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Breathing gas Decompression sickness Deep diving Equivalent air depth Equivalent narcotic depth High-pressure nervous syndrome List of diving hazards and precautions Maximum operating depth Nitrogen narcosis Nitrox Oxygen toxicity Partial pressure Rebreather Technical diving Trimix (breathing gas) 1 8 23 28 29 30 32 38 40 49 56 72 77 91 97
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Breathing gas is a mixture of gaseous chemical elements and compounds used for respiration. Air is the most common and only natural breathing gas. Other artificial gases, either pure gases or mixtures of gases, are used in breathing equipment and enclosed habitats such as SCUBA equipment, surface supplied diving equipment, recompression chambers, submarines, space suits, spacecraft and anaesthetic machines.   Most breathing gases are a mixture of oxygen and one or more inert gases.  Other breathing gases have been developed to improve on the performance of air by reducing the risk of decompression sickness, reducing the duration of decompression stops, reducing nitrogen narcosis or allowing safer deep diving.  A safe breathing gas has three essential features: • it must contain sufficient oxygen to support the life, consciousness and work rate of the breather.   • it must not contain harmful gases. Carbon monoxide and carbon dioxide are common poisons in breathing gases. There are many others.   • it must not become toxic when being breathed at high pressure such as when underwater. Oxygen and nitrogen are examples of gases that become toxic under pressure.   The techniques used to fill diving cylinders with gases other than air are called gas blending. 
Common diving breathing gases
Common diving breathing gases are: • Air is a mixture of 21% oxygen, 78% nitrogen, and approximately 1% other trace gases; to simplify calculations this last 1% is usually treated as if it were nitrogen. Being cheap and simple to use, it is the most common diving gas.   As its nitrogen component causes nitrogen narcosis it is considered to have a safe depth limit of about 40 metres (130 feet) for most divers, although the maximum operating depth of air is 66.2 metres (218 feet). 
• Pure oxygen is mainly used to speed the shallow decompression stops at the end of a military, commercial or technical dive and is only safe down to a depth of 6 meters (maximum operating depth) before oxygen toxicity steps in.    It was much used in frogmen's rebreathers.    • Nitrox is a mixture of oxygen and air, and generally refers to mixtures which are more than 21% oxygen. It can be used as a tool to accelerate in-water decompression stops or to decrease the risk of decompression sickness and thus prolong a dive (a common misconception is that the diver can go deeper, this is not true owing to a shallower maximum operating depth than on conventional air).    • Trimix is a mixture of oxygen, nitrogen and helium and is often used at depth in technical diving and commercial diving instead of air to reduce nitrogen narcosis and to avoid the dangers of oxygen toxicity.   • Heliox is a mixture of oxygen and helium and is often used in the deep phase of a commercial deep dive to eliminate nitrogen narcosis.    • Heliair is a form of trimix that is easily blended from helium and air without using pure oxygen. It always has a 21:79 ratio of oxygen to nitrogen; the balance of the mix is helium.  • Hydreliox is a mixture of oxygen, helium, and hydrogen and is used for dives below 130 metres in commercial diving.     • Hydrox, a gas mixture of hydrogen and oxygen is used as a breathing gas in very deep diving.     • Neox (also called neonox) is a mixture of oxygen and neon sometimes employed for in deep commercial diving. It is rarely used due to its cost. Also, DCS symptoms produced by neon ("neox bends") have a poor reputation, being widely reported to be more severe than those produced by an exactly equivalent dive-table and mix with helium.   
  The fraction of the oxygen determines the deepest the mixture gas can safely be used to avoid oxygen toxicity. • hyperoxic mixes have more than 21% oxygen. This depth is called the maximum operating depth. If the body is deprived of oxygen for more than a few minutes. Heliox and Heliair create typical hypoxic mixes and are used in technical diving as deep breathing gases.  The maximum operating depth of a normoxic mix could be as shallow as 47 metres (155 feet). NEDU gas analysis lab Filling a diving cylinder with pure oxygen costs around five times more than filling it with compressed air. It is expressed by the partial pressure of oxygen (ppO2). unconsciousness and death result. which sustains life.  • normoxic mixes have the same proportion of oxygen as air. 21%.   Hyperoxic mixtures.    The partial pressure of any component gas in a mixture is calculated as: partial pressure = total absolute pressure x volume fraction of gas component For the oxygen component: ppO2 = P x FO2 . and are designed only to be breathed at depth as a "bottom gas" where the higher pressure increases the partial pressure of oxygen to a safe level. The human body cannot store oxygen for later use as it does with food. Enriched Air Nitrox (EANx) is a typical hyperoxic breathing gas. Fraction of oxygen The fraction of the oxygen component of a breathing gas mixture is sometimes used when naming the mix: • hypoxic mixes.   This is because it is essential to the human body's metabolic process.Breathing gas 2 Individual component gases Oxygen Oxygen (O2) must be present in every breathing gas. Trimix with between 17% and 21% oxygen is often described as normoxic because it contains a high enough proportion of oxygen to be safe to breathe at the surface. The tissues and organs within the body (notably the heart and brain) are damaged if deprived of oxygen for much longer than four minutes. but is increasingly obtained by non cryogenic technologies such as pressure swing adsorption (PSA) and vacuum-pressure swing adsorption (VPSA) technologies.    Partial pressure of oxygen The concentration of oxygen in a gas mix depends on both the fraction and the pressure of the mixture. cause oxygen toxicity at shallower depths but can be used to shorten decompression stops by drawing dissolved inert gases out of the body more quickly. it should be handled with caution when gas blending. strictly.   Trimix.  Oxygen has historically been obtained by fractional distillation of liquid air. As oxygen supports combustion and causes rust in diving cylinders. when compared to air. although often a boundary of 16% is used. contain less than 21% oxygen.
in case problems are later found with its purity. Divox "Divox" is oxygen.    Equivalent air depth is used to estimate the decompression requirements of a nitrox (oxygen/nitrogen) mixture. the diver risks oxygen toxicity including a seizure. so its use is limited to shallower dives. the cheapest and most common breathing gas used for diving. Navy has been known to authorize dives with a ppO2 of as much as 180 kPa (1. The chief difference between them is that the paper record-keeping trail is much more extensive for medical oxygen. It causes nitrogen narcosis in the diver. It is typically between 100 kPa (1 bar) and 160 kPa (1.Breathing gas 3 where: ppO2 P FO2 = partial pressure of oxygen = total pressure = volume fraction of oxygen The minimum safe partial pressure of oxygen in a breathing gas is commonly held to be 16 kPa (0. such as that used in welding. but labeled and tanked differently. pure oxygen for breathing purposes is regarded as medicinal as opposed to industrial oxygen. . Many divers find that the level of narcosis caused by a 30 m (100 ft) dive. Nitrogen can cause decompression sickness. The maximum safe ppO2 in a breathing gas depends on exposure time. in order to more easily identify the exact manufacturing trail of a "lot" of oxygen. the level of exercise and the security of the breathing equipment being used.     Nitrogen in a gas mix is almost always obtained by adding air to the mix. In the Netherlands.S.4 bar). In most countries. The diving industry "created" Divox and registered it as a trademark to circumvent the strict rules concerning medicinal oxygen thus making it easier for (recreational) scuba divers to obtain oxygen for blending their breathing gas. Below this partial pressure the diver may be at risk of unconsciousness and death due to hypoxia. When a hypoxic mix is breathed in shallow water it may not have a high enough ppO2 to keep the diver conscious. and is only available on medical prescription.  Each breathing gas has a maximum operating depth that is determined by its oxygen content. there is no difference in purity in medical oxygen and industrial oxygen.     At high ppO2 or longer exposures. Nitrogen Nitrogen (N2) is a diatomic gas and the main component of air. whilst breathing air. For this reason normoxic or hyperoxic "travel gases" are used at medium depth between the "bottom" and "decompression" phases of the dive. although the U. depending on factors including individual physiology and level of exertion.     Oxygen analysers measure the ppO2 in the gas mix.8 bar). Equivalent narcotic depth is used to estimate the narcotic potency of trimix (oxygen/helium/nitrogen mixture).16 bar). as they are produced by exactly the same methods and manufacturers.6 bar) but for dives of less than three hours is commonly considered to be 140 kPa (1. is a comfortable maximum.
which may impede communication. it does not distort the diver's voice. Helium is found in significant amounts only in natural gas. so is not generally suitable as a diving breathing gas. but considerably less expensive than helium. but unlike helium. Argon is more expensive than air or oxygen. from which it is extracted at low temperatures by fractional distillation.  Helium leaks from damaged or faulty valves more readily than other gases because atoms of helium are smaller allowing them to pass through smaller gaps in seals. The hydrogen-oxygen mix when used as a diving gas is sometimes referred to as Hydrox. because of argon's good thermal insulation properties. it increases the timbre of the diver's voice. At high pressures.    This limits use of hydrogen to deep dives and imposes complicated protocols to ensure that oxygen is cleared from the lungs.   This is because the speed of sound is faster in a lower molecular weight gas.    Like Hydrogen Hydrogen (H2) has been used in deep diving gas mixes but is very explosive when mixed with more than about 4 to 5% oxygen (such as the oxygen found in breathing gas). which is a CNS irritation syndrome which is in some ways opposite to narcosis.Breathing gas 4 Helium Helium (He) is an inert gas that is less narcotic than nitrogen at equivalent pressure (in fact there is no evidence for any narcosis from helium at all).  Helium is equally able to cause decompression sickness. Unwelcome components of breathing gases Many gases are not suitable for use in diving breathing gases. Argox is used for decompression research. Neon Neon (Ne) is an inert gas sometimes used in deep commercial diving but is very expensive.  Helium's low molecular weight (monatomic MW=4. which increases the resonance frequency of the vocal cords. . Helium is not very suitable for dry suit inflation due to its poor thermal insulation properties — helium is a very good conductor of heat (compared to air which is a rather poor. helium. the blood stream and the breathing equipment before breathing hydrogen starts.    Helium fills typically cost ten times more than an equivalent air fill. so it is more suitable for deeper dives than nitrogen.    It is sometimes used for dry suit inflation by divers whose primary breathing gas is helium-based. helium also causes High Pressure Nervous Syndrome. it is less narcotic than nitrogen. present in a diving environment:  Here is an incomplete list of gases commonly Argon Argon (Ar) is an inert gas that is more narcotic than nitrogen. Like helium. making it more of an insulator). compared with diatomic nitrogen MW=28) increases the timbre of the breather's voice.
especially when not atomized properly . In hot climates. The dry gas extracts moisture from the diver's lungs while underwater contributing to dehydration. which contains organic matter (since it usually contains humus). leaks. this coupled with the extreme reduction in temperature. also due to the decompression can cause the moisture to solidify as ice. Four • Internal combustion engine exhaust gas containing CO in the air being drawn into a diving air compressor. which is also thought to be a predisposing risk factor of decompression sickness. especially in high-oxygen gas mixtures. This problem is reduced in rebreathers because the soda lime reaction to remove carbon dioxide puts moisture back into the breathing gas. CO in the intake air cannot be stopped by any filter. where the intake of the compressor cannot be arbitrarily moved as far as desired from the engine and compressor exhausts. helping to prevent icing up. and these represent a more severe CO danger when introduced into a cylinder. and this is a particular problem on boats. open circuit diving can accelerate heat exhaustion because of dehydration. A more severe danger is that air particulates on boats and industrial areas. often contain carbon-particulate combustion products (these are what makes a dirt rag black). causing a dry mouth and throat and making the diver thirsty. which contains "organic" (carbon-containing) matter. This icing up in a regulator can cause moving parts to seize and the regulator to fail or free flow.  This is good for corrosion prevention in the cylinder but means that the diver inhales very dry gas. ordinary dust will be introduced to the cylinder. where cylinders are filled. • Inhaling oil mist can damage the lungs and ultimately cause the lungs to degenerate with severe lipid pneumonia or emphysema. Moisture content The process of compressing gas into a diving cylinder removes moisture from the gas.Breathing gas 5 Carbon dioxide Carbon dioxide (CO2) is produced by the metabolism in the human body and can cause carbon dioxide poisoning. They can enter diving cylinders as a result of contamination. . newly decompressed air. and the oil may (and usually will) then undergo combustion. It is also uncomfortable. common sources are:    See carbon monoxide poisoning. If the compressor air filter(s) fail. The exhausts of all internal combustion engines running on petroleum fuels contain some CO.   Carbon monoxide Carbon monoxide (CO) is produced by incomplete combustion. • Heating of lubricants inside the compressor may vaporize them sufficiently to be available to a compressor intake or intake system line. or due to incomplete combustion near the air intake. especially in cylinders which are used for hyperoxic gas mixtures. Another concern with regard to moisture content is the tendency of moisture to condense as the gas is decompressed while passing through the regulator. • A similar process is thought to potentially happen to any particulate material. quickly conducts heat from the surrounding water to the cold.     • They can act as a fuel in combustion increasing the risk of explosion. Since heavy oils don't burn well . with its good thermal conductive properties. and chrome plated (for protection). Brass. being ignited by the immense compression ratio and subsequent temperature rise.incomplete combustion will result in carbon monoxide production. • In some cases hydrocarbon lubricating oil may be drawn into the compressor's cylinder directly through damaged or worn seals. It is for this reason that SCUBA regulators are generally constructed from brass. Hydrocarbons Hydrocarbons (CxHy) are present in compressor lubricants and fuels.
NC: Divers Alert Network. OCLC 2068005.: 286.  Ackerman MJ. rubicon-foundation. mechanisms and prevention of the high pressure nervous syndrome" (http:/ / archive. . html).  Tech Diver. . Menduno. Drew. . . Diving and Hyperbaric Medicine. Res.  Rostain. org/ 4862). "Effects of inert gas narcosis on behavior--a critical review. (2003). United States Navy Experimental Diving Unit Technical Report NEDU-RR-01-61. Mouldey PG (2008). Retrieved 2010-01-13. Retrieved 2008-08-29. Retrieved 2008-08-29. United States: US Naval Sea Systems Command. org/ 6014)." (http:/ / archive. (eds). G (1985).  Fowler. PMID 1226588. org/ 3778).  Universal Industrial Gases. Retrieved 2008-08-29. Retrieved 2008-08-29. . References  Brubakk. T. (1985). Durham. "An evaluation of the equivalent air depth theory" (http:/ / archive.  Bowen. 2006. org/ 3019). org/ 2487). PMID 3212843. Undersea Biomed. "Cleaning and gas analysis for diving applications handbook. DeepTech..  Logan. "Effects of a H2-He-O2 mixture on the HPNS up to 450 msw." (http:/ / archive. rubicon-foundation. helium analyser. C. Maitland G (December 1975). 12 (4): 369–402.  Brauer RW (ed). "Closed-circuit oxygen diving in the U." (http:/ / archive. "Heliair: Poor man's mix" (http:/ / www. "Non-Cryogenic Air Separation Processes" (http:/ / www. com/ ezinefreearticles/ HeliairPoorMansMix. B. Airspeed Press. . "Oxygen toxicity: A brief history of oxygen in diving" (http:/ / archive. Chris (1999). Bennett and Elliott's physiology and medicine of diving. (1974). . "Equivalent air depth: fact or fiction" (http:/ / archive. Undersea Biomed. ISBN 0702025712. Electronic sensors exist for some gases. org/ 2738). Naquet. advanceddivermagazine. Oxygen Hacker's Companion. Curt. Michael R.  Butler FK (2004). Texas A&M University Sea Grant TAMU-SG-79-201." (http:/ / archive. rubicon-foundation. Res. J. OCLC 2068005. rubicon-foundation. JA (1961).  NAVSEA (2005). rubicon-foundation. Retrieved 2008-08-29. rubicon-foundation." (http:/ / archive. McCraken TM (December 1979). . Shreeves. Powell. pp. PMID 538866. Ackles.  Lang.  Hamilton Jr Robert W. "Proceedings of Rebreather Forum 2. 9th Undersea and Hyperbaric Medical Society Workshop. Tarrytown Labs LTD NY CRL-T-797. "Neon Decompression" (http:/ / archive. 5th Rev ed. Karl. "Compressed breathing air – the potential for evil from within.  Richardson.. Retrieved 2008-08-29. Undersea Biomed Res 2 (4): 305–10. W." (http:/ / archive. Retrieved 2008-08-29.  US Navy Diving Manual. ISSN 0093-5387. OCLC 2068005. pdf). . 33rd Undersea and Hyperbaric Medical Society Workshop. rubicon-foundation. PMID 4082343. . S. "Calculation of the relative speed of sound in a gas mixture" (http:/ / archive. ISSN 0093-5387. Undersea Hyperb Med 31 (1): 3–20. Bethesda. V (2002). pp. OCLC 16986801. Retrieved 2009-02-28. org/ 7563). (2001).   Oxygen analysers are commonly found underwater in rebreathers. Retrieved 2008-08-29.  Fife. (1996).  Acott. PMID 4619860. Retrieved 2008-08-29. ws/ exotic_gases. .. org/ 2661). org/ 2835). odourless and tasteless. M. rubicon-foundation. . Neuman (2003). M (1974). . Diving Science and Technology Workshop. Undersea Biomed Res 6 (4): 379–84. DAN Nitrox Workshop Proceedings (http:/ / archive. org/ 3835). Robert W. . Freitag. Retrieved 2008-08-29. Retrieved 2008-08-29. South Pacific Underwater Medicine Society Journal 29 (3). .. 800. rubicon-foundation. Lemaire. carbon monoxide detectors and carbon dioxide detectors. M. . org/ 00c3_publications. Undersea Biomed.  Berghage TE. rubicon-foundation. (Undersea and Hyperbaric Medical Society) (UHMS Publication Number 69(WS-HYD)3-1-87): 336 pages. ISSN 0093-5387. ISBN 0967887321. PMID 15233156. (South Pacific Underwater Medicine Society) 38: 145–51. shtml). KN. techdiver.  Millar IL. Retrieved 2008-08-29. rubicon-foundation. asp?destPage=00c3& pageID=3. rubicon-foundation. L. Retrieved 2008-08-29. "Exotic Gases" (http:/ / www. United States: Saunders Ltd. David J. B. 15 (4): 257–70. Gardette-Chauffour. pp.0. . org/ 4855). C.Breathing gas 6 Gas detection and measurement Divers find it difficult to detect most gases that are likely to be present in diving cylinders because they are colourless. Res. 197. such as oxygen analysers. William P (1979). com/ noncryo. 272. org/ 7964). . . "The causes. 6th revision (http:/ / www. uigi.  Hamilton Jr. Michael. rubicon-foundation. ISSN 0813-1988..  Hunger Jr. "The use of Non-Explosive mixtures of hydrogen and oxygen for diving". NAVSEA Technical Manual (NAVAL SEA SYSTEMS COMMAND) SS521-AK-HBK-010. A. (1988). P. Retrieved 2008-08-29.S. Inc. org/ 7555). Schreiner Hans R (eds) (1975). Bennett. R. Oxygen and helium analysers are often used on the surface during gas blending to determine the percentage of oxygen or helium in a breathing gas mix. 1 (1): 1–28. org/ 4498). Retrieved 2008-09-16.A. rubicon-foundation. . Porlier. O.  Harlow. "Hydrogen as a Diving Gas. Chemical and other types of gas detection methods are not often used in recreational diving. Retrieved 2008-08-29. Kenyon. org/ 3986). Navy" (http:/ / archive. rubicon-foundation. MD: Undersea and Hyperbaric Medical Society. supsalv. C. 9). Development of Decompression Procedures for Depths in Excess of 400 feet (http:/ / archive. Retrieved 2008-08-29.
westfalengassen. JM (2007).426" (http://www.altitude. Westfalen. org/ 2869). • OSHA. "Staged decompression to 3. org/ 6045).org. Undersea Biomed Res 7 (3): 199–209. E. Brooks AFB. Rokitka MA (March 1976). U. Stoltzfus. Balldin UI. .  Lambertsen. NASA. Retrieved 2008-08-29.gov/pls/oshaweb/owadisp. altitude. Smith LS (September 1980). MS. Krause KM (December 2003). TX School of Aerospace Medicine Technical Report SAM-TR-67-77.S. PMID 1273982. Institute for Environmental Medicine. "Separation of basic parameters of decompression using fingerling salmon" (http:/ / archive. rubicon-foundation. "Fact sheet on Divox" (http://www. Retrieved 2008-08-28. org/ 4861). Retrieved 2008-08-29. rubicon-foundation. Retrieved 2008-08-29. Webb JT.nl/technischegassen/divox/divox.pdf) (in Dutch). rubicon-foundation.Breathing gas  Rahn H. Occupational Safety & Health Administration. com/ content/ asma/ asem/ 2003/ 00000074/ 00000012/ art00004). . "Commercial Diving Regulations (Standards . J. PMID 14692466. "A Brief History Of Mixed Gas Diving" (http://www-personal. PA) IFEM Report No. KR.  Pilmanis AA. Retrieved 2008-08-29. rubicon-foundation. Shoffstall. Aviat Space Environ Med 74 (12): 1243–50. Johnson Space Center Technical Report NASA/TM-2007-213740. Department of Labor. ingentaconnect. Retrieved 2008-08-29. . rubicon-foundation. Undersea Biomed Res 3 (1): 25–34. 2-71. Stayton L.Mixed-gas diving." (http:/ / archive. "Narcotic potency of N2.htm). .1910. Environmental Biomedical Stress Data Center. .show_document?p_id=9986&p_table=STANDARDS).  Glatte Jr H. L. and N2O evaluated by the physical performance of mouse colonies at simulated depths" (http:/ / archive. (1971). "Carbon Dioxide Tolerance and Toxicity" (http:/ / archive. • Westfalen (2004). org/ 3861).  D'Aoust BG.29 CFR) . Retrieved 2008-08-29. Retrieved 2008-08-29.org/oxgyen_levels. org/ 2768). "Altitude oxygen calculator" (http://www.. A.edu/~lpt/mixhistory.org. J.. Retrieved 2008-08-29. C. Retrieved 2008-08-29. Welch B. . "Carbon Dioxide Tolerance Studies" (http:/ / archive. 7 External links • altitude. A. PMID 7423658.php). "Guide for Oxygen Compatibility Assessments on Oxygen Components and Systems. . .5 psi using argon-oxygen and 100% oxygen breathing mixtures" (http:/ / www. University of Pennsylvania Medical Center (Philadelphia. Motsay G.umich. • Taylor. osha.  Rosales. (1967).
there is a significantly higher chance of successful recovery. ICD-10 ICD-9 DiseasesDB eMedicine MeSH T70. and scuba divers use dive tables or dive computers to set limits on their exposure to pressure and their ascent speed. musculoskeletal system. with minor modifications.Decompression sickness 8 Decompression sickness Caisson disease [decompression sickness] Classification and external resources Two United States Navy sailors prepare for training inside a decompression chamber. and "Type II ('serious')" for symptoms where other organs (such as the central nervous system) are involved. Type II DCS is considered more serious and usually has worse outcomes.3 3491      emerg/121 C21. If treated early. Individual susceptibility can vary from day to day. flying in unpressurised aircraft.866. may still be used today. its potential severity is such that much research has gone into preventing it. introduced a simpler classification using the term "Type I ('simple')" for symptoms involving only the skin. Classification DCS is classified by symptoms. This system. "chokes" for breathing problems. the bends or caisson disease) describes a condition arising from dissolved gases coming out of solution into bubbles inside the body on depressurization. Although DCS is not a common event.120. DCS can produce many symptoms. and "staggers" for neurological problems. or lymphatic system. this classification is now much less useful in diagnosis.248 Decompression sickness (DCS. also known as divers' disease. and different individuals under the same conditions may be affected differently or not at all. Golding et al.3 993. and extra-vehicular activity from spacecraft. Following changes to treatment methods. . and both Type I and Type II DCS have the same initial management. and its effects may vary from joint pain and rashes to paralysis and death. Since bubbles can form in or migrate to any part of the body. Treatment is by hyperbaric oxygen therapy in a recompression chamber. In 1960. The earliest descriptions of DCS used the terms: "bends" for joint or skeletal pain. since neurological symptoms may develop after the initial presentation. The classification of types of DCS by its symptoms has evolved since its original description over a hundred years ago. DCS most commonly refers to a specific type of scuba diving hazard but may be experienced in other depressurisation events such as caisson working.
nausea. tingling or numbness paresthesia. Their spectra of symptoms also overlap. with the shoulder being the most common site. and ankles. DCS is most frequently observed in the shoulders. Skin manifestations are present in about 10% to 15% of cases. and upper torso Sensation of tiny insects crawling over the skin (formication) Mottled or marbled skin usually around the shoulders. whereas decompression sickness and arterial gas embolism are commonly classified together as decompression illness when a precise diagnosis cannot be made. arterial gas embolism. unconsciousness Ascending weakness or paralysis in the legs Girdling abdominal or chest pain Urinary incontinence and fecal incontinence Headache Unexplained fatigue Generalised malaise. The pain may be reduced by bending the joint to find a more comfortable position. The table below shows symptoms for different DCS types. Itching. pain can occur immediately or up to many hours later. If caused by altitude. increased sensitivity hyperesthesia Confusion or memory loss (amnesia) Visual abnormalities Unexplained mood or behaviour changes Seizures. elbows. knees.S. accompanied by tiny scar-like skin depressions (pitting edema) Altered sensation. • ankles) • • Cutaneous Skin • • • • Neurologic Brain • • • • • Neurologic Spinal cord • • • • • • • • • • • • Constitutional Whole body Audiovestibular Inner ear   Pulmonary Lungs . The U. although those from arterial gas embolism are generally more severe because they often arise from an infarction (blockage of blood supply and tissue death). vomiting Hearing loss Dry persistent cough Burning chest pain under the sternum. Active and passive motion of the joint aggravates the pain. hip. ranging from mild to excruciating. DCS and arterial gas embolism are treated very similarly because they are both the result of gas bubbles in the body. face. Navy prescribes identical treatment for Type II DCS and arterial gas embolism. shoulders. and barotrauma.Decompression sickness 9 Decompression illness and dysbarism The term dysbarism encompasses decompression sickness. poorly localised aches Loss of balance Dizziness. vertigo. Joint pain ("the bends") accounts for about 60% to 70% of all altitude DCS cases. but rarely a sharp pain. Pulmonary DCS ("the chokes") is very rare in divers and has been observed much less frequently in aviators since the introduction of oxygen pre-breathing protocols. with itching Swelling of the skin. knees. aggravated by breathing Shortness of breath Musculoskeletal Mostly large joints (elbows. Signs and symptoms While bubbles can form anywhere in the body. wrists. usually around the ears. Sometimes a dull ache. neck. upper chest and abdomen. Neurological symptoms are present in 10% to 15% of DCS cases with headache and visual disturbances the most common symptom. Signs and symptoms of decompression sickness DCS type Bubble location • Signs & symptoms (clinical manifestations) Localized deep pain. arms.
the rate and duration of gas absorption under pressure – the deeper or longer the dive the more gas is absorbed into body tissue in higher concentrations than normal (Henry's Law). Causes DCS is caused by a reduction in ambient pressure that results in the formation of bubbles of inert gases within tissues of the body. Two principal factors control the risk of a diver suffering DCS: 1. ascending from depth.   or types of symptom. the rate and duration of outgassing on depressurization – the faster the ascent and the shorter the interval between dives the less time there is for absorbed gas to be offloaded safely through the lungs. Even when the change in pressure causes no immediate symptoms. without ascending gradually and making the decompression stops needed to slowly reduce the excess pressure of inert gases dissolved in the body.Decompression sickness 10 Frequency Symptoms local joint pain arm symptoms leg symptoms dizziness paralysis shortness of breath extreme fatigue collapse/unconsciousness Frequency 89% 70% 30% 5. 2.3% 2.S.  DCS has been confirmed in rare cases of breath-holding divers who have made a sequence of many deep dives with short surface intervals.3% 0. causing these gases to come out of solution and form "micro bubbles" in the blood. Ascent from depth DCS is best known as a diving disorder that affects divers having breathed gas that is at a higher pressure than the surface pressure. owing to the pressure of the surrounding water. DON can develop from a single exposure to rapid decompression. . rapid pressure change can cause permanent bone injury called dysbaric osteonecrosis (DON). in more than half of all cases symptoms do not begin to present until over an hour following the dive.3% 1.6% 1. Navy and Technical Diving International. a leading technical diver training organization. Navy are as  follows: Although onset of DCS can occur rapidly after a dive. and it may be the cause of the disease called taravana by South Pacific island natives who for centuries have dived by breath-holding for food and pearls. or ascending to altitude. in extreme cases even before a dive has been completed. The risk of DCS increases when diving for extended periods or at greater depth. The U. The table does not differentiate between types of DCS. It may happen when leaving a high-pressure environment.S.5% Onset Time to onset within 1 hour within 3 hours within 8 hours within 24 hours within 48 hours Percentage of cases 42% 60% 83% 98% 100% The distribution of symptoms of DCS observed by the U. The specific risk factors are not well understood and some divers may be more susceptible than others under identical conditions. have published a table that indicates onset of first symptoms.
However. there is very little evidence of altitude DCS occurring among healthy individuals who have not been scuba diving at pressure altitudes below 5500 m (18000 ft). where caissons under pressure were used to keep water from The principal features of a caisson are the workspace. Although exposures to incremental altitudes above 5500 m (18000 ft) show an incremental risk of altitude DCS.   Altitude DCS became a common problem in the 1930s with the development of high-altitude balloon and aircraft flights. A US Air Force study of altitude DCS cases reported that 87% of incidents occurred at 7500 m (24600 ft) or higher. DCS is very rare in healthy individuals who experience pressures equivalent to this altitude. Workers spending supply.  There is no specific altitude threshold that can be considered safe for everyone and below which no one will develop altitude DCS. pressurised by an external air flooding the excavations. Ascent to altitude Passengers may be at risk of DCS when an unpressurized aircraft ascends to high altitude. in large engineering excavations below the water table. Also. there is increased risk for divers flying in any aircraft shortly after diving. The higher the altitude of exposure the greater is the risk of developing altitude DCS. since the pressure in the cabin is not actually maintained at sea-level pressure. this term was used in the 19th century. they do not show a direct relationship with the severity of the various types of DCS. Nevertheless. and the access tube with an airlock time in high-pressure atmospheric pressure conditions are at risk when they return to the lower pressure outside the caisson if the pressure surrounding them was not reduced slowly.Decompression sickness 11 Leaving a high-pressure environment When a worker comes out of a pressurized caisson or out of a mine that has been pressurized to keep water out.  A similar pressure reduction occurs when an astronaut exits a space vehicle to perform a space-walk or extra-vehicular activity. High altitude parachutists performing a HALO jump may develop altitude DCS if they do not flush nitrogen from the body by pre-breathing pure oxygen. allowing safe flights at 12000 m (39000 ft) or more. . Today. cabin pressurization systems still fail occasionally. they will experience a significant reduction in ambient pressure. and later during construction of the Brooklyn Bridge. when 15 workers died from what was then a mysterious illness. there is still a risk of DCS in individuals having dived recently. such as bridge supports and tunnels. since even in a pressurized aircraft the cabin pressure is not maintained at sea-level pressure but may drop to as low as 73% of sea level pressure. where it incapacitated the project leader Washington Roebling. cabin pressurization systems maintain commercial aircraft cabin pressure at the equivalent altitude of 2400 m (7900 ft) or less. where the pressure in his spacesuit is lower than the pressure in the vehicle. DCS was a major factor during construction of Eads Bridge. Individual exposures to pressure altitudes between 5500 m (18000 ft) and 7500 m (24600 ft) have shown a low occurrence of altitude DCS. and some people may be predisposed to the drop in pressure that occurs even in pressurized aircraft.    Likewise.    The original name for DCS was "caisson disease".
 • scuba diving before flying – divers who ascend to altitude soon after a dive increase their risk of developing DCS even if the dive itself was within the dive table safe limits. while recreational dive tables such as the Bühlmann tables require an ascent rate of 10 m/min (33 ft/min) with the last 6 m (20 ft) taking at least one minute. Repetitive ascents to altitudes above 5500 metres (18000 ft) within similar short periods increase the risk of developing altitude DCS. the pressure maintained inside even a pressurized aircraft may be as low as the pressure equivalent to an altitude of 2400 m (7900 ft) above sea level.  • the rate of ascent – the faster the ascent the greater the risk of developing DCS. especially to altitudes of 5500 m (18000 ft) and above. scuba divers in Eritrea who drive from the coast to the Asmara plateau at 2400 m (7900 ft) increase their risk of DCS. Therefore. and an otherwise-safe dive may then exceed the dive table limits. Longer flights. They may be considered as either environmental or individual.Decompression sickness 12 Predisposing factors Although the occurrence of DCS is not easily predictable. The US Navy Dive Manual indicates that ascent rates greater than about 20 m/min (66 ft/min) when diving increase the chance of DCS. An individual exposed to a rapid decompression (high rate of ascent) above 5500 metres (18000 ft) has a greater risk of altitude DCS than being exposed to the same altitude but at a lower rate of ascent. the assumption that the dive table surface interval occurs at normal atmospheric pressure is invalidated by flying during that surface interval.   • repetitive exposures – repetitive dives within a short period of time (a few hours) increase the risk of developing DCS. carry a greater risk of altitude DCS. the greater is the risk of DCS.  • the duration of exposure – the longer the duration of the dive.  Individual . Dive tables make provisions for post-dive time at surface level before flying to allow any residual excess nitrogen to outgas. many predisposing factors are known. Lake Titicaca is at 3800 m (12500 ft) — without using versions of decompression tables or dive computers that are modified for high-altitude. However. • diving at altitude – diving in water whose surface altitude is above 300 m (980 ft) — for example. for example.   • diving before travelling to altitude – DCS can occur without flying if the person moves to a high-altitude location on land immediately after scuba diving. Environmental The following environmental factors have been shown to increase the risk of DCS: • the magnitude of the pressure reduction ratio – a large pressure reduction ratio is more likely to cause DCS than a small one.
 • alcohol consumption and dehydration – although alcohol consumption increases dehydration and therefore may increase susceptibility to DCS. In about 20% of adults the flap does not completely seal. but stores about half of the total amount of nitrogen (about 1 litre) at normal pressures. . Atrial septal defect (PFO) showing left-to-right shunt.  Decompression sickness risk can be reduced by increased ambient temperature during decompression following dives in cold water. In the brain. Maintaining proper hydration is recommended.  This is due to nitrogen's five times greater solubility in fat than in water. In the arterial system. A right-to-left shunt may allow bubbles to pass into the arterial circulation.  • ambient temperature – there is some evidence suggesting that individual exposure to very cold ambient temperatures may increase the risk of altitude DCS. where the bubbles would otherwise be filtered out by the lung capillary system. leading to greater amounts of total body dissolved nitrogen during time at pressure. Studies by Walder concluded that decompression sickness could be reduced in aviators when the serum surface tension was raised by drinking isotonic saline. due to local loss of blood flow).  • previous injury – there is some indication that recent joint or limb injuries may predispose individuals to developing decompression-related bubbles. bubbles (arterial gas embolism) are far more dangerous because they block circulation and cause infarction (tissue death. Fat represents about 15–25 percent of a healthy adult's body. however. a person who has a high body fat content is at greater risk of DCS. and return directly to the arterial system (including arteries to the brain. and the high surface tension of water is generally regarded as helpful in controlling bubble size. and in the spinal cord it may result in paralysis. this can allow venous blood with microbubbles of inert gas to bypass the lungs.Decompression sickness 13 The following individual factors have been identified as possibly contributing to increased risk of DCS: • a person's age – there are some reports indicating a higher risk of altitude DCS with increasing age. • patent foramen ovale – a hole between the atrial chambers of the heart in the fetus is normally closed by a flap with the first breaths at birth. a 2005 study concluded that alcohol consumption did not increase the risk of DCS. spinal cord and heart). infarction results in stroke. In diving. • body type – typically. allowing blood through the hole when coughing or during activities that raise chest pressure.
a diver will switch to mixtures containing progressively less helium and more oxygen and nitrogen during the ascent. known as ebullism. but is about 4.  Bubbles may form whenever the body experiences a reduction in pressure. but.  If inert gas comes out of solution too quickly to allow outgassing in the lungs then bubbles may form in the blood or within the solid tissues of the body. chamber to avoid decompression sickness. sensory dysfunction. or death. Helium both enters and leaves the body faster than nitrogen. the amount of that gas dissolved in the liquid will also decrease proportionately. Breathing gas mixtures such as trimix and heliox include helium. which were dissolved under higher pressure.  A similar effect. Under normal conditions. while large numbers of bubbles in the venous blood can cause lung damage. resulting in an arterial gas embolism. but nitrogen is not the only gas that can cause DCS. The most severe types of DCS interrupt — and This surfacing diver must enter a decompression ultimately damage — spinal cord function.5 times more soluble. may occur during explosive decompression. such as a patent foramen ovale. Switching between gas mixtures that have very different fractions of nitrogen and helium can result in "fast" tissues (those tissues that have a good blood supply) actually increasing their total inert gas loading. These bubbles produce the symptoms of decompression sickness. it is preferred over nitrogen in gas mixtures for deep diving. venous bubbles may enter the arterial system. In the presence of a right-to-left shunt of the heart. when water vapour forms bubbles in body fluids due to a dramatic reduction in environmental pressure. The amount of gas dissolved in a liquid is described by Henry's Law. so different decompression schedules are required. Inert gases The main inert gas in air is nitrogen. which can also cause decompression sickness.Decompression sickness 14 Mechanism Depressurisation causes inert gases. as . On ascent from a dive. most offgassing occurs by gas exchange in the lungs. There is some debate as to the decompression requirements for helium during short-duration dives. leading to paralysis. when the pressure of a gas in contact with a liquid is decreased. Any inert gas that is breathed under pressure can form bubbles when the ambient pressure decreases. This is often found to provoke inner ear decompression sickness. since helium does not cause narcosis. Isobaric counterdiffusion Further information: Isobaric counterdiffusion DCS can also be caused at a constant ambient pressure when switching between gas mixtures containing different proportions of inert gas. however some groups like the WKPP have been pioneering the use of shorter decompression times by including deep stops. Nitrogen diffuses into tissues 2. to come out of physical solution and form gas bubbles within the body.65 times slower than helium. The formation of bubbles in the skin or joints results in milder symptoms. and presents a problem for very deep dives. after using a very helium-rich trimix at the deepest part of the dive. Most divers do longer decompressions. but not all bubbles result in DCS. inert gas comes out of solution in a process called "outgassing" or "offgassing". For example. which indicates that. This is known as isobaric counterdiffusion. Very deep dives have been made using hydrogen-oxygen mixtures (hydrox). but controlled decompression is still required to avoid DCS.
 Prevention Underwater diving To prevent the excess formation of bubbles that can lead to decompression sickness. they are not as good at determining the diagnosis as a proper history of the event and description of the symptoms. .Decompression sickness the ear seems particularly sensitive to this effect. 4. This will result in a shorter available time under water or an increased decompression time during the subsequent dive. but do not reduce it to zero. and remain at that depth until sufficient gas has been eliminated from the body to allow further ascent.  The decompression schedule may be derived from decompression tables.  Although MRI or CT can frequently identify bubbles in DCS. within 24 hours of diving. and tables will indicate the time at normal pressures that is required. 95% of all cases reported to Divers Alert Network had shown symptoms within 24 hours. or none at all. dive time. In 1995. These models. Reduction in decompression requirements can also be gained by breathing a nitrox mix during the dive. The algorithms used are designed to reduce the probability of DCS to a very low level. The total elimination of excess gas may take many hours. Following a decompression schedule does not completely protect against DCS. The diagnosis is confirmed if the symptoms are relieved by recompression. such as the Bühlmann decompression algorithm. whereas the likelihood of bubble formation depends on the difference between the inert gas partial pressure in the diver's body and the ambient pressure. and decompression information. Since divers on the surface after a dive still have excess inert gas in their bodies. 15 Diagnosis Decompression sickness should be suspected if any of the symptoms associated with the condition occurs following a drop in pressure. any subsequent dive before this excess is fully eliminated needs to modify the schedule to take account of the residual gas load from the previous dive. Each of these is termed a "decompression stop". divers limit their ascent rate to about 10 metres (33 ft) per minute. but divers usually schedule a short "safety stop" at 3 metres (10 ft). An alternative diagnosis should be suspected if severe symptoms begin more than six hours following decompression without an altitude exposure or if any symptom occurs more than 24 hours after surfacing. and these are The display of a basic personal dive computer commonly based upon a mathematical model of the body's uptake and shows depth. are designed to fit empirical data and provide a decompression schedule for a given depth and dive duration. release of inert gas as pressure changes. Decompression time can be significantly shortened by breathing mixtures containing much less inert gas during the decompression phase of the dive (or pure oxygen at stops in 6 metres (20 ft) of water or less). This schedule requires the diver to ascend to a particular depth. decompression software. depending on the training agency. and carry out a decompression schedule as necessary. and a schedule for a given bottom time and depth may contain one or more stops. Dives that contain no decompression stops are called "no-stop dives".6 metres (15 ft). or from dive computers. in particular. or 6 metres (20 ft). which may be up to 18 hours. since less nitrogen will be taken into the body than during the same dive done on air. The reason is that the inert gas outgases at a rate proportional to the difference between the partial pressure of inert gas in the diver's body and its partial pressure in the breathing gas.
   Oxygen first aid has been used as an emergency treatment for diving injuries for years. Neurological symptoms. breathing pure oxygen during flight alone (ascent.70 bar). it is recommended that these cases still be evaluated.30 bar). 10. although research has examined the possibility of using 100% O2 at 9. but are no longer recommended for extended periods. Treatment Further information: Hyperbaric medicine All cases of decompression sickness should be treated initially with 100% oxygen until hyperbaric oxygen therapy (100% oxygen delivered in a high-pressure chamber) can be provided. which operate at 4. spending eight sleeping hours in the Quest airlock chamber before their spacewalk. Astronauts aboard the International Space Station preparing for extra-vehicular activity (EVA) "camp out" at low atmospheric pressure. Therefore.  . it is logistically complicated and expensive for the protection of civil aviation flyers. It is no longer recommended to administer aspirin. During the EVA they breathe 100% oxygen in their spacesuits. It is also used by flight test crews involved with certifying aircraft.3 psi (0. Most fully closed-circuit rebreathers can deliver sustained high concentrations of oxygen-rich breathing gas and could be used as a means of supplying oxygen if dedicated equipment is not available. and mottled or marbled skin lesions should be treated with hyperbaric oxygen therapy if seen within 10 to 14 days of development.66 bar) in the suits to lessen the pressure reduction.5 psi (0. or the recovery position if vomiting occurs. it increases the success of recompression therapy as well as a decrease the number of recompression treatments required. Recompression is normally carried out in a recompression chamber. both the Trendelenburg position and the left lateral decubitus position (Durant's maneuver) have been suggested as beneficial where air emboli are suspected. Evidence of the effectiveness of recompression therapy utilizing oxygen was first shown by Yarbrough and Behnke. pulmonary symptoms. provides effective protection upon exposure to low-barometric pressure environments. it is currently used only by military flight crews and astronauts for protection during high-altitude and space operations.  However. and hence the risk of DCS. It is beneficial to give fluids. unless advised to do so by medical personnel. as this helps reduce dehydration. owing to concerns regarding cerebral edema. either commercial or private. however. descent) does not decrease the risk of altitude DCS.2 psi (0. People should be made comfortable and placed in the supine position (horizontal). The recompression chamber at the Neutral Buoyancy Lab. and has since become the standard of care for treatment of DCS.  Although pure oxygen pre-breathing is an effective method to protect against altitude DCS. Mild cases of the "bends" and some skin symptoms may disappear during descent from high altitude. en route. At a dive site. a riskier alternative is in-water recompression. In the past. if continued without interruption. as analgesics may mask symptoms. Recompression on room air was shown to be an effective treatment for minor DCS symptoms by Keays in 1909. Breathing pure oxygen significantly reduces the nitrogen loads in body tissues and. If given within the first four hours of surfacing.Decompression sickness 16 Exposure to altitude One of the most significant breakthroughs in the prevention of altitude DCS is oxygen pre-breathing.
 DCS affects approximately 1. Explanations at the time included: cold or exhaustion causing reflex spinal cord damage.8 cases per 10. "not a man escaped the repeated attacks of rheumatism and cold". Three-month follow-ups on diving accidents reported to DAN in 1987 showed 14. The Eads Bridge where 42 workers were injured by caisson disease • 1872: The similarity between decompression sickness and iatrogenic air embolism as well as the relationship between inadequate decompression and decompression sickness was noted by Friedburg. and recompression treatment for severe cases. followed by recompression in a hyperbaric chamber. from which 28 recompressions were required — although these will almost certainly contain incidents of arterial gas embolism (AGE) — a rate of about 0. The project chief engineer Washington Roebling suffered from caisson disease. scuba divers per year. Jaminet developed decompression sickness and his personal description was the first such recorded. Alphonse Jaminet as the physician in charge. • 1870: Bauer published outcomes of 25 paralyzed caisson workers. Recompression treatment was not used. • 1871: The Eads Bridge in St Louis employed 352 compressed air workers including Dr.  The project employed 600 compressed air workers.3% of the 268 divers surveyed "still had residual signs and symptoms from Type II DCS and 7% from Type I DCS". four-hour working shifts. using only healthy workers. This description of a viper in a vacuum was the first recorded description of decompression sickness. Emily. He battled the after-effects of the disease for the rest of his life. He suggested that intravascular gas was released by rapid decompression and recommended: slow compression and decompression.000 U. From 1998 to 2002. In 1999. Dr. During this project. with the risk 2.Decompression sickness 17 Prognosis Immediate treatment with 100% oxygen. (He took charge after his father John Augustus Roebling died of tetanus.05%. the Divers Alert Network (DAN) created "Project Dive Exploration" to collect data on dive profiles and incidents. decompression sickness became known as "The [Grecian] Bends" because afflicted individuals characteristically . • 1769: Giovanni Morgagni described the post mortem findings of air in cerebral circulation and surmised that this was the cause of death. estimated at 2. electricity cause by friction on compression. commented that. • 1840: Colonel William Pasley.150 dives.6 times greater for males than females. they recorded 50. There were 30 seriously injured and 12 fatalities.  Long-term follow-ups showed similar results. Epidemiology The incidence of decompression sickness is rare. However. or organ congestion.) Washington's wife. Andrew Smith first utilized the term "caisson disease" describing 110 cases of decompression sickness as the physician in charge during construction of the Brooklyn Bridge. will in most cases result in no long term effects. helped manage the construction of the bridge after his sickness confined him to his home in Brooklyn. of those having made frequent dives. with 16% having permanent neurological sequelae. • 1873: Dr.000 dives.  History • 1670: Robert Boyle demonstrated that a reduction in ambient pressure could lead to bubble formation in living tissue. permanent long-term injury from DCS is possible. who was involved in the recovery of the sunken warship HMS Royal George. reported by a mining engineer who observed pain and muscle cramps among coal miners working in mine shafts air-pressurized to keep water out. all prominent features were established. and vascular stasis caused by decompression.1 psig (4 ATA). limit to maximum depth 44. From 1870 to 1910.S. • 1841: First documented case of decompression sickness.
a personal dive computer. 1957: Robert Workman established a new method for calculation of decompression requirements (M-values). treatment of DCS is provided by the National Health Service. or as historian David McCullough asserts in The Great Bridge it was a crude reference to "Greek" or anal sex.  Hill advocated linear or uniform decompression profiles. This is because scuba diving is considered an elective and "high-risk" activity and treatment for decompression sickness is expensive. using a microprocessor to calculate nitrogen absorption for twelve tissue compartments. experimented with oxygen for recompression therapy. A typical stay in a recompression chamber will easily cost several thousand dollars. As a result. Society and culture Economics In the United States. • 1924: The US Navy published the first standardized recompression procedure. 1983: Orca produced the "EDGE". Boycott and Damant recommending staged decompression. • 1900: Leonard Hill used a frog model to prove that decompression causes bubbles and that recompression resolves them. His work was financed by Augustus Siebe and the Siebe Gorman Company. 1960: FC Golding et al. Louis D Homer and Edward T Flynn introduce survival analysis into the study of decompression sickness. 1941: Altitude DCS is treated with hyperbaric oxygen for the first time. even before emergency transportation is included. either at a specialised facility or at a Hyperbaric Centre based within a general hospital.   • • • • • • • • 18 An early recompression chamber 1937: Behnke introduced the “no-stop” decompression tables." which detailed his deterministic model for calculation of decompression schedules. • 1930s: Albert R Behnke separated the symptoms of Arterial Gas Embolism (AGE) from those of DCS. was introduced. 1984: Albert A Bühlmann released his book "Decompression-Decompression Sickness. These tables were accepted for use by the Royal Navy. groups such as Divers Alert Network (DAN) offer medical insurance policies that specifically cover all aspects of treatment for decompression sickness at rates of less than $100 per year. a submersible mechanical device that simulated nitrogen uptake and release.  This type of decompression is used today by saturation divers. split the classification of DCS into Type 1 and 2. it is common for medical insurance not to cover treatment for the bends that is the result of recreational diving.Decompression sickness arched their backs: this is possibly reminiscent of a then fashionable women's dance maneuver known as the Grecian Bend. 1982: Paul K Weathersby. 1959: The "SOS Decompression Meter". • 1908: "The Prevention of Compressed Air Illness" was published by JS Haldane. • 1935: Behnke et al. . In the United Kingdom.
 Elliott. gov/ cgi/ mesh/ 2011/ MB_cgi?mode=& term=Decompression+ Sickness& field=entry#TreeC21. Mitchell. RL. . Retrieved 18 May 2010. Conkin. U. Richard D. doi:10. OCLC 26915585.S. ISSN 0813-1988. U. ISBN 978-0-7817-2898-0. US Air Force Technical Report AL-SR-1992-0005. "The Physiological Basis of Decompression" (http:/ / archive. 1908  Francis & Mitchell p. org/ 6853).S.  Butler. . 20–25. 248 Francis & Mitchell p. JR (2002). Retrieved 18 May 2010. Retrieved 18 May 2010. "Biophysical basis for inner ear decompression sickness" (http:/ / jap. 37.2002 (inactive 7 January 2010). South Pacific Underwater Medicine Society Journal 29 (1). pdf). rubicon-foundation. PMID 15686275. rubicon-foundation. Naval Sea Systems Command. org. jsc. "Caisson disease during the construction of the Eads and Brooklyn Bridges: A review" (http:/ / archive. ISSN 1066-2936. rubicon-foundation. David H (1999). . 71  Francis & Mitchell pp. com/ getICD9Code. David J. rubicon-foundation. "Taravana revisited: Decompression illness after breath-hold diving" (http:/ / archive. Petar J.01090. Stephen A (27 November 2007). gov/ collections/ TRS/ _techrep/ TM-1999-209374. org/ 1002). "Chapter 20: Diagnosis and Treatment of Decompression Sickness and Arterial Gas Embolism" (http:/ / supsalv. Retrieved 15 May 2010. WP (2004). Navy Supervisor of Diving (2008) (PDF). org/ 4027). int/ classifications/ apps/ icd/ icd10online/ ?gt66.1152/japplphysiol. pdf) (PDF).S. and Environmental Medicine 55 (12): 1097–1102. Hitoshi (February 1974). "Describing Decompression Illness" (http:/ / archive. "The Proceedings of the Hypobaric Decompression Sickness Workshop" (http:/ / archive. OCLC 16986801.  Powell p. Undersea and Hyperbaric Medicine 31 (4): 431–44. . org/ 6010). rubicon-foundation. nlm. 75(Phys)6-1-89: 437. 38th Undersea and Hyperbaric Medical Society Workshop. Richard D (1995). Retrieved 18 May 2010. "Bone lesions in divers" (http:/ / www. Retrieved 15 May 2010. OCLC 16986801.S. Fundamentals Of Aerospace Medicine: Translating Research Into Clinical Applications (3rd Rev ed. emedicine. Johnny. Retrieved 30 May 2010. Undersea and Hyperbaric Medicine Abstract 28 (Supplement). . p. "Statistical Bubble Dynamics Algorithms for Assessment of Altitude Decompression Sickness Incidence" (http:/ / archive. 578 Pulley. Simon J (2003). nih. vol. Vann. . "Decompression Sickness" (http:/ / emedicine. NASA STI Report Series NASA/TM—1999–209374. PMID 15686274.  Marx p. Aviation. rubicon-foundation. Dervay. 42nd Undersea and Hyperbaric Medical Society Workshop 79(DECO)5-15-91. org/ cgi/ content/ full/ 94/ 6/ 2145).  TDI Decompression Procedures Manual (Rev 1c). org/ pdf/ DiveMan_rev6. Yoshimi. Edward D (2004). ashx?icd9=993. Journal of Bone and Joint Surgery (British Editorial Society of Bone and Joint Surgery) 56B (1): 3–15. htm+ t703 http:/ / www. . BJ (2001). "A theoretical method for selecting space craft and space suit atmospheres". page 38  Vann. United States: Lippincott Williams And Wilkins. pdf) (PDF). Journal of Applied Physiology 94 (6): 2145–50.  Dehart. Retrieved 18 May 2010. Gerth. . DeNoble. Two of the best-recorded instances of it both occurred at Boesmansgat. org/ 5988).5. revision 6. Retrieved 18 May 2010.  Lippmann & Mitchell pp. . jbjs. Retrieved 18 May 2010. Retrieved 18 May 2010. Navy Diving Manual (http:/ / supsalv.  Benton. physiology. Space. PMID 12562679. T James R.). Smith. SS521-AG-PRO-010. Carl F.Decompression sickness 19 Footnotes        http:/ / apps.  Francis & Mitchell p. . com/ emerg/ topic121. Wayne A. U. Andrew A (1990). . who. . Wayne A. Medscape. SS521-AG-PRO-010. South Africa — once to Nuno Gomes in an early world record attempt. Matsunaga. 3 http:/ / www. Retrieved 15 May 2010.  Vann. 70  U.  Powell p. Undersea and Hyperbaric Medicine 31 (4): 445–59.  Inner ear counter diffusion is a rare form of DCS sometimes experienced by divers engaged in extreme deep diving.  Vann. OCLC 26915585. "Early Decompression experience: Compressed air work" (http:/ / archive. volume 5. US Air Force Technical Report TR-1995-0037. icd9data. org/ 4499). Navy Diving Manual. ISSN 0813-1988. 120. caused by helium being released from the tissues but blocked by heavier nitrogen molecules. 579  Francis. uk/ cgi/ content/ abstract/ 56-B/ 1/ 3). com/ article/ 769717-overview). ISSN 0095-6562. revision 6. Pieper. JR (1984). nasa. rubicon-foundation. Navy Supervisor of Diving (2008). PMID 6151391. ed (1989). org/ pdf/ DiveMan_rev6.S. . DJ (1991).  Wong. com/ ddb3491. 580  U. Richard D.  Gerth. who had been one of Gomes's support divers. . RM (1999).  Pilmanis. and later to Don Shirley when he tried to rescue David Shaw on his fateful dive trying to recover the body of Deon Dreyer. org/ 4028). htm http:/ / www. p. "An Evidenced-Based Approach for Estimating Decompression Sickness Risk in Aircraft Operations" (http:/ / ston. diseasesdatabase. Richard D. 65–66  Ohta. Retrieved 23 May 2010. Retrieved 15 May 2010. org/ 4102). "Acute Decompression Illness (DCI): the Significance of Provocative Dive Profiles" (http:/ / archive. Torre-Bueno. Retrieved 18 May 2010. rubicon-foundation.S. 866. RR. rubicon-foundation. Naval Sea Systems Command. . JP. Davis. 578–584  Doolette. "Experimental trials to assess the risks of decompression sickness in flying after diving" (http:/ / archive. htm http:/ / www. U. Thalmann.  Robinson. 720. South Pacific Underwater Medicine Society Journal 29 (3). org/ 5892). ISSN 1066-2936. . medscape. pp.
OCLC 51607923. England: Technivision Services. BC. United States: Divers Alert Network. Melchor J (14 July 2005). PMID 1226585. ISBN 978-0-85102-023-5. PMID 14620473. rubicon-foundation. "Hydrogen as a Diving Gas" (http:/ / archive. ed (1985). Vann. Subatmospheric decompression sickness in man.1017/S0022172400015862. 127.Decompression sickness  Powell. Eric P (1975). Retrieved 23 May 2010. org/ 1181). JCC (1908).  Kindwall. Antuñano. Retrieved 30 July 2010. SM. OCLC 2068005. ISSN 1066-2936. . "Measurement of helium elimination from man during decompression breathing air or oxygen" (http:/ / archive. Blogg. . Brubakk. Retrieved 18 May 2010. Edward T (2007). Retrieved 18 May 2010. DI (1969). pdf). L. Presented at the Annual Meeting of the Research Society on Alcoholism.  Lippmann & Mitchell p. Flying After Diving Workshop. ISSN 0813-1988. "Influence of bottom time on preflight surface intervals before flying after diving" (http:/ / archive.  Francis & Mitchell pp. Michael J. Space. "Alcohol use in scuba divers treated for diving injuries: A comparison of decompression sickness and arterial gas embolism" (http:/ / depts. 501. Alcoholism: Clinical and Experimental Research (29 (Suppl. Bruce R. .  Brauer. Bennett and Elliott's physiology and medicine of diving. .  Lippmann & Mitchell p. Pollock. org/ 3867). 79  Egi. Denoble. Lanphier.  Fife. com/ vacuum. VL. . rubicon-foundation. Defence R&D Canada (DRDC) Technical Report DCIEM-73-CP-960. John J. org/ 2194). KN (1973). "10. RGBM Technical Series 9. .  Walder. rubicon-foundation. 475  Wienke. California. . faa. Texas A&M University Sea Grant TAMU-SG-79-201. .  Hamilton & Thalmann p. ingentaconnect. 157A). Gerth. geoffreylandis. org/ 4531). Tom S. Baz. D. Wayne A. AE. Retrieved 27 June 2010. PMID 17672177. Retrieved 27 June 2010. Undersea Biomedical Research 2 (4): 285–297. Brubakk. . . com/ content/ asma/ asem/ 2003/ 00000074/ 00000011/ art00006). EN. tek-dive. Peter (2007). org/ 5611). Thalmann. 70  Ackles. . "Risk of decompression sickness during exposure to high cabin altitude after diving" (http:/ / www. In Brubakk. Edward D. Ruterbusch. org/ 5136). Undersea and Hyperbaric Medicine 34 (3): 211–20. ISSN 1066-2936. Carl F (2007). . ISBN 0-9673066-4-7. 477 20 . "A case of high doppler scores during altitude decompression in a subject with a fractured arm" (http:/ / archive. Natoli. Pieper. rubicon-foundation. Geoffrey A (19 March 2009). Undersea and Hyperbaric Medicine 22 (3): 281–300. "Experiments on the influence of fatness on susceptibility to caisson disease". Freiberger. Retrieved 23 May 2010.  Lippmann & Mitchell p.  Leigh. Neal W. and Environmental Medicine 74 (11): 1163–68. Federal Aviation Administration. Journal of Hygiene (Cambridge University Press) 8 (4): 445–56. Retrieved 18 May 2010. Aviation. JR. Linnarson. Richard D (2002). Undersea and Hyperbaric Medicine Supplement (abstract). 71  Moon. Undersea Hyperbaric Medicine 34 (Supplement). "Altitude-Induced Decompression Sickness" (http:/ / www. Royal Air Force Technical Report. 232  Bassett. . OCLC 26915585. Richard G (2005). United States Navy Experimental Diving Unit Technical Report NEDU-TR-06-07. Florida: NAUI Technical Diving Operations. Ron Y. "The Surface Tension of the Blood Serum in 'Bends'". . United States: Saunders Ltd. Lightfoot. washington. Joseph (1998). O'Leary. Dennis N (1945). ISSN 0093-5387. Petar J. "The Influence of Thermal Exposure on Diver Susceptibility to Decompression Sickness" (http:/ / archive.  Lippmann & Mitchell p. . rubicon-foundation. p. Olav S (2003). Dunford. Seireg. rubicon-foundation. Retrieved 23 May 2010. Tampa. US Air Force School of Aerospace Medicine Technical Report SAM-TR-82-47.  Kindwall. rubicon-foundation. Long. Michael J. Proceedings of the DAN 2002 Workshop (http:/ / archive. PMID 1226586. org/ 7343). RW. Neal W. Michael R (2002). pdf).  Fryer. William P (1979). Wayne A. South Pacific Underwater Medicine Society Journal 28 (3). rubicon-foundation. "The use of Non-Explosive mixtures of hydrogen and oxygen for diving".  Vann. 343. org/ 4862). Damant.  Sheffield. OCLC 16986801. June 2005. "Diving at altitude: a review of decompression strategies" (http:/ / archive. gov/ pilots/ safety/ pilotsafetybrochures/ media/ dcs. rubicon-foundation. Timothy R (10 October 2002).  Nishi.  Hamilton & Thalmann p.  Karlsson. Gennser. OCLC 2068005. ISBN 0-7020-2571-2.). . . Undersea Biomedical Research 2 (4): 277–284. Retrieved 18 May 2010. Alf O. Retrieved 23 May 2010. PMC 2167151. Richard D. Retrieved 18 May 2010. PMID 20474366. PMID 7580768. M. Lindholm. com/ portal/ upload/ deep. "Nitrogen elimination in man during decompression" (http:/ / archive. "Decompression limits in commercial aircraft cabins with forced descent" (http:/ / archive. org/ 2741). html). SL. Kisslo. Retrieved 18 May 2010. "PFO and decompression illness: An update" (http:/ / archive. Retrieved 18 May 2010. org/ 5063). Santa Barbara. p.  Boycott.  Brown. Edward H. Eftedal. "Deep stops and deep helium" (http:/ / www. rubicon-foundation. 33rd Undersea and Hyperbaric Medical Society Workshop (Undersea and Hyperbaric Medical Society) (UHMS Publication Number 69(WS–HYD)3–1–87). "Decompression Procedures for Flying After Diving. Richard D (November 2003). AM-400-95/2. A. 5th Revised edition. Retrieved 18 May 2010.3: Bubble Detection". Neuman. rubicon-foundation. rubicon-foundation. Paul J. Eric P. 580–41  Landis. "Explosive Decompression and Vacuum Exposure" (http:/ / www. Alf O. p. Retrieved 18 May 2010. doi:10. ISSN 0093-5387. pdf). org/ 5949). OCLC 26915585. edu/ adai/ pubs/ pres/ LeighRSAPoster. Bruce E (1982). and Diving at Altitudes above Sea Level" (http:/ / archive.  Gerth. Richard E. Vann. Alf O (1995). Natoli. A (1975). org/ 2742). "Blood-Bubble Interaction in Decompression Sickness" (http:/ / archive.  Pollock.
. PT (1989). Retrieved 30 May 2010. Steve (December 2004). Thomas E. 108. Richard D. James. . Richard E. Merk Sharp and Dohme. . Divers Alert Network. Moon.  "Project Dive Exploration: Project Overview" (http:/ / www. rubicon-foundation. Barnard. rubicon-foundation. G. Dovenbarger. Youngblood. . Divers Alert Network. with a report of 3. OCLC 26915585. BSAC tables have a safety stop at 6 metres (20 ft). Albert R (1939). "Human tolerance to 100% oxygen at 9. Retrieved 2008-04-05. . Vorosmarti Jr. "Air embolism" (http:/ / cmbi. . 48th Undersea and Hyperbaric Medical Society Workshop (http:/ / archive. Peking University. 45th Undersea and Hyperbaric Medical Society Workshop" (http:/ / archive. htm). org/ 5990). South Pacific Underwater Medicine Society Journal 28 (1). ISSN 0095-9030. Proceedings XV Meeting European Undersea Biomedical Society: 209.  Marx p.  Moon. rubicon-foundation. merck. rubicon-foundation. OCLC 16986801. Chris (1999). "The treatment of compressed air illness using oxygen". PMID 2730484. Retrieved 26 June 2010. . . James T. Richard E. 616  Longphre. "Compressed air illness. org/ 4269). Mark A (October 2000).  Berghage. 471  Hamilton & Thalmann p. AquaCorp 11.  Hamilton & Thalmann p. org/ 5919).  Pyle. Divers Alert Network.  Bennett. 456–57  Hamilton & Thalmann pp. com/ mmpe/ sec21/ ch323/ ch323c. org/ 4261). rubicon-foundation. org/ 3414).Decompression sickness  Burton. Retrieved 25 May 2010. rubicon-foundation. "Preflight Interview: Joe Tanner" (http:/ / www. Edmond. rubicon-foundation. html). edu. . Retrieved 25 May 2010. "First aid normobaric oxygen for the treatment of recreational diving injuries" (http:/ / archive. Petar J. Report on Diving Accidents and Fatalities in 1995 (http:/ / archive. ISSN 0813-1988. Joel A. "What is Bends?". Merrill P (1999). Spencer. PMID 17393938. diversalertnetwork. . Undersea and Hyperbaric Medicine 34 (1): 43–49. Bühlmann tables have a safety stop at 3 metres (9. Epidemiology of Bends (http:/ / archive. Retrieved 25 May 2010. org/ 7782).6 m). rubicon-foundation. .  Edmonds.  Moon. Dixon. . bjmu. . David A (1995). org/ 5514). . FJ (1909). ScubaEngineer. "Decompression Illness: What Is It and What Is The Treatment?" (http:/ / www. 43rd Undersea and Hyperbaric Medical Society Workshop (Undersea and Hyperbaric Medical Society) 80(BENDS)6-1-91: 13–20. South Pacific Underwater Medicine Society Journal 25 (3). . . UHMS Publication Number WD712 (Undersea and Hyperbaric Medical Society): 426. html). Retrieved 23 May 2010. Department of Medicine Publications of Cornell University Medical College 2: 1–55. In Nashimoto. Richard E (1998). NASA. rubicon-foundation. org/ 5629). Retrieved 3 August 2010. ISSN 0813-1988. Merck Manual Professional. Peter B. Report on Decompression Illness and Diving Fatalities (1988) (http:/ / archive. scubaengineer. Steve (2003). Retrieved 25 May 2010. John M. Journal of industrial hygiene and toxicology 21: 213–18. Edward D (March/April 2004). Aviation Space and Environmental Medicine 60 (5): 415–21. "Assessment of patients with decompression illness" (http:/ / archive.  Divers Alert Network (1997). p. Amiko (2006). Kelley. htm). eds (1996). org/ 7999). 1813  Keays. OD.  O'Dowd. 456  Nevills. RW. OCLC 16986801. asp?articleid=65). Paul J. "Rebreathers" (http:/ / archive. "Isobaric Counter Diffusion" (http:/ / www. org/ research/ projects/ pde/ overview. In water recompression. Corson. "Epidemiological review of 276 dysbaric diving accidents". Divers Alert Network. "Arterial Gas Embolism: Injury During Diving or Work in Compressed Air" (http:/ / www.692 cases". diversalertnetwork. Retrieved 30 May 2010. "In-water Recompression as an emergency field treatment of decompression illness" (http:/ / archive. com/ isobaric_counter_diffusion. EH. org/ 7997). .  Moon & Gorman p. 1912  Marx p. "The diving "Law-ers": A brief resume of their lives" (http:/ / archive. Retrieved 21 . Sheffield.  Acott. Karen (1991). Retrieved 25 May 2010. I.8 ft)  Hamilton & Thalmann pp. "Underwater oxygen for treatment of decompression sickness: A review" (http:/ / archive. rubicon-foundation.  Goble. Behnke. South Pacific Underwater Medicine Society Journal (South Pacific Underwater Medicine Society) 29 (1). asp). org/ 6083). "Treatment of Decompression Illness. Alfred A (April 2009). gov/ mission_pages/ shuttle/ shuttlemissions/ sts115/ interview_tanner. Retrieved 25 July 2010. Retrieved 8 August 2010. US Naval Medical Research Center Technical Report NMRI-78-16. Retrieved 23 May 2010.  Dovenbarger. Vann. Olson. org/ medical/ articles/ article. .  Bove. Carl (1998). Chinese Medical Biotechnology Information Network. org/ 6428).  Webb. RM.  Kay. 471–73  Hamilton & Thalmann pp. "Recompression treatment tables used throughout the world by government and industry" (http:/ / archive. 2010. 455  Tables based on US Navy tables have a safety stop at 15 feet (4. Richard L. Joel A (1988). Retrieved 10 January 2010.  Thalmann. rubicon-foundation.  Desola. Barnicott. DeNoble. Krutz. Liza C. nasa. J (1989). EEP (1978). rubicon-foundation. cn/ uptodate/ critical care/ embolic disease/ air embolism. John J (2007). United States: Undersea and Hyperbaric Medical Society. Retrieved 8 August 2010.5 psia during five daily simulated 8-hour EVA exposures". 474–75  Hamilton & Thalmann p.  Yarbrough. Freiberger. Journal of the South Pacific Underwater Medicine Society 33 (2): 98–102. Lanphier. Retrieved 30 May 2010. ISSN 1066-2936.
British Journal of Industrial Medicine 17 (3): 167–80. Australia: J L Publications. Retrieved 30 May 2010. Richard E. Messer. AE. Bennett and Elliott's physiology and medicine of diving (5th Revised ed. org/ cgi/ pmidlookup?view=long& pmid=6490468). Paul K. physiology. org/ 3458). F Campbell. Tom S. pp. Bennett and Elliott's physiology and medicine of diving (5th Revised ed. Bennett and Elliott's physiology and medicine of diving (5th Revised ed. 1936).). PMID 13850667. Simon J (2003). "10. Alf O. ISBN 0-387-13308-9. In Brubakk. Retrieved 2009-04-27. OCLC 16986801. Daryl. Griffiths. google. Mitchell. physiology. "The circulatory and respiratory disturbances of acute compressed-air illness and the administration of oxygen as a therapeutic measure" (http:/ / ajplegacy. "Altitude decompression sickness: hyperbaric therapy results in 145 cases". T James R.  Weathersby.  Bühlmann. 22 References Bibliography • Hamilton. London Hyperbaric Ltd. ISBN 0-7020-2571-2. PMID 20474365. Anderson GK (August 1977). The Great Bridge: The Epic Story of the Building of the Brooklyn Bridge (http:/ / www. Robert W. Flynn. United States: Saunders Ltd. John. Alf O. Heimbach RD.  Thalmann. Simon J (2003). T James R.1017/S0022172400003399. Homer.). Walder. pp. P. GCC. Retrieved 30 May 2010. Americal Journal of Physiology 114 (3): 526–533. Retrieved 22 August 2011.  McCullough. ISBN 1-113-96529-0. doi:10. asp?theid=1212). rubicon-foundation. Leonard Erskine (1912).  Davis Jefferson C. Retrieved 30 May 2010. Mitchell. Bennett and Elliott's physiology and medicine of diving (5th Revised ed. rubicon-foundation. In Brubakk.  Acott. Deeper into Diving (2nd ed. org/ cgi/ content/ citation/ 114/ 3/ 526). Principles of U. OCLC 51607923. Neuman. . Chris (1999). pp. PMC 1038052. • Moon. com/ departments/ gearingup/ accessories/ may00_computer. Des F (2003). .  Carson. asp). and Environmental Medicine 48 (8): 722–30.  "NHS Funded Treatment" (http:/ / www. skin-diver. 578–99. "10. Albert R. OCLC 51607923. ISBN 0-7020-2571-2. . Retrieved 30 May 2010. Shaw. . PMID 6490468. DN (July 1960). diversalertnetwork. . Retrieved 30 May 2010. Navy Experimental Diving Unit Technical Report NEDU-RR-11-57. 1903  Smith. In Brubakk. Davis. United States: Saunders Ltd.). The Physiological. "10. Dunn JM. Simon & Schuster. "Decompression sickness during construction of the Dartford Tunnel".). . ISSN 0813-1988. "Diving Accident Management". ISBN 0-7020-2571-2. • Francis. HV. In Brubakk. Edward D (1990). Aviation. Thalmann.). WDM. Damant. "Calculation of air saturation decompression tables" (http:/ / archive. 2003. United States: Saunders Ltd. .  Boycott. London: Arnold. Skin-Diver. ISBN 0-7432-1737-3. Space. com/ decompression-illness/ nhs-funded-treatment). Andrew Heermance (1886). 41st Undersea and Hyperbaric Medical Society Workshop (Undersea and Hyperbaric Medical Society) 78(DIVACC)12-1-90. OCLC 51607923. Berlin New York: Springer-Verlag.S Navy recompression treatments for decompression sickness (http:/ / archive. • Lippmann. com/ content/ book. • Francis. Alf O.6: Manifestations of Decompression Disorders". Journal of Applied Physiology 57 (3): 815–25. 530–56. Haldane. South Pacific Underwater Medicine Society Journal (South Pacific Underwater Medicine Society) 29 (2). google. Schuknecht L. Anne C.  Workman. . United States: Saunders Ltd. Caisson sickness.7: Treatment of the Decompression Disorders". Motley. simonsays. Edward T (September 1984).  Behnke. PMID 889546. Robert M. Louis D. Richard E.4: Pathophysiology of Decompression Sickness". . Tom S. Decompression-Decompression Sickness. Tom S. com/ ?id=FTC0AAAAIAAJ& dq=Leonard+ Erskine+ Hill& printsec=frontcover). Moon. org/ 6004). pp. "Prevention of compressed air illness" (http:/ / archive. "Dive Computer Evolution" (http:/ / www. Journal of Hygiene 8 (3): 342–443. rubicon-foundation.com. org/ insurance/ index. Simon (2005). . Divers Alert Network. org/ 7996). Retrieved 30 May 2010. org/ 7489).  Marx p. Mitchell. Melbourne. . ISBN 0-9752290-1-X. E Preble (January 31. David (June 2001). Retrieved 30 May 2010. Paton. Albert A (1984). Louis A. and the physiology of work in compressed air (http:/ / books. Retrieved 30 May 2010. Retrieved 25 July 2010. com/ ?id=hLq981_A5bMC& printsec=frontcover& dq=Diving).  Golding. Hempleman. "On the likelihood of decompression sickness" (http:/ / jap. Thomson. Peter B. rubicon-foundation. John Scott (1908). "A brief history of diving and decompression illness" (http:/ / archive. Neuman.  "DAN Insurance" (http:/ / www.  Hill. ISBN 0-7020-2571-2. . Sheffield Paul J. Robert D (1957). 455–500. Neuman.2: Decompression Practice". "10. George S. . Edward D (2003). Gorman. Retrieved 30 May 2010. londonhyperbaric. OCLC 51607923. Douglas G. 600–650. Alf O. Tom S.Decompression sickness 30 May 2010. cfm?tab=1& pid=414117& er=9780743217378). PMC 2167126. Pathological and Therapeutical Effects of Compressed Air (http:/ / books. Neuman. In Bennett.
ndc. An atmospheric diving suit allows very deep dives of up to 700 metres. Southend-on-Sea: Aquapress.rubicon-foundation. These suits are capable of withstanding the pressure at great depth permitting the diver to remain at normal atmospheric pressure.noaa. Deco for Divers. PADI define anything from 18 metres / 60 feet . The open-sea diving depth record was achieved in 1988 by a team of Comex divers who performed pipe line connection exercises at a depth of 534 metres in the Mediterranean Sea as part of the Hydra 8 programme. breathing gas. 100 metres / 330 feet may be a "deep dive" This definition essentially relates to recreational diving.Decompression sickness • Marx. 23 External links • Environmental Physiology Medical Literature (http://archive. in 1977. Mark (2008). Rosen's emergency medicine: concepts and clinical practice (7th ed. ISBN 1-905492-07-3.org/medical/articles/index. One example being the Comex Janus IV open-sea dive to 500 metres. PA: Mosby/Elsevier. This eliminates the problems associated with breathing high pressure gases. These divers needed to breathe special gas mixtures because they were exposed to very high ambient pressure (more than 50 times atmospheric pressure).30 metres / 100 feet as a "deep dive" (other diving organisations vary) • in technical diving. Deep diving may have quite a different meaning in the commercial diving field.gov/dp_forms.). For instance the early experiments carried out by Comex S. 60 metres / 200 feet may be a "deep dive" • in surface supplied diving. (Compagnie maritime d'expertises) using hydrox and also nitrogen trimix attained far greater depths than any recreational technical diving. It is defined by the level of the diver's diver training. Diver returning from a 600 ft/180 metres dive . John (2010). • Powell.A. ISBN 978-0-323-05472-0. asp) • Dive Tables from the NOAA (http://www.html) Deep diving The meaning of the term deep diving is a form of technical diving.diversalertnetwork. and surface support: • in recreational diving.org) • Divers Alert Network: diving medicine articles (http://www. Philadelphia. diving equipment.
leading to increasing risk of hypercapnia.4 ATA. adults. Very deep diving using a helium–oxygen mixture (heliox) carries a risk of high pressure nervous syndrome. Deep diving involves a much greater danger of all of these. the “narks” or “rapture of the deep”. In the event of an emergency the diver cannot make an immediate ascent to the surface without risking decompression sickness. All of these considerations result in the amount of breathing gas required for deep diving being much greater than for shallow open water diving. . a diver breathes 6 times as much as on the surface (1 bar). an excess of carbon dioxide in the blood. The need to do decompression stops increases with depth. Heavy physical exertion causes even more gas to be breathed.  Particular problems associated with deep dives Deep diving has more consequences and dangers than basic open water diving. Air embolism causes loss of consciousness and speech and visual problems. Coping with the physical and physiological stresses of deep diving requires good physical conditioning. which may lead to a convulsion underwater. starts with feelings of euphoria and over-confidence but then leads to numbness and memory impairment similar to alcohol intoxication. Technical diving limit for "extended range" dives breathing air to a maximum ppO2 of 1. The diver needs a disciplined approach to planning and conducting dives to minimise these additional risks. where the pressure is 6 bar.000 feet/610 meters World record for deepest dive on SCUBA. 509 feet/155 meters Record depth for scuba dive on compressed air. Decompression sickness. when excess inert gas leaves solution in the blood and tissues and forms bubbles. Recommended technical diving limit. most commonly the upper arm and the thighs.   330 feet/100 meters Technical diving training limit for divers breathing trimix. breathing gas consumption is proportional to ambient pressure . A diver at 6 metres (20 ft) may be able to dive for many hours without needing to do decompression stops. This tends to be life threatening. though minimal visibility possible farther down.so at 50 metres (160 ft).Deep diving 24 Deep Diving Depth  Comments Recreational diving limit for divers aged under 12 years old and beginner divers. Depth at which compressed air results in an unacceptable risk of oxygen toxicity. Recreational diving limit for divers with Open Water certification but without greater training and experience. and presents the additional risk of oxygen toxicity. At depths greater than 40 metres (130 ft).  Navy diver in Atmospheric Diving System (ADS) suit .083 feet/330 meters 2. Nitrogen narcosis. 660 feet/200 meters Absolute limit for surface light penetration sufficient for plant growth. a diver may have only a few minutes at the deepest part of the dive before decompression stops are needed. Bone degeneration (dysbaric osteonecrosis) is caused by the bubbles forming inside the bones. and gas becomes denser requiring increased effort to breathe with depth. These bubbles produce mechanical and biochemical effects that lead to the condition. Recommended recreational diving limit for divers. can happen if a diver ascends too fast.  Average depth at which nitrogen narcosis symptoms begin to appear in 40 feet/12 meters 60 feet/18 meters 100 feet/30 meters 130 feet/40 meters 180 feet/55 meters 218 feet/65 meters Absolute recreational diving limit for divers specified by Recreational Scuba Training Council (RSTC). and requires a recompression chamber for treatment. 1. Using normal scuba equipment. or the “bends”. The effects tend to be delayed until reaching the surface.
but are inherently more complex than open circuit scuba. • Rebreathers manage gas much more efficiently than open circuit scuba. fitness and surface support. Technical divers preparing for a mixed-gas decompression dive in Bohol. Ultra-deep diving Verified SCUBA dives below 800 feet Name Nuno Gomes Location Red Sea Red Sea South Africa South Africa Depth 1044 feet (318 m) 890 feet (270 m) 927 feet (283 m) 826 feet (252 m) Year 2005 2004 1996 1994 Pascal Bernabé Mediterranean Mediterranean 1083 feet 2005 (330 m) 2005 873 feet (266 m) 888 feet (271 m) 2004 898 feet (274 m) 2002 1010 feet 2001 (310 m) 2001 833 feet (254 m) 925 feet (282 m) 825 feet (251 m) 1994 1993 David Shaw  South Africa Gilberto M de Oliveira Brazil John Bennett  Philippines Philippines Jim Bowden Mexico Mexico South Africa Mexico South Africa Andaman Sea Thailand Sheck Exley Don Shirley  863 feet (263 m) 1993 867 feet (264 m) 1989 820 feet (250 m) 2005 1026 feet 2003 (313 m) 2003 850 feet (260 m) Mark Ellyatt Amongst technical divers. • Use of helium-based breathing gases such as trimix reduces nitrogen narcosis and stays below the limits of oxygen toxicity.Deep diving 25 Dealing with depth • Divers carry larger volumes of breathing gas to compensate for the increased gas consumption and decompression stops. Ultra-deep diving requires extraordinarily high levels of training. • A diving shot. a decompression trapeze or a decompression buoy can help divers return to their surface safety cover at the end of a dive.    That is fewer . Philippines. Only eight (or possibly nine) persons are known to have ever dived below a depth of 800 feet (240 m) on self contained breathing apparatus recreationally. Note the backplate and wing setup with sidemounted stage tanks containing EAN50 (left side) and pure oxygen (right side). there are certain elite divers who participate in ultra-deep diving on SCUBA (using closed circuit rebreathers and heliox) below 660 feet (200 m). experience.
" The National Geographic Magazine. contributed to an astonishingly high fatality rate amongst those attempting records. (2006). 1994. Besides scuba. org/ mslib/ servlet/ onepetropreview?id=SUT-AUTOE-v14-107& soc=SUT& speAppNameCookie=ONEPETRO)  Comex S. Deep sea explorer William Beebe reported seeing blueness. Bret Gilliam chronicles the various fatal attempts to set records as well as the smaller number of successes. which occurs at 218 feet breathing air. vg/ books?id=HVbjgdorRXAC& lpg=PA35& ots=TjUeuuvLmB& dq="bret gilliam" record air& pg=PA35#v=onepage& q="bret gilliam" record air& f=false)  Assuming crystal clear water. See generally Deep Diving by Bret Gilliam.6 bar ppO2.Deep diving than the number of people who have walked on the surface of the moon. HYDRA 8 and HYDRA 10 test projects (http:/ / www. and other factors not fully understood. and it should be noted that Dr Marion's second dive computer only registered a depth of 490 feet. not blackness. Fractionally deeper depths may apply in relation to freshwater due to its lower density  Oxygen toxicity depends upon a combination of partial pressure and time of exposure. References  Brylske.A.  Set by Dr Dan Marion on March 18. This created an extreme risk of both narcosis and oxygen toxicity in the divers and. Paul Raymeakers and Pim van der Horst. 26 Ultra deep air While extreme deep diving on air is extremely dangerous. Deep Diving. A. ISBN 0-922769-31-1.  Hydra 8: Pre-commercial Hydrogen Diving Project (http:/ / www. a colleague of Jacques Cousteau. at pages 35 and following. first achieved by John Bennett in 2001. although it looked like the black pit-mouth of hell itself---yet still showed blue. 660. again reporting no ill effects from narcosis or oxygen toxicity. Marco Reis. From the comparatively few who survived extremely deep air dives: • • • • • 1947 Frédéric Dumas. • 1994 Dan Manion set the current record for a deep dive on air at 509 feet (155 m). Unusually. there is a small group of divers who have reached depths below 200 meters on closed-circuit rebreathers." (William Beebe. Don Shirley. The Holy Grail of deep SCUBA diving was the 1000 ft (300 m) mark. p. fr/ suite/ ceh/ histo/ histo anglais. comex. Alessandro Scuotto.proof being as tangible as faith more often than not. Gilliam remained largely functional at depth and was able to complete basic maths problems and answer simple questions written on a slate by his crew beforehand. Manion reported he was almost completely incapacitated by narcosis and has no recollection of time at depth.) . The record is not officially recognised anywhere. dived to 307 feet (94 m) on air 1959 Ennie Falco reported having reached a depth of 435 feet (133 m) on air. In 2003 Mark Ellyatt claimed dives to depths of 260m and 313m. Mario Marconi. surface light may disappear completely at much shallower depths in murky conditions. individual physiology. 3rd edition. NOAA recommends that divers do not expose themselves to breathing oxygen at greater than 1. perhaps unsurprisingly. html)  All depths specified for sea water. "I peered down and again I felt the old longing to go farther. Some examples are David Shaw. Since the recent introduction of depth gauges capable of reading to 330m it is unlikely that such records will be attempted in the future. Encyclopedia of Recreational Diving. google. June 1931. In deference to the high death rate. (http:/ / books. and has only been achieved five times since. Minimal visibility is still possible far deeper. Watson reported that he had no recollection at all of what transpired at the bottom of the descent due to narcosis. ISBN 1878663011. the Guinness World Records ceased to publish records on deep air dives. before the popularity of Trimix attempts were made to set world record depths using conventional air. at 1400 feet (424 meters). "A Round Trip to Davey Jones's Locker. United States: PADI. • 1993 Bret Gilliam extended his own world record to 475 feet (145 m). Dives of this nature have been impossible to verify . onepetro. • 1990 Bret Gilliam dived to a depth of 452 feet (138 m) on air. but had no means to record it 1965 Tom Mount and Frank Martz dive to a depth of 360 feet (110 m) on air 1967 Hal Watts and AJ Muns dive to a depth of 390 feet (120 m) on air 1968 Neil Watson and John Gruener dived to 437 feet (133 m) on air in the Bahamas. In his book.
 Navy diver sets world record (http:/ / www. htm). google. procedures and systems (http:/ / books.083 feet was the depth reportedly achieved by Pascal Bernabé in 2005.  Scubarecords. scubarecords. --Knafelc. . MA and Smith. but that dive has not been independently verified. rubicon-foundation. In: Lang. the Guinness World Records still recognises the 1. Retrieved 2008-07-24. . and commercial divers (although commercial diving to that depth is unknown on SCUBA). NE (eds). . It was a Turkish Navy experimental dive. Retrieved 2008-07-05. com/ features/ 0.044 feet dive by Nuno Gomes earlier in the same year as the current official world record. In 1989 the US Navy experimental diving unit published a paper entitled EX19 [a type of experimental rebreather] Performance Testing at 850 and 450 FSW which included a section on results from tests on the use of rebreathers at 850 feet. "Verified dives below 200 metres" (http:/ / www. External links • Recreational Deep Diving (http://www. DG (2006). Proceedings of Advanced Scientific Diving Workshop (Washington. N.Deep diving  1. htm). US Naval Experimental Diving Unit Technical Report NEDU-8-89. NE (eds). However. "EX 19 Performance Testing at 850 and 450 FSW (Feet of Seawater)" (http:/ / archive. Retrieved 2008-06-14.00. Bret Gilliam. Retrieved 2008-07-05. Proceedings of Advanced Scientific Diving Workshop (Washington.com. military. 27 Footnotes Further reading • Dent. DC).108883. html)  Egstrom GH (2006). ME (1989). an advanced guide to physiology. ISBN 9780922769315. co.  Subsequently died during diving accidents. rubicon-foundation.org/4669). dived to a depth of 998 feet (304 m) off the coast of Cyprus.  Southerland.  Deep Diving. "Historic Perspective: Scientific Deep Diving and the Management of the Risk" (http:/ / archive. rubicon-foundation. In: Lang.htm) .  In 2007 Erdogan Bayburt.rubicon-foundation. . MA and Smith.  Statistics exclude military divers (classified).  Gomes. com/ DeepRecords. Retrieved 2008-06-14. "Medical Fitness at 300 FSW" (http:/ / archive. "AAUS Deep Diving Standards" (http://archive. Retrieved 2009-11-19. . com/ ?id=HVbjgdorRXAC& pg=PT1& lpg=PT1& dq=Bret+ Gilliam+ deep+ diving#v=onepage& q=& f=false). Retrieved 2008-07-05. a former Turkish Navy diver. Proceedings of Advanced Scientific Diving Workshop (Washington. DC). DC). "Recorded Deep Dives Below 200 m" (http:/ / www.divinglore. org/ 4653). org/ 4659). 1995-01-25. NE (eds). W (2006). org/ 7423). In: Lang. . His dive was aborted due to equipment failure.com/RecreationalDeepDiving. He used a closed-circuit rebreather. MA and Smith.15240. nunogomes. za/ rec.
"An evaluation of the equivalent air depth theory" (http:/ / archive. for a nitrox mix containing 64% nitrogen (EAN36) being used at 90 feet.79 − 10 EAD = 37 × 0.64 / 0.Equivalent air depth 28 Equivalent air depth The equivalent air depth (EAD) is a way of approximating the decompression requirements of breathing gas mixtures that contain nitrogen and oxygen in different proportions to those in air. At 27 metres the Bühlmann 1986 table (0–700 m) allows 20 minutes bottom time without requiring a decompression stop. 197. References  Logan. . . JA (1961). org/ 2835). the EAD is: EAD = (27 + 10) × 0.79 − 33 Working the earlier example. Retrieved 2008-05-02. is the depth of a dive when breathing air that would have the same partial pressure of nitrogen. "Equivalent air depth: fact or fiction" (http:/ / archive. for a nitrox mix containing 64% nitrogen (EAN36) being used at 27 metres. the EAD is: EAD = (90 + 33) × 0. org/ 3835). (2001). This shows that using EAN36 for a 27 metre dive can give a 75% increase in bottom time over using air. United States Navy Experimental Diving Unit Technical Report NEDU-RR-01-61. Durham. Dive tables Although not all dive tables are recommended for use in this way. the Bühlmann tables are suitable for use with these kind of calculations. rubicon-foundation. While at 20 metres the no-stop time is 35 minutes. the diver would calculate their decompression requirements as if on air at 20 metres. . for example. So. Calculations in feet The equivalent air depth can be calculated for depths in feet as follows: EAD = (Depth + 33) × Fraction of N2 / 0. DAN Nitrox Workshop Proceedings (http:/ / archive. PMID 538866. McCraken TM (December 1979). a gas mix containing 36% oxygen (EAN36) being used at 27 metres (89 ft) has an EAD of 20 metres (66 ft).79 − 10 Working the earlier example. Undersea Biomedical Research 6 (4): 379–84. known as nitrox. p.79 − 33 EAD = 123 × 0.64 / 0. Calculations in metres The equivalent air depth can be calculated for depths in metres as follows: EAD = (Depth + 10) × Fraction of N2 / 0. for a given nitrox mix and depth. the diver would calculate their decompression requirements as if on air at 67 feet.81 − 10 EAD = 30 − 10 EAD = 20 metres So at 27 metres on this mix. Retrieved 2008-05-01. Michael A.  Lang. rubicon-foundation. .  Berghage Thomas E. Retrieved 2008-05-01. rubicon-foundation. NC: Divers Alert Network.81 − 33 EAD = 100 − 33 EAD = 67 feet So at 90 feet on this mix. org/ 4855).   The equivalent air depth.
The method is. thus reducing its effect to a level similar to that of nitrogen.6 − 33 END = 140 − 33 END = 107 feet So at 200 feet on this mix. for a gas mix containing 40% helium being used at 60 metres.4) − 33 END = 233 × 0. . the NOAA diving manual recommends treating oxygen and nitrogen as equally narcotic.Equivalent narcotic depth 29 Equivalent narcotic depth Equivalent narcotic depth (END) is used in technical diving as a way of estimating the narcotic effect of a breathing gas mixture. a trimix containing 20% oxygen. 40% helium. it is likely that some of the oxygen is metabolised. for a given mix and depth. This is now preferred to the previous method of considering only nitrogen as narcotic. The equivalent narcotic depth of a breathing gas mix at a particular depth is calculated by finding the depth of a dive when breathing air that would have the same total partial pressure of nitrogen and oxygen as the breathing gas in question. Calculations Metres The equivalent narcotic depth can be calculated for depths in metres as follows: END = (Depth + 10) × (1 − Fraction of helium) − 10 Working the earlier example. Oxygen Narcosis Since there is evidence that oxygen plays a part in the narcotic effects of a gas mixture. such as heliox and trimix. In this analysis.6 − 10 END = 42 − 10 END = 32 metres So at 60 metres on this mix. Although oxygen has greater lipid solubility than nitrogen and therefore should be more narcotic (Meyer-Overton correlation). the END is: END = (200 + 33) × (1 − 0. the END is: END = (60 + 10) × (1 − 0. the diver would feel the same narcotic effect as a dive on air to 32 metres. it is assumed that the narcotic potentials of nitrogen and oxygen are similar. the diver would feel the same narcotic effect as a dive on air to 107 feet. 40% nitrogen (trimix 20/40) being used at 60 metres (200 ft) has an END of 32 metres (105 ft). since it is more conservative. For example. for a gas mix containing 40% helium being used at 200 feet. to calculate the depth which would produce the same narcotic effect when breathing air.4) − 10 END = 70 × 0. Feet The equivalent narcotic depth can be calculated for depths in feet as follows: END = (Depth + 33) × (1 − Fraction of helium) − 33 Working the earlier example.
NOAA Diving Manual.  Breathing Mixture Including other gases in the mix.. The term high pressure nervous syndrome was first used by Brauer to describe the combined symptoms of tremor. Fagraeus L. but reduce within a few hours once the pressure has stabilised.  Russian scientist G. The non-helium portion (i.   . National Oceanic and Atmospheric Administration.2. Undersea Biomed Res 5 (4): 391–400. the sum of the oxygen and the nitrogen) is to be regarded as having the same narcotic potency as an equivalent partial pressure of nitrogen in air." High-pressure nervous syndrome High-pressure nervous syndrome (HPNS – also known as high-pressure neurological syndrome) is a neurological and physiological diving disorder that results when a commercial diver or scuba diver descends below about 500 feet (150 m) while breathing a helium–oxygen mixture. and carbon dioxide in compressed-air narcosis" (http:/ / archive.. The compression effects may occur when descending below 500 feet (150 m) at rates greater than a few metres per minute. Unfortunately these reports were not available in the West until 1967. dizziness. 4th.e. regardless of the proportions of oxygen and nitrogen. HPNS is a limiting factor in future deep diving. since oxygen has some narcotic properties. and decreased mental performance. The susceptibility of divers and animals to HPNS varies over a wide range depending on the individual. one resulting from the speed of compression and the other from the absolute pressure. Zal'tsman also reported on helium tremors in his experiments from 1961.1978). Adolfson J (December 1978). "[16.  Causes HPNS has two components. Retrieved 2008-05-01. Bennett.  Rate of Compression Utilizing slow rates of compression or adding stops to the compression have been found to prevent large initial decrements in performance. Prevention It is likely that HPNS can not be entirely prevented but there are effective methods to delay or change the development of the symptoms. Diving for Science and Technology. myoclonic jerking. "Roles of nitrogen. The effects depend on the rate of descent and the depth. such as nitrogen (creating trimix) or hydrogen (hydreliox) suppresses the neurological effects. rubicon-foundation.  "Mixed-Gas & Oxygen". EEG changes. The effects from depth become significant at depths exceeding 1000 feet (300 m) and remain regardless of the time spent at that depth. org/ 2810).1.. electroencephalography (EEG) changes. somnolence. visual disturbance. and somnolence that appeared during a 1189-foot (362 m) chamber dive in Marseilles. PMID 734806. L. nausea. it is appropriate to include the oxygen in the END calculation when using trimixes (Lambersten et al. oxygen. but has little variation between different dives by the same diver. 2002.Equivalent narcotic depth 30 References  Hesser CM. "Helium tremors" were first widely described in 1965 by Royal Navy physiologist Peter B. .4] .3. Symptoms Symptoms of HPNS include tremors. 1977. who also founded the Divers Alert Network.
"Contribution to the study of the neurological and mental reactions of the organism of the higher mammal to gaseous mixtures under pressure". "Syndrome neurologique et electrographique des hautes pressions".. "Psychological principles of a sojourn of a human in conditions of raised pressure of the gaseous medium (in Russian. M. S. Naquet.  Zal'tsman. B. PMID 4619860. Neuman. 1961)". X. R. R. anesthetics and anticonvulsant drugs have had varying results in suppressing HPNS with animals. ISSN 0093-5387. rubicon-foundation. org/ 2661). Bennett and Elliott's physiology and medicine of diving. A. Gardette-Chauffour. P.rubicon-foundation. ISSN 0093-5387. C. W. McLeod. B. R. Ohio). OCLC 2068005. (1970). United States: Saunders. W. W. "The causes. Rev Neurol (Paris) 121 (3): 264–5. Jean Claude (2003). Coggin. Tom S. L. Peter B. L. PMID 3212843. ISSN 0093-5387. "Effects of a H2-He-O2 mixture on the HPNS up to 450 msw" (http:/ / archive. Bennett. C. (1968). Fructus. Royal Navy Personnel Research Committee. AD655 360 (Wright Patterson Air Force Base. B.. Gosset. ISBN 0702025712.  Brauer. C.  Rostain. . External links • Select publications about HPNS (http://archive. Fructus. Ocean Industry (London) 3: 28–33.High-pressure nervous syndrome 31 Drugs Alcohol. P. Undersea Biomed. R. 251 (London). pp. (1967). P.  Fife. Dimov. None are currently in use for humans. Retrieved 2008-04-07. Retrieved 2008-04-07.  Bennett. English translation. OCLC 2068005. P.. Alf O.  Vigreux. . W. .  Hunger Jr.. "The use of Non-Explosive mixtures of hydrogen and oxygen for diving". R. Undersea Biomedical Research 15 (4): 257–70. MD Thesis (Toulouse University). Res. G. PMID 7168098. PMID 5378824. mechanisms and prevention of the high pressure nervous syndrome" (http:/ / archive. Texas A&M University Sea Grant TAMU-SG-79-201. Foreign Technology Division. org/ 2920). Lemaire. J. P. Retrieved 2008-04-07. OCLC 2068005. rubicon-foundation. (1968). "Psychometric impairment in men breathing oxygen-helium at increased pressures". References  Bennett. 5th Rev ed. 323–57. Underwater Physiology Subcommittee Report No. (1979).. org/ 2487). Res. (1965). "Seeking man's depth level".org/dspace/simple-search?query=high+ pressure+nervous+syndrome) hosted by the Rubicon Foundation . "Effect of compression rate on use of trimix to ameliorate HPNS in man to 686 m (2250 ft)" (http:/ / archive. Rostain.  Bennett. J. (1988).  Brauer. Naquet. "The High Pressure Nervous Syndrome". M. (1982).. In Brubakk. rubicon-foundation. (1974). Undersea Biomed. 9 (4): 335–51. 1 (1): 1–28.
or dive tool/knife. Some deep diving breathing gases such as trimix and heliox can be hypoxic at shallow depths Don't breathe hypoxic gas in shallow water. Click on the boldface links to find symptoms and more information for each topic. every hour of recreational diving is 36 to 62 times riskier than automobile driving. before the diver uses the cylinder Anoxia due to having no air or gas to breathe Equipment failure . According to a North American 1970 study. including poor dive discipline Running out of air due to getting trapped by nets Running out of air due to getting trapped or lost in enclosed spaces underwater (e.particularly in rebreathers that monitor and maintain oxygen content Running out of air due to a number of factors. including in using a compass underwater Keep equipment routinely checked and in good condition A full cylinder standing for a long time while the inside of the cylinder rusts.g. Oxygen toxicity Breathing gas at too high a partial pressure of oxygen. Effects of relying on breathing equipment while underwater Being unable to breathe fresh air naturally whilst submerged and relying on limited breathing gas supplies and fallible breathing equipment can have these effects. Specific training and leadership for such types of diving. caves and shipwrecks) Running out of air due to getting lost in open water Salt water aspiration syndrome Inhaling a mist of sea water from a faulty demand valve causing a reaction in the lungs . but where the oxygen partial pressure is too low to sustain normal activity or consciousness. hypoxic gas Proper training before using a rebreather. Keep equipment routinely checked and in good condition Better training of divers. If a cylinder has stood full for months. A faulty or misused rebreather can provide the diver with Keep rebreathers properly maintained. in caissons. See cave diving and wreck diving. Better awareness underwater. Types of this sort of diving disorder. with scuba or other diving equipment) or use high pressure breathing gases.g. empty it and refill it. Better training and leadership. partial pressure depends upon proportion of oxygen and depth Hypoxia or anoxia occurs while having gas to breathe. Some of these conditions also affect people who work in raised pressure environments out of water. According to a 2000 Japanese study. Corerect identification of cylinder gases and safe procedures for gas changes. using up oxygen in the contained air. and how to avoid them Type Drowning Secondary drowning Cause Being unable to inhale anything but water Can occur hours after a near drowning How to avoid it See under "anoxia" hereinunder Prompt medical treatment after near drowning Proper training before using a rebreather or oxygen enriched gases such as nitrox. e.g. Keep cylinders routinely checked and tested.List of diving hazards and precautions 32 List of diving hazards and precautions Divers face specific physical and health risks when they go underwater (e. Carry a diver's net cutter. diving was (on a man-hours based criteria) 96 times more dangerous than driving an automobile. Proper training before using mixed gases. More disciplined attitude when underwater.
On descent Air spaces within the body provide no support against greater outside pressure. How to avoid it Do not dive if the eustachian tube is congested. This is a particular risk with a pumped surface air feed. For example. The pressure in the outer ear not equalizing with surrounding pressure Damage to other body air spaces. Click on the boldface links to find symptoms and more information for each topic. and how to avoid them Type Eardrum damage. British naval divers called it shallow water blackout. Proper diver training in clearing the ears. Keep rebreathers properly maintained. Carbon dioxide poisoning: hypercapnia With a rebreather. Various effects of breathing a wrong gas A wrong gas was put in a cylinder Effects of barotrauma or pressure damage See barotrauma and pressure for more information. See Rebreather#Carbon dioxide scrubber. such as the paranasal sinuses. Proper training before using a rebreather. Do not dive with conditions such as the common cold Let air into the mask through the nose. This can happen from losing control of buoyancy causing excessive vertical speed during descent. never wear earplugs. Cold water in the middle ear chills the inner ear.g. this hazard can happen with diving with a large "bubblehead" helmet. Check conditions where you have your cylinders refilled. like in a diesel engine Proper precautions when filling cylinders Carbon monoxide poisoning Proper servicing of the compressor Emphysema caused by inhaling oil mist This happens gradually over a long time. Put the proper gas identification markings on cylinders. the diver re-inhales carbon dioxide because the soda lime scrubber cannot absorb the exhaled carbon dioxide as fast as the diver produces it. Re-inhaling carbon dioxide-laden exhaled gas Use proper filters in the air pump or air compressor. Make sure that your hood does not make an airtight seal over the outside ear hole. often its own engine's exhaust gas Oil getting into the air feed and firing in the air compression cylinder.List of diving hazards and precautions 33 Air cylinder filled by a compressor which sucked in products of combustion. Types of this sort of diving disorder. Cause Failing to equalize the pressure in the middle ear with surrounding pressure. with the common cold. e. Minimise the volume of any enclosed spaces which the diver breathes through. causing dizziness and disorientation etc. Do not dive with eyes-only goggles. Squeeze damage to blood vessels around the eyes Obstruction to the sinus ducts Caused by suction from the air space inside a mask ("mask squeeze") which is not a fullface mask .
however. this requires substantial pressure difference caused by aforementioned failures in the air supply and the non-return valve (which was absent from the earliest models of this type of diving suit). In severe cases much of the diver's body could be mangled and compacted inside the helmet. Click on the boldface links to find symptoms and more information for each topic. or from losing control of buoyancy causing excessive vertical speed during ascent. Effects of breathing gas at high pressure Click on the boldface links to find symptoms and more information for each topic. and how to avoid them Type Cause How to avoid it Never hold your breath while diving with breathing apparatus Pulmonary barotrauma: "burst lung" Holding the breath while ascending This can cause: Pneumothorax Interstitial emphysema Subcutaneous emphysema Gas embolism Collapsed lung. e.g. air loose in the pleural cavity Gas trapped in the chest after burst lung Gas loose under the skin. Proper training in its use. . Its effects can be very similar to decompression sickness. Air or other gas in the blood stream. Blockage of the sinus's duct Blocked Eustachian tube Pain in a sinus Eardrum bursting outwards Do not dive with nasal congestion. with the old standard diving dress. accompanied by a failure of the air compressor (on the surface) to pump enough air into the suit for the gas pressure inside the suit remaining equal to the outside pressure of the water. Squeeze damage to skin under Suction into the space inside the fold folds in a drysuit Lung squeeze: blood in lungs Extreme depth when snorkelling Helmet squeeze. This can happen from holding the breath on ascent. the common cold. Types of this sort of diving disorder. This does not happen with scuba where there is no solid pressure-tight helmet A non-return valve in the helmet failing. On ascent Air spaces within the body expand when the outside pressure decreases.List of diving hazards and precautions 34 Modern drysuits have a tube connection to inflate the drysuit from the cylinder Use an underwater breathing set Keep equipment in good order and inspected.
With mixed gas diving. much heat can be lost from a head without a hood. Learn to identify it. Some of these conditions also affect people who work in raised pressure environments out of water. Where it says "Avoid diving with bare skin". Stings Stings. Learn about the dangerous species. Nitrogen narcosis Breathing a high partial pressure of nitrogen (or other gas. Use another diving technique. Divers face specific physical and health risks when they go underwater (e. Do not get too close to coral. ascending too quickly will cause gas to supersaturate and form bubbles in tissues depending on time and depth of the dive. particularly in caves or shipwrecks. Other risks encountered by people in water Types of this class of diving disorder. a boilersuit could be worn in very warm water. If stops are necessary. Water carries heat away far better than air. See decompression sickness for a detailed list of the symptoms. and how to avoid them Type Decompression sickness ("the bends") Cause Gas dissolves in tissues under pressure according to Henry's Law over time. How to avoid it Plan your dive. wear an adequately warm diving suit for the conditions. increase surface interval or reduce dive depth. etc. This can also happen when diving with open-circuit scuba and semi-closed circuit rebreathers if the maximum operating depth for the breathing gas is exceeded. some dangerous Fire coral Some jellyfish . Use an underwater breathing apparatus and ascend at a rate determined by decompression tables or computer. arterial gas embolism. Many deep dives in succession. Know how long you can stay at the planned depth and still make a normal ascent. in caissons. Type Hypothermia Cause Losing body heat to the water. Use breathing gas mixtures with reduced inert gas fraction. use the correct breathing gas mixture to limit the equivalent narcotic depth to an acceptable level for the planned depth. Bends in snorkellers.g. Provide something for the diver to hold onto while ascending and decompressing to maintain accurate depth during stops and correct ascent rate. Avoid diving with bare skin. Avoid dehydration and hypothermia. Maintain cardiovascular fitness. eg Nitrox. Dont dive deep on air. or add a little nitrogen as described at HPNS. Uncommon but known. How to avoid it In cool or cold water. and how to avoid them. Avoid diving in bare skin. Limit the depth of the dive to limit the partial pressures of gases with narcotic effects to a level that you can safely manage. It is yellow. Also.g. sometimes with Coral coral tissue left in them Cuts Rock. with scuba) or use high pressure breathing gases. Reduce the number of deep dives. to varying degrees) Oxygen toxicity Breathing a high partial pressure of oxygen HPNS: High Pressure Nervous Syndrome or Helium Tremors Breathing a high partial pressure of helium The term dysbarism describes Decompression sickness.List of diving hazards and precautions 35 Types of this sort of diving disorder. After dive. Click on the boldface links to find symptoms and more information for each topic. Training in using diving tables and a dive computer. metal. Avoid diving with bare skin. and barotrauma. Cuts. such as an ROV. do not miss or cut short decompression stops. e. This hazard is well known with closed circuit rebreathers when the control of the mixture fails. See taravana.
In affected water. . stonefish. Get proper information on them. Keep a lookout for the fish and move away if they act aggressively Crocodile attack Crocodiles. in some South American fresh water Electric ray. Also used for long-range communication with submarines Weil's disease (in rat's urine) Bilharzia (in some warm fresh water) Various bacteria found in sewage May be found in water polluted by industrial waste outfalls or by natural sources. Poison-injecting spines Poison injection Shark bites Learn to identify them. bruises and skin conditions that result from diving in tropical waters. Ensure that boat uses a positive check system to identify each diver is on board after a dive. bleeding wounds and other trauma Use Surface detection aids or a diving shot to mark surfacing position and aid searchers. Carry a signalling mirror and/or sound signalling device. This includes sunburn. Colliding with a boat or its propeller. jellyfish stings. See Underwater Port Security System. where protected from attack by sharks. Avoid large ships' ordinary sonar. Local knowledge. This tropical Indo-Pacific fish is very territorial during breeding season and will attack and bite divers Epinephelus lanceolatus can grow very big in tropical waters. lionfish. Avoid waters known to be inhabited by crocodiles.   Electric eel. Wave action on the shore. surface weather on the shore make the sea too rough to safely exit. Left behind due to inaccurate check by boat crew Diver lost at sea after Big waves made it unsafe to leave the water. scrapes. Get proper information on them. dive in watertight drysuit and full face diving mask Exposure to disease carried by in-water organisms Exposure to harmful chemicals in the water Broken bones. Consult location-specific information to determine risk. There have been cases    of very large groupers trying to swallow humans. For example hydrogen sulfide in some lakes and caves can be absorbed through the skin. good weather forecasts. some sea urchins in warm seas Blue ringed octopus. Carry a personal submersible EPIRB or submersible vhf radio. Plan a safe exit point and check weather and tidal conditions. Sudden loss of underwater visibility Silt out: stirring up silt or other light loose material Training in diving in zero visibility. in parts of the Pacific Ocean Sharks. Learn the frog kick. Care when wading. currents moved a shore dive the diver away from a safe exit. fire coral inflammation and other skin injuries that a diver may gain from using a shorty wetsuit or no diving suit. A deep cut which leaves poison in the wound Reef rash sting ray (its self-defence reaction) A generic catch-all term that refers to the various cuts. in some warm seas It is said that some naval anti-frogman defences use electric shock Keep out of armed forces areas Get proper information on them Electrocution Powerful ultrasound It is said that some naval anti-frogman defences use powerful ultrasound. crown of thorns starfish. likelihood of risk is location dependent Wear a full-body exposure suit to prevent direct skin to environment contact. never molest even seemingly-tame sharks underwater. plan alternative exits Diver lost at sea after Separated from boat cover due to poor visibility at surface or a boat dive strong underwater currents. Care when wading. Carry a yellow flag or surface marker buoy to attract attention.List of diving hazards and precautions 36 Do not poke about in sand where they live. sea lice bites. Keep out of armed forces areas. in some tropical waters Attack by Titan Triggerfish Attack by an unusually large grouper. Keep away from them.
Cyber Diver News Network. html). Train in wreck diving and cave diving techniques. .  Alevizon. ufl.DDRC. FloridaToday. grouper attacks?" (http:/ / www. Correct use of reels and route to the surface lines. directional markers. 4 feet side side to side. page 138: 15 feet long.  Arthur C. Bill (2005-06-26). shtml).List of diving hazards and precautions 37 Carry at least one line cutting implement. Retrieved 2009-08-08. Retrieved 2009-08-08. 2005-06-19. "Is recreational diving safe?" (http:/ / archive. . org/ 6770). ISBN 0-7434-4502-3. debris or caves Getting lost under an overhead Losing your way in wrecks and caves where there is no direct Proper training and dive planning. Evan T (2002-01-04). rubicon-foundation. Jacksonville.  "Goliath grouper attacks" (http:/ / www. Undersea and Hyperbaric Medical Society. Retrieved 2009-08-08. Sri Lanka External links • Diving Diseases Research Centre (http://www. nets. California Medicine 116 (6): 18–22. Use low snag equipment configurations (avoid dangling gear and snap hooks that can snag on lines) Entrapment Snagging on lines. James M (1972).  Ikeda.  Sargent. "A Case for Regulation of the Feeding of Fishes and Other Marine Wildlife by Divers and Snorkelers" (http:/ / www. Reefs of Taprobane.org) . Retrieved 2009-08-08. in the sunken Admiralty floating dock in Trincomalee. PMC 1518314. References  Lansche.  Allard. "Big Grouper Grabs Diver On Keys Reef" (http:/ / www. com/ tu-online/ stories/ 061905/ spo_19030958. flmnh. cdnn. PMID 5031739. shtml). H (2000). "Did fish feeding cause recent shark. jacksonville. . edu/ fish/ InNews/ grouperattack2005. "Deaths During Skin and Scuba Diving in California in 1970". wrecks. html). Bill (July 2000). Retrieved 2009-08-08. Backup lights. Reef Relief.com (Florida Times-Union). . org/ science_body4. Clarke.com. reefrelief. Florida Museum of Natural History. . Ashida. T. info/ eco/ e020104/ e020104. Dive with a buddy who is capable of helping to free you and will stay close enough to notice.
 The MOD is significant when planning dives using gases such as nitrox and trimix because the proportion of oxygen in the mix determines the maximum safe depth for breathing that gas. It does this by multiplying by the appropriate amount of depth to produce an atmosphere of pressure: 33 feet (10 m) of salt water (fsw) or 10 meters of salt water.2 to 1. Of this total pressure which can be tolerated by the diver. In metres In which ppO2 is the desired partial pressure in oxygen and the FO2 is the decimal value of the fraction of oxygen in the mixture. 180 minutes at 1. Note that 21% is the concentration of oxygen in normal air.).Maximum operating depth 38 Maximum operating depth In technical diving and nitrox diving.3 feet (29. 120 minutes at 1.4 bar. Formulas To calculate the MOD for a specific ppO2 and percentage of oxygen.4 / 0. The remaining part in each formula merely converts pressure in atm produced by depth in water. if a gas contains 36% oxygen and the maximum ppO2 is 1.4 bar.4 / 0. and the rest is due to depth in water.1] = 95. Safe limit of partial pressure of oxygen The maximum single exposure limits recommended in the NOAA Diving Manual are 45 minutes at 1. the level of underwater exertion planned and the planned duration of the dive. the maximum operating depth (MOD) of a breathing gas is the depth at which the partial pressure of oxygen (ppO2) of the gas mix exceeds a safe limit. Note that the formula simply divides the total partial pressure of PURE oxygen which can be tolerated (expressed in bar or atmospheres) by the fraction of oxygen in the nitrox.0 m).6 bar.4 bar.5. to give the rest of the pressure added by water (in atmospheres). 150 minutes at 1.9 metres. For example. the MOD (m) is 10 metres x [(1. . 1 atmosphere is due to the Earth's air. The tables below show MODs for a selection of oxygen mixes.1] = 28. the MOD (fsw) is 33 feet (10 m) x [(1. etc. This safe limit varies depending on the diver training agency. For example.2 bar. but is normally in the range of 1. the following formulas are used: In feet In which ppO2 is the desired partial pressure in oxygen and the FO2 is the decimal value of the fraction of oxygen in the mixture.6 bar.36) . There is a risk of oxygen toxicity if the MOD is exceeded.3 bar and 210 minutes at 1. if a gas contains 36% oxygen and the maximum ppO2 is 1. so divide by 0. to calculate to total atmospheres pressure this mix can be breathed at (obviously 50% nitrox can be breathed at twice the pressure of 100% oxygen. to the depth.5 bar.36) . So the 1 atm for the air is subtracted out.
8 10.4 52.3 206.2 to 1.0 123.9 36.8 6.9 23.3 67.8 56.2 390.3 20.6 523.3 256.3 15.2 38.5 1617 792 517 379 297 242 202 173 150 132 117 104 95 1.5 31.1 23.5 490.9 66.3 61.3 70.9 16.0 73.4 26.3 1397 682 443 324 253 205 171 145 125 110 99 1.4 30.1 16.1 25.2 56.7 14.3 145.0 15.5 13.0 13.0 5.8 123.0 18.3 4.4 76.3 21.6 4.0 8.0 11.7 28.7 62.7 78.4 3.0 56.5 5.0 90.3 10.4 31.0 7.1 3.4 10.0 98.7 14.6 12. MOD table in metres Maximum Operating Depth (MOD) in metres of sea water for ppO2 1.1 40.0 35.4 28.8 18.7 5.9 44.3 2.9 25.3 6.6 22.5 10.7 32.3 423.0 156.7 134.5 45.0 4.7 1.6 MOD (msw) 3 6 9 12 15 18 21 24 27 30 33 % oxygen 36 39 42 45 50 55 60 65 70 75 80 85 90 100 Maximum ppO2 1.7 115.4 456.0 8.5 7.4 23.0 8.0 28.0 17.5 6.9 11.1 11.7 167.6 106.6 6.8 1.3 96.0 190.0 240.2 to 1.3 38.7 47.0 90.1 33.3 29.1 18.1 6.3 41.0 13.7 223.3 1.6 40.0 8.7 49.8 7.6 MOD (fsw) 3 6 9 12 15 18 21 24 27 30 % oxygen 33 36 39 42 45 50 55 60 65 70 75 80 85 90 100 Maximum ppO2 (bar) 1.3 5.6 1727 847 553 407 319 260 218 187 162 143 127 113 102 92 84 72 63 54 48 42 37 33 29 25 93 1.7 48.3 11.0 7.3 20.0 34.7 23.Maximum operating depth 39 MOD table in feet Maximum Operating Depth (MOD) in feet of sea water for ppO2 1.6 7.0 .6 11.5 25.0 19.5 34.6 16.7 83.0 (bar) 8.0 26.4 1507 737 480 352 275 223 187 159 138 121 107 97 1.3 21.3 43.0 1.2 51.2 1287 627 407 297 231 187 155 132 113 87 77 68 61 55 46 39 33 27 23 19 16 13 11 86 77 69 62 52 45 38 33 28 24 20 17 14 85 77 69 59 51 44 38 33 28 24 21 18 84 77 66 57 49 43 37 33 28 25 22 19 16 13 9 6 These depths are rounded down to the nearest foot.7 10.
as susceptibility varies widely from dive to dive and amongst individuals. M.6 1. helium and nitrogen for deep dives to avoid the effects of narcosis. Durham. and probably neon. is a reversible alteration in consciousness that occurs while scuba diving at depth. inert gas narcosis.1 20. DAN Nitrox Workshop Proceedings (http:/ / archive. all gases that can be breathed have a narcotic effect.613. NC: Divers Alert Network.7 2. (2001).6 Narcosis while diving (also known as nitrogen narcosis. rubicon-foundation.571 Some components of breathing gases.0 25. org/ 4855). Nitrogen narcosis Inert gas narcosis [Nitrogen narcosis] Classification and external resources Divers breathe a mixture of oxygen. . Retrieved 2008-06-24. predicting the depth at which narcosis will affect a diver is difficult. and their relative narcotic potentcies  Gas Ne H2 N2 O2 Ar Kr CO2 Xe Relative narcotic potency 0. DiseasesDB MeSH 30088   C21. p.3 0. Martini effect). 197. a term used by Homer and Hippocrates. As depth increases. While narcosis affects all divers.3 7. which is greater as the lipid solubility of the gas increases. but usually does not become noticeable until greater depths. Narcosis produces a state similar to alcohol intoxication or nitrous oxide inhalation. Apart from helium. The Greek word ναρκωσις (narcosis) is derived from narke. beyond 30 meters (100 ft). Although divers can learn to cope with the effects. and can occur during shallow dives. "temporary decline or loss of senses and movement. numbness". it is not possible to develop a tolerance. .Maximum operating depth 40 References  Lang.A.0 1.455. raptures of the deep. A cylinder label shows the maximum operating depth and mixture (oxygen/helium). the effects may become hazardous as the diver is increasingly impaired.
 The noble gases argon. When more serious. making it difficult to read multiple gauges The most dangerous aspects of narcosis are the loss of decision-making ability and focus. or paranoia. the diver may feel overconfident. disregarding normal safe diving practices. For this reason. the onset of narcosis may be hard to recognize. oxygen and hydrogen cause a decrement in mental function. multi-tasking and coordination. They also resemble (though not as closely) the effects of alcohol and the familiar benzodiazepine drugs such as diazepam and alprazolam. and xenon anesthesia systems are still being proposed and designed. or for standard diving safety guides. extreme anxiety.a feeling of tranquility and mastery of the environment. krypton. These effects are essentially identical to various concentrations of nitrous oxide. depending on the individual diver and the diver's medical or personal history. as well as nitrogen. Professional divers use such a calculation only as a rough guide to give new divers a metaphor.  At its most benign. Signs and symptoms Due to its perception-altering effects. 41 Classification Narcosis results from breathing gases under elevated pressure and may be classified by the principal gas involved. This is a very rough guide. and xenon are more narcotic than nitrogen at a given pressure. but their effect on psychomotor function (processes affecting the coordination of sensory or cognitive processes and motor activity) varies widely. only worsening if the diver ventures deeper. narcosis results in relief of anxiety . Narcosis can produce tunnel vision. Diving beyond 40 m (130 ft) is considered outside the scope of recreational diving: as narcosis and oxygen toxicity become critical factors. the effects generally remain the same at a given depth. and impaired judgement. The effects of carbon dioxide consistently result in a decrease of both mental and psychomotor function. This is the idea that narcosis results in the feeling of one martini for every 10 m (33 ft) below 20 m (66 ft) depth.Nitrogen narcosis The condition is completely reversed by ascending to a shallower depth with no long-term effects. except helium and probably neon. The syndrome may cause exhilaration. Such effects are not harmful unless they cause some immediate danger not to be recognized and addressed. Other effects include vertigo. Once stabilized. Reported signs and symptoms are summarized against typical depths in meters and feet of sea water in the following table: . depression. The relation of depth to narcosis is sometimes informally known as "Martini's law". and visual or auditory disturbances. and xenon has so much anesthetic activity that it is actually a usable anesthetic at 80% concentration and normal atmospheric pressure. comparing a situation they may be more familiar with. giddiness. The noble gases. but it has been successfully used for surgical operations. specialist training is required in the use of various gas mixtures such as trimix or heliox. narcosis while diving in open water rarely develops into a serious problem as long as the divers are aware of its symptoms and ascend to manage it. and not a substitute for an individual diver's known susceptibility. Xenon has historically been too expensive to be used very much in practice.
Occasional dizziness. researchers have been looking at neurotransmitter receptor protein mechanisms as a possible cause of the narcosis. Over-confidence and sense of well-being. and unconsciousness. Terror in some. impaired judgment. disorganization of the sense of time. The breathing gas mix entering the diver's lungs will have the same pressure as the surrounding water. Poor concentration and mental confusion. Hallucinations. Laughter and loquacity (in chambers) which may be overcome by self control.  A divers' cognition may be affected on dives as shallow as 10 m (33 ft). Unconsciousness. or the severity of the effect on an individual diver. Severe delay in response to signals. However there is no reliable method to predict the depth at which narcosis becomes noticeable. Reasoning and immediate memory affected more than motor coordination. manic or depressive states. Death. Delayed response to visual and auditory stimuli. Modern theories have suggested that inert gases dissolving in the lipid bilayer of cell membranes cause narcosis.  Rapid compression potentiates narcosis. Calculation errors and wrong choices. Hallucinations. 4–6 30–50 100–165 6–8 50–70 165–230 8–10 70–90 230–300 10+ 90+ 300+ Causes The cause of narcosis is related to the increased solubility of gases in body tissues. owing to carbon dioxide retention. Because of these incidents. but the changes are not usually noticeable. Idea fixation. Most sport scuba training organizations recommend depths of no more than 40 m (130 ft) because of risk of narcosis. When breathing air at depths of 90 m (300 ft)—an ambient pressure of about 10 bar (1000 kPa)—narcosis in most divers leads to hallucinations. Mild euphoria possible. Anxiety (common in cold murky water). Mildly impaired reasoning. known as the ambient pressure. For any given depth. as the effect may vary from dive to dive (even on the same day). increased excitability. loss of memory.  Significant impairment due to narcosis is an increasing risk below depths of about 30 m (100 ft). hysteria (in chamber).Nitrogen narcosis 42 Signs and symptoms of narcosis (breathing air) Pressure (bar) 1–2 2–4 Depth (m) 0–10 10–30 Depth (ft) 0-33 33–100 Comments Unnoticeable small symptoms. Stupefaction with some decrease in dexterity and judgment. . as a result of the elevated pressures at depth (Henry's law). Sleepiness. dizziness. the Guinness Book of World Records no longer reports on this figure. or no symptoms at all. a sense of levitation. Sense of impending blackout. confusion. corresponding to an ambient pressure of about 4 bar (400 kPa). Loss of memory. Increased intensity of vision and hearing. changes in facial appearance.  A number of divers have died in attempts to set air depth records below 120 m (400 ft). euphoria. Mild impairment of performance of unpracticed tasks. More recently. Uncontrolled laughter. instructions and other stimuli. the pressure of gases in the blood passing through the brain catches up with ambient pressure within a minute or two and this produces a delay in narcotic effect after coming to a new depth.
other gases including argon. Increased risk of narcosis results from increasing the amount of carbon dioxide retained through heavy exercise. the initial management—ascending closer to the surface—is still essential. but it appears to be the direct effect of gas dissolving into nerve membranes and causing temporary disruption in nerve transmissions. heavy work. the increase of gas dissolved in nerve cell membranes may cause altered ion permeability properties of the neural cells' lipid bilayers. stress. such as opiate narcotics and benzodiazepines. the basic and most general underlying idea. shallow or skip breathing. the less partial pressure is needed. Given the setting. increasing the effects of other gases. specific types of chemically-gated receptors in nerve cells have been identified as being involved with anesthesia and narcosis. or hypothermia causing rapid breathing and shivering. showing the hydrophilic heads on the unlikely to be a strictly chemical bonding to receptors in the usual outside and hydrophobic tails inside sense of a chemical bond. causing direct mechanical interference with the transmission of signals from one nerve cell to another. their Illustration of a lipid bilayer. krypton and hydrogen cause very similar effects at higher than atmospheric pressure.  Carbon dioxide has a high narcotic potential and also causes increased blood flood to the brain. Nevertheless the presence of any of these symptoms should imply narcosis. Narcosis is known to be additive to even minimal alcohol intoxication.Nitrogen narcosis Narcosis has been compared with altitude sickness insofar as its variability (though not its symptoms). ascending is always the correct initial response. typical of a cell reproduction by the very chemically inactive gas argon makes them membrane.  and also to the effects of other drugs such as marijuana (which is more likely than alcohol to have effects which last into a day of abstinence from use). early signs of oxygen toxicity causing visual disturbances. fatigue. other likely conditions do not produce reversible effects. with variations between individuals. Similar to the mechanism of ethanol's effect. and carbon dioxide retention all increase the risk and severity of narcosis. However. similar to the mechanism of nonpolar anesthetics such diethyl ether or ethylene. The management of narcosis is simply to ascend to shallower depths. have suggested non-chemical binding due to the attractive van der Waals force between proteins and inert gases. Trudell et al. remains largely unchallenged. However. In the event of complications or other conditions being present. add to narcosis. Other sedative and analgesic drugs. the effects then disappear within minutes. Alleviation of the effects upon ascending to a shallower depth will confirm the diagnosis. the Meyer-Overton hypothesis suggested that narcosis happens when the gas penetrates the lipids of the brain's nerve cells. or because of poor gas exchange in the lungs. Thermal cold. Some of these effects may be due to antagonism at NMDA receptors and potentiation of GABAA receptors. In the rare event of misdiagnosis when another condition is causing the symptoms.  Diagnosis and management The symptoms described may be caused by other factors during a dive: ear problems causing disorientation or nausea. its effects depend on many factors. An indirect physical effect—such as a change in membrane volume—would therefore be needed to affect the ligand-gated ion channels of nerve cells. that nerve transmission is altered in many diffuse areas of the brain as a result of gas molecules dissolved in the nerve cells' fatty membranes. While the effect was first observed with air. An early theory. The partial pressure of a gas required to cause a measured degree of impairment correlates well with the lipid solubility of the gas: the greater the solubility. 43 Mechanism The precise mechanism is not well understood.   More recently. .
Further training is normally required for certification up to 30 m (100 ft) on air. based on relative lipid solubilities. and strongly encourage helium. Some diver training agencies offer specialty training to prepare recreational divers to go to depths of 40 m (130 ft).33 times the narcotic effect of nitrogen. Some gases have other dangerous effects when breathed at pressure. and cure. and is not suitable as a breathing gas for diving (it is used as a drysuit inflation gas. however. one diver may have trouble with eye focus (close accommodation for middle-aged divers).28 times that pressure. another may experience feelings of euphoria. 44 Prevention The most straightforward way to avoid nitrogen narcosis is for a diver to limit the depth of dives. Specialist training may help divers in identifying these personal onset signs. The National Oceanic and Atmospheric Administration (NOAA) Diving Manual now states that both oxygen and nitrogen should be considered equally narcotic. its effects. which are somewhat more repeatable than for the average group of divers. the first symptoms of narcosis for any given diver are often more predictable and personal. Deep dives should be made only after a gradual training to gradually test the individual diver's sensitivity to increasing depths. Helium is stored in brown cylinders. Some divers report that they have hearing changes. For example. the effects disappear almost immediately upon ascending to a shallower depth. then it is necessary to abort the dive.  The use of these gases forms part of technical diving and requires further training and certification. While the individual diver cannot predict exactly at what depth the onset of narcosis will occur on a given day. has 2. and at these depths narcosis does not present a large risk.  Scuba organizations which train for diving beyond Narcosis while deep diving is prevented by filling recreational depths. Since narcosis becomes more severe as depth increases. Equivalent narcotic depth (END) is a commonly used way of expressing the narcotic effect of different breathing gases.Nitrogen narcosis Should problems remain. and that the sound which their exhaled bubbles make becomes different. Standard tables. neon at a given pressure has a narcotic effect equivalent to nitrogen at 0. a diver keeping to shallower depths can avoid serious narcosis. Most recreational dive schools will only certify basic divers to depths of 18 m (60 ft). and this training should include a discussion of narcosis. and these may then be used as a signal to ascend to shallower depths. owing to its low thermal conductivity). The decompression schedule can still be followed unless other conditions require emergency assistance. a diver who remains calm and is alert to the danger will be capable of resolving these problems at an earlier stage. Argon. Although helium is the . and another feelings of claustrophobia. often consisting of further theory and some practice in deep dives with close supervision. Diving organizations such as Global Underwater Explorers (GUE) emphasize that such sessions are for the purpose of gaining experience in recognizing the onset symptoms of narcosis for an individual. If narcosis does occur. high-pressure oxygen can lead to oxygen toxicity. Although severe narcosis may interfere with the judgment necessary to take preventive action. list conversion factors for narcotic effect of other gases. Scientific evidence does not show that a diver can train to overcome any measure of narcosis at a given depth or become tolerant of it. for example. so in principle it should be usable at nearly four times the depth. with careful supervision and logging of reactions. the use of other breathing gas mixes containing helium in place of some or all of the nitrogen in air—such as trimix and heliox—because helium has no narcotic potential. may forbid diving with gases that cause too dive cylinders with a gas mixture containing much narcosis at depth in the average diver. For example.
a still-mysterious but apparently unrelated phenomenon."  Junod suggested that narcosis resulted from pressure causing increased blood flow and hence stimulating nerve centers. Abstinence time needed for marijuana is unknown. Experts recommend total abstinence from alcohol at least 12 hours before diving. even for repeated. a prominent Victorian physician. at greater depths it can cause high pressure nervous syndrome. makes nitrogen narcosis more likely. and other factors are also important. Tests have shown that all divers are affected by nitrogen narcosis.  Nevertheless. noting "the functions of the brain are activated. yet still be affected by it. Except for occasional amnesia of events at depth. Meyer in 1899. Junod was the first to describe symptoms of narcosis in 1834. divers should avoid sedating medications and drugs. hypothesized in 1881 that pressure forced blood to inaccessible parts of the body and the stagnant blood then resulted in emotional changes. and longer for other drugs. A hangover. The first report of anesthetic potency being related to Both Meyer and Overton discovered that the narcotic potency of an anesthetic can lipid solubility was published by Hans generally be predicted from its solubility in oil H. combined with the reduced physical capacity that goes with it. Inert gas narcosis is only one factor which influences the choice of gas mixture. thoughts have a peculiar charm and. the underlying behavioral effects remain.   These effects are particularly dangerous because a diver may feel they are not experiencing narcosis. chronic or acute exposure. symptoms of intoxication are present. Even though it is possible that some divers can manage better than others because of learning to cope with the subjective impairment. entitled Zur Theorie der Alkoholnarkose. though some are less affected than others. Because of similar and additive effects. it is likely to be longer than for alcohol. the risks of decompression sickness and oxygen toxicity. Two years later a similar theory was published independently by Charles Ernest Overton. but due to the much longer half-life of the active agent of this drug in the body. History French researcher Victor T. in some persons. as the result of illogical behavior in a dangerous environment. What became known as the Meyer-Overton Hypothesis is illustrated in the diagram to the right. such as marijuana and alcohol before any dive. the severity of narcosis is unpredictable and it can be fatal while diving. the effects of narcosis are entirely reversible by ascending and therefore pose no problem in themselves. cost. . imagination is lively. Walter Moxon (1836–1886).Nitrogen narcosis least intoxicating of the breathing gases. 45 Prognosis and epidemiology Narcosis is potentially one of the most dangerous conditions to affect the scuba diver below about 30 m (100 ft).
S.  Petri. . from man to cell membrane" (http:/ / archive.  Askitopoulou. .  Hobbs M (2008). Behnke and O. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society. "Professional Scuba Association International History" (http:/ / www. "Clinical and experimental study of xenon anesthesia" (http:/ / www.S. Ioanna A. Liu. (Value for Krypton from 4th Edition. following research by Christian J.Philippines. U. "Change in strategy of solving psychological tests: evidence of nitrogen narcosis in shallow air-diving" (http:/ / archive. John. org/ 3976).L. VN (November–December 1999). A (2006). html). Alf O. OCLC 2068005. general-anaesthesia. PMC 2199778. This measures the relative concentration of different gases required to prevent motor response in 50% of subjects in response to stimulus.  Hill. Eleni (April 12. nih. Konsolaki.  Burov. htm  http:/ / www. Encyclopedia of Recreational Diving (3rd ed. rubicon-foundation. "Nitrogen narcosis".  Brubakk & Neuman 2003. p. Journal of the South Pacific Underwater Medicine Society (first published at Oceans 2000 Conference) 5 (2). Inc 35 (3): 175–84. p. "Diver narcosis. EM. MD: Undersea and Hyperbaric Medical Society) (UHMS Publication Number 64WS(NN)4-26-85). Retrieved 2009-08-07. p. Journal of Hygiene 41 (3): 225–49. PMID 16869533. RH. Kornienko. . RP. nlm. . deep diving experiments using hydrox were conducted by Arne Zetterström between 1943 and 1945. Retrieved 2008-12-23. 305  Hesser. and carbon dioxide in compressed-air narcosis" (http:/ / archive. rubicon-foundation. rubicon-foundation. Simon J (2005). diseasesdatabase. 301  U. Tom S. rubicon-foundation. 613. gov/ cgi/ mesh/ 2011/ MB_cgi?mode=& term=Nitrogen+ Narcosis& field=entry#TreeC21. As hydrogen has only 0. "Subjective and behavioural responses to nitrogen narcosis and alcohol" (http:/ / archive. Haldane.  PSAI Philippines. Inc) 5 (4): 391–400. Undersea and Hyperbaric Medicine 33 (3): 197–204. . "Deep diving and ordinary diving". "Nitrogen Narcosis" (http:/ / archive. Navy Diving Manual (http:/ / supsalv. "Inert Gas Narcosis". 176). revision 6. "Roles of nitrogen. ISBN 0702025712. SS521-AG-PRO-010. Australia: J. . International Anesthesia Research Society. Fagraeus. CM.). 571  Bennett. doi:10.  Rostain. org/ 2810). com/ xenon-anaesthesia. Retrieved 2008-12-23.  Brubakk & Neuman 2003. rubicon-foundation. "Human physiology under high pressure". p. in 1977 and 1978.  Lippmann & Mitchell 2005. Ramoutsaki. 105  Brylske. et al. Retrieved 2009-07-29. rubicon-foundation. . 2000). RW. Albert R.55 the solubility of nitrogen. anesthesiaanalgesia.). Victoria. Publications. PMID 14756232. PMID 734806. The (NOAA) Diving Manual was revised to recommend treating oxygen as if it were as narcotic as nitrogen. pdf). html). Rostain. com/ history. Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society. (1933). GN. Mitchell. org/ 5060). Peter. 29th Undersea and Hyperbaric Medical Society Workshop (Bethesda. ISBN 1878663011. Naval Sea Systems Command. Yarborough demonstrated that gases other than nitrogen also could cause narcosis. Inc) 30 (4): 293–303. . org/ 4496). OCLC 66524750. . Report of a Committee Appointed by the British Admiralty. NE. NM (2003). William (1975). In Brubakk. p. For an inert gas the narcotic potency was found to be proportional to its lipid solubility.  Brubakk & Neuman 2003. J (1978). oxygen. . United States: Professional Association of Diving Instructors. org/ 8101). org/ 5897). Jean Claude (2003). 304. Further research into the possible mechanisms of narcosis by anesthetic action led to the "minimum alveolar concentration" concept in 1965. L. Jean C. Deeper into Diving (2nd ed. "Etymology and Literary History of Related Greek Words" (http:/ / www. Professional Scuba Association International . OCLC 51607923. Makeev. ISSN 0093-5387. 308  Paton. 303  Hamilton. Adolfson. psai-philippines. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society. PMID 18619113. Retrieved 2008-12-23. . ISBN 097522901X. 455.). com/ ddb30088. p. David. Navy Supervisor of Diving (2008) (PDF). Leonard. KW (eds) (1985). Bennett and Elliott's physiology and medicine of diving (5th ed. p. United States: Saunders Ltd. D. Retrieved June 9. 103.S. Retrieved 2008-12-23. org/ content/ 91/ 2/ 486.Nitrogen narcosis In 1939. U. org/ pdf/ DiveMan_rev6. full). PMID 20475589. Retrieved 2008-10-31.  Lippmann.1017/S0022172400012432. Anesteziol Reanimatol (6): 56–60. Jacques-Yves Cousteau in 1953 famously described it as "l’ivresse des grandes profondeurs" or the "rapture of the deep". Balon N (2006). "Recent neurochemical basis of inert gas narcosis and pressure effects" (http:/ / archive. and shows similar results for anesthetic potency as the measurements of lipid solubility. Retrieved 2009-06-29.  Brubakk & Neuman 2003. Potapov. Lambertsen et al. Selby. 2010. p. Kizer.  Case. Helen. Neuman. John Burdon Sanderson (1941). Analgesia and Anesthesia. 46 Footnotes  http:/ / www. Retrieved 2008-11-03.
Lieb. rubicon-foundation. such as TDI and IANTD teach "extended range" or "deep air" courses which teach diving to depths of up to 55 m (180 ft) without helium.. B (1995). it is appropriate to include the oxygen in the END calculation when using trimixes (Lambersten et al. Bennett and Elliott's physiology and medicine of diving (5th ed. Thom. org/ 4498). KN. PMID 1417647. "Otorhinolaryngological aspects of diving". Neuman. MF. In Brubakk. . pp. "A molecular description of how noble gases and nitrogen bind to a model site of anesthetic action" (http:/ / www.1001/archpsyc. Ola (2003). ISSN 1066-2936.  Bennett. MD: Undersea and Hyperbaric Medical Society) (UHMS Publication Number WS2-28-76): 272.).1172/JCI101995. Tom S. Gruber. Yurgelun-Todd. .3.e. the sum of the oxygen and the nitrogen) is to be regarded as having the same narcotic potency as an equivalent partial pressure of nitrogen in air. OCLC 51607923.  Molvaer. B. Anesthesia and Analgesia 91 (6): 1542–9. IANTD/IAND. Otto I (2003). Huestis.  Brubakk & Neuman 2003. Eberhard (December 2000). Schreiner. html).  Lippmann & Mitchell 2005. 1977. "Subjective and behavioral effects associated with repeated exposure to narcosis".909. p.1097/00000539-200012000-00045. php?did=80& site=2). PMC 439519. Aviation.  Trudell. PMID 7509043. . Seymour S. doi:10. 35–46  "Extended Range Diver" (http:/ / www. Michael J. "The effects of altered arterial tensions of carbon dioxide and oxygen on cerebral blood flow ans cerebral oxygen consumption of normal young men". James I. NP. Rostain. Igor B. 2. Retrieved 2009-07-29. Zieglgänsberger. Inc 14 (4): 347–69. "Molecular and cellular mechanisms of general anaesthesia". Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society 22 (1): 41–9. 2009. doi:10. British Sub-Aqua Club. . 2002. OCLC 51607923. Hudson. space. Alf O. "IANTD Scuba & CCR. pp. In Brubakk. Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society 12 (4): 369–402.1. In Brubakk. "Oxygen under pressure". K. .10. "Thermal considerations in diving". 9. OCLC 26915585. anesthesia-analgesia.." (http:/ / archive. Kochs. Navy Diving Manual 2008. techdiver.). Marguerite (2008).  Fowler. James M. rubicon-foundation. K. United States: Saunders Ltd. Gerhard. Carl F (1948). Jean Claude (2003).. Fowler. 129. 430–1  St Leger Dowse. "Development of Decompression Procedures for Depths in Excess of 400 feet" (http:/ / archive. . G (1985). Eiken. Retrieved 2009-08-16.  Pope.  Franks. EI (1998). ISBN 0702025712. com/ page.Nitrogen narcosis  Kety. Alf O. 234."  Anttila. "Effects of inert gas narcosis on behavior--a critical review. Koblin. Alf O. United States: Saunders Ltd. since oxygen has some narcotic properties.  A number of technical diving agencies. 4th. "Effects of ethanol and amphetamine on inert gas narcosis in humans" (http:/ / archive.  Smith.. Heslegrave. p. Retrieved 2008-12-23. Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society. PMID 11576028. ISBN 0702025712. "Priestley lecture 1986. United States: Saunders Ltd. . 304  Hapfelmeier. com/ iantd3. "Diving Officer's Conference presentations" (http:/ / www. Rainer. ama-assn. The non-helium portion (i. org/ 2720). org/ cgi/ content/ abstract/ 87/ 2/ 411). "Neuropsychological performance in long-term cannabis users" (http:/ / archpsyc.  Lippmann & Mitchell 2005.  Michalodimitrakis. 9th Undersea and Hyperbaric Medical Society Workshop (Bethesda. PMID 3775969. Ackles. Retrieved 2009-03-22. PMID 7742709. "[16. EB (July 1987).58. Undersea Biomedical Research 13 (3): 345–54. 110–3  Fowler. . Deborah (2001). Retrieved 2008-12-01. Peter.1038/367607a0. DD. Bennett and Elliott's physiology and medicine of diving (5th ed. R (1992). MF. RW. Archives of General Psychiatry (American Medical Association) 58 (10): 909–15. "Nitrogen narcosis and alcohol consumption--a scuba diving fatality". p. Schneck. com/ index.  Hamilton. HR (eds) (1975). ISSN 0021-9738. "Nitrous oxide and xenon increase the efficacy of GABA at recombinant mammalian GABA(A) receptors" (http:/ / www. Retrieved 2008-12-23. Laliberté.  Mekjavic. Eger. Hamilton. Laliberté. B. org/ 2199). PMID 16695569. Tipton. Hajo. K. A (1987). pp. tdisdi. In Brubakk.  Clark. OCLC 51607923. 374. org/ cgi/ content/ full/ 58/ 10/ 909). org/ 3019). United States: Saunders Ltd. p.2. Diving for Science and Technology. . SAA and other European training agencies teach recreational diving to a depth limit of 50 m (160 ft). Retrieved 2008-06-10. ws/ exotic_gases.1097/00000539-199808000-00034. 47 . G (1986). WR (1994). Alf O. PMID 3307084. org/ cgi/ content/ full/ 91/ 6/ 1542). p.  "Mixed-Gas & Oxygen". International Training.  Lippmann & Mitchell 2005. PMID 11094015. Bennett and Elliott's physiology and medicine of diving (5th ed. anesthesia-analgesia. doi:10. Porlier. Tom S. OCLC 51607923. PMID 3612064. Retrieved 2009-07-02. Schmidt. Anesthesia and Analgesia 87 (2): 411–8. Bennett and Elliott's physiology and medicine of diving (5th ed. NOAA Diving Manual. Nature 367 (6464): 607–14. regardless of the proportions of oxygen and nitrogen. "Dissociation of the behavioral and subjective components of nitrogen narcosis and diver adaptation" (http:/ / archive. iantd. . 323–57. . doi:10. Patsalis. vol.  Hamilton Jr. PSCR & SCR Rebreather Diver Programs (Recreational Trimix Diver)" (http:/ / www. and environmental medicine 63 (10): 865–9. Tom S. Retrieved 2009-07-29. Marilyn A. Stephen R (2003). "Narcotic factors of gases" (http:/ / www. PMID 9706942. Retrieved 2009-07-29. 106  U. ISBN 0702025712. Neuman. Haseneder. rubicon-foundation.  BSAC. bsac. shtml#6). asp?section=2595& sectionTitle=DOC+ presentation+ summaries& preview=1). Neuman. org/ 3050). Retrieved 2008-10-31. Journal of Clinical Investigation 27 (4): 484–492. Inc. Journal of Forensic Sciences 32 (4): 1095–7. ch. Amanda J.).  IANTD (1 January 2009). doi:10. On the science of deep-sea diving--observations on the respiration of different kinds of air" (http:/ / archive. ISBN 0702025712. Tom S.4] . Walter. rubicon-foundation. rubicon-foundation.  Hamilton. JR.).1978). Neuman. E. "The High Pressure Nervous Syndrome". Porlier. p. Harrison G. National Oceanic and Atmospheric Administration. Matti.S.
ddrc. Retrieved 2009-03-22. Anesthesiology 26 (6): 756–63.uhms. (2009-02-01). George D. 1978" (http:/ / archives. Ernest S. Allgemeiner Pharmakologie (Institut für Pharmakologie). The Silent World: A Story of Undersea Discovery and Adventure. publications about nitrogen narcosis. • Campbell.1097/00000542-196511000-00010. p. "University of Pennsylvania Institute for Environmental Medicine report.  Ornhagen.  Lambertsen. PMID 2741255.  Eger. Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society 16 (3): 227–32. "Nitrogen Narcosis" (http://www.  Overton.1057. Ernest S. Victor T (1834). Revue médicale française et étrangère: journal des progrès de la médecine hippocratique (Chez Gabon et compagnie): 350–368. 266. Retrieved 2009-08-25. edu/ uhmsupiemr. Jacques-Yves. American Journal of Physiology (126): 409–15. WH. . Charles Ernest (1901). JM (1978). G (1989).com/page74. Saidman. . LJ. Dumas. pp. PMID 4082343. FOA Rapport C58015-H1 (Stockholm: National Defence Research Institute). 48 References External links • Undersea and Hyperbaric Medical Society (http://www. "Recherches physiologiques et thérapeutiques sur les effets de la compression et de la raréfaction de l'air" (http:/ / books. ScubaDoc's overview of marijuana and diving. duke. Moeller. Harper & Brothers Publishers. p. 306  Moxon. EI. • Campbell. "Respiratory resistance. Retrieved 2009-07-29. .  Cousteau.htm).  Rogers. "Minimum alveolar anesthetic concentration: a standard of anesthetic potency". org/ 2522). "Studien Über Die Narkose" (in German). "Effect of brief. "Alcohol and Diving" (http://scuba-doc. ISSN 0347-7665. Diving with Deep-Six. com/ ?id=K5XREXyDSQoC).rubicon-foundation.  Brubakk & Neuman 2003. mc. Gelfand. Institute for Environmental Medicine. H (1984). google. Retrieved 2009-07-29. informaworld. html). • Rubicon Research Repository (http://archive. Retrieved 2009-06-04. "Diving While Using Marijuana" (http://scuba-doc.org/) Searchable repository of Diving and Environmental Physiology Research. repeated hyperbaric exposures on susceptibility to nitrogen narcosis" (http:/ / archive. .deep-six. Retrieved 2009-03-22.491.1136/bmj. com/ smpp/ content~content=a789031692~db=all). ScubaDoc's overview of alcohol and diving. Christian J. OCLC 2068005. rubicon-foundation. British Medical Journal 1: 491–7. AR. Retrieved 2009-08-25. PMID 5844267. B (1965).3 MPa". 583–5. ISBN 0792267966. Retrieved 2009-08-25. University of Pennsylvania. Frédéric (1953).org/) UK charity dedicated to treatment of diving diseases. Yarborough. . "Hydrogen-Oxygen (Hydrox) breathing at 1. (2009-06-25). Clark. . • Campbell.  Behnke. oil-water solubility and mental effects of argon compared with helium and nitrogen". (2009-05-03). • Diving Diseases Research Centre (DDRC) (http://www.com/marij.1. PMID 20749857.Nitrogen narcosis ISSN 0093-5387. 300  Junod.com/alch.org) Scientific body. OD (1939). Brandstater. R. ISSN 0093-5387.html). Walter (1881). OCLC 2068005. doi:10. "Croonian lectures on the influence of the circulation on the nervous system" (http:/ / www.htm).  Brubakk & Neuman 2003. doi:10.
divers tend not to utilize nitrox at greater depths where more pronounced narcosis symptoms are more likely to occur. For example. Nitrox is not a safer gas than compressed air in all respects. it increases the risk of oxygen toxicity and fire. the fact that the study mentioned was conducted in a dry chamber with an ideal decompression profile may have been sufficient to reduce sub-clinical DCS and prevent fatigue in both nitrox and air divers. Breathing nitrox is not thought to reduce the effects of narcosis. as oxygen seems to have equally narcotic properties under pressure as nitrogen.e. showing adjusted no-decompression times. would be necessary to fully investigate this issue. There is anecdotal evidence that the use of nitrox reduces post-dive fatigue. Reducing the proportion of nitrogen by increasing the proportion of oxygen reduces the risk of decompression sickness for the same dive profile. nitrox with an oxygen content above 21%.Nitrox 49 Nitrox Nitrox refers to any gas mixture composed (excluding trace gases) of nitrogen and oxygen. a study was published using wet divers at the same depth and confirmed that no statistically significant reduction in reported fatigue is seen. where the reduced percentage of nitrogen is advantageous in reducing nitrogen uptake in the body's tissues and so extending the possible dive time. however. and also different levels of exertion. however a double-blind study to test this found no statistically significant reduction in reported fatigue. and 1% other gases. primarily argon. 21% oxygen. This may be due to a dissociation of the subjective and behavioural effects of narcosis. it should be noted that because of risks associated with oxygen toxicity. there is much better scientific evidence that breathing high-oxygen gases . thus one should not expect a reduction in narcotic effects due only to the use of nitrox. Purpose Enriched Air Nitrox. nitrox is normally Typical Nitrox cylinder marking differentiated and handled differently from air. The most common use of nitrox mixtures containing higher than normal levels of oxygen is in scuba. micro bubbles in the blood insufficient to cause symptoms of DCS). there are people in the diving community who insist that they feel reduced narcotic effects at depths breathing nitrox. some suggestion that post dive fatigue is due to sub-clinical decompression sickness (DCS) (i. are generally used by divers. this includes normal air which is approximately 78% nitrogen. although its use can reduce the risk of decompression sickness. However. which are further discussed below. or allows extended dive times without increasing the need for decompression stops for the same risk. Further studies with a number of different dive profiles. is mainly used in scuba diving to reduce the proportion of nitrogen in the breathing gas mixture. and/or reducing the risk of decompression sickness (also known as the bends).   Nonetheless.   However. For a reduction in narcotic effects trimix or heliox. In 2008. particularly in older and or obese divers. Enriched Air Nitrox diving tables.  There was. gases which also contain helium. in scuba diving.
Nitrox increase exercise tolerance, during aerobic exertion. Though even moderate exertion while breathing from the regulator is a relatively uncommon occurrence in scuba, as divers usually try to minimize it in order to conserve gas, episodes of exertion while regulator-breathing do occasionally occur in sport diving. Examples are surface-swimming a distance to a boat or beach after surfacing, where residual "safety" cylinder gas is often used freely, since the remainder will be wasted anyway when the dive is completed. It is possible that these so-far un-studied situations have contributed to some of the positive reputation of nitrox.
Nitrox is known by many names: Enhanced Air Nitrox, Oxygen Enriched Air, Nitrox, EANx or Safe Air.  The name "nitrox" may be capitalized when referring to specific mixtures such as Nitrox32, which contains 68% nitrogen and 32% oxygen. When one figure is stated, it refers to the oxygen percentage, not the nitrogen percentage. The original convention, Nitrox68/32 became shortened as the first figure is redundant. Although "nitrox" usually refers to a mixture of nitrogen and oxygen with more than 21% oxygen, it can refer to mixtures that are leaner in oxygen than air. "Enriched Air Nitrox", "Enriched Air" or "EAN" are used to emphasise richer than air mixtures. In "EANx", the "x" indicates the percentage of oxygen in the mix and is replaced by a number when the percentage is known; for example a 40% oxygen mix is called EAN40. The two most popular blends are EAN32 and EAN36 (also named Nitrox I and Nitrox II, respectively, or Nitrox68/32 and Nitrox64/36).
In its early days of introduction to non-technical divers, nitrox has occasionally also been known by detractors by less complimentary terms, such as "devil gas" or "voodoo gas" (a term now sometimes used with pride). These percentages are what the gas blender aims for in partial-pressure blending, but the final actual mix in such cases will be unique, and so a small flow of gas from the cylinder must be measured with a handheld oxygen analyzer, before the diver breathes from the cylinder underwater.
Richness of mix
The two most common recreational diving nitrox mixes contain 32% and 36% oxygen, which have maximum operating depths (MODs) of 34 metres (112 ft) and 29 metres (95 ft) respectively when limited to a maximum partial pressure of oxygen of 1.4 bar (140 kPa). Divers may calculate an equivalent air depth to determine their decompression requirements or may use nitrox tables or a nitrox-capable dive computer.    Nitrox with more than 40% oxygen is uncommon within recreational diving. There are two main reasons for this: the first is that Technical divers preparing for a mixed-gas decompression dive in Bohol, Philippines. Note the backplate and wing setup with sidemounted stage tanks all pieces of diving equipment that come containing EAN50 (left side) and pure oxygen (right side). into contact with mixes containing higher proportions of oxygen, particularly at high pressure, need special cleaning and servicing to reduce the risk of fire.  The second reason is that richer mixes extend the time the diver can stay underwater without needing decompression stops far further than the duration of typical diving cylinders. For example, based on the PADI nitrox recommendations, the maximum operating depth
Nitrox for EAN45 would be 21 metres (69 ft) and the maximum dive time available at this depth even with EAN36 is nearly 1 hour 15 minutes: a diver with a breathing rate of 20 litres per minute using twin 10 litre, 230 bar (about double 85 cu. ft.) cylinders would have completely emptied the cylinders after 1 hour 14 minutes at this depth. Usage of nitrox mixtures containing 50% to 80% oxygen is common in technical diving as a decompression gas, which by virtue of its lower partial pressure of inert gases such as nitrogen and helium, allows for more efficient (faster) elimination of these gases from the tissues than leaner oxygen mixtures. In deep open circuit technical diving, where hypoxic gases are breathed during the bottom portion of the dive, a Nitrox mix with 50% or less oxygen called a "travel mix" is sometimes breathed during the beginning of the descent in order to avoid hypoxia. Normally, however, the most oxygen-lean of the diver's decompression gases would be used for this purpose, since descent time spent reaching a depth where bottom mix is no longer hypoxic is normally small, and the distance between this depth and the MOD of any nitrox decompression gas is likely to be very short, if it occurs at all.
Any cylinder containing any blend of gas other than the standard air content is required by most diving training organizations to be clearly marked. Some organizations, e.g. GUE, argue that it does not make sense to have a permanent marking on a gas tank that can be filled with any gas. The standard nitrox cylinder is yellow in color and marked with a green band around the shoulder of the tank, with Nitrox or "Enriched air" marked in white or yellow letters inside. Tanks of any other color are generally marked with six inch band around the shoulder, with a one inch yellow band on the top and bottom, with four inches of green in the middle. This green band will also have the designation of "NITROX" or something similar inside, in yellow or white letters. Every nitrox cylinder should also have a sticker stating whether or not the cylinder is oxygen clean and suitable for partial pressure blending. Any oxygen clean cylinder may have any mix up to 100% oxygen inside. If by some accident an oxygen clean cylinder is filled at a station which does not supply gas to oxygen-clean standards it is then considered contaminated and must be re-cleaned before a gas containing more than 40% oxygen may again be added. Cylinders marked as not-oxygen clean may only be filled with enriched oxygen mixtures from membrane or stick blending systems where the gas is mixed before being added to the cylinder. Finally, all nitrox cylinders should have a tag that, at minimum, states the oxygen content of the cylinder, the date it was blended, the gas blender's name, and the maximum operating depth along with the partial pressure this depth was calculated with. Other requirements Cylinder showing Nitrox band and sticker marked with MOD and O2% may be made as to what is marked on the cylinder, but these markings are considered standard and safe by the diving community, and any cylinders lacking these markings should be considered possibly unsafe. Training for nitrox certification suggests this tag be verified by the diver himself by using an oxygen analyzer.
Diving and handling nitrox raises a number of potentially fatal dangers due to the high partial pressure of oxygen (ppO2).  Nitrox is not a deep-diving gas mixture owing to the increased proportion of oxygen, which becomes toxic when breathed at high pressure. For example, the maximum operating depth of nitrox with 36% oxygen, a popular recreational diving mix, is 29 metres (95 ft) to ensure a maximum ppO2 of no more than 1.4 bar (140 kPa). The exact value of the maximum allowed ppO2 and maximum operating depth varies depending on factors such as the training agency, the type of dive, the breathing equipment and the level of surface support, with professional divers sometimes being allowed to breath higher ppO2 than those recommended to recreational divers. To dive safely with nitrox, the diver must learn good buoyancy control, a vital part of scuba diving in its own right, and a disciplined approach to preparing, planning and executing a dive to ensure that the ppO2 is known, and the maximum operating depth is not exceeded. Most dive shops, dive operators, and gas blenders require the diver to have a nitrox certification card before selling nitrox to divers. Some training agencies, such as Technical Diving International, teach the use of two depth limits to protect against oxygen toxicity. The shallower depth is called the "maximum operating depth" and is reached when the partial pressure of oxygen in the breathing gas reaches 1.4 bar (140 kPa). The deeper depth, called the "contingency depth", is reached when the partial pressure reaches 1.6 bar (160 kPa). Diving at or beyond this level exposes the diver to the risk of central nervous system (CNS) oxygen toxicity. This can be extremely dangerous since its onset is often without warning and can lead to drowning, as the regulator may be spat out during convulsions, which occur in conjunction with sudden unconsciousness (general seizure induced by oxygen toxicity). Divers trained to use nitrox memorise the acronym VENTID-C (which stands for Vision (blurriness), Ears (ringing sound), Nausea, Twitching, Irritability, Dizziness, and Convulsions). However, evidence from non-fatal oxygen convulsions indicates that most convulsions are not preceded by any warning symptoms at all. Further, many of the suggested warning signs are also symptoms of nitrogen narcosis, and so may lead to misdiagnosis by a diver. A solution to either is to ascend to a shallower depth.
Precautionary procedures at the fill station
Many training agencies such as PADI, CMAS, SSI and NAUI train their divers to personally check the oxygen percentage content of each nitrox cylinder before every dive. If the oxygen percentage deviates by more than 1% from the value written on the cylinder by the gas blender, the scuba diver must either recalculate his or her bottom times with the new mix, or else abort the dive to remain safe and avoid oxygen toxicity or decompression sickness. Under IANTD and ANDI rules for use of nitrox, which are followed by most dive resorts around the world, filled nitrox cylinders are signed out personally in a gas blender log book, which contains, for each cylinder and fill, the cylinder number, the measured oxygen percent composition, the signature of the receiving diver (who should have personally measured the oxygen percent with an instrument at the fill-shop), and finally a calculation of the maximum operating depth for that fill/cylinder. All of these steps minimize danger but increase complexity of operations (for example, personalized cylinders for each diver must generally be kept track of on dive boats with nitrox, which is not the case with generic compressed air cylinders).
For many years Dr. Texas that year) banned nitrox training providers from the show. A few facilities have begun to fill cylinders with air which has been enriched with oxygen by a pre-mixing process. However. The pre-mixing is accomplished either by a membrane system which removes nitrogen from the air during compression or by a 'stick' blending technique where pure oxygen is mixed with air in a baffled chamber attached to the compressor intake. However.e. In 1992 BSAC banned its members from using nitrox.  In 1985 Dick Rutkowski. and met with heavy skepticism by the diving community. These developments were kept secret until independently duplicated by civilians in the 1960s. even if a recognized fire does not happen. in a watershed moment. but it is also used in some smaller diver shops. In World War II or soon after. any gas which contains a significantly larger percentage of oxygen than air is a fire hazard. formed IAND (International Association of Nitrox Divers) and began teaching nitrox use for recreational diving.S. Furthermore. In 1991. so that it is pressurized as nitrox for the first time in the diving cylinder. He also developed a process for mixing oxygen and air which he called a continuous blending system. For a history of this controversy see Luxfer cylinders  . nitrox which is mixed before being put into the cylinder) below 40% oxygen does not require a specially cleaned cylinder or other equipment. Compressed Gas Association (CGA) and two international nitrox teaching agencies (IANTD and ANDI) now support the standard that any gas containing more than 23. a number of organisations took the opportunity to present nitrox workshops outside the show. the U. . there is some discussion over whether or not mixtures of gas which contain less than 40% oxygen may sometimes be exempt from oxygen clean standards.. a former NOAA diving safety officer.   Most nitrox fill stations which supply pre-mixed nitrox will fill non-oxygen clean cylinders with mixtures below 40%. no differently from pure oxygen) for purposes of oxygen cleanliness and oxygen compatibility (i.Nitrox 53 Fire and toxic cylinder contamination from oxygen reactions Diving cylinders are usually filled with nitrox by a gas blending technique such as partial pressure blending or premix decanting (in which a nitrox mix is supplied to the filler in pressurized larger cylinders).e.is still teaching that pre-mixed nitrox (i. Wells' invention was the only practical alternative to partial pressure blending. in the USN Diving Manual. Partial blending using pure oxygen is often used to provide nitrox for multiple dives on live-aboard dive boats. began instituting diving procedures for oxygen-enriched air. This created a backlash. British commando frogmen and work divers started sometimes diving with oxygen rebreathers adapted for semi-closed-circuit nitrox (which they called "mixture") diving by fitting larger cylinders and carefully setting the gas flow rate using a flow meter. History In the 1920s or 1930s Draeger of Germany made a nitrox backpack independent air supply for a standard diving suit. Some of the controversy comes from a single U. This was considered dangerous by some. With the use of pure oxygen during "partial pressure blending" (where pure oxygen is added from a large oxygen cylinder to the nearly empty dive cylinder until it reaches 300–500 psi (20–30 bar) before air is added by compressor) there is an especially increased risk of fire. However.5% oxygen should be treated as nitrox (which is to say. the largest training agency . regulation intended for commercial divers (not recreational divers) years ago. Morgan Wells.PADI . who was the first director of the National Oceanographic and Atmospheric Administration (NOAA) Diving Center. In 1970.S. such gases can also react with hydrocarbons or incorrect lubricants inside a dive cylinder to produce carbon monoxide. In the 1950s the United States Navy (USN) documented enriched oxygen gas procedures for military use of what we today call nitrox. Dr. oxygen "servicability"). the annual DEMA show (held in Houston. At present. and when DEMA relented. In 1979 NOAA published Wells' procedures for the scientific use of nitrox in the NOAA Diving Manual.
ScubaBoard. Fowler B (March 1995). http:/ / archive.  Ergogenic Aids (http:/ / www. Retrieved 2008-05-02. Neuman. Retrieved 2008-05-02. M. p.which invented the term "Safe Air" for marketing purposes . Meanwhile. J. rubicon-foundation.g. 5th Rev ed. In 1993 Skin Diver magazine. Helium is considered to have very little narcotic effect. OCLC 2068005. A.A. Pollock NW. CM.. it was PADI's endorsement that put nitrox over the top as a standard sport diving "option. T. PMID 7742709. scubaboard. Undersea Biomedical Research (Bethesda. . . but instead of cheap or free tank fills with compressed air. Fagraeus. 2007. ISBN 0702025712. up to 35% in the Upper Carboniferous. pp. oxygen.  Hamilton K. 304. S. In 1993 Dive Rite manufactured the first nitrox compatible dive computer. New organizations. the Professional Association of Diving Instructors (PADI) announced full educational support for nitrox. published a three part series arguing that nitrox was unsafe for sport divers. United States: Saunders Ltd. While other main line scuba organizations had announced their support of nitrox earlier. (2001). Retrieved 2008-04-08." (http:/ / archive. ISBN 0941332705. com/ forums/ basic-scuba-discussions/ poll-1630-a. pponline.  Chapman SD. rubicon-foundation.and Bret Gilliam's Technical Diving International (TDI) gave scientific credence to nitrox. the agencies teaching nitrox were not the main scuba agencies. pp." 54 Nitrox in nature Sometimes in the geologic past the Earth's atmosphere contained much more than 20% oxygen: e. Plato PA. In the early 1990s. Tom S (2003). This let animals absorb oxygen more easily and influenced evolution. (2001). J (1978). in 1992 NAUI became the first existing major sport diver training agency to sanction nitrox. rubicon-foundation. United States: Saunders Ltd.. DAN Nitrox Workshop Proceedings (http:/ / archive. Alf O. "Dissociation of the behavioral and subjective components of nitrogen narcosis and diver adaptation" (http:/ / archive. Doolette DJ. but results in HPNS when breathed at high pressures. Adolfson. ISSN 0093-5387. org/ 8005. In 1996. rubicon-foundation. Fourth Edition. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society) 22 (1): 41–9. O.  Oxygen has the potential to be 1.  Brubakk. NC: Divers Alert Network. html). called the Bridge. Laliberté MF. Retrieved 2009-05-21. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society) 30 (4): 285–91. org/ 2810). United States: Best Publishing.  "How does nitrox make you feel?" (http:/ / www. the leading recreational diving publication at the time. 660. .. Retrieved 2009-01-27. Against this trend. It is clear that different gases result in different narcotic effects at depth. and carbon dioxide in compressed-air narcosis. Md: Undersea and Hyperbaric Medical Society) 5 (4): 391–400. rubicon-foundation. . With the new dive computers which could be programmed to allow for the longer bottom-times and shorter residual nitrogen times which nitrox gave. relative narcotic effects at depth have never been studied in detail.. "Measurement of fatigue following 18 msw dry chamber dives breathing air or enriched air nitrox" (http:/ / archive. In: Brueggeman P. the incentive for the sport diver to use the gas increased.  Lang. which does not happen with gases with have greater narcotic qualities. NOAA Diving Manual: Diving for Science and Technology. diving stores were finding a purely economic reason to offer nitrox: not only was an entire new course and certification needed to use it. Retrieved 2009-05-21.  References  Brubakk.  Hesser. uk/ encyc/ 1008. Bennett and Elliott's physiology and medicine of diving. including Ed Betts' American Nitrox Divers International (ANDI) . Williams DJ (2003). org/ 4855). htm) . L. 197. pp. PMID 14756231. org/ 3975).  Joiner. the T being added when the European Association of Technical Divers (EATD) merged with IAND.Nitrox In 1992 the name was changed to the International Association of Nitrox and Technical Divers (IANTD).7 times more narcotic than nitrogen . Diving for Science 2008. Durham. org/ 2199). PMID 734806. 5th Rev ed. . Bennett and Elliott's physiology and medicine of diving. "Roles of nitrogen. ISBN 0702025712. Neuman (2003). 800. Proceedings of the American Academy of Underwater Sciences 27th Symposium. T. Measurement of Fatigue following 18 msw Open Water Dives Breathing Air or EAN36. Wilkinson DC.  Harris RJ.see relevant narcotic potency of gases  Although oxygen appears chemically more narcotic at the surface. co. dive shops found they could charge premium amounts of money for custom-gas blending of nitrox to their ordinary moderately experienced divers.. An intersection of economics and scientific validity had occurred. eds.
"Nitrox" (http:/ / archive.  http:/ / www. luxfercylinders. Retrieved 2008-05-02. org/ 6310). Wilmington.  ATMOSPHERIC OXYGEN. rubicon-foundation. org/ 3835). John.uk/pages/misc/Nitrox. Hamilton Jr. Publications.CANFIELD (1989. ROBERT DUDLEY* Department of Zoology. 40(5) May: 35-36. In Brubakk. Retrieved 2008-05-02. ISSN 0813-1988. . Nitrox Gas Blending Manual. andihq. "The PADI Enriched Air Diver course and DSAT oxygen exposure limits. 6th revision (http:/ / www. org/ 6309). Glen L. McCraken TM (December 1979). org/ 00c3_publications. Mastro. rubicon-foundation. Retrieved 2008-06-05. "An evaluation of the equivalent air depth theory" (http:/ / archive.Nitrox  Elliott. reprinted in South Pacific Underwater Medicine Society Journal 26 (3). 2006. "BSAC gives the OK to nitrox.gasdiving. ISBN 0702025712. supsalv. Australia: J. OCLC 66524750. Simon J (October 2005). South Pacific Underwater Medicine Society Journal 26 (3).BERNER AND D. at pages 9-11  Allen.dive-hive. AMERICAN JOURNAL OF SCIENCE 289. 1992 at the University of North Carolina at Wilmington. James M. Stoltzfus JM (2007). LB.  TDI. 55 Footnotes External links • Nitrox .) Proceedings of the American Academy of Underwater Sciences Twelfth Annual Scientific Diving Symposium "Diving for Science 1992". .  Lippmann. USA and Smithsonian Tropical Research Institute. org/ 2835). Tom S. OCLC 16986801. Neuman.shtml) • Online Nitrox calculator for EAD. Stephen R (2003). United States Navy Experimental Diving Unit Technical Report NEDU-RR-01-61. com/ support/ faq/ aluminumoxygen. In: Cahoon. D and Shreeves. html  Rosales KR. Retrieved 2008-05-01. United States: Saunders. "Equivalent air depth: fact or fiction" (http:/ / archive. Alan W.  A position which it would formally maintain until in 1995 magazine editor Bill Gleason was reported to say that nitrox was "all right". rubicon-foundation.  Logan. pp. Retrieved 2011-01-11. . Mitchell.333-361.). MOD and PPO2. University of Texas. org/ 4861). . "Guide for Oxygen Compatibility Assessments on Oxygen Components and Systems. Thom. Retrieved 2008-05-01. (American Academy of Underwater Sciences). ISBN 097522901X. PMID 538866. com/ nitrox/ preview_p03. warns if a critical limit is reached (http://www.com/support/faq/ aluminumoxygen. htm  R. Balboa. org/ 9033). 403–4. 9). com/ pages/ mainpage. South Pacific Underwater Medicine Society Journal 26 (3). Retrieved 2008-05-02. C (1996)." (http:/ / archive. ISSN 0813-1988. Austin.frequently asked questions (http://www. D (1996). org/ 6275). Bennett and Elliott's physiology and medicine of diving (5th ed." (http:/ / archive. Skin Diver would later go into bankruptcy. .  Clark. "Oxygen under pressure". rubicon-foundation.htm) • Useful Luxfer FAQ on the CGA and "40% rule" controversy (http://www.org/diving-nitrox. com/nitrox_calc. PO Box 2072. OCLC 51607923. Undersea Biomedical Research 6 (4): 379–84. OCLC 16986801. Diver 1995. Steven J. GIANT PALEOZOIC INSECTS AND THE EVOLUTION OF AERIAL LOCOMOTOR PERFORMANCE. "28". "Oxygen safety in the production of enriched air nitrox breathing mixtures. asp?destPage=00c3& pageID=3. JA (1961). K (1996). Republic of Panama Accepted 28 October 1997.html) . americandivecenter.  Berghage Thomas E. United States: US Naval Sea Systems Command. NC. Victoria. . Hulbert. 375.). Alf O. (1992). A NEW MODEL FOR ATMOSPHERIC OXYGEN OVER PHANEROZOIC TIME.E. Retrieved 2008-04-24.  http:/ / www. p. rubicon-foundation. published on WWW 24 March 1998.  Richardson. (ed. ISSN 0813-1988. shtml  US Navy Diving Manual. Deeper into Diving (2 ed. OCLC 16986801.co.php?lang=en) • Diving Nitrox (http://dive-center. TX 78712." (http:/ / archive.luxfercylinders.A.  Butler. pp. . . rubicon-foundation." (http:/ / archive. Robert W. NASA Johnson Space Center Technical Report NASA/TM-2007-213740.  http:/ / www. Shoffstall MS.L. Held September 24-27. rubicon-foundation.
retinal detachment. The result of breathing elevated concentrations of oxygen is hyperoxia. The chamber is pressurised with air to 3. hyperbaric medicine. Pulmonary and ocular toxicity result from longer exposure to elevated oxygen levels at normal pressure. and vision changes such as myopia. with pulmonary and ocular damage being mainly confined to the problems of managing premature infants. Studies show that. It is also known as oxygen toxicity syndrome. breathing problems. and seizures. Symptoms may include disorientation. Protocols for avoidance of hyperoxia exist in fields where oxygen is breathed at higher-than-normal partial pressures. after the researchers who pioneered its discovery and description in the late 19th century. Severe cases can result in cell damage and death. The body is affected in different ways depending on the type of exposure. including underwater diving using compressed breathing gases. in the long term. an excess of oxygen in body tissues.7 bar. Central nervous system toxicity is caused by short exposure to high concentrations of oxygen at greater than atmospheric pressure.8    D018496 Oxygen toxicity is a condition resulting from the harmful effects of breathing molecular oxygen (O2) at elevated partial pressures. Prolonged or very high oxygen concentrations can cause oxidative damage to cell membranes. lungs and eyes. Oxygen toxicity is a concern for scuba divers. the collapse of the alveoli in the lungs.Oxygen toxicity 56 Oxygen toxicity Oxygen toxicity Classification and external resources In 1942–43 the UK Government carried out extensive testing for oxygen toxicity in divers. Oxygen toxicity is managed by reducing the exposure to elevated oxygen levels. oxygen has become available for recreational use in oxygen bars. a robust recovery from most types of oxygen toxicity is possible. those on high concentrations of supplemental oxygen (particularly premature babies).8 987. Historically. and those undergoing hyperbaric oxygen therapy. and the pulmonary condition the Lorrain Smith effect. neonatal care and human spaceflight. and oxygen poisoning. These protocols have resulted in the increasing rarity of seizures due to oxygen toxicity. the central nervous system condition was called the Paul Bert effect. and should have specific training in using such gases. with effects most often seen in the central nervous system. In recent years. The US Food and Drug Administration has warned those suffering from problems such as heart or lung disease not to use oxygen bars. The  subject in the centre is breathing 100% oxygen from a mask. . ICD-10 ICD-9 MeSH T59. oxygen intoxication. Scuba divers use breathing gases containing up to 100% oxygen.
occurring when breathing elevated pressures of oxygen for extended periods.21 bar (21 kPa) and the lower limit for toxicity is more than 0. characterised by difficulty in breathing and pain within the chest.3 bar (30 kPa). heart (myocardial). . Oxygen toxicity is not associated with hyperventilation. and thyroid).  In unusual circumstances. brief periods of rigidity followed by convulsions and unconsciousness. Pulmonary and ocular damage are most likely to occur when supplemental oxygen is administered as part of a treatment. Central nervous system oxygen toxicity can cause seizures. occurring under hyperbaric conditions. Oxidative damage may occur in any cell in the body but the effects on the three most susceptible organs will be the primary concern. high oxygen concentrations may contribute to bone damage. Oxidative damage to the eye may lead to myopia or partial detachment of the retina. effects on other tissues may be observed: it is suspected that during spaceflight. occurring when breathing elevated pressures of oxygen for extended periods. endocrine glands (adrenal. and general damage to cells. but are also a concern during hyperbaric oxygen therapy.Oxygen toxicity 57 Classification The effects of oxygen toxicity may be classified by the organs affected. gonads. causing pain and difficulty in breathing. • Pulmonary (lungs). characterised by alterations to the eyes. • Ocular (retinopathic conditions). and is of concern to divers who encounter greater than atmospheric pressures. Hyperoxia can also indirectly cause carbon dioxide narcosis in patients with lung ailments such as chronic obstructive pulmonary disease or with central respiratory depression. Pulmonary oxygen toxicity results in damage to the lungs. because breathing air at atmospheric pressure always has a partial pressure of oxygen (ppO2) of 0.  damage to liver (hepatic).   or kidneys (renal). particularly to newborn infants. characterised by convulsions followed by unconsciousness. producing three principal forms:   • Central nervous system. It may also be implicated in red blood cell destruction (hemolysis).
irritability (personality changes. anxiety.5 bar (50 kPa) is intermittent. and in the same individual from day to day. followed by rapid spasms of alternate muscle relaxation and contraction producing convulsive jerking (clonic). vertigo. lip-twitching and syncope. of Subjects 1 3 4 4 6 8 4 6 Symptoms Prolonged dazzle. twitch L arm. lip-twitching. severe spasmodic vomiting Severe lip-twitching.   Other factors. The symptoms appear in the upper chest region (substernal and carinal regions). many external factors. If breathing elevated partial pressures of oxygen is not discontinued. as tests have shown a wide variation. spasmodic respiration. "Diaphragmatic spasm". such as darkness and caffeine. patients experience a mild burning on inhalation along with uncontrollable coughing and occasional shortness of breath (dyspnea). epigastric aura. Convulsed Convulsed. This may be followed by a tonic–clonic seizure consisting of two phases: intense muscle contraction occurs for several seconds (tonic). However. epigastric aura.  Tests in animals have indicated a variation in tolerance similar to that found in central nervous system toxicity. Severe lip-twitching. fell asleep. . vertigo. such as underwater immersion. Inspiratory predominance. Physical findings related to pulmonary toxicity have included bubbling sounds heard through a stethoscope (bubbling rales). Euphoria.   In addition. confusion. paraesthesiae.  The onset of seizure depends upon the partial pressure of oxygen (ppO2) in the breathing gas and exposure duration. exposure to cold. increase tolerance in test animals.Oxygen toxicity 58 Signs and symptoms Oxygen Poisoning at 90 ft (27 m) in the Dry in 36 Subjects in Order of Performance – K W Donald Exposure (mins. Severe nausea Central nervous system Central nervous system oxygen toxicity manifests as symptoms such as visual changes (especially tunnel vision). as noted by a reduction in the amount of air that the lungs can hold (vital capacity) and changes in expiratory function and lung elasticity. and exercise will decrease the time to onset of central nervous system symptoms. The seizure ends with a period of unconsciousness (the postictal state). both amongst individuals. but these effects have not been proven in humans. Blubbering of lips. Dazed Nausea. When the exposure to oxygen above 0. as well as significant variations between species. Decrease of tolerance is closely linked to retention of carbon dioxide.  Pulmonary Pulmonary toxicity symptoms result from an inflammation that starts in the airways leading to the lungs and then spreads into the lungs (tracheobronchial tree). and increased blood flow to the lining of the nose (hyperemia of the nasal mucosa). The radiological finding from the lungs shows inflammation and swelling (pulmonary edema).). Vertigo and severe lip twitching. and dizziness. fever.) 96 60–69 50–55 31–35 21–30 16–20 11–15 6–10 Num. amnesia Convulsed. it permits the lungs to recover and delays the onset of toxicity. arm twitch Severe lip-twitching. etc. exposure time before onset is unpredictable. Nausea and vertigo.   This begins as a mild tickle on inhalation and progresses to frequent coughing.  Pulmonary function measurements are reduced. Drowsiness. ringing in the ears (tinnitus). twitching (especially of the face). Dazzle. Nausea and confusion Dazed and lip-twitching. nausea.
will prevent this effect. or inflammation of the upper airways. Evidence of decline in lung function as measured by pulmonary function testing can occur as quickly as 24 hours of continuous exposure to 100% oxygen. Pulmonary toxicity occurs with exposure to concentrations of oxygen greater than 0. Preterm newborns are known to be at higher risk for bronchopulmonary dysplasia with extended exposure to high concentrations of oxygen. Signs of pulmonary toxicity begins with evidence of tracheobronchitis. . Experiments on rats show pulmonary manifestations of oxygen toxicity are not the same for normobaric conditions as they are for hyperbaric conditions. Likewise. In each case.  Divers breathing air at depths greater than 60 m (200 ft) face an increasing risk of an oxygen toxicity "hit" (seizure).6 bars (160 kPa)—about eight times the atmospheric concentration—are usually associated with central nervous system oxygen toxicity and are most likely to occur among patients undergoing hyperbaric oxygen therapy and divers. from minutes to a few hours. can similarly suffer a seizure at shallower depths. This occurs in three principal settings: underwater diving. (IV) the retina begins to detach from the inner wall of the eye (choroid). with evidence of diffuse alveolar damage and the onset of acute respiratory distress syndrome usually occurring after 48 hours on 100% oxygen. with some studies suggesting symptoms usually begin after approximately 14 hours at this level of oxygen. Pulmonary toxicity The lungs. At partial pressures of oxygen of 2 to 3 bar (200 to 300 kPa)—100% oxygen at 2 to 3 times atmospheric pressure—these symptoms may begin as early as 3 hours after exposure to oxygen. in addition to any oxygen exposure during the dive. Since atmospheric pressure is about 1 bar (100 kPa). are exposed to the highest concentration of oxygen in the human body and are therefore the first organs to show toxicity. while—at the same partial pressure of oxygen—the presence of significant partial pressures of inert gases. typically nitrogen. (II) the demarcation becomes a ridge. and patients exposed to chemicals that increase risk for oxygen toxicity such the chemotherapeutic agent bleomycin. such as nitrox. Central nervous system toxicity Exposures. corresponding to an oxygen fraction of 50% at normal atmospheric pressure. as well as the remainder of the respiratory tract. Causes Oxygen toxicity is caused by exposure to oxygen at partial pressures greater than those to which the body is normally exposed. particularly to premature infants. divers who undergo treatment of decompression sickness are at increased risk of oxygen toxicity as treatment entails exposure to long periods of oxygen breathing under hyperbaric conditions. Divers breathing a gas mixture enriched with oxygen. Other groups at higher risk for oxygen toxicity are patients on mechanical ventilation with exposure to levels of oxygen greater than 50%. Therefore.Oxygen toxicity 59 Ocular In premature babies. (III) growth of new blood vessels occurs around the ridge. to partial pressures of oxygen above 1. or ROP) are observed via an ophthalmoscope as a demarcation between the vascularized and non-vascularised regions of an infant's retina. hyperbaric oxygen therapy and the provision of supplemental oxygen. after an asymptomatic period between 4 and 22 hours at greater than 95% oxygen. the risk factors are markedly different. central nervous system toxicity can only occur under hyperbaric conditions. where ambient pressure is above normal. should they descend below the maximum depth allowed for the mixture. signs of damage to the eye (retinopathy of prematurity. The degree of this demarcation is used to designate four stages: (I) the demarcation is a line. current guidelines for patients on mechanical ventilation in intensive care suggests keeping oxygen concentration less than 60%. Breathing 100% oxygen also eventually leads to collapse of the alveoli (atelectasis).5 bar (50 kPa).
  Although the body has many antioxidant systems such as glutathione that guard against oxidative stress. which are natural by-products of the normal metabolism of oxygen and have important roles in cell signalling. is not the main risk factor for development of this disease. Oxygen is necessary for cell metabolism. one of the most reactive products of oxidative stress is the hydroxyl radical (·OH). is possibly involved in iron acquisition. Higher than normal concentrations of oxygen lead to increased levels of reactive oxygen species. which harm DNA and other biomolecules. Restricting supplemental oxygen use does not necessarily reduce the rate of retinopathy of prematurity. and the blood supplies it to all parts of the body. which can initiate a damaging chain reaction of lipid peroxidation in the unsaturated lipids within cell membranes. During times of environmental stress.   It also occurs frequently in those undergoing repeated hyperbaric oxygen therapy. since axial length and keratometry readings do not reveal a corneal or length basis for a myopic shift.  It is usually reversible with time. One species produced by the body. a hyperoxic condition will rapidly spread.  While all the reaction mechanisms of these species within the body are not yet fully understood. High concentrations of oxygen also increase the formation of other free radicals. which can damage cell structures and produce oxidative stress.  Mechanism The biochemical basis for the toxicity of oxygen is the partial reduction of oxygen by one or two electrons to form reactive oxygen species. levels of reactive oxygen species can increase dramatically. and the rate of cell damage exceeds the capacity of the systems that prevent or repair it. The lipid peroxidation mechanism shows a single radical initiating a chain reaction with the most vascularised tissues being which converts unsaturated lipids to lipid peroxides. peroxynitrite.Oxygen toxicity 60 Ocular toxicity Prolonged exposure to high inspired fractions of oxygen causes damage to the retina. and trioxidane.  In preterm infants. most vulnerable. these systems are eventually overwhelmed at very high concentrations of free oxygen. and may raise the risk of hypoxia-related systemic complications.  This is due to an increase in the refractive power of the lens.  Hyperoxia may be a contributing factor for the disorder called retrolental fibroplasia or retinopathy of prematurity (ROP) in infants. Associated with the growth of these new vessels is fibrous tissue (scar tissue) that may contract to cause retinal detachment. while a risk factor. . the superoxide anion (O2–). Retinopathy of prematurity occurs when the development of the retinal vasculature is arrested and then proceeds abnormally. When oxygen is breathed at high partial pressures. Hyperoxic myopia has occurred in closed circuit oxygen rebreather divers with prolonged exposures.   Damage to the developing eye of infants exposed to high oxygen fraction at normal pressure has a different mechanism and effect from the eye damage experienced by adult divers under hyperbaric conditions. such as nitric oxide.   Cell damage and cell death then result. the retina is often not fully vascularised. Supplemental oxygen exposure.
an echocardiogram can help to eliminate other possible causes such as congenital heart defects or pulmonary arterial hypertension.  Many Nitrox-capable dive computers calculate an oxygen loading and can track it across multiple dives. ear problems. congestion and coldness. dizziness. long dives and dives where oxygen-rich breathing gases are used. This is a notional alarm clock. Diagnosis of bronchopulmonary dysplasia in new-born infants with breathing difficulties is difficult in the first few weeks.  In some diver training courses for these types of diving. during which victims can lose their regulator and The label on the diving cylinder shows that it drown. 28 metres. a seizure occurring in the setting of breathing oxygen at partial pressures greater than 1. which ticks more quickly at increased ppO2 and is set to activate at the maximum single exposure limit recommended in the National Oceanic and Atmospheric Administration Diving Manual. but is impossible to predict with any reliability whether or when toxicity symptoms will occur. As the ppO2 depends on the fraction of oxygen in the breathing gas and the depth of the dive.6 bar (160 kPa). blood tests and x-rays may be used to confirm bronchopulmonary dysplasia. The diver may experience no warning symptoms. Prematurity.Oxygen toxicity 61 Diagnosis Diagnosis of central nervous system oxygen toxicity in divers prior to seizure is difficult as the symptoms of visual disturbance.  For the following partial pressures of oxygen the limit is: 45 minutes at 1. if the infant's breathing does not improve during this time. low birth weight and a history of oxygen exposure are the principal indicators. Prevention The prevention of oxygen toxicity depends entirely on the setting. divers are taught to plan and monitor what is called the oxygen clock of their dives. The effects are sudden convulsions and unconsciousness. The aim is to avoid activating the alarm by reducing the ppO2 of the breathing gas or the length of time breathing gas of higher ppO2. One of the advantages of a full-face diving mask is contains oxygen-rich gas (36%) and is boldly prevention of regulator loss in the event of a seizure. However.4 bar (140 kPa). In addition.3 bar (130 kPa) and 210 minutes at 1. In this case prevention of bronchopulmonary dysplasia and retinopathy of prematurity must be carried out without compromising a supply of oxygen adequate to preserve the infant's life. the diver obtains more time on the oxygen clock by diving at a shallower depth. In either case. The diagnosis of retinopathy of prematurity in infants is typically suggested by the clinical setting. However. As there is an marked with a maximum operating depth of increased risk of central nervous system oxygen toxicity on deep dives. 180 minutes at 1. confusion and nausea can be due to many factors common to the underwater environment such as narcosis. proper precautions can eliminate the most pernicious effects.2 bar (120 kPa). while no hereditary factors have been shown to yield a pattern. these symptoms may be helpful in diagnosing the first stages of oxygen toxicity in patients undergoing hyperbaric oxygen therapy. Underwater A seizure caused by oxygen toxicity to the central nervous system is a deadly but avoidable event while diving. Premature infants commonly require supplemental oxygen to treat complications of preterm birth. divers are taught to calculate a maximum operating depth for oxygen-rich breathing gases. 120 minutes at 1. unless there is a prior history of epilepsy or tests indicate hypoglycemia. and cylinders containing such mixtures must be clearly marked with that depth. by . 150 minutes at 1.4 bar (140 kPa) suggests a diagnosis of oxygen toxicity. Both underwater and in space.5 bar (150 kPa).
The U. .8 standard atmospheres (280 kPa). This is illustrated by modern pure oxygen use in spacesuits.9 atm (190 kPa) over 30 minutes on oxygen. However. The schedules used for treatment of decompression illness allow for periods of breathing air rather than 100% oxygen (oxygen breaks) to reduce the chance of seizure or lung damage. consisting of two periods of 15 minutes air/60 minutes oxygen. so a gas mixture must be used which contains less than 21% oxygen (a hypoxic mixture). Increasing the proportion of nitrogen is not viable. This is followed by a slow reduction in pressure to 1. Current guidelines require that all babies of less than 32 weeks gestational age or having a birth weight less than 1. To balance the risks of hypoxia and retinopathy of prematurity.4 psi). or by replacing part of the nitrogen with helium. since it would produce a strongly narcotic mixture. Vitamin E and selenium were proposed and later rejected as a potential method of protection against pulmonary oxygen toxicity. for example. which must operate at low pressure (also historically. reversible) complication for divers. table 6 requires 75 minutes (three periods of 20 minutes oxygen/5 minutes air) at an ambient pressure of 2.S.3 bar (4.  Diving below 60 m (200 ft) on air would expose a diver to increasing danger of oxygen toxicity as the partial pressure of oxygen exceeds 1. One or two days of exposure without oxygen breaks are needed to cause such damage. In such applications as extra-vehicular activity. The limited duration and naturally intermittent nature of most diving makes this a relatively rare (and even then. Navy uses treatment tables based on periods alternating between 100% oxygen and air. because the oxygen partial pressure is not allowed to chronically exceed 0. Retinopathy of prematurity is largely preventable by screening. modern protocols now require monitoring of blood oxygen levels in premature infants receiving oxygen.N. Normobaric setting Bronchopulmonary dysplasia is reversible in the early stages by use of break periods on lower pressures of oxygen.5 kg (3. and therefore prevent retinal changes following repetitive hyperbaric oxygen exposures. high-fraction oxygen is non-toxic. helium is not narcotic.S. producing a trimix. not merely by high oxygen fraction. before the pressure is reduced to atmospheric over 30 minutes on oxygen. equivalent to a depth of 18 metres (60 ft). Pulmonary oxygen toxicity is an entirely avoidable event while diving.Oxygen toxicity breathing a less oxygen-rich gas. The National Cooperative Study in 1954 showed a causal link between supplemental oxygen and retinopathy of prematurity.3 lb) should be screened for retinopathy of prematurity at least every two weeks.4 bar (140 kPa). very high percentage oxygen and lower than normal atmospheric pressure was used in early spacecraft. but it may eventually result in irreversible lung injury if allowed to progress to severe damage. Hypobaric setting In low-pressure environments oxygen toxicity may be avoided since the toxicity is caused by high partial pressure of oxygen.   62 Hyperbaric setting The presence of a fever or a history of seizure is a relative contraindication to hyperbaric oxygen treatment. the Gemini and Apollo spacecraft). and a usable mixture may be blended either by completely replacing nitrogen with helium (the resulting mix is called heliox). even at breathing mixture fractions approaching 100%.   There is however some experimental evidence in rats that vitamin E and selenium aid in preventing in vivo lipid peroxidation and free radical damage. U. The patient then remains at that pressure for a further 150 minutes. but subsequent curtailment of supplemental oxygen caused an increase in infant mortality. or by shortening the duration of exposure to oxygen-rich gases. For example. Guidelines have been established that allow divers to calculate when they are at risk of pulmonary toxicity.
6 bar (60 kPa). while inside a hyperbaric chamber pressurised with air to about 2. Retinopathy of prematurity may regress spontaneously. Upon reaching the surface. emergency services are always contacted as there is a possibility of further complications requiring medical attention.S. thereby dropping the partial pressure of oxygen inspired below 0. since lungs continue to grow during the first 5–7 years and the damage caused by bronchopulmonary dysplasia is to some extent reversible (even in adults). A seizure underwater requires that the diver is brought to the surface as soon as practicable. and carry out a controlled buoyant lift. a ventilator may be needed to ensure that the lung tissue remains inflated. Although for many years the recommendation has been not to raise the diver during the seizure itself.  . However. Rescuers need to ensure that their own safety is not compromised during the convulsive phase. The silicone band (scleral buckle. They then ensure that the victim's air supply is established and maintained. it remained uncertain for many years whether damage to the nervous system following the seizure could occur and several studies searched for evidence of such damage.  The majority of infants who have survived following an incidence of bronchopulmonary dysplasia will eventually recover near-normal lung function. there is no evidence of expiratory obstruction during seizure and benefit may be gained by raising the diver during the seizure's clonic phase. Seizures during the therapy are managed by removing the mask from the patient. the patient will usually breathe 100% oxygen from a mask. Navy has procedures for completing the decompression stops where a recompression chamber is not immediately available.Oxygen toxicity 63 Management During hyperbaric oxygen therapy. along with a reduction in the periods of exposure retina to re-attach. This brings the wall of the eye respiratory distress syndrome is treated by lowering the fraction of into contact with the detached retina. and an increase in the break periods where normal air is supplied. but should the disease progress beyond a threshold (defined as five contiguous or eight cumulative hours of stage 3 retinopathy of prematurity). Reductions in pressure and exposure will be made progressively and medications such as bronchodilators and pulmonary surfactants may be used. no long-term neurological damage from the seizure remains. techniques such as scleral buckling and vitrectomy surgery may assist in re-attaching the retina. The retina (red) is detached at the top of the eye. owing to the danger of arterial gas embolism.8 bar (280 kPa). allowing the oxygen administered. blue) is placed The occurrence of symptoms of bronchopulmonary dysplasia or acute around the eye. Prognosis Although the convulsions caused by central nervous system oxygen toxicity may lead to incidental injury to the victim. Lifting an unconscious body is taught by most diver training agencies. both cryosurgery and laser surgery have been shown to reduce the risk of blindness as an outcome. An overview of these studies by Bitterman in 2004 concluded that following removal of breathing gas containing high fractions of oxygen. Where supplemental oxygen is required for treatment of another disease (particularly in infants). Where the disease has progressed further. they are likely be more susceptible to respiratory infections for the rest of their lives and the severity of later infections is often greater than that in their peers. The U.
Oxygen toxicity Retinopathy of prematurity (ROP) in infants frequently regresses without intervention and eyesight may be normal in later years. Where the disease has progressed to the stages requiring surgery, the outcomes are generally good for the treatment of stage 3 ROP, but are much worse for the later stages. Although surgery is usually successful in restoring the anatomy of the eye, damage to the nervous system by the progression of the disease leads to comparatively poorer results in restoring vision. The presence of other complicating diseases also reduces the likelihood of a favourable outcome.
The incidence of central nervous system toxicity among divers has decreased since the Second World War, as protocols have developed to limit exposure and partial pressure of oxygen inspired. In 1947, Donald recommended limiting the depth allowed for breathing pure oxygen to 7.6 m (25 ft), or a ppO2 of 1.8 bar (180 kPa). This limit has been reduced, until today a limit of 1.4 bar (140 kPa) during a recreational dive and 1.6 bar (160 kPa) during shallow decompression stops is accepted. Oxygen toxicity has now become a rare occurrence other than when caused by equipment malfunction and Retinopathy of prematurity (ROP) is more common in middle income countries where neonatal intensive care services are increasing; but greater awareness of the problem, human error. Historically, the U.S.  leading to preventive measures, has not yet occurred. Navy has refined its Navy Diving Manual Tables to reduce oxygen toxicity incidents. Between 1995 and 1999, reports showed 405 surface-supported dives using the helium–oxygen tables; of these, oxygen toxicity symptoms were observed on 6 dives (1.5%). As a result, the U.S. Navy in 2000 modified the schedules and conducted field tests of 150 dives, none of which produced symptoms of oxygen toxicity. Revised tables were published in 2001. The variability in tolerance and other variable factors such as workload have resulted in the U.S. Navy abandoning screening for oxygen tolerance. Of the 6,250 oxygen-tolerance tests performed between 1976 and 1997, only 6 episodes of oxygen toxicity were observed (0.1%).  Central nervous system oxygen toxicity among patients undergoing hyperbaric oxygen therapy is rare, and is influenced by a number of a factors: individual sensitivity and treatment protocol; and probably therapy indication and equipment used. A study by Welslau in 1996 reported 16 incidents out of a population of 107,264 patients (0.015%), while Hampson and Atik in 2003 found a rate of 0.03%.  Yildiz, Ay and Qyrdedi, in a summary of 36,500 patient treatments between 1996 and 2003, reported only 3 oxygen toxicity incidents, giving a rate of 0.008%. A later review of over 80,000 patient treatments revealed an even lower rate: 0.0024%. The reduction in incidence may be partly due to use of a mask (rather than a hood) to deliver oxygen. Bronchopulmonary dysplasia is among the most common complications of prematurely born infants and its incidence has grown as the survival of extremely premature infants has increased. Nevertheless, the severity has decreased as better management of supplemental oxygen has resulted in the disease now being related mainly to
Oxygen toxicity factors other than hyperoxia. In 1997 a summary of studies of neonatal intensive care units in industrialised countries showed that up to 60% of low birth weight babies developed retinopathy of prematurity, which rose to 72% in extremely low birth weight babies, defined as less than 1 kg (2.2 lb) at birth. However, severe outcomes are much less frequent: for very low birth weight babies—those less than 1.5 kg (3.3 lb) at birth—the incidence of blindness was found to be no more than 8%.
Central nervous system toxicity was first described by Paul Bert in 1878.  He showed that oxygen was toxic to insects, arachnids, myriapods, molluscs, earthworms, fungi, germinating seeds, birds, and other animals. Central nervous system toxicity may be referred to as the "Paul Bert effect". Pulmonary oxygen toxicity was first described by J. Lorrain Smith in 1899 when he noted central nervous system toxicity and discovered in experiments in mice and birds that 0.43 bar (43 kPa) had no effect but 0.75 bar (75 kPa) of oxygen was a pulmonary irritant. Pulmonary toxicity may be referred to as the "Lorrain Smith effect". The first recorded human exposure was undertaken in 1910 by Bornstein when two men breathed oxygen at 2.8 bar (280 kPa) for 30 minutes while he went on to 48 minutes with no symptoms. In 1912, Bornstein developed cramps in his hands and legs while breathing oxygen at Paul Bert, a French physiologist, first described oxygen toxicity in 1878. 2.8 bar (280 kPa) for 51 minutes. Smith then went on to show that intermittent exposure to a breathing gas with less oxygen permitted the lungs to recover and delayed the onset of pulmonary toxicity. Albert R. Behnke et al. in 1935 were the first to observe visual field contraction (tunnel vision) on dives between 1.0 bar (100 kPa) and 4.1 bar (410 kPa).  During World War II, Donald and Yarbrough et al. performed over 2,000 experiments on oxygen toxicity to support the initial use of closed circuit oxygen rebreathers.  Naval divers in the early years of oxygen rebreather diving developed a mythology about a monster called "Oxygen Pete", who lurked in the bottom of the Admiralty Experimental Diving Unit "wet pot" (a water-filled hyperbaric chamber) to catch unwary divers. They called having an oxygen toxicity attack "getting a Pete".  In the decade following World War II, Lambertsen et al. made further discoveries on the effects of breathing oxygen under pressure as well as methods of prevention.  Their work on intermittent exposures for extension of oxygen tolerance and on a model for prediction of pulmonary oxygen toxicity based on pulmonary function are key documents in the development of standard operating procedures when breathing elevated pressures of oxygen. Lambertsen's work showing the effect of carbon dioxide in decreasing time to onset of central nervous system symptoms has influenced work from current exposure guidelines to future breathing apparatus design.   Retinopathy of prematurity was not observed prior to World War II, but with the availability of supplemental oxygen in the decade following, it rapidly became one of the principal causes of infant blindness in developed countries. By 1960 the use of oxygen had become identified as a risk factor and its administration restricted. The resulting fall in retinopathy of prematurity was accompanied by a rise in infant mortality and hypoxia-related complications. Since then, more sophisticated monitoring and diagnosis have established protocols for oxygen use which aim to balance between hypoxic conditions and problems of retinopathy of prematurity. Bronchopulmonary dysplasia was first described by Northway in 1967, who outlined the conditions that would lead to the diagnosis. This was later expanded by Bancalari and in 1988 by Shennan, who suggested the need for supplemental oxygen at 36 weeks could predict long-term outcomes. Nevertheless, Palta et al. in 1998 concluded that radiographic evidence was the most accurate predictor of long-term effects.
Oxygen toxicity Bitterman et al. in 1986 and 1995 showed that darkness and caffeine would delay the onset of changes to brain electrical activity in rats.  In the years since, research on central nervous system toxicity has centred on methods of prevention and safe extension of tolerance. Sensitivity to central nervous system oxygen toxicity has been shown to be affected by factors such as circadian rhythm, drugs, age, and gender.    In 1988, Hamilton et al. wrote procedures for the National Oceanic and Atmospheric Administration to establish oxygen exposure limits for habitat operations.   Even today, models for the prediction of pulmonary oxygen toxicity do not explain all the results of exposure to high partial pressures of oxygen.
Society and culture
Recreational scuba divers commonly breathe nitrox containing up to 40% oxygen, while technical divers use pure oxygen or nitrox containing up to 80% oxygen. Divers who breathe oxygen fractions greater than in air (21%) need to be trained in the dangers of oxygen toxicity and how to prevent them. In order to buy nitrox, a diver has to show evidence of such qualification. Since the late 1990s the recreational use of oxygen has been promoted by oxygen bars, where customers breathe oxygen through a nasal cannula. Claims have been made that this reduces stress, increases energy, and lessens the effects of hangovers and headaches, despite the lack of any scientific evidence to support them. There are also devices on sale that offer "oxygen massage" and "oxygen detoxification" with claims of removing body toxins and reducing body fat. The American Lung Association has stated "there is no evidence that oxygen at the low flow levels used in bars can be dangerous to a normal person's health", but the U.S. Center for Drug Evaluation and Research cautions that people with heart or lung disease need their supplementary oxygen carefully regulated and should not use oxygen bars. Victorian society had a fascination for the rapidly expanding field of science. In "Dr. Ox's Experiment", a short story written by Jules Verne in 1872, the eponymous doctor uses electrolysis of water to separate oxygen and hydrogen. He then pumps the pure oxygen throughout the town of Quiquendone, causing the normally tranquil inhabitants and their animals to become aggressive and plants to grow rapidly. An explosion of the hydrogen and oxygen in Dr Ox's factory brings his experiment to an end. Verne summarised his story by explaining that the effects of oxygen described in the tale were his own invention. There is also a brief episode of oxygen intoxication in his "From the Earth to the Moon".
      Donald 1947a http:/ / apps. who. int/ classifications/ apps/ icd/ icd10online/ ?gt51. htm+ t598 http:/ / www. icd9data. com/ getICD9Code. ashx?icd9=987. 8 http:/ / www. nlm. nih. gov/ cgi/ mesh/ 2011/ MB_cgi?field=uid& term=D018496 Brubakk & Neuman 2003, pp. 358–60 Acott, Chris (1999). "Oxygen toxicity: A brief history of oxygen in diving" (http:/ / archive. rubicon-foundation. org/ 6014). South Pacific Underwater Medicine Society Journal 29 (3): 150–5. ISSN 0813-1988. OCLC 16986801. . Retrieved 2008-04-29.  Beehler, CC (1964). "Oxygen and the eye". Survey of Ophthalmology 45: 549–60. PMID 14232720.  Goldstein, JR; Mengel, CE (1969). "Hemolysis in mice exposed to varying levels of hyperoxia". Aerospace Medicine 40 (1): 12–13. PMID 5782651.  Larkin, EC; Adams, JD; Williams, WT; Duncan, DM (1972). "Hematologic responses to hypobaric hyperoxia". American Journal of Physiology 223 (2): 431–7. PMID 4403030.  Schaffner, Fenton; Felig, Philip (1965). "Changes in hepatic structure in rats produced by breathing pure oxygen" (http:/ / jcb. rupress. org/ cgi/ reprint/ 27/ 3/ 505. pdf) (PDF). Journal of Cell Biology 27 (3): 505–17. doi:10.1083/jcb.27.3.505. PMC 2106769. PMID 5885427. .  Caulfield, JB; Shelton, RW; Burke, JF (1972). "Cytotoxic effects of oxygen on striated muscle". Archives of Pathology 94 (2): 127–32. PMID 5046798.  Bean, JW; Johnson, PC (1954). "Adrenocortical response to single and repeated exposure to oxygen at high pressure". American Journal of Physiology 179 (3): 410–4. PMID 13228600.  Edstrom, JE; Rockert, H (1962). "The effect of oxygen at high pressure on the histology of the central nervous system and sympathetic and endocrine cells". Acta Physiologica Scandinavica 55: 255–63. doi:10.1111/j.1748-1716.1962.tb02438.x. PMID 13889254.
67 .  Smerz.W. "The PADI enriched air diver course and DSAT oxygen exposure limits" (http:/ / archive. PMID 4948324. Claude A. org/ 7555). PMID 16992479. "Pathophysiology of pulmonary oxygen toxicity".. Retrieved 2008-04-29. doi:10. org/ 3044). N. doi:10. Schaal. Shreeves. rubicon-foundation.. "Symptoms of Oxygen Poisoning and Limits of Tolerance at Rest and at Work" (http:/ / archive. PMID 4613232. Alfred R. PMID 3905287. (1978). Behnke. (1990). "Rate of development of pulmonary O2 toxicity in man during O2 breathing at 2. M. "Bronchopulmonary dysplasia: changes in pathogenesis. Washington DC. N. PMID 19291278. SB.S. 3. Dharmeshkumar N. Welham. Chest 88 (6): 900–905. American Review of Respiratory Disease 110 (6 Pt 2): 40–50. NEDU-47-01 (United States Navy Experimental Diving Unit Technical Report). Ilene R.D. R.C. Krishna K (2003). C.. org/ 6310). doi:10. NAS/NRC.  Wittner. E. nic. London: Mac Keith Press : Distributed by Cambridge University Press.  Ricci. DB (1971). 383  Clark. Lambertsen. Journal. . pp. J. John M (1974). Kramer. 4. 33. Pharmacological Reviews 23 (2): 37–133. OCLC 16986801. 179–88. p. . Undersea and Hyperbaric Medicine 31 (1): 63–72.  Clark.. PMID 5155150. Proceedings of the Third International Conference on Hyperbaric Medicine. Martin C..1378/chest. Steven G. Navy Diving Manual 2008. Melamed.00450. Farmer. ISBN 0-521-45150-7. (1985). Navy Diving Manual 2008. Transactions of the American Ophthalmological Society 76: 116–24. Michael. Menduno. pdf) (PDF). ed. doi:10. PMID 8574677. "Effect of light on oxygen-induced retinopathy in the rat model. Ivan T. S. "CNS oxygen toxicity" (http:/ / archive. org/ content/ 88/ 6/ 900. org/ content/ 24/ 1/ 19. "Hyperoxic myopia". physoc. Undersea and Hyperbaric Medicine 31 (2): 199–202. H. Lepore. 1. (1995). (2009). Diving Science and Technology Workshop: 286. Shreeves. rubicon-foundation. epidemiology and definition". John M. PMID 8989851. Y. PMID 15485081. Alistair R. O. Menzel. .1186/cc7151. Bax. "Metabolic factors in oxygen poisoning". (2004). (1947).  Bitterman.Oxygen toxicity  Gersh.88. ch. 18. (1996).2006. physiology...  Lang 2001. vol. in/ jac/ t03/ i3/ jact03i3p234. Barry W. Karl (1996). – and others as discussed by Clark & Lambertsen 1970. Brain Research 696 (1–2): 250–3.. "Similar but not the same: normobaric and hyperbaric pulmonary oxygen toxicity. Claure.S. Seminars in Neonatology (London: Elsevier Science) 8 (1): 63–71. Welty-Wolf. Retrieved 2008-04-29. I. Alistair R.S.Lorrain (1899). 376  U.. A. Neal B. PMID 754368. Anthony. "Proceedings of rebreather forum 2. M. Simonson.. PMID 15233161.. PMID 12667831. Lakhani.1007/BF00145813. Retrieved 2008-09-20. "The pathological effects due to increase of oxygen tension in the air breathed" (http:/ / jp. Christian J. pp.  Bitterman. Rosenbaum. (2003). org/ 4010).  Lang 2001. Joseph C.0. chestjournal. 82  Richardson. Retrieved 2008-04-30. 7  Bitterman.013 bars. PMID 17416738. (1966). W. Undersea and Hyperbaric Medicine 23 (4): 215–9.1016/0006-8993(95)00820-G. PMID 3705247.  Hess. p. Journal of Applied Physiology 30 (5): 739–52. 22  Bitterman. Karl (eds) (1996).  Brubakk & Neuman 2003. . Claude A.. "CNS oxygen toxicity in the rat: role of ambient illumination" (http:/ / archive. Journal of Physiology (London: The Physiological Society and Blackwell Publishing) 24 (1): 19–35. org/ cgi/ content/ full/ 293/ 1/ L229). .  Jackson. full. Critical Care 13 (1): 205.  Clark. B. Piantadosi.  Demchenko. ISSN 0813-1988. 386–7  Smith. Karen E. CE (1945).0 Ata". rubicon-foundation. pdf) (PDF).1152/ajplung. PMID 1701697. doi:10. The Management of Visual Impairment in Childhood. Retrieved 2008-09-20. Retrieved 2008-05-02. Goel. Indian Academy of Clinical Medicine 4 (3): 234–7. pp. Wagner. p.  Richardson. "Effect of dietary antioxidant level and oxygen exposure on the fine structure of the proximal convoluted tubules"... Maggiano. . Documenta Ophthalmologica 74 (4): 287–301. Light and OIR in the rat".  Anderson. South Pacific Underwater Medicine Society Journal 26 (3). p. M. Fielder. John M.  Bancalari. "Pulmonary oxygen toxicity" (http:/ / www. rubicon-foundation. p.  Clark & Lambertsen 1970  Brubakk & Neuman 2003. Ashish. N. (1986). R. "Pulmonary oxygen toxicity: a review".  Yarbrough. ..  Brubakk & Neuman 2003.. p. rubicon-foundation. (2007). Piantadosi. (1993).  Patel. American Journal of Physiology 144 (2): 270–7. Garg. rubicon-foundation. the role of nitric oxide" (http:/ / ajplung. "Central nervous system oxygen toxicity during hyperbaric treatment of patients with carbon monoxide poisoning" (http:/ / archive.6. vol. PMC 2688103. rubicon-foundation. "Bench-to-bedside review: oxygen as a drug". p. O. Santo. R. . full. Undersea Biomedical Research 13 (1): 19–25. Agarwal.. 44  U. PMID 4929472.900. RT.. Lambertsen. D'Urso. . "The toxicity of oxygen". PMC 1311617. Allen. (2004).  Hampson. Drew. Christian J. (1971). Aerospace Medicine 42 (6): 646–9. Best.M.M.. Retrieved 2008-04-29. PMC 1516623. 256–60. (1971). D. Drew. Brinton. "Incidence of oxygen toxicity during the treatment of dysbarism" (http:/ / archive.  Fielder. "Caffeine attenuates CNS oxygen toxicity in rats". Praveenkumar.1016/S1084-2756(02)00192-6. 1404. American Journal of Physiology – Lung Cellular and Molecular Physiology 293 (1): L229–38.. . N. doi:10. org/ 2232). Note: 1 atmosphere (atm) is 1. "Oxygen toxicity" (http:/ / medind.S. Retrieved 2008-09-28. I. Nelson. B. Perlman.. ch. org/ 3991). Sosenko. pdf+ html). org/ 3316)." (http:/ / archive. Eduardo. .. Iossa.
68 .030502. doi:10. U.L. (2004). archive..D)" (http:/ / web. E. PMC 50203. "Glutathione in the cellular defense of human lung cells exposed to hyperoxia and high pressure" (http:/ / archive.1126/science. nbdhmt. Barbara E. A.. pdf) (PDF).  NBDHMT (2009-02-04). (2004). doi:10. Retrieved 2008-09-19. PMID 16809515. Retrieved 2008-09-26. Undersea and Hyperbaric Medicine 35 (2): 131–43. Retrieved 2009-04-29. "Effects of high oxygen pressures on the eye". R. Annual Review of Microbiology 57: 395–418. and central nervous system O2 toxicity" (http:/ / www. Undersea and Hyperbaric Medicine 31 (2): 227–32.D. %20Toxicity%20Calculations. H2O2. Proceedings of the National Academy of Sciences of the United States of America 89 (20): 9715–9.. "Superoxide dismutase responds to hyperoxia in rat hippocampus" (http:/ / archive. . USA: US Naval Experimental Diving Unit Technical Report). Claude A. nitric oxide. Department of Health & Human Services. PMID 1329105. C.  Djurhuus. Undersea and Hyperbaric Medicine 26 (1): 41–5. atsjournals.  Shykoff. Navy" (http:/ / archive. New England Journal of Medicine 338 (22): 1620–1. Y. Harvey. . PMID 14527285. R. "Extracellular superoxide dismutase.  Schaal.1016/j.  Anderson Jr. A.1056/NEJM196907032810106.S. Svardal. 157–62  Baker. Steven R. nih. Greenbaum. p. Andrew J. . . D. Crapo. . "Superoxide-dependent iron uptake: a new role for anion exchange protein 2" (http:/ / ajrcmb. Martha-sue. rubicon-foundation. Retrieved 2008-09-26. New England Journal of Medicine 281 (1): 25–30. doi:10.  Freiberger. colostate.89. (1986).. Alfred A. Archived from the original (http:/ / www. p.  Thom. p. "Cell signaling. Frank K. (1991). "Preventing blindness in premature infants"...D. PMID 1886163. . White. Journal of Neuroscience Research 29 (1): 100–6.. Free Radical Biology & Medicine 45 (5): 562–9. Y. PMID 10372426.  Ghio. T.  Shykoff.. doi:10. rubicon-foundation. Claude A. (1998). org/ CHT/ recommended-guidelines.S. Mercatante. .. 822.1073/pnas. Danielle R.013. PMID 1316738. rubicon-foundation. PMID 10353183. "Hyperoxic myopia in a closed-circuit mixed-gas scuba diver" (http:/ / archive. html).1056/NEJM199805283382210. a necessary evil for cell signaling". (1999). Rubinstein.2008.  Fridovich.2003-0070OC. vivo. Retrieved 2009-03-26. "Oxygen effect on ocular lens" (in Hebrew). In: Bove. PMID 18549826. Frank K.. org/ CHT/ recommended-guidelines. (2000). M.  Clark & Lambertsen 1970. "Central nervous system oxygen toxicity in closed circuit scuba divers II" (http:/ / archive. "Carbon monoxide. Harefuah 144 (11): 777–80.S. Carraway.9715. Turi. Piantadosi.  Piantadosi.G. Ryszard.W. (1992). E. Coulombe.1016/0003-9861(92)90532-2. doi:10. Piantadosi. Claude A. (1999).  Kim. nbdhmt. Beiran. PMID 15485085. doi:10. PMID 3727183. org/ Baker/ Oxygen) (PDF). B. Eva. Barbara E. PMID 18500077. Arthur J. A. PMC 2570053. Lambertsen Christian (1969). org/ 4014). "Oxygen toxicity: a radical explanation" (http:/ / jeb... Suliman. org/ cgi/ reprint/ 201/ 8/ 1203.  Butler. Retrieved 2008-04-29. PMID 15233156. Frank K. org/ 3492). (2003). Brown & Flynn 1998. full. (2008).1130481. pp. Retrieved 2008-09-26. org/ content/ 89/ 20/ 9715.35 ATM Oxygen Partial Pressure" (http:/ / archive. html). Colorado State University. pnas. 2007. org/ 2315).1002/jnr. Shelton. biologists.pdf. org/ 2312). "Oligodendroglial cell death induced by oxygen radicals and its protection by catalase". org/ 2459). Undersea Biomedical Research 14 (6): 485–501. Journal of Experimental Biology 201 (8): 1203–9. doi:10..freeradbiomed.1165/rcmb. PMID 2825395. Leon (eds. edu/ hbooks/ pathphys/ misc_topics/ radicals. I.. . decompression.57. Jaspers. B. Thorsen. (1998). .pdf "Oxygen toxicity calculations" (ftp:/ / downloadfiles:decompression1@ftp. Erik C. Twa. Marquis.E.. Piantadosi. (2006). Nozik-Grayck. Ho. pdf) (PDF). PMID 12791678.V. Undersea Biomedical Research 13 (2): 193–223. John J. (1987). S. PMID 4891642.) Ninth International Symposium of the UHMS (Undersea and Hyperbaric Medical Society): 607–11. Retrieved 2009-06-29.090938. "Inert gas enhancement of superoxide radical production".. Undersea and Hyperbaric Medicine 31 (1): 3–20. . Kole.. Science 312 (5782): 1882–3.. Retrieved 2008-09-28. "Axial length in hyperoxic myopia". I. (2005).micro. org/ 3986). 360  Rhee S. Hagir. Undersea and Hyperbaric Medicine 26 (2): 75–85.1146/annurev. Bachrach. NEDU-TR-05-20 (Panama City. reactive oxygen signaling. "Pathways of oxidative damage". 195  Butler.M.  "How is bronchopulmonary dysplasia diagnosed?" (http:/ / www. .20. FL.  Brubakk & Neuman 2003. "Pulmonary effects of submerged oxygen breathing in resting divers: repeated exposures to 140 kPa". gov/ health/ dci/ Diseases/ Bpd/ Bpd_Diagnosis.  Nichols. rubicon-foundation. American Journal of Respiratory Cell and Molecular Biology 29 (6): 653–60. I.. S. Jennifer. LA: National Board of Diving and Hyperbaric Medical Technology. html) on September 20. and oxidative stress". Dovrat. doi:10. "Free Radicals and Reactive Oxygen" (http:/ / www. Claude A. R. Edward D. %20Toxicity%20Calculations. (1987). PMID 16358652.S. org/ 3045). "Closed-circuit oxygen diving in the U. Ilona. org/ web/ 20070920173032/ http:/ / www. 375  Lang 2001. rubicon-foundation. . (2008). (2003).  Imlay. 178  Brubakk & Neuman 2003..  Thom. J. "Recommended Guidelines for Clinical Internship in Hyperbaric Technology (V: C. nhlbi. PMID 9510531.  Bowen. Kim. J. Thalmann. org/ cgi/ content/ full/ 29/ 6/ 653). Retrieved 2008-09-26. "Free radical reactions and the inhibitory and lethal actions of high-pressure gases" (http:/ / archive.  Butler. (2005).Oxygen toxicity  Drack. Archives of Biochemistry and Biophysics 295 (2): 391–6..  Regillo.05. PMID 9603802.  Oury. p. "Repeated Six-Hour Dives 1.U.490290111. Steven R. rubicon-foundation. Miller. doi:10. . Kathy.. html).A. Retrieved 2008-04-29. rubicon-foundation. (1992).
69 . "Screening for oxygen intolerance in U. Robert W. doi:10. and surfacing techniques. "Screening for oxygen sensitivity in U. rcophth. org/ 4865).. David J. A. PMID 3705251. nlm. R. Inc. (1965). D. Grune & Stratton. Retrieved 2008-10-20. html).O. 41. Scott. Peterson. Royal College of Ophthalmologists & British Association of Perinatal Medicine. rubicon-foundation. Simon J (2008-01-20). 20. Technical Report 88-1A (Rockville. . org/ 6038).) Handbook of Physiology: Respiration (American Physiological Society) Sec 3 Vol 2: 1027–46. "Retinopathy of prematurity: epidemiology" (http:/ / www.S.. html). Beers D. org/ 4866). 1.S.. Frank K. (1989). L. p. R." (http:/ / archive. Retrieved 2008-10-03. Retrieved 2008-10-02. In: The Mysterious Malady: Toward an understanding of decompression injuries (http:/ / www.  U. Rahn.  Hamilton R W. ISBN 20060725.H.. org/ 2358). oxygen limits. "Effects of dietary supplementation with vitamin E. OCLC 16428246.1016/0891-5849(89)90043-9. Retrolental Fibroplasia: A Modern Parable (http:/ / www. PMID 10813436. U. (eds.S. Retrieved 2008-04-29. (2000). (2003). Navy Diving Manual 2008. Howard.  U.  Donald 1947b  Gerth. p. "Bronchopulmonary dysplasia (BPD)" (http:/ / kidshealth. 3. rubicon-foundation. .. 2007. Kerem.. Peterson R. "Repex habitat diving procedures: Repetitive vertical excursions. Undersea and Hyperbaric Medicine 27 (1): 21–6. vol. Krutz. . H.W. Global Underwater Explorers.  Spear. com/ rebreather-accidents-incidents/ 16705-standardizing-ccr-rescue-skills-3. University of Aberdeen. MD: NOAA Office of Undersea Research). org/ medical/ articles/ article. (1986). "Dietary selenium and vitamin E as a possible prophylactic to pulmonary oxygen poisoning". W. gue.S. PMID 1852722.  "National Institutes of Health: What is bronchopulmonary dysplasia?" (http:/ / www. org/ parent/ medical/ lungs/ bpd.. org/ 0953-6833/ 10/ jceh_10_22_022. Divers Alert Network. . MD: NOAA Office of Undersea Research).1991." (http:/ / archive. G. nhlbi. i. and surfacing techniques.L. rubicon-foundation. South Pacific Underwater Medicine Society Journal 27 (1). Retrieved 2008-09-25. U. Retrieved 2008-10-02. National Library of Medicine. Brown & Flynn 1998. PMID 2730484. 41  Schatte.. rebreatherworld. . ac. Pharmacology & Toxicology 68 (2): 77–82.  Thalmann.S.. Wayne A.. Robert W.  Boadi. html). Clare (1997). OCLC 51607923.. Department of Health & Human Services. Navy Diving Manual 2008. In Brubakk. Aviation Space and Environmental Medicine 60 (5): 415–21. Scotland (Aberdeen: Aberdeen University Press): 84–91. G.E..E. Dixon. P.L. Christian J. org/ 4654).Oxygen toxicity  Hamilton. K. 37–39  "NIH MedlinePlus: Bronchopulmonary dysplasia" (http:/ / www. P. OCLC 16986801. . M. Retrieved 2009-04-02. cehjournal. diversalertnetwork.. Free Radical Biology & Medicine 6 (5): 505–12. ch.A. M.A. Butler G.L.. Emi (2008-11-07). "OXTOX: If You Dive Nitrox You Should Know About OXTOX" (http:/ / www. Robert W. "Standardizing CCR rescue skills" (http:/ / www.. 45  Mitchell. doi:10. S. . nih. .  Regillo. pdf) (PDF). htm). 9. Neuman. ISBN 0-08-024918-3.. Bennett and Elliott's physiology and medicine of diving (5th ed. oxygen limits. Technical Report 88-1B (Rockville. "Hyperbaric Oxygen Therapy: Contraindications" (http:/ / emedicine. (1997). Royal College of Paediatrics and Child Health. Olson. org/ 3046). (1989). pp.S. James T. "Decompression sickness and oxygen toxicity in U. "Human tolerance to 100% oxygen at 9. riboflavin and selenium on central nervous system oxygen toxicity".  Silverman. Hollis. Retrieved 2008-04-29. Kenyon David J.. Brown & Flynn 1998. Retrieved 2009-05-26.1600-0773.  Hamilton. E. rubicon-foundation.Section "What do you do if oxygen toxicity or a convulsion happens?"  U. Bachrach.. (1988).  Hamilton. Proceedings of the Sixth International Congress on Hyperbaric Medicine.x. Medscape. vol. (1988). W. Knafelc. p. Butler. Aberdeen. Alf O.S. medscape.1111/j. rubicon-foundation.. 190  Gilbert. asp?articleid=35). org/ classics/ parable/ ).. 39.  Walters. ISBN 0-7020-2571-2. nih. Retrieved 2008-10-02. Thalmann.tb02039. . vol. Undersea Biomedical Research 13 (1): 91–8. pp. 5. . ch. RebreatherWorld. Retrieved 2008-10-02. [DVD].. Navy surface-supplied He-O2 diving" (http:/ / archive.L. uk/ docs/ publications/ ROP_Guideline_-_Masterv11-ARF-2.C. . Henderson. Navy combat swimmers" (http:/ / archive. William (1980). p. Proceedings of Advanced Scientific Diving Workshop (Smithsonian Institution). Nemours Foundation.S. (2006). "Tolerating oxygen exposure" (http:/ / archive. ch. pp. (2006). p. Navy Diving Manual 2008. ISBN 0-8089-1264-X.H. Yannai. . . Edward D. R. M. neonatology. Journal of Community Eye Health (London: International Centre for Eye Health) 10 (22): 22–4. W. . PMID 2744583. "Repex habitat diving procedures: Repetitive vertical excursions. . Thaire.T. Frank K... gov/ medlineplus/ ency/ article/ 001088.  Latham. Retrieved 2008-04-29.  Webb. Tom S.  Regillo. Claude A. Edward D (2003-12-02). 143. . 2. C. In: Fenn. com/ ?q=en/ node/ 193). (1991). Kenyon.). "Decompression practice". rubicon-foundation. html#post163661). This forum post's author chairs the diving committee of the Underwater and Hyperbaric Medical Society. Retrieved 2008-10-02. (1977).reviewer.  "UK Retinopathy of Prematurity Guideline" (http:/ / www. E.Y. Retrieved 2008-09-19. .. R. . Gould. 184  Lambertsen. United States: Saunders Ltd.  Butler. (June 2008).5 psia during five daily simulated 8-hour EVA exposures". "The role of antioxidant nutrients in preventing hyperbaric oxygen damage to the retina". Michael L. Navy divers" (http:/ / archive.M. Barnicott. J..T. gov/ health/ dci/ Diseases/ Bpd/ Bpd_WhatIs.  Piantadosi. Payne. 475–479. ISSN 0813-1988. com/ article/ 1464149-overview). R.  Stone. "Effects of oxygen at high partial pressure".
Bronchopulmonary dysplasia"..P. (1935). O2Planet LLC. mamashealth. PMID 5061633. . Undersea Biomedical Research 2 (3): 223–7. "VIII [At seventy-eight thousand one hundred and fourteen leagues]" (http:/ / www. Undersea and Hyperbaric Medicine 31 (1): 21–31. E.. Columbus.). . L.1111/j. D. gutenberg.  Shennan. A. Atik D. com/ doc/ oxygen.. PMID 5130131. . PMID 15622741. S. IANTD Journal.C. Michael B. Forbes. . Paul (1943) [First published in French in 1878]. John M.1016/S0022-3476(98)70485-8. . Motley. . Surbiton. FDA Consumer magazine.M.. Newborn Lung Project". Aviation. 6. PMID 15233157. rubicon-foundation. "Effect of circadian rhythm on CNS oxygen toxicity". American Journal of Physiology 110: 565–72. (1935). "Seizure incidence in 80.  Shykoff. Christian J. Aktas S. (1972).000 patient treatments with hyperbaric oxygen" (http:/ / www. "Hormonal protection of rats breathing oxygen at high pressure".G. Retrieved 2008-09-20.  Behnke. Retrieved 2009-07-01. "Evaluation of criteria for chronic lung disease in surviving very low birth weight infants. Cimsit M. A Fantasy of Dr Ox (http:/ / search. Pediatrics 82 (4): 527–32. (1998). M.  Hart. Retrieved 2008-05-29. therapy.Y. (2004).  Lang 2001. Lennox. org/ 2432).S. "Central nervous system oxygen toxicity during routine hyperbaric oxygen therapy" (http:/ / archive. pp. Retrieved 2008-10-21.013 bars. org/ 21). S. (1975). Sadek. 81–6  Northway. Ford. Translated from French. Mengel.  Hampson Neal.S.  Verne. Ohlsson. Retrieved 2008-09-20.. ingentaconnect.x. Jules (2004) . British Sub-Aqua Club. "Gender differences in human skeletal muscle and subcutaneous tissue gases under ambient and hyperbaric oxygen conditions" (http:/ / archive. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society..  Bren. doi:10.tb07544. com/ HTML/ fitness. H.S. Deep Diving and Submarine Operations (6th ed.S. org/ 6867).  Troy.  British Sub-aqua Club (1985). rubicon-foundation. J.. S. mindspring... Richard D. Office of Naval Research (Durham. org/ etext/ 12901). org/ 3967). PMID 9470001. Richard D. Journal of Pediatrics 132 (1): 57–63.. PMID 12964858. 3-1-2000 (Philadelphia. "Lambertsen and O2: Beginnings of operational physiology" (http:/ / archive.R.. Jules (1877) . Aerospace Medicine 42 (12): 1293–6. PMID 3174313. Inc) 31 (2): 189–90.  Hof. Tolworth.  Donald 1992  Taylor. Retrieved 2008-10-20. Robert H. Translated from French.. (1955). Surrey: Siebe Gorman & Company Ltd. University of Pennsylvania: Physiologic interactions of oxygen and carbon dioxide effects and relations to hyperoxic toxicity. H.. Strauss. "The Ocean Diver Nitrox Workshop" (http:/ / www. Undersea and Hyperbaric Medicine 34 (3): 147–61. C. FL: U. Dunn. University of Pennsylvania Medical Center). "Oxygen Enriched Air: A New Breathing Mix?" (http:/ / www.1972. London: Ward Lock. 291. Weiss.. rubicon-foundation.J. "Abnormal pulmonary outcomes in premature infants: prediction from oxygen requirement in the neonatal period". com/ A-Fantasy-of-Dr-Ox/ Jules-Verne/ e/ 9781843910671/ ?itm=1). Vann. NC: Duke University).S. Hitchcock.H. R. Retrieved 2008-06-06. (1996).. J. (2003). ISBN 978-1-84391-067-1. R.  Verne. . html). org/ 7346). . Clark. Barometric pressure: Researches in Experimental Physiology. PMID 17672171. "Central nervous system oxygen toxicity during routine hyperbaric oxygen therapy" (http:/ / archive. Autour de la Lune [Round the Moon]. . p.P. bsac. W. American Journal of Physiology 114: 436–442. (2000). OH: College Book Company. Barbara E.  Torley. "Pulmonary disease following respirator therapy of hyaline-membrane disease. "Performance of various models in predicting vital capacity changes caused by breathing high oxygen partial pressures" (http:/ / archive. . London: Stanley Paul. o2planet. Alfred R.T. . (1967). Barnet. Hesperus Press. Acta Neurologica Scandinavica 48 (2): 231–42.H. Naval Experimental Diving Unit Technical Report). Note: 1 atmosphere (atm) is 1. OCLC 12807848. Retrieved 2010-09-15. Toğrol E (2004).  Yildiz. Retrieved 2008-04-29.Oxygen toxicity  Yildiz. ISBN 2253005878. Fred A. J. htm). doi:10. "The Oxygen research program. asp). E. (2007). "O2 Planet . pdf) (PDF). Ay H. org/ 3987). (2007). (2004).H. (1971).S. Retrieved 2008-10-03..1056/NEJM196702162760701.  Bert. Dexter. p.Exercise and Fitness Equipment" (http:/ / www. Space and Environmental Medicine 75 (11): 992–4.1600-0404.  Davis. "The effect of oxygen on man at pressures from 1 to 4 atmospheres". Inc) 30 (2): 147–53. Motley.E... "Circulatory and visual effects of oxygen at 3 atmospheres pressure". org/ uploads/ moved/ documents/ Resources/ Nitrox/ OD_Nitrox_Workshop_Student_Workbook_V00bh. doi:10. ISBN 0-09-163831-3. A. D.  Behnke. rubicon-foundation. et al.. and decompression.. Retrieved 2009-05-08. M. . barnesandnoble. PMID 15559001. "Factors Affecting CNS Oxygen Toxicity in Humans" (http:/ / archive. Rosan. "Oxygen Bars: Is a Breath of Fresh Air Worth It?" (http:/ / www. Retrieved 2008-04-29.013 bars.D. Mary Alice.  O2Planet (2006).  Lambertsen. Porter. ..  Natoli. PA: Environmental Biomedical Stress Data Center. com/ ~divegeek/ eanx. H. Alfred R.  Vann..  British Sub-Aqua Club (2006). K. (1988). NEDU-TR-07-13 (Panama City. Sport diving : the British Sub-Aqua Club diving manual. Larry "Harris" (1993). Translated by: Hitchcock. Hoskins. 70 .. rubicon-foundation. Linda (November–December 2002). Johnson. Note: 1 atmosphere (atm) is 1. rubicon-foundation. . PMID 15485078. Ay. M. p.  Palta. Summation: 1940 to 1999". M. rubicon-foundation. PMID 5334613. New England Journal of Medicine 276 (7): 357–68. com/ content/ asma/ asem/ 2004/ 00000075/ 00000011/ art00011). "Effects of age and magnesium ions on oxygen toxicity in the neonate chicken" (http:/ / archive. F.. Poppen..W. Report to the U. 110. D. E. EBSDC-IFEM Report No. Institute for Environmental Medicine. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society. Retrieved 2009-06-26. Qyrdedi. George B. org/ 4007). T.S. Gelfand. Retrieved 2009-09-02.
– Video of "Oxygen Toxicity" lecture by Dr. "Oxygen under pressure". United States: Saunders Ltd. Stan (1993). Mitchell. UK: Underwater World Publications. Gary C. doi:10. 197 pages.org/dspace/simple-search?query=oxygen+ toxicity&submit=Go).diversalertnetwork. ISBN 0-9752290-1-X.). • Regillo. PMID 20248086. ISBN 0-946020-18-3.lib. 121–4..rubicon-foundation. Navy Supervisor of Diving (2008) (PDF). Vitreoretinal Disease: The Essentials. Retrieved 2009-06-29. Flynn. Simon (2005). (1992).org/ 4855). The Diving Emergency Handbook. Revised version of Donald's articles also available as: Donald. OCLC 44018369. Harry W.) (2001). Kenneth W.1.rubicon-foundation. British Medical Journal 1 (4506): 667–72. U. 1-70 (Philadelphia. • Lippmann. PMID 20248096. British Medical Journal 1 (4507): 712–7. (1947). John. Brown. PA: Environmental Biomedical Stress Data Center.mcg. • Physiology at MCG 4/4ch7/s4ch7_7 (http://www. OCLC 26894235. "Oxygen poisoning in man—part I". doi:10..). Retrieved 2008-04-29. Flagstaff: Best Publishing.712. Richard Vann (free download. Victoria. (1947). (2003). • Lippmann. mp4. Deeper into Diving (2nd ed.org/FastAccess/ 2008TechnicalDiving. Stephen R.htm). ISBN 0-86577-761-6. 693 pages.L. "Pulmonary oxygen tolerance in man and derivation of pulmonary oxygen tolerance curves" (http://archive. pp. John. Naval Sea Systems Command.aspx). Tom S. – Wide and detailed discussion of the effects of breathing oxygen on the respiratory system. OCLC 52056845. • U. Durham. Alf O.1136/bmj. Carl D.1. UK: Harley Swan.S.org/pdf/ DiveMan_rev6..1136/bmj. Retrieved 2008-09-20. • Lang. • Donald. OCLC 51607923. Michael A.. (ed. NC: Divers Alert Network. Navy Diving Manual (http://supsalv.rubicon-foundation. Bennett and Elliott's physiology and medicine of diving (5th ed. "Oxygen poisoning in man—part II". – Online collection of the oxygen toxicity research Specialised The following external sites contain resources specific to particular topics: • 2008 Divers Alert Network Technical Diving Conference (http://www. Lambertsen.667. Teddington. Institute for Environmental Medicine. revision 6. Christian J. Neuman. Bugg. John S. 86MB).S. (1998). In Brubakk. OCLC 66524750. Further reading • Lamb. (1999). External links General The following external site is a compendium of resources: • Rubicon Research Repository (http://archive. New York: Thieme. OCLC 39170393. Kenneth W. 358–418. IFEM Report No. DAN nitrox workshop proceedings (http://archive. Thom.4507. ISBN 1-85421-176-5.Oxygen toxicity 71 Sources • Clark.S. ISBN 0-7020-2571-2.org/3863). . ISBN 0-941332-68-3. Oxygen and the diver. SS521-AG-PRO-010. PMC 2053251.edu/edu/eshuphysio/program/section4/4ch7/ s4ch7_7. University of Pennsylvania Medical Center). • Clark. James M. • Donald. PMC 2053400. The Practice of Oxygen Measurement for Divers. (1970).pdf). pp. U. 120 pages.4506.. 237 pages. Kenneth W. John M. Australia: J. Publications. "Oxygen".
is set by the partial pressure of oxygen alone. In chemistry. or dissolved in blood. The partial pressure of a gas is a measure of thermodynamic activity of the gas's molecules. – Concise clinical overview with extensive references. For example. The partial pressure of a gas dissolved in a liquid is the partial pressure of that gas which would be generated in a gas phase in equilibrium with the liquid at the same temperature. Prabhakar (2009-03-11). eMedicine. This is true across a very wide range of different concentrations of oxygen present in various inhaled breathing gases. 72 Partial pressure In a mixture of ideal gases.com/article/ 406564-overview). Gases will always flow from a region of higher partial pressure to one of lower pressure. the necessary amount of oxygen for human respiration. the partial pressure of a gas in a mixture of gases is defined as above. For example. This is because ideal gas molecules are so far apart that they don't interfere with each other at all. each gas has a partial pressure which is the pressure which the gas would have if it alone occupied the volume. "Bronchopulmonary Dysplasia" (http://emedicine. A consequence of this is that the total pressure of a mixture of ideal gases is equal to the sum of the partial pressures of the individual gases in the mixture as stated by Dalton's law.Oxygen toxicity • Rajiah. and react according to their partial pressures.medscape. and not according to their concentrations in gas mixtures or liquids. and the amount that is toxic. Actual real-world gases come very close to this ideal. This general property of gasses is also true of chemical reactions of gasses in biology. the larger this difference. The total pressure of a gas mixture is the sum of the partial pressures of each individual gas in the mixture. Gases dissolve. given an ideal gas mixture of nitrogen (N2). diffuse. hydrogen (H2) and ammonia (NH3): where: = total pressure of the gas mixture = partial pressure of nitrogen (N2) = partial pressure of hydrogen (H2) = partial pressure of ammonia (NH3) . the faster the flow. Retrieved 2009-06-29. Dalton's law of partial pressures The partial pressure of an ideal gas in a mixture is equal to the pressure it would exert if it occupied the same volume alone at the same temperature.
and is useful in gas mixtures. oxygen.Partial pressure 73 Ideal gas mixtures Ideally the ratio of partial pressures is the same as the ratio of molecules.g.g. air. It can be approximated both from partial pressure and molar fraction:  • • • • • • Vx is the partial volume of any individual gas component (X) Vtot is the total volume in gas mixture Px is the partial pressure of gas X Ptot is the total pressure in gas mixture nx is the amount of substance of a gas (X) ntot is the total amount of substance in gas mixture . e. That is. to focus on one particular gas component. the mole fraction of an individual gas component in an ideal gas mixture can be expressed in terms of the component's partial pressure or the moles of the component: and the partial pressure of an individual gas component in an ideal gas can be obtained using this expression: where: = mole fraction of any individual gas component in a gas mixture = partial pressure of any individual gas component in a gas mixture = moles of any individual gas component in a gas mixture = total moles of the gas mixture = total pressure of the gas mixture The mole fraction of a gas component in a gas mixture is equal to the volumetric fraction of that component in a gas mixture. with unchanged pressure and temperature. Partial volume (Amagat's law of additive volume) The partial volume of a particular gas is the volume which the gas would have if it alone occupied the volume. e.
Most often the term is used to describe a liquid's tendency to evaporate. The vapor pressure chart to the right has graphs of the vapor pressures versus temperatures for a variety of liquids. As can be seen in the chart.Partial pressure 74 Vapor pressure Vapor pressure is the pressure of a vapor in equilibrium with its non-vapor phases (i. which is where the vapor pressure curve of propane (the purple line) intersects the horizontal pressure line of one atmosphere (atm) of absolute vapor pressure.7 °C). the lower the normal boiling point of the liquid. For a reversible reaction involving gas reactants and gas products. It also has the lowest normal boiling point (-43. A typical vapor pressure chart for various liquids Equilibrium constants of reactions involving gas mixtures It is possible to work out the equilibrium constant for a chemical reaction involving a mixture of gases given the partial pressure of each gas and the overall reaction formula.. It is a measure of the tendency of molecules and atoms to escape from a liquid or a solid. The higher the vapor pressure of a liquid at a given temperature. the liquids with the highest vapor pressures have the lowest normal boiling points. at any given temperature. such as: the equilibrium constant of the reaction would be: .e. liquid or solid). For example. propane has the highest vapor pressure of any of the liquids in the chart. A liquid's atmospheric pressure boiling point corresponds to the temperature at which its vapor pressure is equal to the surrounding atmospheric pressure and it is often called the normal boiling point.
However. ideal solutions and for solutions where the liquid solvent does not react chemically with the gas being dissolved. the reaction kinetics may either oppose or enhance the equilibrium shift. This statement is known as Henry's Law and the equilibrium constant is quite often referred to as the Henry's Law constant. readers of the technical literature must be quite careful to note which version of the Henry's Law equation is being used. . is also referred to as the Henry's Law constant. the reaction kinetics may be the over-riding factor to consider. Since both may be referred to as the Henry's Law constant. Henry's Law and the solubility of gases Gases will dissolve in liquids to an extent that is determined by the equilibrium between the undissolved gas and the gas that has dissolved in the liquid (called the solvent).   Henry's Law is sometimes written as: (2) where above. The equilibrium constant for that equilibrium is: (1) where: = the equilibrium constant for the solvation process = partial pressure of gas = the concentration of gas in equilibrium with a solution containing some of the gas in the liquid solution The form of the equilibrium constant shows that the concentration of a solute gas in a solution is directly proportional to the partial pressure of that gas above the solution. Henry's Law is an approximation that only applies for dilute.Partial pressure 75 where: = the equilibrium constant of the reaction = coefficient of reactant = coefficient of reactant = coefficient of product = coefficient of product = the partial pressure of = the partial pressure of = the partial pressure of = the partial pressure of raised to the power of raised to the power of raised to the power of raised to the power of For reversible reactions. In some cases. changes in the total pressure. temperature or reactant concentrations will shift the equilibrium so as to favor either the right or left side of the reaction in accordance with Le Chatelier's Principle. As can be seen by comparing equations (1) and (2) is the reciprocal of .
Using diving terms. References          Charles Henrickson (2005). Perry. html) . at 50 metres (165 feet).3 bar absolute where: ppi P Fi ppN2 ppO2 = partial pressure of gas component i = = total pressure = in the terms used in this article in the terms used in this article . ISBN 0-07-049841-5. Chemistry. Dalton's Law of Partial Pressures (http:/ / dbhs. edu/ ~chem312/ Class Summaries/ Class12. (Editors) (1997).W. Typically. Hypoxia and sudden unconsciousness becomes a problem with an oxygen partial pressure of less than 0.5 bar absolute. ca. edu/ pchem/ C443/ Lectures/ Lecture33. 6th Edition. Oxygen toxicity becomes a risk when these oxygen partial pressures and exposures are exceeded. The partial pressure of oxygen determines the maximum operating depth of a gas mixture. in the terms used in this article = volume fraction of gas component i = mole fraction.H. R. of 150 minutes at 1. Cliffs Notes. html) Pittsburgh University chemical engineering class notes (http:/ / granular.16 bar absolute. che. arizona. uk/ sciences/ reference/ plambeck/ chem2/ p01182. udel. ac. Oxygen toxicity. 1 bar of atmospheric pressure + 5 bar of water pressure) and the partial pressures of the main components of air. wvusd. html) University of Arizona chemistry class notes (http:/ / www. Flemming Cornelius. 2008. us/ webdocs/ GasLaw/ Gas-Dalton. partial pressure is calculated as: partial pressure = total absolute pressure x volume fraction of gas component For the component gas "i": ppi = P x Fi For example.16 bar (16 kPa) absolute. k12. D. of 180 minutes at 1. McGraw-Hill.e. and Green. becomes a problem when oxygen partial pressure is too high.21 = 1. involving convulsions. ISBN 0-764-57419-1. pitt. the total absolute pressure is 6 bar (600 kPa) (i.Partial pressure 76 Partial pressure in diving breathing gases In recreational diving and professional diving the richness of individual component gases of breathing gases is expressed by partial pressure. html) Page 200 in: Medical biophysics.7 bar absolute ppO2 = 6 bar x 0. rice.5 bar absolute. owlnet.3 bar absolute and of 210 minutes at 1. chem. htm) University of Delaware physical chemistry lecture (http:/ / www. edu/ ~salzmanr/ 103a004/ nts004/ l41/ l41. edu/ ~mccarthy/ che0035/ MB/ single/ ideal. the maximum total partial pressure of narcotic gases used when planning for technical diving is 4.). Perry's Chemical Engineers' Handbook (7th ed. oxygen 21% by volume and nitrogen 79% by volume are: ppN2 = 6 bar x 0. of 120 minutes at 1.79 = 4. = partial pressure of nitrogen = = partial pressure of oxygen = in the terms used in this article in the terms used in this article The minimum safe lower limit for the partial pressures of oxygen in a gas mixture is 0.6 bar absolute.2 bar absolute. pdf) Rice University chemistry class notes (http:/ / www.4 bar absolute. The NOAA Diving Manual recommends a maximum single exposure of 45 minutes at 1. Intute University Introductory Chemistry (http:/ / www. based on an equivalent narcotic depth of 35 metres (115 ft).. Nitrogen narcosis is a problem when breathing gases at high pressure. intute.
The remaining oxygen is exhaled along with nitrogen and carbon dioxide. • Himalayan mountaineering.Rebreather 77 Rebreather A rebreather is a type of breathing set that provides a breathing gas containing oxygen and recycled exhaled gas. Because exhaled air can contain as much as 79% nitrogen (which is not utilized in the body) and 16% (or more) unused oxygen. SCR = "semi closed rebreather". which has to be replaced from the air supply. It removes the carbon dioxide by a process called scrubbing. "closed circuit scuba". the gas in the rebreather's circuit remains breathable and supports life and the diver needs only a fraction of the gas that would be required for an open-circuit system. to replace the oxygen that was consumed. or CCUBA = "closed circuit underwater breathing apparatus". which represents an increasingly smaller fraction of the compressed air breathed in. the body consumes oxygen and makes carbon dioxide. • Crewed spacecraft and space suits – outer space is. • Mine rescue and in industry – where poisonous gases may be present or oxygen may be absent. Rebreather technology is used in many environments: • Underwater – where it is sometimes known as CCR = "closed circuit rebreather". At shallow depths. A high rate of system failures due to extreme cold has not been solved. This recycling reduces the volume of breathing gas used. which is known as "open circuit scuba". roughly the same quantity of oxygen is used. making a rebreather lighter and more compact than an open-circuit breathing set for the same duration in environments where humans cannot safely breathe from the atmosphere.  It absorbs the carbon dioxide. "semi closed scuba". The rebreather recirculates the exhaled gas for re-use and does not discharge it to the atmosphere or water. which otherwise would accumulate and cause carbon dioxide poisoning. potentially useful gas volume. . Both chemical and compressed oxygen has been used in experimental closed-circuit oxygen systems—the first on Mt. every exhaled breath from an open-circuit scuba set represents at least 95% wasted. as opposed to Aqua-Lung-type equipment. A fully closed circuit electronic rebreather (Ambient Pressure Diving Inspiration) • Submarines and hyperbaric oxygen therapy chambers – where the gas in the habitat must remain safe. In the armed forces it is sometimes called "CCUBA" (Closed Circuit Underwater Breathing Apparatus). Here the rebreather is big and is connected to the air in the habitat. for all intents and purposes. The rebreather adds oxygen. Everest in 1938. As the diver goes deeper. a person with an open-circuit breathing set typically only uses about a quarter of the oxygen in the air that is breathed in (4%–5% of the inspired volume). • Hospital anaesthesia breathing systems – to supply controlled proportions of gases to patients without letting anaesthetic gas get into the atmosphere that the staff breathe. a vacuum where there is no oxygen to support life. Thus. Theory As a person breathes.
invented Oxylithe. The oldest known rebreather used an oxygen reservoir and relates to the 1849 patent from the Frenchman Pierre Aimable De Saint Simon Sicard. at first oval like in this image.g. Hermann Stelzner. In 1909 Captain S. later British frogman's rebreathers had a square recess in the top so they could extend further up onto his shoulders. leading to a fullface mask with one big face window. to rescue mineworkers who were trapped by water. Those first breathing sets may have been modified Davis Submarine Escape Sets.  In 1903 to 1907 Professor Georges Jaubert. It was designed about 1900 in Britain for escape from Royal Navy frogman in 1945 sunken submarines. Records show that. In World War II captured Italian frogmen's rebreathers influenced design of British frogmen's rebreathers. were those used by the German helmet divers during World War II. as in the illustration below. The first recorded mass production of rebreathers started in 1912 with the Dräger rebreathers. invented some years sooner by an engineer of the Dräger company. Schwann designed a rebreather in Belgium. both invented in the early 1900s) were descended from it. he likely generated oxygen by heating saltpetre (potassium nitrate) in a metal pan to make it emit oxygen. The Dräger rebreathers. R. In 1853 Professor T. R. which is a form of sodium peroxide (Na2O2) or sodium dioxide (NaO2). Rees. the Siebe Gorman Salvus and the Siebe Gorman Proto. which was used effectively in World War II. he accidentally made a crude rebreather more than two centuries before Saint Simon Sicard's patent. especially the DM40 model series. Many British frogmen's breathing sets' oxygen cylinders were German pilot's oxygen cylinders recovered from shot-down German Luftwaffe planes. one version of it had a flip-up single window for both eyes to let the user get binoculars to his eyes when on the surface. and later rectangular (mostly flat.. That may explain how Drebbel's men were not affected by carbon dioxide build-up as much as would be expected.S. Another systematic use of rebreathers for diving was by Italian sport spearfishers in the 1930s. Various industrial oxygen rebreathers (e. Hall.N. the Royal Navy accepted it. If so. Cornelius Drebbel made an early oar-powered submarine. O.  The Davis Escape Set was the first rebreather which was practical for use and produced in quantity.Rebreather 78 History of rebreathers Around 1620 in England. developed a submarine escape apparatus using Oxylithe. to re-oxygenate the air inside it. it was used in the first filming (1907) of Twenty Thousand Leagues Under the Sea. That would turn the saltpetre into potassium oxide or hydroxide.. It was used for shallow water diving but never in a submarine escape. . which developed its frogman unit Decima Flottiglia MAS. which would tend to absorb carbon dioxide from the air around. In 1878 Henry Fleuss invented a rebreather using stored oxygen and absorption of carbon dioxide by an absorbent (here rope yarn soaked in caustic potash solution). Early British frogman's rebreathers had rectangular breathing bags on the chest like Italian frogman's rebreathers. Some British armed forces divers used bulky thick diving suits called Sladen suits.N. he exhibited it in Paris in 1878. As it absorbs carbon dioxide it emits oxygen. but the ends curved back to allow more vision sideways). This practice came to the attention of the Italian Navy. this link shows a Draeger rebreather used for mines rescue in 1907. in front they had a rubber collar that was clamped around the absorbent canister. and Dr. But in later operations different designs were used. their fullface masks were the type intended for the Siebe Gorman Salvus.
Feasibility advantages Long or deep dives using open circuit equipment may not be feasible as there are limits to the number and weight of diving cylinders the diver can carry. The breathing gas in a rebreather is warmer and more moist than the dry and cold gas from open circuit equipment making it more comfortable to breathe on long dives and causing less dehydration in the diver. the advantage of a rebreather is even more marked. For example. the diver on open-circuit scuba only uses about 5% of his cylinders' contents. Most modern rebreathers have a system of very sensitive oxygen sensors. the entire breath is expelled into the surrounding water when the diver exhales. the diver is not using any more of the O2 gas supply than when shallower. A very small amount of trimix would then last for many dives. The fully closed circuit rebreather is able to minimise the proportion of inert gases in the breathing mix. A breath inhaled from an open circuit scuba system whose cylinders are filled with ordinary air is about 21% oxygen.  Lambertsen held the first closed-circuit oxygen rebreather course in the United States for the Office of Strategic Services maritime unit at the Naval Academy on 17 May 1943. Lambertsen for underwater warfare and is considered by the US Navy as "the father of the Frogmen". Care must be taken that the ppO2 is not set to a level where it can become toxic though. this can conceal military divers and allow divers engaged in marine biology and underwater photography to avoid alarming marine animals and thereby get closer to them. the remaining 75% is lost. This can offer a dramatic advantage at the end of deeper dives. It is not uncommon for a 3 litre (19 cubic foot) diluent cylinder to last for eight 40 m (130 ft) dives. At depth. due to venting of the gas on ascent. a closed circuit rebreather diver effectively doesn't use any of their diluent gas once they've reached the bottom phase of the dive.Rebreather In the early 1940s US Navy rebreathers were developed by Dr. This leaves the available oxygen utilization at about 25%. Other advantages Except on ascent. This is a marked difference from open circuit where the amount of gas used is directly proportional to the depth. This means that at depth. closed circuit rebreathers produce no bubbles and make no bubble noise and much less gas hissing. This lack of exhale also allows shipwreck divers to enter enclosed areas on sunken ships and avoid slowly filling them with air. only oxygen is consumed: small volumes of expensive inert gases are reused during (only) one dive. they could turn off their diluent. and therefore minimise the decompression requirements of the diver. which then supports the growth of rust. With open circuit scuba. the amount of O2 consumption doesn't change. by maintaining a specific and relatively high oxygen partial pressure (ppO2) at all depths.  79 Advantages of rebreather diving Efficiency advantages The main advantage of the rebreather over other breathing equipment is the rebreather's economical use of gas. unlike open-circuit scuba. in order to shorten decompression times. it has an oxygen level in the range of 15 to 16% when the diver is at atmospheric pressure. no diluent is added.5% of O2 is converted to CO2 on exhalation). therefore CO2 generation doesn't change.6 bar is toxic . Christian J. however most of that in circuit is lost. In normal use. Since the generation of CO2 is directly related to the body's consumption of O2 (about ~99. where a diver can raise the partial pressure of oxygen somewhat at shallower depth. Research has shown that a ppO2 of 1. The economy of gas consumption is also useful when the gas mix being breathed contains expensive gases. which allow the diver to adjust the partial pressure of oxygen. On ascent. When that breath is exhaled back into the surrounding environment. such as helium. As the remaining 79% of the breathing gas (mostly nitrogen) is inert.
they are still the most commonly used for industrial applications on the surface. The gas is injected into the loop at a constant rate to replenish oxygen consumed from the loop by the diver. have a deeper maximum operating depth than oxygen rebreathers and are fairly simple and cheap. Oxygen rebreathers are also sometimes used when decompressing from a deep open-circuit dive. oxygen rebreathers are currently limited to a depth of 6 meters (20 ft). As the oxygen in the vented gas cannot be separated from the inert gas. Oxygen rebreathers can be remarkably simple designs. As pure oxygen is toxic when inhaled at pressure. due to their simplicity and compact size. and lower slightly with each exhalation. (SCBA) such as in mines. Semi-closed circuit rebreather Military and recreational divers use these because they provide better underwater duration than open circuit. some say 9 meters (30 ft). In some rebreathers. Simplified diagram of the loop in an oxygen rebreather The diving pioneer Hans Hass used Dräger oxygen rebreathers in the early 1940s. One is constant flow. In the Salvus there is no second stage and the gas is turned on and off at the cylinder. This means that the diver has a tendency to rise slightly with each inhalation. Some simple oxygen rebreathers had no constant-flow valve. 80 Main rebreather design variants Oxygen rebreather This is the oldest type of rebreather and was commonly used by navies from the early twentieth century. e. the other is a plain on-off valve called a bypass. In the past they have been used deeper (up to 20 meters) but such dives were more risky than what is now considered acceptable. Excess gas must be constantly vented from the loop in small volumes to make space for fresh. a quantity of highly compressed gas from his cylinder is reduced in pressure by a regulator. Oxygen rebreathers are no longer commonly used in diving because of the depth limit imposed by oxygen toxicity.g. semi-closed circuit is wasteful of oxygen. The diver must fill the cylinders with gas mix that has a maximum operating depth that is safe for the depth of the dive being planned. and the diver had to operate the valve at intervals to refill the breathing bag as he used the oxygen. When an open-circuit scuba diver inhales. The only gas that it supplies is oxygen. the oxygen cylinder has two first stages in parallel. Simplified diagram of the loop in a semi-closed circuit rebreather . However. because the diver is circulating a roughly constant volume of gas between his lungs and the breathing bag. both feed into the same exit pipe which feeds the breathing bag. as breathing pure oxygen makes the nitrogen diffuse out of the blood more rapidly. and their invention predates that of open-circuit scuba. the Siebe Gorman Salvus. This does not happen to a rebreather diver. Semi-closed circuit equipment generally supplies one breathing gas such as air or nitrox or trimix. oxygen-rich gas. but only the bypass. and enters the lungs at a much higher volume than it occupied in the cylinder.Rebreather with extended exposure One major difference between rebreather diving and open-circuit scuba diving is in keeping neutral buoyancy.
a condition causing convulsions which can make the diver lose the mouthpiece when they occur underwater. Non-simplified diagram of the loop in a semi-closed circuit rebreather Fully closed circuit rebreather Military. Closed circuit rebreathers generally supply two breathing gases to the loop: one is pure oxygen and the other is a diluent or diluting gas such as air or trimix. This system is dangerous because of the explosively hot reaction that happens if water gets on the potassium superoxide. in the loop and to warn the diver if it is becoming dangerously low or high. Tests on the IDA71 at the United States Navy Experimental Diving Unit in Panama City. known as the oxygen partial pressure. which gives off oxygen as it absorbs carbon dioxide: 4KO2 + 2CO2 = 2K2CO3 + 3O2. Florida showed that the IDA71 could give significantly longer dive time with superoxide in one of the canisters than without. In fully automatic closed-circuit systems. Simplified diagram of the loop in a fully closed circuit rebreather Non-simplified diagram of the loop in a fully closed circuit rebreather Rebreathers using an absorbent that releases oxygen There have been a few rebreather designs (e. Too high a concentration of oxygen results in hyperoxia. Manually adding oxygen is risky as additional small volumes of oxygen in the loop can easily raise the partial pressure of oxygen to dangerous levels. a mechanism injects oxygen into the loop when it detects that the partial pressure of oxygen in the loop has fallen below the required level. the Oxylite) which had an absorbent canister filled with potassium superoxide. photographic. The major task of the fully closed circuit rebreather is to control the oxygen concentration. Adding diluent can prevent the loop's gas mixture becoming too oxygen rich. Too low a concentration of oxygen results in hypoxia leading to sudden unconsciousness and ultimately death. The concentration of oxygen in the loop depends on two factors: depth and the proportion of oxygen in the mix. and recreational divers use these because they allow long dives and produce no bubbles. The Russian IDA71 military and naval rebreather was designed to be run in this mode or as an ordinary rebreather. it had a very small oxygen cylinder to fill the loop at the start of the dive. leading to oxygen toxicity. and can lead to drowning. The diver may be able to manually control the mixture by adding diluent gas or oxygen. A higher gas injection rate reduces the likelihood of hypoxia but consumes more gas and wastes more oxygen.Rebreather 81 As the amount of oxygen required by the diver increases with work rate.g. the gas injection rate must be carefully chosen and controlled to prevent unconsciousness in the diver due to hypoxia. . Often this mechanism is electrical and relies on oxygen sensitive electro-galvanic fuel cells called “ppO2 meters” to measure the concentration of oxygen in the loop.
g. industrial sets of this type may not be suitable for diving. It had a duration of 6 hours and a maximum dive depth of 200 meters of salt water. a regular scrubber was needed. Cryogenic rebreather A cryogenic rebreather has a tank of liquid oxygen and no absorbent canister. The set's liquid oxygen tank must be filled immediately before use. They include these types: • Aerophor. Cryogenic rebreathers were widely used in Soviet oceanography in the period 1980 to 1990. • Aerorlox  • Cryogenic rebreather: see below. Aerorlox rebreather in a coal mining museum A cryogenic rebreather called the S-1000 was built around or soon after 1960 by Sub-Marine Systems Corporation.  Other designs • In the Siebe Gorman Proto the absorbent was in a flexible-walled compartment in the bottom of the breathing bag and not in a canister. The carbon dioxide is frozen out in a "snow box" by the cold produced as the liquid oxygen expands to gas as the oxygen is used and is replaced from the oxygen tank. Its ppO2 could be set to anything from 0. the Siebe Gorman CDBA) had a backpack weight pouch instead of the diver having a separate weight belt. like in an old Draeger standard diving suit variant which had a rebreather pack attached. • Some British naval rebreathers (e. corresponding to an oxygen consumption of 2 liters per minute.2 bar to 2 bar without electronics.Rebreather 82 Rebreathers which store liquid oxygen If used underwater. and diving sets of this type may not be suitable for use out of water. thus controlling the equilibrium pressure of oxygen gas above the liquid. As a result. by controlling the temperature of the liquid oxygen. . The diluent could be either liquid nitrogen or helium depending on the depth of the dive. If oxygen was consumed faster (high workload). the liquid-oxygen tank must be well insulated against heat coming in from the water. • This link  describes an experimental drysuit (with built-in hood and fullface mask) and rebreather combination where the drysuit acts as the breathing bag. The set could freeze out 230 grams of carbon dioxide per hour from the loop.
so recreational rebreathers and many professional diving rebreathers also have a cylinder of diluent gas. it may be used in an emergency either to flush the loop with breathable gas or as a bailout. or if the diver's lips get slack letting water leak in. Depending on the rebreather design variant. Attached to the loop there will be at least one valve allowing injection of gases. Nearly always. the oxygen source will either be pure or a breathing gas mixture. Some have a single pendulum hose.Rebreather 83 Parts of a rebreather The loop Although there are several design variations of diving rebreather. this oxygen is stored in a gas cylinder. This diluent cylinder may be filled with compressed air or another diving gas mix such as nitrox or trimix. The loop consists of components sealed together. sometimes a mouth-and-nose mask). It is important that the diluent is not an oxygen-free gas. Regardless of whether the rebreather in question has the facility to trap any ingress of water. Many rebreathers have "water traps" in the counterlungs. Back of a closed circuit rebreather. any training on a rebreather will feature procedures for removing any excess water. There may be valves allowing venting of gas from the loop. where the inhaled and exhaled gas passes through the same tube in opposite directions. all types have a gas-tight loop that the diver inhales from and exhales into. The loop also includes a scrubber containing carbon dioxide absorbent to remove from the loop the carbon dioxide exhaled by the diver. from a gas source into the loop. The diluent reduces the percentage of oxygen breathed and increases the maximum operating depth of the rebreather. Most modern rebreathers have a twin hose mouthpiece or breathing mask where the direction of flow of gas through the loop is controlled by one-way valves. A simple naval-type diving oxygen rebreather with the parts labelled Gas sources A rebreather must have a source of oxygen to replenish that consumed by the diver. such as oxygen and perhaps a diluting gas. The mouthpiece often has a valve letting the diver take the mouthpiece from the mouth while underwater or floating on the surface without water getting into the loop. This holds gas when it is not in the diver's lungs. . The diver breathes through a mouthpiece or a fullface mask (or with industrial breathing sets. and is breathable. This is connected to one or more tubes bringing inhaled gas and exhaled gas between the diver and a counterlung or breathing bag. to stop large volumes of water from entering the loop if the diver removes the mouthpiece underwater without closing the valve. such as pure nitrogen or helium. with the casing opened Pure oxygen is not considered to be safe for recreational diving deeper than 6 meters.
It gives rise to a chalky taste. thus preventing CO2 from reaching the scrubber material. as the reaction consumes the active ingredients. the scrubber needs to be bigger than is needed for a shallow-water or industrial oxygen rebreather. are not cleaned or lubricated or fitted properly. and the US Navy to describe Micropore's absorbent curtains for emergency submarine use. The carbon dioxide passing through the scrubber absorbent is removed when it reacts with the absorbent in the canister. a rebreather absorbent called "Protosorb" supplied by Siebe Gorman had a red dye. because of this effect. a fan is used to pass gas through the canister.Rebreather 84 Carbon dioxide scrubber The exhaled gases are directed through the chemical scrubber. This is useful in dry open environments. or outside water or gas may get in circuit. For example. This reaction occurs along a "front" which is a cross section of the canister. which should prompt the diver to switch to an alternative source of breathing gas and rinse his or her mouth out with water. In deep diving with a nitrox or other gas-mixture rebreather. It changes the colour of the soda lime after the active ingredient is consumed. Some absorbent chemical designed for diving applications are Sofnolime. With a transparent canister. In larger environments. which was said to go white when the absorbent was exhausted. However. the scrubber will be less efficient. If any of the seals. but is not useful on diving equipment. this type of carbon dioxide poisoning was called shallow water blackout. this may be able to show the position of the reaction "front". Color indicating dye was removed from US Navy fleet use in 1996 when it was suspected of releasing chemicals into the circuit. There are several ways that the scrubber may fail or become less efficient: • Complete consumption of the active ingredient ("break through"). Scrubber failure The term "break through" means the failure of the "scrubber" to continue removing carbon dioxide from the exhaled gas mix. Dragersorb. from the gas input end to the gas output end. Many modern diving rebreather absorbents are designed not to produce "cocktail" if they get wet. Some systems use a prepackaged Reactive Plastic Curtain (RPC) based cartridge: Reactive Plastic Curtain (RPC) was first used between Micropore Inc. where: . such as o rings. this chemical reaction is exothermic. of the unreacted soda lime that is exposed to carbon dioxide-laden gas. which removes the carbon dioxide from the gas mixture and leaves the oxygen and other gases available for re-breathing. Failure prevention • An indicating dye in the soda lime. Among British naval rebreather divers. • A Caustic Cocktail – Soda lime is caustic and can cause burns to the eyes and skin. and then more recently RPC has been used on the web to describe their Reactive Plastic Cartridges – ExtendAir . A "caustic cocktail" is a mixture of water and soda lime that occurs when the "scrubber" floods. In a rebreather. because the carbon dioxide in the gas going through the canister needs time to reach the surface of a grain of absorbent. this front would be a wide zone. such as recompression chambers. or spacers that prevent bypassing of the scrubber. This allows the exhaled gas to bypass the absorbent. • The scrubber canister has been incorrectly packed or configured. or Sodasorb. and then time to penetrate to the middle of each grain of absorbent as the outside of the grain becomes exhausted. This front moves through the scrubber canister. the soda lime must be packed tightly so that all exhaled gas comes into close contact with the granules of soda lime and the loop is designed to avoid any spaces or gaps between the soda lime and the loop walls that would let gas avoid contact with the absorbent. • in below-freezing operation (primarily mountain climbing) the wet scrubber chemicals can freeze when oxygen bottles are changed. a canister full of some suitable carbon dioxide absorbent such as a form of soda lime. the inside of the canister is more crowded by other gas molecules (oxygen or diluent) and the carbon dioxide molecules are not so free to move around to reach the absorbent. • When the gas mix is under pressure caused by depth.
Divers are trained to monitor and plan the exposure time of the soda lime in the scrubber and replace it within the recommended time limit. for example. The diver must monitor the exposure of the scrubber and replace it when necessary. the set also has a manual on/off valve called a bypass. • Temperature monitoring. rather than lack of oxygen. Counterlung . In many rebreathers the diver can control the gas mix and volume in the loop manually by injecting each of the different available gases to the loop and by venting the loop. along the length of the scrubber can be used to measure the position of the front and therefore the life of the scrubber.Rebreather • A transparent canister would likely be brittle and easily cracked by knocks. such as a recompression chamber or a hospital. At present. In some early rebreathers the diver had to manually open and close the valve to the oxygen cylinder to refill the counter-lung each time. the first CO2 detector to be produced for rebreathers in a diving application was patented by Clive Wilcox of Amphilogic. the design of the rebreather. injecting more oxygen if necessary or issuing an audible warning to the diver if the ppO2 reaches dangerously high or low levels. • Opening the canister to look inside would flood it with water or let unbreathable external gas in. temperature sensors. If not enough new oxygen is being added. the proportion of oxygen in the loop may be too low to support life. inside the breathing bag or inside a backpack box. which monitor the ppO2. In humans. As the reaction between carbon dioxide and soda lime is exothermic. it may be possible to put fresh absorbent in the canister when break through occurs. In some dry open environments. and the size of the canister. The resulting serious hypoxia causes sudden blackout with little or no warning. the urge to breathe is normally caused by a build-up of carbon dioxide in the blood. the pressure in the breathing bag controls the oxygen flow like the demand valve in open-circuit scuba. Such systems are not useful as a tool for monitoring scrubber life when underwater as the onset of scrubber "break through" occurs quite rapidly. Effectiveness In rebreather diving. e.g. This makes hypoxia a deadly problem for rebreather divers. In others the oxygen flow is kept constant by a pressure-reducing flow valve like the valves on blowtorch cylinders. there is no effective technology for detecting the end of the life of the scrubber or a dangerous increase in the concentration of carbon dioxide causing carbon dioxide poisoning. • The canister is usually out of sight of the user. the typical effective duration of the scrubber will be half an hour to several hours of breathing. In some modern rebreathers. 85 Controlling the mix A basic need with a rebreather is to keep the partial pressure of oxygen (ppO2) in the mix from getting too low (causing hypoxia) or too high (causing oxygen toxicity). trying to breathe in from an empty bag makes the cylinder release more gas. most likely digital. The loop often has a pressure relief valve to prevent over-pressure injuries caused by over-pressure of the loop. • Carbon dioxide gas sensors exist.  • Diver training. Such systems should be used as an essential safety device to warn divers to bail off the loop immediately. depending on the granularity and composition of the soda lime. the ambient temperature. Most modern closed-circuit rebreathers have electro-galvanic fuel cell sensors and onboard electronics. Narked at 90 Ltd – Deep Pursuit Advanced electronic rebreather controller.
bailout strategy becomes a crucial part of dive planning. Although some rebreather divers—referred to as "alpinists"—do not carry bailouts. has an effect on the ease of breathing. this does not matter so much: for example. particularly for long dives and deeper dives in technical diving. the rebreather may fail and be unable to provide a safe breathing mix for the duration of the ascent back to the surface. Often the planned dive is limited by the capacity of the bailout and not the capacity of the rebreather. in an industrial version of the Siebe Gorman Salvus the breathing bag hangs down by the left hip. to prevent the rubber from perishing due to UV light. Underwater. • An open-circuit demand valve connected to the rebreather's oxygen cylinder. The KISS Classic). Rebreather diver with bailout and decompression cylinders Several types of bailout are possible: • An open-circuit demand valve connected to the rebreather's diluent cylinder. while others incorporate the counter lungs into a solid case (e. Some are designed as over-the-shoulder lungs (e. Innerspace Systems Megalodon). or on the back. the position of the breathing bag. It is easier to inhale from a front mounted counterlung and exhale to a back mounted counterlung for diver swimming facedown and horizontally. This is similar to the open circuit diluent bailout except it can only safely be used in depths of 6 metres (20 ft) or less because of the risk of oxygen toxicity.g.g. For use out of water. on the chest. . While this option has the advantages of being permanently mounted on the rebreather and not heavy. should be sheltered from sunlight when not in use. The breathing gas mix must be carefully chosen to be safe at all depths of the ascent. The extra cylinders are heavy and cumbersome but larger cylinders let the diver carry more gas providing protection for the ascent from deeper and long dives. the quantity of gas held by the rebreather is small so the protection offered is low. over the shoulders. • An independent open-circuit system. • An independent closed-circuit system. which is designed to change in size by the same volume as the diver's lungs when breathing. In this case the diver needs an alternative breathing source: the bailout. 86 Bailout While the diver is underwater.Rebreather The counterlung is a flexible part of the loop. Its purpose is to let the loop expand to hold the gas exhaled by the diver and to contract when the diver inhales letting the total volume of gas in the lungs and the loop remain constant throughout the diver's breathing cycle. This is due to the pressure difference between the counterlung and the diver's lung caused by the vertical distance between the two. The design of the rebreathers' counterlungs can also affect the swimming diver's streamlining due to location of the counterlungs themselves. A rebreather whose counterlung is rubber and not in an enclosed casing.
In fully closed circuit equipment. aging oxygen sensors may become "current limited" and fail to measure high partial pressures of oxygen resulting in dangerously high oxygen levels. This casing needs venting to let surrounding water or air in and out to allow for volume changes as the breathing bag inflates and deflates. closed-circuit rebreathers are ideal to treat various altitude related illnesses as the user is brought back to sea level in terms of oxygen pp. in the IDA71 and Cis-Lunar. (Because there has been very little use of mountaineering rebreathers. during hard work or fast swimming. The scrubber efficiency may be reduced at depth where the increased concentration of other gas molecules. for example. so the absorbent can work all the time. Diffuser Some military rebreathers have a diffuser over the blowoff valve.Rebreather 87 Casing Many rebreathers have their main parts in a hard backpack casing. to keep the exhaled gas flowing over the carbon dioxide absorbent. this also has the . is completely sealed. due to pressure. In a diving rebreather this needs fairly large holes. A particular problem when using a closed circuit rebreather is the drop in ambient pressure caused by the ascent phase of the dive. panic. The SEFA. and holes for the oxygen cylinder's on/off valve and the cylinder pressure gauge. e. which raises the partial pressure of oxygen to hyperoxic levels.g. which is used for mine rescue. not with the theory of rebreathing): • Sudden blackout due to hypoxia caused by too low a partial pressure of oxygen in the loop. headache. In mountaineering. Another problem is the diver producing carbon dioxide faster than the absorbent can handle. stops all the carbon dioxide molecules reaching the active ingredient of the scrubber. equipment. The solution to this is to slow down and let the absorbent catch up. Divers need to lose any air conservation habits that may have been developed while diving with open-circuit scuba. and procedural. such a seal could conceivably cause an unconscious user to suffocate when the oxygen ran out or the scrubber became exhausted. Disadvantages of rebreather diving Risks The percentage of deaths that involve the use of a rebreather among United States and Canadian residents increased from approximately 1 to 5% of the total diving fatalities collected by the Divers Alert Network from 1998 through 2004. this danger is still only theoretical.) Closed circuit disorders In addition to the other diving disorders suffered by divers. and hyperventilation due to excess of carbon dioxide caused by incorrect configuration. to keep grit and stones out of its working. Investigations into rebreather deaths focus on three main areas: medical. except for a large vent panel covered with metal mesh. which helps to conceal the diver's presence by masking the release of bubbles. Underwater the casing also serves for streamlining. • Disorientation. rebreather divers are also more susceptible to the following disorders (all of which are directly connected with the effectiveness of actual rebreather designs and construction. This can be caused by the rise in ambient pressure caused by the descent phase of the dive. • Seizures due to oxygen toxicity caused by too high a partial pressure of oxygen in the loop. which reduces the partial pressure of oxygen to hypoxic levels leading to what is sometimes called deep water blackout. • The rebreather diver must keep breathing in and out all the time. it must be packed and sealed correctly. The danger is that a sick climber using a rebreather might become unconscious. failure or inefficiency of the scrubber. Because an absolute atmospheric seal is required for rebreathers to work correctly. including a hole at the bottom to drain the water out when the diver comes out of water. In closed circuit rebreathers. The scrubber must be configured so that no exhaled gas can bypass it.
which may give inaccurate readings to the oxygen control system. believing that an irrecoverable rebreather failure is very unlikely. • Integrated decompression computers – these allow divers to take advantage of the content and generate a schedule of decompression stops. A malfunctioning rebreather can supply a gas mixture which contains too little oxygen to sustain life. • "Caustic cocktail" in the loop if water comes into contact with the soda lime used in the carbon dioxide scrubber. . rebreathers have some disadvantages including expense. Sport diving rebreather technology innovations Over the past ten or fifteen years rebreather technology has advanced considerably. This flushes out the old mix and replaces it with a known proportion of oxygen 88 Compared with open circuit When compared with Aqua-Lungs. • Carbon dioxide scrubber life monitoring systems – temperature sensors monitor the progress of the reaction of the soda lime and provide an indication of when the scrubber will be exhausted. The technique involves simultaneously venting the loop and injecting diluent. improper configuration and misuse. such as when using a normoxic diluent and observing the diluent's maximum operating depth. fully closed circuit rebreather itself – use of electronics and electro-galvanic fuel cells to monitor oxygen concentration within the loop and maintain a certain partial pressure of oxygen • Automatic diluent valves – these inject diluent gas into the loop when the loop pressure falls below the limit at which the diver can comfortably breathe. An important safety device when carbon dioxide poisoning occurs. The diver is normally alerted to this by a chalky taste in the mouth. often driven by the growing market in recreational diving equipment. This practice is known as alpinism or alpinist diving and is generally maligned due to the perceived extremely high risk of death if the rebreather fails. These are expensive and susceptible to failure. complexity of operation and maintenance.Rebreather advantage of mixing the gases preventing oxygen-rich and oxygen-lean spaces developing within the loop. sensors and alarm systems. The first ever system that was proved to function correctly was patented by Clive Wilcox of Amphilogic. • Carbon dioxide monitoring systems – Gas sensing cell and interpretive electronics which detect the presence of carbon dioxide in the unique environment of a rebreather loop. • Dive/surface valves or bailout valves – a device in the mouthpiece on the loop which connects to a bailout demand valve and can be switched to provide gas from either the loop or the demand valve without the diver taking the mouthpiece from his or her mouth. or it may allow carbon dioxide to build up to dangerous levels. but instead rely on the rebreather. The bailout requirement of rebreather diving can sometimes also require a rebreather diver to carry almost as much bulk of cylinders as an open-circuit diver so the diver can complete the necessary decompression stops if the rebreather fails completely. A safe response is to bail out to "open circuit" and rinse the mouth out. Restoring the oxygen content of the loop Many diver training organizations teach the "diluent flush" technique as a safe way to restore the mix in the loop to a level of oxygen that is neither too high nor too low. Typically rebreathers try to solve these problems by monitoring the system with electronics. Innovations include: • The electronic. and fewer failsafes. Some rebreather divers prefer not to carry enough bailout for a safe ascent breathing open circuit. It only works when partial pressure of oxygen in the diluent alone would not cause hypoxia or hyperoxia.
org/ 7782). PMID 8653065. W (2003). RANSUM-4-69. Velocity Press. "Closed circuit oxygen system. D. W and Horn.. Retrieved 2008-07-17. htm)  Bech. Drew. Retrieved 2008-10-24. divingheritage. JM. "A History Of Closed Circuit Oxygen Underwater Breathing Apparatus" (http:/ / archive. org/ research/ treks/ palautz97/ rb. School of Underwater Medicine. ISBN 20060725. "Equipment for the working diver" 1970 symposium. .). dutchsubmarines. Retrieved 2008-08-20. . Shreeves. Tolworth. . NE (eds. org/ 5110). htm  Norfleet. Dutch Submarines. . Retrieved 2008-06-14. .  Saint Simon Sicard's invention as mentioned by the Musée du Scaphandre website (a diving museum in Espalion. p. htm). Closed circuit cryogenic SCUBA.). Surrey: Siebe Gorman & Company Ltd. 2005 at the University of Connecticut at Avery Point.  Hawkins T (1st Quarter 2000). D. School of Underwater Medicine." (http:/ / archive. Caldwell JM (March 1996).  http:/ / www. JM. In: Godfrey. "OSS Maritime".  Quick.  http:/ / www.  Shreeves. June 1969. Dean.  Warkander. html  Lillo RS. (1970). Gummin DD. Oxygen therapy and toxicity.  "Sportsmen-podvodnik journal. "Mechanical and Operational Tests of a Russian 'Superoxide' Rebreather. rubicon-foundation. . rubicon-foundation. . 693. South Pacific Underwater Medicine Society Journal 27 (1). 28. PMID 15233156. (American Academy of Underwater Sciences). . Karl (eds).  http:/ / www. The Blast 32 (1). high altitude oxygen" (http:/ / www. a specialised website. Undersea Hyperb Med 31 (1): 21–31. com/ drager. Vet Clin North Am Small Anim Pract 2002. OCLC 16986801. rubicon-foundation. com/ rebreathers/ vision/ scrubbermonitor/ • . Undersea Hyperb Med 23 (1): 43–53. MA and Smith. "DEVELOPMENT OF A SCRUBBER GAUGE FOR CLOSED-CIRCUIT DIVING.32:1005-1020. In: Lang. ISSN 0032-4558. . co. Undersea Hyperb Med 31 (1): 3–20. org/ 2238). (1969). "Mixed-Gas Closed-Circuit Rebreathers: An Overview of Use in Sport Diving and Application to Deep Scientific Diving" (http:/ / archive. org/ 6039). v. D (2006). RH (1955). Tom (2006). Cryogenic Rebreather.S. DE (2007). "Lambertsen and O2: beginnings of operational physiology" (http:/ / archive.  Goble. . therebreathersite. nl/ Zuurstofrebreathers/ German/ photos_draeger_1907_rescue_apparatus. . "Closed-circuit oxygen diving in the U. Retrieved 2009-07-17. therebreathersite. • Cushman. Retrieved 2008-06-09. com/ productfrm." (http:/ / archive. com/ scaphandre/ autonomie/ autonomes_sans_detendeur.  Butler FK (2004). popmech. Royal Australian Navy. htm Fischel H. Janwillem. WW. rubicon-foundation.Rebreather 89 References  Richardson. com/ closedcircuit. Menduno.  Davis. . DC. scubadiving. org/ 3987). Proceedings of Advanced Scientific Diving Workshop Smithsonian Institution. Retrieved 2008-04-25. therebreathersite. Retrieved 2008-06-13. JS. Proceedings of the American Academy of Underwater Sciences Symposium on March 10-12. Ruby A. Connecticut. ru/ article/ 5567-zhidkaya-voda-zhidkiy-vozduh/ ). N7. ru/ biblioteka/ Knigi/ sportsmen_podvodnik_046. 79. Michael. Retrieved 2008-06-09. Washington. "Theoretical Considerations in the Design of Closed Circuit Oxygen Rebreathing Equipment" (http:/ / archive. org/ 3451). "Seeking New Depths". uk/ rescue/ glossary/ aerorlox. US Naval Submarine Medical Research Center Technical Report NSMRL-TR-1228. rubicon-foundation. "Chemical safety of U. "Some limitations of simi-closed rebreathers" (http:/ / archive. Herron.  "Popular mechanics (ru). org/ 4992). Marine Technology Society 1970:229-244. SE. (1997). htm)  Vann RD (2004). Retrieved 2008-02-23. "Theodor Schwann" (http:/ / www. Navy" (http:/ / archive. Surbiton. apdiving. Sundstrom. Retrieved 2008-04-25. velocitypress. org/ 4958). Skin Diver magazine. "Scuba Bubble Noise and Fish Behavior: A Rationale for Silent Diving Technology.0. .  Older. rubicon-foundation. Royal Australian Navy.  http:/ / www. Popular Mechanics 183 (12): 58. . RANSUM-1-70. rubicon-foundation. Navy Fleet soda lime" (http:/ / archive. (http:/ / www. 1977" (http:/ / www. "Rebreathers" (http:/ / archive. №7(81) June 2009" (http:/ / www. Retrieved 2008-04-25. Retrieved 2009-01-31. and reprinted in Aqua Corps magazine. south of France) (http:/ / www. L." (http:/ / archive. DC. Phillip S (2005). com/ specials/ special_drebbel. org/ 7555). Undersea Hyperb Med Society Annual Meeting. Retrieved 19 September 2010. org/ 4667).: 286.  Manning AM. . Retrieved 2008-06-14. rubicon-foundation. Steve (2003). Glen Harlan (December 2006). html  Elliott. pdf).S. Porter WR.  http:/ / www.. Shumway. "Proceedings of Rebreather Forum 2. rubicon-foundation.  Holzel. Groton. healeyhero.  Kelley. Diving For Science 2005. ISSN 0813-1988. . Journal of the South Pacific Underwater Medicine Society 33 (2): 98–102. . org/ 3986). nl/ 06_Homebuilders/ secret_rebreather.  http:/ / www. shtml). htm  Drägerwerk page in Divingheritage. (1996). US Navy Experimental Diving Unit Technical Report NEDU-Evaluation-11-68. .  "Cornelius Drebbel: inventor of the submarine" (http:/ / www. rubicon-foundation. Retrieved 2008-06-14. USA. Retrieved 2011-01-09. rubicon-foundation. PMID 15233157. (abstract)" (http:/ / archive. K and Richardson. org/ 4960). org/ 9011).  Reynolds. Deep Diving and Submarine Operations (6th ed. Washington. rubicon-foundation. P. extendair.com.  Lobel. htm). EB (1968). Retrieved 2008-02-23. espalion-12. nl/ Zuurstofrebreathers/ German/ theodore_schwann. Diving Science and Technology Workshop. rubicon-foundation. bishopmuseum. "Carbon Dioxide Scrubbing Capabilities of Two New Non-Powered Technologies" (http:/ / archive.
 Liddiard. . may be slow to download • Information on shallow water blackout (http://www. jlunderwater." (http:/ / archive. Retrieved 2008-04-25.html) .org/ 4960).a  Vann RD. org/ 7981).com/latenthypoxia. In: NW Pollock and JM Godfrey (Eds. Retrieved 2010-12-29. therebreathersite.  Warkander Dan E (2007). Retrieved 2009-03-03. . Lee DA (2008). JCB. . . . . org/ 4855). Nitrox Rebreather Diving. "Development of the Canadian Underwater Mine Apparatus and the CUMA Mine Countermeasures dive system.specwargear. 197 pages. jlunderwater. Retrieved 2009-03-03. NC: Divers Alert Network. 90 External links • RebreatherPro (http://www. published in 1970. html) and many useful references in its "Further Reading" section • A history of closed circuit oxygen underwater breathing apparatus (http://archive. DIRrebreather publishing. Retrieved 2008-06-14.) the Diving for Science…2007 (Dauphin Island. Motor skills learning and current bailout procedures in recreational rebreather diving. David J.  Chapple. uk/ old_site/ photoix/ bailout/ bailout. rubicon-foundation.rubicon-foundation.rebreatherpro. plenty of images.org/research/treks/palautz97/rb. section 1.com/dive&swim. rubicon-foundation. Retrieved 2009-03-31. www. html). Defence R&D Canada Technical Report (Defence R&D Canada) (DCIEM 92-06). John. org/ 5110).) (2001). "Development of a scrubber gauge for closed-circuit diving" (http:/ / archive.co.uk.bishopmuseum.  "OC – DSV – BOV – FFM page" (http:/ / www. org/ 7282).2.html) • In-depth explanation on how rebreathers work (http://www.  Verdier C. htm). rubicon-foundation. nl/ 01_Informative/ BOV_page/ BOV_page. rubicon-foundation. org/ 6997).scuba-doc. co.com) Free searchable multimedia resource for rebreather divers • Image gallery of LAR-6 and LAR-7 and FGT II and LAR V rebreathers. and other combat frogman's kit (http:// www.nl. Undersea and Hyperbaric Medicine Abstract 34. and Denoble PJ (2007). Ala. Eaton. (http:/ / archive. Pollock NW. rubicon-foundation. ISBN 0-9800423-1-3. Retrieved 2011-07-30.: American Academy of Underwater Sciences) Proceedings of the American Academy of Underwater Sciences (Twenty-sixth annual Scientific Diving Symposium). Durham. (ed. Michael A. . including mountaineering rebreathers. DAN nitrox workshop proceedings (http:/ / archive.therebreathersite.Rebreather  Lang. "Bailout" (http:/ / www. "Rebreather Fatality Investigation" (http:/ / archive. 8 November 2010.
technical divers may work in the range of 170 ft to 350 ft. • PADI. The following table tries to describe the differences between technical and recreational diving. sometimes even deeper. The term technical diving has been credited to Michael Menduno. While the recommended maximum depth for conventional scuba diving is 130 ft. Even those who agree on the broad definitions of technical diving may disagree on the precise boundaries between technical and recreational diving. Certain minority views contend that certain non-specific higher risk factors should cause diving to be classed as technical diving.Technical diving 91 Technical diving Technical diving (sometimes referred to as Tec diving) is a form of scuba diving that exceeds the scope of recreational diving (although the vast majority of technical divers dive for recreation and nothing else). required stage decompression. accelerated stage decompression and/or the use of multiple gas mixtures in a single dive. are both relatively recent Technical diver during a decompression stop. or by the length of time that the diver intends to spend underwater. However. . Technical diving almost always requires one or more mandatory decompression "stops" upon ascent. advents. specialized equipment and often breathe breathing gases other than air or standard nitrox. nitrox diving was considered technical.   Until recently. Some say that technical diving is any type of scuba diving that is considered higher risk than conventional recreational diving. the largest recreational diver training agency in North America. diving in an overhead environment beyond 130 linear feet from the surface. defines technical diving as "diving other than conventional commercial or recreational diving that takes divers beyond recreational diving limits. whereas others contend that penetrating overhead environments should be regarded as a separate type of diving. although divers have been engaging in what is now commonly referred to as technical diving for decades. Others seek to define technical diving solely by reference to the use of decompression." NOAA does not address issues relating to overhead environments in its definition." • NOAA defines technical diving in this way: "Technical diving is a term used to describe all diving methods that exceed the limits imposed on depth and/or immersion time for recreational scuba diving. technical diving. Technical divers require advanced training. Technical diving often involves the use of special gas mixtures (other than compressed air) for breathing. It is further defined as an activity that includes one or more of the following: diving beyond 40 meters/130 feet. but this is no longer the case. The concept and term. who was editor of the (now defunct) diving magazine AquaCorps in 1991. some advocate that this should include penetration diving (as opposed to open-water diving). The type of gas mixture used is determined either by the maximum depth planned for the dive. during which the diver may change breathing gas mixes at least once. extensive experience. Definition of technical diving There is some professional disagreement as to what the term should encompass.
 Such environments may include fresh and saltwater caves and the interiors of shipwrecks.Technical diving 92 Technical Diving Activity Deep diving Decompression  diving Mixed gas diving Gas switching Recreational Maximum depth of 40 metres (130 ft) No decompression  Technical Beyond 40 metres (130 ft) Decompression diving Air and Nitrox Single gas used Trimix. PADI Recreational diving requires buddy system others as technical diving. Heliair and Hydrox May switch between gases to accelerate decompression and/or "travel mixes" to permit descent carrying hypoxic gas mixes Deeper penetration Wreck diving Penetration limited to "light zone" or 30 metres (100 ft) depth/penetration Penetration limited to "light zone" or 30 metres  (100 ft) depth/penetration Some agencies regard ice diving as recreational diving. The depth-based definition is derived from the fact that breathing regular air while experiencing pressures causes a Diver returning from a 600ft dive progressively increasing amount of impairment due to nitrogen narcosis that normally becomes serious at depths of 100 feet (30 m) or greater. Increasing pressure at depth also increases the risk of oxygen toxicity based on the partial pressure of oxygen in the breathing mixture. technical dives also include planned decompression carried out over a number of stages during a controlled ascent to the surface at the end of the dive. . This is a fairly conservative definition of technical diving. Heliox. technical diving often includes the use of breathing mixtures other than air. NAUI    Some agencies regard use of semi-closed rebreathers as recreational diving. In many cases. NAUI  Solo diving Depth Technical dives may be defined as being dives deeper than about 130 feet (40 m) or dives in an overhead environment with no direct access to the surface or natural light. For this reason. These factors increase the level of risk and training required for technical diving far beyond that required for recreational diving. PADI  Cave diving Deeper penetration Ice diving Rebreathers Solo diving others as technical diving.
Decompression stops A diver at the end of a long or deep dive may need to do decompression stops to avoid decompression sickness. reducing the risk of "the bends. such as nitrogen and helium. In recent years. This form of diving implies a much larger reliance on redundant equipment and training since the diver must stay underwater until it is safe to ascend or the diver has left the overhead environment. These dissolved gases must be released slowly from body tissues by pausing or "doing stops" at various depths during the ascent to the surface.diving inside a shipwreck.diving into a cave system. . Ice diving . it is common to use trimix which adds helium to replace nitrogen in the diver's breathing mixture. Wreck diving . Free floating decompression stop. Most technical divers breathe enriched oxygen breathing gas mixtures such as nitrox during the beginning and ending portion of the dive.diving under ice.Technical diving 93 Inability to ascend directly Technical dives may alternatively be defined as dives where the diver cannot safely ascend directly to the surface either due to a mandatory decompression stop or a physical ceiling. are absorbed into body tissues when inhaled under high pressure during the deep phase of the dive. long. To avoid nitrogen narcosis while at maximum depth. most technical divers have greatly increased the depth of the first stops to reduce the risk of bubble formation before the more traditional. Deep diving . Pure oxygen is then used during shallow decompression stops to reduce the time needed by divers to rid themselves of most of the remaining excess inert gas in their body tissues. also known as the "bends". shallow stops. Metabolically inert gases in the diver's breathing gas." Surface intervals (time spent on the surface between dives) are usually required to prevent the residual nitrogen from building up to dangerous levels on subsequent dives.diving into greater depths. Physical ceiling These types of overhead diving can prevent the diver surfacing directly: • • • • Cave diving .
but are now commonly called "extended range" courses. and dizziness. The depth limit of nitrox is governed by the percentage of oxygen used. Note the backplate and wing setup with sidemounted stage tanks swings. saying that helium mixes should be used for dives beyond a certain limit (100–130 feet (30–40 m). Deep air proponents base the proper depth limit of air diving upon the risk of oxygen toxicity. as there are multiple oxygen percentages available in nitrox. they view the limit as being the depth at which partial pressure of oxygen reaches 1. as the breathing regulator falls out and the victim drowns. depending upon agency).4 ATA. irritability and mood Philippines.Technical diving 94 Extremely limited visibility Technical dives in waters where the diver's vision is severely impeded by low-light conditions. This reduces the nitrogen percentage. and heliair. heliox. as well as allowing for a greater number of multiple dives compared to standard air. Deep air/extended range diving One of the more divisive subjects in technical diving concerns using compressed air as a breathing gas on dives below 130 feet (40 m). due to depth also causes nitrogen to become narcotic. These can include visual and auditory hallucinations. By adding helium to the breathing mix. Nitrox is another common gas mix. Once the oxygen is reduced below 18 percent the mix is known as a hypoxic mix as it does not contain enough oxygen to be used safely at the surface. The first sign of oxygen toxicity is usually a convulsion without warning which usually results in death. such as trimix. in the face and hands). resulting in a reduced ability to react or think clearly (see nitrogen narcosis). and because vision is often reduced by water currents. as helium does not have the same narcotic properties at depth. and while it is not used for deep diving. and suggest that when . GUE. a minority (NAUI Tec. twitching (especially Technical divers preparing for a mixed-gas decompression dive in Bohol. nausea. Further training and knowledge is required in order to use safely and understand the effects of these gases on the body during a dive. it decreases the build up of nitrogen within the diver's body by increasing the percentage of oxygen. Helitrox/triox proponents argue that the defining risk should be nitrogen narcosis. UTD) argue that diving deeper on air is unacceptably risky. Increasing pressure containing EAN50 (left side) and pure oxygen (right side). IANTD and DSAT/PADI). The combination of low visibility and swift current make these technical dives extremely risky to all but the most skilled and well-equipped divers. Sometimes the diver may get warning symptoms prior to the convulsion. divers can reduce these effects. require greater knowledge and skill to operate in such an environment. While mainstream training agencies still promote and teach such courses (TDI. These gas mixes can also lower the level of oxygen in the mix to reduce the danger of oxygen toxicity. caused by silt or depth. Gas mixes Technical dives may also be characterised by the use of hypoxic breathing gas mixtures other than air. which occurs at about 186 feet (57 m). Breathing normal air (with 21 percent oxygen) at depths greater than 180 feet (55 m) creates a high risk of oxygen toxicity. Such courses used to be referred to as "deep air" courses. Accordingly.
 British Sub-Aqua Club (BSAC) training has always had a technical element to its higher qualifications. There are many technical training organisations: see the Technical Diving section in the list of diver training organizations. . and Diving Science and Technology (DSAT). It has also recently introduced trimix qualifications and continues to develop closed circuit training. it has recently begun to introduce more technical level Skill Development Courses into all its training schemes by introducing technical awareness into its lowest level qualification of Ocean Diver. Training Technical diving requires specialised equipment and training. although scientific evidence does not show that a diver can train to overcome any measure of narcosis at a given depth. The stage cylinders are normally carried using an adaptation of a sidemount configuration. The Scuba Schools International (SSI) Technical Diving Program (TechXR – Technical eXtended Range) was launched in 2005. or become tolerant of it.0 ATA. Divers trained and experienced in deep air diving report less problems with narcosis than those trained and experienced in mixed gas diving trimix/heliox. for example. Profesional Scuba Association International(PSAI). The technical diver may also carry additional cylinders. International Association of Nitrox and Technical Divers (IANTD) and National Association of Underwater Instructors (NAUI) were popular as of 2009. Both sides of the community tend to present self-supporting data. there is a need for redundant equipment. however. Technical divers therefore increase their supply of available breathing gas by either connecting multiple high capacity diving cylinders and/or by using a rebreather. but indicates the additional risks involved. and nitrox training will become mandatory. Technical Diving International (TDI). In the event of a failure. the technical arm of Professional Association of Diving Instructors (PADI). known as stage bottles. Because required decompression stops act as an obstacle preventing a diver in difficulty from surfacing immediately. with a reserve for bail-out in case of failure of their primary breathing gas. Recent entries into the market include Unified Team Diving (UTD). Typically. 95 Equipment Technical divers may use unusual diving equipment. the second tank and regulator act as a back-up system. technical dives last longer than average recreational scuba dives. to ensure adequate breathing gas supply for decompression. which occurs at about 130 feet (40 m). each with its own regulator.Technical diving the partial pressure of nitrogen reaches approximately 4. Global Underwater Explorers (GUE). Technical divers usually carry at least two tanks. helium is necessary to offset the effects of the narcosis. The Divers Alert Network does not formally reject deep air diving per se. Technical diver with decompression gases in side mounted stage cylinders.
South Pacific Underwater Medicine Society Journal 33 (4). Peter Bennett Symposium Proceedings. Des F (1992).TechDivingMag. aspx  Some training agencies regard solo diving within the "recreational" sphere." (http:/ / archive.Technical diving program" (http:/ / www.  "SSI TechXR . divessi. html). as all dives involve an element of decompression as the diver off-gases. asp)  There is a reasonable body of professional opinion that considers decompression diving to be the sole differentiator for "technical" diving. author and leading technical diver. diversalertnetwork. .Technical diving 96 References  Richardson.  Hamilton Jr. Retrieved 2011-01-15. R (1992). rubicon-foundation. org/ 6425). php?did=80& site=2). com/ ?id=HVbjgdorRXAC& pg=PT1& lpg=PT1& dq=bret+ gilliam+ deep+ diving& q=). February 24.TechnicalDiving. "Safe Limits: A International Dive Symposium. 2006. ISBN 978-1-878663-31-3  "Technical Diving" (http:/ / oceanexplorer. Advanced Wreck Diving. South Pacific Underwater Medicine Society Journal 22 (1). ISBN 9780922769315.: (Divers Alert Network). au/ modx/ bluebeyond-dive-deep-air-is-stupidity.com • http://www. rubicon-foundation." (http:/ / archive. . padi. Piantadosi CA..Hosted by the Rubicon Foundation • RebreatherPro (http://www. In: Moon RE. . Retrieved 2009-06-22. "Taking 'tec' to 'rec': the future of technical diving" (http:/ / archive. Retrieved 2009-09-03. html). aspx  http:/ / www. South Pacific Underwater Medicine Society Journal 25 (1). com/ padi/ en/ kd/ semiclosedrebreather. commented that there was no accepted term for divers who dived beyond agency-specified recreational limits for non-professional purposes. "High-tech diving". . Durham.  Gorman.liquidtravel. . tdisdi. asp?articleid=29). However. 15. com/ index. South Pacific Underwater Medicine Society Journal 26 (1).  "Deep Air IS Stupdity" (http:/ / www. com/ index. divessi. org/ technical_divers. aspx  http:/ / www. Drew (2003). p. . PMID 1417647.html) . Retrieved 2009-08-07.  Gorman. N. and Gary Gentile published a further book in 1999 entitled The Technical Diving Handbook. "What is technical diving? (letter to editor)" (http:/ / archive. SDI (http:/ / www. "Subjective and behavioral effects associated with repeated exposure to narcosis". Retrieved 2009-09-14. Retrieved 2009-08-07. Retrieved 2009-09-03. Held May 1. Gary Gentile. Camporesi EM (eds. SJ (2007). Retrieved 2009-08-07. com. . (http:/ / www. RW (1996).  Hamilton. gov/ technology/ diving/ technical/ technical. Laliberté. MF. Enriched Air Diving.com • Select publications on technical diving and technical diving history (http://archive.rubicon-foundation. NOAA.  http:/ / www.  Many recreational diving agencies recommend diving no deeper than 30 metres (100 ft).  As most technical diving training agencies point out.org/transitioning-to-technical-diving. Heslegrave.  John Lippmann. Introduction. DAN. Retrieved 2008-09-25.  In his 1989 book.com) Jill Heinerth's interactive multimedia technical diving site • Transitioning to technical diving (http://www. "Technical Diving.  Bret Gilliam (1995-01-25).  "TDI . naui. tdisdi. Des F (1995). Scuba Schools International. com/ english/ common/ courses/ rec/ continue/ deepdiver. Deep Diving (http:/ / books. padi. rubicon-foundation. com/ txr). space. noaa. com/ techxr)  Some certification agencies prefer to the term "cavern diving" to cave penetration within recreational diving limits. K. Dr. php?did=60& site=3)  Mitchell. SSI (http:/ / www. Footnotes External links • http://www. com/ padi/ en/ kd/ icedivercourse. org/ 8125). 2004.C.org/ dspace/simple-search?query=technical+diving&submit=Go) .rebreatherpro. padi.Extended Range Diver" (http:/ / www. google. Revised editions use the term technical diving. org/ 9061). org/ 6266). rubicon-foundation. page 91. org/ medical/ articles/ article. Retrieved 2009-09-03. "How deep is too deep?" (http:/ / www.). and suggest an absolute limit of 40 metres (130 ft). the term decompression diving is often used to describe diving which involves one or more mandatory decompression stops prior to surfacing. . Aviation. bluebeyond.  PADI. and environmental medicine 63 (10): 865–9. . references to "decompression diving" is a misnomer. .
helium enters and leaves tissues more rapidly than nitrogen as the pressure is increased or reduced (this is called on-gassing and off-gassing). A lower proportion of nitrogen is required to reduce nitrogen narcosis and other physiological effects of the gas at depth. since air conducts heat 50% faster than argon. Analysis of two-component gases is much simpler than three component gases. helium and nitrogen. Disadvantages of helium in the mix Helium conducts heat six times faster than air. to allow the gas mix to be breathed safely on deep dives. and is often used in deep commercial diving and during the deep phase of dives carried out using technical diving techniques. Argon. damage to skin caused by pressurizing dry suit folds. separate tank. where the increased rate of off-gassing is largely counterbalanced by the equivalently increased rate of on-gassing. helium does not load tissues as heavily as nitrogen. This is to avoid the risk of hypothermia caused by using helium as inflator gas. Dry suits (if used together with a buoyancy compensator) still require a minimum of inflation to avoid "squeezing". i. helium is a faster gas to saturate and desaturate. Helium dissolves into tissues more rapidly than nitrogen as the ambient pressure is increased (this is called on-gassing). and helium is more likely to come out of solution and cause decompression sickness following a fast ascent. Helium has very little narcotic effect. The lower density of helium reduces breathing resistance at depth. which is a distinct advantage in saturation diving. consisting of oxygen. The mixture of helium and oxygen with a 0% nitrogen content is generally known as Heliox. connected only to the inflator of the drysuit is preferred to air.Trimix (breathing gas) 97 Trimix (breathing gas) Trimix is a breathing gas. This is frequently used as a breathing gas in deep commercial diving operations. . A lower proportion of oxygen reduces the risk of oxygen toxicity on deep dives. but at the same time the tissues can not support as high an amount of helium when super-saturated.e. A consequence of the higher loading in some tissues is that many decompression algorithms require deeper decompression stops than a similar decompression dive using air. Mixes Advantages of helium in the mix The main reason for adding helium to the breathing mix is to reduce the proportions of nitrogen and oxygen below those of air. where it is often recycled to save the expensive helium component. Some divers suffer from hyperbaric arthralgia during descent. In effect. Because of its lower solubility. carried in a small. but less so in bounce diving.  Because of its low molecular weight.  With a mixture of three gases it is possible to create mixes suitable for different depths or purposes by adjusting the proportions of each gas. often helium breathing divers carry a separate supply of a different gas to inflate drysuits.
3 or 1. Oxygen. . a hypoxic mix such as "10/50" is used for deeper diving. To ensure an accurate mix. Most trimix divers limit their working oxygen partial pressure [PO2] to 1. The benefit of such a system is that the helium delivery tank pressure need not be as high as that used in the partial pressure method of blending and residual gas can be 'topped up' to best mix after the dive.3 bar and an equivalent narcotic depth of 43 m (141 ft). Safe limits for mix of gases in trimix are generally accepted to be a maximum partial pressure of oxygen (ppO2—see Dalton's law) of 1.2 depending on the depth. as a bottom gas only. Naming Conventionally. Blending Gas blending of trimix involves decanting oxygen and helium into the diving cylinder and then topping up the mix with air from a diving air compressor. the mix is named by its oxygen percentage.18 and hypoxic trimix—with a PO2 less than 0. Less commonly. A second method called 'continuous blending' is now gaining favor. See breathing gas for more information on the composition and choice of gas blends. the duration and the kind of breathing system used [open circuit vs closed circuit rebreather]    Advantages of keeping some nitrogen in the mix Retaining nitrogen in trimix can contribute to the prevention of High Pressure Nervous Syndrome. nitrogen.18 bar. In open-circuit scuba. Hyperoxic trimix is sometimes referred to as Helitrox or TriOx. after each helium and oxygen transfer. and cannot safely be breathed at shallow depths where the ppO2 is less than 0. For example. a mix named "trimix 10/70" or trimix 10/70/20. consisting of 10% oxygen. the mix is allowed to cool. A normoxic mix such as "19/30" is used in the 30 to 60 m (100 to 200 ft) depth range. 20% nitrogen is suitable for a 100-metre (330 ft) dive. helium percentage and optionally the balance percentage. At 100 m (330 ft). the mix can be hyperoxic in shallow water because the rebreather automatically adds oxygen to maintain a specific ppO2.4 and may reduce the PO2 further to 1. On the high pressure side of the compressor a regulator is used to reduce pressure of a sample flow and the trimix is analyzed (preferably for both helium and oxygen) so that the fine adjustment to the intake gas flows can be made. 70% helium.Trimix (breathing gas) 98 Advantages of reducing oxygen in the mix Lowering the oxygen content increases the maximum operating depth and duration of the dive before which oxygen toxicity becomes a limiting factor. two classes of trimix are commonly used: normoxic trimix—with a minimum PO2 at the surface of 0. its pressure is measured and further gas is decanted until the correct pressure is achieved. hyperoxic trimix is sometimes used on open circuit scuba.0 to 1. The oxygen and helium are fed into the air stream using flow meters.18 at the surface. "12/52" has a PPO2 of 1. This process often takes hours and is sometimes spread over days at busy blending stations.6 bar and maximum equivalent narcotic depth of 30 to 50 m (100 to 160 ft). The ratio of gases in a particular mix is chosen to give a safe maximum operating depth and comfortable equivalent narcotic depth for the planned dive. In fully closed circuit rebreathers that use trimix diluents. so as to achieve the rough mix. a problem that can occur when breathing heliox at depths beyond about 130 metres (430 ft). The low pressure mixture is analyzed for oxygen content and the oxygen and helium flows adjusted accordingly. helium and air are blended on the intake side of a compressor.    Nitrogen is also much less expensive than helium. This is important mainly because of the high cost of helium.
a number of "standard" mixes have evolved (such as 21/35. Most of these mixes originated from filling the cylinders with a certain percentage of helium. Soon. which simplified mixing. 18/45 and 15/55).the desire to keep that equivalent narcotic depth (END) of the mix at approximately 34 metres (112 ft).e. since the ratio of the oxygen fraction in the final mix to the oxygen fraction in the initial nitrox gives the fraction of nitrox in the final mix. Heliox was used with air tables resulting in a high incidence of decompression sickness so the use of helium was discontinued. DIY versions of the continuous blend units can be made for as little as $200 (excluding analyzers). and the usual forms for indicating constituent gas fraction.  99 "Standard" mixes Although theoretically trimix can be blended with almost any combination of helium and oxygen. This allows diving throughout the usual recreational range. 17% helium. The "standard" mixes evolved because of three coinciding factors . and then topping the mix with 32% enriched air nitrox. where it has an equivalent narcotic depth of 35 metres (115 ft). Helitrox requires decompression stops similar to Nitrox-I (EAN28) and has a maximum operating depth of 44 metres (144 ft). GUE and UTD also promote hyperoxic trimix.Trimix (breathing gas) Drawbacks may be that the high heat of compression of helium results in the compressor over-heating (especially in tropical climates) and that the hot trimix entering the analyzer on the high pressure side can affect the reliability of the analysis. 26% oxygen. and feel that the term Trimix is sufficient. while decreasing decompression obligation and narcotic effects compared to air. the requirement to keep the partial pressure of oxygen at 1. 80% helium) had been successfully decompressed from deep dives. including salvage diver Max "Gene" Nohl's dive to 127 meters.only helium and banked nitrox needs to be used to top up the residual gas from the last fill. modified as appropriate with the terms hypoxic.  . human subjects breathing heliox 20/80 (20% oxygen. normoxic and hyperoxic. The effects from narcosis was not proven until the salvage of the USS Squalus in 1939. It is demonstrably true that the END of a nitrox-helium mixture at its maximum operating depth (MOD) is equal to the MOD of the nitrox alone. 1925 The US Navy begins examining helium's potential usage and by the mid 1920's lab animals were exposed to experimental chamber dives using heliox. Other divers question whether this proliferation of terminology is useful. 1937 Several test dives are conducted with helium mixtures. but prefer the term "TriOx". The method of mixing a known nitrox mix with helium allows analysis of the fractions of each gas using only an oxygen analyser. The use of standard mixes makes it relatively easy to top up diving cylinders after a dive using residual mix . and the fact that many dive shops stored standard 32% enriched air nitrox in banks.4 ATA or below at the deepest point of the dive. hence the fractions of the three components are easily calculated. i. History as a diving gas 1919 Professor Elihu Thompson speculates that helium could be used instead of nitrogen to reduce the breathing resistance at great depth. Hyperoxic trimix The National Association of Underwater Instructors (NAUI) uses the term "helitrox" for hyperoxic 26/17 Trimix. 57% nitrogen.
Retrieved March 9. successfully complete a series of wreck dives on the RMS Lusitania expedition to a depth of 100 meters using trimix. 2005. Proceedings of Advanced Scientific Diving Workshop (Washington. pdf). Cave divers Sheck Exley and Jochen Hasenmayer use heliox to a depth of 212 meters. O. 5th Rev ed. pp. 100 References  Brubakk. 1979 A research team headed by Peter B. com/ thermal-conductivity-d_429. bishopmuseum. Air:0. S. mil/ published_volumes/ harshEnv2/ HE2ch31.. "Argon:0. Retrieved 2008-08-28. Exley teaches non-commercial divers in relation to trimix usage in cave diving. Medical Aspects of Harsh Environments. 1994 Combined UK/USA team. Retrieved 2008-08-28. Retrieved 2008-10-07. 800. 2002. Bishop Museum. In: Lang. 1991 Billy Deans commences teaching of trimix diving for recreational diving. using Trimix. 2001 The Guinness Book of records recognises John Bennett as the first scuba diver to dive to 1000 ft." (http:/ / archive. The Engineering ToolBox. "Biomedical and Operational Considerations for Surface-Supplied Mixed-Gas Diving to 300 FSW. United States: Saunders Ltd. NC. initially called "Monitor Mix" became NOAA Trimix I. . NE (eds).. rubicon-foundation. ML (2006). html). 1970 Hal Watts performs dual body recovery at Mystery Sink (126 m).  Gernhardt. 1997.024. including leading wreck divers John Chatterton and Gary Gentile. 2010. org/ 4655). engineeringtoolbox. Tom Mount develops first trimix training standards (IANTD). bordeninstitute. NOAA's mix. Bennett and Elliott's physiology and medicine of diving. Bennett at the Duke University Medical Center Hyperbaric Laboratory began the "Atlantis Dive Series" which proved the mechanisms behind the use of trimix to prevent High Pressure Nervous Syndrome symptoms. . dying while repeating the dive. army.  Source: "Trimix and heliox diving" .Trimix (breathing gas) 1939 US Navy used heliox in USS Squalus salvage operation.142 W/mK"  Vann RD and Vorosmarti J (2002).  "Thermal conductivity of some common materials" (http:/ / www. Helium:0. with decompression tables published in the NOAA Diving Manual. DC). Volume 2 (Borden Institute): p980. "Military Diving Operations and Support" (http:/ / www. . T. ISBN 0702025712. org/ research/ treks/ palautz97/ phys. Neuman (2003). 1965 First saturation dives using heliox. . . 2005 David Shaw sets depth record for using a trimix rebreather. Use of trimix spreads rapidly to North East American wreck diving community. Retrieved 2008-08-28. February 14. MA and Smith. 1995 The National Oceanographic and Atmospheric Administration (NOAA) and Key West Divers team up to conduct the first NOAA-sponsored trimix dives on the wreck of USS Monitor off Cape Hatteras. 1987 First mass use of trimix and heliox: Wakulla Springs Project.016..  "Diving Physics and "Fizzyology"" (http:/ / www. html). A.
 Campbell. C. ingentaconnect. ws/ trimix_eng.  http:/ / www." (http:/ / archive. Retrieved 2011-03-16. com/ content/ asma/ asem/ 2007/ 00000078/ 00000002/ art00001). . L. Retrieved 2008-08-28. "Oxygen toxicity: A brief history of oxygen in diving" (http:/ / archive.). org/ 2661). 9 (4): 335–51. In: Moon RE. org/ 6004). 2006. Bennett PB and Elliott DH. Time Magazine. South Pacific Underwater Medicine Society Journal 29 (3). (1974). Retrieved 2011-03-16. Camporesi EM (eds. org/ 9057). Retrieved 2009-03-17. . html). org/ 7555). (Balliere Tindall Cassell): 226–251. PMID 17310877. Menduno. PMID 7168098. com/ time/ magazine/ article/ 0.  Acott. techdiver.". Oxygen Hacker's Companion. PMID 4619860.  Bennett." (http:/ / archive. . ISBN 0967887321. In: Lang. shtml). OCLC 2068005. Retrieved 2009-06-11.  Hunger Jr." (http:/ / archive. K. Airspeed Press. OCLC 16986801. Albert R. Britz HC (February 2007).758630-1. rubicon-foundation. ISSN 0813-1988. be/ post/ 3924720/ continuous-trimix-blending-with-2-nitrox-stic).  staff (1937-12-13). . com/ HPNS. "Decompression Sickness and Oxygen Toxicity in US Navy Surface-Supplied He-O2 Diving. mechanisms and prevention of the high pressure nervous syndrome" (http:/ / archive.  TDI Advanced Gas Blender manual  "NAUI Technical Courses: Helitrox Diver" (http:/ / www. B. Retrieved 2008-08-28. 1 (1): 1–28. Shreeves. Cronjé FJ.C. South Pacific Underwater Medicine Society Journal 29 (2). M. OCLC 16986801. Retrieved 2008-08-28. ISSN 0093-5387. Retrieved 2009-07-29. org/ technical_divers.. Coggin. naui. youtube. M. Meintjes WA. NAUI Worldwide. "Science: Deepest Dive" (http:/ / www. "Some early studies of decompression. Eds. Diving Medicine Online.0. P. Retrieved 2008-08-28.  David Shaw. org/ 6014). ISSN 0093-5387. D. rubicon-foundation. Durham. N. Res. Undersea Biomed. Enrico M (2007). rubicon-foundation. rubicon-foundation. "The Last Dive of David Shaw" (http:/ / www. ws/ exotic_gases. aspx#070). Retrieved 2008-08-28.9171. . Piantadosi CA. . Aviat Space Environ Med 78 (2): 81–6. "Exotic Gases" (http:/ / www. Retrieved 2008-04-07. McLeod. Undersea Biomed. (1982). shtml 101 . Retrieved 2009-11-29. Peter Bennett Symposium Proceedings. Chistopher (1999).Trimix (breathing gas)  Acott. E.  Behnke. rubicon-foundation.  Gerth." (http:/ / archive. rubicon-foundation. "The Atlantis Series and Other Deep Dives. . ISSN 0813-1988. "A brief history of diving and decompression illness.  Camporesi. "Proceedings of Rebreather Forum 2. skynetblogs. . 2004. "High Pressure Nervous Syndrome" (http:/ / www. Diving Science and Technology Workshop.00. Res.  Harlow. (1999). "The causes. Proceedings of Advanced Scientific Diving Workshop (Washington. B. (eds). WA (2006). rubicon-foundation. techdiver.: (Divers Alert Network). . Bennett.  Mitchell SJ.: 286. .  "Continuous trimix blending with 2 nitrox sticks (English)" (http:/ / shadowdweller. html). The shadowdweller. com/ watch?v=mF4iFJ-G74o). R. (1969). Retrieved 2008-08-28. OCLC 2068005. In: the Physiology and Medicine of Diving and Compressed air work. Held May 1. time. org/ 2920).  Richardson. . . . Dr. V (2002).. . P. W. NE (eds). org/ 4654). (1996). DC). scuba-doc. "Fatal respiratory failure during a "technical" rebreather dive at extreme pressure" (http:/ / www. MA and Smith. Retrieved 2008-08-28.  Tech Diver. "Effect of compression rate on use of trimix to ameliorate HPNS in man to 686 m (2250 ft)" (http:/ / archive.
Stefan. Owain. Mark. Lightmouse. TimVickers. 4 anonymous edits Equivalent narcotic depth Source: http://en. Gits (Neo). PaulHanson. The ClayJar. Wouterstomp. Jack Merridew. Sbharris. 63. Norman Yarvin. Julesd. W guice. 76 anonymous edits Oxygen toxicity Source: http://en. Rich Farmbrough. Sodium.146. Badger Drink. Otsykes. Gene Hobbs.murphy. Biorem. Scubadoc. Greg L. Rich Farmbrough. PowerCS. Gr0ff. Kosebamse. Michagal. MadRat Jack. Hugo-cs. Moppet65535. Ian Dunster. Physchim62. Abtract. NikoSilver. Klparrot. Lowellian. Kjhskj75. Lexicon. BD2412. Eubulides. Watch Rider. Bluez57. Benemin. Countincr. Denislarsen. Abyssadventurer. Brianski.goodchild. WRK. Deli nk. Hmoul. 248 anonymous edits . RexxS. FKmailliW. Herd of Swine. Steven J. 91 anonymous edits Rebreather Source: http://en. Ebayburt. Mceder. Dkazdan. Epbr123. Sirscuba. Anderson. Nimur. Cesiumfrog. Fuhghettaboutit. Vasiľ. Technopat. Rich Farmbrough. Brainsik. X!. clown will eat me. Nickthechemist. Milo99. Bryan Derksen. PhilipMW.M. Canis Lupus. Brandingularity. Elkman. El C. Wperdue. Jeus. Lumpy Dog. Dolphin51. Oleg Eterevsky. Scubadiver-dad. Monk3ysonfire. GoatOverlord. Moondyne.murphy. SEWilco. Kosebamse.xxx. Bbatsell. PBarak. Moshe Constantine Hassan Al-Silverburg. DabMachine. MrWhipple. Swatrecon. Stefan. Dave3141592. Aquaregia27. Pinikas. RexNL. Fudoreaper. OnePt618. Nono64. Legis.wikipedia. Jolenine. Milen. Sbharris. ChildofMidnight.5. MKoltnow. Saimhe. Draeco. 6 anonymous edits High-pressure nervous syndrome Source: http://en. CommonsDelinker. Jenda. Nakon. Tempodivalse. Headbomb. Dassaultdriver. ChrisCork. Excirial. Nuttycoconut. Decodiver. Koavf. Nono64. Patrick. Dave3141592. WATransplant. Sir Vicious. KRBROWN92. DabMachine. Bluelion. Can't sleep. Woohookitty. Nicholasjarvie.wikipedia.24. RexxS. 120 anonymous edits Nitrox Source: http://en. Karn. Drilnoth. Paul A. Mh26.Article Sources and Contributors 102 Article Sources and Contributors Breathing gas Source: http://en. Deglr6328. Dancter. 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Krich.uk. Phirst. Pcpcpc. Pbsouthwood.253. Dave3141592. Michael Hardy. Gxdoyle. Gene Hobbs. Unixsage. Owain.92. Hike395. O'Dea. Gr0ff. DiverDave. Bryan Derksen. Mark. KingScuba. Matt Gies. Lari-fari. Spiritia. Rich Farmbrough. Gorm. Bento00. Mc2246. Sanspeur. Anthony Appleyard. SpiderJon. Hu12.org/w/index. Hede2000. Lightmouse. Alfie66. AtonX. Spetzna-. Mav. Hephaestos. 62. Bubbleboys.wikipedia. SCEhardt. Headbomb. Aquanaut. Georgekwatson. Mfischman. Gorm.murphy. Dsyzdek.php?oldid=437697999 Contributors: Ali@gwc.51. SenorBeef. TheJoby. Destynova. A2Kafir. Nihiltres. Kpjas. Gene Hobbs. Finell. Michagal. Johan Lont.davies.org/w/index. 49 anonymous edits 103 . LoverOfArt. Cyrius. Watch Rider.wikipedia. Vuonghn.Article Sources and Contributors Technical diving Source: http://en.Newman. Download.murphy. Legis. PierreAbbat. SteOsu.xxx. Finavon. SlipperyHippo. KingTT. Lubos. Maldivian. SummerPhD.php?oldid=441541942 Contributors: 62. Mion. Pengo. Michael Hardy. Collabi. Nathan.org. Ehagerty. Bluez57.64. RexxS. PontBrownJm. Auntof6. Cryptic C62. Crum375. RupertMillard. Tabletop. Breals. Rjwilmsi. Wasell. Hamiltondaniel. Mark. Extraordinary. Tossmysalad. Dolphin51. Anthony Appleyard. RexxS. Editus Reloaded. Gerard. Conversion script. 84user. 105 anonymous edits Trimix (breathing gas) Source: http://en. Rongen. Laubzega. Sirscuba. BillGarrett. Leigh. Evercat. Legis. Elf. HaeB. Woohookitty. Cybercobra. Jhog1978.xxx. Kintaro. Triddle. EddEdmondson. Superm401. Algorithm. Lotje.
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