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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.   
NEDU gas analysis lab Filling a diving cylinder with pure oxygen costs around five times more than filling it with compressed air. 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. • hyperoxic mixes have more than 21% oxygen. strictly. 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.  Oxygen has historically been obtained by fractional distillation of liquid air.    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 .   This is because it is essential to the human body's metabolic process.   Trimix. 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. contain less than 21% oxygen.  The fraction of the oxygen determines the deepest the mixture gas can safely be used to avoid oxygen toxicity. it should be handled with caution when gas blending. although often a boundary of 16% is used. but is increasingly obtained by non cryogenic technologies such as pressure swing adsorption (PSA) and vacuum-pressure swing adsorption (VPSA) technologies.  The maximum operating depth of a normoxic mix could be as shallow as 47 metres (155 feet). It is expressed by the partial pressure of oxygen (ppO2). when compared to air. The tissues and organs within the body (notably the heart and brain) are damaged if deprived of oxygen for much longer than four minutes. Fraction of oxygen The fraction of the oxygen component of a breathing gas mixture is sometimes used when naming the mix: • hypoxic mixes. Heliox and Heliair create typical hypoxic mixes and are used in technical diving as deep breathing gases. 21%.    Partial pressure of oxygen The concentration of oxygen in a gas mix depends on both the fraction and the pressure of the mixture.  • normoxic mixes have the same proportion of oxygen as air. which sustains life. This depth is called the maximum operating depth. As oxygen supports combustion and causes rust in diving cylinders. The human body cannot store oxygen for later use as it does with food.   Hyperoxic mixtures.Breathing gas 2 Individual component gases Oxygen Oxygen (O2) must be present in every breathing gas. unconsciousness and death result. If the body is deprived of oxygen for more than a few minutes. Enriched Air Nitrox (EANx) is a typical hyperoxic breathing gas.
For this reason normoxic or hyperoxic "travel gases" are used at medium depth between the "bottom" and "decompression" phases of the dive. the level of exercise and the security of the breathing equipment being used. depending on factors including individual physiology and level of exertion. In most countries. is a comfortable maximum. and is only available on medical prescription.8 bar). there is no difference in purity in medical oxygen and industrial oxygen. pure oxygen for breathing purposes is regarded as medicinal as opposed to industrial oxygen. Below this partial pressure the diver may be at risk of unconsciousness and death due to hypoxia. It is typically between 100 kPa (1 bar) and 160 kPa (1. Many divers find that the level of narcosis caused by a 30 m (100 ft) dive. such as that used in welding. .6 bar) but for dives of less than three hours is commonly considered to be 140 kPa (1. in order to more easily identify the exact manufacturing trail of a "lot" of oxygen. Nitrogen can cause decompression sickness.16 bar). 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. as they are produced by exactly the same methods and manufacturers. although the U.S. When a hypoxic mix is breathed in shallow water it may not have a high enough ppO2 to keep the diver conscious. whilst breathing air. but labeled and tanked differently. The maximum safe ppO2 in a breathing gas depends on exposure time. Nitrogen Nitrogen (N2) is a diatomic gas and the main component of air.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. so its use is limited to shallower dives. in case problems are later found with its purity. Equivalent narcotic depth is used to estimate the narcotic potency of trimix (oxygen/helium/nitrogen mixture). In the Netherlands. the cheapest and most common breathing gas used for diving. the diver risks oxygen toxicity including a seizure.  Each breathing gas has a maximum operating depth that is determined by its oxygen content. It causes nitrogen narcosis in the diver.    Equivalent air depth is used to estimate the decompression requirements of a nitrox (oxygen/nitrogen) mixture.     Oxygen analysers measure the ppO2 in the gas mix. Divox "Divox" is oxygen. The chief difference between them is that the paper record-keeping trail is much more extensive for medical oxygen.     At high ppO2 or longer exposures. Navy has been known to authorize dives with a ppO2 of as much as 180 kPa (1.4 bar).     Nitrogen in a gas mix is almost always obtained by adding air to the mix.
  Helium's low molecular weight (monatomic MW=4.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). which may impede communication. Argon is more expensive than air or oxygen. from which it is extracted at low temperatures by fractional distillation. which is a CNS irritation syndrome which is in some ways opposite to narcosis.    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). Neon Neon (Ne) is an inert gas sometimes used in deep commercial diving but is very expensive. The hydrogen-oxygen mix when used as a diving gas is sometimes referred to as Hydrox. helium also causes High Pressure Nervous Syndrome. because of argon's good thermal insulation properties.    Helium fills typically cost ten times more than an equivalent air fill.    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. it increases the timbre of the diver's voice. helium. it is less narcotic than nitrogen. Unwelcome components of breathing gases Many gases are not suitable for use in diving breathing gases. Like helium. . it does not distort the diver's voice. 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.    It is sometimes used for dry suit inflation by divers whose primary breathing gas is helium-based. Argox is used for decompression research. 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. making it more of an insulator). but considerably less expensive than helium. which increases the resonance frequency of the vocal cords. but unlike helium. so it is more suitable for deeper dives than nitrogen. the blood stream and the breathing equipment before breathing hydrogen starts.  Helium is equally able to cause decompression sickness. compared with diatomic nitrogen MW=28) increases the timbre of the breather's voice. Helium is found in significant amounts only in natural gas.  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. At high pressures. so is not generally suitable as a diving breathing gas.
incomplete combustion will result in carbon monoxide production. CO in the intake air cannot be stopped by any filter. open circuit diving can accelerate heat exhaustion because of dehydration. • In some cases hydrocarbon lubricating oil may be drawn into the compressor's cylinder directly through damaged or worn seals. which contains organic matter (since it usually contains humus). In hot climates. • Heating of lubricants inside the compressor may vaporize them sufficiently to be available to a compressor intake or intake system line.especially when not atomized properly . It is also uncomfortable. Another concern with regard to moisture content is the tendency of moisture to condense as the gas is decompressed while passing through the regulator. especially in cylinders which are used for hyperoxic gas mixtures. If the compressor air filter(s) fail.     • They can act as a fuel in combustion increasing the risk of explosion. newly decompressed air. helping to prevent icing up. which contains "organic" (carbon-containing) matter. • Inhaling oil mist can damage the lungs and ultimately cause the lungs to degenerate with severe lipid pneumonia or emphysema. Brass. this coupled with the extreme reduction in temperature. and these represent a more severe CO danger when introduced into a cylinder. leaks. Moisture content The process of compressing gas into a diving cylinder removes moisture from the gas. and this is a particular problem on boats. which is also thought to be a predisposing risk factor of decompression sickness.  This is good for corrosion prevention in the cylinder but means that the diver inhales very dry gas. also due to the decompression can cause the moisture to solidify as ice. being ignited by the immense compression ratio and subsequent temperature rise. common sources are:    See carbon monoxide poisoning. where cylinders are filled.Breathing gas 5 Carbon dioxide Carbon dioxide (CO2) is produced by the metabolism in the human body and can cause carbon dioxide poisoning. or due to incomplete combustion near the air intake. The exhausts of all internal combustion engines running on petroleum fuels contain some CO. They can enter diving cylinders as a result of contamination. Since heavy oils don't burn well . and chrome plated (for protection). This icing up in a regulator can cause moving parts to seize and the regulator to fail or free flow. ordinary dust will be introduced to the cylinder. . often contain carbon-particulate combustion products (these are what makes a dirt rag black). Four • Internal combustion engine exhaust gas containing CO in the air being drawn into a diving air compressor. with its good thermal conductive properties. The dry gas extracts moisture from the diver's lungs while underwater contributing to dehydration. and the oil may (and usually will) then undergo combustion. especially in high-oxygen gas mixtures. quickly conducts heat from the surrounding water to the cold. where the intake of the compressor cannot be arbitrarily moved as far as desired from the engine and compressor exhausts. Hydrocarbons Hydrocarbons (CxHy) are present in compressor lubricants and fuels. • A similar process is thought to potentially happen to any particulate material. It is for this reason that SCUBA regulators are generally constructed from brass. A more severe danger is that air particulates on boats and industrial areas.   Carbon monoxide Carbon monoxide (CO) is produced by incomplete combustion. causing a dry mouth and throat and making the diver thirsty. This problem is reduced in rebreathers because the soda lime reaction to remove carbon dioxide puts moisture back into the breathing gas.
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The earliest descriptions of DCS used the terms: "bends" for joint or skeletal pain. Since bubbles can form in or migrate to any part of the body. Classification DCS is classified by symptoms. and both Type I and Type II DCS have the same initial management. DCS most commonly refers to a specific type of scuba diving hazard but may be experienced in other depressurisation events such as caisson working. Type II DCS is considered more serious and usually has worse outcomes. the bends or caisson disease) describes a condition arising from dissolved gases coming out of solution into bubbles inside the body on depressurization. Following changes to treatment methods. "chokes" for breathing problems. If treated early. and "Type II ('serious')" for symptoms where other organs (such as the central nervous system) are involved. Although DCS is not a common event. or lymphatic system.248 Decompression sickness (DCS. and scuba divers use dive tables or dive computers to set limits on their exposure to pressure and their ascent speed. The classification of types of DCS by its symptoms has evolved since its original description over a hundred years ago. In 1960. This system. Individual susceptibility can vary from day to day. DCS can produce many symptoms. with minor modifications.120.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. since neurological symptoms may develop after the initial presentation. may still be used today. Treatment is by hyperbaric oxygen therapy in a recompression chamber. musculoskeletal system.866.3 3491      emerg/121 C21. introduced a simpler classification using the term "Type I ('simple')" for symptoms involving only the skin.3 993. this classification is now much less useful in diagnosis. and "staggers" for neurological problems. and its effects may vary from joint pain and rashes to paralysis and death. its potential severity is such that much research has gone into preventing it. and different individuals under the same conditions may be affected differently or not at all. also known as divers' disease. Golding et al. there is a significantly higher chance of successful recovery. ICD-10 ICD-9 DiseasesDB eMedicine MeSH T70. flying in unpressurised aircraft. . and extra-vehicular activity from spacecraft.
vomiting Hearing loss Dry persistent cough Burning chest pain under the sternum. aggravated by breathing Shortness of breath Musculoskeletal Mostly large joints (elbows. hip. whereas decompression sickness and arterial gas embolism are commonly classified together as decompression illness when a precise diagnosis cannot be made. and barotrauma. nausea. usually around the ears. although those from arterial gas embolism are generally more severe because they often arise from an infarction (blockage of blood supply and tissue death). pain can occur immediately or up to many hours later. knees. Neurological symptoms are present in 10% to 15% of DCS cases with headache and visual disturbances the most common symptom. Navy prescribes identical treatment for Type II DCS and arterial gas embolism. 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 . wrists. upper chest and abdomen.Decompression sickness 9 Decompression illness and dysbarism The term dysbarism encompasses decompression sickness. DCS and arterial gas embolism are treated very similarly because they are both the result of gas bubbles in the body. and ankles. with the shoulder being the most common site. Signs and symptoms of decompression sickness DCS type Bubble location • Signs & symptoms (clinical manifestations) Localized deep pain. elbows. Skin manifestations are present in about 10% to 15% of cases. arterial gas embolism. The table below shows symptoms for different DCS types. Active and passive motion of the joint aggravates the pain. tingling or numbness paresthesia. Their spectra of symptoms also overlap. Signs and symptoms While bubbles can form anywhere in the body. with itching Swelling of the skin. The U. unconsciousness Ascending weakness or paralysis in the legs Girdling abdominal or chest pain Urinary incontinence and fecal incontinence Headache Unexplained fatigue Generalised malaise. shoulders. Itching.S. The pain may be reduced by bending the joint to find a more comfortable position. Joint pain ("the bends") accounts for about 60% to 70% of all altitude DCS cases. poorly localised aches Loss of balance Dizziness. If caused by altitude. knees. ranging from mild to excruciating. increased sensitivity hyperesthesia Confusion or memory loss (amnesia) Visual abnormalities Unexplained mood or behaviour changes Seizures. DCS is most frequently observed in the shoulders. and upper torso Sensation of tiny insects crawling over the skin (formication) Mottled or marbled skin usually around the shoulders. neck. face. arms. 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. but rarely a sharp pain. Sometimes a dull ache. vertigo.
a leading technical diver training organization. Two principal factors control the risk of a diver suffering DCS: 1. Even when the change in pressure causes no immediate symptoms. in more than half of all cases symptoms do not begin to present until over an hour following the dive.   or types of symptom.3% 0. ascending from depth. The table does not differentiate between types of DCS.S. The risk of DCS increases when diving for extended periods or at greater depth. The U.S. without ascending gradually and making the decompression stops needed to slowly reduce the excess pressure of inert gases dissolved in the body.3% 2. in extreme cases even before a dive has been completed. 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. 2. DON can develop from a single exposure to rapid decompression. . 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. Navy are as  follows: Although onset of DCS can occur rapidly after a dive. The specific risk factors are not well understood and some divers may be more susceptible than others under identical conditions.3% 1.6% 1. or ascending to altitude. owing to the pressure of the surrounding water. 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. 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. rapid pressure change can cause permanent bone injury called dysbaric osteonecrosis (DON). causing these gases to come out of solution and form "micro bubbles" in the blood. It may happen when leaving a high-pressure environment. have published a table that indicates onset of first symptoms. 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).  DCS has been confirmed in rare cases of breath-holding divers who have made a sequence of many deep dives with short surface intervals.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. Navy and Technical Diving International.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.
cabin pressurization systems maintain commercial aircraft cabin pressure at the equivalent altitude of 2400 m (7900 ft) or less. . since the pressure in the cabin is not actually maintained at sea-level pressure. Although exposures to incremental altitudes above 5500 m (18000 ft) show an incremental risk of altitude DCS. they will experience a significant reduction in ambient pressure.  There is no specific altitude threshold that can be considered safe for everyone and below which no one will develop altitude DCS. Today.    The original name for DCS was "caisson disease". 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. when 15 workers died from what was then a mysterious illness. Workers spending supply. DCS is very rare in healthy individuals who experience pressures equivalent to this altitude. there is increased risk for divers flying in any aircraft shortly after diving. Nevertheless. where caissons under pressure were used to keep water from The principal features of a caisson are the workspace. and later during construction of the Brooklyn Bridge. cabin pressurization systems still fail occasionally. they do not show a direct relationship with the severity of the various types of DCS. The higher the altitude of exposure the greater is the risk of developing altitude DCS.    Likewise. pressurised by an external air flooding the excavations.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. there is still a risk of DCS in individuals having dived recently. allowing safe flights at 12000 m (39000 ft) or more. A US Air Force study of altitude DCS cases reported that 87% of incidents occurred at 7500 m (24600 ft) or higher. where the pressure in his spacesuit is lower than the pressure in the vehicle. and some people may be predisposed to the drop in pressure that occurs even in pressurized aircraft. 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. 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). such as bridge supports and tunnels. where it incapacitated the project leader Washington Roebling. DCS was a major factor during construction of Eads Bridge. in large engineering excavations below the water table. 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.   Altitude DCS became a common problem in the 1930s with the development of high-altitude balloon and aircraft flights. Individual exposures to pressure altitudes between 5500 m (18000 ft) and 7500 m (24600 ft) have shown a low occurrence of altitude DCS. this term was used in the 19th century. Ascent to altitude Passengers may be at risk of DCS when an unpressurized aircraft ascends to high altitude. Also.
many predisposing factors are known. 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. the assumption that the dive table surface interval occurs at normal atmospheric pressure is invalidated by flying during that surface interval.  • the duration of exposure – the longer the duration of the dive.   • 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. However. scuba divers in Eritrea who drive from the coast to the Asmara plateau at 2400 m (7900 ft) increase their risk of DCS.Decompression sickness 12 Predisposing factors Although the occurrence of DCS is not easily predictable. carry a greater risk of altitude DCS. Therefore. 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. 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. for example. Dive tables make provisions for post-dive time at surface level before flying to allow any residual excess nitrogen to outgas. especially to altitudes of 5500 m (18000 ft) and above. • diving at altitude – diving in water whose surface altitude is above 300 m (980 ft) — for example.  Individual . and an otherwise-safe dive may then exceed the dive table limits. the greater is the risk of DCS.   • repetitive exposures – repetitive dives within a short period of time (a few hours) increase the risk of developing DCS. Repetitive ascents to altitudes above 5500 metres (18000 ft) within similar short periods increase the risk of developing altitude 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. Longer flights. 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. They may be considered as either environmental or individual.  • the rate of ascent – the faster the ascent the greater the risk of developing DCS. • 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. Lake Titicaca is at 3800 m (12500 ft) — without using versions of decompression tables or dive computers that are modified for high-altitude.
Fat represents about 15–25 percent of a healthy adult's body. A right-to-left shunt may allow bubbles to pass into the arterial circulation. where the bubbles would otherwise be filtered out by the lung capillary system. In about 20% of adults the flap does not completely seal. Studies by Walder concluded that decompression sickness could be reduced in aviators when the serum surface tension was raised by drinking isotonic saline. In the arterial system.  Decompression sickness risk can be reduced by increased ambient temperature during decompression following dives in cold water.  • previous injury – there is some indication that recent joint or limb injuries may predispose individuals to developing decompression-related bubbles. and in the spinal cord it may result in paralysis. but stores about half of the total amount of nitrogen (about 1 litre) at normal pressures. a 2005 study concluded that alcohol consumption did not increase the risk of DCS. • alcohol consumption and dehydration – although alcohol consumption increases dehydration and therefore may increase susceptibility to DCS. • 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. and return directly to the arterial system (including arteries to the brain. due to local loss of blood flow). infarction results in stroke.  This is due to nitrogen's five times greater solubility in fat than in water. however.  • ambient temperature – there is some evidence suggesting that individual exposure to very cold ambient temperatures may increase the risk of altitude DCS. Atrial septal defect (PFO) showing left-to-right shunt. spinal cord and heart). allowing blood through the hole when coughing or during activities that raise chest pressure. and the high surface tension of water is generally regarded as helpful in controlling bubble size. . a person who has a high body fat content is at greater risk of DCS. bubbles (arterial gas embolism) are far more dangerous because they block circulation and cause infarction (tissue death.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. • body type – typically. In diving. leading to greater amounts of total body dissolved nitrogen during time at pressure. this can allow venous blood with microbubbles of inert gas to bypass the lungs. In the brain. Maintaining proper hydration is recommended.
resulting in an arterial gas embolism. most offgassing occurs by gas exchange in the lungs. known as ebullism. These bubbles produce the symptoms of decompression sickness.  A similar effect. the amount of that gas dissolved in the liquid will also decrease proportionately. Under normal conditions. Any inert gas that is breathed under pressure can form bubbles when the ambient pressure decreases. leading to paralysis. 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. In the presence of a right-to-left shunt of the heart. which can also cause decompression sickness. so different decompression schedules are required. a diver will switch to mixtures containing progressively less helium and more oxygen and nitrogen during the ascent. inert gas comes out of solution in a process called "outgassing" or "offgassing". however some groups like the WKPP have been pioneering the use of shorter decompression times by including deep stops. Helium both enters and leaves the body faster than nitrogen. Very deep dives have been made using hydrogen-oxygen mixtures (hydrox).  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. The amount of gas dissolved in a liquid is described by Henry's Law. when the pressure of a gas in contact with a liquid is decreased. but.65 times slower than helium. which indicates that. The formation of bubbles in the skin or joints results in milder symptoms. such as a patent foramen ovale. since helium does not cause narcosis. Nitrogen diffuses into tissues 2. venous bubbles may enter the arterial system. There is some debate as to the decompression requirements for helium during short-duration dives. but is about 4. may occur during explosive decompression. which were dissolved under higher pressure. This is known as isobaric counterdiffusion. This is often found to provoke inner ear decompression sickness. it is preferred over nitrogen in gas mixtures for deep diving. to come out of physical solution and form gas bubbles within the body. but controlled decompression is still required to avoid DCS. On ascent from a dive. Inert gases The main inert gas in air is nitrogen. while large numbers of bubbles in the venous blood can cause lung damage. sensory dysfunction. Most divers do longer decompressions. but nitrogen is not the only gas that can cause DCS. and presents a problem for very deep dives. when water vapour forms bubbles in body fluids due to a dramatic reduction in environmental pressure.  Bubbles may form whenever the body experiences a reduction in pressure.Decompression sickness 14 Mechanism Depressurisation causes inert gases. or death. For example.5 times more soluble. chamber to avoid decompression sickness. as . The most severe types of DCS interrupt — and This surfacing diver must enter a decompression ultimately damage — spinal cord function. but not all bubbles result in DCS. after using a very helium-rich trimix at the deepest part of the dive. 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. Breathing gas mixtures such as trimix and heliox include helium.
or none at all. The algorithms used are designed to reduce the probability of DCS to a very low level. and carry out a decompression schedule as necessary. Prevention Underwater diving To prevent the excess formation of bubbles that can lead to decompression sickness. or from dive computers. and tables will indicate the time at normal pressures that is required. 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. they are not as good at determining the diagnosis as a proper history of the event and description of the symptoms. dive time. The diagnosis is confirmed if the symptoms are relieved by recompression.  The decompression schedule may be derived from decompression tables. 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. This will result in a shorter available time under water or an increased decompression time during the subsequent dive. 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. which may be up to 18 hours. are designed to fit empirical data and provide a decompression schedule for a given depth and dive duration. such as the Bühlmann decompression algorithm. 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). 4. Since divers on the surface after a dive still have excess inert gas in their bodies. or 6 metres (20 ft). These models. depending on the training agency.  Although MRI or CT can frequently identify bubbles in DCS. The total elimination of excess gas may take many hours. . Reduction in decompression requirements can also be gained by breathing a nitrox mix during the dive.Decompression sickness the ear seems particularly sensitive to this effect. In 1995. but do not reduce it to zero. and a schedule for a given bottom time and depth may contain one or more stops. 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. release of inert gas as pressure changes. since less nitrogen will be taken into the body than during the same dive done on air. in particular. but divers usually schedule a short "safety stop" at 3 metres (10 ft). Dives that contain no decompression stops are called "no-stop dives". within 24 hours of diving. 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. 95% of all cases reported to Divers Alert Network had shown symptoms within 24 hours. 15 Diagnosis Decompression sickness should be suspected if any of the symptoms associated with the condition occurs following a drop in pressure. and decompression information.6 metres (15 ft). divers limit their ascent rate to about 10 metres (33 ft) per minute. Following a decompression schedule does not completely protect against DCS. This schedule requires the diver to ascend to a particular depth. decompression software. and remain at that depth until sufficient gas has been eliminated from the body to allow further ascent. Each of these is termed a "decompression stop".
  Although pure oxygen pre-breathing is an effective method to protect against altitude DCS. Recompression on room air was shown to be an effective treatment for minor DCS symptoms by Keays in 1909.5 psi (0. but are no longer recommended for extended periods. although research has examined the possibility of using 100% O2 at 9. 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. a riskier alternative is in-water recompression.  However. provides effective protection upon exposure to low-barometric pressure environments. owing to concerns regarding cerebral edema. however. People should be made comfortable and placed in the supine position (horizontal). breathing pure oxygen during flight alone (ascent. or the recovery position if vomiting occurs.30 bar). either commercial or private.2 psi (0. as analgesics may mask symptoms. Breathing pure oxygen significantly reduces the nitrogen loads in body tissues and. Evidence of the effectiveness of recompression therapy utilizing oxygen was first shown by Yarbrough and Behnke. it is logistically complicated and expensive for the protection of civil aviation flyers. it is recommended that these cases still be evaluated. spending eight sleeping hours in the Quest airlock chamber before their spacewalk. and hence the risk of DCS. and has since become the standard of care for treatment of DCS. If given within the first four hours of surfacing. en route. descent) does not decrease the risk of altitude DCS.Decompression sickness 16 Exposure to altitude One of the most significant breakthroughs in the prevention of altitude DCS is oxygen pre-breathing.   Oxygen first aid has been used as an emergency treatment for diving injuries for years.  . both the Trendelenburg position and the left lateral decubitus position (Durant's maneuver) have been suggested as beneficial where air emboli are suspected. unless advised to do so by medical personnel. Recompression is normally carried out in a recompression chamber. Mild cases of the "bends" and some skin symptoms may disappear during descent from high altitude. At a dive site.70 bar). as this helps reduce dehydration. 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. if continued without interruption.3 psi (0. which operate at 4. and mottled or marbled skin lesions should be treated with hyperbaric oxygen therapy if seen within 10 to 14 days of development. The recompression chamber at the Neutral Buoyancy Lab. In the past. pulmonary symptoms. It is beneficial to give fluids. 10. During the EVA they breathe 100% oxygen in their spacesuits. Therefore. Astronauts aboard the International Space Station preparing for extra-vehicular activity (EVA) "camp out" at low atmospheric pressure. Neurological symptoms. It is also used by flight test crews involved with certifying aircraft. it is currently used only by military flight crews and astronauts for protection during high-altitude and space operations.66 bar) in the suits to lessen the pressure reduction. it increases the success of recompression therapy as well as a decrease the number of recompression treatments required. It is no longer recommended to administer aspirin.
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. "not a man escaped the repeated attacks of rheumatism and cold". He suggested that intravascular gas was released by rapid decompression and recommended: slow compression and decompression. and vascular stasis caused by decompression. using only healthy workers. This description of a viper in a vacuum was the first recorded description of decompression sickness. Explanations at the time included: cold or exhaustion causing reflex spinal cord damage. helped manage the construction of the bridge after his sickness confined him to his home in Brooklyn.  Long-term follow-ups showed similar results. Alphonse Jaminet as the physician in charge. However. Emily.1 psig (4 ATA). From 1870 to 1910. with 16% having permanent neurological sequelae. electricity cause by friction on compression. • 1840: Colonel William Pasley. limit to maximum depth 44. and recompression treatment for severe cases. with the risk 2.150 dives. of those having made frequent dives.  The project employed 600 compressed air workers.8 cases per 10. Three-month follow-ups on diving accidents reported to DAN in 1987 showed 14. There were 30 seriously injured and 12 fatalities. • 1870: Bauer published outcomes of 25 paralyzed caisson workers. • 1841: First documented case of decompression sickness.000 dives. four-hour working shifts.  History • 1670: Robert Boyle demonstrated that a reduction in ambient pressure could lead to bubble formation in living tissue. who was involved in the recovery of the sunken warship HMS Royal George. From 1998 to 2002. scuba divers per year. In 1999.) Washington's wife.000 U. He battled the after-effects of the disease for the rest of his life. Epidemiology The incidence of decompression sickness is rare. the Divers Alert Network (DAN) created "Project Dive Exploration" to collect data on dive profiles and incidents. or organ congestion. commented that. Jaminet developed decompression sickness and his personal description was the first such recorded. DCS affects approximately 1.3% of the 268 divers surveyed "still had residual signs and symptoms from Type II DCS and 7% from Type I DCS".S. The project chief engineer Washington Roebling suffered from caisson disease.6 times greater for males than females. will in most cases result in no long term effects. Recompression treatment was not used. • 1769: Giovanni Morgagni described the post mortem findings of air in cerebral circulation and surmised that this was the cause of death. they recorded 50. (He took charge after his father John Augustus Roebling died of tetanus. 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. reported by a mining engineer who observed pain and muscle cramps among coal miners working in mine shafts air-pressurized to keep water out. followed by recompression in a hyperbaric chamber. estimated at 2.Decompression sickness 17 Prognosis Immediate treatment with 100% oxygen. from which 28 recompressions were required — although these will almost certainly contain incidents of arterial gas embolism (AGE) — a rate of about 0. • 1871: The Eads Bridge in St Louis employed 352 compressed air workers including Dr.05%. Dr. During this project. decompression sickness became known as "The [Grecian] Bends" because afflicted individuals characteristically . permanent long-term injury from DCS is possible. all prominent features were established. • 1873: Dr.
 • 1935: Behnke et al. 1959: The "SOS Decompression Meter". 1960: FC Golding et al. treatment of DCS is provided by the National Health Service. Louis D Homer and Edward T Flynn introduce survival analysis into the study of decompression sickness. 1984: Albert A Bühlmann released his book "Decompression-Decompression Sickness. using a microprocessor to calculate nitrogen absorption for twelve tissue compartments. 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. Boycott and Damant recommending staged decompression. As a result. • 1900: Leonard Hill used a frog model to prove that decompression causes bubbles and that recompression resolves them. 1982: Paul K Weathersby. .  Hill advocated linear or uniform decompression profiles. either at a specialised facility or at a Hyperbaric Centre based within a general hospital. a submersible mechanical device that simulated nitrogen uptake and release. was introduced. A typical stay in a recompression chamber will easily cost several thousand dollars. In the United Kingdom. a personal dive computer. even before emergency transportation is included.  This type of decompression is used today by saturation divers. 1957: Robert Workman established a new method for calculation of decompression requirements (M-values).   • • • • • • • • 18 An early recompression chamber 1937: Behnke introduced the “no-stop” decompression tables. or as historian David McCullough asserts in The Great Bridge it was a crude reference to "Greek" or anal sex. • 1930s: Albert R Behnke separated the symptoms of Arterial Gas Embolism (AGE) from those of DCS. • 1908: "The Prevention of Compressed Air Illness" was published by JS Haldane. These tables were accepted for use by the Royal Navy.Decompression sickness arched their backs: this is possibly reminiscent of a then fashionable women's dance maneuver known as the Grecian Bend. Society and culture Economics In the United States. 1941: Altitude DCS is treated with hyperbaric oxygen for the first time." which detailed his deterministic model for calculation of decompression schedules. it is common for medical insurance not to cover treatment for the bends that is the result of recreational diving. 1983: Orca produced the "EDGE". His work was financed by Augustus Siebe and the Siebe Gorman Company. • 1924: The US Navy published the first standardized recompression procedure. experimented with oxygen for recompression therapy. split the classification of DCS into Type 1 and 2. This is because scuba diving is considered an elective and "high-risk" activity and treatment for decompression sickness is expensive.
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html) Deep diving The meaning of the term deep diving is a form of technical diving.gov/dp_forms.noaa. (Compagnie maritime d'expertises) using hydrox and also nitrogen trimix attained far greater depths than any recreational technical diving. ISBN 1-905492-07-3. One example being the Comex Janus IV open-sea dive to 500 metres. Rosen's emergency medicine: concepts and clinical practice (7th ed. ISBN 978-0-323-05472-0. 60 metres / 200 feet may be a "deep dive" • in surface supplied diving. asp) • Dive Tables from the NOAA (http://www. Mark (2008). PADI define anything from 18 metres / 60 feet .diversalertnetwork. An atmospheric diving suit allows very deep dives of up to 700 metres. diving equipment. and surface support: • in recreational diving. It is defined by the level of the diver's diver training. PA: Mosby/Elsevier.30 metres / 100 feet as a "deep dive" (other diving organisations vary) • in technical diving. Philadelphia. These divers needed to breathe special gas mixtures because they were exposed to very high ambient pressure (more than 50 times atmospheric pressure). Deep diving may have quite a different meaning in the commercial diving field.org/medical/articles/index. 100 metres / 330 feet may be a "deep dive" This definition essentially relates to recreational diving.org) • Divers Alert Network: diving medicine articles (http://www. • Powell. Deco for Divers.Decompression sickness • Marx.rubicon-foundation. breathing gas. Southend-on-Sea: Aquapress. 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.). 23 External links • Environmental Physiology Medical Literature (http://archive.ndc. John (2010). This eliminates the problems associated with breathing high pressure gases. in 1977. For instance the early experiments carried out by Comex S. Diver returning from a 600 ft/180 metres dive .A. These suits are capable of withstanding the pressure at great depth permitting the diver to remain at normal atmospheric pressure.
though minimal visibility possible farther down. which may lead to a convulsion underwater. The diver needs a disciplined approach to planning and conducting dives to minimise these additional risks. Recommended technical diving limit. The need to do decompression stops increases with depth. Depth at which compressed air results in an unacceptable risk of oxygen toxicity. and gas becomes denser requiring increased effort to breathe with depth. can happen if a diver ascends too fast. when excess inert gas leaves solution in the blood and tissues and forms bubbles.4 ATA. Recreational diving limit for divers with Open Water certification but without greater training and experience. . Bone degeneration (dysbaric osteonecrosis) is caused by the bubbles forming inside the bones. A diver at 6 metres (20 ft) may be able to dive for many hours without needing to do decompression stops. 660 feet/200 meters Absolute limit for surface light penetration sufficient for plant growth. a diver breathes 6 times as much as on the surface (1 bar).  Navy diver in Atmospheric Diving System (ADS) suit . This tends to be life threatening. All of these considerations result in the amount of breathing gas required for deep diving being much greater than for shallow open water diving. 509 feet/155 meters Record depth for scuba dive on compressed air. most commonly the upper arm and the thighs.so at 50 metres (160 ft). leading to increasing risk of hypercapnia. In the event of an emergency the diver cannot make an immediate ascent to the surface without risking decompression sickness.   330 feet/100 meters Technical diving training limit for divers breathing trimix.000 feet/610 meters World record for deepest dive on SCUBA. an excess of carbon dioxide in the blood. At depths greater than 40 metres (130 ft). Air embolism causes loss of consciousness and speech and visual problems. and presents the additional risk of oxygen toxicity. Using normal scuba equipment. Deep diving involves a much greater danger of all of these. 1. breathing gas consumption is proportional to ambient pressure . or the “bends”.083 feet/330 meters 2. Recommended recreational diving limit for divers. Coping with the physical and physiological stresses of deep diving requires good physical conditioning. Decompression sickness.  Particular problems associated with deep dives Deep diving has more consequences and dangers than basic open water diving. and requires a recompression chamber for treatment. starts with feelings of euphoria and over-confidence but then leads to numbness and memory impairment similar to alcohol intoxication. The effects tend to be delayed until reaching the surface.Deep diving 24 Deep Diving Depth  Comments Recreational diving limit for divers aged under 12 years old and beginner divers. Heavy physical exertion causes even more gas to be breathed. adults.  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). These bubbles produce mechanical and biochemical effects that lead to the condition. Very deep diving using a helium–oxygen mixture (heliox) carries a risk of high pressure nervous syndrome. the “narks” or “rapture of the deep”. a diver may have only a few minutes at the deepest part of the dive before decompression stops are needed. Technical diving limit for "extended range" dives breathing air to a maximum ppO2 of 1. Nitrogen narcosis. where the pressure is 6 bar.
fitness and surface support. Philippines. a decompression trapeze or a decompression buoy can help divers return to their surface safety cover at the end of a dive. but are inherently more complex than open circuit scuba. 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. 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. • A diving shot. experience. Ultra-deep diving requires extraordinarily high levels of training. • Use of helium-based breathing gases such as trimix reduces nitrogen narcosis and stays below the limits of oxygen toxicity. there are certain elite divers who participate in ultra-deep diving on SCUBA (using closed circuit rebreathers and heliox) below 660 feet (200 m).    That is fewer . Note the backplate and wing setup with sidemounted stage tanks containing EAN50 (left side) and pure oxygen (right side). Technical divers preparing for a mixed-gas decompression dive in Bohol.Deep diving 25 Dealing with depth • Divers carry larger volumes of breathing gas to compensate for the increased gas consumption and decompression stops. • Rebreathers manage gas much more efficiently than open circuit scuba.
Minimal visibility is still possible far deeper. comex. fr/ suite/ ceh/ histo/ histo anglais.) . NOAA recommends that divers do not expose themselves to breathing oxygen at greater than 1. onepetro. dived to 307 feet (94 m) on air 1959 Ennie Falco reported having reached a depth of 435 feet (133 m) on air. and other factors not fully understood. a colleague of Jacques Cousteau. Watson reported that he had no recollection at all of what transpired at the bottom of the descent due to narcosis. html)  All depths specified for sea water.proof being as tangible as faith more often than not. and has only been achieved five times since. A. This created an extreme risk of both narcosis and oxygen toxicity in the divers and. Some examples are David Shaw. Dives of this nature have been impossible to verify . although it looked like the black pit-mouth of hell itself---yet still showed blue. June 1931. United States: PADI. Since the recent introduction of depth gauges capable of reading to 330m it is unlikely that such records will be attempted in the future. "A Round Trip to Davey Jones's Locker. at 1400 feet (424 meters). Besides scuba. again reporting no ill effects from narcosis or oxygen toxicity. first achieved by John Bennett in 2001. 3rd edition.Deep diving than the number of people who have walked on the surface of the moon. (http:/ / books. 26 Ultra deep air While extreme deep diving on air is extremely dangerous. 1994. surface light may disappear completely at much shallower depths in murky conditions. the Guinness World Records ceased to publish records on deep air dives. • 1994 Dan Manion set the current record for a deep dive on air at 509 feet (155 m). ISBN 0-922769-31-1. Don Shirley. Encyclopedia of Recreational Diving. The record is not officially recognised anywhere. Bret Gilliam chronicles the various fatal attempts to set records as well as the smaller number of successes. p. • 1990 Bret Gilliam dived to a depth of 452 feet (138 m) on air. The Holy Grail of deep SCUBA diving was the 1000 ft (300 m) mark. Manion reported he was almost completely incapacitated by narcosis and has no recollection of time at depth. In deference to the high death rate." (William Beebe. In 2003 Mark Ellyatt claimed dives to depths of 260m and 313m. Paul Raymeakers and Pim van der Horst. "I peered down and again I felt the old longing to go farther. google.  Hydra 8: Pre-commercial Hydrogen Diving Project (http:/ / www.A. Mario Marconi." The National Geographic Magazine. at pages 35 and following. ISBN 1878663011. Marco Reis. org/ mslib/ servlet/ onepetropreview?id=SUT-AUTOE-v14-107& soc=SUT& speAppNameCookie=ONEPETRO)  Comex S. Alessandro Scuotto. Deep sea explorer William Beebe reported seeing blueness. HYDRA 8 and HYDRA 10 test projects (http:/ / www. From the comparatively few who survived extremely deep air dives: • • • • • 1947 Frédéric Dumas. 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. References  Brylske. perhaps unsurprisingly. before the popularity of Trimix attempts were made to set world record depths using conventional air. See generally Deep Diving by Bret Gilliam. and it should be noted that Dr Marion's second dive computer only registered a depth of 490 feet. Deep Diving.6 bar ppO2. there is a small group of divers who have reached depths below 200 meters on closed-circuit rebreathers. 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. 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. contributed to an astonishingly high fatality rate amongst those attempting records. In his book.  Set by Dr Dan Marion on March 18. (2006). individual physiology. Unusually. 660. not blackness. 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. • 1993 Bret Gilliam extended his own world record to 475 feet (145 m). which occurs at 218 feet breathing air.
"Verified dives below 200 metres" (http:/ / www. MA and Smith.044 feet dive by Nuno Gomes earlier in the same year as the current official world record. . "EX 19 Performance Testing at 850 and 450 FSW (Feet of Seawater)" (http:/ / archive. ME (1989).  Deep Diving.15240. NE (eds). NE (eds).com/RecreationalDeepDiving. Retrieved 2008-07-05. scubarecords. and commercial divers (although commercial diving to that depth is unknown on SCUBA). Retrieved 2008-07-24. a former Turkish Navy diver. htm). htm). 27 Footnotes Further reading • Dent. an advanced guide to physiology. 1995-01-25.  Gomes. In: Lang. 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. "Recorded Deep Dives Below 200 m" (http:/ / www. MA and Smith. In: Lang. DC). co.htm) . NE (eds). External links • Recreational Deep Diving (http://www. Bret Gilliam. rubicon-foundation. Retrieved 2008-07-05. Retrieved 2008-06-14.  In 2007 Erdogan Bayburt. rubicon-foundation. . nunogomes. "AAUS Deep Diving Standards" (http://archive. .  Scubarecords. com/ DeepRecords. ISBN 9780922769315. MA and Smith. military.00. N. He used a closed-circuit rebreather. google. dived to a depth of 998 feet (304 m) off the coast of Cyprus.108883. .  Subsequently died during diving accidents. com/ features/ 0. Proceedings of Advanced Scientific Diving Workshop (Washington. US Naval Experimental Diving Unit Technical Report NEDU-8-89. org/ 7423). za/ rec. rubicon-foundation. html)  Egstrom GH (2006). Proceedings of Advanced Scientific Diving Workshop (Washington. "Historic Perspective: Scientific Deep Diving and the Management of the Risk" (http:/ / archive.divinglore. Proceedings of Advanced Scientific Diving Workshop (Washington.  Statistics exclude military divers (classified). but that dive has not been independently verified.  Southerland. Retrieved 2009-11-19. However. "Medical Fitness at 300 FSW" (http:/ / archive. --Knafelc. DC). the Guinness World Records still recognises the 1. org/ 4653). procedures and systems (http:/ / books.  Navy diver sets world record (http:/ / www.083 feet was the depth reportedly achieved by Pascal Bernabé in 2005. . Retrieved 2008-07-05.org/4669). It was a Turkish Navy experimental dive. DC). DG (2006). His dive was aborted due to equipment failure. In: Lang. org/ 4659).Deep diving  1. W (2006).com. Retrieved 2008-06-14. . com/ ?id=HVbjgdorRXAC& pg=PT1& lpg=PT1& dq=Bret+ Gilliam+ deep+ diving#v=onepage& q=& f=false).rubicon-foundation.
org/ 3835). So. . Calculations in metres The equivalent air depth can be calculated for depths in metres as follows: EAD = (Depth + 10) × Fraction of N2 / 0. DAN Nitrox Workshop Proceedings (http:/ / archive. rubicon-foundation. References  Logan. a gas mix containing 36% oxygen (EAN36) being used at 27 metres (89 ft) has an EAD of 20 metres (66 ft). NC: Divers Alert Network.  Berghage Thomas E. rubicon-foundation. org/ 4855). org/ 2835). .64 / 0. known as nitrox. the EAD is: EAD = (27 + 10) × 0.79 − 10 EAD = 37 × 0. (2001). the diver would calculate their decompression requirements as if on air at 67 feet.64 / 0.79 − 10 Working the earlier example. At 27 metres the Bühlmann 1986 table (0–700 m) allows 20 minutes bottom time without requiring a decompression stop. "An evaluation of the equivalent air depth theory" (http:/ / archive. McCraken TM (December 1979). the EAD is: EAD = (90 + 33) × 0.  Lang. for a given nitrox mix and depth. Michael A.   The equivalent air depth. PMID 538866. JA (1961). is the depth of a dive when breathing air that would have the same partial pressure of nitrogen. Dive tables Although not all dive tables are recommended for use in this way.79 − 33 EAD = 123 × 0. for example. Retrieved 2008-05-01. Retrieved 2008-05-02. United States Navy Experimental Diving Unit Technical Report NEDU-RR-01-61. the Bühlmann tables are suitable for use with these kind of calculations. p. for a nitrox mix containing 64% nitrogen (EAN36) being used at 90 feet. . Calculations in feet The equivalent air depth can be calculated for depths in feet as follows: EAD = (Depth + 33) × Fraction of N2 / 0. This shows that using EAN36 for a 27 metre dive can give a 75% increase in bottom time over using air.81 − 10 EAD = 30 − 10 EAD = 20 metres So at 27 metres on this mix. the diver would calculate their decompression requirements as if on air at 20 metres. While at 20 metres the no-stop time is 35 minutes. . 197. Undersea Biomedical Research 6 (4): 379–84. Durham. Retrieved 2008-05-01. rubicon-foundation.79 − 33 Working the earlier example.81 − 33 EAD = 100 − 33 EAD = 67 feet So at 90 feet on this mix.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. for a nitrox mix containing 64% nitrogen (EAN36) being used at 27 metres. "Equivalent air depth: fact or fiction" (http:/ / archive.
4) − 33 END = 233 × 0.6 − 10 END = 42 − 10 END = 32 metres So at 60 metres on this mix. a trimix containing 20% oxygen. since it is more conservative. for a gas mix containing 40% helium being used at 60 metres. the END is: END = (200 + 33) × (1 − 0. the END is: END = (60 + 10) × (1 − 0. 40% nitrogen (trimix 20/40) being used at 60 metres (200 ft) has an END of 32 metres (105 ft). This is now preferred to the previous method of considering only nitrogen as narcotic. In this analysis. for a gas mix containing 40% helium being used at 200 feet. such as heliox and trimix. Oxygen Narcosis Since there is evidence that oxygen plays a part in the narcotic effects of a gas mixture. .6 − 33 END = 140 − 33 END = 107 feet So at 200 feet on this mix. for a given mix and depth. Although oxygen has greater lipid solubility than nitrogen and therefore should be more narcotic (Meyer-Overton correlation). the diver would feel the same narcotic effect as a dive on air to 107 feet. 40% helium. 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. the diver would feel the same narcotic effect as a dive on air to 32 metres.4) − 10 END = 70 × 0. to calculate the depth which would produce the same narcotic effect when breathing air. For example. it is likely that some of the oxygen is metabolised.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. it is assumed that the narcotic potentials of nitrogen and oxygen are similar. The method is. 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. the NOAA diving manual recommends treating oxygen and nitrogen as equally narcotic. 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. thus reducing its effect to a level similar to that of nitrogen.
National Oceanic and Atmospheric Administration." 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. Undersea Biomed Res 5 (4): 391–400.  Breathing Mixture Including other gases in the mix. oxygen.1. it is appropriate to include the oxygen in the END calculation when using trimixes (Lambersten et al. Symptoms Symptoms of HPNS include tremors.e. dizziness. Diving for Science and Technology. Fagraeus L. The compression effects may occur when descending below 500 feet (150 m) at rates greater than a few metres per minute. PMID 734806. The effects from depth become significant at depths exceeding 1000 feet (300 m) and remain regardless of the time spent at that depth.  Causes HPNS has two components.  Russian scientist G. who also founded the Divers Alert Network. regardless of the proportions of oxygen and nitrogen. NOAA Diving Manual. . "Helium tremors" were first widely described in 1965 by Royal Navy physiologist Peter B. since oxygen has some narcotic properties.. "Roles of nitrogen. myoclonic jerking. The effects depend on the rate of descent and the depth. and somnolence that appeared during a 1189-foot (362 m) chamber dive in Marseilles. Zal'tsman also reported on helium tremors in his experiments from 1961. 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. Unfortunately these reports were not available in the West until 1967. 2002.4] .. Retrieved 2008-05-01.   . nausea. 4th. somnolence. one resulting from the speed of compression and the other from the absolute pressure. Bennett. HPNS is a limiting factor in future deep diving. "[16. 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. 1977.3. The non-helium portion (i. and decreased mental performance.2. L. such as nitrogen (creating trimix) or hydrogen (hydreliox) suppresses the neurological effects. rubicon-foundation. EEG changes. The term high pressure nervous syndrome was first used by Brauer to describe the combined symptoms of tremor. but has little variation between different dives by the same diver. Adolfson J (December 1978).  "Mixed-Gas & Oxygen".. but reduce within a few hours once the pressure has stabilised. visual disturbance. The susceptibility of divers and animals to HPNS varies over a wide range depending on the individual. electroencephalography (EEG) changes. org/ 2810).Equivalent narcotic depth 30 References  Hesser CM. and carbon dioxide in compressed-air narcosis" (http:/ / archive.1978).  Rate of Compression Utilizing slow rates of compression or adding stops to the compression have been found to prevent large initial decrements in performance.
org/ 2920). "Effects of a H2-He-O2 mixture on the HPNS up to 450 msw" (http:/ / archive. Texas A&M University Sea Grant TAMU-SG-79-201. Jean Claude (2003). . Tom S. M. anesthetics and anticonvulsant drugs have had varying results in suppressing HPNS with animals. Undersea Biomed. org/ 2487). 1 (1): 1–28. org/ 2661). . United States: Saunders. R. (1967). (1974). 251 (London). 1961)".  Bennett. Dimov. PMID 5378824.  Bennett. L. . English translation. "Syndrome neurologique et electrographique des hautes pressions". S. 323–57.  Hunger Jr. References  Bennett. W. Ocean Industry (London) 3: 28–33. Res. ISSN 0093-5387. Gardette-Chauffour.. Coggin. PMID 4619860. "Effect of compression rate on use of trimix to ameliorate HPNS in man to 686 m (2250 ft)" (http:/ / archive. W. Res. Fructus. C.  Fife. Naquet. 5th Rev ed.  Zal'tsman. W. Lemaire. (1965). X. Naquet. Rev Neurol (Paris) 121 (3): 264–5. Bennett and Elliott's physiology and medicine of diving.High-pressure nervous syndrome 31 Drugs Alcohol. rubicon-foundation. 9 (4): 335–51. Underwater Physiology Subcommittee Report No. Retrieved 2008-04-07. M. "The use of Non-Explosive mixtures of hydrogen and oxygen for diving". ISSN 0093-5387. Alf O. "Contribution to the study of the neurological and mental reactions of the organism of the higher mammal to gaseous mixtures under pressure". P. P. Neuman. P. Foreign Technology Division. Rostain.. R. Retrieved 2008-04-07. (1988). PMID 3212843.. OCLC 2068005. Retrieved 2008-04-07. Undersea Biomedical Research 15 (4): 257–70. B. B. MD Thesis (Toulouse University).. Royal Navy Personnel Research Committee. OCLC 2068005.  Rostain. OCLC 2068005. AD655 360 (Wright Patterson Air Force Base. pp. In Brubakk. P. mechanisms and prevention of the high pressure nervous syndrome" (http:/ / archive. ISSN 0093-5387. rubicon-foundation. None are currently in use for humans. (1979). Peter B. PMID 7168098. R. ISBN 0702025712. External links • Select publications about HPNS (http://archive. "Seeking man's depth level". (1968).rubicon-foundation. (1982). L. rubicon-foundation.. J. Fructus. (1970). "Psychological principles of a sojourn of a human in conditions of raised pressure of the gaseous medium (in Russian. (1968)..org/dspace/simple-search?query=high+ pressure+nervous+syndrome) hosted by the Rubicon Foundation . C. Undersea Biomed.  Brauer.  Vigreux.  Brauer. R. Gosset. "The causes. W. P. Ohio). "Psychometric impairment in men breathing oxygen-helium at increased pressures". B. J. "The High Pressure Nervous Syndrome". Bennett. McLeod. C. R. G. A.
Types of this sort of diving disorder. Proper training before using mixed gases. More disciplined attitude when underwater. with scuba or other diving equipment) or use high pressure breathing gases. partial pressure depends upon proportion of oxygen and depth Hypoxia or anoxia occurs while having gas to breathe. or dive tool/knife. empty it and refill it. 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. Keep cylinders routinely checked and tested. Oxygen toxicity Breathing gas at too high a partial pressure of oxygen. According to a North American 1970 study. e. hypoxic gas Proper training before using a rebreather. See cave diving and wreck 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 .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.g.particularly in rebreathers that monitor and maintain oxygen content Running out of air due to a number of factors. According to a 2000 Japanese study. Some of these conditions also affect people who work in raised pressure environments out of water. using up oxygen in the contained air. before the diver uses the cylinder Anoxia due to having no air or gas to breathe Equipment failure . Better awareness underwater. Some deep diving breathing gases such as trimix and heliox can be hypoxic at shallow depths Don't breathe hypoxic gas in shallow water.g. Specific training and leadership for such types of diving. but where the oxygen partial pressure is too low to sustain normal activity or consciousness. Corerect identification of cylinder gases and safe procedures for gas changes. 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. 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.g. Carry a diver's net cutter. If a cylinder has stood full for months. Keep equipment routinely checked and in good condition Better training of divers. 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. A faulty or misused rebreather can provide the diver with Keep rebreathers properly maintained. in caissons. Better training and leadership. Click on the boldface links to find symptoms and more information for each topic. diving was (on a man-hours based criteria) 96 times more dangerous than driving an automobile. every hour of recreational diving is 36 to 62 times riskier than automobile driving.
For example. Put the proper gas identification markings on cylinders. this hazard can happen with diving with a large "bubblehead" helmet. This is a particular risk with a pumped surface air feed. often its own engine's exhaust gas Oil getting into the air feed and firing in the air compression cylinder. The pressure in the outer ear not equalizing with surrounding pressure Damage to other body air spaces. Cold water in the middle ear chills the inner ear. Types of this sort of diving disorder. British naval divers called it shallow water blackout. Minimise the volume of any enclosed spaces which the diver breathes through. Click on the boldface links to find symptoms and more information for each topic. with the common cold. e. 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. Keep rebreathers properly maintained. Cause Failing to equalize the pressure in the middle ear with surrounding pressure. See Rebreather#Carbon dioxide scrubber. How to avoid it Do not dive if the eustachian tube is congested. and how to avoid them Type Eardrum damage. Proper training before using a rebreather. causing dizziness and disorientation etc. Check conditions where you have your cylinders refilled. never wear earplugs.g. the diver re-inhales carbon dioxide because the soda lime scrubber cannot absorb the exhaled carbon dioxide as fast as the diver produces it. 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.List of diving hazards and precautions 33 Air cylinder filled by a compressor which sucked in products of combustion. This can happen from losing control of buoyancy causing excessive vertical speed during descent. 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 . Proper diver training in clearing the ears. 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. Do not dive with conditions such as the common cold Let air into the mask through the nose. On descent Air spaces within the body provide no support against greater outside pressure. such as the paranasal sinuses. Carbon dioxide poisoning: hypercapnia With a rebreather.
This can happen from holding the breath on ascent.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. 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. with the old standard diving dress. Types of this sort of diving disorder. Its effects can be very similar to decompression sickness. or from losing control of buoyancy causing excessive vertical speed during ascent. Proper training in its use. In severe cases much of the diver's body could be mangled and compacted inside the helmet. On ascent Air spaces within the body expand when the outside pressure decreases. Effects of breathing gas at high pressure Click on the boldface links to find symptoms and more information for each topic. Blockage of the sinus's duct Blocked Eustachian tube Pain in a sinus Eardrum bursting outwards Do not dive with nasal congestion. Click on the boldface links to find symptoms and more information for each topic. e. 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. however. the common cold. . 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). air loose in the pleural cavity Gas trapped in the chest after burst lung Gas loose under the skin. Air or other gas in the blood stream. This does not happen with scuba where there is no solid pressure-tight helmet A non-return valve in the helmet failing. 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.g.
See decompression sickness for a detailed list of the symptoms. some dangerous Fire coral Some jellyfish . Maintain cardiovascular fitness. Nitrogen narcosis Breathing a high partial pressure of nitrogen (or other gas. such as an ROV. with scuba) or use high pressure breathing gases. or add a little nitrogen as described at HPNS. Divers face specific physical and health risks when they go underwater (e. Avoid diving with bare skin. in caissons. 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. Uncommon but known. It is yellow. increase surface interval or reduce dive depth. particularly in caves or shipwrecks. Provide something for the diver to hold onto while ascending and decompressing to maintain accurate depth during stops and correct ascent rate. This hazard is well known with closed circuit rebreathers when the control of the mixture fails. use the correct breathing gas mixture to limit the equivalent narcotic depth to an acceptable level for the planned depth. sometimes with Coral coral tissue left in them Cuts Rock. a boilersuit could be worn in very warm water. With mixed gas diving. e. wear an adequately warm diving suit for the conditions. Learn to identify it. Reduce the number of deep dives. Avoid dehydration and hypothermia. Some of these conditions also affect people who work in raised pressure environments out of water. etc. and how to avoid them. Avoid diving in bare skin. and barotrauma. much heat can be lost from a head without a hood. If stops are necessary. Do not get too close to coral. Cuts. 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. Stings Stings. Click on the boldface links to find symptoms and more information for each topic. See taravana. Use breathing gas mixtures with reduced inert gas fraction. Also.g. ascending too quickly will cause gas to supersaturate and form bubbles in tissues depending on time and depth of the dive. Bends in snorkellers. eg Nitrox. Know how long you can stay at the planned depth and still make a normal ascent. Use an underwater breathing apparatus and ascend at a rate determined by decompression tables or computer. Water carries heat away far better than air. Limit the depth of the dive to limit the partial pressures of gases with narcotic effects to a level that you can safely manage. How to avoid it Plan your dive. Other risks encountered by people in water Types of this class of diving disorder. Type Hypothermia Cause Losing body heat to the water.g. arterial gas embolism. Where it says "Avoid diving with bare skin". Dont dive deep on air.List of diving hazards and precautions 35 Types of this sort of diving disorder. How to avoid it In cool or cold water. Avoid diving with bare skin. After dive. metal. Many deep dives in succession. Training in using diving tables and a dive computer. do not miss or cut short decompression stops. and how to avoid them Type Decompression sickness ("the bends") Cause Gas dissolves in tissues under pressure according to Henry's Law over time. Use another diving technique. Learn about the dangerous species.
bleeding wounds and other trauma Use Surface detection aids or a diving shot to mark surfacing position and aid searchers. Get proper information on them. Care when wading.   Electric eel. likelihood of risk is location dependent Wear a full-body exposure suit to prevent direct skin to environment contact. sea lice bites. 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. Colliding with a boat or its propeller. Local knowledge. jellyfish stings. surface weather on the shore make the sea too rough to safely exit. Keep out of armed forces areas. where protected from attack by sharks. Get proper information on them. Ensure that boat uses a positive check system to identify each diver is on board after a dive. Poison-injecting spines Poison injection Shark bites Learn to identify them. For example hydrogen sulfide in some lakes and caves can be absorbed through the skin. Carry a yellow flag or surface marker buoy to attract attention. 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. Carry a signalling mirror and/or sound signalling device. There have been cases    of very large groupers trying to swallow humans. good weather forecasts. See Underwater Port Security System. crown of thorns starfish. scrapes.List of diving hazards and precautions 36 Do not poke about in sand where they live. Consult location-specific information to determine risk. Care when wading. Sudden loss of underwater visibility Silt out: stirring up silt or other light loose material Training in diving in zero visibility. in some South American fresh water Electric ray. 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. . In affected water. This includes sunburn. in some tropical waters Attack by Titan Triggerfish Attack by an unusually large grouper. in parts of the Pacific Ocean Sharks. Wave action on the shore. Learn the frog kick. Left behind due to inaccurate check by boat crew Diver lost at sea after Big waves made it unsafe to leave the water. Keep a lookout for the fish and move away if they act aggressively Crocodile attack Crocodiles. Plan a safe exit point and check weather and tidal conditions. Avoid large ships' ordinary sonar. 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. Carry a personal submersible EPIRB or submersible vhf radio. lionfish. currents moved a shore dive the diver away from a safe exit. stonefish. fire coral inflammation and other skin injuries that a diver may gain from using a shorty wetsuit or no diving suit. bruises and skin conditions that result from diving in tropical waters. never molest even seemingly-tame sharks underwater. Keep away from them. 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. some sea urchins in warm seas Blue ringed octopus. 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. Avoid waters known to be inhabited by crocodiles.
cdnn. PMID 5031739. PMC 1518314. Retrieved 2009-08-08.  Ikeda. H (2000). shtml). Correct use of reels and route to the surface lines. Bill (July 2000). html). flmnh. .  Sargent. Bill (2005-06-26). Cyber Diver News Network. 4 feet side side to side. directional markers. reefrelief. Reef Relief. ufl.  Arthur C. com/ tu-online/ stories/ 061905/ spo_19030958. wrecks. References  Lansche. Sri Lanka External links • Diving Diseases Research Centre (http://www.  Alevizon. "Is recreational diving safe?" (http:/ / archive. rubicon-foundation. Ashida. in the sunken Admiralty floating dock in Trincomalee. 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. . . org/ 6770). org/ science_body4. Clarke.com (Florida Times-Union). . Retrieved 2009-08-08. Backup lights. T. info/ eco/ e020104/ e020104. Reefs of Taprobane. Train in wreck diving and cave diving techniques. James M (1972). California Medicine 116 (6): 18–22. grouper attacks?" (http:/ / www. FloridaToday. page 138: 15 feet long. shtml). Retrieved 2009-08-08. ISBN 0-7434-4502-3.DDRC. . "Big Grouper Grabs Diver On Keys Reef" (http:/ / www. jacksonville. 2005-06-19. nets.org) .List of diving hazards and precautions 37 Carry at least one line cutting implement.com. Dive with a buddy who is capable of helping to free you and will stay close enough to notice. "Did fish feeding cause recent shark. Use low snag equipment configurations (avoid dangling gear and snap hooks that can snag on lines) Entrapment Snagging on lines. Florida Museum of Natural History. "Deaths During Skin and Scuba Diving in California in 1970". "A Case for Regulation of the Feeding of Fishes and Other Marine Wildlife by Divers and Snorkelers" (http:/ / www. Undersea and Hyperbaric Medical Society. Retrieved 2009-08-08. Evan T (2002-01-04). Jacksonville. html).  "Goliath grouper attacks" (http:/ / www.  Allard. edu/ fish/ InNews/ grouperattack2005. Retrieved 2009-08-08.
if a gas contains 36% oxygen and the maximum ppO2 is 1. but is normally in the range of 1.6 bar. 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.36) . So the 1 atm for the air is subtracted out. so divide by 0. Note that 21% is the concentration of oxygen in normal air. and the rest is due to depth in water. For example.5.). to give the rest of the pressure added by water (in atmospheres).Maximum operating depth 38 Maximum operating depth In technical diving and nitrox diving. 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. 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. if a gas contains 36% oxygen and the maximum ppO2 is 1. etc. 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. For example. the MOD (m) is 10 metres x [(1. There is a risk of oxygen toxicity if the MOD is exceeded.2 to 1.5 bar.9 metres.4 / 0.4 / 0.4 bar. to the depth. 150 minutes at 1. 120 minutes at 1. 180 minutes at 1.1] = 28. 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. the level of underwater exertion planned and the planned duration of the dive.3 feet (29. 1 atmosphere is due to the Earth's air. 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).4 bar.3 bar and 210 minutes at 1.2 bar. the MOD (fsw) is 33 feet (10 m) x [(1. The remaining part in each formula merely converts pressure in atm produced by depth in water.36) .1] = 95. This safe limit varies depending on the diver training agency. 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. Formulas To calculate the MOD for a specific ppO2 and percentage of oxygen. . The tables below show MODs for a selection of oxygen mixes.6 bar.4 bar. Of this total pressure which can be tolerated by the diver. Safe limit of partial pressure of oxygen The maximum single exposure limits recommended in the NOAA Diving Manual are 45 minutes at 1.
3 11.0 90.4 1507 737 480 352 275 223 187 159 138 121 107 97 1.3 29.3 10.3 20.3 41.7 167.4 28.0 .0 8.0 34.0 4.0 8.7 28.0 156.8 6.6 12.4 31.3 5.2 56.0 5.3 1.3 423.6 22.3 67.1 6.9 66.0 73.6 7.3 145.7 5.7 10.8 10.2 51.7 47.0 35.7 78.1 16.7 134.8 18.3 70.3 96.0 7.5 13.6 523.4 10. MOD table in metres Maximum Operating Depth (MOD) in metres of sea water for ppO2 1.1 23.2 38.5 490.3 21.3 4.3 20.3 15.9 16.0 13.0 98.9 44.9 11.9 36.8 7.3 1397 682 443 324 253 205 171 145 125 110 99 1.0 19.0 56.7 23.1 11.0 123.0 240.0 15.0 1.9 23.8 123.6 40.4 23.6 6.3 61.7 62.3 6.6 11.2 to 1.5 34.5 10.4 456.7 83.9 25.7 115.1 40.4 52.3 256.7 48.3 43.7 32.3 2.8 1.Maximum operating depth 39 MOD table in feet Maximum Operating Depth (MOD) in feet of sea water for ppO2 1.2 390.0 18.1 18.3 21.6 16.0 17.5 25.1 33.8 56.6 106.7 49.0 28.4 26.0 190.5 1617 792 517 379 297 242 202 173 150 132 117 104 95 1.0 8.5 5.4 30.0 (bar) 8.4 76.0 13.5 7.3 206.7 14.0 7.7 14.0 26.0 90.1 3.0 8.7 1.6 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 1.5 45.2 to 1.5 31.3 38.4 3.2 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.7 223.6 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) 1.0 11.5 6.6 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 1.6 4.1 25.
3 0. NC: Divers Alert Network. all gases that can be breathed have a narcotic effect. Retrieved 2008-06-24. . and can occur during shallow dives. the effects may become hazardous as the diver is increasingly impaired. rubicon-foundation. but usually does not become noticeable until greater depths.455. M. Nitrogen narcosis Inert gas narcosis [Nitrogen narcosis] Classification and external resources Divers breathe a mixture of oxygen.7 2. helium and nitrogen for deep dives to avoid the effects of narcosis. Apart from helium. Although divers can learn to cope with the effects. While narcosis affects all divers. As depth increases. Durham. p. A cylinder label shows the maximum operating depth and mixture (oxygen/helium).0 25. is a reversible alteration in consciousness that occurs while scuba diving at depth.A.6 1. Martini effect).Maximum operating depth 40 References  Lang. DiseasesDB MeSH 30088   C21. and their relative narcotic potentcies  Gas Ne H2 N2 O2 Ar Kr CO2 Xe Relative narcotic potency 0. The Greek word ναρκωσις (narcosis) is derived from narke. and probably neon. a term used by Homer and Hippocrates.1 20. (2001). as susceptibility varies widely from dive to dive and amongst individuals. Narcosis produces a state similar to alcohol intoxication or nitrous oxide inhalation.6 Narcosis while diving (also known as nitrogen narcosis. beyond 30 meters (100 ft).613.0 1.3 7. "temporary decline or loss of senses and movement. which is greater as the lipid solubility of the gas increases. DAN Nitrox Workshop Proceedings (http:/ / archive. raptures of the deep. inert gas narcosis. it is not possible to develop a tolerance. 197. predicting the depth at which narcosis will affect a diver is difficult.571 Some components of breathing gases. numbness". . org/ 4855).
depending on the individual diver and the diver's medical or personal history. multi-tasking and coordination. Other effects include vertigo. These effects are essentially identical to various concentrations of nitrous oxide. This is a very rough guide. or for standard diving safety guides. or paranoia. specialist training is required in the use of various gas mixtures such as trimix or heliox. as well as nitrogen. but their effect on psychomotor function (processes affecting the coordination of sensory or cognitive processes and motor activity) varies widely. and impaired judgement. krypton. but it has been successfully used for surgical operations. and xenon anesthesia systems are still being proposed and designed. Diving beyond 40 m (130 ft) is considered outside the scope of recreational diving: as narcosis and oxygen toxicity become critical factors. The noble gases. the diver may feel overconfident. Such effects are not harmful unless they cause some immediate danger not to be recognized and addressed. 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. disregarding normal safe diving practices.a feeling of tranquility and mastery of the environment. Reported signs and symptoms are summarized against typical depths in meters and feet of sea water in the following table: . giddiness. the onset of narcosis may be hard to recognize. oxygen and hydrogen cause a decrement in mental function. narcosis results in relief of anxiety . The effects of carbon dioxide consistently result in a decrease of both mental and psychomotor function. and xenon are more narcotic than nitrogen at a given pressure. For this reason. only worsening if the diver ventures deeper. making it difficult to read multiple gauges The most dangerous aspects of narcosis are the loss of decision-making ability and focus. When more serious. and not a substitute for an individual diver's known susceptibility. 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. The syndrome may cause exhilaration.  At its most benign. The noble gases argon. 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. the effects generally remain the same at a given depth. Once stabilized. depression.Nitrogen narcosis The condition is completely reversed by ascending to a shallower depth with no long-term effects. except helium and probably neon. and visual or auditory disturbances. Professional divers use such a calculation only as a rough guide to give new divers a metaphor. and xenon has so much anesthetic activity that it is actually a usable anesthetic at 80% concentration and normal atmospheric pressure. Xenon has historically been too expensive to be used very much in practice. Narcosis can produce tunnel vision. They also resemble (though not as closely) the effects of alcohol and the familiar benzodiazepine drugs such as diazepam and alprazolam. comparing a situation they may be more familiar with. extreme anxiety. The relation of depth to narcosis is sometimes informally known as "Martini's law".
Delayed response to visual and auditory stimuli. increased excitability. Hallucinations. instructions and other stimuli. or no symptoms at all. the Guinness Book of World Records no longer reports on this figure. 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. . Increased intensity of vision and hearing. confusion. Anxiety (common in cold murky water). a sense of levitation. Severe delay in response to signals. Mild euphoria possible. Modern theories have suggested that inert gases dissolving in the lipid bilayer of cell membranes cause narcosis. Sense of impending blackout. Sleepiness. Calculation errors and wrong choices. impaired judgment. hysteria (in chamber). loss of memory. Mildly impaired reasoning. Most sport scuba training organizations recommend depths of no more than 40 m (130 ft) because of risk of narcosis. but the changes are not usually noticeable. 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. Over-confidence and sense of well-being.  Rapid compression potentiates narcosis.  Significant impairment due to narcosis is an increasing risk below depths of about 30 m (100 ft). Terror in some. and unconsciousness. owing to carbon dioxide retention. 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.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. Laughter and loquacity (in chambers) which may be overcome by self control. Unconsciousness. or the severity of the effect on an individual diver. For any given depth. Uncontrolled laughter. Stupefaction with some decrease in dexterity and judgment. Poor concentration and mental confusion. Occasional dizziness. dizziness. euphoria. researchers have been looking at neurotransmitter receptor protein mechanisms as a possible cause of the narcosis. changes in facial appearance. More recently. corresponding to an ambient pressure of about 4 bar (400 kPa).  A divers' cognition may be affected on dives as shallow as 10 m (33 ft). as a result of the elevated pressures at depth (Henry's law).  A number of divers have died in attempts to set air depth records below 120 m (400 ft). known as the ambient pressure. However there is no reliable method to predict the depth at which narcosis becomes noticeable. Mild impairment of performance of unpracticed tasks. Reasoning and immediate memory affected more than motor coordination. Hallucinations. as the effect may vary from dive to dive (even on the same day). disorganization of the sense of time. Loss of memory. Because of these incidents. manic or depressive states. The breathing gas mix entering the diver's lungs will have the same pressure as the surrounding water. Idea fixation. Death.
krypton and hydrogen cause very similar effects at higher than atmospheric pressure. but it appears to be the direct effect of gas dissolving into nerve membranes and causing temporary disruption in nerve transmissions. add to narcosis. While the effect was first observed with air. the less partial pressure is needed. shallow or skip breathing. the increase of gas dissolved in nerve cell membranes may cause altered ion permeability properties of the neural cells' lipid bilayers. 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. and carbon dioxide retention all increase the risk and severity of narcosis. 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.  Carbon dioxide has a high narcotic potential and also causes increased blood flood to the brain. or because of poor gas exchange in the lungs. typical of a cell reproduction by the very chemically inactive gas argon makes them membrane. other gases including argon. Alleviation of the effects upon ascending to a shallower depth will confirm the diagnosis. the basic and most general underlying idea. In the rare event of misdiagnosis when another condition is causing the symptoms.   More recently. Increased risk of narcosis results from increasing the amount of carbon dioxide retained through heavy exercise. Narcosis is known to be additive to even minimal alcohol intoxication. its effects depend on many factors. causing direct mechanical interference with the transmission of signals from one nerve cell to another. increasing the effects of other gases. Some of these effects may be due to antagonism at NMDA receptors and potentiation of GABAA receptors. the Meyer-Overton hypothesis suggested that narcosis happens when the gas penetrates the lipids of the brain's nerve cells. An early theory.  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). Thermal cold. similar to the mechanism of nonpolar anesthetics such diethyl ether or ethylene. specific types of chemically-gated receptors in nerve cells have been identified as being involved with anesthesia and narcosis. 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.  Diagnosis and management The symptoms described may be caused by other factors during a dive: ear problems causing disorientation or nausea. remains largely unchallenged. However. other likely conditions do not produce reversible effects. have suggested non-chemical binding due to the attractive van der Waals force between proteins and inert gases. the effects then disappear within minutes. with variations between individuals. such as opiate narcotics and benzodiazepines. In the event of complications or other conditions being present. Similar to the mechanism of ethanol's effect. Given the setting. Other sedative and analgesic drugs. ascending is always the correct initial response. However. The management of narcosis is simply to ascend to shallower depths. the initial management—ascending closer to the surface—is still essential. Nevertheless the presence of any of these symptoms should imply narcosis. 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. stress. heavy work. their Illustration of a lipid bilayer. Trudell et al. early signs of oxygen toxicity causing visual disturbances. 43 Mechanism The precise mechanism is not well understood. .Nitrogen narcosis Narcosis has been compared with altitude sickness insofar as its variability (though not its symptoms). fatigue. or hypothermia causing rapid breathing and shivering.
 Standard tables. a diver keeping to shallower depths can avoid serious narcosis.  The use of these gases forms part of technical diving and requires further training and certification. one diver may have trouble with eye focus (close accommodation for middle-aged divers). The National Oceanic and Atmospheric Administration (NOAA) Diving Manual now states that both oxygen and nitrogen should be considered equally narcotic. and that the sound which their exhaled bubbles make becomes different. While the individual diver cannot predict exactly at what depth the onset of narcosis will occur on a given day. for example. Argon. and at these depths narcosis does not present a large risk.28 times that pressure. Equivalent narcotic depth (END) is a commonly used way of expressing the narcotic effect of different breathing gases. then it is necessary to abort the dive. For example. and this training should include a discussion of narcosis. Further training is normally required for certification up to 30 m (100 ft) on air. 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. 44 Prevention The most straightforward way to avoid nitrogen narcosis is for a diver to limit the depth of dives. with careful supervision and logging of reactions. Although severe narcosis may interfere with the judgment necessary to take preventive action. the effects disappear almost immediately upon ascending to a shallower depth. a diver who remains calm and is alert to the danger will be capable of resolving these problems at an earlier stage. and strongly encourage helium. and is not suitable as a breathing gas for diving (it is used as a drysuit inflation gas. and another feelings of claustrophobia.33 times the narcotic effect of nitrogen. 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.  Scuba organizations which train for diving beyond Narcosis while deep diving is prevented by filling recreational depths. 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. Some gases have other dangerous effects when breathed at pressure. The decompression schedule can still be followed unless other conditions require emergency assistance. If narcosis does occur. so in principle it should be usable at nearly four times the depth. Specialist training may help divers in identifying these personal onset signs. and these may then be used as a signal to ascend to shallower depths. another may experience feelings of euphoria. Although helium is the . For example. owing to its low thermal conductivity). may forbid diving with gases that cause too dive cylinders with a gas mixture containing much narcosis at depth in the average diver. and cure. often consisting of further theory and some practice in deep dives with close supervision. which are somewhat more repeatable than for the average group of divers. Some divers report that they have hearing changes. Since narcosis becomes more severe as depth increases. list conversion factors for narcotic effect of other gases. Helium is stored in brown cylinders. Some diver training agencies offer specialty training to prepare recreational divers to go to depths of 40 m (130 ft). based on relative lipid solubilities. high-pressure oxygen can lead to oxygen toxicity.Nitrogen narcosis Should problems remain. its effects. Deep dives should be made only after a gradual training to gradually test the individual diver's sensitivity to increasing depths. the first symptoms of narcosis for any given diver are often more predictable and personal. has 2. however. Most recreational dive schools will only certify basic divers to depths of 18 m (60 ft). neon at a given pressure has a narcotic effect equivalent to nitrogen at 0.
at greater depths it can cause high pressure nervous syndrome. divers should avoid sedating medications and drugs. the underlying behavioral effects remain.   These effects are particularly dangerous because a diver may feel they are not experiencing narcosis. Except for occasional amnesia of events at depth. in some persons. Meyer in 1899. entitled Zur Theorie der Alkoholnarkose. the risks of decompression sickness and oxygen toxicity. Junod was the first to describe symptoms of narcosis in 1834. symptoms of intoxication are present. makes nitrogen narcosis more likely. imagination is lively. it is likely to be longer than for alcohol. 45 Prognosis and epidemiology Narcosis is potentially one of the most dangerous conditions to affect the scuba diver below about 30 m (100 ft). 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. . as the result of illogical behavior in a dangerous environment. and other factors are also important. Two years later a similar theory was published independently by Charles Ernest Overton. Tests have shown that all divers are affected by nitrogen narcosis. even for repeated. such as marijuana and alcohol before any dive. Because of similar and additive effects. A hangover."  Junod suggested that narcosis resulted from pressure causing increased blood flow and hence stimulating nerve centers. cost. a prominent Victorian physician. Walter Moxon (1836–1886).Nitrogen narcosis least intoxicating of the breathing gases. chronic or acute exposure. a still-mysterious but apparently unrelated phenomenon. though some are less affected than others. Inert gas narcosis is only one factor which influences the choice of gas mixture. What became known as the Meyer-Overton Hypothesis is illustrated in the diagram to the right. noting "the functions of the brain are activated. and longer for other drugs. combined with the reduced physical capacity that goes with it. yet still be affected by it. Even though it is possible that some divers can manage better than others because of learning to cope with the subjective impairment. History French researcher Victor T. but due to the much longer half-life of the active agent of this drug in the body. Experts recommend total abstinence from alcohol at least 12 hours before diving. Abstinence time needed for marijuana is unknown. hypothesized in 1881 that pressure forced blood to inaccessible parts of the body and the stagnant blood then resulted in emotional changes.  Nevertheless. the severity of narcosis is unpredictable and it can be fatal while diving. thoughts have a peculiar charm and. the effects of narcosis are entirely reversible by ascending and therefore pose no problem in themselves.
and carbon dioxide in compressed-air narcosis" (http:/ / archive. PMID 734806. Liu. p. diseasesdatabase. Retrieved 2009-08-07.  Lippmann & Mitchell 2005. RH. Fagraeus.  Lippmann. Retrieved 2008-12-23.S. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society. Further research into the possible mechanisms of narcosis by anesthetic action led to the "minimum alveolar concentration" concept in 1965. org/ 3976). Retrieved 2008-12-23. Mitchell. Yarborough demonstrated that gases other than nitrogen also could cause narcosis. Australia: J. rubicon-foundation. Inc) 5 (4): 391–400. . ISBN 1878663011. Balon N (2006). . et al. ISSN 0093-5387.  Brubakk & Neuman 2003. Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society. 613. com/ history. p. "Recent neurochemical basis of inert gas narcosis and pressure effects" (http:/ / archive. . . htm  http:/ / www. html).  Brubakk & Neuman 2003. International Anesthesia Research Society. William (1975).Philippines. p. U. This measures the relative concentration of different gases required to prevent motor response in 50% of subjects in response to stimulus. revision 6. Jean Claude (2003). Bennett and Elliott's physiology and medicine of diving (5th ed.  Brubakk & Neuman 2003. RW. org/ 4496). com/ xenon-anaesthesia. . Inc) 30 (4): 293–303. . U. ISBN 097522901X. rubicon-foundation. Encyclopedia of Recreational Diving (3rd ed. 301  U. rubicon-foundation. 305  Hesser. "Nitrogen narcosis". 2000). For an inert gas the narcotic potency was found to be proportional to its lipid solubility. Inc 35 (3): 175–84. Retrieved 2008-12-23. Kizer. Konsolaki. p. Publications. "Inert Gas Narcosis". 29th Undersea and Hyperbaric Medical Society Workshop (Bethesda. Jacques-Yves Cousteau in 1953 famously described it as "l’ivresse des grandes profondeurs" or the "rapture of the deep".). Victoria. rubicon-foundation. 455. As hydrogen has only 0. Adolfson. Journal of the South Pacific Underwater Medicine Society (first published at Oceans 2000 Conference) 5 (2). deep diving experiments using hydrox were conducted by Arne Zetterström between 1943 and 1945. full). (Value for Krypton from 4th Edition.  PSAI Philippines. Naval Sea Systems Command. 571  Bennett. following research by Christian J. Behnke and O. . 46 Footnotes  http:/ / www. Retrieved 2008-10-31. nlm. and shows similar results for anesthetic potency as the measurements of lipid solubility. EM. nih. United States: Professional Association of Diving Instructors. VN (November–December 1999).1017/S0022172400012432. Rostain. Navy Diving Manual (http:/ / supsalv. Alf O. Anesteziol Reanimatol (6): 56–60. com/ ddb30088. PMC 2199778. anesthesiaanalgesia.  Askitopoulou. p. Analgesia and Anesthesia. Deeper into Diving (2nd ed. United States: Saunders Ltd. Report of a Committee Appointed by the British Admiralty. ISBN 0702025712.  Case. D. Retrieved June 9. L. doi:10. p. David. 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EI (1998). In Brubakk. SAA and other European training agencies teach recreational diving to a depth limit of 50 m (160 ft). Heslegrave. PMID 1417647.. Laliberté. Retrieved 2009-07-29. Tipton. OCLC 51607923. asp?section=2595& sectionTitle=DOC+ presentation+ summaries& preview=1). Carl F (1948).  Brubakk & Neuman 2003. . Bennett and Elliott's physiology and medicine of diving (5th ed. "A molecular description of how noble gases and nitrogen bind to a model site of anesthetic action" (http:/ / www.3. Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society 12 (4): 369–402. In Brubakk. Lieb. Retrieved 2008-12-01. Jean Claude (2003). org/ 2720). Otto I (2003). Bennett and Elliott's physiology and medicine of diving (5th ed. org/ 3019). Huestis. KN.58. org/ cgi/ content/ full/ 58/ 10/ 909). 234.2. Diving for Science and Technology. rubicon-foundation. pp.). Haseneder.10. 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Hajo. it is appropriate to include the oxygen in the END calculation when using trimixes (Lambersten et al. OCLC 51607923. PMID 11576028.). Nature 367 (6464): 607–14. Patsalis. OCLC 26915585. Journal of Forensic Sciences 32 (4): 1095–7.1001/archpsyc. 9th Undersea and Hyperbaric Medical Society Workshop (Bethesda. org/ 3050). p. Undersea Biomedical Research 13 (3): 345–54.). ISBN 0702025712. com/ index. ws/ exotic_gases.1038/367607a0.  Hamilton. Eiken. Seymour S. org/ cgi/ content/ full/ 91/ 6/ 1542). Amanda J. ISBN 0702025712. "Diving Officer's Conference presentations" (http:/ / www. . org/ 4498).e. Neuman. K.. Hamilton. Retrieved 2008-12-23.  Mekjavic.  Lippmann & Mitchell 2005.  Lippmann & Mitchell 2005. Peter. Tom S. A (1987).  A number of technical diving agencies. Koblin.1. Hudson. ama-assn. DD. United States: Saunders Ltd. PSCR & SCR Rebreather Diver Programs (Recreational Trimix Diver)" (http:/ / www. National Oceanic and Atmospheric Administration. MF. Gruber. 106  U. 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"Development of Decompression Procedures for Depths in Excess of 400 feet" (http:/ / archive. 2009. Marilyn A. MF. p. regardless of the proportions of oxygen and nitrogen. iantd. 4th. Alf O. rubicon-foundation.  Hamilton Jr. NOAA Diving Manual. Marguerite (2008). 430–1  St Leger Dowse. 323–57." (http:/ / archive.  Pope.1172/JCI101995. Retrieved 2009-07-29. Igor B. rubicon-foundation. Inc. Anesthesia and Analgesia 91 (6): 1542–9. "Otorhinolaryngological aspects of diving". . Ola (2003). NP. pp. E. B. 129. Retrieved 2009-07-29. anesthesia-analgesia. ISSN 0021-9738.  Franks. "[16. Eberhard (December 2000). PMID 11094015. Fowler. Anesthesia and Analgesia 87 (2): 411–8. org/ cgi/ content/ abstract/ 87/ 2/ 411). vol. Alf O. PMID 9706942. PMID 3307084. doi:10. p. Alf O. ISSN 1066-2936. Archives of General Psychiatry (American Medical Association) 58 (10): 909–15. "Neuropsychological performance in long-term cannabis users" (http:/ / archpsyc. p..  BSAC. Rostain. 47 . 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1136/bmj. Victor T (1834). • Campbell. pp.html). "Effect of brief. 266. (2009-02-01). Retrieved 2009-03-22. "Croonian lectures on the influence of the circulation on the nervous system" (http:/ / www. WH. "Studien Über Die Narkose" (in German).  Lambertsen. Retrieved 2009-08-25. "Hydrogen-Oxygen (Hydrox) breathing at 1. Retrieved 2009-07-29.491. "Respiratory resistance. JM (1978). com/ smpp/ content~content=a789031692~db=all).  Eger. ISSN 0347-7665. LJ. . PMID 20749857. Jacques-Yves. Retrieved 2009-07-29. OCLC 2068005. Christian J. . Ernest S.deep-six. Ernest S. p. edu/ uhmsupiemr. . Frédéric (1953).Nitrogen narcosis ISSN 0093-5387. Gelfand. Retrieved 2009-03-22.1097/00000542-196511000-00010.com/page74. Clark. (2009-05-03). com/ ?id=K5XREXyDSQoC). html). ISSN 0093-5387. H (1984).rubicon-foundation.htm). Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society 16 (3): 227–32. . (2009-06-25). Walter (1881). Anesthesiology 26 (6): 756–63. Allgemeiner Pharmakologie (Institut für Pharmakologie).  Behnke. ScubaDoc's overview of alcohol and diving. G (1989). OD (1939). AR. 1978" (http:/ / archives. George D.ddrc.  Ornhagen. Retrieved 2009-08-25.uhms. Dumas. Revue médicale française et étrangère: journal des progrès de la médecine hippocratique (Chez Gabon et compagnie): 350–368. duke.1057.htm). ScubaDoc's overview of marijuana and diving. "Alcohol and Diving" (http://scuba-doc.  Brubakk & Neuman 2003. Retrieved 2009-06-04. Moeller. 300  Junod. British Medical Journal 1: 491–7. • Campbell. American Journal of Physiology (126): 409–15. mc. 306  Moxon. The Silent World: A Story of Undersea Discovery and Adventure.1. "Recherches physiologiques et thérapeutiques sur les effets de la compression et de la raréfaction de l'air" (http:/ / books. PMID 4082343.  Overton. Saidman.  Cousteau. • Diving Diseases Research Centre (DDRC) (http://www.com/marij. Brandstater. doi:10. publications about nitrogen narcosis. Institute for Environmental Medicine.  Rogers.org/) UK charity dedicated to treatment of diving diseases. Harper & Brothers Publishers.  Brubakk & Neuman 2003. google. R. • Rubicon Research Repository (http://archive.3 MPa". Diving with Deep-Six. B (1965).org/) Searchable repository of Diving and Environmental Physiology Research.com/alch. . informaworld. Retrieved 2009-08-25. 48 References External links • Undersea and Hyperbaric Medical Society (http://www. repeated hyperbaric exposures on susceptibility to nitrogen narcosis" (http:/ / archive. "Diving While Using Marijuana" (http://scuba-doc. EI. 583–5. oil-water solubility and mental effects of argon compared with helium and nitrogen". org/ 2522). . ISBN 0792267966. PMID 2741255. • Campbell. "Nitrogen Narcosis" (http://www. rubicon-foundation. OCLC 2068005. University of Pennsylvania. PMID 5844267. "University of Pennsylvania Institute for Environmental Medicine report.org) Scientific body. Yarborough. "Minimum alveolar anesthetic concentration: a standard of anesthetic potency". p. FOA Rapport C58015-H1 (Stockholm: National Defence Research Institute). doi:10. Charles Ernest (1901).
divers tend not to utilize nitrox at greater depths where more pronounced narcosis symptoms are more likely to occur. particularly in older and or obese divers. In 2008. would be necessary to fully investigate this issue. For a reduction in narcotic effects trimix or heliox. gases which also contain helium. are generally used by divers. and/or reducing the risk of decompression sickness (also known as the bends). and also different levels of exertion.   However. it increases the risk of oxygen toxicity and fire. there is much better scientific evidence that breathing high-oxygen gases . nitrox with an oxygen content above 21%. Breathing nitrox is not thought to reduce the effects of narcosis.  There was. showing adjusted no-decompression times. there are people in the diving community who insist that they feel reduced narcotic effects at depths breathing nitrox. Enriched Air Nitrox diving tables. some suggestion that post dive fatigue is due to sub-clinical decompression sickness (DCS) (i. thus one should not expect a reduction in narcotic effects due only to the use of nitrox. or allows extended dive times without increasing the need for decompression stops for the same risk. Purpose Enriched Air Nitrox. a study was published using wet divers at the same depth and confirmed that no statistically significant reduction in reported fatigue is seen. The most common use of nitrox mixtures containing higher than normal levels of oxygen is in scuba. Reducing the proportion of nitrogen by increasing the proportion of oxygen reduces the risk of decompression sickness for the same dive profile. in scuba diving. however a double-blind study to test this found no statistically significant reduction in reported fatigue. it should be noted that because of risks associated with oxygen toxicity. although its use can reduce the risk of decompression sickness. as oxygen seems to have equally narcotic properties under pressure as nitrogen. nitrox is normally Typical Nitrox cylinder marking differentiated and handled differently from air. this includes normal air which is approximately 78% nitrogen. primarily argon. however. micro bubbles in the blood insufficient to cause symptoms of DCS). which are further discussed below.e.Nitrox 49 Nitrox Nitrox refers to any gas mixture composed (excluding trace gases) of nitrogen and oxygen. For example. 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.   Nonetheless. There is anecdotal evidence that the use of nitrox reduces post-dive fatigue. Further studies with a number of different dive profiles. 21% oxygen. Nitrox is not a safer gas than compressed air in all respects. and 1% other gases. is mainly used in scuba diving to reduce the proportion of nitrogen in the breathing gas mixture. However. where the reduced percentage of nitrogen is advantageous in reducing nitrogen uptake in the body's tissues and so extending the possible dive time. This may be due to a dissociation of the subjective and behavioural effects of narcosis.
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).
S. 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.5% oxygen should be treated as nitrox (which is to say. However. any gas which contains a significantly larger percentage of oxygen than air is a fire hazard. Furthermore. Dr. a number of organisations took the opportunity to present nitrox workshops outside the show. even if a recognized fire does not happen.S. who was the first director of the National Oceanographic and Atmospheric Administration (NOAA) Diving Center. Some of the controversy comes from a single U. Texas that year) banned nitrox training providers from the show. so that it is pressurized as nitrox for the first time in the diving cylinder. Compressed Gas Association (CGA) and two international nitrox teaching agencies (IANTD and ANDI) now support the standard that any gas containing more than 23.   Most nitrox fill stations which supply pre-mixed nitrox will fill non-oxygen clean cylinders with mixtures below 40%.e. In 1992 BSAC banned its members from using nitrox. and met with heavy skepticism by the diving community. 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. Morgan Wells. in the USN Diving Manual.PADI . For a history of this controversy see Luxfer cylinders  .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). A few facilities have begun to fill cylinders with air which has been enriched with oxygen by a pre-mixing process. History In the 1920s or 1930s Draeger of Germany made a nitrox backpack independent air supply for a standard diving suit. no differently from pure oxygen) for purposes of oxygen cleanliness and oxygen compatibility (i. In 1970. oxygen "servicability"). For many years Dr. the U. such gases can also react with hydrocarbons or incorrect lubricants inside a dive cylinder to produce carbon monoxide. In 1991. regulation intended for commercial divers (not recreational divers) years ago. in a watershed moment. formed IAND (International Association of Nitrox Divers) and began teaching nitrox use for recreational diving.. Wells' invention was the only practical alternative to partial pressure blending. In World War II or soon after. 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. a former NOAA diving safety officer. This was considered dangerous by some. the largest training agency . the annual DEMA show (held in Houston. However. Partial blending using pure oxygen is often used to provide nitrox for multiple dives on live-aboard dive boats. However. began instituting diving procedures for oxygen-enriched air.  In 1985 Dick Rutkowski. This created a backlash. In the 1950s the United States Navy (USN) documented enriched oxygen gas procedures for military use of what we today call nitrox. nitrox which is mixed before being put into the cylinder) below 40% oxygen does not require a specially cleaned cylinder or other equipment. In 1979 NOAA published Wells' procedures for the scientific use of nitrox in the NOAA Diving Manual. . He also developed a process for mixing oxygen and air which he called a continuous blending system. These developments were kept secret until independently duplicated by civilians in the 1960s. 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.e. At present. and when DEMA relented.is still teaching that pre-mixed nitrox (i. but it is also used in some smaller diver shops.
published a three part series arguing that nitrox was unsafe for sport divers.  "How does nitrox make you feel?" (http:/ / www. Meanwhile. Against this trend. Tom S (2003). CM." 54 Nitrox in nature Sometimes in the geologic past the Earth's atmosphere contained much more than 20% oxygen: e. (2001).  References  Brubakk. Helium is considered to have very little narcotic effect.. 304. ISBN 0702025712. Retrieved 2009-05-21. 800. Williams DJ (2003). PMID 7742709. Undersea Biomedical Research (Bethesda.  Chapman SD. ." (http:/ / archive. Adolfson. the leading recreational diving publication at the time. Plato PA. Bennett and Elliott's physiology and medicine of diving. oxygen. which does not happen with gases with have greater narcotic qualities. S.  Brubakk. PMID 14756231. . org/ 2199). and carbon dioxide in compressed-air narcosis. United States: Saunders Ltd. "Dissociation of the behavioral and subjective components of nitrogen narcosis and diver adaptation" (http:/ / archive.. org/ 8005. rubicon-foundation. DAN Nitrox Workshop Proceedings (http:/ / archive. up to 35% in the Upper Carboniferous. html). it was PADI's endorsement that put nitrox over the top as a standard sport diving "option. p. org/ 3975).Nitrox In 1992 the name was changed to the International Association of Nitrox and Technical Divers (IANTD). pp. It is clear that different gases result in different narcotic effects at depth.which invented the term "Safe Air" for marketing purposes ..  Harris RJ. Bennett and Elliott's physiology and medicine of diving. org/ 2810).A. In 1993 Skin Diver magazine.and Bret Gilliam's Technical Diving International (TDI) gave scientific credence to nitrox. Md: Undersea and Hyperbaric Medical Society) 5 (4): 391–400. O. ISBN 0702025712. Measurement of Fatigue following 18 msw Open Water Dives Breathing Air or EAN36.7 times more narcotic than nitrogen . pp. htm) .. the Professional Association of Diving Instructors (PADI) announced full educational support for nitrox. In 1996. but instead of cheap or free tank fills with compressed air. diving stores were finding a purely economic reason to offer nitrox: not only was an entire new course and certification needed to use it. eds. United States: Saunders Ltd. rubicon-foundation.. org/ 4855). M. in 1992 NAUI became the first existing major sport diver training agency to sanction nitrox. New organizations. Pollock NW. "Roles of nitrogen. the incentive for the sport diver to use the gas increased. Neuman. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society) 30 (4): 285–91. While other main line scuba organizations had announced their support of nitrox earlier. In: Brueggeman P. T.  Joiner.g. J (1978). In the early 1990s. Retrieved 2008-05-02. rubicon-foundation. In 1993 Dive Rite manufactured the first nitrox compatible dive computer. J. ISBN 0941332705. Alf O. called the Bridge. 660. T. com/ forums/ basic-scuba-discussions/ poll-1630-a. . 5th Rev ed. Proceedings of the American Academy of Underwater Sciences 27th Symposium. Laliberté MF. Retrieved 2008-05-02. L. An intersection of economics and scientific validity had occurred. dive shops found they could charge premium amounts of money for custom-gas blending of nitrox to their ordinary moderately experienced divers. NOAA Diving Manual: Diving for Science and Technology. the T being added when the European Association of Technical Divers (EATD) merged with IAND. http:/ / archive.  Ergogenic Aids (http:/ / www.  Hamilton K. but results in HPNS when breathed at high pressures. ISSN 0093-5387. A. (2001). rubicon-foundation. Retrieved 2009-01-27. including Ed Betts' American Nitrox Divers International (ANDI) . PMID 734806.  Hesser.see relevant narcotic potency of gases  Although oxygen appears chemically more narcotic at the surface. co. relative narcotic effects at depth have never been studied in detail. OCLC 2068005. Fagraeus. the agencies teaching nitrox were not the main scuba agencies. This let animals absorb oxygen more easily and influenced evolution. United States: Best Publishing. scubaboard. Fourth Edition. Fowler B (March 1995). NC: Divers Alert Network. Diving for Science 2008. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society) 22 (1): 41–9. 197. rubicon-foundation. Wilkinson DC. 2007. . pponline. Retrieved 2008-04-08. ScubaBoard. Neuman (2003). With the new dive computers which could be programmed to allow for the longer bottom-times and shorter residual nitrogen times which nitrox gave. 5th Rev ed. Doolette DJ. Durham. pp. Retrieved 2009-05-21.  Lang. "Measurement of fatigue following 18 msw dry chamber dives breathing air or enriched air nitrox" (http:/ / archive. uk/ encyc/ 1008.  Oxygen has the potential to be 1. .
shtml  US Navy Diving Manual. org/ 9033). (1992). OCLC 16986801. 40(5) May: 35-36. 55 Footnotes External links • Nitrox .gasdiving. JA (1961). published on WWW 24 March 1998. ISSN 0813-1988. Retrieved 2008-04-24. Retrieved 2008-05-02. Stephen R (2003). "Nitrox" (http:/ / archive. at pages 9-11  Allen. TX 78712. org/ 2835). . rubicon-foundation.  Berghage Thomas E. James M. Shoffstall MS.shtml) • Online Nitrox calculator for EAD. org/ 6309). org/ 6275). . andihq. Retrieved 2008-06-05. South Pacific Underwater Medicine Society Journal 26 (3). "Oxygen safety in the production of enriched air nitrox breathing mixtures. Republic of Panama Accepted 28 October 1997.). . Diver 1995. html  Rosales KR. Skin Diver would later go into bankruptcy. Undersea Biomedical Research 6 (4): 379–84. org/ 4861). LB. Austin.). org/ 00c3_publications. K (1996).BERNER AND D. rubicon-foundation.org/diving-nitrox. MOD and PPO2. rubicon-foundation.co. NC.L. ROBERT DUDLEY* Department of Zoology. United States: US Naval Sea Systems Command.  http:/ / www. rubicon-foundation. Australia: J. pp. Balboa. 2006. Robert W.uk/pages/misc/Nitrox. United States: Saunders. rubicon-foundation. org/ 3835).  http:/ / www. Retrieved 2008-05-01. PMID 538866. Nitrox Gas Blending Manual. com/nitrox_calc. AMERICAN JOURNAL OF SCIENCE 289. A NEW MODEL FOR ATMOSPHERIC OXYGEN OVER PHANEROZOIC TIME." (http:/ / archive. McCraken TM (December 1979). Publications. C (1996).E. United States Navy Experimental Diving Unit Technical Report NEDU-RR-01-61. Glen L. NASA Johnson Space Center Technical Report NASA/TM-2007-213740. OCLC 66524750. Stoltzfus JM (2007). warns if a critical limit is reached (http://www. Retrieved 2008-05-02. Alan W. OCLC 51607923.html) .  Butler. Retrieved 2011-01-11. ISBN 097522901X. Bennett and Elliott's physiology and medicine of diving (5th ed. .  Richardson. Hamilton Jr. 6th revision (http:/ / www. Deeper into Diving (2 ed. com/ support/ faq/ aluminumoxygen.  Logan. supsalv.  http:/ / www. rubicon-foundation." (http:/ / archive. com/ pages/ mainpage. University of Texas. John. OCLC 16986801.  A position which it would formally maintain until in 1995 magazine editor Bill Gleason was reported to say that nitrox was "all right". Retrieved 2008-05-02. 375. org/ 6310). Retrieved 2008-05-01. D and Shreeves. . Thom. In Brubakk. (American Academy of Underwater Sciences).  ATMOSPHERIC OXYGEN. Alf O. PO Box 2072.  Clark. luxfercylinders. "BSAC gives the OK to nitrox. Held September 24-27. Tom S. p. GIANT PALEOZOIC INSECTS AND THE EVOLUTION OF AERIAL LOCOMOTOR PERFORMANCE. . Simon J (October 2005). (ed. .A. pp.com/support/faq/ aluminumoxygen.luxfercylinders. ISSN 0813-1988. Mastro. USA and Smithsonian Tropical Research Institute.333-361.) Proceedings of the American Academy of Underwater Sciences Twelfth Annual Scientific Diving Symposium "Diving for Science 1992"." (http:/ / archive. South Pacific Underwater Medicine Society Journal 26 (3). 9). Mitchell. "Equivalent air depth: fact or fiction" (http:/ / archive. ISSN 0813-1988. 1992 at the University of North Carolina at Wilmington. Steven J. In: Cahoon. "28".  TDI.dive-hive. "Guide for Oxygen Compatibility Assessments on Oxygen Components and Systems. Hulbert.  Lippmann. "The PADI Enriched Air Diver course and DSAT oxygen exposure limits. rubicon-foundation. asp?destPage=00c3& pageID=3. ISBN 0702025712." (http:/ / archive.htm) • Useful Luxfer FAQ on the CGA and "40% rule" controversy (http://www.php?lang=en) • Diving Nitrox (http://dive-center. reprinted in South Pacific Underwater Medicine Society Journal 26 (3).frequently asked questions (http://www. Wilmington. OCLC 16986801.Nitrox  Elliott. Neuman.CANFIELD (1989. . americandivecenter. Victoria. htm  R. com/ nitrox/ preview_p03. D (1996). "Oxygen under pressure". 403–4. "An evaluation of the equivalent air depth theory" (http:/ / archive.
The US Food and Drug Administration has warned those suffering from problems such as heart or lung disease not to use oxygen bars. hyperbaric medicine. Scuba divers use breathing gases containing up to 100% oxygen. and seizures. and the pulmonary condition the Lorrain Smith effect. The result of breathing elevated concentrations of oxygen is hyperoxia. oxygen intoxication. a robust recovery from most types of oxygen toxicity is possible. Central nervous system toxicity is caused by short exposure to high concentrations of oxygen at greater than atmospheric pressure. The body is affected in different ways depending on the type of exposure. retinal detachment. breathing problems. Severe cases can result in cell damage and death. after the researchers who pioneered its discovery and description in the late 19th century. and vision changes such as myopia. oxygen has become available for recreational use in oxygen bars. The chamber is pressurised with air to 3. It is also known as oxygen toxicity syndrome.8 987. ICD-10 ICD-9 MeSH T59. Historically. with pulmonary and ocular damage being mainly confined to the problems of managing premature infants.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. Symptoms may include disorientation. those on high concentrations of supplemental oxygen (particularly premature babies). Oxygen toxicity is a concern for scuba divers. with effects most often seen in the central nervous system. These protocols have resulted in the increasing rarity of seizures due to oxygen toxicity. and oxygen poisoning. The  subject in the centre is breathing 100% oxygen from a mask. the collapse of the alveoli in the lungs. neonatal care and human spaceflight. Pulmonary and ocular toxicity result from longer exposure to elevated oxygen levels at normal pressure. and should have specific training in using such gases. an excess of oxygen in body tissues. In recent years. Protocols for avoidance of hyperoxia exist in fields where oxygen is breathed at higher-than-normal partial pressures. Oxygen toxicity is managed by reducing the exposure to elevated oxygen levels. the central nervous system condition was called the Paul Bert effect.7 bar. in the long term. and those undergoing hyperbaric oxygen therapy. including underwater diving using compressed breathing gases.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. . Studies show that.
occurring when breathing elevated pressures of oxygen for extended periods.  damage to liver (hepatic). brief periods of rigidity followed by convulsions and unconsciousness. • Ocular (retinopathic conditions). and thyroid).   or kidneys (renal). characterised by alterations to the eyes. It may also be implicated in red blood cell destruction (hemolysis). effects on other tissues may be observed: it is suspected that during spaceflight. Pulmonary oxygen toxicity results in damage to the lungs.3 bar (30 kPa). Hyperoxia can also indirectly cause carbon dioxide narcosis in patients with lung ailments such as chronic obstructive pulmonary disease or with central respiratory depression.21 bar (21 kPa) and the lower limit for toxicity is more than 0.  In unusual circumstances. endocrine glands (adrenal. but are also a concern during hyperbaric oxygen therapy. producing three principal forms:   • Central nervous system. particularly to newborn infants. occurring under hyperbaric conditions. gonads. . Pulmonary and ocular damage are most likely to occur when supplemental oxygen is administered as part of a treatment. and general damage to cells. Oxidative damage to the eye may lead to myopia or partial detachment of the retina. because breathing air at atmospheric pressure always has a partial pressure of oxygen (ppO2) of 0.Oxygen toxicity 57 Classification The effects of oxygen toxicity may be classified by the organs affected. • Pulmonary (lungs). characterised by convulsions followed by unconsciousness. heart (myocardial). occurring when breathing elevated pressures of oxygen for extended periods. Oxidative damage may occur in any cell in the body but the effects on the three most susceptible organs will be the primary concern. causing pain and difficulty in breathing. and is of concern to divers who encounter greater than atmospheric pressures. Oxygen toxicity is not associated with hyperventilation. Central nervous system oxygen toxicity can cause seizures. characterised by difficulty in breathing and pain within the chest. high oxygen concentrations may contribute to bone damage.
Nausea and confusion Dazed and lip-twitching. However. and exercise will decrease the time to onset of central nervous system symptoms. Dazed Nausea. severe spasmodic vomiting Severe lip-twitching.  The onset of seizure depends upon the partial pressure of oxygen (ppO2) in the breathing gas and exposure duration. both amongst individuals. Severe lip-twitching. fever. The seizure ends with a period of unconsciousness (the postictal state). followed by rapid spasms of alternate muscle relaxation and contraction producing convulsive jerking (clonic).   In addition. and increased blood flow to the lining of the nose (hyperemia of the nasal mucosa). arm twitch Severe lip-twitching. spasmodic respiration. lip-twitching.   This begins as a mild tickle on inhalation and progresses to frequent coughing. such as underwater immersion. amnesia Convulsed. etc. lip-twitching and syncope. fell asleep. ringing in the ears (tinnitus). many external factors. twitching (especially of the face). anxiety. This may be followed by a tonic–clonic seizure consisting of two phases: intense muscle contraction occurs for several seconds (tonic). such as darkness and caffeine.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. Drowsiness. exposure to cold. as well as significant variations between species. The symptoms appear in the upper chest region (substernal and carinal regions). Decrease of tolerance is closely linked to retention of carbon dioxide. epigastric aura. The radiological finding from the lungs shows inflammation and swelling (pulmonary edema). Vertigo and severe lip twitching.   Other factors.  Pulmonary function measurements are reduced. patients experience a mild burning on inhalation along with uncontrollable coughing and occasional shortness of breath (dyspnea). exposure time before onset is unpredictable. Convulsed Convulsed. twitch L arm. . If breathing elevated partial pressures of oxygen is not discontinued. increase tolerance in test animals. Nausea and vertigo.5 bar (50 kPa) is intermittent. epigastric aura. and dizziness. but these effects have not been proven in humans. Euphoria.  Tests in animals have indicated a variation in tolerance similar to that found in central nervous system toxicity. and in the same individual from day to day. confusion. irritability (personality changes. Physical findings related to pulmonary toxicity have included bubbling sounds heard through a stethoscope (bubbling rales). Inspiratory predominance. Dazzle. Blubbering of lips. as tests have shown a wide variation. 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. "Diaphragmatic spasm". it permits the lungs to recover and delays the onset of toxicity. paraesthesiae.  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). vertigo.). of Subjects 1 3 4 4 6 8 4 6 Symptoms Prolonged dazzle.) 96 60–69 50–55 31–35 21–30 16–20 11–15 6–10 Num. When the exposure to oxygen above 0. nausea. vertigo.
 Therefore. in addition to any oxygen exposure during the dive. (III) growth of new blood vessels occurs around the ridge. Experiments on rats show pulmonary manifestations of oxygen toxicity are not the same for normobaric conditions as they are for hyperbaric conditions. with some studies suggesting symptoms usually begin after approximately 14 hours at this level of oxygen. such as nitrox. typically nitrogen. (II) the demarcation becomes a ridge. signs of damage to the eye (retinopathy of prematurity. with evidence of diffuse alveolar damage and the onset of acute respiratory distress syndrome usually occurring after 48 hours on 100% oxygen. should they descend below the maximum depth allowed for the mixture. where ambient pressure is above normal. will prevent this effect. Central nervous system toxicity Exposures. Since atmospheric pressure is about 1 bar (100 kPa). Pulmonary toxicity occurs with exposure to concentrations of oxygen greater than 0.Oxygen toxicity 59 Ocular In premature babies. Signs of pulmonary toxicity begins with evidence of tracheobronchitis. Other groups at higher risk for oxygen toxicity are patients on mechanical ventilation with exposure to levels of oxygen greater than 50%.5 bar (50 kPa). as well as the remainder of the respiratory tract. or inflammation of the upper airways. Divers breathing a gas mixture enriched with oxygen. 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. . and patients exposed to chemicals that increase risk for oxygen toxicity such the chemotherapeutic agent bleomycin. after an asymptomatic period between 4 and 22 hours at greater than 95% oxygen. to partial pressures of oxygen above 1. Breathing 100% oxygen also eventually leads to collapse of the alveoli (atelectasis). Pulmonary toxicity The lungs. corresponding to an oxygen fraction of 50% at normal atmospheric pressure. central nervous system toxicity can only occur under hyperbaric conditions. or ROP) are observed via an ophthalmoscope as a demarcation between the vascularized and non-vascularised regions of an infant's retina. The degree of this demarcation is used to designate four stages: (I) the demarcation is a line. (IV) the retina begins to detach from the inner wall of the eye (choroid). the risk factors are markedly different. can similarly suffer a seizure at shallower depths. are exposed to the highest concentration of oxygen in the human body and are therefore the first organs to show toxicity. In each case. particularly to premature infants. This occurs in three principal settings: underwater diving.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. current guidelines for patients on mechanical ventilation in intensive care suggests keeping oxygen concentration less than 60%.  Divers breathing air at depths greater than 60 m (200 ft) face an increasing risk of an oxygen toxicity "hit" (seizure). Preterm newborns are known to be at higher risk for bronchopulmonary dysplasia with extended exposure to high concentrations of oxygen. Causes Oxygen toxicity is caused by exposure to oxygen at partial pressures greater than those to which the body is normally exposed. from minutes to a few hours. Likewise. 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. hyperbaric oxygen therapy and the provision of supplemental oxygen. 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. while—at the same partial pressure of oxygen—the presence of significant partial pressures of inert gases.
 One species produced by the body. levels of reactive oxygen species can increase dramatically.  Hyperoxia may be a contributing factor for the disorder called retrolental fibroplasia or retinopathy of prematurity (ROP) in infants. Higher than normal concentrations of oxygen lead to increased levels of reactive oxygen species. which can initiate a damaging chain reaction of lipid peroxidation in the unsaturated lipids within cell membranes. which harm DNA and other biomolecules. is not the main risk factor for development of this disease. a hyperoxic condition will rapidly spread.  While all the reaction mechanisms of these species within the body are not yet fully understood. 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.  Although the body has many antioxidant systems such as glutathione that guard against oxidative stress.Oxygen toxicity 60 Ocular toxicity Prolonged exposure to high inspired fractions of oxygen causes damage to the retina. and trioxidane. Hyperoxic myopia has occurred in closed circuit oxygen rebreather divers with prolonged exposures.  In preterm infants. Supplemental oxygen exposure.   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. peroxynitrite. and the rate of cell damage exceeds the capacity of the systems that prevent or repair it. and may raise the risk of hypoxia-related systemic complications. Retinopathy of prematurity occurs when the development of the retinal vasculature is arrested and then proceeds abnormally. High concentrations of oxygen also increase the formation of other free radicals. . is possibly involved in iron acquisition.  This is due to an increase in the refractive power of the lens. which are natural by-products of the normal metabolism of oxygen and have important roles in cell signalling.  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. When oxygen is breathed at high partial pressures. Oxygen is necessary for cell metabolism. these systems are eventually overwhelmed at very high concentrations of free oxygen. the superoxide anion (O2–). Restricting supplemental oxygen use does not necessarily reduce the rate of retinopathy of prematurity. such as nitric oxide.   Cell damage and cell death then result. which can damage cell structures and produce oxidative stress. the retina is often not fully vascularised. since axial length and keratometry readings do not reveal a corneal or length basis for a myopic shift.   It also occurs frequently in those undergoing repeated hyperbaric oxygen therapy. Associated with the growth of these new vessels is fibrous tissue (scar tissue) that may contract to cause retinal detachment. During times of environmental stress.  It is usually reversible with time. most vulnerable. one of the most reactive products of oxidative stress is the hydroxyl radical (·OH). while a risk factor. and the blood supplies it to all parts of the body.
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. by . if the infant's breathing does not improve during this time. 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. a seizure occurring in the setting of breathing oxygen at partial pressures greater than 1. while no hereditary factors have been shown to yield a pattern. However. 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. proper precautions can eliminate the most pernicious effects. Prematurity. 180 minutes at 1.  For the following partial pressures of oxygen the limit is: 45 minutes at 1. 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. As the ppO2 depends on the fraction of oxygen in the breathing gas and the depth of the dive. congestion and coldness. divers are taught to calculate a maximum operating depth for oxygen-rich breathing gases. Prevention The prevention of oxygen toxicity depends entirely on the setting. In addition. low birth weight and a history of oxygen exposure are the principal indicators.6 bar (160 kPa).4 bar (140 kPa).Oxygen toxicity 61 Diagnosis Diagnosis of central nervous system oxygen toxicity in divers prior to seizure is difficult as the symptoms of visual disturbance. 150 minutes at 1.5 bar (150 kPa). long dives and dives where oxygen-rich breathing gases are used. divers are taught to plan and monitor what is called the oxygen clock of their dives.  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. The effects are sudden convulsions and unconsciousness. these symptoms may be helpful in diagnosing the first stages of oxygen toxicity in patients undergoing hyperbaric oxygen therapy. but is impossible to predict with any reliability whether or when toxicity symptoms will occur.  Many Nitrox-capable dive computers calculate an oxygen loading and can track it across multiple dives. blood tests and x-rays may be used to confirm bronchopulmonary dysplasia. confusion and nausea can be due to many factors common to the underwater environment such as narcosis. In either case. This is a notional alarm clock. As there is an marked with a maximum operating depth of increased risk of central nervous system oxygen toxicity on deep dives. 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.3 bar (130 kPa) and 210 minutes at 1. unless there is a prior history of epilepsy or tests indicate hypoglycemia. Both underwater and in space. However. The diver may experience no warning symptoms. dizziness.2 bar (120 kPa). 120 minutes at 1. the diver obtains more time on the oxygen clock by diving at a shallower depth. The diagnosis of retinopathy of prematurity in infants is typically suggested by the clinical setting.4 bar (140 kPa) suggests a diagnosis of oxygen toxicity. and cylinders containing such mixtures must be clearly marked with that depth. 28 metres. Diagnosis of bronchopulmonary dysplasia in new-born infants with breathing difficulties is difficult in the first few weeks. ear problems. an echocardiogram can help to eliminate other possible causes such as congenital heart defects or pulmonary arterial hypertension.
Current guidelines require that all babies of less than 32 weeks gestational age or having a birth weight less than 1. very high percentage oxygen and lower than normal atmospheric pressure was used in early spacecraft. because the oxygen partial pressure is not allowed to chronically exceed 0. table 6 requires 75 minutes (three periods of 20 minutes oxygen/5 minutes air) at an ambient pressure of 2. U. One or two days of exposure without oxygen breaks are needed to cause such damage. before the pressure is reduced to atmospheric over 30 minutes on oxygen.N. In such applications as extra-vehicular activity.3 lb) should be screened for retinopathy of prematurity at least every two weeks. To balance the risks of hypoxia and retinopathy of prematurity.Oxygen toxicity breathing a less oxygen-rich gas.9 atm (190 kPa) over 30 minutes on oxygen. . which must operate at low pressure (also historically.8 standard atmospheres (280 kPa). reversible) complication for divers. Normobaric setting Bronchopulmonary dysplasia is reversible in the early stages by use of break periods on lower pressures of oxygen. and therefore prevent retinal changes following repetitive hyperbaric oxygen exposures. since it would produce a strongly narcotic mixture. Guidelines have been established that allow divers to calculate when they are at risk of pulmonary toxicity. the Gemini and Apollo spacecraft). so a gas mixture must be used which contains less than 21% oxygen (a hypoxic mixture). modern protocols now require monitoring of blood oxygen levels in premature infants receiving oxygen. The patient then remains at that pressure for a further 150 minutes. The U. For example. but it may eventually result in irreversible lung injury if allowed to progress to severe damage. This is followed by a slow reduction in pressure to 1.   There is however some experimental evidence in rats that vitamin E and selenium aid in preventing in vivo lipid peroxidation and free radical damage. Retinopathy of prematurity is largely preventable by screening. However. Navy uses treatment tables based on periods alternating between 100% oxygen and air.  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. and a usable mixture may be blended either by completely replacing nitrogen with helium (the resulting mix is called heliox). equivalent to a depth of 18 metres (60 ft).S. even at breathing mixture fractions approaching 100%. This is illustrated by modern pure oxygen use in spacesuits.4 bar (140 kPa). high-fraction oxygen is non-toxic. The National Cooperative Study in 1954 showed a causal link between supplemental oxygen and retinopathy of prematurity. Increasing the proportion of nitrogen is not viable.3 bar (4. Pulmonary oxygen toxicity is an entirely avoidable event while diving. or by replacing part of the nitrogen with helium. helium is not narcotic.4 psi). The limited duration and naturally intermittent nature of most diving makes this a relatively rare (and even then. not merely by high oxygen fraction. Vitamin E and selenium were proposed and later rejected as a potential method of protection against pulmonary oxygen toxicity. 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.5 kg (3. Hypobaric setting In low-pressure environments oxygen toxicity may be avoided since the toxicity is caused by high partial pressure of oxygen. 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.   62 Hyperbaric setting The presence of a fever or a history of seizure is a relative contraindication to hyperbaric oxygen treatment. producing a trimix. consisting of two periods of 15 minutes air/60 minutes oxygen.S.
and an increase in the break periods where normal air is supplied. and carry out a controlled buoyant lift. emergency services are always contacted as there is a possibility of further complications requiring medical attention.  The majority of infants who have survived following an incidence of bronchopulmonary dysplasia will eventually recover near-normal lung function. owing to the danger of arterial gas embolism. but should the disease progress beyond a threshold (defined as five contiguous or eight cumulative hours of stage 3 retinopathy of prematurity). techniques such as scleral buckling and vitrectomy surgery may assist in re-attaching the retina. Retinopathy of prematurity may regress spontaneously. A seizure underwater requires that the diver is brought to the surface as soon as practicable. 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). 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.S. However. The U. Where the disease has progressed further. 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. Lifting an unconscious body is taught by most diver training agencies.8 bar (280 kPa). The retina (red) is detached at the top of the eye. thereby dropping the partial pressure of oxygen inspired below 0. Rescuers need to ensure that their own safety is not compromised during the convulsive phase. The silicone band (scleral buckle. Although for many years the recommendation has been not to raise the diver during the seizure itself. blue) is placed The occurrence of symptoms of bronchopulmonary dysplasia or acute around the eye. while inside a hyperbaric chamber pressurised with air to about 2. both cryosurgery and laser surgery have been shown to reduce the risk of blindness as an outcome.  . allowing the oxygen administered. Where supplemental oxygen is required for treatment of another disease (particularly in infants). Navy has procedures for completing the decompression stops where a recompression chamber is not immediately available. They then ensure that the victim's air supply is established and maintained. no long-term neurological damage from the seizure remains. there is no evidence of expiratory obstruction during seizure and benefit may be gained by raising the diver during the seizure's clonic phase. Upon reaching the surface. This brings the wall of the eye respiratory distress syndrome is treated by lowering the fraction of into contact with the detached retina. along with a reduction in the periods of exposure retina to re-attach. An overview of these studies by Bitterman in 2004 concluded that following removal of breathing gas containing high fractions of oxygen.Oxygen toxicity 63 Management During hyperbaric oxygen therapy.6 bar (60 kPa). Reductions in pressure and exposure will be made progressively and medications such as bronchodilators and pulmonary surfactants may be used. the patient will usually breathe 100% oxygen from a mask. Seizures during the therapy are managed by removing the mask from the patient. Prognosis Although the convulsions caused by central nervous system oxygen toxicity may lead to incidental injury to the victim. a ventilator may be needed to ensure that the lung tissue remains inflated.
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".
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htm).) (2001). "Oxygen under pressure". UK: Harley Swan. U. 120 pages. Thom. The Diving Emergency Handbook.). Flagstaff: Best Publishing. doi:10. (1998).. James M. 237 pages. (ed.aspx). Navy Supervisor of Diving (2008) (PDF). • Lang. Publications. Oxygen and the diver. Revised version of Donald's articles also available as: Donald. In Brubakk. DAN nitrox workshop proceedings (http://archive. • Lippmann.. "Oxygen poisoning in man—part I". revision 6. John S.1. Bugg. mp4. "Oxygen poisoning in man—part II".1136/bmj. Naval Sea Systems Command. Deeper into Diving (2nd ed. • Clark. Christian J. . Kenneth W. OCLC 39170393.712. Teddington.org/dspace/simple-search?query=oxygen+ toxicity&submit=Go). Further reading • Lamb.1. ISBN 0-946020-18-3. Neuman. doi:10. PMID 20248086. OCLC 52056845. John. – Video of "Oxygen Toxicity" lecture by Dr. (2003).). Gary C. 197 pages.S. NC: Divers Alert Network. • U. PMC 2053400. British Medical Journal 1 (4507): 712–7. Lambertsen.org/3863). ISBN 1-85421-176-5.lib. Retrieved 2008-04-29. IFEM Report No. Kenneth W.S. PMID 20248096. Kenneth W. – Wide and detailed discussion of the effects of breathing oxygen on the respiratory system. Richard Vann (free download. John M. Mitchell. Navy Diving Manual (http://supsalv.edu/edu/eshuphysio/program/section4/4ch7/ s4ch7_7. United States: Saunders Ltd.pdf). OCLC 66524750. Vitreoretinal Disease: The Essentials. Retrieved 2009-06-29.org/pdf/ DiveMan_rev6. ISBN 0-7020-2571-2. Victoria. OCLC 26894235.rubicon-foundation. 121–4.rubicon-foundation. OCLC 44018369. 358–418... (1970). Carl D. Bennett and Elliott's physiology and medicine of diving (5th ed. • Donald.4507.mcg. (1947). UK: Underwater World Publications. Alf O. • Donald.. (1999). "Pulmonary oxygen tolerance in man and derivation of pulmonary oxygen tolerance curves" (http://archive. PMC 2053251. The Practice of Oxygen Measurement for Divers. External links General The following external site is a compendium of resources: • Rubicon Research Repository (http://archive. • Regillo. PA: Environmental Biomedical Stress Data Center.org/FastAccess/ 2008TechnicalDiving. University of Pennsylvania Medical Center). Brown. • Physiology at MCG 4/4ch7/s4ch7_7 (http://www.4506.org/ 4855).1136/bmj. Stephen R. SS521-AG-PRO-010. ISBN 0-86577-761-6. U.rubicon-foundation. OCLC 51607923.S. pp. 693 pages. Flynn. ISBN 0-941332-68-3.diversalertnetwork. "Oxygen". New York: Thieme. pp. Durham. (1992). – 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. 86MB). 1-70 (Philadelphia. ISBN 0-9752290-1-X.667. Harry W. Simon (2005). • Lippmann. Tom S. Australia: J. British Medical Journal 1 (4506): 667–72.Oxygen toxicity 71 Sources • Clark. Stan (1993).L. John. Institute for Environmental Medicine. (1947). Michael A. Retrieved 2008-09-20.
the larger this difference. 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) . In chemistry. the faster the flow.com/article/ 406564-overview). the partial pressure of a gas in a mixture of gases is defined as above. Actual real-world gases come very close to this ideal. each gas has a partial pressure which is the pressure which the gas would have if it alone occupied the volume. For example. and the amount that is toxic. This general property of gasses is also true of chemical reactions of gasses in biology. is set by the partial pressure of oxygen alone. "Bronchopulmonary Dysplasia" (http://emedicine. and react according to their partial pressures.medscape. given an ideal gas mixture of nitrogen (N2). The partial pressure of a gas is a measure of thermodynamic activity of the gas's molecules. 72 Partial pressure In a mixture of ideal gases. Retrieved 2009-06-29. The total pressure of a gas mixture is the sum of the partial pressures of each individual gas in the mixture. For example. and not according to their concentrations in gas mixtures or liquids. Gases will always flow from a region of higher partial pressure to one of lower pressure. the necessary amount of oxygen for human respiration. Prabhakar (2009-03-11). Gases dissolve. – Concise clinical overview with extensive references. 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. eMedicine. or dissolved in blood. This is true across a very wide range of different concentrations of oxygen present in various inhaled breathing gases. diffuse. 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. This is because ideal gas molecules are so far apart that they don't interfere with each other at all.Oxygen toxicity • Rajiah. 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.
g. That is.g.Partial pressure 73 Ideal gas mixtures Ideally the ratio of partial pressures is the same as the ratio of molecules. oxygen. with unchanged pressure and temperature. 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. to focus on one particular gas component. 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. 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. and is useful in gas mixtures.
at any given temperature. Most often the term is used to describe a liquid's tendency to evaporate. The higher the vapor pressure of a liquid at a given temperature. 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. propane has the highest vapor pressure of any of the liquids in the chart. such as: the equilibrium constant of the reaction would be: . For example. liquid or solid). 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. As can be seen in the chart. the liquids with the highest vapor pressures have the lowest normal boiling points.Partial pressure 74 Vapor pressure Vapor pressure is the pressure of a vapor in equilibrium with its non-vapor phases (i. For a reversible reaction involving gas reactants and gas products. The vapor pressure chart to the right has graphs of the vapor pressures versus temperatures for a variety of liquids. It also has the lowest normal boiling point (-43.. It is a measure of the tendency of molecules and atoms to escape from a liquid or a solid. the lower the normal boiling point of the liquid. 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.e.7 °C).
However. In some cases. As can be seen by comparing equations (1) and (2) is the reciprocal of .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. is also referred to as the Henry's Law constant. . 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. the reaction kinetics may be the over-riding factor to consider. changes in the total pressure. 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.   Henry's Law is sometimes written as: (2) where above. 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). 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. Since both may be referred to as the Henry's Law constant. 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. Henry's Law is an approximation that only applies for dilute.
html) University of Arizona chemistry class notes (http:/ / www. htm) University of Delaware physical chemistry lecture (http:/ / www.5 bar absolute. edu/ ~chem312/ Class Summaries/ Class12. = 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 0.4 bar absolute. Cliffs Notes. the maximum total partial pressure of narcotic gases used when planning for technical diving is 4. of 180 minutes at 1. of 150 minutes at 1. arizona. uk/ sciences/ reference/ plambeck/ chem2/ p01182.21 = 1. The partial pressure of oxygen determines the maximum operating depth of a gas mixture. Perry.H. the total absolute pressure is 6 bar (600 kPa) (i.6 bar absolute.e. at 50 metres (165 feet). Intute University Introductory Chemistry (http:/ / www. Oxygen toxicity becomes a risk when these oxygen partial pressures and exposures are exceeded. References          Charles Henrickson (2005).16 bar (16 kPa) absolute. 2008.3 bar absolute and of 210 minutes at 1. Typically. Oxygen toxicity. 1 bar of atmospheric pressure + 5 bar of water pressure) and the partial pressures of the main components of air. of 120 minutes at 1. html) Pittsburgh University chemical engineering class notes (http:/ / granular. oxygen 21% by volume and nitrogen 79% by volume are: ppN2 = 6 bar x 0. Dalton's Law of Partial Pressures (http:/ / dbhs.5 bar absolute. rice. ISBN 0-764-57419-1. and Green. Using diving terms.79 = 4. involving convulsions.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 . ac. html) .). edu/ ~mccarthy/ che0035/ MB/ single/ ideal. pitt. 6th Edition. che. ISBN 0-07-049841-5. edu/ pchem/ C443/ Lectures/ Lecture33.16 bar absolute. D. us/ webdocs/ GasLaw/ Gas-Dalton.2 bar absolute.. edu/ ~salzmanr/ 103a004/ nts004/ l41/ l41.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. (Editors) (1997). 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. html) Page 200 in: Medical biophysics. k12. chem. Hypoxia and sudden unconsciousness becomes a problem with an oxygen partial pressure of less than 0. The NOAA Diving Manual recommends a maximum single exposure of 45 minutes at 1. wvusd. Chemistry. Flemming Cornelius. R. McGraw-Hill. becomes a problem when oxygen partial pressure is too high.W. owlnet. pdf) Rice University chemistry class notes (http:/ / www. udel. intute. based on an equivalent narcotic depth of 35 metres (115 ft). Perry's Chemical Engineers' Handbook (7th ed. ca. Nitrogen narcosis is a problem when breathing gases at high pressure.7 bar absolute ppO2 = 6 bar x 0. in the terms used in this article = volume fraction of gas component i = mole fraction.
which otherwise would accumulate and cause carbon dioxide poisoning. This recycling reduces the volume of breathing gas used. which has to be replaced from the air supply. or CCUBA = "closed circuit underwater breathing apparatus". which represents an increasingly smaller fraction of the compressed air breathed in. Because exhaled air can contain as much as 79% nitrogen (which is not utilized in the body) and 16% (or more) unused oxygen. as opposed to Aqua-Lung-type equipment. potentially useful gas volume. roughly the same quantity of oxygen is used. SCR = "semi closed rebreather". • Himalayan mountaineering. for all intents and purposes. • Mine rescue and in industry – where poisonous gases may be present or oxygen may be absent. every exhaled breath from an open-circuit scuba set represents at least 95% wasted. . As the diver goes deeper. The rebreather adds oxygen.Rebreather 77 Rebreather A rebreather is a type of breathing set that provides a breathing gas containing oxygen and recycled exhaled gas. At shallow depths. A high rate of system failures due to extreme cold has not been solved. Everest in 1938. Both chemical and compressed oxygen has been used in experimental closed-circuit oxygen systems—the first on Mt. the body consumes oxygen and makes carbon dioxide. It removes the carbon dioxide by a process called scrubbing. • Hospital anaesthesia breathing systems – to supply controlled proportions of gases to patients without letting anaesthetic gas get into the atmosphere that the staff breathe.  It absorbs the carbon dioxide. The remaining oxygen is exhaled along with nitrogen and carbon dioxide. Theory As a person breathes. Thus. 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. Here the rebreather is big and is connected to the air in the habitat. In the armed forces it is sometimes called "CCUBA" (Closed Circuit Underwater Breathing Apparatus). 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). The rebreather recirculates the exhaled gas for re-use and does not discharge it to the atmosphere or water. Rebreather technology is used in many environments: • Underwater – where it is sometimes known as CCR = "closed circuit rebreather". "closed circuit scuba". • Crewed spacecraft and space suits – outer space is. 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. to replace the oxygen that was consumed. which is known as "open circuit scuba". 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. a vacuum where there is no oxygen to support life. "semi closed scuba".
R. O. Early British frogman's rebreathers had rectangular breathing bags on the chest like Italian frogman's rebreathers. the Siebe Gorman Salvus and the Siebe Gorman Proto. at first oval like in this image. which developed its frogman unit Decima Flottiglia MAS. as in the illustration below.. in front they had a rubber collar that was clamped around the absorbent canister.g. to rescue mineworkers who were trapped by water. and later rectangular (mostly flat. Schwann designed a rebreather in Belgium. which was used effectively in World War II. the Royal Navy accepted it. invented Oxylithe.N. The Dräger rebreathers. That may explain how Drebbel's men were not affected by carbon dioxide build-up as much as would be expected.N. their fullface masks were the type intended for the Siebe Gorman Salvus. but the ends curved back to allow more vision sideways). R.S. he likely generated oxygen by heating saltpetre (potassium nitrate) in a metal pan to make it emit oxygen. Rees. Hermann Stelzner. But in later operations different designs were used. Hall. Various industrial oxygen rebreathers (e. The first recorded mass production of rebreathers started in 1912 with the Dräger rebreathers. In 1853 Professor T. That would turn the saltpetre into potassium oxide or hydroxide. This practice came to the attention of the Italian Navy. Another systematic use of rebreathers for diving was by Italian sport spearfishers in the 1930s. The oldest known rebreather used an oxygen reservoir and relates to the 1849 patent from the Frenchman Pierre Aimable De Saint Simon Sicard. In World War II captured Italian frogmen's rebreathers influenced design of British frogmen's rebreathers. and Dr.  In 1903 to 1907 Professor Georges Jaubert. If so. Some British armed forces divers used bulky thick diving suits called Sladen suits. Cornelius Drebbel made an early oar-powered submarine. It was used for shallow water diving but never in a submarine escape. Records show that. It was designed about 1900 in Britain for escape from Royal Navy frogman in 1945 sunken submarines. it was used in the first filming (1907) of Twenty Thousand Leagues Under the Sea. both invented in the early 1900s) were descended from it. In 1909 Captain S.Rebreather 78 History of rebreathers Around 1620 in England. . especially the DM40 model series. As it absorbs carbon dioxide it emits oxygen. leading to a fullface mask with one big face window. invented some years sooner by an engineer of the Dräger company. he accidentally made a crude rebreather more than two centuries before Saint Simon Sicard's patent. 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). were those used by the German helmet divers during World War II. which is a form of sodium peroxide (Na2O2) or sodium dioxide (NaO2). developed a submarine escape apparatus using Oxylithe. this link shows a Draeger rebreather used for mines rescue in 1907. he exhibited it in Paris in 1878. Many British frogmen's breathing sets' oxygen cylinders were German pilot's oxygen cylinders recovered from shot-down German Luftwaffe planes. which would tend to absorb carbon dioxide from the air around. Those first breathing sets may have been modified Davis Submarine Escape Sets. later British frogman's rebreathers had a square recess in the top so they could extend further up onto his shoulders. to re-oxygenate the air inside it.. 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.  The Davis Escape Set was the first rebreather which was practical for use and produced in quantity.
a closed circuit rebreather diver effectively doesn't use any of their diluent gas once they've reached the bottom phase of the dive. As the remaining 79% of the breathing gas (mostly nitrogen) is inert. This is a marked difference from open circuit where the amount of gas used is directly proportional to the depth. it has an oxygen level in the range of 15 to 16% when the diver is at atmospheric pressure. where a diver can raise the partial pressure of oxygen somewhat at shallower depth. 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. This can offer a dramatic advantage at the end of deeper dives. closed circuit rebreathers produce no bubbles and make no bubble noise and much less gas hissing. For example. The economy of gas consumption is also useful when the gas mix being breathed contains expensive gases. the advantage of a rebreather is even more marked. the diver on open-circuit scuba only uses about 5% of his cylinders' contents. A very small amount of trimix would then last for many dives. by maintaining a specific and relatively high oxygen partial pressure (ppO2) at all depths. due to venting of the gas on ascent. Research has shown that a ppO2 of 1.  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. This means that at depth. 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. therefore CO2 generation doesn't change. Christian J. With open circuit scuba. Care must be taken that the ppO2 is not set to a level where it can become toxic though. the diver is not using any more of the O2 gas supply than when shallower. only oxygen is consumed: small volumes of expensive inert gases are reused during (only) one dive. they could turn off their diluent. In normal use. the remaining 75% is lost.Rebreather In the early 1940s US Navy rebreathers were developed by Dr. such as helium. the entire breath is expelled into the surrounding water when the diver exhales. When that breath is exhaled back into the surrounding environment. and therefore minimise the decompression requirements of the diver. Since the generation of CO2 is directly related to the body's consumption of O2 (about ~99. This leaves the available oxygen utilization at about 25%. no diluent is added. 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. On ascent. The fully closed circuit rebreather is able to minimise the proportion of inert gases in the breathing mix. which then supports the growth of rust. Lambertsen for underwater warfare and is considered by the US Navy as "the father of the Frogmen". Other advantages Except on ascent. Most modern rebreathers have a system of very sensitive oxygen sensors.  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. A breath inhaled from an open circuit scuba system whose cylinders are filled with ordinary air is about 21% oxygen. At depth. however most of that in circuit is lost. This lack of exhale also allows shipwreck divers to enter enclosed areas on sunken ships and avoid slowly filling them with air.5% of O2 is converted to CO2 on exhalation).6 bar is toxic . in order to shorten decompression times. It is not uncommon for a 3 litre (19 cubic foot) diluent cylinder to last for eight 40 m (130 ft) dives. the amount of O2 consumption doesn't change. unlike open-circuit scuba. which allow the diver to adjust the partial pressure of oxygen.
This means that the diver has a tendency to rise slightly with each inhalation. Semi-closed circuit rebreather Military and recreational divers use these because they provide better underwater duration than open circuit. Semi-closed circuit equipment generally supplies one breathing gas such as air or nitrox or trimix. However. the Siebe Gorman Salvus. In the past they have been used deeper (up to 20 meters) but such dives were more risky than what is now considered acceptable. and enters the lungs at a much higher volume than it occupied in the cylinder. As the oxygen in the vented gas cannot be separated from the inert gas. 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. some say 9 meters (30 ft). oxygen rebreathers are currently limited to a depth of 6 meters (20 ft). they are still the most commonly used for industrial applications on the surface. because the diver is circulating a roughly constant volume of gas between his lungs and the breathing bag. Some simple oxygen rebreathers had no constant-flow valve. Oxygen rebreathers are also sometimes used when decompressing from a deep open-circuit dive. Simplified diagram of the loop in an oxygen rebreather The diving pioneer Hans Hass used Dräger oxygen rebreathers in the early 1940s. e. The only gas that it supplies is oxygen.g. semi-closed circuit is wasteful of oxygen. and their invention predates that of open-circuit scuba. Simplified diagram of the loop in a semi-closed circuit rebreather . As pure oxygen is toxic when inhaled at pressure. the other is a plain on-off valve called a bypass. In some rebreathers. both feed into the same exit pipe which feeds the breathing bag. Oxygen rebreathers are no longer commonly used in diving because of the depth limit imposed by oxygen toxicity. due to their simplicity and compact size. When an open-circuit scuba diver inhales. oxygen-rich gas. as breathing pure oxygen makes the nitrogen diffuse out of the blood more rapidly. have a deeper maximum operating depth than oxygen rebreathers and are fairly simple and cheap. the oxygen cylinder has two first stages in parallel. The gas is injected into the loop at a constant rate to replenish oxygen consumed from the loop by the diver.Rebreather with extended exposure One major difference between rebreather diving and open-circuit scuba diving is in keeping neutral buoyancy. (SCBA) such as in mines. but only the bypass. One is constant flow. Oxygen rebreathers can be remarkably simple designs. and the diver had to operate the valve at intervals to refill the breathing bag as he used the oxygen. This does not happen to a rebreather diver. Excess gas must be constantly vented from the loop in small volumes to make space for fresh. and lower slightly with each exhalation. 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. a quantity of highly compressed gas from his cylinder is reduced in pressure by a regulator. In the Salvus there is no second stage and the gas is turned on and off at the cylinder.
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. 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. which gives off oxygen as it absorbs carbon dioxide: 4KO2 + 2CO2 = 2K2CO3 + 3O2. Adding diluent can prevent the loop's gas mixture becoming too oxygen rich. leading to oxygen toxicity. Too high a concentration of oxygen results in hyperoxia. the gas injection rate must be carefully chosen and controlled to prevent unconsciousness in the diver due to hypoxia. 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. . and can lead to drowning. Florida showed that the IDA71 could give significantly longer dive time with superoxide in one of the canisters than without. The concentration of oxygen in the loop depends on two factors: depth and the proportion of oxygen in the mix. Too low a concentration of oxygen results in hypoxia leading to sudden unconsciousness and ultimately death. a condition causing convulsions which can make the diver lose the mouthpiece when they occur underwater. known as the oxygen partial pressure. This system is dangerous because of the explosively hot reaction that happens if water gets on the potassium superoxide. In fully automatic closed-circuit systems. Non-simplified diagram of the loop in a semi-closed circuit rebreather Fully closed circuit rebreather Military. in the loop and to warn the diver if it is becoming dangerously low or high. and recreational divers use these because they allow long dives and produce no bubbles. A higher gas injection rate reduces the likelihood of hypoxia but consumes more gas and wastes more oxygen. 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. 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 Russian IDA71 military and naval rebreather was designed to be run in this mode or as an ordinary rebreather. The diver may be able to manually control the mixture by adding diluent gas or oxygen.Rebreather 81 As the amount of oxygen required by the diver increases with work rate. the Oxylite) which had an absorbent canister filled with potassium superoxide. The major task of the fully closed circuit rebreather is to control the oxygen concentration. Tests on the IDA71 at the United States Navy Experimental Diving Unit in Panama City.g. it had a very small oxygen cylinder to fill the loop at the start of the dive. photographic.
.2 bar to 2 bar without electronics. corresponding to an oxygen consumption of 2 liters per minute. • 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 Siebe Gorman CDBA) had a backpack weight pouch instead of the diver having a separate weight belt. Cryogenic rebreather A cryogenic rebreather has a tank of liquid oxygen and no absorbent canister. Its ppO2 could be set to anything from 0.  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 liquid-oxygen tank must be well insulated against heat coming in from the water. The set could freeze out 230 grams of carbon dioxide per hour from the loop.Rebreather 82 Rebreathers which store liquid oxygen If used underwater. industrial sets of this type may not be suitable for diving. If oxygen was consumed faster (high workload). 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. The set's liquid oxygen tank must be filled immediately before use. Cryogenic rebreathers were widely used in Soviet oceanography in the period 1980 to 1990. 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. It had a duration of 6 hours and a maximum dive depth of 200 meters of salt water. • Some British naval rebreathers (e.g. • Aerorlox  • Cryogenic rebreather: see below. by controlling the temperature of the liquid oxygen. and diving sets of this type may not be suitable for use out of water. a regular scrubber was needed. They include these types: • Aerophor. As a result. thus controlling the equilibrium pressure of oxygen gas above the liquid. The diluent could be either liquid nitrogen or helium depending on the depth of the dive. like in an old Draeger standard diving suit variant which had a rebreather pack attached.
sometimes a mouth-and-nose mask). 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. It is important that the diluent is not an oxygen-free gas. and is breathable. This holds gas when it is not in the diver's lungs.Rebreather 83 Parts of a rebreather The loop Although there are several design variations of diving rebreather. so recreational rebreathers and many professional diving rebreathers also have a cylinder of diluent gas. The diluent reduces the percentage of oxygen breathed and increases the maximum operating depth of the rebreather. This diluent cylinder may be filled with compressed air or another diving gas mix such as nitrox or trimix. any training on a rebreather will feature procedures for removing any excess water. The loop also includes a scrubber containing carbon dioxide absorbent to remove from the loop the carbon dioxide exhaled by the diver. Some have a single pendulum hose. with the casing opened Pure oxygen is not considered to be safe for recreational diving deeper than 6 meters. all types have a gas-tight loop that the diver inhales from and exhales into. this oxygen is stored in a gas cylinder. it may be used in an emergency either to flush the loop with breathable gas or as a bailout. Many rebreathers have "water traps" in the counterlungs. from a gas source into the loop. to stop large volumes of water from entering the loop if the diver removes the mouthpiece underwater without closing the valve. There may be valves allowing venting of gas from the loop. Depending on the rebreather design variant. 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. . Nearly always. The loop consists of components sealed together. 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. or if the diver's lips get slack letting water leak in. where the inhaled and exhaled gas passes through the same tube in opposite directions. This is connected to one or more tubes bringing inhaled gas and exhaled gas between the diver and a counterlung or breathing bag. such as oxygen and perhaps a diluting gas. Regardless of whether the rebreather in question has the facility to trap any ingress of water. Back of a closed circuit rebreather. Attached to the loop there will be at least one valve allowing injection of gases. such as pure nitrogen or helium. The diver breathes through a mouthpiece or a fullface mask (or with industrial breathing sets. the oxygen source will either be pure or a breathing gas mixture.
which was said to go white when the absorbent was exhausted. but is not useful on diving equipment. where: . In a rebreather. or Sodasorb. This allows the exhaled gas to bypass the absorbent. such as o rings. There are several ways that the scrubber may fail or become less efficient: • Complete consumption of the active ingredient ("break through"). Dragersorb. which should prompt the diver to switch to an alternative source of breathing gas and rinse his or her mouth out with water. a canister full of some suitable carbon dioxide absorbent such as a form of soda lime. However. This is useful in dry open environments. this chemical reaction is exothermic. which removes the carbon dioxide from the gas mixture and leaves the oxygen and other gases available for re-breathing. the scrubber will be less efficient. this front would be a wide zone. 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. It changes the colour of the soda lime after the active ingredient is consumed. as the reaction consumes the active ingredients. If any of the seals. Among British naval rebreather divers. 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. In deep diving with a nitrox or other gas-mixture rebreather. or outside water or gas may get in circuit. In larger environments. Some systems use a prepackaged Reactive Plastic Curtain (RPC) based cartridge: Reactive Plastic Curtain (RPC) was first used between Micropore Inc.Rebreather 84 Carbon dioxide scrubber The exhaled gases are directed through the chemical scrubber. • The scrubber canister has been incorrectly packed or configured. of the unreacted soda lime that is exposed to carbon dioxide-laden gas. a rebreather absorbent called "Protosorb" supplied by Siebe Gorman had a red dye. this type of carbon dioxide poisoning was called shallow water blackout. It gives rise to a chalky taste. • in below-freezing operation (primarily mountain climbing) the wet scrubber chemicals can freeze when oxygen bottles are changed. For example. Failure prevention • An indicating dye in the soda lime. are not cleaned or lubricated or fitted properly. • A Caustic Cocktail – Soda lime is caustic and can cause burns to the eyes and skin. This front moves through the scrubber canister. this may be able to show the position of the reaction "front". Some absorbent chemical designed for diving applications are Sofnolime. and then more recently RPC has been used on the web to describe their Reactive Plastic Cartridges – ExtendAir . because the carbon dioxide in the gas going through the canister needs time to reach the surface of a grain of absorbent. such as recompression chambers. 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. because of this effect. Color indicating dye was removed from US Navy fleet use in 1996 when it was suspected of releasing chemicals into the circuit. thus preventing CO2 from reaching the scrubber material. the scrubber needs to be bigger than is needed for a shallow-water or industrial oxygen rebreather. A "caustic cocktail" is a mixture of water and soda lime that occurs when the "scrubber" floods. a fan is used to pass gas through the canister. and the US Navy to describe Micropore's absorbent curtains for emergency submarine use. This reaction occurs along a "front" which is a cross section of the canister. or spacers that prevent bypassing of the scrubber. The carbon dioxide passing through the scrubber absorbent is removed when it reacts with the absorbent in the canister. • When the gas mix is under pressure caused by depth. and then time to penetrate to the middle of each grain of absorbent as the outside of the grain becomes exhausted. With a transparent canister. Scrubber failure The term "break through" means the failure of the "scrubber" to continue removing carbon dioxide from the exhaled gas mix.
Counterlung . Such systems should be used as an essential safety device to warn divers to bail off the loop immediately. such as a recompression chamber or a hospital. the first CO2 detector to be produced for rebreathers in a diving application was patented by Clive Wilcox of Amphilogic.Rebreather • A transparent canister would likely be brittle and easily cracked by knocks. This makes hypoxia a deadly problem for rebreather divers. Effectiveness In rebreather diving. As the reaction between carbon dioxide and soda lime is exothermic.g. • Temperature monitoring. In some dry open environments. The resulting serious hypoxia causes sudden blackout with little or no warning. inside the breathing bag or inside a backpack box. • Carbon dioxide gas sensors exist. the proportion of oxygen in the loop may be too low to support life. the ambient temperature. Such systems are not useful as a tool for monitoring scrubber life when underwater as the onset of scrubber "break through" occurs quite rapidly. 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. the urge to breathe is normally caused by a build-up of carbon dioxide in the blood. the set also has a manual on/off valve called a bypass. In some modern rebreathers. and the size of the canister. Narked at 90 Ltd – Deep Pursuit Advanced electronic rebreather controller. The diver must monitor the exposure of the scrubber and replace it when necessary. At present. Most modern closed-circuit rebreathers have electro-galvanic fuel cell sensors and onboard electronics. 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. the pressure in the breathing bag controls the oxygen flow like the demand valve in open-circuit scuba. injecting more oxygen if necessary or issuing an audible warning to the diver if the ppO2 reaches dangerously high or low levels. depending on the granularity and composition of the soda lime. The loop often has a pressure relief valve to prevent over-pressure injuries caused by over-pressure of the loop. temperature sensors. 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). along the length of the scrubber can be used to measure the position of the front and therefore the life of the scrubber. 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. it may be possible to put fresh absorbent in the canister when break through occurs. • Opening the canister to look inside would flood it with water or let unbreathable external gas in. the typical effective duration of the scrubber will be half an hour to several hours of breathing. which monitor the ppO2. 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. If not enough new oxygen is being added. for example. • The canister is usually out of sight of the user. In humans. In others the oxygen flow is kept constant by a pressure-reducing flow valve like the valves on blowtorch cylinders. e. trying to breathe in from an empty bag makes the cylinder release more gas. the design of the rebreather.  • Diver training. rather than lack of oxygen. most likely digital.
Underwater.g. while others incorporate the counter lungs into a solid case (e. the quantity of gas held by the rebreather is small so the protection offered is low. The breathing gas mix must be carefully chosen to be safe at all depths of the ascent. bailout strategy becomes a crucial part of dive planning. • An independent open-circuit system. 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 this option has the advantages of being permanently mounted on the rebreather and not heavy. It is easier to inhale from a front mounted counterlung and exhale to a back mounted counterlung for diver swimming facedown and horizontally. Although some rebreather divers—referred to as "alpinists"—do not carry bailouts. the rebreather may fail and be unable to provide a safe breathing mix for the duration of the ascent back to the surface. in an industrial version of the Siebe Gorman Salvus the breathing bag hangs down by the left hip. Innerspace Systems Megalodon). on the chest. . • An open-circuit demand valve connected to the rebreather's oxygen cylinder. A rebreather whose counterlung is rubber and not in an enclosed casing. to prevent the rubber from perishing due to UV light. or on the back. over the shoulders. 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. Often the planned dive is limited by the capacity of the bailout and not the capacity of the rebreather.g. particularly for long dives and deeper dives in technical diving. 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. has an effect on the ease of breathing. • An independent closed-circuit system. this does not matter so much: for example. 86 Bailout While the diver is underwater. For use out of water. The design of the rebreathers' counterlungs can also affect the swimming diver's streamlining due to location of the counterlungs themselves. the position of the breathing bag. This is due to the pressure difference between the counterlung and the diver's lung caused by the vertical distance between the two. The KISS Classic). should be sheltered from sunlight when not in use.Rebreather The counterlung is a flexible part of the loop. 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. which is designed to change in size by the same volume as the diver's lungs when breathing. Some are designed as over-the-shoulder lungs (e. In this case the diver needs an alternative breathing source: the bailout.
is completely sealed. due to pressure. • The rebreather diver must keep breathing in and out all the time. • Seizures due to oxygen toxicity caused by too high a partial pressure of oxygen in the loop. The solution to this is to slow down and let the absorbent catch up. • Disorientation. Diffuser Some military rebreathers have a diffuser over the blowoff valve.) Closed circuit disorders In addition to the other diving disorders suffered by divers. In a diving rebreather this needs fairly large holes. headache. e. Investigations into rebreather deaths focus on three main areas: medical. this danger is still only theoretical. such a seal could conceivably cause an unconscious user to suffocate when the oxygen ran out or the scrubber became exhausted. which is used for mine rescue. equipment. The scrubber efficiency may be reduced at depth where the increased concentration of other gas molecules. In mountaineering. and hyperventilation due to excess of carbon dioxide caused by incorrect configuration. stops all the carbon dioxide molecules reaching the active ingredient of the scrubber. including a hole at the bottom to drain the water out when the diver comes out of water. The SEFA. This can be caused by the rise in ambient pressure caused by the descent phase of the dive. which reduces the partial pressure of oxygen to hypoxic levels leading to what is sometimes called deep water blackout. which raises the partial pressure of oxygen to hyperoxic levels. in the IDA71 and Cis-Lunar. not with the theory of rebreathing): • Sudden blackout due to hypoxia caused by too low a partial pressure of oxygen in the loop. which helps to conceal the diver's presence by masking the release of bubbles. so the absorbent can work all the time. 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. 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. to keep grit and stones out of its working. and procedural. except for a large vent panel covered with metal mesh. and holes for the oxygen cylinder's on/off valve and the cylinder pressure gauge. failure or inefficiency of the scrubber. In fully closed circuit equipment. 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. The danger is that a sick climber using a rebreather might become unconscious. this also has the . during hard work or fast swimming. Underwater the casing also serves for streamlining. A particular problem when using a closed circuit rebreather is the drop in ambient pressure caused by the ascent phase of the dive. In closed circuit rebreathers.g. The scrubber must be configured so that no exhaled gas can bypass it. 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. to keep the exhaled gas flowing over the carbon dioxide absorbent. Because an absolute atmospheric seal is required for rebreathers to work correctly. panic. for example. it must be packed and sealed correctly. Divers need to lose any air conservation habits that may have been developed while diving with open-circuit scuba. (Because there has been very little use of mountaineering rebreathers.Rebreather 87 Casing Many rebreathers have their main parts in a hard backpack casing. Another problem is the diver producing carbon dioxide faster than the absorbent can handle.
 • Integrated decompression computers – these allow divers to take advantage of the content and generate a schedule of decompression stops. • 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 diver is normally alerted to this by a chalky taste in the mouth. Some rebreather divers prefer not to carry enough bailout for a safe ascent breathing open circuit. rebreathers have some disadvantages including expense. improper configuration and misuse. 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. sensors and alarm systems. These are expensive and susceptible to failure. Typically rebreathers try to solve these problems by monitoring the system with electronics. A safe response is to bail out to "open circuit" and rinse the mouth out. Innovations include: • The electronic.Rebreather advantage of mixing the gases preventing oxygen-rich and oxygen-lean spaces developing within the loop. It only works when partial pressure of oxygen in the diluent alone would not cause hypoxia or hyperoxia. or it may allow carbon dioxide to build up to dangerous levels. 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. believing that an irrecoverable rebreather failure is very unlikely. • 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. 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. An important safety device when carbon dioxide poisoning occurs. but instead rely on the rebreather. often driven by the growing market in recreational diving equipment. complexity of operation and maintenance. The first ever system that was proved to function correctly was patented by Clive Wilcox of Amphilogic. and fewer failsafes. which may give inaccurate readings to the oxygen control system. 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. such as when using a normoxic diluent and observing the diluent's maximum operating depth. 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. . The technique involves simultaneously venting the loop and injecting diluent. • 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. Sport diving rebreather technology innovations Over the past ten or fifteen years rebreather technology has advanced considerably. 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.
"Equipment for the working diver" 1970 symposium. ISBN 20060725. south of France) (http:/ / www. DE (2007). Retrieved 2008-04-25. OCLC 16986801. Dean.  Older. . Undersea Hyperb Med 31 (1): 21–31. RANSUM-4-69. Menduno. Retrieved 2008-06-14. html  Lillo RS. Washington. Porter WR. Tom (2006). Navy Fleet soda lime" (http:/ / archive.: 286. (abstract)" (http:/ / archive. org/ 4958). . US Navy Experimental Diving Unit Technical Report NEDU-Evaluation-11-68. nl/ 06_Homebuilders/ secret_rebreather. 79. . . Washington. Retrieved 2008-06-13. "Rebreathers" (http:/ / archive.  "Sportsmen-podvodnik journal. Groton. School of Underwater Medicine. (1997). 2005 at the University of Connecticut at Avery Point. htm Fischel H. . com/ closedcircuit. "Closed circuit oxygen system.com.0. Retrieved 2008-06-14. org/ 4667). Surrey: Siebe Gorman & Company Ltd.  http:/ / www. US Naval Submarine Medical Research Center Technical Report NSMRL-TR-1228. Oxygen therapy and toxicity. 693. htm)  Vann RD (2004). Journal of the South Pacific Underwater Medicine Society 33 (2): 98–102. Diving Science and Technology Workshop. MA and Smith. In: Lang. Tolworth. Proceedings of the American Academy of Underwater Sciences Symposium on March 10-12. velocitypress. htm). JM. Undersea Hyperb Med 31 (1): 3–20. WW." (http:/ / archive.  "Popular mechanics (ru).  Holzel. org/ 3987). Undersea Hyperb Med Society Annual Meeting. Sundstrom. rubicon-foundation." (http:/ / archive. W and Horn. . Proceedings of Advanced Scientific Diving Workshop Smithsonian Institution.  http:/ / www. 1977" (http:/ / www. Ruby A. "Some limitations of simi-closed rebreathers" (http:/ / archive. org/ 7555). (American Academy of Underwater Sciences). org/ 9011). Drew. rubicon-foundation. Steve (2003). . JS. high altitude oxygen" (http:/ / www. . Retrieved 2008-06-09. org/ 7782).  Saint Simon Sicard's invention as mentioned by the Musée du Scaphandre website (a diving museum in Espalion. Retrieved 2008-10-24." (http:/ / archive. shtml). . rubicon-foundation. "Carbon Dioxide Scrubbing Capabilities of Two New Non-Powered Technologies" (http:/ / archive.  Manning AM. com/ drager. com/ scaphandre/ autonomie/ autonomes_sans_detendeur. "Lambertsen and O2: beginnings of operational physiology" (http:/ / archive. "DEVELOPMENT OF A SCRUBBER GAUGE FOR CLOSED-CIRCUIT DIVING. Royal Australian Navy.. nl/ Zuurstofrebreathers/ German/ theodore_schwann. rubicon-foundation. (1996). rubicon-foundation. NE (eds. "Closed-circuit oxygen diving in the U. "OSS Maritime". rubicon-foundation. org/ 5110). Marine Technology Society 1970:229-244. PMID 15233156. healeyhero. "Proceedings of Rebreather Forum 2. K and Richardson. ru/ article/ 5567-zhidkaya-voda-zhidkiy-vozduh/ ). Retrieved 2009-01-31. Diving For Science 2005. rubicon-foundation. rubicon-foundation. .Rebreather 89 References  Richardson. Connecticut. Surbiton. ISSN 0032-4558. EB (1968). Shreeves.  Goble. htm). Cryogenic Rebreather. Retrieved 2009-07-17. "Mechanical and Operational Tests of a Russian 'Superoxide' Rebreather. Janwillem. Shumway. Retrieved 2008-02-23. bishopmuseum. P. RANSUM-1-70. Phillip S (2005).).  Warkander. DC.32:1005-1020. South Pacific Underwater Medicine Society Journal 27 (1). com/ rebreathers/ vision/ scrubbermonitor/ • . and reprinted in Aqua Corps magazine. co.). ru/ biblioteka/ Knigi/ sportsmen_podvodnik_046.  http:/ / www.  Davis. com/ productfrm.  Reynolds. therebreathersite. L.  Quick. org/ 2238). Michael. "A History Of Closed Circuit Oxygen Underwater Breathing Apparatus" (http:/ / archive. June 1969. Retrieved 2008-02-23. "Chemical safety of U. "Scuba Bubble Noise and Fish Behavior: A Rationale for Silent Diving Technology. org/ 4960). Gummin DD. Herron.  http:/ / www. . Glen Harlan (December 2006). USA. Retrieved 2008-07-17. org/ 3986). Deep Diving and Submarine Operations (6th ed. Navy" (http:/ / archive. htm  Drägerwerk page in Divingheritage. • Cushman. ISSN 0813-1988. nl/ Zuurstofrebreathers/ German/ photos_draeger_1907_rescue_apparatus. Retrieved 2008-06-09. D.  http:/ / www. org/ research/ treks/ palautz97/ rb. rubicon-foundation. "Seeking New Depths". PMID 8653065. apdiving. Velocity Press. rubicon-foundation. rubicon-foundation. Caldwell JM (March 1996). . org/ 4992). W (2003). (1969). Popular Mechanics 183 (12): 58.  http:/ / www. htm)  Bech. The Blast 32 (1).  "Cornelius Drebbel: inventor of the submarine" (http:/ / www. rubicon-foundation. "Mixed-Gas Closed-Circuit Rebreathers: An Overview of Use in Sport Diving and Application to Deep Scientific Diving" (http:/ / archive.  Butler FK (2004). D (2006). . v. org/ 3451).. extendair. org/ 6039). Closed circuit cryogenic SCUBA. SE. N7. Royal Australian Navy. pdf). (1970). .  Hawkins T (1st Quarter 2000). divingheritage. Retrieved 2011-01-09.  Lobel. . html  Elliott. Retrieved 2008-04-25. dutchsubmarines. . Retrieved 2008-04-25. p. RH (1955). Dutch Submarines. espalion-12. "Theoretical Considerations in the Design of Closed Circuit Oxygen Rebreathing Equipment" (http:/ / archive. Retrieved 2008-06-14. Undersea Hyperb Med 23 (1): 43–53. DC. rubicon-foundation. №7(81) June 2009" (http:/ / www. Retrieved 19 September 2010. In: Godfrey. 28.  Kelley. . Vet Clin North Am Small Anim Pract 2002. (http:/ / www. a specialised website. . JM. therebreathersite. Skin Diver magazine. School of Underwater Medicine. popmech. Retrieved 2008-08-20. therebreathersite. PMID 15233157. "Theodor Schwann" (http:/ / www. htm  Norfleet. scubadiving. D.S. Karl (eds). uk/ rescue/ glossary/ aerorlox. com/ specials/ special_drebbel.S.  Shreeves.
jlunderwater. nl/ 01_Informative/ BOV_page/ BOV_page.  "OC – DSV – BOV – FFM page" (http:/ / www.2. org/ 6997).com/latenthypoxia.: American Academy of Underwater Sciences) Proceedings of the American Academy of Underwater Sciences (Twenty-sixth annual Scientific Diving Symposium). org/ 5110).com) Free searchable multimedia resource for rebreather divers • Image gallery of LAR-6 and LAR-7 and FGT II and LAR V rebreathers.org/ 4960).Rebreather  Lang. "Rebreather Fatality Investigation" (http:/ / archive. rubicon-foundation. co. (ed. Michael A. Durham. . html). 90 External links • RebreatherPro (http://www.org/research/treks/palautz97/rb." (http:/ / archive. rubicon-foundation. published in 1970.rebreatherpro. .  Chapple. . "Development of a scrubber gauge for closed-circuit diving" (http:/ / archive. uk/ old_site/ photoix/ bailout/ bailout. Lee DA (2008).specwargear.com/dive&swim.a  Vann RD. Retrieved 2010-12-29. org/ 7282). ISBN 0-9800423-1-3. NC: Divers Alert Network. DAN nitrox workshop proceedings (http:/ / archive.scuba-doc. org/ 7981). Retrieved 2009-03-03. including mountaineering rebreathers.co. Retrieved 2011-07-30. Nitrox Rebreather Diving.  Liddiard. JCB. plenty of images. Undersea and Hyperbaric Medicine Abstract 34. htm).rubicon-foundation.  Verdier C. rubicon-foundation. John.html) • In-depth explanation on how rebreathers work (http://www.uk. Ala. 8 November 2010. "Bailout" (http:/ / www. Pollock NW. Motor skills learning and current bailout procedures in recreational rebreather diving. html) and many useful references in its "Further Reading" section • A history of closed circuit oxygen underwater breathing apparatus (http://archive. In: NW Pollock and JM Godfrey (Eds. DIRrebreather publishing. may be slow to download • Information on shallow water blackout (http://www. . (http:/ / archive. Retrieved 2008-06-14. Eaton. Defence R&D Canada Technical Report (Defence R&D Canada) (DCIEM 92-06). 197 pages. David J. www. section 1. "Development of the Canadian Underwater Mine Apparatus and the CUMA Mine Countermeasures dive system.) (2001).) the Diving for Science…2007 (Dauphin Island.nl.  Warkander Dan E (2007). . Retrieved 2009-03-03. and Denoble PJ (2007).bishopmuseum. . Retrieved 2009-03-31. and other combat frogman's kit (http:// www. rubicon-foundation.therebreathersite. therebreathersite. Retrieved 2008-04-25. org/ 4855). rubicon-foundation. jlunderwater. .html) .
Even those who agree on the broad definitions of technical diving may disagree on the precise boundaries between technical and recreational diving. The term technical diving has been credited to Michael Menduno. who was editor of the (now defunct) diving magazine AquaCorps in 1991. It is further defined as an activity that includes one or more of the following: diving beyond 40 meters/130 feet. advents. although divers have been engaging in what is now commonly referred to as technical diving for decades. While the recommended maximum depth for conventional scuba diving is 130 ft. However. Some say that technical diving is any type of scuba diving that is considered higher risk than conventional recreational diving. The concept and term.   Until recently. technical diving. whereas others contend that penetrating overhead environments should be regarded as a separate type of diving. specialized equipment and often breathe breathing gases other than air or standard nitrox. are both relatively recent Technical diver during a decompression stop. • PADI. but this is no longer the case. accelerated stage decompression and/or the use of multiple gas mixtures in a single dive. required stage decompression. 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." • 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. or by the length of time that the diver intends to spend underwater. The following table tries to describe the differences between technical and recreational 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). extensive experience. sometimes even deeper. Technical diving often involves the use of special gas mixtures (other than compressed air) for breathing. Definition of technical diving There is some professional disagreement as to what the term should encompass. Others seek to define technical diving solely by reference to the use of decompression. technical divers may work in the range of 170 ft to 350 ft. . some advocate that this should include penetration diving (as opposed to open-water diving). nitrox diving was considered technical. defines technical diving as "diving other than conventional commercial or recreational diving that takes divers beyond recreational diving limits. diving in an overhead environment beyond 130 linear feet from the surface." NOAA does not address issues relating to overhead environments in its definition. Technical diving almost always requires one or more mandatory decompression "stops" upon ascent. Certain minority views contend that certain non-specific higher risk factors should cause diving to be classed as technical diving. the largest recreational diver training agency in North America. Technical divers require advanced training.
NAUI    Some agencies regard use of semi-closed rebreathers as recreational diving. These factors increase the level of risk and training required for technical diving far beyond that required for recreational diving. In many cases. Heliox. For this reason. .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. 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. This is a fairly conservative definition of technical diving. 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. PADI Recreational diving requires buddy system others as technical diving. Increasing pressure at depth also increases the risk of oxygen toxicity based on the partial pressure of oxygen in the breathing mixture. 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. Such environments may include fresh and saltwater caves and the interiors of shipwrecks. technical diving often includes the use of breathing mixtures other than air. 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. PADI  Cave diving Deeper penetration Ice diving Rebreathers Solo diving others as technical diving.
Deep diving .diving into a cave system.diving into greater depths. Decompression stops A diver at the end of a long or deep dive may need to do decompression stops to avoid decompression sickness." 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 under ice. long. shallow stops. 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. Most technical divers breathe enriched oxygen breathing gas mixtures such as nitrox during the beginning and ending portion of the dive. also known as the "bends". it is common to use trimix which adds helium to replace nitrogen in the diver's breathing mixture. are absorbed into body tissues when inhaled under high pressure during the deep phase of the dive. most technical divers have greatly increased the depth of the first stops to reduce the risk of bubble formation before the more traditional. In recent years. Physical ceiling These types of overhead diving can prevent the diver surfacing directly: • • • • Cave diving . reducing the risk of "the bends. Metabolically inert gases in the diver's breathing gas. such as nitrogen and helium. . 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.diving inside a shipwreck. Ice diving . To avoid nitrogen narcosis while at maximum depth. Wreck diving . Free floating decompression stop. These dissolved gases must be released slowly from body tissues by pausing or "doing stops" at various depths during the ascent to the surface.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.
Sometimes the diver may get warning symptoms prior to the convulsion. The combination of low visibility and swift current make these technical dives extremely risky to all but the most skilled and well-equipped divers. Deep air proponents base the proper depth limit of air diving upon the risk of oxygen toxicity. While mainstream training agencies still promote and teach such courses (TDI. IANTD and DSAT/PADI). 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). By adding helium to the breathing mix. require greater knowledge and skill to operate in such an environment. nausea. Breathing normal air (with 21 percent oxygen) at depths greater than 180 feet (55 m) creates a high risk of oxygen toxicity. saying that helium mixes should be used for dives beyond a certain limit (100–130 feet (30–40 m). a minority (NAUI Tec. in the face and hands). and while it is not used for deep diving.Technical diving 94 Extremely limited visibility Technical dives in waters where the diver's vision is severely impeded by low-light conditions. The depth limit of nitrox is governed by the percentage of oxygen used. Helitrox/triox proponents argue that the defining risk should be nitrogen narcosis. as helium does not have the same narcotic properties at depth. and because vision is often reduced by water currents. as well as allowing for a greater number of multiple dives compared to standard air. The first sign of oxygen toxicity is usually a convulsion without warning which usually results in death. depending upon agency). twitching (especially Technical divers preparing for a mixed-gas decompression dive in Bohol. Such courses used to be referred to as "deep air" courses. These gas mixes can also lower the level of oxygen in the mix to reduce the danger of oxygen toxicity. These can include visual and auditory hallucinations. and suggest that when . Gas mixes Technical dives may also be characterised by the use of hypoxic breathing gas mixtures other than air. Nitrox is another common gas mix. heliox. Note the backplate and wing setup with sidemounted stage tanks swings. UTD) argue that diving deeper on air is unacceptably risky. irritability and mood Philippines. 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. resulting in a reduced ability to react or think clearly (see nitrogen narcosis). This reduces the nitrogen percentage. but are now commonly called "extended range" courses. Further training and knowledge is required in order to use safely and understand the effects of these gases on the body during a dive. as there are multiple oxygen percentages available in nitrox. caused by silt or depth. GUE. which occurs at about 186 feet (57 m). and heliair. and dizziness. as the breathing regulator falls out and the victim drowns. Accordingly. they view the limit as being the depth at which partial pressure of oxygen reaches 1.4 ATA. due to depth also causes nitrogen to become narcotic. divers can reduce these effects. it decreases the build up of nitrogen within the diver's body by increasing the percentage of oxygen. Increasing pressure containing EAN50 (left side) and pure oxygen (right side). such as trimix.
Technical diving the partial pressure of nitrogen reaches approximately 4. 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. technical dives last longer than average recreational scuba dives. There are many technical training organisations: see the Technical Diving section in the list of diver training organizations.0 ATA. Technical Diving International (TDI). Technical divers usually carry at least two tanks. with a reserve for bail-out in case of failure of their primary breathing gas. there is a need for redundant equipment. The Divers Alert Network does not formally reject deep air diving per se. Global Underwater Explorers (GUE). which occurs at about 130 feet (40 m). The Scuba Schools International (SSI) Technical Diving Program (TechXR – Technical eXtended Range) was launched in 2005. . Training Technical diving requires specialised equipment and training. the technical arm of Professional Association of Diving Instructors (PADI). It has also recently introduced trimix qualifications and continues to develop closed circuit training. to ensure adequate breathing gas supply for decompression. 95 Equipment Technical divers may use unusual diving equipment. International Association of Nitrox and Technical Divers (IANTD) and National Association of Underwater Instructors (NAUI) were popular as of 2009. Technical diver with decompression gases in side mounted stage cylinders. each with its own regulator. but indicates the additional risks involved. Because required decompression stops act as an obstacle preventing a diver in difficulty from surfacing immediately. Typically. for example. the second tank and regulator act as a back-up system. Divers trained and experienced in deep air diving report less problems with narcosis than those trained and experienced in mixed gas diving trimix/heliox. or become tolerant of it. and nitrox training will become mandatory. helium is necessary to offset the effects of the narcosis. however. known as stage bottles. Profesional Scuba Association International(PSAI). British Sub-Aqua Club (BSAC) training has always had a technical element to its higher qualifications. Both sides of the community tend to present self-supporting data. and Diving Science and Technology (DSAT). Technical divers therefore increase their supply of available breathing gas by either connecting multiple high capacity diving cylinders and/or by using a rebreather. The stage cylinders are normally carried using an adaptation of a sidemount configuration. In the event of a failure. The technical diver may also carry additional cylinders. Recent entries into the market include Unified Team Diving (UTD). although scientific evidence does not show that a diver can train to overcome any measure of narcosis at a given depth.
Footnotes External links • http://www. com/ index. as all dives involve an element of decompression as the diver off-gases. Retrieved 2009-08-07.html) . padi.com • http://www. Advanced Wreck Diving..  PADI. org/ medical/ articles/ article. com/ padi/ en/ kd/ icedivercourse. DAN. Introduction. Held May 1. Piantadosi CA. divessi.com • Select publications on technical diving and technical diving history (http://archive. Deep Diving (http:/ / books. bluebeyond. rubicon-foundation. Retrieved 2009-09-03. aspx  http:/ / www.rubicon-foundation. 2006.  Bret Gilliam (1995-01-25). space. Heslegrave. South Pacific Underwater Medicine Society Journal 26 (1).  Gorman. . South Pacific Underwater Medicine Society Journal 25 (1). author and leading technical diver. Aviation. . padi.  Gorman. Laliberté. com/ ?id=HVbjgdorRXAC& pg=PT1& lpg=PT1& dq=bret+ gilliam+ deep+ diving& q=). South Pacific Underwater Medicine Society Journal 33 (4). Durham.). . noaa. org/ 9061). ISBN 978-1-878663-31-3  "Technical Diving" (http:/ / oceanexplorer. "Subjective and behavioral effects associated with repeated exposure to narcosis". diversalertnetwork. . tdisdi.org/transitioning-to-technical-diving.Hosted by the Rubicon Foundation • RebreatherPro (http://www. Scuba Schools International. gov/ technology/ diving/ technical/ technical. p. org/ technical_divers. com/ english/ common/ courses/ rec/ continue/ deepdiver.Technical diving program" (http:/ / www. com. Drew (2003).  Hamilton Jr. "What is technical diving? (letter to editor)" (http:/ / archive. Retrieved 2009-09-03. Retrieved 2009-08-07. references to "decompression diving" is a misnomer. 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. asp?articleid=29).  Hamilton. aspx  Some training agencies regard solo diving within the "recreational" sphere. In: Moon RE.  In his 1989 book. asp)  There is a reasonable body of professional opinion that considers decompression diving to be the sole differentiator for "technical" diving. "Technical Diving. Enriched Air Diving. Gary Gentile." (http:/ / archive. aspx  http:/ / www.  "TDI . PMID 1417647. Retrieved 2009-09-14. Retrieved 2011-01-15.com) Jill Heinerth's interactive multimedia technical diving site • Transitioning to technical diving (http://www. N. org/ 8125). Retrieved 2009-09-03. Revised editions use the term technical diving. SDI (http:/ / www. com/ techxr)  Some certification agencies prefer to the term "cavern diving" to cave penetration within recreational diving limits. Des F (1992). google.C. and environmental medicine 63 (10): 865–9. SSI (http:/ / www. February 24. com/ txr). html). Retrieved 2009-06-22.Technical diving 96 References  Richardson. R (1992). .liquidtravel. (http:/ / www. South Pacific Underwater Medicine Society Journal 22 (1). 15. padi. com/ index. NOAA. RW (1996).TechnicalDiving. Des F (1995). the term decompression diving is often used to describe diving which involves one or more mandatory decompression stops prior to surfacing. . Dr. "High-tech diving". tdisdi.org/ dspace/simple-search?query=technical+diving&submit=Go) . naui. "Taking 'tec' to 'rec': the future of technical diving" (http:/ / archive. divessi.: (Divers Alert Network). Peter Bennett Symposium Proceedings.  Many recreational diving agencies recommend diving no deeper than 30 metres (100 ft).  http:/ / www. However.Extended Range Diver" (http:/ / www. "How deep is too deep?" (http:/ / www. Camporesi EM (eds. MF.TechDivingMag. Retrieved 2008-09-25. K. au/ modx/ bluebeyond-dive-deep-air-is-stupidity.  "Deep Air IS Stupdity" (http:/ / www. php?did=80& site=2). . "Safe Limits: A International Dive Symposium. SJ (2007). and Gary Gentile published a further book in 1999 entitled The Technical Diving Handbook. .  As most technical diving training agencies point out. page 91. rubicon-foundation. ISBN 9780922769315.rebreatherpro. 2004. php?did=60& site=3)  Mitchell. html).  "SSI TechXR . org/ 6425). org/ 6266)." (http:/ / archive. . and suggest an absolute limit of 40 metres (130 ft). rubicon-foundation. rubicon-foundation. Retrieved 2009-08-07. .  John Lippmann.
Because of its lower solubility. The mixture of helium and oxygen with a 0% nitrogen content is generally known as Heliox. . since air conducts heat 50% faster than argon. The lower density of helium reduces breathing resistance at depth. A lower proportion of oxygen reduces the risk of oxygen toxicity on deep dives. In effect. This is frequently used as a breathing gas in deep commercial diving operations. helium and nitrogen. consisting of oxygen. but at the same time the tissues can not support as high an amount of helium when super-saturated. Analysis of two-component gases is much simpler than three component gases. and is often used in deep commercial diving and during the deep phase of dives carried out using technical diving techniques. Helium dissolves into tissues more rapidly than nitrogen as the ambient pressure is increased (this is called on-gassing). often helium breathing divers carry a separate supply of a different gas to inflate drysuits. helium does not load tissues as heavily as nitrogen.  Because of its low molecular weight. Dry suits (if used together with a buoyancy compensator) still require a minimum of inflation to avoid "squeezing". separate tank. This is to avoid the risk of hypothermia caused by using helium as inflator gas. Disadvantages of helium in the mix Helium conducts heat six times faster than air. damage to skin caused by pressurizing dry suit folds. Some divers suffer from hyperbaric arthralgia during descent. and helium is more likely to come out of solution and cause decompression sickness following a fast ascent. 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. A lower proportion of nitrogen is required to reduce nitrogen narcosis and other physiological effects of the gas at depth. i. helium enters and leaves tissues more rapidly than nitrogen as the pressure is increased or reduced (this is called on-gassing and off-gassing).e. where the increased rate of off-gassing is largely counterbalanced by the equivalently increased rate of on-gassing. connected only to the inflator of the drysuit is preferred to air. 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. which is a distinct advantage in saturation diving. helium is a faster gas to saturate and desaturate. where it is often recycled to save the expensive helium component. Helium has very little narcotic effect. to allow the gas mix to be breathed safely on deep dives.  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. carried in a small. Argon.Trimix (breathing gas) 97 Trimix (breathing gas) Trimix is a breathing gas. but less so in bounce diving.
a problem that can occur when breathing heliox at depths beyond about 130 metres (430 ft).18 bar. "12/52" has a PPO2 of 1. Less commonly. At 100 m (330 ft). Oxygen. 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. 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. and cannot safely be breathed at shallow depths where the ppO2 is less than 0. A second method called 'continuous blending' is now gaining favor.    Nitrogen is also much less expensive than helium. See breathing gas for more information on the composition and choice of gas blends.18 at the surface. 70% helium. 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. two classes of trimix are commonly used: normoxic trimix—with a minimum PO2 at the surface of 0. consisting of 10% oxygen. Most trimix divers limit their working oxygen partial pressure [PO2] to 1. a hypoxic mix such as "10/50" is used for deeper diving. For example.6 bar and maximum equivalent narcotic depth of 30 to 50 m (100 to 160 ft). helium percentage and optionally the balance percentage. after each helium and oxygen transfer. The low pressure mixture is analyzed for oxygen content and the oxygen and helium flows adjusted accordingly. the mix is named by its oxygen percentage. nitrogen.2 depending on the depth. 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. the mix can be hyperoxic in shallow water because the rebreather automatically adds oxygen to maintain a specific ppO2. In open-circuit scuba. To ensure an accurate mix. a mix named "trimix 10/70" or trimix 10/70/20. hyperoxic trimix is sometimes used on open circuit scuba. A normoxic mix such as "19/30" is used in the 30 to 60 m (100 to 200 ft) depth range. so as to achieve the rough mix. the mix is allowed to cool. its pressure is measured and further gas is decanted until the correct pressure is achieved. Naming Conventionally. 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.4 and may reduce the PO2 further to 1. In fully closed circuit rebreathers that use trimix diluents.3 or 1.3 bar and an equivalent narcotic depth of 43 m (141 ft).0 to 1. The oxygen and helium are fed into the air stream using flow meters. 20% nitrogen is suitable for a 100-metre (330 ft) dive.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. This process often takes hours and is sometimes spread over days at busy blending stations. as a bottom gas only. helium and air are blended on the intake side of a compressor.18 and hypoxic trimix—with a PO2 less than 0. 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. Hyperoxic trimix is sometimes referred to as Helitrox or TriOx. . This is important mainly because of the high cost of helium.
e. where it has an equivalent narcotic depth of 35 metres (115 ft). a number of "standard" mixes have evolved (such as 21/35. hence the fractions of the three components are easily calculated. GUE and UTD also promote hyperoxic trimix. The effects from narcosis was not proven until the salvage of the USS Squalus in 1939. DIY versions of the continuous blend units can be made for as little as $200 (excluding analyzers). Soon. The method of mixing a known nitrox mix with helium allows analysis of the fractions of each gas using only an oxygen analyser. while decreasing decompression obligation and narcotic effects compared to air. and the fact that many dive shops stored standard 32% enriched air nitrox in banks. The use of standard mixes makes it relatively easy to top up diving cylinders after a dive using residual mix . human subjects breathing heliox 20/80 (20% oxygen. 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. 17% helium.4 ATA or below at the deepest point of the dive. 57% nitrogen. Other divers question whether this proliferation of terminology is useful. i. normoxic and hyperoxic.only helium and banked nitrox needs to be used to top up the residual gas from the last fill. 1937 Several test dives are conducted with helium mixtures. 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. and the usual forms for indicating constituent gas fraction. Hyperoxic trimix The National Association of Underwater Instructors (NAUI) uses the term "helitrox" for hyperoxic 26/17 Trimix. the requirement to keep the partial pressure of oxygen at 1.  . This allows diving throughout the usual recreational range.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. which simplified mixing. but prefer the term "TriOx". 80% helium) had been successfully decompressed from deep dives. and then topping the mix with 32% enriched air nitrox. modified as appropriate with the terms hypoxic. 26% oxygen. Helitrox requires decompression stops similar to Nitrox-I (EAN28) and has a maximum operating depth of 44 metres (144 ft).  99 "Standard" mixes Although theoretically trimix can be blended with almost any combination of helium and oxygen. including salvage diver Max "Gene" Nohl's dive to 127 meters. The "standard" mixes evolved because of three coinciding factors . Most of these mixes originated from filling the cylinders with a certain percentage of helium. Heliox was used with air tables resulting in a high incidence of decompression sickness so the use of helium was discontinued. 18/45 and 15/55). 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. 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.the desire to keep that equivalent narcotic depth (END) of the mix at approximately 34 metres (112 ft). and feel that the term Trimix is sufficient.
1991 Billy Deans commences teaching of trimix diving for recreational diving." (http:/ / archive. . Tom Mount develops first trimix training standards (IANTD).  "Diving Physics and "Fizzyology"" (http:/ / www. Medical Aspects of Harsh Environments. Bennett and Elliott's physiology and medicine of diving. . bordeninstitute. Retrieved March 9. . United States: Saunders Ltd. engineeringtoolbox. S. . 2005 David Shaw sets depth record for using a trimix rebreather. initially called "Monitor Mix" became NOAA Trimix I. Use of trimix spreads rapidly to North East American wreck diving community. 2005. using Trimix. NC. O. DC). army. February 14. org/ 4655).Trimix (breathing gas) 1939 US Navy used heliox in USS Squalus salvage operation. NE (eds). Retrieved 2008-08-28. dying while repeating the dive.142 W/mK"  Vann RD and Vorosmarti J (2002).. Neuman (2003). "Argon:0. Air:0. Cave divers Sheck Exley and Jochen Hasenmayer use heliox to a depth of 212 meters. 1970 Hal Watts performs dual body recovery at Mystery Sink (126 m). org/ research/ treks/ palautz97/ phys. 2010.  Gernhardt. com/ thermal-conductivity-d_429. 1994 Combined UK/USA team.016. 2001 The Guinness Book of records recognises John Bennett as the first scuba diver to dive to 1000 ft. 800. rubicon-foundation. T. ISBN 0702025712. 5th Rev ed. Exley teaches non-commercial divers in relation to trimix usage in cave diving. Bishop Museum. successfully complete a series of wreck dives on the RMS Lusitania expedition to a depth of 100 meters using trimix. pdf). 100 References  Brubakk. pp. Retrieved 2008-08-28. A. 1997.024. .  "Thermal conductivity of some common materials" (http:/ / www. 2002. html). including leading wreck divers John Chatterton and Gary Gentile.. bishopmuseum. Retrieved 2008-08-28.. 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. In: Lang. 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. ML (2006). Retrieved 2008-10-07. Helium:0. mil/ published_volumes/ harshEnv2/ HE2ch31. 1965 First saturation dives using heliox. MA and Smith.  Source: "Trimix and heliox diving" . "Military Diving Operations and Support" (http:/ / www. The Engineering ToolBox. html). Volume 2 (Borden Institute): p980. 1987 First mass use of trimix and heliox: Wakulla Springs Project. 1979 A research team headed by Peter B. "Biomedical and Operational Considerations for Surface-Supplied Mixed-Gas Diving to 300 FSW. with decompression tables published in the NOAA Diving Manual. Proceedings of Advanced Scientific Diving Workshop (Washington. NOAA's mix.
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Jooler. Jones. Todd Vierling. SDC. Spitfire26. RichSed. Sbharris. Srice13. Lumpy Dog. 63. Farzanegan. CommonsDelinker. Sirius683. DMG413. Thue. Fudoreaper. Owain. GTBacchus. Lotje.davies. Paul A.wikipedia. Leuko. Physchim62. Kubigula. Sceptre. Expyram. Snowmanradio. Scubasixstring. Cmdrjameson. TimVickers.davies. Chessphoon. Brianski. GULLIVER ARM.xxx. Bluekieran. Killian441.baum. Huw Powell. Klparrot. RexxS. Jrdioko. Nakon. Minesweeper. Axl.murphy. WATransplant. Excirial. Grenavitar. Pushnell. Draeco. Rob. Elysdir. ErelOnline. Erich gasboy. Garion96. Neckro. Mark. Nono64. Hklygre. Crowsnest. Derek. Agateller. Kingpin13. Zwiadowca21. Mark. Prodego. Muad. Cesiumfrog. Александър.org/w/index. DavidCary. Cjpuffin. Nickthechemist. Fabiform. Straker. MKoltnow. Owain. Gentgeen. Leuko. Cloudo. Jaganath.M. David Eppstein. Rosarinagazo. Rhombus. Alansohn. Technopat. ScottJ. RexxS. Cyclonenim. Subversive. ReelExterminator. Johnred32.murphy. Gene Hobbs. Quarl. DelanaSmall. Knobunc. Attilios.wikipedia. Ijustam. Cremepuff222. Sitethief. Dr. Xanzzibar.org/w/index. Kitsunedai. Sirmylesnagopaleentheda. Nonoisense.wikipedia.benko. Gene Hobbs. Pablo X.92. DroEsperanto. Wokwiki424. Benemin. Gaius Cornelius. Horsten. El C. Aquaregia27.wikipedia. Alansohn.php?oldid=445676160 Contributors: A930913. AtonX. DaGizza. Gits (Neo). Amore proprio.php?oldid=446017928 Contributors: Adrian. Angela. Tony1. Bbtommy. LWF. Fgb. Eubulides. Nasnema. Harland1.24. Can't sleep. Chrislk02. Downward machine. Tnxman307. Arrenlex. Anthony Appleyard. Serpent's Choice. Kpjas. Anthony Appleyard. Supaluminal. Xanzzibar. Anderson. Hut 8. Farzanegan. Dinomite. Zachlipton. Foobar. TBloemink. PaulGGraham. ScubaMagazinedotnet. Tholzel. Rich Farmbrough. Kosebamse.murphy.murphy. Mushroom. Dougluce. Legis. Tlunsford. Aitias. WillyJS. LilHelpa. Lexicon. Hu12.org/w/index. 381 . Crum375. Blackhawk charlie2003. Davemarshall04. KNewman. Kjhskj75.wikipedia. Erich gasboy. Frencheigh. ChildofMidnight. 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Patrick. Stubblyhead. Huw Powell. BecauseWhy?. Abyssadventurer. BillC. Delldot. Wperdue. MeltBanana. Drpepper469. Airwolfe04. Vargob. Nuggetboy.cashman. Andonic. Mark. Fang Aili. Rep07.murphy. Anthony Appleyard.5.delanoy. Shoefly. FNG0027. Korath. Mmoneypenny. Plutonium27.173. Acdx. Clovis Sangrail. El C. Sfmammamia. 96 anonymous edits Decompression sickness Source: http://en. Wavelength. HappierPanda.davies. Gene Hobbs. RobertGougaloff. Pjf. Keenan Pepper. Jumping cheese. Cyrius.org/w/index. Duk. Pt. PacificBoy. RexxS. Dkazdan. Diverite. Stewartadcock.. GregorB. Altes2009. Headbomb. Arawak3. NikoSilver. EncMstr. Taoster. BD2412. WRK. Hatcat. Owain. Dhollm. Patrick. Headbomb. The Anome.wikipedia. Scubadoc. Kosebamse. Momet. Otsykes. RexNL. DJ Clayworth. PowerCS. GaryW. Mtiller. Skepticus. Mark.msc. Michael Hardy. Yobol. Mion. Headbomb. Pardon me stellar. Gr0ff. Elkman. Norman Yarvin. Dbutler1986. Nakon. PBarak. Chzz. Trumpet marietta 45750. Sbharris. WhatamIdoing. Splamo. 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Moondyne. Pinikas. 4 anonymous edits Equivalent narcotic depth Source: http://en. Mark. Hamiltondaniel.cashman. Mark. Lightmouse. Trevor MacInnis. Circeus. BaileyZRose. Anthony Appleyard. Oleg Eterevsky. Eraserhead1. Cab88. Wouterstomp. Longhair.55 דודanonymous edits Deep diving Source: http://en. Milen. MadRat Jack.24. Cvf-ps. BryanG. Ccrvic. 62. MichaelBillington. Farras Octara. Legis. Abiermans. Ploum's. Seejyb. Famously Sharp. Gene Hobbs. Rmfitzgerald50. Ron S. Hawkeye1444. Casliber. Scubadoc. Viking6. McHildinger. YK Times. Auntof6. Mbell. Conversion script. Ajchapman. Arcadian. Nitroshockwave. Nonnormalizable. Dycedarg. Bodybagger. GProcter. Carlroller. Bento00. Watch Rider. Nono64. Crum375. Hydraton31. Onco p53. The Obfuscator. Vsmith. Gr0ff. Dycedarg. Mattmexico63. Gambitq72. Krj373. Hmoul. Ahpook. Dabomb87. JTN. Rifleman 82. Antandrus. Graham87. RichiH. Jaganath. Ex nihil.61.tan. Ianjm. 6 anonymous edits High-pressure nervous syndrome Source: http://en. Aaron Kauppi. 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Bryan Derksen. Legis. SpiderJon.xxx. Gr0ff.murphy. KingTT. Extraordinary. Bluez57.51. SummerPhD. Vuonghn. Kintaro. Lotje.xxx. A2Kafir. Wasell. Leigh. Owain. RupertMillard. 62. AtonX. Cryptic C62.uk. PierreAbbat. Cyrius.92. Michael Hardy. Hike395.murphy. Mc2246. Anthony Appleyard.253. Spiritia. Sanspeur. Lari-fari. Anthony Appleyard. Watch Rider. Pcpcpc. Matt Gies. HaeB. KingScuba. Woohookitty.php?oldid=441541942 Contributors: 62. Mark. Finavon. Michagal. Pengo. LoverOfArt.org/w/index. Auntof6. Bento00. Gxdoyle.64. SlipperyHippo. Gene Hobbs. Hede2000.wikipedia. Spetzna-. Krich. Mav. SteOsu. Destynova. Jhog1978. Headbomb. SCEhardt. Tossmysalad. Cybercobra. Mfischman. DiverDave. PontBrownJm. Pbsouthwood. 84user. Phirst. Rjwilmsi. Hamiltondaniel. Evercat. Triddle.org/w/index. Kpjas. Hu12. Dave3141592. Aquanaut. Laubzega. Mark. Gene Hobbs. Maldivian. Editus Reloaded. Alfie66. Gerard. Gorm. 49 anonymous edits 103 . Elf. Rich Farmbrough. SenorBeef.org. Superm401. EddEdmondson. Nathan. Bubbleboys. Algorithm. Conversion script.wikipedia. Dsyzdek. BillGarrett.davies. Lubos. Download. Michael Hardy. RexxS. Collabi. Tabletop. Gorm. Breals. Hephaestos. Johan Lont. RexxS. Ehagerty. TheJoby. Legis. Sirscuba. Finell.php?oldid=437697999 Contributors: Ali@gwc. Crum375. Nihiltres. Dolphin51. Unixsage. Lightmouse.Article Sources and Contributors Technical diving Source: http://en. Mion.Newman. O'Dea. 105 anonymous edits Trimix (breathing gas) Source: http://en. Georgekwatson. Rongen.
org/w/index.0 Contributors: Avraham.0 Contributors: Mike File:Eads Bridge panorama 20090119.jpg Source: http://en.jpg Source: http://en.php?title=File:TechDiving_NOAA.php?title=File:Lipid_peroxidation.php?title=File:Cylinder_mod.wikipedia.0 Contributors: Aladin-pdc.php?title=File:Deepursuit. Kauczuk.0 Contributors: Mark.wikipedia.org/w/index.org/w/index.wikipedia. Man vyi.org/bst/029/0358/bst0290358.org/w/index.wikipedia.org/w/index.php?title=File:Paul_Bert. Anthony Appleyard Image:Inspiration back with arrows. File:Human eye cross section detached retina. Licenses and Contributors 104 Image Sources.JPG Source: http://en. John M. (SVG version by User:RexxS) Image:Lipid peroxidation.wikipedia.org/w/index. 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