety. In most cases (approx.especially for recreational diving. skin symptoms can be found and 5% of the cases suffer from blocked lymph channels. while all other divers in his group are free of symptoms although they all ascended at the same rate and followed a similar dive profile. Type one is characterized by the fact that pain is the only symptom. than tables used by professional divers in the fields of technical or military diving. The later can result in edemas and severe pain. In about 75% of all cases the joints are the most affected areas. Type two is defined by severe conditions affecting the nervous system (brain. The development of modern diagnostical methods. due to the pain forcing the patient to bend the joints (this is where the name "The Bends" comes from). This pain can be felt in different parts of the body and results from local damage to body tissue. Supplying Oxygen is mandatory and treatment in a recompression chamber should be considered in severe cases. This is because it cannot be clearly predicted where and when small bubbles of Nitrogen clot. namely the ultrasound Doppler detector allowed to prove that the amount of Nitrogen bubbles forming after every dive differs every time. On the other hand professional divers work under water what has effects on the behavior of their tissues that need to be taken into account. These models mainly differ in their complexity and their field of application. The Two Types Of Decompression Sickness: Decompression Sickness can be divided into two categories due to their signs and symptoms. This circumstance makes it even more important to stay on the conservative side and properly plan each dive . such as parts of the heart or nervous system. 20% of the cases. [PADI 1988: The Encyclopedia Of Recreational Diving] The tables estimate the minimum time needed for the different tissues to de-saturate safely. However: Statistical uncertainties are involved. form a larger bubble and block a passage to an important body compartment. shallow breathing. In some cases one diver shows symptoms after a dive. spinal cord) and the respiratory system. 2/3) decompression sickness of type two also shows the symptoms of type one. so more accurate models for tables and later dive computers could be derived. The symptoms are as in type one plus choking and coughing. In ca. that is "on the safe side". Damage to the nervous system can result in many different 3 .
Especially damage to the skeleton in the form of arthritis can cause remaining painful deformations of the joints. the symptoms of chronic decompression sickness also can develop over a long period of time.Pain in joints and skin (formation of bubbles) . although harmless in single cases.and bone tissues. chest pain.Choking.Confined feeling in chest (fat embolism in coronary vessels) Treatment: .Paraplegia .When conscious give something to drink (water.and speech problems . from paralysis of different parts of the body or numbness. The reason for this is not known for sure yet but it is thought that microscopic Nitrogen bubbles remaining in the cartilage.Administer 100% Oxygen . So far this is the only known long term side effect of SCUBA diving when practiced safely.Activate EMS and organize transportation to nearest recompression chamber .Nausea.Hemiplegia . cause the problems through a summation of their damaging effects over the years. blurry vision.Maintain body temperature .Thrombosis prophylactics by giving Heparin or Aspirin .Place infusion if properly trained .symptoms. hear. lost sensitivity in hands or legs and even sudden clinical death. Signs and Symptoms of Decompression Sickness summed up: .Administer CPR if needed . tea. Decompression sickness does not necessarily occur suddenly (the symptoms of type one and two as described develop within two hours after ascend). juice) 4 . shallow breathing (also with air embolism!) . vertigo. blurry vision.
there are other aids for safer deep and decompression diving. The latest models include a constant monitoring of the air demand and respiratory activity of the diver which play a key role in the Nitrogen saturation of the tissue. mathematical models and physical data incorporated. a more realistic and complex analysis and simulation of the actual physical and physiological proceedings is necessary. such as decompression chambers for professional divers and special breathing gases. Helium might also be released faster by the tissues in which it is dissolved because it perforates membranes easier since it is a much smaller molecule than N2.they are reserved for special applications in researchand technical diving and require extensive training to handle the potential life threatening risks. In order to be safe. The computers can be categorized into different generations according to the complexity of their simulations.Modern Methods for Handling the Decompression Problem The need for more usable bottom time finally lead to a step beyond the reliable dive tables: the development of real-time simulating devices. The first of these mechanisms worked on a mechanical and pneumatical base and simulated only one average saturation condition for all tissue compartments. References and literature:  PADI 1988: The Encyclopedia of Recreational Diving 5 . This way one can get a most realistic model of the true proceedings and the actual situation of the diver. The advances in the field of electronics allowed to develop small. However. Decometers simulate continuously the saturation situation and time in maximum and shallower depth as well as the de saturation during ascent are considered when evaluating maximum decompression limits. dive profile and time and simulate up to 16 different body tissues simultaneously. the most conservative model had to be taken into account but even so it was already possible to increase the bottom time noticeable. In order to increase the dive time to its practical and theoretical limits without exceeding no decompression time. Computer assisted dives need to be planned thoroughly since every diver can only rely on his own computer what makes it more difficult to plan group dives with maximized bottom time. usually incorporating Helium instead of Nitrogen to avoid Nitrogen toxicity. fast computer units with enough capacity to analyze ambient pressure. although one has to take into account that there are no safety margins left when using this type of computer. These are after all techniques that currently do not play a big role for recreational divers .
Naglschmid: Sporttauchen  UWATEC 1990: Company Information "Aladin Pro"  Sherwood 1992: The Source . no. F. PADI 1991: Adventures In Diving  PADI 1991: Rescue Diver Manual  PADI 1991: Divemaster Manual  VDST 1994: Sporttaucher. 2  Dr.User Manual  Zane Bilgrav: Handouts & Lectures 6 .
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