Scuba Diving

Technical terms

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Contents
Articles
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

1

Breathing gas
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.[1] [2] [3] Most breathing gases are a mixture of oxygen and one or more inert gases.[1] [3] 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.[1] [3] A safe breathing gas has three essential features: • it must contain sufficient oxygen to support the life, consciousness and work rate of the breather.[1] [2] [3] • it must not contain harmful gases. Carbon monoxide and carbon dioxide are common poisons in breathing gases. There are many others.[1] [2] [3] • 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.[1] [2] [3] The techniques used to fill diving cylinders with gases other than air are called gas blending.[4] [5]

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.[1] [2] [3] 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).[1] [3]
[6]

• 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.[1] [2] [3] [6] It was much used in frogmen's rebreathers.[2] [6] [7] [8] • 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).[1] [2] [3] [9] • 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.[1] [2] [3] • 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.[1] [2] [3] [10] • 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.[3] [11] • Hydreliox is a mixture of oxygen, helium, and hydrogen and is used for dives below 130 metres in commercial diving.[1] [3] [10] [12] [13] • Hydrox, a gas mixture of hydrogen and oxygen is used as a breathing gas in very deep diving.[1] [3] [10] [12] [14] • 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.[1] [3] [10] [15]

It is expressed by the partial pressure of oxygen (ppO2).[1] [3] [6] [9] Partial pressure of oxygen The concentration of oxygen in a gas mix depends on both the fraction and the pressure of the mixture.Breathing gas 2 Individual component gases Oxygen Oxygen (O2) must be present in every breathing gas. unconsciousness and death result. This depth is called the maximum operating depth. • hyperoxic mixes have more than 21% oxygen.[1] [3] [9] Hyperoxic mixtures.[4] [5] Oxygen has historically been obtained by fractional distillation of liquid air.[16] Fraction of oxygen The fraction of the oxygen component of a breathing gas mixture is sometimes used when naming the mix: • hypoxic mixes.[1] [3] The maximum operating depth of a normoxic mix could be as shallow as 47 metres (155 feet). The tissues and organs within the body (notably the heart and brain) are damaged if deprived of oxygen for much longer than four minutes.[1] [3] [6] [9] 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 . Enriched Air Nitrox (EANx) is a typical hyperoxic breathing gas. Trimix with between 17% and 21% oxygen is often described as normoxic because it contains a high enough proportion of oxygen to be safe to breathe at the surface. 21%. when compared to air. but is increasingly obtained by non cryogenic technologies such as pressure swing adsorption (PSA) and vacuum-pressure swing adsorption (VPSA) technologies. 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. If the body is deprived of oxygen for more than a few minutes. The human body cannot store oxygen for later use as it does with food. contain less than 21% oxygen. which sustains life. strictly. although often a boundary of 16% is used. NEDU gas analysis lab Filling a diving cylinder with pure oxygen costs around five times more than filling it with compressed air.[1] [3] • normoxic mixes have the same proportion of oxygen as air.[1] [2] [3] This is because it is essential to the human body's metabolic process. As oxygen supports combustion and causes rust in diving cylinders. Heliox and Heliair create typical hypoxic mixes and are used in technical diving as deep breathing gases. it should be handled with caution when gas blending.[6] [9] The fraction of the oxygen determines the deepest the mixture gas can safely be used to avoid oxygen toxicity.[1] [2] [3] 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.

In most countries. 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. Nitrogen Nitrogen (N2) is a diatomic gas and the main component of air. 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. The maximum safe ppO2 in a breathing gas depends on exposure time.4 bar).6 bar) but for dives of less than three hours is commonly considered to be 140 kPa (1.Breathing gas 3 where: ppO2 P FO2 = partial pressure of oxygen = total pressure = volume fraction of oxygen The minimum safe partial pressure of oxygen in a breathing gas is commonly held to be 16 kPa (0. the level of exercise and the security of the breathing equipment being used.[4] Divox "Divox" is oxygen. in order to more easily identify the exact manufacturing trail of a "lot" of oxygen. Nitrogen can cause decompression sickness. is a comfortable maximum. Equivalent narcotic depth is used to estimate the narcotic potency of trimix (oxygen/helium/nitrogen mixture). in case problems are later found with its purity. the diver risks oxygen toxicity including a seizure.[1] [2] [3] [6] [9] Oxygen analysers measure the ppO2 in the gas mix.S.[1] [2] [3] [17] Equivalent air depth is used to estimate the decompression requirements of a nitrox (oxygen/nitrogen) mixture. depending on factors including individual physiology and level of exertion. as they are produced by exactly the same methods and manufacturers. but labeled and tanked differently. the cheapest and most common breathing gas used for diving. so its use is limited to shallower dives. Navy has been known to authorize dives with a ppO2 of as much as 180 kPa (1.[1] [2] [3] [18] [19] Nitrogen in a gas mix is almost always obtained by adding air to the mix. although the U. . For this reason normoxic or hyperoxic "travel gases" are used at medium depth between the "bottom" and "decompression" phases of the dive. In the Netherlands. whilst breathing air. The chief difference between them is that the paper record-keeping trail is much more extensive for medical oxygen. pure oxygen for breathing purposes is regarded as medicinal as opposed to industrial oxygen. It causes nitrogen narcosis in the diver.8 bar).[1] [2] Each breathing gas has a maximum operating depth that is determined by its oxygen content. there is no difference in purity in medical oxygen and industrial oxygen. Below this partial pressure the diver may be at risk of unconsciousness and death due to hypoxia. and is only available on medical prescription.16 bar).[1] [2] [3] [6] [9] At high ppO2 or longer exposures. When a hypoxic mix is breathed in shallow water it may not have a high enough ppO2 to keep the diver conscious. such as that used in welding.

[1] [2] [3] [20] Helium fills typically cost ten times more than an equivalent air fill.[23] Argox is used for decompression research. Unwelcome components of breathing gases Many gases are not suitable for use in diving breathing gases. but considerably less expensive than helium. helium also causes High Pressure Nervous Syndrome. from which it is extracted at low temperatures by fractional distillation. [3] [10] [15] 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). it does not distort the diver's voice. it is less narcotic than nitrogen. which may impede communication. but unlike helium.[1] helium. so is not generally suitable as a diving breathing gas. so it is more suitable for deeper dives than nitrogen.[5] present in a diving environment: [22] Here is an incomplete list of gases commonly Argon Argon (Ar) is an inert gas that is more narcotic than nitrogen.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).[1] [3] Helium's low molecular weight (monatomic MW=4. which increases the resonance frequency of the vocal cords. it increases the timbre of the diver's voice. At high pressures. The hydrogen-oxygen mix when used as a diving gas is sometimes referred to as Hydrox. the blood stream and the breathing equipment before breathing hydrogen starts.[1] [3] [21] This is because the speed of sound is faster in a lower molecular weight gas.[1] [3] [10] [12] This limits use of hydrogen to deep dives and imposes complicated protocols to ensure that oxygen is cleared from the lungs. Neon Neon (Ne) is an inert gas sometimes used in deep commercial diving but is very expensive. Like helium.[1] [21] 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. Helium is found in significant amounts only in natural gas. compared with diatomic nitrogen MW=28) increases the timbre of the breather's voice.[1] [3] [24] [25] It is sometimes used for dry suit inflation by divers whose primary breathing gas is helium-based. 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. Argon is more expensive than air or oxygen. . making it more of an insulator).[1] [3] Helium is equally able to cause decompression sickness. because of argon's good thermal insulation properties. which is a CNS irritation syndrome which is in some ways opposite to narcosis.

A more severe danger is that air particulates on boats and industrial areas. where cylinders are filled. It is also uncomfortable. This icing up in a regulator can cause moving parts to seize and the regulator to fail or free flow. Since heavy oils don't burn well .especially when not atomized properly .[8] In hot climates. especially in cylinders which are used for hyperoxic gas mixtures. This problem is reduced in rebreathers because the soda lime reaction to remove carbon dioxide puts moisture back into the breathing gas. The exhausts of all internal combustion engines running on petroleum fuels contain some CO. • Heating of lubricants inside the compressor may vaporize them sufficiently to be available to a compressor intake or intake system line.[22] [26] [27] Carbon monoxide Carbon monoxide (CO) is produced by incomplete combustion. Hydrocarbons Hydrocarbons (CxHy) are present in compressor lubricants and fuels. • Inhaling oil mist can damage the lungs and ultimately cause the lungs to degenerate with severe lipid pneumonia or emphysema. Moisture content The process of compressing gas into a diving cylinder removes moisture from the gas. causing a dry mouth and throat and making the diver thirsty. quickly conducts heat from the surrounding water to the cold. leaks. and chrome plated (for protection). with its good thermal conductive properties. this coupled with the extreme reduction in temperature. helping to prevent icing up. and the oil may (and usually will) then undergo combustion. which is also thought to be a predisposing risk factor of decompression sickness.[1] common sources are: [2] [5] [22] See carbon monoxide poisoning. where the intake of the compressor cannot be arbitrarily moved as far as desired from the engine and compressor exhausts. and this is a particular problem on boats. It is for this reason that SCUBA regulators are generally constructed from brass. CO in the intake air cannot be stopped by any filter. especially in high-oxygen gas mixtures.incomplete combustion will result in carbon monoxide production. Four • Internal combustion engine exhaust gas containing CO in the air being drawn into a diving air compressor. . • In some cases hydrocarbon lubricating oil may be drawn into the compressor's cylinder directly through damaged or worn seals. often contain carbon-particulate combustion products (these are what makes a dirt rag black).[2] [4] [5] [22] [28] • They can act as a fuel in combustion increasing the risk of explosion. They can enter diving cylinders as a result of contamination. which contains organic matter (since it usually contains humus). being ignited by the immense compression ratio and subsequent temperature rise.[5] [22] This is good for corrosion prevention in the cylinder but means that the diver inhales very dry gas. Brass. also due to the decompression can cause the moisture to solidify as ice. If the compressor air filter(s) fail.Breathing gas 5 Carbon dioxide Carbon dioxide (CO2) is produced by the metabolism in the human body and can cause carbon dioxide poisoning. newly decompressed air. • A similar process is thought to potentially happen to any particulate material. open circuit diving can accelerate heat exhaustion because of dehydration. or due to incomplete combustion near the air intake. The dry gas extracts moisture from the diver's lungs while underwater contributing to dehydration. which contains "organic" (carbon-containing) matter. and these represent a more severe CO danger when introduced into a cylinder. Another concern with regard to moisture content is the tendency of moisture to condense as the gas is decompressed while passing through the regulator. ordinary dust will be introduced to the cylinder.

ISSN 0093-5387. Drew. OCLC 2068005. "Calculation of the relative speed of sound in a gas mixture" (http:/ / archive. com/ ezinefreearticles/ HeliairPoorMansMix. Neuman (2003). . "Equivalent air depth: fact or fiction" (http:/ / archive. [11] Bowen. org/ 4862). ISSN 0093-5387." (http:/ / archive. Maitland G (December 1975). pdf). [19] Berghage TE. Naquet. [18] Logan. Undersea Biomed. [21] Ackerman MJ. rubicon-foundation. helium analyser. "Heliair: Poor man's mix" (http:/ / www." (http:/ / archive.[4] Chemical and other types of gas detection methods are not often used in recreational diving. Retrieved 2008-08-29. "Effects of a H2-He-O2 mixture on the HPNS up to 450 msw. United States Navy Experimental Diving Unit Technical Report NEDU-RR-01-61. NAVSEA Technical Manual (NAVAL SEA SYSTEMS COMMAND) SS521-AK-HBK-010. A. L." (http:/ / archive. org/ 2835). [8] Richardson. . S. [3] Tech Diver. Inc. T. Robert W. "Compressed breathing air – the potential for evil from within. 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(1996). org/ 4855). pp. Retrieved 2010-01-13.[2] [4] [5] Oxygen analysers are commonly found underwater in rebreathers. Airspeed Press. [5] Millar IL.[8] Oxygen and helium analysers are often used on the surface during gas blending to determine the percentage of oxygen or helium in a breathing gas mix. OCLC 2068005. [22] NAVSEA (2005).. Undersea Biomed. Res. Undersea Biomed Res 6 (4): 379–84. (1985). Retrieved 2008-08-29. MD: Undersea and Hyperbaric Medical Society. O. C.S. Electronic sensors exist for some gases. DeepTech. David J. (1974).0. ISSN 0813-1988. McCraken TM (December 1979). [2] US Navy Diving Manual. R. (2001).Breathing gas 6 Gas detection and measurement Divers find it difficult to detect most gases that are likely to be present in diving cylinders because they are colourless. Undersea Hyperb Med 31 (1): 3–20. org/ 2487). Michael. Bennett and Elliott's physiology and medicine of diving. . PMID 538866. . rubicon-foundation. 9). Gardette-Chauffour. PMID 4619860." 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" (http:/ / archive. [25] Pilmanis AA.Breathing gas [23] Rahn H. osha. org/ 2869). . . "Guide for Oxygen Compatibility Assessments on Oxygen Components and Systems. . org/ 4861). Undersea Biomed Res 3 (1): 25–34. Retrieved 2008-08-28. [26] Lambertsen. L. Retrieved 2008-08-29. rubicon-foundation. Retrieved 2008-08-29.edu/~lpt/mixhistory.Mixed-gas diving.org. Retrieved 2008-08-29. "Carbon Dioxide Tolerance Studies" (http:/ / archive. Smith LS (September 1980). 2-71. TX School of Aerospace Medicine Technical Report SAM-TR-67-77. NASA.. "Carbon Dioxide Tolerance and Toxicity" (http:/ / archive.gov/pls/oshaweb/owadisp. rubicon-foundation. (1971).altitude. Westfalen. "A Brief History Of Mixed Gas Diving" (http://www-personal. org/ 3861). "Staged decompression to 3. Undersea Biomed Res 7 (3): 199–209. . PMID 1273982. Retrieved 2008-08-29. • OSHA. Stoltzfus. Krause KM (December 2003). A.org. Brooks AFB. J.show_document?p_id=9986&p_table=STANDARDS). Department of Labor.org/oxgyen_levels. Environmental Biomedical Stress Data Center. Institute for Environmental Medicine. and N2O evaluated by the physical performance of mouse colonies at simulated depths" (http:/ / archive. .nl/technischegassen/divox/divox. Webb JT. "Altitude oxygen calculator" (http://www. PA) IFEM Report No.westfalengassen. rubicon-foundation. Balldin UI. "Commercial Diving Regulations (Standards . . Johnson Space Center Technical Report NASA/TM-2007-213740. Motsay G. ingentaconnect. Aviat Space Environ Med 74 (12): 1243–50. Retrieved 2008-08-29. KR. PMID 7423658.php). Rokitka MA (March 1976). Occupational Safety & Health Administration. [27] Glatte Jr H. University of Pennsylvania Medical Center (Philadelphia. A. E. Retrieved 2008-08-29.29 CFR) . C. Retrieved 2008-08-29. Retrieved 2008-08-29. rubicon-foundation. MS.S.htm). org/ 6045)..1910. Shoffstall. Retrieved 2008-08-29.umich. U.5 psi using argon-oxygen and 100% oxygen breathing mixtures" (http:/ / www. [24] D'Aoust BG. PMID 14692466. "Separation of basic parameters of decompression using fingerling salmon" (http:/ / archive. "Narcotic potency of N2. • Taylor. 7 External links • altitude. JM (2007). Stayton L. .426" (http://www.pdf) (in Dutch). Welch B. • Westfalen (2004). J. com/ content/ asma/ asem/ 2003/ 00000074/ 00000012/ art00004). altitude. "Fact sheet on Divox" (http://www. [28] Rosales. org/ 2768). rubicon-foundation. . (1967).

Although DCS is not a common event.3 993. or lymphatic system.[8] Following changes to treatment methods. introduced a simpler classification using the term "Type I ('simple')" for symptoms involving only the skin. The classification of types of DCS by its symptoms has evolved since its original description over a hundred years ago. Treatment is by hyperbaric oxygen therapy in a recompression chamber. and both Type I and Type II DCS have the same initial management. and its effects may vary from joint pain and rashes to paralysis and death. Since bubbles can form in or migrate to any part of the body. and "Type II ('serious')" for symptoms where other organs (such as the central nervous system) are involved. If treated early.248 Decompression sickness (DCS. Golding et al.120. Classification DCS is classified by symptoms. the bends or caisson disease) describes a condition arising from dissolved gases coming out of solution into bubbles inside the body on depressurization. The earliest descriptions of DCS used the terms: "bends" for joint or skeletal pain.[6] Type II DCS is considered more serious and usually has worse outcomes. musculoskeletal system. and extra-vehicular activity from spacecraft. DCS most commonly refers to a specific type of scuba diving hazard but may be experienced in other depressurisation events such as caisson working. and different individuals under the same conditions may be affected differently or not at all.[6] In 1960. this classification is now much less useful in diagnosis. flying in unpressurised aircraft.3 3491 [1] [2] [3] [4] [5] emerg/121 C21. may still be used today. and scuba divers use dive tables or dive computers to set limits on their exposure to pressure and their ascent speed. also known as divers' disease. Individual susceptibility can vary from day to day. and "staggers" for neurological problems.[9] since neurological symptoms may develop after the initial presentation. ICD-10 ICD-9 DiseasesDB eMedicine MeSH T70. with minor modifications.[7] This system. "chokes" for breathing problems. there is a significantly higher chance of successful recovery.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. DCS can produce many symptoms.866.[10] . its potential severity is such that much research has gone into preventing it.

S. arms. pain can occur immediately or up to many hours later. poorly localised aches Loss of balance Dizziness. wrists. neck. tingling or numbness paresthesia. Navy prescribes identical treatment for Type II DCS and arterial gas embolism. 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. face.[11] 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.[10] The U. vomiting Hearing loss Dry persistent cough Burning chest pain under the sternum. Active and passive motion of the joint aggravates the pain. nausea. knees.[14] Signs and symptoms of decompression sickness DCS type Bubble location • Signs & symptoms (clinical manifestations) Localized deep pain. Signs and symptoms While bubbles can form anywhere in the body. although those from arterial gas embolism are generally more severe because they often arise from an infarction (blockage of blood supply and tissue death). Joint pain ("the bends") accounts for about 60% to 70% of all altitude DCS cases. upper chest and abdomen. DCS is most frequently observed in the shoulders. ranging from mild to excruciating. aggravated by breathing Shortness of breath Musculoskeletal Mostly large joints (elbows. arterial gas embolism. unconsciousness Ascending weakness or paralysis in the legs Girdling abdominal or chest pain Urinary incontinence and fecal incontinence Headache Unexplained fatigue Generalised malaise. hip.Decompression sickness 9 Decompression illness and dysbarism The term dysbarism encompasses decompression sickness. elbows. usually around the ears. vertigo. Itching. and upper torso Sensation of tiny insects crawling over the skin (formication) Mottled or marbled skin usually around the shoulders. whereas decompression sickness and arterial gas embolism are commonly classified together as decompression illness when a precise diagnosis cannot be made. Skin manifestations are present in about 10% to 15% of cases. Neurological symptoms are present in 10% to 15% of DCS cases with headache and visual disturbances the most common symptom. but rarely a sharp pain. with itching Swelling of the skin.[13] The table below shows symptoms for different DCS types. • ankles) • • Cutaneous Skin • • • • Neurologic Brain • • • • • Neurologic Spinal cord • • • • • • • • • • • • Constitutional Whole body Audiovestibular Inner ear [15] [16] Pulmonary Lungs . knees. If caused by altitude. increased sensitivity hyperesthesia Confusion or memory loss (amnesia) Visual abnormalities Unexplained mood or behaviour changes Seizures. Sometimes a dull ache. The pain may be reduced by bending the joint to find a more comfortable position.[12] Their spectra of symptoms also overlap. accompanied by tiny scar-like skin depressions (pitting edema) Altered sensation. shoulders. and barotrauma.

3% 2. have published a table that indicates onset of first symptoms. 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. The risk of DCS increases when diving for extended periods or at greater depth. in more than half of all cases symptoms do not begin to present until over an hour following the dive. ascending from depth. or ascending to altitude. 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). a leading technical diver training organization.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.S. 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. in extreme cases even before a dive has been completed. It may happen when leaving a high-pressure environment.[22] Two principal factors control the risk of a diver suffering DCS: 1.[20] [21] DCS has been confirmed in rare cases of breath-holding divers who have made a sequence of many deep dives with short surface intervals.S.[24] . without ascending gradually and making the decompression stops needed to slowly reduce the excess pressure of inert gases dissolved in the body. DON can develop from a single exposure to rapid decompression.3% 0. 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. 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. The U.[23] Even when the change in pressure causes no immediate symptoms. Navy are as [17] follows: Although onset of DCS can occur rapidly after a dive.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. rapid pressure change can cause permanent bone injury called dysbaric osteonecrosis (DON). Navy and Technical Diving International. causing these gases to come out of solution and form "micro bubbles" in the blood.6% 1. The specific risk factors are not well understood and some divers may be more susceptible than others under identical conditions. The table does not differentiate between types of DCS.3% 1. 2. owing to the pressure of the surrounding water. [18] [19] or types of symptom.

The higher the altitude of exposure the greater is the risk of developing altitude DCS. However. where the pressure in his spacesuit is lower than the pressure in the vehicle.[20] [25] A similar pressure reduction occurs when an astronaut exits a space vehicle to perform a space-walk or extra-vehicular activity. there is increased risk for divers flying in any aircraft shortly after diving. where caissons under pressure were used to keep water from The principal features of a caisson are the workspace. they will experience a significant reduction in ambient pressure.[20] [26] [27] [30] Likewise. when 15 workers died from what was then a mysterious illness. since the pressure in the cabin is not actually maintained at sea-level pressure. in large engineering excavations below the water table. 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.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. such as bridge supports and tunnels.[32] [33] There is no specific altitude threshold that can be considered safe for everyone and below which no one will develop altitude DCS. DCS is very rare in healthy individuals who experience pressures equivalent to this altitude. DCS was a major factor during construction of Eads Bridge.[20] [26] [27] [28] The original name for DCS was "caisson disease". Individual exposures to pressure altitudes between 5500 m (18000 ft) and 7500 m (24600 ft) have shown a low occurrence of altitude DCS.[20] [26] [31] Altitude DCS became a common problem in the 1930s with the development of high-altitude balloon and aircraft flights. and some people may be predisposed to the drop in pressure that occurs even in pressurized aircraft. pressurised by an external air flooding the excavations. Nevertheless. they do not show a direct relationship with the severity of the various types of DCS. Workers spending supply. cabin pressurization systems still fail occasionally. there is still a risk of DCS in individuals having dived recently.[35] . 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.[34] 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. cabin pressurization systems maintain commercial aircraft cabin pressure at the equivalent altitude of 2400 m (7900 ft) or less. allowing safe flights at 12000 m (39000 ft) or more. 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). Also. Today. Although exposures to incremental altitudes above 5500 m (18000 ft) show an incremental risk of altitude DCS. this term was used in the 19th century. and later during construction of the Brooklyn Bridge.[29] Ascent to altitude Passengers may be at risk of DCS when an unpressurized aircraft ascends to high altitude. where it incapacitated the project leader Washington Roebling. A US Air Force study of altitude DCS cases reported that 87% of incidents occurred at 7500 m (24600 ft) or higher.

Decompression sickness 12 Predisposing factors Although the occurrence of DCS is not easily predictable. Therefore.[38] [39] [40] • 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.[37] An individual exposed to a rapid decompression (high rate of ascent) above 5500 metres (18000 ft) has a greater risk of altitude DCS than being exposed to the same altitude but at a lower rate of ascent. the 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. especially to altitudes of 5500 m (18000 ft) and above. the assumption that the dive table surface interval occurs at normal atmospheric pressure is invalidated by flying during that surface interval. carry a greater risk of altitude DCS. 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 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 greater is the risk of DCS. 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.[26] [36] • the rate of ascent – the faster the ascent the greater 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. Longer flights. However. Lake Titicaca is at 3800 m (12500 ft) — without using versions of decompression tables or dive computers that are modified for high-altitude. Dive tables make provisions for post-dive time at surface level before flying to allow any residual excess nitrogen to outgas.[26] [36] • the duration of exposure – the longer the duration of the dive.[26] [31] [36] • repetitive exposures – repetitive dives within a short period of time (a few hours) increase the risk of developing DCS. scuba divers in Eritrea who drive from the coast to the Asmara plateau at 2400 m (7900 ft) increase their risk of DCS.[26] • 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. many predisposing factors are known.[38] [42] Individual .[41] • diving at altitude – diving in water whose surface altitude is above 300 m (980 ft) — for example. and an otherwise-safe dive may then exceed the dive table limits.

[44] Atrial septal defect (PFO) showing left-to-right shunt.[50] . In the brain. but stores about half of the total amount of nitrogen (about 1 litre) at normal pressures.[20] [36] This is due to nitrogen's five times greater solubility in fat than in water.[20] [36] Decompression sickness risk can be reduced by increased ambient temperature during decompression following dives in cold water.[49] In the arterial system.[20] [43] • ambient temperature – there is some evidence suggesting that individual exposure to very cold ambient temperatures may increase the risk of altitude DCS. In diving. a person who has a high body fat content is at greater risk of DCS. where the bubbles would otherwise be filtered out by the lung capillary system. however.[20] [36] • previous injury – there is some indication that recent joint or limb injuries may predispose individuals to developing decompression-related bubbles. Fat represents about 15–25 percent of a healthy adult's body. leading to greater amounts of total body dissolved nitrogen during time at pressure. 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. this can allow venous blood with microbubbles of inert gas to bypass the lungs.[48] • 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.[46] Studies by Walder concluded that decompression sickness could be reduced in aviators when the serum surface tension was raised by drinking isotonic saline. A right-to-left shunt may allow bubbles to pass into the arterial circulation.[45] • alcohol consumption and dehydration – although alcohol consumption increases dehydration and therefore may increase susceptibility to DCS. In about 20% of adults the flap does not completely seal. infarction results in stroke.[47] and the high surface tension of water is generally regarded as helpful in controlling bubble size. due to local loss of blood flow). allowing blood through the hole when coughing or during activities that raise chest pressure. and in the spinal cord it may result in paralysis.[36] Maintaining proper hydration is recommended.[36] a 2005 study concluded that alcohol consumption did not increase the risk of DCS. • body type – typically. and return directly to the arterial system (including arteries to the brain. spinal cord and heart).

The most severe types of DCS interrupt — and This surfacing diver must enter a decompression ultimately damage — spinal cord function. but is about 4. 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. while large numbers of bubbles in the venous blood can cause lung damage. This is known as isobaric counterdiffusion.65 times slower than helium.[61] For example. which can also cause decompression sickness.[10] [55] A similar effect. it is preferred over nitrogen in gas mixtures for deep diving. to come out of physical solution and form gas bubbles within the body. a diver will switch to mixtures containing progressively less helium and more oxygen and nitrogen during the ascent. since helium does not cause narcosis. the amount of that gas dissolved in the liquid will also decrease proportionately. so different decompression schedules are required. or death. however some groups like the WKPP have been pioneering the use of shorter decompression times by including deep stops. most offgassing occurs by gas exchange in the lungs.[57] There is some debate as to the decompression requirements for helium during short-duration dives. may occur during explosive decompression. In the presence of a right-to-left shunt of the heart. venous bubbles may enter the arterial system.[60] 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. and presents a problem for very deep dives. Most divers do longer decompressions. resulting in an arterial gas embolism. after using a very helium-rich trimix at the deepest part of the dive. when water vapour forms bubbles in body fluids due to a dramatic reduction in environmental pressure. On ascent from a dive. The formation of bubbles in the skin or joints results in milder symptoms. chamber to avoid decompression sickness.5 times more soluble.[59] but controlled decompression is still required to avoid DCS. These bubbles produce the symptoms of decompression sickness.Decompression sickness 14 Mechanism Depressurisation causes inert gases. Very deep dives have been made using hydrogen-oxygen mixtures (hydrox). but. leading to paralysis. Helium both enters and leaves the body faster than nitrogen. known as ebullism. inert gas comes out of solution in a process called "outgassing" or "offgassing". Under normal conditions.[58] Any inert gas that is breathed under pressure can form bubbles when the ambient pressure decreases. as . Nitrogen diffuses into tissues 2. such as a patent foramen ovale. sensory dysfunction.[20] [51] Bubbles may form whenever the body experiences a reduction in pressure. when the pressure of a gas in contact with a liquid is decreased.[52] The amount of gas dissolved in a liquid is described by Henry's Law. which indicates that. but nitrogen is not the only gas that can cause DCS.[53] [54] 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.[56] Inert gases The main inert gas in air is nitrogen. This is often found to provoke inner ear decompression sickness. which were dissolved under higher pressure. but not all bubbles result in DCS. Breathing gas mixtures such as trimix and heliox include helium.

since less nitrogen will be taken into the body than during the same dive done on air.[71] 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). they are not as good at determining the diagnosis as a proper history of the event and description of the symptoms. 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.[62] 15 Diagnosis Decompression sickness should be suspected if any of the symptoms associated with the condition occurs following a drop in pressure. and remain at that depth until sufficient gas has been eliminated from the body to allow further ascent.[73] .[72] Following a decompression schedule does not completely protect against DCS. 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.6 metres (15 ft). within 24 hours of diving. 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. decompression software.[68] Each of these is termed a "decompression stop". release of inert gas as pressure changes. but do not reduce it to zero. in particular. Dives that contain no decompression stops are called "no-stop dives". 4. or none at all. Reduction in decompression requirements can also be gained by breathing a nitrox mix during the dive.[67] This schedule requires the diver to ascend to a particular depth. and a schedule for a given bottom time and depth may contain one or more stops.[64] 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. depending on the training agency. and tables will indicate the time at normal pressures that is required.[65] The diagnosis is confirmed if the symptoms are relieved by recompression. but divers usually schedule a short "safety stop" at 3 metres (10 ft).[65] [66] Although MRI or CT can frequently identify bubbles in DCS. or 6 metres (20 ft). such as the Bühlmann decompression algorithm. are designed to fit empirical data and provide a decompression schedule for a given depth and dive duration. divers limit their ascent rate to about 10 metres (33 ft) per minute. 95% of all cases reported to Divers Alert Network had shown symptoms within 24 hours. These models. This will result in a shorter available time under water or an increased decompression time during the subsequent dive. dive time.[63] In 1995.[8] Prevention Underwater diving To prevent the excess formation of bubbles that can lead to decompression sickness. or from dive computers. The algorithms used are designed to reduce the probability of DCS to a very low level. and carry out a decompression schedule as necessary. and decompression information. 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.Decompression sickness the ear seems particularly sensitive to this effect.[70] Since divers on the surface after a dive still have excess inert gas in their bodies. which may be up to 18 hours.[67] [69] The decompression schedule may be derived from decompression tables. The total elimination of excess gas may take many hours.

provides effective protection upon exposure to low-barometric pressure environments. pulmonary symptoms. and hence the risk of DCS. Recompression on room air was shown to be an effective treatment for minor DCS symptoms by Keays in 1909.[86] It is beneficial to give fluids.[84] If given within the first four hours of surfacing. At a dive site. People should be made comfortable and placed in the supine position (horizontal).[63] In the past.[78] Evidence of the effectiveness of recompression therapy utilizing oxygen was first shown by Yarbrough and Behnke.[84] [88] . 10. both the Trendelenburg position and the left lateral decubitus position (Durant's maneuver) have been suggested as beneficial where air emboli are suspected.66 bar) in the suits to lessen the pressure reduction. however. which operate at 4.70 bar). Astronauts aboard the International Space Station preparing for extra-vehicular activity (EVA) "camp out" at low atmospheric pressure. descent) does not decrease the risk of altitude DCS. and mottled or marbled skin lesions should be treated with hyperbaric oxygen therapy if seen within 10 to 14 days of development.[75] 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.Decompression sickness 16 Exposure to altitude One of the most significant breakthroughs in the prevention of altitude DCS is oxygen pre-breathing.[87] but are no longer recommended for extended periods. It is no longer recommended to administer aspirin. it is logistically complicated and expensive for the protection of civil aviation flyers.[81] [82] [83] Oxygen first aid has been used as an emergency treatment for diving injuries for years. a riskier alternative is in-water recompression. it increases the success of recompression therapy as well as a decrease the number of recompression treatments required.[77] The recompression chamber at the Neutral Buoyancy Lab. either commercial or private.3 psi (0. It is also used by flight test crews involved with certifying aircraft. Breathing pure oxygen significantly reduces the nitrogen loads in body tissues and.[76] Mild cases of the "bends" and some skin symptoms may disappear during descent from high altitude. it is currently used only by military flight crews and astronauts for protection during high-altitude and space operations.[74] although research has examined the possibility of using 100% O2 at 9.[80] Recompression is normally carried out in a recompression chamber. or the recovery position if vomiting occurs.30 bar). unless advised to do so by medical personnel.2 psi (0.[26] [27] Although pure oxygen pre-breathing is an effective method to protect against altitude DCS. breathing pure oxygen during flight alone (ascent. it is recommended that these cases still be evaluated. owing to concerns regarding cerebral edema. During the EVA they breathe 100% oxygen in their spacesuits. as analgesics may mask symptoms. en route.[85] 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. Therefore. as this helps reduce dehydration.[26] [27] However. Neurological symptoms. spending eight sleeping hours in the Quest airlock chamber before their spacewalk.[79] and has since become the standard of care for treatment of DCS.5 psi (0. if continued without interruption.

[91] Epidemiology The incidence of decompression sickness is rare. they recorded 50. He suggested that intravascular gas was released by rapid decompression and recommended: slow compression and decompression.S. or organ congestion. with the risk 2.[94] • 1871: The Eads Bridge in St Louis employed 352 compressed air workers including Dr.1 psig (4 ATA). using only healthy workers.[63] In 1999. from which 28 recompressions were required — although these will almost certainly contain incidents of arterial gas embolism (AGE) — a rate of about 0.[7] [92] History • 1670: Robert Boyle demonstrated that a reduction in ambient pressure could lead to bubble formation in living tissue.[29] (He took charge after his father John Augustus Roebling died of tetanus. permanent long-term injury from DCS is possible.Decompression sickness 17 Prognosis Immediate treatment with 100% oxygen. followed by recompression in a hyperbaric chamber.150 dives. scuba divers per year. The project chief engineer Washington Roebling suffered from caisson disease.8 cases per 10.000 U. Alphonse Jaminet as the physician in charge. There were 30 seriously injured and 12 fatalities. estimated at 2. decompression sickness became known as "The [Grecian] Bends" because afflicted individuals characteristically . This description of a viper in a vacuum was the first recorded description of decompression sickness.[8] DCS affects approximately 1. four-hour working shifts.[29] 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.[93] • 1769: Giovanni Morgagni described the post mortem findings of air in cerebral circulation and surmised that this was the cause of death. commented that. all prominent features were established.6 times greater for males than females. From 1870 to 1910. of those having made frequent dives. However. and vascular stasis caused by decompression. Jaminet developed decompression sickness and his personal description was the first such recorded.[94] • 1840: Colonel William Pasley.[89] [90] Long-term follow-ups showed similar results.3% of the 268 divers surveyed "still had residual signs and symptoms from Type II DCS and 7% from Type I DCS". limit to maximum depth 44. and recompression treatment for severe cases. Recompression treatment was not used. He battled the after-effects of the disease for the rest of his life.) Washington's wife. Explanations at the time included: cold or exhaustion causing reflex spinal cord damage. who was involved in the recovery of the sunken warship HMS Royal George. 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. electricity cause by friction on compression. will in most cases result in no long term effects. helped manage the construction of the bridge after his sickness confined him to his home in Brooklyn.[95] • 1841: First documented case of decompression sickness. • 1870: Bauer published outcomes of 25 paralyzed caisson workers. "not a man escaped the repeated attacks of rheumatism and cold". Emily. • 1873: Dr. reported by a mining engineer who observed pain and muscle cramps among coal miners working in mine shafts air-pressurized to keep water out. From 1998 to 2002. the Divers Alert Network (DAN) created "Project Dive Exploration" to collect data on dive profiles and incidents. During this project. Dr.000 dives.[29] [96] The project employed 600 compressed air workers. with 16% having permanent neurological sequelae.05%. Three-month follow-ups on diving accidents reported to DAN in 1987 showed 14.

[94] [98] Hill advocated linear or uniform decompression profiles. using a microprocessor to calculate nitrogen absorption for twelve tissue compartments.[104] 1960: FC Golding et al. a submersible mechanical device that simulated nitrogen uptake and release. or as historian David McCullough asserts in The Great Bridge it was a crude reference to "Greek" or anal sex.Decompression sickness arched their backs: this is possibly reminiscent of a then fashionable women's dance maneuver known as the Grecian Bend.[109] . it is common for medical insurance not to cover treatment for the bends that is the result of recreational diving. a personal dive computer. experimented with oxygen for recompression therapy. His work was financed by Augustus Siebe and the Siebe Gorman Company.[94] • 1924: The US Navy published the first standardized recompression procedure. A typical stay in a recompression chamber will easily cost several thousand dollars.[108] In the United Kingdom.[99] These tables were accepted for use by the Royal Navy.[106] 1983: Orca produced the "EDGE". As a result.[97] • 1900: Leonard Hill used a frog model to prove that decompression causes bubbles and that recompression resolves them." which detailed his deterministic model for calculation of decompression schedules.[94] 1941: Altitude DCS is treated with hyperbaric oxygen for the first time. Boycott and Damant recommending staged decompression.[94] • 1935: Behnke et al.[94] [100] [101] • • • • • • • • 18 An early recompression chamber 1937: Behnke introduced the “no-stop” decompression tables. 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. treatment of DCS is provided by the National Health Service.[105] 1982: Paul K Weathersby. even before emergency transportation is included.[94] • 1908: "The Prevention of Compressed Air Illness" was published by JS Haldane.[107] Society and culture Economics In the United States. Louis D Homer and Edward T Flynn introduce survival analysis into the study of decompression sickness. This is because scuba diving is considered an elective and "high-risk" activity and treatment for decompression sickness is expensive.[103] 1959: The "SOS Decompression Meter".[94] [98] This type of decompression is used today by saturation divers.[100] • 1930s: Albert R Behnke separated the symptoms of Arterial Gas Embolism (AGE) from those of DCS.[102] 1957: Robert Workman established a new method for calculation of decompression requirements (M-values). either at a specialised facility or at a Hyperbaric Centre based within a general hospital. split the classification of DCS into Type 1 and 2. was introduced.[104] 1984: Albert A Bühlmann released his book "Decompression-Decompression Sickness.

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United States: Lippincott Williams And Wilkins. . ISSN 0813-1988. [32] Robinson. 75(Phys)6-1-89: 437. Stephen A (27 November 2007). Two of the best-recorded instances of it both occurred at Boesmansgat. com/ article/ 769717-overview).5. RL. caused by helium being released from the tissues but blocked by heavier nitrogen molecules.). . "Statistical Bubble Dynamics Algorithms for Assessment of Altitude Decompression Sickness Incidence" (http:/ / archive. Navy Diving Manual. Petar J. Undersea and Hyperbaric Medicine Abstract 28 (Supplement). Navy Supervisor of Diving (2008). OCLC 16986801. Retrieved 18 May 2010. . . Retrieved 15 May 2010. .S. OCLC 16986801. 579 [10] Francis.S. Naval Sea Systems Command. org/ 6010). com/ ddb3491. Navy Supervisor of Diving (2008) (PDF). Space. David H (1999). revision 6. Journal of Bone and Joint Surgery (British Editorial Society of Bone and Joint Surgery) 56B (1): 3–15. US Air Force Technical Report AL-SR-1992-0005. who. org/ 4027). 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gov/dp_forms. ISBN 1-905492-07-3. Southend-on-Sea: Aquapress. 23 External links • Environmental Physiology Medical Literature (http://archive.html) Deep diving The meaning of the term deep diving is a form of technical diving. asp) • Dive Tables from the NOAA (http://www.A.[3] These divers needed to breathe special gas mixtures because they were exposed to very high ambient pressure (more than 50 times atmospheric pressure).noaa.Decompression sickness • Marx.). Deco for Divers.ndc.[1] It is defined by the level of the diver's diver training. For instance the early experiments carried out by Comex S. ISBN 978-0-323-05472-0. • Powell. Diver returning from a 600 ft/180 metres dive . PA: Mosby/Elsevier. breathing gas. in 1977. 100 metres / 330 feet may be a "deep dive" This definition essentially relates to recreational diving. An atmospheric diving suit allows very deep dives of up to 700 metres. One example being the Comex Janus IV open-sea dive to 500 metres. This eliminates the problems associated with breathing high pressure gases.org/medical/articles/index. John (2010). and surface support: • in recreational diving. PADI define anything from 18 metres / 60 feet . Mark (2008).org) • Divers Alert Network: diving medicine articles (http://www. Rosen's emergency medicine: concepts and clinical practice (7th ed. Deep diving may have quite a different meaning in the commercial diving field.[2] 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.rubicon-foundation.diversalertnetwork. These suits are capable of withstanding the pressure at great depth permitting the diver to remain at normal atmospheric pressure. diving equipment.30 metres / 100 feet as a "deep dive" (other diving organisations vary) • in technical diving. 60 metres / 200 feet may be a "deep dive" • in surface supplied diving. (Compagnie maritime d'expertises) using hydrox and also nitrogen trimix attained far greater depths than any recreational technical diving. Philadelphia.

Deep diving 24 Deep Diving Depth [4] Comments Recreational diving limit for divers aged under 12 years old and beginner divers. a diver may have only a few minutes at the deepest part of the dive before decompression stops are needed. Very deep diving using a helium–oxygen mixture (heliox) carries a risk of high pressure nervous syndrome.000 feet/610 meters World record for deepest dive on SCUBA. starts with feelings of euphoria and over-confidence but then leads to numbness and memory impairment similar to alcohol intoxication. Heavy physical exertion causes even more gas to be breathed. This tends to be life threatening. which may lead to a convulsion underwater. an excess of carbon dioxide in the blood. breathing gas consumption is proportional to ambient pressure . Recreational diving limit for divers with Open Water certification but without greater training and experience. All of these considerations result in the amount of breathing gas required for deep diving being much greater than for shallow open water diving.[10] Nitrogen narcosis. [1] 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). Recommended recreational diving limit for divers.[7] 1.4 ATA. Recommended technical diving limit. adults. Depth at which compressed air results in an unacceptable risk of oxygen toxicity. The effects tend to be delayed until reaching the surface. can happen if a diver ascends too fast. These bubbles produce mechanical and biochemical effects that lead to the condition. Bone degeneration (dysbaric osteonecrosis) is caused by the bubbles forming inside the bones.so at 50 metres (160 ft). most commonly the upper arm and the thighs.083 feet/330 meters 2. the “narks” or “rapture of the deep”. The diver needs a disciplined approach to planning and conducting dives to minimise these additional risks. and gas becomes denser requiring increased effort to breathe with depth. Decompression sickness. A diver at 6 metres (20 ft) may be able to dive for many hours without needing to do decompression stops. [8] Navy diver in Atmospheric Diving System (ADS) suit . At depths greater than 40 metres (130 ft). 509 feet/155 meters Record depth for scuba dive on compressed air. though minimal visibility possible farther down. In the event of an emergency the diver cannot make an immediate ascent to the surface without risking decompression sickness. Deep diving involves a much greater danger of all of these. [9] Particular problems associated with deep dives Deep diving has more consequences and dangers than basic open water diving. . where the pressure is 6 bar. leading to increasing risk of hypercapnia.[6] 660 feet/200 meters Absolute limit for surface light penetration sufficient for plant growth. or the “bends”. [5] [1] 330 feet/100 meters Technical diving training limit for divers breathing trimix. and requires a recompression chamber for treatment. a diver breathes 6 times as much as on the surface (1 bar). Coping with the physical and physiological stresses of deep diving requires good physical conditioning. when excess inert gas leaves solution in the blood and tissues and forms bubbles. Technical diving limit for "extended range" dives breathing air to a maximum ppO2 of 1. The need to do decompression stops increases with depth.[11] Using normal scuba equipment. and presents the additional risk of oxygen toxicity. Air embolism causes loss of consciousness and speech and visual problems.

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 [12] South Africa Gilberto M de Oliveira Brazil John Bennett [12] Philippines Philippines Jim Bowden Mexico Mexico South Africa Mexico South Africa Andaman Sea Thailand Sheck Exley Don Shirley [12] 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. Philippines. • A diving shot. a decompression trapeze or a decompression buoy can help divers return to their surface safety cover at the end of a dive. there are certain elite divers who participate in ultra-deep diving on SCUBA (using closed circuit rebreathers and heliox) below 660 feet (200 m). Ultra-deep diving requires extraordinarily high levels of training.[13] [14] [15] [16] That is fewer . • Use of helium-based breathing gases such as trimix reduces nitrogen narcosis and stays below the limits of oxygen toxicity. 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. Technical divers preparing for a mixed-gas decompression dive in Bohol. Note the backplate and wing setup with sidemounted stage tanks containing EAN50 (left side) and pure oxygen (right side).Deep diving 25 Dealing with depth • Divers carry larger volumes of breathing gas to compensate for the increased gas consumption and decompression stops. experience. fitness and surface support. but are inherently more complex than open circuit scuba. • Rebreathers manage gas much more efficiently than open circuit scuba.

a colleague of Jacques Cousteau." The National Geographic Magazine.) . Since the recent introduction of depth gauges capable of reading to 330m it is unlikely that such records will be attempted in the future. surface light may disappear completely at much shallower depths in murky conditions. p. 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. 660. 26 Ultra deep air While extreme deep diving on air is extremely dangerous. comex.6 bar ppO2. Bret Gilliam chronicles the various fatal attempts to set records as well as the smaller number of successes. In deference to the high death rate. References [1] Brylske. 3rd edition. org/ mslib/ servlet/ onepetropreview?id=SUT-AUTOE-v14-107& soc=SUT& speAppNameCookie=ONEPETRO) [3] Comex S. although it looked like the black pit-mouth of hell itself---yet still showed blue. individual physiology. perhaps unsurprisingly. A. United States: PADI. html) [4] All depths specified for sea water. contributed to an astonishingly high fatality rate amongst those attempting records. again reporting no ill effects from narcosis or oxygen toxicity. vg/ books?id=HVbjgdorRXAC& lpg=PA35& ots=TjUeuuvLmB& dq="bret gilliam" record air& pg=PA35#v=onepage& q="bret gilliam" record air& f=false) [7] Assuming crystal clear water. ISBN 1878663011." (William Beebe. fr/ suite/ ceh/ histo/ histo anglais. at 1400 feet (424 meters). and it should be noted that Dr Marion's second dive computer only registered a depth of 490 feet. See generally Deep Diving by Bret Gilliam. The Holy Grail of deep SCUBA diving was the 1000 ft (300 m) mark. Don Shirley. there is a small group of divers who have reached depths below 200 meters on closed-circuit rebreathers. Alessandro Scuotto. 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. Minimal visibility is still possible far deeper. Paul Raymeakers and Pim van der Horst. (http:/ / books. Deep Diving. • 1994 Dan Manion set the current record for a deep dive on air at 509 feet (155 m). Some examples are David Shaw. Dives of this nature have been impossible to verify . Deep sea explorer William Beebe reported seeing blueness. The record is not officially recognised anywhere. Marco Reis. which occurs at 218 feet breathing air. Manion reported he was almost completely incapacitated by narcosis and has no recollection of time at depth. "A Round Trip to Davey Jones's Locker. onepetro. HYDRA 8 and HYDRA 10 test projects (http:/ / www. [2] Hydra 8: Pre-commercial Hydrogen Diving Project (http:/ / www. Besides scuba. ISBN 0-922769-31-1. dived to 307 feet (94 m) on air 1959 Ennie Falco reported having reached a depth of 435 feet (133 m) on air. google. • 1990 Bret Gilliam dived to a depth of 452 feet (138 m) on air.A. Encyclopedia of Recreational Diving. the Guinness World Records ceased to publish records on deep air dives. Watson reported that he had no recollection at all of what transpired at the bottom of the descent due to narcosis. • 1993 Bret Gilliam extended his own world record to 475 feet (145 m). Mario Marconi. and other factors not fully understood. [6] Set by Dr Dan Marion on March 18. This created an extreme risk of both narcosis and oxygen toxicity in the divers and. "I peered down and again I felt the old longing to go farther. and has only been achieved five times since.[17] From the comparatively few who survived extremely deep air dives: • • • • • 1947 Frédéric Dumas. (2006). In 2003 Mark Ellyatt claimed dives to depths of 260m and 313m. not blackness. 1994. first achieved by John Bennett in 2001. Fractionally deeper depths may apply in relation to freshwater due to its lower density [5] Oxygen toxicity depends upon a combination of partial pressure and time of exposure. before the popularity of Trimix attempts were made to set world record depths using conventional air. at pages 35 and following.proof being as tangible as faith more often than not. June 1931. In his book.Deep diving than the number of people who have walked on the surface of the moon. NOAA recommends that divers do not expose themselves to breathing oxygen at greater than 1. Unusually.

. Bret Gilliam. ME (1989). MA and Smith. Retrieved 2008-06-14. --Knafelc. org/ 4659). and commercial divers (although commercial diving to that depth is unknown on SCUBA). the Guinness World Records still recognises the 1. "Recorded Deep Dives Below 200 m" (http:/ / www. Proceedings of Advanced Scientific Diving Workshop (Washington. html) [10] Egstrom GH (2006). NE (eds). MA and Smith. NE (eds). 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. an advanced guide to physiology. [15] Statistics exclude military divers (classified). "Historic Perspective: Scientific Deep Diving and the Management of the Risk" (http:/ / archive. . htm). .15240. .Deep diving [8] 1. htm). rubicon-foundation. a former Turkish Navy diver. DG (2006). However. Retrieved 2008-07-05.108883. org/ 4653). N. . Proceedings of Advanced Scientific Diving Workshop (Washington.044 feet dive by Nuno Gomes earlier in the same year as the current official world record.083 feet was the depth reportedly achieved by Pascal Bernabé in 2005. com/ DeepRecords.rubicon-foundation.com. military. . MA and Smith. Retrieved 2009-11-19.org/4669). "Medical Fitness at 300 FSW" (http:/ / archive. [11] Southerland. DC). NE (eds). Retrieved 2008-07-05. [14] Scubarecords.htm) . [9] Navy diver sets world record (http:/ / www. [16] In 2007 Erdogan Bayburt. dived to a depth of 998 feet (304 m) off the coast of Cyprus.divinglore. DC). but that dive has not been independently verified. com/ features/ 0. It was a Turkish Navy experimental dive. procedures and systems (http:/ / books. 1995-01-25. His dive was aborted due to equipment failure. US Naval Experimental Diving Unit Technical Report NEDU-8-89. com/ ?id=HVbjgdorRXAC& pg=PT1& lpg=PT1& dq=Bret+ Gilliam+ deep+ diving#v=onepage& q=& f=false). za/ rec. Retrieved 2008-07-05. He used a closed-circuit rebreather. W (2006). External links • Recreational Deep Diving (http://www. [17] Deep Diving. Retrieved 2008-07-24. "EX 19 Performance Testing at 850 and 450 FSW (Feet of Seawater)" (http:/ / archive. [12] Subsequently died during diving accidents. In: Lang. Retrieved 2008-06-14.00.com/RecreationalDeepDiving. ISBN 9780922769315. nunogomes. 27 Footnotes Further reading • Dent. scubarecords. Proceedings of Advanced Scientific Diving Workshop (Washington. "Verified dives below 200 metres" (http:/ / www. DC). co. rubicon-foundation. In: Lang. rubicon-foundation. [13] Gomes. org/ 7423). In: Lang. "AAUS Deep Diving Standards" (http://archive. google.

Dive tables Although not all dive tables are recommended for use in this way. p.81 − 10 EAD = 30 − 10 EAD = 20 metres So at 27 metres on this mix. (2001). the EAD is: EAD = (27 + 10) × 0. org/ 2835). At 27 metres the Bühlmann 1986 table (0–700 m) allows 20 minutes bottom time without requiring a decompression stop. While at 20 metres the no-stop time is 35 minutes. for a given nitrox mix and depth.[1] [2] [3] The equivalent air depth.64 / 0. . PMID 538866.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. Undersea Biomedical Research 6 (4): 379–84. Retrieved 2008-05-01. United States Navy Experimental Diving Unit Technical Report NEDU-RR-01-61. the Bühlmann tables are suitable for use with these kind of calculations. [2] Berghage Thomas E.79 − 33 EAD = 123 × 0.79 − 10 EAD = 37 × 0. for a nitrox mix containing 64% nitrogen (EAN36) being used at 90 feet. JA (1961). for example. NC: Divers Alert Network. Durham. Michael A. org/ 3835). rubicon-foundation. Retrieved 2008-05-02. References [1] Logan.79 − 10 Working the earlier example. This shows that using EAN36 for a 27 metre dive can give a 75% increase in bottom time over using air.81 − 33 EAD = 100 − 33 EAD = 67 feet So at 90 feet on this mix. 197. a gas mix containing 36% oxygen (EAN36) being used at 27 metres (89 ft) has an EAD of 20 metres (66 ft). the diver would calculate their decompression requirements as if on air at 67 feet. DAN Nitrox Workshop Proceedings (http:/ / archive. "An evaluation of the equivalent air depth theory" (http:/ / archive. rubicon-foundation. . rubicon-foundation. Calculations in feet The equivalent air depth can be calculated for depths in feet as follows: EAD = (Depth + 33) × Fraction of N2 / 0. known as nitrox. the diver would calculate their decompression requirements as if on air at 20 metres. Retrieved 2008-05-01.79 − 33 Working the earlier example.64 / 0. is the depth of a dive when breathing air that would have the same partial pressure of nitrogen. [3] Lang. the EAD is: EAD = (90 + 33) × 0. Calculations in metres The equivalent air depth can be calculated for depths in metres as follows: EAD = (Depth + 10) × Fraction of N2 / 0. for a nitrox mix containing 64% nitrogen (EAN36) being used at 27 metres. . "Equivalent air depth: fact or fiction" (http:/ / archive. org/ 4855). . McCraken TM (December 1979). So.

for a gas mix containing 40% helium being used at 200 feet.[1] the NOAA diving manual recommends treating oxygen and nitrogen as equally narcotic.[2] This is now preferred to the previous method of considering only nitrogen as 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.4) − 10 END = 70 × 0. The method is. to calculate the depth which would produce the same narcotic effect when breathing air. 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 diver would feel the same narcotic effect as a dive on air to 107 feet.6 − 10 END = 42 − 10 END = 32 metres So at 60 metres on this mix. the END is: END = (60 + 10) × (1 − 0. .Equivalent narcotic depth 29 Equivalent narcotic depth Equivalent narcotic depth (END) is used in technical diving as a way of estimating the narcotic effect of a breathing gas mixture. a trimix containing 20% oxygen. 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. it is assumed that the narcotic potentials of nitrogen and oxygen are similar. the diver would feel the same narcotic effect as a dive on air to 32 metres.4) − 33 END = 233 × 0. for a gas mix containing 40% helium being used at 60 metres. 40% nitrogen (trimix 20/40) being used at 60 metres (200 ft) has an END of 32 metres (105 ft). for a given mix and depth. since it is more conservative. For example. it is likely that some of the oxygen is metabolised.6 − 33 END = 140 − 33 END = 107 feet So at 200 feet on this mix. Oxygen Narcosis Since there is evidence that oxygen plays a part in the narcotic effects of a gas mixture. thus reducing its effect to a level similar to that of nitrogen. the END is: END = (200 + 33) × (1 − 0. such as heliox and trimix. 40% helium. In this analysis. Although oxygen has greater lipid solubility than nitrogen and therefore should be more narcotic (Meyer-Overton correlation).

1977.[1] HPNS is a limiting factor in future deep diving. it is appropriate to include the oxygen in the END calculation when using trimixes (Lambersten et al. regardless of the proportions of oxygen and nitrogen. The compression effects may occur when descending below 500 feet (150 m) at rates greater than a few metres per minute.1978). somnolence.[3] The term high pressure nervous syndrome was first used by Brauer to describe the combined symptoms of tremor. Zal'tsman also reported on helium tremors in his experiments from 1961. 2002. 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..[1] [2] Russian scientist G. such as nitrogen (creating trimix) or hydrogen (hydreliox) suppresses the neurological effects.2.[5] visual disturbance.4] . L. 4th.e. EEG changes. and somnolence that appeared during a 1189-foot (362 m) chamber dive in Marseilles. and carbon dioxide in compressed-air narcosis" (http:/ / archive.. dizziness. .[1] [6] Rate of Compression Utilizing slow rates of compression or adding stops to the compression have been found to prevent large initial decrements in performance. The non-helium portion (i. "Roles of nitrogen. Fagraeus L. org/ 2810).3. rubicon-foundation.[1] [2] Causes HPNS has two components..1.Equivalent narcotic depth 30 References [1] Hesser CM. one resulting from the speed of compression and the other from the absolute pressure. National Oceanic and Atmospheric Administration. "Helium tremors" were first widely described in 1965 by Royal Navy physiologist Peter B.[1] 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.[1] [7] Breathing Mixture Including other gases in the mix. and decreased mental performance. but has little variation between different dives by the same diver. Undersea Biomed Res 5 (4): 391–400. "[16. [2] "Mixed-Gas & Oxygen". The effects from depth become significant at depths exceeding 1000 feet (300 m) and remain regardless of the time spent at that depth. The effects depend on the rate of descent and the depth. oxygen. NOAA Diving Manual. Bennett.[1] The susceptibility of divers and animals to HPNS varies over a wide range depending on the individual. Unfortunately these reports were not available in the West until 1967. who also founded the Divers Alert Network. but reduce within a few hours once the pressure has stabilised.[4] Symptoms Symptoms of HPNS include tremors. Adolfson J (December 1978). myoclonic jerking." 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.[8] [9] [10] . Retrieved 2008-05-01. nausea. Diving for Science and Technology. since oxygen has some narcotic properties. electroencephalography (EEG) changes. PMID 734806.

L. S. ISBN 0702025712... Retrieved 2008-04-07. OCLC 2068005. (1974). P. X.rubicon-foundation. 1 (1): 1–28. W. Royal Navy Personnel Research Committee. Undersea Biomed. org/ 2661). P. rubicon-foundation. (1968). W. Coggin. McLeod. ISSN 0093-5387. Texas A&M University Sea Grant TAMU-SG-79-201. MD Thesis (Toulouse University). AD655 360 (Wright Patterson Air Force Base. B. anesthetics and anticonvulsant drugs have had varying results in suppressing HPNS with animals. PMID 7168098. Undersea Biomed. 323–57. Foreign Technology Division. "The High Pressure Nervous Syndrome". (1970). R. "Seeking man's depth level". B. United States: Saunders. Rev Neurol (Paris) 121 (3): 264–5. [5] Brauer. Gosset.. "The use of Non-Explosive mixtures of hydrogen and oxygen for diving". PMID 4619860. mechanisms and prevention of the high pressure nervous syndrome" (http:/ / archive. Res. W.org/dspace/simple-search?query=high+ pressure+nervous+syndrome) hosted by the Rubicon Foundation . "Effects of a H2-He-O2 mixture on the HPNS up to 450 msw" (http:/ / archive. Peter B. ISSN 0093-5387. J. Retrieved 2008-04-07. Lemaire. In Brubakk. . Neuman. "Syndrome neurologique et electrographique des hautes pressions". "The causes. C. (1982). [4] Brauer. [6] Hunger Jr. Bennett and Elliott's physiology and medicine of diving. References [1] Bennett. "Contribution to the study of the neurological and mental reactions of the organism of the higher mammal to gaseous mixtures under pressure".. R. (1965). pp. 251 (London). "Psychological principles of a sojourn of a human in conditions of raised pressure of the gaseous medium (in Russian. G. L. R. "Effect of compression rate on use of trimix to ameliorate HPNS in man to 686 m (2250 ft)" (http:/ / archive. Fructus. Retrieved 2008-04-07. . . (1967). ISSN 0093-5387. A. Tom S.High-pressure nervous syndrome 31 Drugs Alcohol. [2] Bennett. 5th Rev ed. P. rubicon-foundation. Rostain. (1979). M. Naquet. M. [7] Bennett. Res. 9 (4): 335–51. (1988). OCLC 2068005. Gardette-Chauffour. Bennett. Undersea Biomedical Research 15 (4): 257–70. C. [3] Zal'tsman. rubicon-foundation. (1968). [10] Rostain. OCLC 2068005. Ocean Industry (London) 3: 28–33. 1961)". Ohio). P. Fructus.. B. J. W. Alf O. English translation. "Psychometric impairment in men breathing oxygen-helium at increased pressures". org/ 2920).[1] None are currently in use for humans. Underwater Physiology Subcommittee Report No. P. Jean Claude (2003). C. External links • Select publications about HPNS (http://archive. R. R. PMID 3212843. [8] Vigreux. PMID 5378824.. org/ 2487). Naquet. Dimov. [9] Fife.

Corerect identification of cylinder gases and safe procedures for gas changes. partial pressure depends upon proportion of oxygen and depth Hypoxia or anoxia occurs while having gas to breathe. 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 . Carry a diver's net cutter. If a cylinder has stood full for months. empty it and refill it. Click on the boldface links to find symptoms and more information for each topic. See cave diving and wreck diving. Some of these conditions also affect people who work in raised pressure environments out of water. Keep equipment routinely checked and in good condition Better training of divers. hypoxic gas Proper training before using a rebreather. Types of this sort of diving disorder. every hour of recreational diving is 36 to 62 times riskier than automobile driving.[2] 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. but where the oxygen partial pressure is too low to sustain normal activity or consciousness. diving was (on a man-hours based criteria) 96 times more dangerous than driving an automobile. Better awareness underwater. A faulty or misused rebreather can provide the diver with Keep rebreathers properly maintained. with scuba or other diving equipment) or use high pressure breathing gases.g. Better training and leadership. According to a North American 1970 study. or dive tool/knife. Some deep diving breathing gases such as trimix and heliox can be hypoxic at shallow depths Don't breathe hypoxic gas in shallow water. in caissons. Keep cylinders routinely checked and tested. 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. 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. More disciplined attitude when underwater. before the diver uses the cylinder Anoxia due to having no air or gas to breathe Equipment failure . 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. Specific training and leadership for such types of diving.g. Proper training before using mixed gases. Oxygen toxicity Breathing gas at too high a partial pressure of oxygen.[1] According to a 2000 Japanese study.g. using up oxygen in the contained air.particularly in rebreathers that monitor and maintain oxygen content Running out of air due to a number of factors. e.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.

Do not dive with eyes-only goggles. Carbon dioxide poisoning: hypercapnia With a rebreather.List of diving hazards and precautions 33 Air cylinder filled by a compressor which sucked in products of combustion. Proper diver training in clearing the ears. For example. Check conditions where you have your cylinders refilled. Re-inhaling carbon dioxide-laden exhaled gas Use proper filters in the air pump or air compressor.g. Keep rebreathers properly maintained. 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. never wear earplugs. and how to avoid them Type Eardrum damage. Cold water in the middle ear chills the inner ear. Do not dive with conditions such as the common cold Let air into the mask through the nose. 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. Minimise the volume of any enclosed spaces which the diver breathes through. Proper training before using a rebreather. the diver re-inhales carbon dioxide because the soda lime scrubber cannot absorb the exhaled carbon dioxide as fast as the diver produces it. This is a particular risk with a pumped surface air feed. British naval divers called it shallow water blackout. 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 . such as the paranasal sinuses. e. with the common cold. this hazard can happen with diving with a large "bubblehead" helmet. often its own engine's exhaust gas Oil getting into the air feed and firing in the air compression cylinder. Put the proper gas identification markings on cylinders. Cause Failing to equalize the pressure in the middle ear with surrounding pressure. How to avoid it Do not dive if the eustachian tube is congested. This can happen from losing control of buoyancy causing excessive vertical speed during descent. Click on the boldface links to find symptoms and more information for each topic. Make sure that your hood does not make an airtight seal over the outside ear hole. On descent Air spaces within the body provide no support against greater outside pressure. The pressure in the outer ear not equalizing with surrounding pressure Damage to other body air spaces. Types of this sort of diving disorder. See Rebreather#Carbon dioxide scrubber. causing dizziness and disorientation etc.

air loose in the pleural cavity Gas trapped in the chest after burst lung Gas loose under the skin. In severe cases much of the diver's body could be mangled and compacted inside the helmet. 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. Proper training in its use. however. e. Squeeze damage to skin under Suction into the space inside the fold folds in a drysuit Lung squeeze: blood in lungs Extreme depth when snorkelling Helmet squeeze. This can happen from holding the breath on ascent. 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).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. the common cold. with the old standard diving dress. On ascent Air spaces within the body expand when the outside pressure decreases. Air or other gas in the blood stream. Types of this sort of diving disorder. or from losing control of buoyancy causing excessive vertical speed during ascent.g. Its effects can be very similar to decompression sickness. Click on the boldface links to find symptoms and more information for each topic. 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. This does not happen with scuba where there is no solid pressure-tight helmet A non-return valve in the helmet failing. Blockage of the sinus's duct Blocked Eustachian tube Pain in a sinus Eardrum bursting outwards Do not dive with nasal congestion. . Effects of breathing gas at high pressure Click on the boldface links to find symptoms and more information for each topic.

a boilersuit could be worn in very warm water. This hazard is well known with closed circuit rebreathers when the control of the mixture fails. Avoid dehydration and hypothermia. Also. Many deep dives in succession. Reduce the number of deep dives. Do not get too close to coral. See taravana. Water carries heat away far better than air. 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. such as an ROV. Divers face specific physical and health risks when they go underwater (e. Use an underwater breathing apparatus and ascend at a rate determined by decompression tables or computer. Type Hypothermia Cause Losing body heat to the water. metal. Use another diving technique. in caissons. Use breathing gas mixtures with reduced inert gas fraction. Limit the depth of the dive to limit the partial pressures of gases with narcotic effects to a level that you can safely manage. Nitrogen narcosis Breathing a high partial pressure of nitrogen (or other gas. much heat can be lost from a head without a hood. Where it says "Avoid diving with bare skin". and barotrauma. Stings Stings. Other risks encountered by people in water Types of this class of diving disorder. With mixed gas diving. How to avoid it In cool or cold water. After dive. How to avoid it Plan your dive.g. do not miss or cut short decompression stops. and how to avoid them. It is yellow. eg Nitrox. Bends in snorkellers. Avoid diving with bare skin.List of diving hazards and precautions 35 Types of this sort of diving disorder. e. Click on the boldface links to find symptoms and more information for each topic. etc. Learn to identify it. Avoid diving in bare skin. 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. sometimes with Coral coral tissue left in them Cuts Rock. Dont dive deep on air. use the correct breathing gas mixture to limit the equivalent narcotic depth to an acceptable level for the planned depth. wear an adequately warm diving suit for the conditions. See decompression sickness for a detailed list of the symptoms. ascending too quickly will cause gas to supersaturate and form bubbles in tissues depending on time and depth of the dive. Uncommon but known. Some of these conditions also affect people who work in raised pressure environments out of water. and how to avoid them Type Decompression sickness ("the bends") Cause Gas dissolves in tissues under pressure according to Henry's Law over time. Maintain cardiovascular fitness. Know how long you can stay at the planned depth and still make a normal ascent.g. some dangerous Fire coral Some jellyfish . Provide something for the diver to hold onto while ascending and decompressing to maintain accurate depth during stops and correct ascent rate. increase surface interval or reduce dive depth. Avoid diving with bare skin. or add a little nitrogen as described at HPNS. arterial gas embolism. Training in using diving tables and a dive computer. Cuts. with scuba) or use high pressure breathing gases. Learn about the dangerous species. If stops are necessary. particularly in caves or shipwrecks.

currents moved a shore dive the diver away from a safe exit. lionfish. bruises and skin conditions that result from diving in tropical waters. in some South American fresh water Electric ray. For example hydrogen sulfide in some lakes and caves can be absorbed through the skin. [6] [7] Electric eel. in some tropical waters Attack by Titan Triggerfish Attack by an unusually large grouper. some sea urchins in warm seas Blue ringed octopus. There have been cases [3] [4] [5] of very large groupers trying to swallow humans. Carry a yellow flag or surface marker buoy to attract attention. Get proper information on them. dive in watertight drysuit and full face diving mask Exposure to disease carried by in-water organisms Exposure to harmful chemicals in the water Broken bones. Sudden loss of underwater visibility Silt out: stirring up silt or other light loose material Training in diving in zero visibility. crown of thorns starfish. Colliding with a boat or its propeller. 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. Get proper information on them. Local knowledge. 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.List of diving hazards and precautions 36 Do not poke about in sand where they live. stonefish. good weather forecasts. Carry a personal submersible EPIRB or submersible vhf radio. Ensure that boat uses a positive check system to identify each diver is on board after a dive. 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. bleeding wounds and other trauma Use Surface detection aids or a diving shot to mark surfacing position and aid searchers. scrapes. Care when wading. Carry a signalling mirror and/or sound signalling device. . See Underwater Port Security System. sea lice bites. Keep away from them. jellyfish stings. Wave action on the shore. Plan a safe exit point and check weather and tidal conditions. Care when wading. in parts of the Pacific Ocean Sharks. never molest even seemingly-tame sharks underwater. 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. Consult location-specific information to determine risk. fire coral inflammation and other skin injuries that a diver may gain from using a shorty wetsuit or no diving suit. surface weather on the shore make the sea too rough to safely exit. Avoid waters known to be inhabited by crocodiles. Keep out of armed forces areas. likelihood of risk is location dependent Wear a full-body exposure suit to prevent direct skin to environment contact. Left behind due to inaccurate check by boat crew Diver lost at sea after Big waves made it unsafe to leave the water. In affected water. Learn the frog kick. Keep a lookout for the fish and move away if they act aggressively Crocodile attack Crocodiles. 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. Avoid large ships' ordinary sonar. where protected from attack by sharks. Poison-injecting spines Poison injection Shark bites Learn to identify them. This includes sunburn.

jacksonville. "Is recreational diving safe?" (http:/ / archive. com/ tu-online/ stories/ 061905/ spo_19030958. html). Clarke. Correct use of reels and route to the surface lines. Undersea and Hyperbaric Medical Society. Retrieved 2009-08-08. . Retrieved 2009-08-08. . 2005-06-19. html). [2] Ikeda. Dive with a buddy who is capable of helping to free you and will stay close enough to notice. Train in wreck diving and cave diving techniques. "A Case for Regulation of the Feeding of Fishes and Other Marine Wildlife by Divers and Snorkelers" (http:/ / www. [6] Sargent. "Big Grouper Grabs Diver On Keys Reef" (http:/ / www. flmnh. H (2000). [4] Allard. Reef Relief. info/ eco/ e020104/ e020104. shtml). org/ science_body4. 4 feet side side to side. page 138: 15 feet long. 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. 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. in the sunken Admiralty floating dock in Trincomalee. Evan T (2002-01-04). . "Did fish feeding cause recent shark.com. [3] Alevizon.DDRC.com (Florida Times-Union). reefrelief. [7] Arthur C. directional markers. Backup lights.org) . Ashida. PMC 1518314. nets. Bill (July 2000). edu/ fish/ InNews/ grouperattack2005. grouper attacks?" (http:/ / www. shtml). PMID 5031739.List of diving hazards and precautions 37 Carry at least one line cutting implement. Bill (2005-06-26). ISBN 0-7434-4502-3. org/ 6770). . [5] "Goliath grouper attacks" (http:/ / www. ufl. "Deaths During Skin and Scuba Diving in California in 1970". FloridaToday. rubicon-foundation. California Medicine 116 (6): 18–22. Retrieved 2009-08-08. T. Reefs of Taprobane. cdnn. References [1] Lansche. . Sri Lanka External links • Diving Diseases Research Centre (http://www. Jacksonville. Cyber Diver News Network. Retrieved 2009-08-08. Retrieved 2009-08-08. wrecks. James M (1972).

3 feet (29. .36) . so divide by 0. This safe limit varies depending on the diver training agency.).Maximum operating depth 38 Maximum operating depth In technical diving and nitrox diving.[1] The tables below show MODs for a selection of oxygen mixes. Of this total pressure which can be tolerated by the diver.6 bar.4 / 0. 120 minutes at 1. 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. 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. The remaining part in each formula merely converts pressure in atm produced by depth in water.4 bar. the level of underwater exertion planned and the planned duration of the dive.1] = 95. 1 atmosphere is due to the Earth's air.4 bar.0 m).3 bar and 210 minutes at 1. For example. 180 minutes at 1. Safe limit of partial pressure of oxygen The maximum single exposure limits recommended in the NOAA Diving Manual are 45 minutes at 1. but is normally in the range of 1.5 bar. Note that 21% is the concentration of oxygen in normal air. if a gas contains 36% oxygen and the maximum ppO2 is 1.36) . to the depth. if a gas contains 36% oxygen and the maximum ppO2 is 1.[1] 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 MOD (m) is 10 metres x [(1.5. 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.[1] Formulas To calculate the MOD for a specific ppO2 and percentage of oxygen. to give the rest of the pressure added by water (in atmospheres). There is a risk of oxygen toxicity if the MOD is exceeded. For example. 150 minutes at 1. etc.9 metres.6 bar. So the 1 atm for the air is subtracted out.4 / 0. the MOD (fsw) is 33 feet (10 m) x [(1. 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. and the rest is due to depth in water. 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. 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.1] = 28.4 bar.2 to 1.2 bar.

4 76.6 106.0 26.0 8.0 18.0 98.8 1.2 51.1 16.7 1.1 23.0 190.4 30.3 206.0 7.7 28.6 523.2 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 83.3 67.7 48.3 20.8 123.3 43.3 15.7 134.3 4.1 11.0 11.9 25.1 18.5 45.0 13.7 62.7 10.7 167.5 490.2 38.2 to 1.0 17.0 .3 10.3 11.9 11.4 456.3 1397 682 443 324 253 205 171 145 125 110 99 1.0 123.3 6.3 1.7 223.0 35.6 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 1.3 256.0 4.7 49.0 8.7 23.2 390.1 3.3 61.4 23.9 16.5 13.9 66.4 28.5 25.0 28.0 90.6 11.0 (bar) 8.3 20.5 6.2 56.6 7.Maximum operating depth 39 MOD table in feet Maximum Operating Depth (MOD) in feet of sea water for ppO2 1.5 5.6 16.5 31.8 56.0 13.0 34.0 7.0 90.9 44.0 5.0 156.7 5.0 8. MOD table in metres Maximum Operating Depth (MOD) in metres of sea water for ppO2 1.1 6.0 73.7 47.0 15.6 4.3 5.3 38.9 36.3 21.5 7.0 19.1 25.4 1507 737 480 352 275 223 187 159 138 121 107 97 1.3 41.8 7.8 18.0 56.4 3.8 10.3 96.4 52.1 33.7 14.3 21.6 12.0 8.3 145.1 40.4 31.7 115.8 6.0 240.6 40.2 to 1.9 23.3 2.7 32.3 70.6 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 1.4 10.5 1617 792 517 379 297 242 202 173 150 132 117 104 95 1.0 1.3 423.4 26.3 29.7 14.5 10.6 6.7 78.6 22.5 34.6 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.

A cylinder label shows the maximum operating depth and mixture (oxygen/helium).A. and can occur during shallow dives. inert gas narcosis.6 Narcosis while diving (also known as nitrogen narcosis. a term used by Homer and Hippocrates. numbness". which is greater as the lipid solubility of the gas increases. DAN Nitrox Workshop Proceedings (http:/ / archive. p. is a reversible alteration in consciousness that occurs while scuba diving at depth.Maximum operating depth 40 References [1] Lang.[4] Narcosis produces a state similar to alcohol intoxication or nitrous oxide inhalation.[5] As depth increases.613.455. org/ 4855).7 2. M. .3 0. Nitrogen narcosis Inert gas narcosis [Nitrogen narcosis] Classification and external resources Divers breathe a mixture of oxygen. 197. it is not possible to develop a tolerance.3 7. NC: Divers Alert Network. beyond 30 meters (100 ft). and their relative narcotic potentcies [3] Gas Ne H2 N2 O2 Ar Kr CO2 Xe Relative narcotic potency 0. but usually does not become noticeable until greater depths. all gases that can be breathed have a narcotic effect. Although divers can learn to cope with the effects. . rubicon-foundation. Apart from helium. and probably neon.571 Some components of breathing gases.0 25. raptures of the deep. helium and nitrogen for deep dives to avoid the effects of narcosis.6 1. While narcosis affects all divers. Durham. "temporary decline or loss of senses and movement. the effects may become hazardous as the diver is increasingly impaired. (2001). DiseasesDB MeSH 30088 [1] [2] C21.1 20. predicting the depth at which narcosis will affect a diver is difficult. The Greek word ναρκωσις (narcosis) is derived from narke. Martini effect). Retrieved 2008-06-24. as susceptibility varies widely from dive to dive and amongst individuals.0 1.

This is a very rough guide. disregarding normal safe diving practices.Nitrogen narcosis The condition is completely reversed by ascending to a shallower depth with no long-term effects.[7] Signs and symptoms Due to its perception-altering effects.[10] Such effects are not harmful unless they cause some immediate danger not to be recognized and addressed.[11] Narcosis can produce tunnel vision. depending on the individual diver and the diver's medical or personal history. They also resemble (though not as closely) the effects of alcohol and the familiar benzodiazepine drugs such as diazepam and alprazolam. or for standard diving safety guides. but it has been successfully used for surgical operations. the effects generally remain the same at a given depth. 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. Professional divers use such a calculation only as a rough guide to give new divers a metaphor. Xenon has historically been too expensive to be used very much in practice. but their effect on psychomotor function (processes affecting the coordination of sensory or cognitive processes and motor activity) varies widely. When more serious. except helium and probably neon. or paranoia. specialist training is required in the use of various gas mixtures such as trimix or heliox. Once stabilized.a feeling of tranquility and mastery of the environment. krypton.[5] as well as nitrogen.[12] The relation of depth to narcosis is sometimes informally known as "Martini's law". 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. Other effects include vertigo. Diving beyond 40 m (130 ft) is considered outside the scope of recreational diving: as narcosis and oxygen toxicity become critical factors. only worsening if the diver ventures deeper. and not a substitute for an individual diver's known susceptibility. 41 Classification Narcosis results from breathing gases under elevated pressure and may be classified by the principal gas involved. narcosis results in relief of anxiety . oxygen and hydrogen cause a decrement in mental function. and xenon has so much anesthetic activity that it is actually a usable anesthetic at 80% concentration and normal atmospheric pressure. The syndrome may cause exhilaration. the onset of narcosis may be hard to recognize. the diver may feel overconfident. and visual or auditory disturbances. The effects of carbon dioxide consistently result in a decrease of both mental and psychomotor function. The noble gases.[8] [9] At its most benign. multi-tasking and coordination.[13] Reported signs and symptoms are summarized against typical depths in meters and feet of sea water in the following table:[12] . comparing a situation they may be more familiar with. and xenon anesthesia systems are still being proposed and designed.[6] The noble gases argon. For this reason. and impaired judgement. depression. extreme anxiety. giddiness. These effects are essentially identical to various concentrations of nitrous oxide. making it difficult to read multiple gauges The most dangerous aspects of narcosis are the loss of decision-making ability and focus. and xenon are more narcotic than nitrogen at a given pressure.

Hallucinations. Stupefaction with some decrease in dexterity and judgment. owing to carbon dioxide retention. Over-confidence and sense of well-being. increased excitability.[16] The breathing gas mix entering the diver's lungs will have the same pressure as the surrounding water. Occasional dizziness. instructions and other stimuli. dizziness. Mild euphoria possible. as the effect may vary from dive to dive (even on the same day). Delayed response to visual and auditory stimuli. as a result of the elevated pressures at depth (Henry's law). or no symptoms at all. Uncontrolled laughter. the Guinness Book of World Records no longer reports on this figure. but the changes are not usually noticeable.[22] . disorganization of the sense of time.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. Reasoning and immediate memory affected more than motor coordination. Calculation errors and wrong choices. hysteria (in chamber). Severe delay in response to signals. impaired judgment. Idea fixation. Mildly impaired reasoning.[15] More recently.[13] 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. 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. Sleepiness. 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. Mild impairment of performance of unpracticed tasks. corresponding to an ambient pressure of about 4 bar (400 kPa). manic or depressive states. and unconsciousness. Sense of impending blackout. Anxiety (common in cold murky water). Hallucinations. Unconsciousness. or the severity of the effect on an individual diver. Death. Loss of memory.[14] [21] A number of divers have died in attempts to set air depth records below 120 m (400 ft). changes in facial appearance.[14] Modern theories have suggested that inert gases dissolving in the lipid bilayer of cell membranes cause narcosis. For any given depth. a sense of levitation. known as the ambient pressure.[14] Most sport scuba training organizations recommend depths of no more than 40 m (130 ft) because of risk of narcosis.[18] [19] A divers' cognition may be affected on dives as shallow as 10 m (33 ft). Poor concentration and mental confusion.[14] [17] Rapid compression potentiates narcosis.[14] [19] Significant impairment due to narcosis is an increasing risk below depths of about 30 m (100 ft). loss of memory. Terror in some. confusion. Increased intensity of vision and hearing.[20] However there is no reliable method to predict the depth at which narcosis becomes noticeable. Because of these incidents. researchers have been looking at neurotransmitter receptor protein mechanisms as a possible cause of the narcosis. euphoria. Laughter and loquacity (in chambers) which may be overcome by self control.

increasing the effects of other gases. krypton and hydrogen cause very similar effects at higher than atmospheric pressure. Thermal cold. add to narcosis.[23] Increased risk of narcosis results from increasing the amount of carbon dioxide retained through heavy exercise. such as opiate narcotics and benzodiazepines. or because of poor gas exchange in the lungs. other likely conditions do not produce reversible effects.[25] 43 Mechanism The precise mechanism is not well understood. typical of a cell reproduction by the very chemically inactive gas argon makes them membrane. the less partial pressure is needed. causing direct mechanical interference with the transmission of signals from one nerve cell to another. However. fatigue. the initial management—ascending closer to the surface—is still essential.[14] [15] [19] More recently. 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. In the rare event of misdiagnosis when another condition is causing the symptoms. the effects then disappear within minutes. heavy work. specific types of chemically-gated receptors in nerve cells have been identified as being involved with anesthesia and narcosis. Given the setting.Nitrogen narcosis Narcosis has been compared with altitude sickness insofar as its variability (though not its symptoms). While the effect was first observed with air.[28] Some of these effects may be due to antagonism at NMDA receptors and potentiation of GABAA receptors. but it appears to be the direct effect of gas dissolving into nerve membranes and causing temporary disruption in nerve transmissions. its effects depend on many factors.[6] [14] Carbon dioxide has a high narcotic potential and also causes increased blood flood to the brain.[27] Other sedative and analgesic drugs.[24] Narcosis is known to be additive to even minimal alcohol intoxication. ascending is always the correct initial response.[35] or hypothermia causing rapid breathing and shivering. 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.[34] early signs of oxygen toxicity causing visual disturbances.[29] similar to the mechanism of nonpolar anesthetics such diethyl ether or ethylene. 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.[25] [26] 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).[30] However. . their Illustration of a lipid bilayer.[31] Trudell et al. other gases including argon. have suggested non-chemical binding due to the attractive van der Waals force between proteins and inert gases. the basic and most general underlying idea.[36] Nevertheless the presence of any of these symptoms should imply narcosis. with variations between individuals.[31] An early theory. remains largely unchallenged. Alleviation of the effects upon ascending to a shallower depth will confirm the diagnosis. and carbon dioxide retention all increase the risk and severity of narcosis.[32] Similar to the mechanism of ethanol's effect. the increase of gas dissolved in nerve cell membranes may cause altered ion permeability properties of the neural cells' lipid bilayers.[37] In the event of complications or other conditions being present. the Meyer-Overton hypothesis suggested that narcosis happens when the gas penetrates the lipids of the brain's nerve cells. stress. shallow or skip breathing. 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.[16] [33] Diagnosis and management The symptoms described may be caused by other factors during a dive: ear problems causing disorientation or nausea.[9] The management of narcosis is simply to ascend to shallower depths.

and these may then be used as a signal to ascend to shallower depths. Some gases have other dangerous effects when breathed at pressure.[37] Deep dives should be made only after a gradual training to gradually test the individual diver's sensitivity to increasing depths. high-pressure oxygen can lead to oxygen toxicity. with careful supervision and logging of reactions.[13] While the individual diver cannot predict exactly at what depth the onset of narcosis will occur on a given day.[5] [42] The use of these gases forms part of technical diving and requires further training and certification.Nitrogen narcosis Should problems remain. 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. 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. one diver may have trouble with eye focus (close accommodation for middle-aged divers). however. 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. and this training should include a discussion of narcosis. For example. often consisting of further theory and some practice in deep dives with close supervision. another may experience feelings of euphoria. If narcosis does occur. neon at a given pressure has a narcotic effect equivalent to nitrogen at 0. and cure. which are somewhat more repeatable than for the average group of divers.[38] 44 Prevention The most straightforward way to avoid nitrogen narcosis is for a diver to limit the depth of dives. a diver keeping to shallower depths can avoid serious narcosis. Helium is stored in brown cylinders. based on relative lipid solubilities. so in principle it should be usable at nearly four times the depth. for example. its effects.[39] [40] Scuba organizations which train for diving beyond Narcosis while deep diving is prevented by filling recreational depths. Argon. Although severe narcosis may interfere with the judgment necessary to take preventive action. The decompression schedule can still be followed unless other conditions require emergency assistance. Specialist training may help divers in identifying these personal onset signs. and at these depths narcosis does not present a large risk. the first symptoms of narcosis for any given diver are often more predictable and personal. and is not suitable as a breathing gas for diving (it is used as a drysuit inflation gas. Although helium is the .[43] Equivalent narcotic depth (END) is a commonly used way of expressing the narcotic effect of different breathing gases.28 times that pressure. owing to its low thermal conductivity).[41] may forbid diving with gases that cause too dive cylinders with a gas mixture containing much narcosis at depth in the average diver. 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 diver training agencies offer specialty training to prepare recreational divers to go to depths of 40 m (130 ft). has 2. Most recreational dive schools will only certify basic divers to depths of 18 m (60 ft). Since narcosis becomes more severe as depth increases. then it is necessary to abort the dive. list conversion factors for narcotic effect of other gases.[45] Standard tables. Some divers report that they have hearing changes.[46] For example. and strongly encourage helium.33 times the narcotic effect of nitrogen. Further training is normally required for certification up to 30 m (100 ft) on air. and that the sound which their exhaled bubbles make becomes different. and another feelings of claustrophobia.[44] The National Oceanic and Atmospheric Administration (NOAA) Diving Manual now states that both oxygen and nitrogen should be considered equally narcotic.

imagination is lively. A hangover.[14] History French researcher Victor T. a prominent Victorian physician. it is likely to be longer than for alcohol. hypothesized in 1881 that pressure forced blood to inaccessible parts of the body and the stagnant blood then resulted in emotional changes. the underlying behavioral effects remain. Junod was the first to describe symptoms of narcosis in 1834.Nitrogen narcosis least intoxicating of the breathing gases. . cost. and longer for other drugs. but due to the much longer half-life of the active agent of this drug in the body. thoughts have a peculiar charm and. divers should avoid sedating medications and drugs. Even though it is possible that some divers can manage better than others because of learning to cope with the subjective impairment.[19] Tests have shown that all divers are affected by nitrogen narcosis. makes nitrogen narcosis more likely.[25] Experts recommend total abstinence from alcohol at least 12 hours before diving.[56] What became known as the Meyer-Overton Hypothesis is illustrated in the diagram to the right."[52] [53] Junod suggested that narcosis resulted from pressure causing increased blood flow and hence stimulating nerve centers. a still-mysterious but apparently unrelated phenomenon. the effects of narcosis are entirely reversible by ascending and therefore pose no problem in themselves. and other factors are also important. at greater depths it can cause high pressure nervous syndrome. even for repeated. in some persons. as the result of illogical behavior in a dangerous environment.[14] [19] Nevertheless.[47] Inert gas narcosis is only one factor which influences the choice of gas mixture. combined with the reduced physical capacity that goes with it.[30] [50] [51] These effects are particularly dangerous because a diver may feel they are not experiencing narcosis. the risks of decompression sickness and oxygen toxicity. noting "the functions of the brain are activated.[49] Abstinence time needed for marijuana is unknown.[54] Walter Moxon (1836–1886). the severity of narcosis is unpredictable and it can be fatal while diving.[48] Because of similar and additive effects. though some are less affected than others.[55] 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. such as marijuana and alcohol before any dive. Except for occasional amnesia of events at depth. yet still be affected by it. entitled Zur Theorie der Alkoholnarkose. Two years later a similar theory was published independently by Charles Ernest Overton. Meyer in 1899. symptoms of intoxication are present. chronic or acute exposure.[27] 45 Prognosis and epidemiology Narcosis is potentially one of the most dangerous conditions to affect the scuba diver below about 30 m (100 ft).

[10] Hobbs M (2008). Retrieved 2008-12-23. SS521-AG-PRO-010. org/ 5060). Australia: J. Kizer. ISBN 097522901X. com/ history. Selby. revision 6. PMID 18619113. Liu. 2000). Ioanna A. nih. Retrieved 2008-11-03. org/ content/ 91/ 2/ 486. D. [20] Petri. PMID 14756232. gov/ cgi/ mesh/ 2011/ MB_cgi?mode=& term=Nitrogen+ Narcosis& field=entry#TreeC21. Behnke and O. Simon J (2005). "Change in strategy of solving psychological tests: evidence of nitrogen narcosis in shallow air-diving" (http:/ / archive. general-anaesthesia. rubicon-foundation. "Roles of nitrogen. Fagraeus. [16] Rostain. Eleni (April 12. Report of a Committee Appointed by the British Admiralty.Nitrogen narcosis In 1939. 303 [19] Hamilton. Naval Sea Systems Command. 103. MD: Undersea and Hyperbaric Medical Society) (UHMS Publication Number 64WS(NN)4-26-85). 176). rubicon-foundation. CM. "Recent neurochemical basis of inert gas narcosis and pressure effects" (http:/ / archive. diseasesdatabase. and carbon dioxide in compressed-air narcosis" (http:/ / archive. p. Leonard. Retrieved 2009-08-07. Albert R. . org/ 3976). org/ 2810). Deeper into Diving (2nd ed. RW. Ramoutsaki. This measures the relative concentration of different gases required to prevent motor response in 50% of subjects in response to stimulus. . . OCLC 2068005. As hydrogen has only 0. Balon N (2006). Navy Diving Manual (http:/ / supsalv. Retrieved 2008-12-23. Alf O. PMID 16869533.[58] Jacques-Yves Cousteau in 1953 famously described it as "l’ivresse des grandes profondeurs" or the "rapture of the deep". VN (November–December 1999). p. . [14] Brubakk & Neuman 2003. Victoria. anesthesiaanalgesia. Peter. William (1975). Retrieved 2009-07-29. Rostain. "Deep diving and ordinary diving". 305 [6] Hesser.S. .Philippines. in 1977 and 1978. NE. Publications. Retrieved 2008-12-23. OCLC 66524750. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society.[60] The (NOAA) Diving Manual was revised to recommend treating oxygen as if it were as narcotic as nitrogen. p. p. 29th Undersea and Hyperbaric Medical Society Workshop (Bethesda. Jean C.[61] 46 Footnotes [1] http:/ / www. L.S. [12] Lippmann & Mitchell 2005. html). Anesteziol Reanimatol (6): 56–60. "Clinical and experimental study of xenon anesthesia" (http:/ / www. 571 [3] Bennett. from man to cell membrane" (http:/ / archive. . Potapov. [11] Lippmann. rubicon-foundation. org/ pdf/ DiveMan_rev6. [21] Hill. John. Konsolaki. KW (eds) (1985). 301 [9] U. [7] Burov. John Burdon Sanderson (1941).L. 308 [15] Paton. 105 [13] Brylske. David. Inc 35 (3): 175–84.). ISBN 0702025712. Lambertsen et al. rubicon-foundation.). and shows similar results for anesthetic potency as the measurements of lipid solubility. Navy Supervisor of Diving (2008) (PDF). Inc) 30 (4): 293–303. p. U. Helen. "Nitrogen Narcosis" (http:/ / archive.55 the solubility of nitrogen. "Diver narcosis. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society. Journal of Hygiene 41 (3): 225–49. deep diving experiments using hydrox were conducted by Arne Zetterström between 1943 and 1945. full). . . [18] Brubakk & Neuman 2003. . "Human physiology under high pressure". 455. "Inert Gas Narcosis". J (1978). oxygen. Retrieved 2009-06-29. com/ ddb30088. United States: Professional Association of Diving Instructors. [4] Askitopoulou. "Professional Scuba Association International History" (http:/ / www. International Anesthesia Research Society. "Etymology and Literary History of Related Greek Words" (http:/ / www. Retrieved 2008-10-31. Retrieved 2008-12-23. Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society. Journal of the South Pacific Underwater Medicine Society (first published at Oceans 2000 Conference) 5 (2).[57] For an inert gas the narcotic potency was found to be proportional to its lipid solubility. psai-philippines. Haldane. "Subjective and behavioural responses to nitrogen narcosis and alcohol" (http:/ / archive. PMC 2199778. html).1017/S0022172400012432. p. nlm. Professional Scuba Association International . org/ 4496). ISBN 1878663011. [17] Case. Analgesia and Anesthesia. Makeev. Inc) 5 (4): 391–400. EM. 304. PMID 20475589. [5] Brubakk & Neuman 2003. . following research by Christian J. rubicon-foundation. Adolfson. Neuman. A (2006). htm [2] http:/ / www. GN. Encyclopedia of Recreational Diving (3rd ed. RH. p. .S. org/ 5897). Mitchell. Jean Claude (2003). Retrieved June 9. RP. (Value for Krypton from 4th Edition. [8] Brubakk & Neuman 2003. Yarborough demonstrated that gases other than nitrogen also could cause narcosis. U.[59] Further research into the possible mechanisms of narcosis by anesthetic action led to the "minimum alveolar concentration" concept in 1965. com/ xenon-anaesthesia. rubicon-foundation. [22] PSAI Philippines. doi:10. "Nitrogen narcosis". et al. Kornienko. p. org/ 8101). Tom S. 613. Bennett and Elliott's physiology and medicine of diving (5th ed. Undersea and Hyperbaric Medicine 33 (3): 197–204. ISSN 0093-5387. 2010. PMID 734806. In Brubakk. NM (2003). OCLC 51607923. United States: Saunders Ltd. (1933).). pdf).

doi:10. OCLC 26915585. iantd. rubicon-foundation. com/ iantd3. SAA and other European training agencies teach recreational diving to a depth limit of 50 m (160 ft). R (1992). United States: Saunders Ltd. International Training. ISSN 1066-2936. Marilyn A. [45] "Mixed-Gas & Oxygen". "Effects of ethanol and amphetamine on inert gas narcosis in humans" (http:/ / archive.10. [35] Clark. 110–3 [25] Fowler. [47] Bennett. PSCR & SCR Rebreather Diver Programs (Recreational Trimix Diver)" (http:/ / www. Thom. space. Navy Diving Manual 2008. A (1987). [40] A number of technical diving agencies. shtml#6). NOAA Diving Manual. Archives of General Psychiatry (American Medical Association) 58 (10): 909–15. "Subjective and behavioral effects associated with repeated exposure to narcosis". JR. K. "Molecular and cellular mechanisms of general anaesthesia". Retrieved 2008-06-10. Hajo. doi:10. regardless of the proportions of oxygen and nitrogen. 374. Retrieved 2009-07-29. "A molecular description of how noble gases and nitrogen bind to a model site of anesthetic action" (http:/ / www. since oxygen has some narcotic properties. [43] Hamilton. PMID 7742709. Neuman. Deborah (2001).58. [42] Hamilton Jr. Schmidt. DD. "Narcotic factors of gases" (http:/ / www. Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society. html). "Priestley lecture 1986. Gerhard. anesthesia-analgesia. [33] Smith. Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society 12 (4): 369–402. 9th Undersea and Hyperbaric Medical Society Workshop (Bethesda. Schneck. anesthesia-analgesia. EI (1998). United States: Saunders Ltd. pp.1097/00000539-199808000-00034. Neuman. James I.1097/00000539-200012000-00045. ch. PMID 3307084. 2009. [36] Mekjavic. British Sub-Aqua Club. . Stephen R (2003). "[16. Jean Claude (2003). 2002. Otto I (2003). doi:10. [34] Molvaer. Alf O.. Bennett and Elliott's physiology and medicine of diving (5th ed. [50] Fowler. Tom S. Tom S. "Development of Decompression Procedures for Depths in Excess of 400 feet" (http:/ / archive. E. org/ 4498). Tom S. p. Koblin. p. Aviation. Retrieved 2009-08-16. rubicon-foundation. Alf O. Anesthesia and Analgesia 87 (2): 411–8. doi:10. "Effects of inert gas narcosis on behavior--a critical review. Marguerite (2008). Hudson. com/ page. Zieglgänsberger. Rostain. asp?section=2595& sectionTitle=DOC+ presentation+ summaries& preview=1). rubicon-foundation. [41] BSAC. Heslegrave. org/ 2720). OCLC 51607923. Patsalis. Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society 22 (1): 41–9. rubicon-foundation. Tom S. "Diving Officer's Conference presentations" (http:/ / www.. OCLC 51607923. 2.). Laliberté. Amanda J. . ama-assn. [31] Franks. Haseneder. . MF. G (1985). [37] Lippmann & Mitchell 2005. "IANTD Scuba & CCR. James M. . Bennett and Elliott's physiology and medicine of diving (5th ed. tdisdi. EB (July 1987). p.3. On the science of deep-sea diving--observations on the respiration of different kinds of air" (http:/ / archive. . "Neuropsychological performance in long-term cannabis users" (http:/ / archpsyc. Ola (2003). vol. Retrieved 2008-12-01. php?did=80& site=2). NP. Neuman. Alf O. "Nitrous oxide and xenon increase the efficacy of GABA at recombinant mammalian GABA(A) receptors" (http:/ / www. B. Bennett and Elliott's physiology and medicine of diving (5th ed. com/ index. .S. . "The effects of altered arterial tensions of carbon dioxide and oxygen on cerebral blood flow ans cerebral oxygen consumption of normal young men". pp. [30] Hamilton. 106 [38] U. . . Gruber. RW. pp.. Nature 367 (6464): 607–14. MF.1038/367607a0. National Oceanic and Atmospheric Administration. Journal of Clinical Investigation 27 (4): 484–492. MD: Undersea and Hyperbaric Medical Society) (UHMS Publication Number WS2-28-76): 272. Matti. OCLC 51607923. PMID 7509043.1001/archpsyc. "Thermal considerations in diving". Porlier. rubicon-foundation. K.4] .). org/ cgi/ content/ full/ 91/ 6/ 1542). PMC 439519. 1977." [46] Anttila. 234. B (1995). Yurgelun-Todd. Hamilton. ISSN 0021-9738. 323–57. [48] Lippmann & Mitchell 2005.1172/JCI101995. Retrieved 2008-12-23. PMID 11576028. WR (1994). Neuman. K. Retrieved 2008-10-31. Schreiner. "Dissociation of the behavioral and subjective components of nitrogen narcosis and diver adaptation" (http:/ / archive. Retrieved 2008-12-23. ISBN 0702025712. 304 [29] Hapfelmeier. [44] IANTD (1 January 2009). 4th. In Brubakk. Porlier. such as TDI and IANTD teach "extended range" or "deep air" courses which teach diving to depths of up to 55 m (180 ft) without helium. KN. [24] Lippmann & Mitchell 2005. 430–1 [49] St Leger Dowse. 35–46 [39] "Extended Range Diver" (http:/ / www. 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. org/ 2199). In Brubakk. PMID 11094015. Huestis. Eiken. Rainer. Laliberté. Diving for Science and Technology. The non-helium portion (i. Anesthesia and Analgesia 91 (6): 1542–9. doi:10. PMID 9706942. techdiver.2. Retrieved 2009-07-29. Lieb. In Brubakk. Kochs.e. [27] Pope. bsac.). 9. In Brubakk. "The High Pressure Nervous Syndrome"." (http:/ / archive. B. org/ 3050). 129. Eberhard (December 2000). United States: Saunders Ltd. . Carl F (1948). Fowler. Ackles. Peter. Retrieved 2009-03-22.). PMID 1417647. ISBN 0702025712. p. Eger. ws/ exotic_gases. [26] Michalodimitrakis. United States: Saunders Ltd. HR (eds) (1975). OCLC 51607923. PMID 16695569.1978).Nitrogen narcosis [23] Kety. Undersea Biomedical Research 13 (3): 345–54. 47 . G (1986). org/ 3019). Retrieved 2009-07-02. Bennett and Elliott's physiology and medicine of diving (5th ed. Alf O. Michael J. . [28] Brubakk & Neuman 2003. "Oxygen under pressure". Inc. org/ cgi/ content/ abstract/ 87/ 2/ 411). Igor B. Journal of Forensic Sciences 32 (4): 1095–7. PMID 3612064. org/ cgi/ content/ full/ 58/ 10/ 909). Walter. PMID 3775969. Tipton. Retrieved 2009-07-29. Inc 14 (4): 347–69. p. ISBN 0702025712..1. Seymour S. and environmental medicine 63 (10): 865–9. it is appropriate to include the oxygen in the END calculation when using trimixes (Lambersten et al. "Nitrogen narcosis and alcohol consumption--a scuba diving fatality". [32] Trudell. "Otorhinolaryngological aspects of diving". IANTD/IAND.909. ISBN 0702025712. p. Harrison G.

"Diving While Using Marijuana" (http://scuba-doc.com/marij. 266. repeated hyperbaric exposures on susceptibility to nitrogen narcosis" (http:/ / archive.uhms. Institute for Environmental Medicine.html). Dumas. mc. . • Diving Diseases Research Centre (DDRC) (http://www.com/page74. Retrieved 2009-07-29. duke. 48 References External links • Undersea and Hyperbaric Medical Society (http://www. "Studien Über Die Narkose" (in German). "University of Pennsylvania Institute for Environmental Medicine report.ddrc. • Campbell.htm). Retrieved 2009-03-22. University of Pennsylvania. Yarborough. Victor T (1834). "Nitrogen Narcosis" (http://www.1057. "Recherches physiologiques et thérapeutiques sur les effets de la compression et de la raréfaction de l'air" (http:/ / books. 583–5. AR. R.deep-six. google. Revue médicale française et étrangère: journal des progrès de la médecine hippocratique (Chez Gabon et compagnie): 350–368. [57] Behnke. . Retrieved 2009-08-25. p. Moeller. doi:10. Retrieved 2009-03-22. ScubaDoc's overview of alcohol and diving. "Alcohol and Diving" (http://scuba-doc. publications about nitrogen narcosis. OCLC 2068005. p. Walter (1881).org) Scientific body. . PMID 20749857. [60] Eger. Diving with Deep-Six. Saidman. Harper & Brothers Publishers. JM (1978).Nitrogen narcosis ISSN 0093-5387. "Effect of brief. G (1989). com/ ?id=K5XREXyDSQoC). 300 [53] Junod. pp. Retrieved 2009-08-25. Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society 16 (3): 227–32. [52] Brubakk & Neuman 2003. PMID 4082343. ISBN 0792267966. American Journal of Physiology (126): 409–15. B (1965). The Silent World: A Story of Undersea Discovery and Adventure. PMID 5844267. (2009-06-25). FOA Rapport C58015-H1 (Stockholm: National Defence Research Institute). edu/ uhmsupiemr. EI. Charles Ernest (1901). [59] Cousteau. Christian J. informaworld. Retrieved 2009-06-04.1136/bmj. Retrieved 2009-07-29.3 MPa". Clark. ISSN 0347-7665.rubicon-foundation. Retrieved 2009-08-25. ISSN 0093-5387. WH. .491.org/) UK charity dedicated to treatment of diving diseases. . [54] Brubakk & Neuman 2003. [61] Lambertsen. 1978" (http:/ / archives. doi:10.1. Jacques-Yves. Anesthesiology 26 (6): 756–63. British Medical Journal 1: 491–7. • Rubicon Research Repository (http://archive. George D. com/ smpp/ content~content=a789031692~db=all). org/ 2522). PMID 2741255. "Respiratory resistance. [58] Ornhagen. • Campbell. [56] Overton. ScubaDoc's overview of marijuana and diving.htm). rubicon-foundation.1097/00000542-196511000-00010. 306 [55] Moxon. Ernest S. Gelfand. Frédéric (1953). LJ. • Campbell. OD (1939). [51] Rogers. Ernest S. (2009-02-01). Allgemeiner Pharmakologie (Institut für Pharmakologie). oil-water solubility and mental effects of argon compared with helium and nitrogen". "Hydrogen-Oxygen (Hydrox) breathing at 1. "Minimum alveolar anesthetic concentration: a standard of anesthetic potency". html). "Croonian lectures on the influence of the circulation on the nervous system" (http:/ / www. H (1984). (2009-05-03). OCLC 2068005.org/) Searchable repository of Diving and Environmental Physiology Research. Brandstater.com/alch. .

this includes normal air which is approximately 78% nitrogen. and 1% other gases. however a double-blind study to test this found no statistically significant reduction in reported fatigue. thus one should not expect a reduction in narcotic effects due only to the use of nitrox. there are people in the diving community who insist that they feel reduced narcotic effects at depths breathing nitrox. or allows extended dive times without increasing the need for decompression stops for the same risk. there is much better scientific evidence that breathing high-oxygen gases . nitrox with an oxygen content above 21%. a study was published using wet divers at the same depth and confirmed that no statistically significant reduction in reported fatigue is seen. which are further discussed below. as oxygen seems to have equally narcotic properties under pressure as nitrogen.[1] [10] There was. are generally used by divers. 21% oxygen. primarily argon. although its use can reduce the risk of decompression sickness. 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. micro bubbles in the blood insufficient to cause symptoms of DCS). gases which also contain helium.[4] [5] [6] Nonetheless. however. showing adjusted no-decompression times. and/or reducing the risk of decompression sickness (also known as the bends). Enriched Air Nitrox diving tables. Reducing the proportion of nitrogen by increasing the proportion of oxygen reduces the risk of decompression sickness for the same dive profile. For example. Nitrox is not a safer gas than compressed air in all respects.[7] This may be due to a dissociation of the subjective and behavioural effects of narcosis. it should be noted that because of risks associated with oxygen toxicity. is mainly used in scuba diving to reduce the proportion of nitrogen in the breathing gas mixture. There is anecdotal evidence that the use of nitrox reduces post-dive fatigue.[9] particularly in older and or obese divers. Purpose Enriched Air Nitrox. divers tend not to utilize nitrox at greater depths where more pronounced narcosis symptoms are more likely to occur. some suggestion that post dive fatigue is due to sub-clinical decompression sickness (DCS) (i. In 2008.[3] The most common use of nitrox mixtures containing higher than normal levels of oxygen is in scuba.[11] Further studies with a number of different dive profiles. would be necessary to fully investigate this issue. and also different levels of exertion. nitrox is normally Typical Nitrox cylinder marking differentiated and handled differently from air.e.Nitrox 49 Nitrox Nitrox refers to any gas mixture composed (excluding trace gases) of nitrogen and oxygen. it increases the risk of oxygen toxicity and fire. Breathing nitrox is not thought to reduce the effects of narcosis. For a reduction in narcotic effects trimix or heliox.[8] However. in scuba diving.[1] [2] [3] 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.

Nitrox increase exercise tolerance, during aerobic exertion.[12] 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.

50

Naming
Nitrox is known by many names: Enhanced Air Nitrox, Oxygen Enriched Air, Nitrox, EANx or Safe Air.[3] [13] 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.[3] "Enriched Air Nitrox", "Enriched Air" or "EAN" are used to emphasise richer than air mixtures.[3] 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).[2]
[3]

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.[14]

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.[2] [3] [15] [16] 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.[2] [3] 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.

51

Cylinder markings
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.[17] 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.

Nitrox

52

Dangers
Oxygen toxicity
Diving and handling nitrox raises a number of potentially fatal dangers due to the high partial pressure of oxygen (ppO2).[2] [3] 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.[18] 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,[19] 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,[20] 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).

These developments were kept secret until independently duplicated by civilians in the 1960s. Compressed Gas Association (CGA) and two international nitrox teaching agencies (IANTD and ANDI) now support the standard that any gas containing more than 23. even if a recognized fire does not happen. Wells' invention was the only practical alternative to partial pressure blending. Partial blending using pure oxygen is often used to provide nitrox for multiple dives on live-aboard dive boats. However.[3] However. History In the 1920s or 1930s Draeger of Germany made a nitrox backpack independent air supply for a standard diving suit. 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.PADI .e.S. This was considered dangerous by some.[2] [3] [19] Most nitrox fill stations which supply pre-mixed nitrox will fill non-oxygen clean cylinders with mixtures below 40%. Furthermore. formed IAND (International Association of Nitrox Divers) and began teaching nitrox use for recreational diving. and met with heavy skepticism by the diving community. no differently from pure oxygen) for purposes of oxygen cleanliness and oxygen compatibility (i. In 1991.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). However. the annual DEMA show (held in Houston. . so that it is pressurized as nitrox for the first time in the diving cylinder. In the 1950s the United States Navy (USN) documented enriched oxygen gas procedures for military use of what we today call nitrox. This created a backlash. such gases can also react with hydrocarbons or incorrect lubricants inside a dive cylinder to produce carbon monoxide. regulation intended for commercial divers (not recreational divers) years ago. in a watershed moment. in the USN Diving Manual.5% oxygen should be treated as nitrox (which is to say. For many years Dr.[2] [3] In 1985 Dick Rutkowski. and when DEMA relented. a number of organisations took the opportunity to present nitrox workshops outside the show. At present. In 1992 BSAC banned its members from using nitrox. but it is also used in some smaller diver shops. oxygen "servicability"). Dr. In 1979 NOAA published Wells' procedures for the scientific use of nitrox in the NOAA Diving Manual.[21] Some of the controversy comes from a single U. A few facilities have begun to fill cylinders with air which has been enriched with oxygen by a pre-mixing process. 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. For a history of this controversy[3] see Luxfer cylinders [22] . In World War II or soon after. the U.. Texas that year) banned nitrox training providers from the show. any gas which contains a significantly larger percentage of oxygen than air is a fire hazard. 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. a former NOAA diving safety officer. the largest training agency . who was the first director of the National Oceanographic and Atmospheric Administration (NOAA) Diving Center. He also developed a process for mixing oxygen and air which he called a continuous blending system.[23] In 1970. nitrox which is mixed before being put into the cylinder) below 40% oxygen does not require a specially cleaned cylinder or other equipment.S.is still teaching that pre-mixed nitrox (i.e. 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. began instituting diving procedures for oxygen-enriched air. Morgan Wells.

[26] it was PADI's endorsement that put nitrox over the top as a standard sport diving "option. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society) 22 (1): 41–9. Measurement of Fatigue following 18 msw Open Water Dives Breathing Air or EAN36. T. 304. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society) 30 (4): 285–91. [3] Lang. Williams DJ (2003). CM. com/ forums/ basic-scuba-discussions/ poll-1630-a.. org/ 3975). Bennett and Elliott's physiology and medicine of diving. ." (http:/ / archive. In 1993 Skin Diver magazine. rubicon-foundation. Retrieved 2009-05-21. PMID 14756231. scubaboard. United States: Saunders Ltd. In the early 1990s. "Measurement of fatigue following 18 msw dry chamber dives breathing air or enriched air nitrox" (http:/ / archive. relative narcotic effects at depth have never been studied in detail. htm) . ISBN 0702025712. "Dissociation of the behavioral and subjective components of nitrogen narcosis and diver adaptation" (http:/ / archive. New organizations. pponline. Md: Undersea and Hyperbaric Medical Society) 5 (4): 391–400. 2007. Diving for Science 2008. In 1993 Dive Rite manufactured the first nitrox compatible dive computer. J. Fowler B (March 1995). in 1992 NAUI became the first existing major sport diver training agency to sanction nitrox. S. which does not happen with gases with have greater narcotic qualities.[19] While other main line scuba organizations had announced their support of nitrox earlier. Undersea Biomedical Research (Bethesda. M."[27] 54 Nitrox in nature Sometimes in the geologic past the Earth's atmosphere contained much more than 20% oxygen: e. [5] Brubakk. Meanwhile. ISBN 0941332705. p. United States: Best Publishing. Bennett and Elliott's physiology and medicine of diving. dive shops found they could charge premium amounts of money for custom-gas blending of nitrox to their ordinary moderately experienced divers. and carbon dioxide in compressed-air narcosis. "Roles of nitrogen. [11] Chapman SD. published a three part series arguing that nitrox was unsafe for sport divers. A. . [8] Hamilton K. including Ed Betts' American Nitrox Divers International (ANDI) . pp. 5th Rev ed. [12] Ergogenic Aids (http:/ / www. http:/ / archive. called the Bridge.[28] [29] References [1] Brubakk. the leading recreational diving publication at the time. org/ 2810). Fagraeus. pp. [6] Oxygen has the potential to be 1. NOAA Diving Manual: Diving for Science and Technology. (2001).and Bret Gilliam's Technical Diving International (TDI) gave scientific credence to nitrox. Tom S (2003). the Professional Association of Diving Instructors (PADI) announced full educational support for nitrox... This let animals absorb oxygen more easily and influenced evolution. 800. org/ 2199). the incentive for the sport diver to use the gas increased. but instead of cheap or free tank fills with compressed air. PMID 734806. Adolfson. org/ 8005. the T being added when the European Association of Technical Divers (EATD) merged with IAND.[24] Against this trend. 660. rubicon-foundation. Retrieved 2008-05-02. but results in HPNS when breathed at high pressures. Retrieved 2008-05-02. rubicon-foundation. ISSN 0093-5387. PMID 7742709. (2001). Wilkinson DC. Durham. Neuman. Plato PA. United States: Saunders Ltd. T. Doolette DJ.g. co. In: Brueggeman P. . DAN Nitrox Workshop Proceedings (http:/ / archive. Alf O. L. [10] Harris RJ. diving stores were finding a purely economic reason to offer nitrox: not only was an entire new course and certification needed to use it.[25] In 1996.which invented the term "Safe Air" for marketing purposes . pp. An intersection of economics and scientific validity had occurred. Laliberté MF. J (1978). Pollock NW. [9] "How does nitrox make you feel?" (http:/ / www.see relevant narcotic potency of gases [7] Although oxygen appears chemically more narcotic at the surface. . html). 5th Rev ed. . the agencies teaching nitrox were not the main scuba agencies.Nitrox In 1992 the name was changed to the International Association of Nitrox and Technical Divers (IANTD). OCLC 2068005. org/ 4855). Retrieved 2009-01-27... Proceedings of the American Academy of Underwater Sciences 27th Symposium. ISBN 0702025712. NC: Divers Alert Network. rubicon-foundation. Neuman (2003).A. Retrieved 2009-05-21. With the new dive computers which could be programmed to allow for the longer bottom-times and shorter residual nitrogen times which nitrox gave. uk/ encyc/ 1008. Retrieved 2008-04-08. up to 35% in the Upper Carboniferous. eds. [2] Joiner. [4] Hesser. ScubaBoard.7 times more narcotic than nitrogen . Helium is considered to have very little narcotic effect. 197. oxygen. rubicon-foundation. Fourth Edition. It is clear that different gases result in different narcotic effects at depth. O.

Mastro." (http:/ / archive. Shoffstall MS. PMID 538866. "Guide for Oxygen Compatibility Assessments on Oxygen Components and Systems. Retrieved 2008-05-01. 6th revision (http:/ / www. Undersea Biomedical Research 6 (4): 379–84. "BSAC gives the OK to nitrox. United States: US Naval Sea Systems Command. Stephen R (2003).co. Retrieved 2008-05-02. ISBN 0702025712.333-361. McCraken TM (December 1979).uk/pages/misc/Nitrox. org/ 4861). John. 9). University of Texas. org/ 9033). 403–4. p. org/ 6275).gasdiving. D and Shreeves. Glen L. United States: Saunders. Wilmington. OCLC 16986801. Retrieved 2008-05-02. 375. [19] Richardson.) Proceedings of the American Academy of Underwater Sciences Twelfth Annual Scientific Diving Symposium "Diving for Science 1992". org/ 00c3_publications. James M. Retrieved 2011-01-11.Nitrox [13] Elliott. asp?destPage=00c3& pageID=3. Publications. Simon J (October 2005). "28". Retrieved 2008-06-05. [24] A position which it would formally maintain until in 1995 magazine editor Bill Gleason was reported to say that nitrox was "all right".L. Tom S. In Brubakk.org/diving-nitrox. (ed. rubicon-foundation. (American Academy of Underwater Sciences). html [21] Rosales KR. [18] Clark. org/ 6309). 2006. C (1996). com/ pages/ mainpage. Retrieved 2008-05-01. "An evaluation of the equivalent air depth theory" (http:/ / archive. USA and Smithsonian Tropical Research Institute. luxfercylinders. htm [28] R. [27] http:/ / www. [22] http:/ / www. .dive-hive. . Balboa.CANFIELD (1989. Stoltzfus JM (2007). com/nitrox_calc. reprinted in South Pacific Underwater Medicine Society Journal 26 (3). Neuman. "Oxygen safety in the production of enriched air nitrox breathing mixtures. [16] Berghage Thomas E. OCLC 16986801. 40(5) May: 35-36. AMERICAN JOURNAL OF SCIENCE 289. MOD and PPO2.luxfercylinders. at pages 9-11 [26] Allen. shtml [23] US Navy Diving Manual. Hulbert. Austin. Robert W. ISSN 0813-1988. 55 Footnotes External links • Nitrox . ." (http:/ / archive. supsalv. K (1996). NC. [20] http:/ / www. Thom. Australia: J. Held September 24-27. . "Oxygen under pressure". ROBERT DUDLEY* Department of Zoology. org/ 2835). . rubicon-foundation. Alf O. Retrieved 2008-04-24. published on WWW 24 March 1998. rubicon-foundation." (http:/ / archive. pp. OCLC 66524750. 1992 at the University of North Carolina at Wilmington. rubicon-foundation. Nitrox Gas Blending Manual. (1992). PO Box 2072." (http:/ / archive. rubicon-foundation. "The PADI Enriched Air Diver course and DSAT oxygen exposure limits. Deeper into Diving (2 ed. warns if a critical limit is reached (http://www. South Pacific Underwater Medicine Society Journal 26 (3). . rubicon-foundation. [15] Logan. Mitchell. ISSN 0813-1988. Hamilton Jr. OCLC 16986801. JA (1961).frequently asked questions (http://www. South Pacific Underwater Medicine Society Journal 26 (3). pp. Alan W. Victoria.php?lang=en) • Diving Nitrox (http://dive-center.htm) • Useful Luxfer FAQ on the CGA and "40% rule" controversy (http://www. TX 78712.). [14] Lippmann. com/ nitrox/ preview_p03. In: Cahoon.shtml) • Online Nitrox calculator for EAD.A. Diver 1995.html) . Skin Diver would later go into bankruptcy. . OCLC 51607923. Bennett and Elliott's physiology and medicine of diving (5th ed. americandivecenter. andihq. Republic of Panama Accepted 28 October 1997.com/support/faq/ aluminumoxygen. . Steven J. A NEW MODEL FOR ATMOSPHERIC OXYGEN OVER PHANEROZOIC TIME. ISBN 097522901X. NASA Johnson Space Center Technical Report NASA/TM-2007-213740. "Equivalent air depth: fact or fiction" (http:/ / archive.E. United States Navy Experimental Diving Unit Technical Report NEDU-RR-01-61. D (1996). [29] ATMOSPHERIC OXYGEN. com/ support/ faq/ aluminumoxygen. Retrieved 2008-05-02.BERNER AND D. [17] Butler. LB. ISSN 0813-1988. rubicon-foundation. [25] TDI.). org/ 6310). org/ 3835). "Nitrox" (http:/ / archive. GIANT PALEOZOIC INSECTS AND THE EVOLUTION OF AERIAL LOCOMOTOR PERFORMANCE.

The body is affected in different ways depending on the type of exposure. in the long term. including underwater diving using compressed breathing gases.8 987. the central nervous system condition was called the Paul Bert effect. lungs and eyes. Protocols for avoidance of hyperoxia exist in fields where oxygen is breathed at higher-than-normal partial pressures. with effects most often seen in the central nervous system. The [1] subject in the centre is breathing 100% oxygen from a mask. breathing problems. and should have specific training in using such gases. and seizures.7 bar. The chamber is pressurised with air to 3. Oxygen toxicity is managed by reducing the exposure to elevated oxygen levels. hyperbaric medicine. ICD-10 ICD-9 MeSH T59. The result of breathing elevated concentrations of oxygen is hyperoxia. an excess of oxygen in body tissues. The US Food and Drug Administration has warned those suffering from problems such as heart or lung disease not to use oxygen bars. Oxygen toxicity is a concern for scuba divers. Studies show that. with pulmonary and ocular damage being mainly confined to the problems of managing premature infants. after the researchers who pioneered its discovery and description in the late 19th century. and the pulmonary condition the Lorrain Smith effect. In recent years. a robust recovery from most types of oxygen toxicity is possible. It is also known as oxygen toxicity syndrome. Pulmonary and ocular toxicity result from longer exposure to elevated oxygen levels at normal pressure. Central nervous system toxicity is caused by short exposure to high concentrations of oxygen at greater than atmospheric pressure. Severe cases can result in cell damage and death. retinal detachment.8 [2] [3] [4] D018496 Oxygen toxicity is a condition resulting from the harmful effects of breathing molecular oxygen (O2) at elevated partial pressures. oxygen has become available for recreational use in oxygen bars.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. These protocols have resulted in the increasing rarity of seizures due to oxygen toxicity. . the collapse of the alveoli in the lungs. and oxygen poisoning. and vision changes such as myopia. Scuba divers use breathing gases containing up to 100% oxygen. Prolonged or very high oxygen concentrations can cause oxidative damage to cell membranes. oxygen intoxication. those on high concentrations of supplemental oxygen (particularly premature babies). Symptoms may include disorientation. Historically. neonatal care and human spaceflight. and those undergoing hyperbaric oxygen therapy.

[18] .3 bar (30 kPa). It may also be implicated in red blood cell destruction (hemolysis). characterised by difficulty in breathing and pain within the chest. occurring when breathing elevated pressures of oxygen for extended periods. Central nervous system oxygen toxicity can cause seizures. high oxygen concentrations may contribute to bone damage.[8] [9] damage to liver (hepatic). causing pain and difficulty in breathing.21 bar (21 kPa) and the lower limit for toxicity is more than 0. Oxidative damage to the eye may lead to myopia or partial detachment of the retina.[10] heart (myocardial). brief periods of rigidity followed by convulsions and unconsciousness. because breathing air at atmospheric pressure always has a partial pressure of oxygen (ppO2) of 0. Pulmonary and ocular damage are most likely to occur when supplemental oxygen is administered as part of a treatment. • Pulmonary (lungs). effects on other tissues may be observed: it is suspected that during spaceflight.[11] endocrine glands (adrenal.Oxygen toxicity 57 Classification The effects of oxygen toxicity may be classified by the organs affected. occurring when breathing elevated pressures of oxygen for extended periods. occurring under hyperbaric conditions.[17] Oxygen toxicity is not associated with hyperventilation. but are also a concern during hyperbaric oxygen therapy. characterised by alterations to the eyes. particularly to newborn infants.[15] and general damage to cells. • Ocular (retinopathic conditions). producing three principal forms:[5] [6] [7] • Central nervous system. and is of concern to divers who encounter greater than atmospheric pressures. and thyroid).[17] Hyperoxia can also indirectly cause carbon dioxide narcosis in patients with lung ailments such as chronic obstructive pulmonary disease or with central respiratory depression.[5] [16] In unusual circumstances. Oxidative damage may occur in any cell in the body but the effects on the three most susceptible organs will be the primary concern. characterised by convulsions followed by unconsciousness. gonads.[12] [13] [14] or kidneys (renal). Pulmonary oxygen toxicity results in damage to the lungs.

Blubbering of lips. epigastric aura.[30] [31] Tests in animals have indicated a variation in tolerance similar to that found in central nervous system toxicity.). vertigo. Euphoria. twitch L arm.[28] [29] Pulmonary function measurements are reduced.[32] . confusion.[30] The radiological finding from the lungs shows inflammation and swelling (pulmonary edema). nausea. vertigo. twitching (especially of the face). such as darkness and caffeine. Dazed Nausea. The seizure ends with a period of unconsciousness (the postictal state).5 bar (50 kPa) is intermittent. fell asleep.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[1] Exposure (mins.[1] Decrease of tolerance is closely linked to retention of carbon dioxide. patients experience a mild burning on inhalation along with uncontrollable coughing and occasional shortness of breath (dyspnea). spasmodic respiration. Nausea and vertigo.[28] Physical findings related to pulmonary toxicity have included bubbling sounds heard through a stethoscope (bubbling rales). and exercise will decrease the time to onset of central nervous system symptoms. as tests have shown a wide variation.[28] [29] [30] This begins as a mild tickle on inhalation and progresses to frequent coughing. This may be followed by a tonic–clonic seizure consisting of two phases: intense muscle contraction occurs for several seconds (tonic). anxiety. of Subjects 1 3 4 4 6 8 4 6 Symptoms Prolonged dazzle. both amongst individuals. amnesia Convulsed. Severe lip-twitching. increase tolerance in test animals. and dizziness. paraesthesiae. exposure to cold.[23] [24] [25] Other factors. Dazzle. epigastric aura. arm twitch Severe lip-twitching.[19] [20] The onset of seizure depends upon the partial pressure of oxygen (ppO2) in the breathing gas and exposure duration. followed by rapid spasms of alternate muscle relaxation and contraction producing convulsive jerking (clonic). lip-twitching and syncope. Vertigo and severe lip twitching.[26] [27] 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). severe spasmodic vomiting Severe lip-twitching. such as underwater immersion. many external factors. as well as significant variations between species. "Diaphragmatic spasm". and in the same individual from day to day. When the exposure to oxygen above 0. lip-twitching.[19] [21] [22] In addition. Severe nausea Central nervous system Central nervous system oxygen toxicity manifests as symptoms such as visual changes (especially tunnel vision). ringing in the ears (tinnitus). and increased blood flow to the lining of the nose (hyperemia of the nasal mucosa). The symptoms appear in the upper chest region (substernal and carinal regions). but these effects have not been proven in humans. fever. Inspiratory predominance. Convulsed Convulsed. 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. irritability (personality changes. it permits the lungs to recover and delays the onset of toxicity. exposure time before onset is unpredictable.[28] If breathing elevated partial pressures of oxygen is not discontinued. etc. Nausea and confusion Dazed and lip-twitching. Drowsiness.) 96 60–69 50–55 31–35 21–30 16–20 11–15 6–10 Num. However.

in addition to any oxygen exposure during the dive. should they descend below the maximum depth allowed for the mixture. Pulmonary toxicity occurs with exposure to concentrations of oxygen greater than 0.[41] Other groups at higher risk for oxygen toxicity are patients on mechanical ventilation with exposure to levels of oxygen greater than 50%. are exposed to the highest concentration of oxygen in the human body and are therefore the first organs to show toxicity. Central nervous system toxicity Exposures. Since atmospheric pressure is about 1 bar (100 kPa).[37] Likewise. or ROP) are observed via an ophthalmoscope as a demarcation between the vascularized and non-vascularised regions of an infant's retina.[36] Pulmonary toxicity The lungs.5 bar (50 kPa).[40] Preterm newborns are known to be at higher risk for bronchopulmonary dysplasia with extended exposure to high concentrations of oxygen. after an asymptomatic period between 4 and 22 hours at greater than 95% oxygen. typically nitrogen.[37] Experiments on rats show pulmonary manifestations of oxygen toxicity are not the same for normobaric conditions as they are for hyperbaric conditions.[38] Therefore. central nervous system toxicity can only occur under hyperbaric conditions. where ambient pressure is above normal.[38] 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. Divers breathing a gas mixture enriched with oxygen. (III) growth of new blood vessels occurs around the ridge. hyperbaric oxygen therapy and the provision of supplemental oxygen.[33] 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. can similarly suffer a seizure at shallower depths. This occurs in three principal settings: underwater diving. to partial pressures of oxygen above 1. as well as the remainder of the respiratory tract. The degree of this demarcation is used to designate four stages: (I) the demarcation is a line. while—at the same partial pressure of oxygen—the presence of significant partial pressures of inert gases.[34] [35] Divers breathing air at depths greater than 60 m (200 ft) face an increasing risk of an oxygen toxicity "hit" (seizure). (II) the demarcation becomes a ridge.[38] with evidence of diffuse alveolar damage and the onset of acute respiratory distress syndrome usually occurring after 48 hours on 100% oxygen. signs of damage to the eye (retinopathy of prematurity. such as nitrox.[37] with some studies suggesting symptoms usually begin after approximately 14 hours at this level of 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.[37] Breathing 100% oxygen also eventually leads to collapse of the alveoli (atelectasis). or inflammation of the upper airways. corresponding to an oxygen fraction of 50% at normal atmospheric pressure. current guidelines for patients on mechanical ventilation in intensive care suggests keeping oxygen concentration less than 60%. Signs of pulmonary toxicity begins with evidence of tracheobronchitis.[39] 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.[34] . particularly to premature infants. the risk factors are markedly different. (IV) the retina begins to detach from the inner wall of the eye (choroid). In each case. and patients exposed to chemicals that increase risk for oxygen toxicity such the chemotherapeutic agent bleomycin. will prevent this effect.Oxygen toxicity 59 Ocular In premature babies.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.

and may raise the risk of hypoxia-related systemic complications.[54] is possibly involved in iron acquisition.[45] [46] Hyperoxia may be a contributing factor for the disorder called retrolental fibroplasia or retinopathy of prematurity (ROP) in infants. these systems are eventually overwhelmed at very high concentrations of free oxygen. Restricting supplemental oxygen use does not necessarily reduce the rate of retinopathy of prematurity. During times of environmental stress. Associated with the growth of these new vessels is fibrous tissue (scar tissue) that may contract to cause retinal detachment.[45] Hyperoxic myopia has occurred in closed circuit oxygen rebreather divers with prolonged exposures. Retinopathy of prematurity occurs when the development of the retinal vasculature is arrested and then proceeds abnormally. most vulnerable.[22] [60] Although the body has many antioxidant systems such as glutathione that guard against oxidative stress.[64] .[55] Higher than normal concentrations of oxygen lead to increased levels of reactive oxygen species.[46] [48] [49] It also occurs frequently in those undergoing repeated hyperbaric oxygen therapy. while a risk factor.[50] [51] It is usually reversible with time. such as nitric oxide.Oxygen toxicity 60 Ocular toxicity Prolonged exposure to high inspired fractions of oxygen causes damage to the retina. 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.[45] [47] In preterm infants. which can initiate a damaging chain reaction of lipid peroxidation in the unsaturated lipids within cell membranes.[52] which are natural by-products of the normal metabolism of oxygen and have important roles in cell signalling.[43] [50] This is due to an increase in the refractive power of the lens.[53] One species produced by the body. peroxynitrite. the retina is often not fully vascularised.[59] High concentrations of oxygen also increase the formation of other free radicals.[61] [62] [63] Cell damage and cell death then result. and trioxidane. and the blood supplies it to all parts of the body. is not the main risk factor for development of this disease.[22] [57] While all the reaction mechanisms of these species within the body are not yet fully understood. When oxygen is breathed at high partial pressures. Supplemental oxygen exposure. the superoxide anion (O2–). which can damage cell structures and produce oxidative stress.[42] [43] [44] 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. and the rate of cell damage exceeds the capacity of the systems that prevent or repair it.[58] one of the most reactive products of oxidative stress is the hydroxyl radical (·OH).[56] Oxygen is necessary for cell metabolism. a hyperoxic condition will rapidly spread. which harm DNA and other biomolecules.[43] [50] 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. since axial length and keratometry readings do not reveal a corneal or length basis for a myopic shift. levels of reactive oxygen species can increase dramatically.

dizziness.5 bar (150 kPa). In addition. 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. 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.[65] Diagnosis of bronchopulmonary dysplasia in new-born infants with breathing difficulties is difficult in the first few weeks. long dives and dives where oxygen-rich breathing gases are used.[69] This is a notional alarm clock. 150 minutes at 1.4 bar (140 kPa) suggests a diagnosis of oxygen toxicity. As the ppO2 depends on the fraction of oxygen in the breathing gas and the depth of the dive. and cylinders containing such mixtures must be clearly marked with that depth. while no hereditary factors have been shown to yield a pattern. ear problems.3 bar (130 kPa) and 210 minutes at 1. 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. during which victims can lose their regulator and The label on the diving cylinder shows that it drown.[25] [69] For the following partial pressures of oxygen the limit is: 45 minutes at 1. but is impossible to predict with any reliability whether or when toxicity symptoms will occur. confusion and nausea can be due to many factors common to the underwater environment such as narcosis.[66] The diagnosis of retinopathy of prematurity in infants is typically suggested by the clinical setting. blood tests and x-rays may be used to confirm bronchopulmonary dysplasia.[70] [71] Many Nitrox-capable dive computers calculate an oxygen loading and can track it across multiple dives.Oxygen toxicity 61 Diagnosis Diagnosis of central nervous system oxygen toxicity in divers prior to seizure is difficult as the symptoms of visual disturbance. the diver obtains more time on the oxygen clock by diving at a shallower depth. low birth weight and a history of oxygen exposure are the principal indicators. As there is an marked with a maximum operating depth of increased risk of central nervous system oxygen toxicity on deep dives.4 bar (140 kPa). by . However.[68] 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.[20] The effects are sudden convulsions and unconsciousness. if the infant's breathing does not improve during this time. congestion and coldness. Premature infants commonly require supplemental oxygen to treat complications of preterm birth.[25] [69] In some diver training courses for these types of diving.[36] The diver may experience no warning symptoms. Both underwater and in space.2 bar (120 kPa). 28 metres. an echocardiogram can help to eliminate other possible causes such as congenital heart defects or pulmonary arterial hypertension. 180 minutes at 1.6 bar (160 kPa). 120 minutes at 1. divers are taught to plan and monitor what is called the oxygen clock of their dives. In either case. However. Prematurity. unless there is a prior history of epilepsy or tests indicate hypoglycemia. a seizure occurring in the setting of breathing oxygen at partial pressures greater than 1. proper precautions can eliminate the most pernicious effects. divers are taught to calculate a maximum operating depth for oxygen-rich breathing gases.[67] Prevention The prevention of oxygen toxicity depends entirely on the setting. Underwater A seizure caused by oxygen toxicity to the central nervous system is a deadly but avoidable event while diving. these symptoms may be helpful in diagnosing the first stages of oxygen toxicity in patients undergoing hyperbaric oxygen therapy.

but subsequent curtailment of supplemental oxygen caused an increase in infant mortality. Increasing the proportion of nitrogen is not viable.9 atm (190 kPa) over 30 minutes on oxygen. However. high-fraction oxygen is non-toxic. Navy uses treatment tables based on periods alternating between 100% oxygen and air.[86] In such applications as extra-vehicular activity. table 6 requires 75 minutes (three periods of 20 minutes oxygen/5 minutes air) at an ambient pressure of 2. This is illustrated by modern pure oxygen use in spacesuits. Current guidelines require that all babies of less than 32 weeks gestational age or having a birth weight less than 1. helium is not narcotic. 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.5 kg (3.Oxygen toxicity breathing a less oxygen-rich gas. The limited duration and naturally intermittent nature of most diving makes this a relatively rare (and even then.4 bar (140 kPa). very high percentage oxygen and lower than normal atmospheric pressure was used in early spacecraft.N.[80] [81] [82] There is however some experimental evidence in rats that vitamin E and selenium aid in preventing in vivo lipid peroxidation and free radical damage. reversible) complication for divers. or by shortening the duration of exposure to oxygen-rich gases. The patient then remains at that pressure for a further 150 minutes. so a gas mixture must be used which contains less than 21% oxygen (a hypoxic mixture). which must operate at low pressure (also historically.[17] Retinopathy of prematurity is largely preventable by screening.[83] Normobaric setting Bronchopulmonary dysplasia is reversible in the early stages by use of break periods on lower pressures of oxygen. not merely by high oxygen fraction.[18] Guidelines have been established that allow divers to calculate when they are at risk of pulmonary toxicity.[75] [76] [77] 62 Hyperbaric setting The presence of a fever or a history of seizure is a relative contraindication to hyperbaric oxygen treatment. modern protocols now require monitoring of blood oxygen levels in premature infants receiving oxygen. because the oxygen partial pressure is not allowed to chronically exceed 0. U. for example. For example.3 bar (4. To balance the risks of hypoxia and retinopathy of prematurity.[85] Hypobaric setting In low-pressure environments oxygen toxicity may be avoided since the toxicity is caused by high partial pressure of oxygen.[86] . but it may eventually result in irreversible lung injury if allowed to progress to severe damage. since it would produce a strongly narcotic mixture. consisting of two periods of 15 minutes air/60 minutes oxygen.[84] The National Cooperative Study in 1954 showed a causal link between supplemental oxygen and retinopathy of prematurity.3 lb) should be screened for retinopathy of prematurity at least every two weeks.S. even at breathing mixture fractions approaching 100%.8 standard atmospheres (280 kPa). The U.[78] 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. and a usable mixture may be blended either by completely replacing nitrogen with helium (the resulting mix is called heliox).4 psi).[79] Vitamin E and selenium were proposed and later rejected as a potential method of protection against pulmonary oxygen toxicity.[72] [73] 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. equivalent to a depth of 18 metres (60 ft). This is followed by a slow reduction in pressure to 1. the Gemini and Apollo spacecraft).S.[74] Pulmonary oxygen toxicity is an entirely avoidable event while diving. producing a trimix. or by replacing part of the nitrogen with helium. and therefore prevent retinal changes following repetitive hyperbaric oxygen exposures.

8 bar (280 kPa). 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. owing to the danger of arterial gas embolism. allowing the oxygen administered.Oxygen toxicity 63 Management During hyperbaric oxygen therapy. Although for many years the recommendation has been not to raise the diver during the seizure itself. the patient will usually breathe 100% oxygen from a mask. along with a reduction in the periods of exposure retina to re-attach.[92] Prognosis Although the convulsions caused by central nervous system oxygen toxicity may lead to incidental injury to the victim. techniques such as scleral buckling and vitrectomy surgery may assist in re-attaching the retina. and an increase in the break periods where normal air is supplied.6 bar (60 kPa). both cryosurgery and laser surgery have been shown to reduce the risk of blindness as an outcome. but should the disease progress beyond a threshold (defined as five contiguous or eight cumulative hours of stage 3 retinopathy of prematurity). 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).[87] there is no evidence of expiratory obstruction during seizure and benefit may be gained by raising the diver during the seizure's clonic phase. and carry out a controlled buoyant lift.[20] A seizure underwater requires that the diver is brought to the surface as soon as practicable. Lifting an unconscious body is taught by most diver training agencies. Where the disease has progressed further.S. Navy has procedures for completing the decompression stops where a recompression chamber is not immediately available.[94] [95] . thereby dropping the partial pressure of oxygen inspired below 0.[89] The U.[88] Rescuers need to ensure that their own safety is not compromised during the convulsive phase. 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. emergency services are always contacted as there is a possibility of further complications requiring medical attention. An overview of these studies by Bitterman in 2004 concluded that following removal of breathing gas containing high fractions of oxygen. Seizures during the therapy are managed by removing the mask from the patient. blue) is placed The occurrence of symptoms of bronchopulmonary dysplasia or acute around the eye. a ventilator may be needed to ensure that the lung tissue remains inflated. They then ensure that the victim's air supply is established and maintained. However.[22] [93] The majority of infants who have survived following an incidence of bronchopulmonary dysplasia will eventually recover near-normal lung function. 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. Where supplemental oxygen is required for treatment of another disease (particularly in infants). while inside a hyperbaric chamber pressurised with air to about 2. no long-term neurological damage from the seizure remains. The silicone band (scleral buckle. Reductions in pressure and exposure will be made progressively and medications such as bronchodilators and pulmonary surfactants may be used.[91] Retinopathy of prematurity may regress spontaneously.[90] The retina (red) is detached at the top of the eye.

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.[96]

64

Epidemiology
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).[98] 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. [97] 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.[99] 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%).[100] [101] 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%.[102] [103] 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%.[102] 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.[104] 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.[41] 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%.[97]

65

History
Central nervous system toxicity was first described by Paul Bert in 1878.[105] [106] 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".[17] 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.[32] Pulmonary toxicity may be referred to as the "Lorrain Smith effect".[17] 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.[6] 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.[32] 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).[107] [108] 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.[42] [109] 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".[110] [111] 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.[112] [113] 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.[18] 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.[24] [25] [114] 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.[97] Bronchopulmonary dysplasia was first described by Northway in 1967, who outlined the conditions that would lead to the diagnosis.[115] 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.[116] Nevertheless, Palta et al. in 1998 concluded that radiographic evidence was the most accurate predictor of long-term effects.[117]

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.[26] [27] In the years since, research on central nervous system toxicity has centred on methods of prevention and safe extension of tolerance.[118] Sensitivity to central nervous system oxygen toxicity has been shown to be affected by factors such as circadian rhythm, drugs, age, and gender.[119] [120] [121] [122] In 1988, Hamilton et al. wrote procedures for the National Oceanic and Atmospheric Administration to establish oxygen exposure limits for habitat operations.[75] [76] [77] Even today, models for the prediction of pulmonary oxygen toxicity do not explain all the results of exposure to high partial pressures of oxygen.[123]

66

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.[69] In order to buy nitrox, a diver has to show evidence of such qualification.[124] 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.[125] There are also devices on sale that offer "oxygen massage" and "oxygen detoxification" with claims of removing body toxins and reducing body fat.[126] 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.[125] 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.[127] There is also a brief episode of oxygen intoxication in his "From the Earth to the Moon".[128]

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NC: Duke University). (1935). New England Journal of Medicine 276 (7): 357–68. . Fred A. [125] Bren.. American Journal of Physiology 110: 565–72. p. Christian J.E.1056/NEJM196702162760701.P. ISBN 0-09-163831-3.S. Aviation. University of Pennsylvania Medical Center). PMID 15233157. (1935).. Cimsit M. Forbes.R. "Oxygen Bars: Is a Breath of Fresh Air Worth It?" (http:/ / www.). University of Pennsylvania: Physiologic interactions of oxygen and carbon dioxide effects and relations to hyperoxic toxicity. Poppen. PMID 15622741. American Journal of Physiology 114: 436–442. . Retrieved 2008-04-29.. org/ etext/ 12901). [123] Shykoff. Mary Alice. Johnson. (1972). Journal of Pediatrics 132 (1): 57–63.. Space and Environmental Medicine 75 (11): 992–4. [119] Hof. . com/ HTML/ fitness. M. Richard D.P. pdf) (PDF).. Note: 1 atmosphere (atm) is 1. George B. [112] Lambertsen. Porter. Hoskins.. Barnet.x. mamashealth. 291. ISBN 2253005878. and decompression. PMID 12964858.S.S. C. (1971). "Abnormal pulmonary outcomes in premature infants: prediction from oxygen requirement in the neonatal period". Ford. doi:10. J. [104] Yildiz. Aerospace Medicine 42 (12): 1293–6. Paul (1943) [First published in French in 1878]. rubicon-foundation. Retrieved 2008-04-29. com/ ~divegeek/ eanx.

 121–4. ISBN 0-946020-18-3. Victoria.edu/edu/eshuphysio/program/section4/4ch7/ s4ch7_7.4506. NC: Divers Alert Network. John S. doi:10. Retrieved 2009-06-29. (ed.rubicon-foundation. Navy Supervisor of Diving (2008) (PDF). ISBN 0-941332-68-3. • Donald. • Regillo. British Medical Journal 1 (4507): 712–7. Stan (1993).org/dspace/simple-search?query=oxygen+ toxicity&submit=Go).1136/bmj.). mp4. IFEM Report No. Naval Sea Systems Command. Flynn. OCLC 66524750. Alf O. Retrieved 2008-09-20. Kenneth W. Simon (2005).aspx).S. PMID 20248096. Flagstaff: Best Publishing. Bennett and Elliott's physiology and medicine of diving (5th ed.1136/bmj.diversalertnetwork. Stephen R.htm).667. (1947). Kenneth W. United States: Saunders Ltd. The Practice of Oxygen Measurement for Divers. PA: Environmental Biomedical Stress Data Center. Australia: J. PMC 2053251. Brown. doi:10. OCLC 44018369. pp. Richard Vann (free download. "Pulmonary oxygen tolerance in man and derivation of pulmonary oxygen tolerance curves" (http://archive. Vitreoretinal Disease: The Essentials. Mitchell. U.).) (2001). John M.pdf). ISBN 0-9752290-1-X. James M. Teddington.4507. "Oxygen". Tom S. • Lang.Oxygen toxicity 71 Sources • Clark. OCLC 26894235. Michael A.. – Wide and detailed discussion of the effects of breathing oxygen on the respiratory system... – 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.rubicon-foundation. Revised version of Donald's articles also available as: Donald. UK: Harley Swan.lib.. OCLC 39170393. Deeper into Diving (2nd ed. In Brubakk. 86MB). 358–418. 693 pages. (1970). John. Gary C. (1992). revision 6. Retrieved 2008-04-29. DAN nitrox workshop proceedings (http://archive. 120 pages.L. (1947). "Oxygen poisoning in man—part II". British Medical Journal 1 (4506): 667–72. • Donald.712. John. Carl D. Christian J.S. • Lippmann. • Clark.S. Publications. ISBN 1-85421-176-5. Institute for Environmental Medicine. • Lippmann. ISBN 0-7020-2571-2. The Diving Emergency Handbook. UK: Underwater World Publications. University of Pennsylvania Medical Center).1. Thom. – Video of "Oxygen Toxicity" lecture by Dr.mcg. Bugg.org/3863). 197 pages. External links General The following external site is a compendium of resources: • Rubicon Research Repository (http://archive. • Physiology at MCG 4/4ch7/s4ch7_7 (http://www. pp. 1-70 (Philadelphia. PMID 20248086. Oxygen and the diver. New York: Thieme. Harry W.rubicon-foundation.1. "Oxygen poisoning in man—part I". SS521-AG-PRO-010. PMC 2053400. . Navy Diving Manual (http://supsalv. OCLC 51607923. Kenneth W.. ISBN 0-86577-761-6. Lambertsen.org/ 4855). Neuman. (1998). Durham. U. • U. Further reading • Lamb.org/pdf/ DiveMan_rev6. 237 pages. (1999).org/FastAccess/ 2008TechnicalDiving. OCLC 52056845. (2003). "Oxygen under pressure".

is set by the partial pressure of oxygen alone. the partial pressure of a gas in a mixture of gases is defined as above. given an ideal gas mixture of nitrogen (N2). or dissolved in blood. In chemistry. Actual real-world gases come very close to this ideal. Gases will always flow from a region of higher partial pressure to one of lower pressure. and not according to their concentrations in gas mixtures or liquids. Prabhakar (2009-03-11). The partial pressure of a gas is a measure of thermodynamic activity of the gas's molecules. This is because ideal gas molecules are so far apart that they don't interfere with each other at all. each gas has a partial pressure which is the pressure which the gas would have if it alone occupied the volume.medscape. eMedicine. A consequence of this is that the total pressure of a mixture of ideal gases is equal to the sum of the partial pressures of the individual gases in the mixture as stated by Dalton's law. Gases dissolve.Oxygen toxicity • Rajiah. 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. and the amount that is toxic.[1] The total pressure of a gas mixture is the sum of the partial pressures of each individual gas in the mixture. This general property of gasses is also true of chemical reactions of gasses in biology. the faster the flow. and react according to their partial pressures. diffuse. Retrieved 2009-06-29. the larger this difference. For example. 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) . 72 Partial pressure In a mixture of ideal gases.[2] For example. – Concise clinical overview with extensive references. the necessary amount of oxygen for human respiration. 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. This is true across a very wide range of different concentrations of oxygen present in various inhaled breathing gases.com/article/ 406564-overview). "Bronchopulmonary Dysplasia" (http://emedicine.

to focus on one particular gas component. e.[3] 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. air. It can be approximated both from partial pressure and molar fraction: [4] • • • • • • 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 . 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.g. e. and is useful in gas mixtures. with unchanged pressure and temperature.Partial pressure 73 Ideal gas mixtures Ideally the ratio of partial pressures is the same as the ratio of molecules. oxygen.g. That is.

. 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. liquid or solid).7 °C). Most often the term is used to describe a liquid's tendency to evaporate. It is a measure of the tendency of molecules and atoms to escape from a liquid or a solid.Partial pressure 74 Vapor pressure Vapor pressure is the pressure of a vapor in equilibrium with its non-vapor phases (i. the liquids with the highest vapor pressures have the lowest normal boiling points. 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. For example. It also has the lowest normal boiling point (-43. 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. The vapor pressure chart to the right has graphs of the vapor pressures versus temperatures for a variety of liquids. 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 a reversible reaction involving gas reactants and gas products.[5] As can be seen in the chart. at any given temperature. The higher the vapor pressure of a liquid at a given temperature. the lower the normal boiling point of the liquid.e.

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 and the solubility of gases Gases will dissolve in liquids to an extent that is determined by the equilibrium between the undissolved gas and the gas that has dissolved in the liquid (called the solvent). Henry's Law is an approximation that only applies for dilute.Partial pressure 75 where: =  the equilibrium constant of the reaction =  coefficient of reactant =  coefficient of reactant =  coefficient of product =  coefficient of product =  the partial pressure of =  the partial pressure of =  the partial pressure of =  the partial pressure of raised to the power of raised to the power of raised to the power of raised to the power of For reversible reactions. . In some cases.[6] 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. is also referred to as the Henry's Law constant. ideal solutions and for solutions where the liquid solvent does not react chemically with the gas being dissolved. Since both may be 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. the reaction kinetics may either oppose or enhance the equilibrium shift. the reaction kinetics may be the over-riding factor to consider. However. This statement is known as Henry's Law and the equilibrium constant is quite often referred to as the Henry's Law constant. changes in the total pressure.[9] As can be seen by comparing equations (1) and (2) is the reciprocal of .[6] [7] [8] Henry's Law is sometimes written as:[9] (2)     where above.

McGraw-Hill. Cliffs Notes. Intute University Introductory Chemistry (http:/ / www. Perry. Oxygen toxicity becomes a risk when these oxygen partial pressures and exposures are exceeded. D. us/ webdocs/ GasLaw/ Gas-Dalton. involving convulsions. pdf) Rice University chemistry class notes (http:/ / www. ca. of 120 minutes at 1. References [1] [2] [3] [4] [5] [6] [7] [8] [9] Charles Henrickson (2005). Dalton's Law of Partial Pressures (http:/ / dbhs. Using diving terms. based on an equivalent narcotic depth of 35 metres (115 ft).4 bar absolute. Nitrogen narcosis is a problem when breathing gases at high pressure. edu/ ~chem312/ Class Summaries/ Class12. 6th Edition. Hypoxia and sudden unconsciousness becomes a problem with an oxygen partial pressure of less than 0.16 bar (16 kPa) absolute.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. Chemistry. R.).79 = 4. the maximum total partial pressure of narcotic gases used when planning for technical diving is 4. chem.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 . edu/ pchem/ C443/ Lectures/ Lecture33. and Green.7 bar absolute ppO2 = 6 bar x 0.H. at 50 metres (165 feet).3 bar absolute and of 210 minutes at 1.5 bar absolute. html) University of Arizona chemistry class notes (http:/ / www.21 = 1.16 bar absolute. Perry's Chemical Engineers' Handbook (7th ed..6 bar absolute. of 150 minutes at 1. Oxygen toxicity. ISBN 0-07-049841-5. owlnet. che. uk/ sciences/ reference/ plambeck/ chem2/ p01182. arizona.W. The NOAA Diving Manual recommends a maximum single exposure of 45 minutes at 1. ac. 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) . Flemming Cornelius.e. (Editors) (1997). wvusd. html) Page 200 in: Medical biophysics. edu/ ~mccarthy/ che0035/ MB/ single/ ideal. k12. becomes a problem when oxygen partial pressure is too high. 1 bar of atmospheric pressure + 5 bar of water pressure) and the partial pressures of the main components of air. of 180 minutes at 1. html) Pittsburgh University chemical engineering class notes (http:/ / granular.2 bar absolute. the total absolute pressure is 6 bar (600 kPa) (i. = 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. edu/ ~salzmanr/ 103a004/ nts004/ l41/ l41. htm) University of Delaware physical chemistry lecture (http:/ / www. ISBN 0-764-57419-1. in the terms used in this article = volume fraction of gas component i  =  mole fraction. pitt. The partial pressure of oxygen determines the maximum operating depth of a gas mixture. 2008. Typically. intute. udel. oxygen 21% by volume and nitrogen 79% by volume are: ppN2 = 6 bar x 0.5 bar absolute. rice.

• Himalayan mountaineering. "semi closed scuba".[1] The rebreather adds oxygen. as opposed to Aqua-Lung-type equipment. In the armed forces it is sometimes called "CCUBA" (Closed Circuit Underwater Breathing Apparatus). or CCUBA = "closed circuit underwater breathing apparatus". 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. 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). roughly the same quantity of oxygen is used.[1] [3] It absorbs the carbon dioxide. • Crewed spacecraft and space suits – outer space is. At shallow depths. The remaining oxygen is exhaled along with nitrogen and carbon dioxide. Everest in 1938.Rebreather 77 Rebreather A rebreather is a type of breathing set that provides a breathing gas containing oxygen and recycled exhaled gas. which represents an increasingly smaller fraction of the compressed air breathed in. A high rate of system failures due to extreme cold has not been solved. a vacuum where there is no oxygen to support life. It removes the carbon dioxide by a process called scrubbing. . the body consumes oxygen and makes carbon dioxide. which is known as "open circuit scuba". Both chemical and compressed oxygen has been used in experimental closed-circuit oxygen systems—the first on Mt. As the diver goes deeper. which otherwise would accumulate and cause carbon dioxide poisoning. 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. Rebreather technology is used in many environments: • Underwater – where it is sometimes known as CCR = "closed circuit rebreather". • Hospital anaesthesia breathing systems – to supply controlled proportions of gases to patients without letting anaesthetic gas get into the atmosphere that the staff breathe.[1] • Mine rescue and in industry – where poisonous gases may be present or oxygen may be absent. "closed circuit scuba". SCR = "semi closed rebreather". potentially useful gas volume. to replace the oxygen that was consumed.[1] Thus.[2] Theory As a person breathes. This recycling reduces the volume of breathing gas used. every exhaled breath from an open-circuit scuba set represents at least 95% wasted. The rebreather recirculates the exhaled gas for re-use and does not discharge it to the atmosphere or water. which has to be replaced from the air supply. for all intents and purposes. Here the rebreather is big and is connected to the air in the habitat. 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. Because exhaled air can contain as much as 79% nitrogen (which is not utilized in the body) and 16% (or more) unused oxygen.

he accidentally made a crude rebreather more than two centuries before Saint Simon Sicard's patent. he likely generated oxygen by heating saltpetre (potassium nitrate) in a metal pan to make it emit oxygen. . O. leading to a fullface mask with one big face window.[6] 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). The first recorded mass production of rebreathers started in 1912 with the Dräger rebreathers.[5] In 1853 Professor T. invented some years sooner by an engineer of the Dräger company. Records show that..N. Various industrial oxygen rebreathers (e. later British frogman's rebreathers had a square recess in the top so they could extend further up onto his shoulders.[7] [8] The Davis Escape Set was the first rebreather which was practical for use and produced in quantity. to re-oxygenate the air inside it. That may explain how Drebbel's men were not affected by carbon dioxide build-up as much as would be expected.[4] The oldest known rebreather used an oxygen reservoir and relates to the 1849 patent from the Frenchman Pierre Aimable De Saint Simon Sicard. Hall. R. If so. 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. were those used by the German helmet divers during World War II.Rebreather 78 History of rebreathers Around 1620 in England. developed a submarine escape apparatus using Oxylithe. But in later operations different designs were used.S.[10] The Dräger rebreathers. in front they had a rubber collar that was clamped around the absorbent canister. as in the illustration below. R. It was designed about 1900 in Britain for escape from Royal Navy frogman in 1945 sunken submarines. Hermann Stelzner. Those first breathing sets may have been modified Davis Submarine Escape Sets.[8] it was used in the first filming (1907) of Twenty Thousand Leagues Under the Sea. which developed its frogman unit Decima Flottiglia MAS. which would tend to absorb carbon dioxide from the air around. In 1909 Captain S. both invented in the early 1900s) were descended from it. Another systematic use of rebreathers for diving was by Italian sport spearfishers in the 1930s. this link shows a Draeger rebreather used for mines rescue in 1907.N. Rees.. invented Oxylithe. their fullface masks were the type intended for the Siebe Gorman Salvus. This practice came to the attention of the Italian Navy. Schwann designed a rebreather in Belgium.[8] Some British armed forces divers used bulky thick diving suits called Sladen suits.[8] In World War II captured Italian frogmen's rebreathers influenced design of British frogmen's rebreathers. but the ends curved back to allow more vision sideways). he exhibited it in Paris in 1878. and later rectangular (mostly flat. the Siebe Gorman Salvus and the Siebe Gorman Proto. It was used for shallow water diving but never in a submarine escape. Cornelius Drebbel made an early oar-powered submarine. Early British frogman's rebreathers had rectangular breathing bags on the chest like Italian frogman's rebreathers. which is a form of sodium peroxide (Na2O2) or sodium dioxide (NaO2). That would turn the saltpetre into potassium oxide or hydroxide. which was used effectively in World War II. the Royal Navy accepted it. and Dr. [9] In 1903 to 1907 Professor Georges Jaubert. As it absorbs carbon dioxide it emits oxygen. at first oval like in this image. especially the DM40 model series. to rescue mineworkers who were trapped by water.g.[8] Many British frogmen's breathing sets' oxygen cylinders were German pilot's oxygen cylinders recovered from shot-down German Luftwaffe planes.

Rebreather In the early 1940s US Navy rebreathers were developed by Dr. by maintaining a specific and relatively high oxygen partial pressure (ppO2) at all depths. With open circuit scuba. and therefore minimise the decompression requirements of the diver. Christian J. Most modern rebreathers have a system of very sensitive oxygen sensors. This can offer a dramatic advantage at the end of deeper dives. such as helium.[15] This lack of exhale also allows shipwreck divers to enter enclosed areas on sunken ships and avoid slowly filling them with air. which then supports the growth of rust. 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. Lambertsen for underwater warfare and is considered by the US Navy as "the father of the Frogmen". the amount of O2 consumption doesn't change. Care must be taken that the ppO2 is not set to a level where it can become toxic though. in order to shorten decompression times. In normal use. As the remaining 79% of the breathing gas (mostly nitrogen) is inert. It is not uncommon for a 3 litre (19 cubic foot) diluent cylinder to last for eight 40 m (130 ft) dives. where a diver can raise the partial pressure of oxygen somewhat at shallower depth. they could turn off their diluent.[14] This leaves the available oxygen utilization at about 25%. due to venting of the gas on ascent. it has an oxygen level in the range of 15 to 16% when the diver is at atmospheric pressure.[11] [12] 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. When that breath is exhaled back into the surrounding environment. Since the generation of CO2 is directly related to the body's consumption of O2 (about ~99. a closed circuit rebreather diver effectively doesn't use any of their diluent gas once they've reached the bottom phase of the dive. A breath inhaled from an open circuit scuba system whose cylinders are filled with ordinary air is about 21%[14] oxygen. only oxygen is consumed: small volumes of expensive inert gases are reused during (only) one dive. the advantage of a rebreather is even more marked. therefore CO2 generation doesn't change.[12] [13] 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. Research has shown that a ppO2 of 1.6 bar is toxic . the diver is not using any more of the O2 gas supply than when shallower. the remaining 75% is lost. On ascent. unlike open-circuit scuba. At depth. the entire breath is expelled into the surrounding water when the diver exhales. Other advantages Except on ascent. the diver on open-circuit scuba only uses about 5% of his cylinders' contents. The fully closed circuit rebreather is able to minimise the proportion of inert gases in the breathing mix. A very small amount of trimix would then last for many dives. closed circuit rebreathers produce no bubbles and make no bubble noise and much less gas hissing. however most of that in circuit is lost. which allow the diver to adjust the partial pressure of oxygen. 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. This is a marked difference from open circuit where the amount of gas used is directly proportional to the depth.[14] 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. For example. This means that at depth.5% of O2 is converted to CO2 on exhalation). The economy of gas consumption is also useful when the gas mix being breathed contains expensive gases. no diluent is added.

and lower slightly with each exhalation.[18] 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. have a deeper maximum operating depth than oxygen rebreathers and are fairly simple and cheap. Simplified diagram of the loop in a semi-closed circuit rebreather . they are still the most commonly used for industrial applications on the surface. the oxygen cylinder has two first stages in parallel. and the diver had to operate the valve at intervals to refill the breathing bag as he used the oxygen. Oxygen rebreathers are no longer commonly used in diving because of the depth limit imposed by oxygen toxicity. a quantity of highly compressed gas from his cylinder is reduced in pressure by a regulator.Rebreather with extended exposure[16] One major difference between rebreather diving and open-circuit scuba diving is in keeping neutral buoyancy.[17] As pure oxygen is toxic when inhaled at pressure. Oxygen rebreathers are also sometimes used when decompressing from a deep open-circuit dive. some say 9 meters (30 ft). The only gas that it supplies is oxygen. as breathing pure oxygen makes the nitrogen diffuse out of the blood more rapidly. However. The gas is injected into the loop at a constant rate to replenish oxygen consumed from the loop by the diver.g. Simplified diagram of the loop in an oxygen rebreather The diving pioneer Hans Hass used Dräger oxygen rebreathers in the early 1940s. semi-closed circuit is wasteful of oxygen. Semi-closed circuit equipment generally supplies one breathing gas such as air or nitrox or trimix. oxygen-rich gas. As the oxygen in the vented gas cannot be separated from the inert gas. because the diver is circulating a roughly constant volume of gas between his lungs and the breathing bag. Excess gas must be constantly vented from the loop in small volumes to make space for fresh. (SCBA) such as in mines. the other is a plain on-off valve called a bypass. Semi-closed circuit rebreather Military and recreational divers use these because they provide better underwater duration than open circuit. and their invention predates that of open-circuit scuba. but only the bypass. e. Oxygen rebreathers can be remarkably simple designs. 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. This does not happen to a rebreather diver. both feed into the same exit pipe which feeds the breathing bag. and enters the lungs at a much higher volume than it occupied in the cylinder. due to their simplicity and compact size. oxygen rebreathers are currently limited to a depth of 6 meters (20 ft). Some simple oxygen rebreathers had no constant-flow valve. This means that the diver has a tendency to rise slightly with each inhalation.[7] In the Salvus there is no second stage and the gas is turned on and off at the cylinder. When an open-circuit scuba diver inhales. 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. One is constant flow. In some rebreathers.

The major task of the fully closed circuit rebreather is to control the oxygen concentration. it had a very small oxygen cylinder to fill the loop at the start of the dive. leading to oxygen toxicity.[20] 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 condition causing convulsions which can make the diver lose the mouthpiece when they occur underwater. 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. Non-simplified diagram of the loop in a semi-closed circuit rebreather Fully closed circuit rebreather Military. photographic. Florida showed that the IDA71 could give significantly longer dive time with superoxide in one of the canisters than without. Too high a concentration of oxygen results in hyperoxia.[21] 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. and can lead to drowning.g.Rebreather 81 As the amount of oxygen required by the diver increases with work rate. The concentration of oxygen in the loop depends on two factors: depth and the proportion of oxygen in the mix. 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. The Russian IDA71 military and naval rebreather was designed to be run in this mode or as an ordinary rebreather.[19] A higher gas injection rate reduces the likelihood of hypoxia but consumes more gas and wastes more oxygen. the gas injection rate must be carefully chosen and controlled to prevent unconsciousness in the diver due to hypoxia. which gives off oxygen as it absorbs carbon dioxide: 4KO2 + 2CO2 = 2K2CO3 + 3O2. Too low a concentration of oxygen results in hypoxia leading to sudden unconsciousness and ultimately death. known as the oxygen partial pressure. the Oxylite) which had an absorbent canister filled with potassium superoxide. Adding diluent can prevent the loop's gas mixture becoming too oxygen rich. The diver may be able to manually control the mixture by adding diluent gas or oxygen. 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. 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. 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.[21] . Tests on the IDA71 at the United States Navy Experimental Diving Unit in Panama City.

. a regular scrubber was needed.[24] [25] 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. • Some British naval rebreathers (e. The diluent could be either liquid nitrogen or helium depending on the depth of the dive. They include these types: • Aerophor. • This link [26] describes an experimental drysuit (with built-in hood and fullface mask) and rebreather combination where the drysuit acts as the breathing bag. the liquid-oxygen tank must be well insulated against heat coming in from the water. thus controlling the equilibrium pressure of oxygen gas above the liquid.g. 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. industrial sets of this type may not be suitable for diving.Rebreather 82 Rebreathers which store liquid oxygen If used underwater. the Siebe Gorman CDBA) had a backpack weight pouch instead of the diver having a separate weight belt. by controlling the temperature of the liquid oxygen.2 bar to 2 bar without electronics. Cryogenic rebreather A cryogenic rebreather has a tank of liquid oxygen and no absorbent canister. The set's liquid oxygen tank must be filled immediately before use. Its ppO2 could be set to anything from 0. like in an old Draeger standard diving suit variant which had a rebreather pack attached. As a result.[23] Cryogenic rebreathers were widely used in Soviet oceanography in the period 1980 to 1990. The set could freeze out 230 grams of carbon dioxide per hour from the loop. corresponding to an oxygen consumption of 2 liters per minute. It had a duration of 6 hours and a maximum dive depth of 200 meters of salt water. • Aerorlox [22] • Cryogenic rebreather: see below. and diving sets of this type may not be suitable for use out of water. 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.

The diluent reduces the percentage of oxygen breathed and increases the maximum operating depth of the rebreather. where the inhaled and exhaled gas passes through the same tube in opposite directions. and is breathable. Attached to the loop there will be at least one valve allowing injection of gases. with the casing opened Pure oxygen is not considered to be safe for recreational diving deeper than 6 meters. This diluent cylinder may be filled with compressed air or another diving gas mix such as nitrox or trimix. this oxygen is stored in a gas cylinder. the oxygen source will either be pure or a breathing gas mixture. This is connected to one or more tubes bringing inhaled gas and exhaled gas between the diver and a counterlung or breathing bag. This holds gas when it is not in the diver's lungs. any training on a rebreather will feature procedures for removing any excess water. or if the diver's lips get slack letting water leak in. The loop consists of components sealed together. sometimes a mouth-and-nose mask). 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. to stop large volumes of water from entering the loop if the diver removes the mouthpiece underwater without closing the valve. Nearly always. it may be used in an emergency either to flush the loop with breathable gas or as a bailout. 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. It is important that the diluent is not an oxygen-free gas. The diver breathes through a mouthpiece or a fullface mask (or with industrial breathing sets. Regardless of whether the rebreather in question has the facility to trap any ingress of water. so recreational rebreathers and many professional diving rebreathers also have a cylinder of diluent gas. The loop also includes a scrubber containing carbon dioxide absorbent to remove from the loop the carbon dioxide exhaled by the diver.Rebreather 83 Parts of a rebreather The loop Although there are several design variations of diving rebreather. Many rebreathers have "water traps" in the counterlungs. There may be valves allowing venting of gas from the loop. such as oxygen and perhaps a diluting gas. from a gas source into the loop. such as pure nitrogen or helium. Some have a single pendulum hose. Back of a closed circuit rebreather. 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. . Depending on the rebreather design variant. all types have a gas-tight loop that the diver inhales from and exhales into.

• The scrubber canister has been incorrectly packed or configured. of the unreacted soda lime that is exposed to carbon dioxide-laden gas. The carbon dioxide passing through the scrubber absorbent is removed when it reacts with the absorbent in the canister. A "caustic cocktail" is a mixture of water and soda lime that occurs when the "scrubber" floods. • in below-freezing operation (primarily mountain climbing) the wet scrubber chemicals can freeze when oxygen bottles are changed.[29] With a transparent canister. This allows the exhaled gas to bypass the absorbent. Some systems use a prepackaged Reactive Plastic Curtain (RPC)[27] based cartridge: Reactive Plastic Curtain (RPC) was first used between Micropore Inc. because of this effect. are not cleaned or lubricated or fitted properly. the scrubber needs to be bigger than is needed for a shallow-water or industrial oxygen rebreather. a rebreather absorbent called "Protosorb" supplied by Siebe Gorman had a red dye. and then time to penetrate to the middle of each grain of absorbent as the outside of the grain becomes exhausted. This is useful in dry open environments. this may be able to show the position of the reaction "front". such as recompression chambers. 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. This front moves through the scrubber canister. Among British naval rebreather divers. which was said to go white when the absorbent was exhausted. In deep diving with a nitrox or other gas-mixture rebreather. because the carbon dioxide in the gas going through the canister needs time to reach the surface of a grain of absorbent. or outside water or gas may get in circuit. such as o rings. or Sodasorb. 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. Many modern diving rebreather absorbents are designed not to produce "cocktail" if they get wet. this chemical reaction is exothermic. Failure prevention • An indicating dye in the soda lime. In a rebreather.Rebreather 84 Carbon dioxide scrubber The exhaled gases are directed through the chemical scrubber. Color indicating dye was removed from US Navy fleet use in 1996 when it was suspected of releasing chemicals into the circuit. which removes the carbon dioxide from the gas mixture and leaves the oxygen and other gases available for re-breathing. and the US Navy to describe Micropore's absorbent curtains for emergency submarine use. a canister full of some suitable carbon dioxide absorbent such as a form of soda lime. or spacers that prevent bypassing of the scrubber. Scrubber failure The term "break through" means the failure of the "scrubber" to continue removing carbon dioxide from the exhaled gas mix. the scrubber will be less efficient. from the gas input end to the gas output end. It gives rise to a chalky taste.[14] Some absorbent chemical designed for diving applications are Sofnolime. • A Caustic Cocktail – Soda lime is caustic and can cause burns to the eyes and skin. as the reaction consumes the active ingredients. thus preventing CO2 from reaching the scrubber material. where: . However. In larger environments. It changes the colour of the soda lime after the active ingredient is consumed. and then more recently RPC has been used on the web to describe their Reactive Plastic Cartridges – ExtendAir [28]. If any of the seals. • When the gas mix is under pressure caused by depth. this type of carbon dioxide poisoning was called shallow water blackout. this front would be a wide zone. a fan is used to pass gas through the canister. There are several ways that the scrubber may fail or become less efficient: • Complete consumption of the active ingredient ("break through"). This reaction occurs along a "front" which is a cross section of the canister. Dragersorb. For example. which should prompt the diver to switch to an alternative source of breathing gas and rinse his or her mouth out with water. but is not useful on diving equipment.

the urge to breathe is normally caused by a build-up of carbon dioxide in the blood. 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). The loop often has a pressure relief valve to prevent over-pressure injuries caused by over-pressure of the loop. • The canister is usually out of sight of the user. rather than lack of oxygen. 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 ambient temperature. the proportion of oxygen in the loop may be too low to support life.Rebreather • A transparent canister would likely be brittle and easily cracked by knocks. Counterlung . the set also has a manual on/off valve called a bypass. along the length of the scrubber can be used to measure the position of the front and therefore the life of the scrubber. which monitor the ppO2. Such systems are not useful as a tool for monitoring scrubber life when underwater as the onset of scrubber "break through" occurs quite rapidly. Most modern closed-circuit rebreathers have electro-galvanic fuel cell sensors and onboard electronics. Such systems should be used as an essential safety device to warn divers to bail off the loop immediately. In some modern rebreathers. Narked at 90 Ltd – Deep Pursuit Advanced electronic rebreather controller. 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. inside the breathing bag or inside a backpack box. the pressure in the breathing bag controls the oxygen flow like the demand valve in open-circuit scuba. the first CO2 detector to be produced for rebreathers in a diving application was patented by Clive Wilcox of Amphilogic. for example. injecting more oxygen if necessary or issuing an audible warning to the diver if the ppO2 reaches dangerously high or low levels. trying to breathe in from an empty bag makes the cylinder release more gas. most likely digital. At present. Effectiveness In rebreather diving. and the size of the canister. such as a recompression chamber or a hospital. The diver must monitor the exposure of the scrubber and replace it when necessary. • Carbon dioxide gas sensors exist. If not enough new oxygen is being added. This makes hypoxia a deadly problem for rebreather divers. The resulting serious hypoxia causes sudden blackout with little or no warning. • Temperature monitoring. • Opening the canister to look inside would flood it with water or let unbreathable external gas in.g. temperature sensors. 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. As the reaction between carbon dioxide and soda lime is exothermic. 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. depending on the granularity and composition of the soda lime. the typical effective duration of the scrubber will be half an hour to several hours of breathing. the design of the rebreather. In humans. e. In others the oxygen flow is kept constant by a pressure-reducing flow valve like the valves on blowtorch cylinders. In some dry open environments.[30] [31] • Diver training. it may be possible to put fresh absorbent in the canister when break through occurs.

The design of the rebreathers' counterlungs can also affect the swimming diver's streamlining due to location of the counterlungs themselves. A rebreather whose counterlung is rubber and not in an enclosed casing. 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. Some are designed as over-the-shoulder lungs (e.Rebreather The counterlung is a flexible part of the loop.g. while others incorporate the counter lungs into a solid case (e. For use out of water. has an effect on the ease of breathing. 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.g. Often the planned dive is limited by the capacity of the bailout and not the capacity of the rebreather. the position of the breathing bag. • An independent closed-circuit system. the rebreather may fail and be unable to provide a safe breathing mix for the duration of the ascent back to the surface. This is due to the pressure difference between the counterlung and the diver's lung caused by the vertical distance between the two. particularly for long dives and deeper dives in technical diving. While this option has the advantages of being permanently mounted on the rebreather and not heavy. • An open-circuit demand valve connected to the rebreather's oxygen cylinder. or on the back. in an industrial version of the Siebe Gorman Salvus the breathing bag hangs down by the left hip. It is easier to inhale from a front mounted counterlung and exhale to a back mounted counterlung for diver swimming facedown and horizontally. The KISS Classic).[32] • An independent open-circuit system. to prevent the rubber from perishing due to UV light. over the shoulders. Although some rebreather divers—referred to as "alpinists"—do not carry bailouts. which is designed to change in size by the same volume as the diver's lungs when breathing. the quantity of gas held by the rebreather is small so the protection offered is low. 86 Bailout While the diver is underwater. 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. bailout strategy becomes a crucial part of dive planning. Underwater. . In this case the diver needs an alternative breathing source: the bailout. on the chest. Innerspace Systems Megalodon). 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. this does not matter so much: for example. should be sheltered from sunlight when not in use. The breathing gas mix must be carefully chosen to be safe at all depths of the ascent.

In closed circuit rebreathers. (Because there has been very little use of mountaineering rebreathers. The SEFA. is completely sealed. The danger is that a sick climber using a rebreather might become unconscious.[34] Investigations into rebreather deaths focus on three main areas: medical. to keep the exhaled gas flowing over the carbon dioxide absorbent. to keep grit and stones out of its working.[33] Disadvantages of rebreather diving Risks The percentage of deaths that involve the use of a rebreather among United States and Canadian residents increased from approximately 1 to 5% of the total diving fatalities collected by the Divers Alert Network from 1998 through 2004. This casing needs venting to let surrounding water or air in and out to allow for volume changes as the breathing bag inflates and deflates. which helps to conceal the diver's presence by masking the release of bubbles. e. which reduces the partial pressure of oxygen to hypoxic levels leading to what is sometimes called deep water blackout. Divers need to lose any air conservation habits that may have been developed while diving with open-circuit scuba. In a diving rebreather this needs fairly large holes. in the IDA71 and Cis-Lunar. • Disorientation. A particular problem when using a closed circuit rebreather is the drop in ambient pressure caused by the ascent phase of the dive. due to pressure. which raises the partial pressure of oxygen to hyperoxic levels. • Seizures due to oxygen toxicity caused by too high a partial pressure of oxygen in the loop. and holes for the oxygen cylinder's on/off valve and the cylinder pressure gauge. headache. which is used for mine rescue.g. failure or inefficiency of the scrubber.[34] In mountaineering. during hard work or fast swimming. The scrubber must be configured so that no exhaled gas can bypass it. aging oxygen sensors may become "current limited" and fail to measure high partial pressures of oxygen resulting in dangerously high oxygen levels. this also has the . The scrubber efficiency may be reduced at depth where the increased concentration of other gas molecules. it must be packed and sealed correctly. for example. Diffuser Some military rebreathers have a diffuser over the blowoff valve. 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. equipment. rebreather divers are also more susceptible to the following disorders (all of which are directly connected with the effectiveness of actual rebreather designs and construction. This can be caused by the rise in ambient pressure caused by the descent phase of the dive. Because an absolute atmospheric seal is required for rebreathers to work correctly. this danger is still only theoretical. and hyperventilation due to excess of carbon dioxide caused by incorrect configuration.) Closed circuit disorders In addition to the other diving disorders suffered by divers. stops all the carbon dioxide molecules reaching the active ingredient of the scrubber. In fully closed circuit equipment. • The rebreather diver must keep breathing in and out all the time.Rebreather 87 Casing Many rebreathers have their main parts in a hard backpack casing. except for a large vent panel covered with metal mesh. not with the theory of rebreathing): • Sudden blackout due to hypoxia caused by too low a partial pressure of oxygen in the loop. Another problem is the diver producing carbon dioxide faster than the absorbent can handle. panic. and procedural. such a seal could conceivably cause an unconscious user to suffocate when the oxygen ran out or the scrubber became exhausted. including a hole at the bottom to drain the water out when the diver comes out of water. Underwater the casing also serves for streamlining. The solution to this is to slow down and let the absorbent catch up. so the absorbent can work all the time.

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. A malfunctioning rebreather can supply a gas mixture which contains too little oxygen to sustain life. and fewer failsafes. Innovations include: • The electronic. complexity of operation and maintenance. Typically rebreathers try to solve these problems by monitoring the system with electronics. The first ever system that was proved to function correctly was patented by Clive Wilcox of Amphilogic. These are expensive and susceptible to failure. It only works when partial pressure of oxygen in the diluent alone would not cause hypoxia or hyperoxia. • 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. . 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. rebreathers have some disadvantages including expense. 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.[37] • Integrated decompression computers – these allow divers to take advantage of the content and generate a schedule of decompression stops. sensors and alarm systems. which may give inaccurate readings to the oxygen control system. • "Caustic cocktail" in the loop if water comes into contact with the soda lime used in the carbon dioxide scrubber.[36] Sport diving rebreather technology innovations Over the past ten or fifteen years rebreather technology has advanced considerably. improper configuration and misuse. 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. or it may allow carbon dioxide to build up to dangerous levels. The technique involves simultaneously venting the loop and injecting diluent.[35] Some rebreather divers prefer not to carry enough bailout for a safe ascent breathing open circuit. 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. often driven by the growing market in recreational diving equipment. An important safety device when carbon dioxide poisoning occurs. A safe response is to bail out to "open circuit" and rinse the mouth out. • 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. but instead rely on the rebreather. believing that an irrecoverable rebreather failure is very unlikely.Rebreather advantage of mixing the gases preventing oxygen-rich and oxygen-lean spaces developing within the loop. such as when using a normoxic diluent and observing the diluent's maximum operating depth.[38] • 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.

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[31] http:/ / www. org/ 5110). rubicon-foundation. south of France) (http:/ / www. [2] Holzel. Shreeves. Proceedings of the American Academy of Underwater Sciences Symposium on March 10-12. JM. "Chemical safety of U." (http:/ / archive. (1969). rubicon-foundation. Skin Diver magazine. Navy Fleet soda lime" (http:/ / archive.32:1005-1020. JS. com/ scaphandre/ autonomie/ autonomes_sans_detendeur. DC. Popular Mechanics 183 (12): 58. . "Seeking New Depths". apdiving. [24] "Popular mechanics (ru). . 28.: 286. Washington. rubicon-foundation. . School of Underwater Medicine. divingheritage. [22] http:/ / www. [14] Reynolds. htm [10] Drägerwerk page in Divingheritage. org/ 3451). (1970). "DEVELOPMENT OF A SCRUBBER GAUGE FOR CLOSED-CIRCUIT DIVING. . Retrieved 2008-06-09. WW. №7(81) June 2009" (http:/ / www. [4] "Cornelius Drebbel: inventor of the submarine" (http:/ / www. Retrieved 2008-04-25. Retrieved 2008-02-23. Undersea Hyperb Med 23 (1): 43–53. [16] Manning AM. Retrieved 2008-04-25..S. shtml). Retrieved 2008-06-14. MA and Smith. Glen Harlan (December 2006). Retrieved 2008-04-25. . Retrieved 2008-07-17. rubicon-foundation. Menduno. ISBN 20060725. com/ rebreathers/ vision/ scrubbermonitor/ • .). ru/ article/ 5567-zhidkaya-voda-zhidkiy-vozduh/ ). ISSN 0032-4558. Retrieved 2009-01-31. Diving Science and Technology Workshop. JM. velocitypress. US Naval Submarine Medical Research Center Technical Report NSMRL-TR-1228. "Closed circuit oxygen system. Oxygen therapy and toxicity. In: Godfrey. Retrieved 2009-07-17. espalion-12. Cryogenic Rebreather. D (2006).0. "Rebreathers" (http:/ / archive. Navy" (http:/ / archive. (http:/ / www. [25] "Sportsmen-podvodnik journal. "OSS Maritime". Gummin DD. PMID 8653065. org/ 6039). Dean. W (2003). Karl (eds).

org/ 5110).: American Academy of Underwater Sciences) Proceedings of the American Academy of Underwater Sciences (Twenty-sixth annual Scientific Diving Symposium). .rebreatherpro. html) and many useful references in its "Further Reading" section • A history of closed circuit oxygen underwater breathing apparatus (http://archive.) the Diving for Science…2007 (Dauphin Island. may be slow to download • Information on shallow water blackout (http://www.bishopmuseum. html). jlunderwater. 197 pages. . Undersea and Hyperbaric Medicine Abstract 34.com/dive&swim. "Development of a scrubber gauge for closed-circuit diving" (http:/ / archive. rubicon-foundation.Rebreather [32] Lang. Defence R&D Canada Technical Report (Defence R&D Canada) (DCIEM 92-06). Retrieved 2008-04-25. Retrieved 2011-07-30. Retrieved 2009-03-03. Michael A.specwargear.org/ 4960). org/ 7282). therebreathersite. org/ 7981). plenty of images.com) Free searchable multimedia resource for rebreather divers • Image gallery of LAR-6 and LAR-7 and FGT II and LAR V rebreathers. [36] Liddiard.) (2001). rubicon-foundation. Retrieved 2009-03-03. Lee DA (2008). [33] Chapple.html) . including mountaineering rebreathers. In: NW Pollock and JM Godfrey (Eds. "Development of the Canadian Underwater Mine Apparatus and the CUMA Mine Countermeasures dive system. (http:/ / archive. Ala. "Rebreather Fatality Investigation" (http:/ / archive. co. Motor skills learning and current bailout procedures in recreational rebreather diving. (ed. .uk. Pollock NW. published in 1970. NC: Divers Alert Network. "Bailout" (http:/ / www.html) • In-depth explanation on how rebreathers work (http://www. Nitrox Rebreather Diving.scuba-doc. . org/ 4855). and Denoble PJ (2007). 8 November 2010. nl/ 01_Informative/ BOV_page/ BOV_page.org/research/treks/palautz97/rb.nl. and other combat frogman's kit (http:// www. ISBN 0-9800423-1-3. John. JCB. [35] Verdier C. . 90 External links • RebreatherPro (http://www.therebreathersite. rubicon-foundation.rubicon-foundation. org/ 6997). DAN nitrox workshop proceedings (http:/ / archive. Durham." (http:/ / archive. [37] "OC – DSV – BOV – FFM page" (http:/ / www.com/latenthypoxia. rubicon-foundation. rubicon-foundation. www. Retrieved 2009-03-31. .a [34] Vann RD. Retrieved 2008-06-14. Eaton. [38] Warkander Dan E (2007). . Retrieved 2010-12-29. uk/ old_site/ photoix/ bailout/ bailout. DIRrebreather publishing.co. section 1.2. htm). David J. jlunderwater.

are both relatively recent Technical diver during a decompression stop. but this is no longer the case. during which the diver may change breathing gas mixes at least once. sometimes even deeper. The type of gas mixture used is determined either by the maximum depth planned for the dive. diving in an overhead environment beyond 130 linear feet from the surface.[2] 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. specialized equipment and often breathe breathing gases other than air or standard nitrox. nitrox diving was considered technical. Some say that technical diving is any type of scuba diving that is considered higher risk than conventional recreational diving. It is further defined as an activity that includes one or more of the following: diving beyond 40 meters/130 feet. Technical diving often involves the use of special gas mixtures (other than compressed air) for breathing. defines technical diving as "diving other than conventional commercial or recreational diving that takes divers beyond recreational diving limits.[3] Definition of technical diving There is some professional disagreement as to what the term should encompass.[4] [5] [6] Until recently. whereas others contend that penetrating overhead environments should be regarded as a separate type of diving. some advocate that this should include penetration diving (as opposed to open-water diving). advents. technical diving. accelerated stage decompression and/or the use of multiple gas mixtures in a single dive. extensive experience."[8] • 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.[7] Certain minority views contend that certain non-specific higher risk factors should cause diving to be classed as technical diving.[1] The concept and term. who was editor of the (now defunct) diving magazine AquaCorps in 1991. Even those who agree on the broad definitions of technical diving may disagree on the precise boundaries between technical and recreational diving. required stage decompression. Technical divers require advanced training."[9] NOAA does not address issues relating to overhead environments in its definition. Others seek to define technical diving solely by reference to the use of decompression. • PADI. However. The following table tries to describe the differences between technical and recreational diving. Technical diving almost always requires one or more mandatory decompression "stops" upon ascent. . technical divers may work in the range of 170 ft to 350 ft. The term technical diving has been credited to Michael Menduno. the largest recreational diver training agency in North America.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). or by the length of time that the diver intends to spend underwater.

PADI Recreational diving requires buddy system others as technical diving. These factors increase the level of risk and training required for technical diving far beyond that required for recreational diving. For this reason.Technical diving 92 Technical Diving Activity Deep diving Decompression [11] diving Mixed gas diving Gas switching Recreational Maximum depth of 40 metres (130 ft) No decompression [10] Technical Beyond 40 metres (130 ft) Decompression diving Air and Nitrox Single gas used Trimix. NAUI [16] 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. Increasing pressure at depth also increases the risk of oxygen toxicity based on the partial pressure of oxygen in the breathing mixture. Heliox. In many cases. . 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. NAUI [15] [14] [14] Some agencies regard use of semi-closed rebreathers as recreational diving.[17] Such environments may include fresh and saltwater caves and the interiors of shipwrecks. This is a fairly conservative definition of technical diving. PADI [13] Cave diving Deeper penetration Ice diving Rebreathers Solo diving others as technical diving. Heliair and Hydrox May switch between gases to accelerate decompression and/or "travel mixes" to permit descent carrying hypoxic gas mixes Deeper penetration Wreck diving Penetration limited to "light zone" or 30 metres (100 ft) depth/penetration Penetration limited to "light zone" or 30 metres [12] (100 ft) depth/penetration Some agencies regard ice diving as recreational diving. technical diving often includes the use of breathing mixtures other than air. 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.

diving under ice. such as nitrogen and helium. Wreck diving . Deep diving . Decompression stops A diver at the end of a long or deep dive may need to do decompression stops to avoid decompression sickness. These dissolved gases must be released slowly from body tissues by pausing or "doing stops" at various depths during the ascent to the surface. it is common to use trimix which adds helium to replace nitrogen in the diver's breathing mixture. 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. 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. To avoid nitrogen narcosis while at maximum depth.diving into a cave system. Metabolically inert gases in the diver's breathing gas. are absorbed into body tissues when inhaled under high pressure during the deep phase of the dive. Ice diving . In recent years. Physical ceiling These types of overhead diving can prevent the diver surfacing directly: • • • • Cave diving . . reducing the risk of "the bends. Most technical divers breathe enriched oxygen breathing gas mixtures such as nitrox during the beginning and ending portion of the dive. Free floating decompression stop. most technical divers have greatly increased the depth of the first stops to reduce the risk of bubble formation before the more traditional.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. long.diving inside a shipwreck." 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. also known as the "bends".diving into greater depths.

caused by silt or depth. Note the backplate and wing setup with sidemounted stage tanks swings. but are now commonly called "extended range" courses. The combination of low visibility and swift current make these technical dives extremely risky to all but the most skilled and well-equipped divers. and dizziness. 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). as there are multiple oxygen percentages available in nitrox. they view the limit as being the depth at which partial pressure of oxygen reaches 1. Deep air proponents base the proper depth limit of air diving upon the risk of oxygen toxicity. UTD) argue that diving deeper on air is unacceptably risky. divers can reduce these effects. This reduces the nitrogen percentage. GUE. as helium does not have the same narcotic properties at depth. Sometimes the diver may get warning symptoms prior to the convulsion. Helitrox/triox proponents argue that the defining risk should be nitrogen narcosis. Further training and knowledge is required in order to use safely and understand the effects of these gases on the body during a dive. resulting in a reduced ability to react or think clearly (see nitrogen narcosis). Accordingly. it decreases the build up of nitrogen within the diver's body by increasing the percentage of oxygen. as the breathing regulator falls out and the victim drowns. saying that helium mixes should be used for dives beyond a certain limit (100–130 feet (30–40 m).4 ATA. and heliair. as well as allowing for a greater number of multiple dives compared to standard air. twitching (especially Technical divers preparing for a mixed-gas decompression dive in Bohol. heliox. Such courses used to be referred to as "deep air" courses. such as trimix. By adding helium to the breathing mix. and because vision is often reduced by water currents. The first sign of oxygen toxicity is usually a convulsion without warning which usually results in death. in the face and hands).[18] While mainstream training agencies still promote and teach such courses (TDI. These gas mixes can also lower the level of oxygen in the mix to reduce the danger of oxygen toxicity. require greater knowledge and skill to operate in such an environment.[19] IANTD and DSAT/PADI). a minority (NAUI Tec. due to depth also causes nitrogen to become narcotic. 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.Technical diving 94 Extremely limited visibility Technical dives in waters where the diver's vision is severely impeded by low-light conditions. and suggest that when . nausea. 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. irritability and mood Philippines. depending upon agency). which occurs at about 186 feet (57 m). Breathing normal air (with 21 percent oxygen) at depths greater than 180 feet (55 m) creates a high risk of oxygen toxicity. These can include visual and auditory hallucinations. and while it is not used for deep diving. The depth limit of nitrox is governed by the percentage of oxygen used. Increasing pressure containing EAN50 (left side) and pure oxygen (right side).

The technical diver may also carry additional cylinders. Recent entries into the market include Unified Team Diving (UTD). Because required decompression stops act as an obstacle preventing a diver in difficulty from surfacing immediately.0 ATA. Technical diver with decompression gases in side mounted stage cylinders. It has also recently introduced trimix qualifications and continues to develop closed circuit training. Both sides of the community tend to present self-supporting data. with a reserve for bail-out in case of failure of their primary breathing gas. each with its own regulator. and Diving Science and Technology (DSAT). the second tank and regulator act as a back-up system. Profesional Scuba Association International(PSAI). although scientific evidence does not show that a diver can train to overcome any measure of narcosis at a given depth. 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. however. there is a need for redundant equipment. . to ensure adequate breathing gas supply for decompression. helium is necessary to offset the effects of the narcosis. for example. International Association of Nitrox and Technical Divers (IANTD) and National Association of Underwater Instructors (NAUI) were popular as of 2009. Global Underwater Explorers (GUE). known as stage bottles. The Scuba Schools International (SSI) Technical Diving Program (TechXR – Technical eXtended Range) was launched in 2005.[20] The Divers Alert Network does not formally reject deep air diving per se.[22] British Sub-Aqua Club (BSAC) training has always had a technical element to its higher qualifications. There are many technical training organisations: see the Technical Diving section in the list of diver training organizations. Technical divers usually carry at least two tanks. which occurs at about 130 feet (40 m). and nitrox training will become mandatory. Technical divers therefore increase their supply of available breathing gas by either connecting multiple high capacity diving cylinders and/or by using a rebreather. Technical Diving International (TDI). or become tolerant of it. but indicates the additional risks involved. In the event of a failure. Divers trained and experienced in deep air diving report less problems with narcosis than those trained and experienced in mixed gas diving trimix/heliox. Training Technical diving requires specialised equipment and training.Technical diving the partial pressure of nitrogen reaches approximately 4. The stage cylinders are normally carried using an adaptation of a sidemount configuration. technical dives last longer than average recreational scuba dives. the technical arm of Professional Association of Diving Instructors (PADI). Typically.[21] 95 Equipment Technical divers may use unusual diving equipment.

rubicon-foundation. Des F (1995). naui. 2006. 15. Revised editions use the term technical diving. org/ 8125). Retrieved 2009-09-14. . Retrieved 2009-06-22. . South Pacific Underwater Medicine Society Journal 25 (1). . org/ 9061). MF. Introduction. ISBN 9780922769315. rubicon-foundation.TechDivingMag.). Retrieved 2009-08-07. google. as all dives involve an element of decompression as the diver off-gases. diversalertnetwork.C.Hosted by the Rubicon Foundation • RebreatherPro (http://www. rubicon-foundation. "Technical Diving. [6] Hamilton Jr. padi. (http:/ / www. com/ padi/ en/ kd/ semiclosedrebreather. [19] "TDI . Laliberté. Retrieved 2011-01-15. PMID 1417647. Camporesi EM (eds. [8] PADI. and Gary Gentile published a further book in 1999 entitled The Technical Diving Handbook. space. divessi. org/ 6425). org/ 6266).rebreatherpro. php?did=60& site=3) [17] Mitchell. au/ modx/ bluebeyond-dive-deep-air-is-stupidity. html). author and leading technical diver. ISBN 978-1-878663-31-3 [9] "Technical Diving" (http:/ / oceanexplorer. divessi. com/ english/ common/ courses/ rec/ continue/ deepdiver. Peter Bennett Symposium Proceedings.Technical diving program" (http:/ / www. R (1992). tdisdi. tdisdi. Advanced Wreck Diving. Retrieved 2009-09-03. com/ index. php?did=80& site=2). Scuba Schools International. South Pacific Underwater Medicine Society Journal 26 (1). Dr.: (Divers Alert Network). . rubicon-foundation. 2004.Extended Range Diver" (http:/ / www. However.com • Select publications on technical diving and technical diving history (http://archive. [4] Gorman.. [7] As most technical diving training agencies point out. South Pacific Underwater Medicine Society Journal 22 (1). com/ ?id=HVbjgdorRXAC& pg=PT1& lpg=PT1& dq=bret+ gilliam+ deep+ diving& q=). the term decompression diving is often used to describe diving which involves one or more mandatory decompression stops prior to surfacing. . . [22] "SSI TechXR . "How deep is too deep?" (http:/ / www. page 91. K. aspx [15] http:/ / www. Footnotes External links • http://www.com • http://www.com) Jill Heinerth's interactive multimedia technical diving site • Transitioning to technical diving (http://www. and suggest an absolute limit of 40 metres (130 ft).Technical diving 96 References [1] Richardson. Aviation. org/ medical/ articles/ article. noaa. Retrieved 2009-09-03. references to "decompression diving" is a misnomer. Retrieved 2009-09-03. aspx [14] http:/ / www. SSI (http:/ / www. "What is technical diving? (letter to editor)" (http:/ / archive.org/ dspace/simple-search?query=technical+diving&submit=Go) . com. Retrieved 2008-09-25. . Deep Diving (http:/ / books. NOAA. asp?articleid=29). Durham. In: Moon RE. p. February 24. Gary Gentile. Des F (1992). and environmental medicine 63 (10): 865–9. "Taking 'tec' to 'rec': the future of technical diving" (http:/ / archive. SJ (2007). gov/ technology/ diving/ technical/ technical." (http:/ / archive. [3] Bret Gilliam (1995-01-25)." (http:/ / archive. padi. . [21] John Lippmann. [20] Hamilton. Drew (2003). [5] Gorman. Heslegrave. bluebeyond. Retrieved 2009-08-07. [18] "Deep Air IS Stupdity" (http:/ / www. rubicon-foundation. [10] Many recreational diving agencies recommend diving no deeper than 30 metres (100 ft).org/transitioning-to-technical-diving. com/ index. aspx [16] Some training agencies regard solo diving within the "recreational" sphere. SDI (http:/ / www. DAN.html) . N. html). Piantadosi CA. com/ padi/ en/ kd/ icedivercourse.TechnicalDiving. "Subjective and behavioral effects associated with repeated exposure to narcosis".liquidtravel. South Pacific Underwater Medicine Society Journal 33 (4). . RW (1996). Enriched Air Diving. [2] In his 1989 book. commented that there was no accepted term for divers who dived beyond agency-specified recreational limits for non-professional purposes. "High-tech diving". "Safe Limits: A International Dive Symposium. padi. [13] http:/ / www. com/ txr). org/ technical_divers. Retrieved 2009-08-07. com/ techxr) [12] Some certification agencies prefer to the term "cavern diving" to cave penetration within recreational diving limits. Held May 1. asp) [11] There is a reasonable body of professional opinion that considers decompression diving to be the sole differentiator for "technical" diving. .

but at the same time the tissues can not support as high an amount of helium when super-saturated. Argon. carried in a small. since air conducts heat 50% faster than argon.[3] A lower proportion of oxygen reduces the risk of oxygen toxicity on deep dives.[1] A lower proportion of nitrogen is required to reduce nitrogen narcosis and other physiological effects of the gas at depth. Because of its lower solubility. but less so in bounce diving.Trimix (breathing gas) 97 Trimix (breathing gas) Trimix is a breathing gas. Disadvantages of helium in the mix Helium conducts heat six times faster than air. separate tank. connected only to the inflator of the drysuit is preferred to air. The lower density of helium reduces breathing resistance at depth. where it is often recycled to save the expensive helium component. i. where the increased rate of off-gassing is largely counterbalanced by the equivalently increased rate of on-gassing. often helium breathing divers carry a separate supply of a different gas to inflate drysuits. helium is a faster gas to saturate and desaturate. and helium is more likely to come out of solution and cause decompression sickness following a fast ascent. consisting of oxygen. helium and nitrogen. Some divers suffer from hyperbaric arthralgia during descent. 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. to allow the gas mix to be breathed safely on deep dives. and is often used in deep commercial diving and during the deep phase of dives carried out using technical diving techniques. This is to avoid the risk of hypothermia caused by using helium as inflator gas. damage to skin caused by pressurizing dry suit folds.[1] [2] 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.e. A consequence of the higher loading in some tissues is that many decompression algorithms require deeper decompression stops than a similar decompression dive using air. The mixture of helium and oxygen with a 0% nitrogen content is generally known as Heliox. helium enters and leaves tissues more rapidly than nitrogen as the pressure is increased or reduced (this is called on-gassing and off-gassing).[1] [3] Because of its low molecular weight.[4] Dry suits (if used together with a buoyancy compensator) still require a minimum of inflation to avoid "squeezing". . which is a distinct advantage in saturation diving. This is frequently used as a breathing gas in deep commercial diving operations. Analysis of two-component gases is much simpler than three component gases. helium does not load tissues as heavily as nitrogen. In effect.[5] Helium dissolves into tissues more rapidly than nitrogen as the ambient pressure is increased (this is called on-gassing). Helium has very little narcotic effect.

. This process often takes hours and is sometimes spread over days at busy blending stations. nitrogen. 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.[12] Less commonly.18 at the surface. a mix named "trimix 10/70" or trimix 10/70/20. after each helium and oxygen transfer. Hyperoxic trimix is sometimes referred to as Helitrox or TriOx.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. 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. two classes of trimix are commonly used: normoxic trimix—with a minimum PO2 at the surface of 0. and cannot safely be breathed at shallow depths where the ppO2 is less than 0. 70% helium. hyperoxic trimix is sometimes used on open circuit scuba. See breathing gas for more information on the composition and choice of gas blends. 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. the mix can be hyperoxic in shallow water because the rebreather automatically adds oxygen to maintain a specific ppO2. consisting of 10% 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. "12/52" has a PPO2 of 1. the mix is allowed to cool.0 to 1.[13] A second method called 'continuous blending' is now gaining favor. the mix is named by its oxygen percentage.2 depending on the depth. 20% nitrogen is suitable for a 100-metre (330 ft) dive. For example.18 and hypoxic trimix—with a PO2 less than 0. as a bottom gas only. so as to achieve the rough mix. the duration and the kind of breathing system used [open circuit vs closed circuit rebreather][1] [2] [6] [7] Advantages of keeping some nitrogen in the mix Retaining nitrogen in trimix can contribute to the prevention of High Pressure Nervous Syndrome. a hypoxic mix such as "10/50" is used for deeper diving. At 100 m (330 ft).18 bar. In fully closed circuit rebreathers that use trimix diluents.6 bar and maximum equivalent narcotic depth of 30 to 50 m (100 to 160 ft). The oxygen and helium are fed into the air stream using flow meters.4 and may reduce the PO2 further to 1. This is important mainly because of the high cost of helium. its pressure is measured and further gas is decanted until the correct pressure is achieved.[13] Oxygen. Naming Conventionally.[1] [8] [9] [10] Nitrogen is also much less expensive than helium. helium and air are blended on the intake side of a compressor. Blending Gas blending of trimix involves decanting oxygen and helium into the diving cylinder and then topping up the mix with air from a diving air compressor. The low pressure mixture is analyzed for oxygen content and the oxygen and helium flows adjusted accordingly. a problem that can occur when breathing heliox at depths beyond about 130 metres (430 ft).[11] A normoxic mix such as "19/30" is used in the 30 to 60 m (100 to 200 ft) depth range. helium percentage and optionally the balance percentage. Most trimix divers limit their working oxygen partial pressure [PO2] to 1.3 bar and an equivalent narcotic depth of 43 m (141 ft). To ensure an accurate mix. In open-circuit scuba.3 or 1.

i. and the usual forms for indicating constituent gas fraction. and then topping the mix with 32% enriched air nitrox.[13] [14] 99 "Standard" mixes Although theoretically trimix can be blended with almost any combination of helium and oxygen.[16] GUE and UTD also promote hyperoxic trimix. including salvage diver Max "Gene" Nohl's dive to 127 meters. and feel that the term Trimix is sufficient.[17] The effects from narcosis was not proven until the salvage of the USS Squalus in 1939. The "standard" mixes evolved because of three coinciding factors . human subjects breathing heliox 20/80 (20% oxygen. which simplified mixing. 80% helium) had been successfully decompressed from deep dives. 57% nitrogen.[17] Heliox was used with air tables resulting in a high incidence of decompression sickness so the use of helium was discontinued. The method of mixing a known nitrox mix with helium allows analysis of the fractions of each gas using only an oxygen analyser.[18] 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. but prefer the term "TriOx".only helium and banked nitrox needs to be used to top up the residual gas from the last fill.4 ATA or below at the deepest point of the dive.e. and the fact that many dive shops stored standard 32% enriched air nitrox in banks. Helitrox requires decompression stops similar to Nitrox-I (EAN28) and has a maximum operating depth of 44 metres (144 ft).[19] [20] . while decreasing decompression obligation and narcotic effects compared to air. Other divers question whether this proliferation of terminology is useful. normoxic and hyperoxic. 26% oxygen. DIY versions of the continuous blend units can be made for as little as $200 (excluding analyzers). 18/45 and 15/55). 17% helium. 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.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. Hyperoxic trimix The National Association of Underwater Instructors (NAUI) uses the term "helitrox" for hyperoxic 26/17 Trimix. modified as appropriate with the terms hypoxic. This allows diving throughout the usual recreational range. 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. Most of these mixes originated from filling the cylinders with a certain percentage of helium. where it has an equivalent narcotic depth of 35 metres (115 ft). the requirement to keep the partial pressure of oxygen at 1.the desire to keep that equivalent narcotic depth (END) of the mix at approximately 34 metres (112 ft). hence the fractions of the three components are easily calculated. a number of "standard" mixes have evolved (such as 21/35. 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. Soon. 1937 Several test dives are conducted with helium mixtures.[15] The use of standard mixes makes it relatively easy to top up diving cylinders after a dive using residual mix .

O. ML (2006). dying while repeating the dive. mil/ published_volumes/ harshEnv2/ HE2ch31. "Argon:0. Proceedings of Advanced Scientific Diving Workshop (Washington. 1997. Retrieved 2008-08-28. org/ research/ treks/ palautz97/ phys.[20] 1987 First mass use of trimix and heliox: Wakulla Springs Project. . Medical Aspects of Harsh Environments. T. Helium:0. Volume 2 (Borden Institute): p980. . "Military Diving Operations and Support" (http:/ / www. bordeninstitute. org/ 4655). DC).Trimix (breathing gas) 1939 US Navy used heliox in USS Squalus salvage operation. 100 References [1] Brubakk.. 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. February 14. Bishop Museum. including leading wreck divers John Chatterton and Gary Gentile. html). Tom Mount develops first trimix training standards (IANTD). Exley teaches non-commercial divers in relation to trimix usage in cave diving. 1994 Combined UK/USA team. 2005 David Shaw sets depth record for using a trimix rebreather. . NC. 1979 A research team headed by Peter B. Neuman (2003). bishopmuseum.142 W/mK" [5] Vann RD and Vorosmarti J (2002). initially called "Monitor Mix" became NOAA Trimix I. [3] "Diving Physics and "Fizzyology"" (http:/ / www. 800. The Engineering ToolBox. 2010. Air:0. ISBN 0702025712. 5th Rev ed. ." (http:/ / archive.016. Cave divers Sheck Exley and Jochen Hasenmayer use heliox to a depth of 212 meters. S. NOAA's mix. html). United States: Saunders Ltd. pdf).. engineeringtoolbox.[17] 1965 First saturation dives using heliox. 2005. 1970 Hal Watts performs dual body recovery at Mystery Sink (126 m). with decompression tables published in the NOAA Diving Manual. army. . pp. [2] Gernhardt. Retrieved March 9. successfully complete a series of wreck dives on the RMS Lusitania expedition to a depth of 100 meters using trimix..[21] [22] Source: "Trimix and heliox diving" [23]. 1991 Billy Deans commences teaching of trimix diving for recreational diving. com/ thermal-conductivity-d_429. Retrieved 2008-10-07. NE (eds). Retrieved 2008-08-28. Retrieved 2008-08-28. [4] "Thermal conductivity of some common materials" (http:/ / www. rubicon-foundation. Use of trimix spreads rapidly to North East American wreck diving community. 2001 The Guinness Book of records recognises John Bennett as the first scuba diver to dive to 1000 ft.024. In: Lang. Bennett and Elliott's physiology and medicine of diving. MA and Smith. 2002. 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. "Biomedical and Operational Considerations for Surface-Supplied Mixed-Gas Diving to 300 FSW. using Trimix. A.

ws/ trimix_eng. South Pacific Underwater Medicine Society Journal 29 (2). Retrieved 2008-04-07. rubicon-foundation. C. [7] Gerth. MA and Smith. org/ 6014). [20] Camporesi. Proceedings of Advanced Scientific Diving Workshop (Washington.. aspx#070). ISSN 0093-5387. Eds. html).". Retrieved 2011-03-16. rubicon-foundation. Enrico M (2007). Diving Science and Technology Workshop. The shadowdweller. "Some early studies of decompression. [23] http:/ / www. "Oxygen toxicity: A brief history of oxygen in diving" (http:/ / archive. L. V (2002). . . Peter Bennett Symposium Proceedings.). (1974). time. Piantadosi CA.0.00. In: Lang. org/ 6004). D. Meintjes WA. . [12] Richardson. [18] Behnke. (1999). 9 (4): 335–51. OCLC 2068005. . . Retrieved 2008-08-28. Oxygen Hacker's Companion. "Effect of compression rate on use of trimix to ameliorate HPNS in man to 686 m (2250 ft)" (http:/ / archive. PMID 4619860. [17] Acott. M.9171. rubicon-foundation. Retrieved 2009-06-11. org/ 4654). In: the Physiology and Medicine of Diving and Compressed air work. shtml 101 . Aviat Space Environ Med 78 (2): 81–6. "High Pressure Nervous Syndrome" (http:/ / www. Britz HC (February 2007). [8] Hunger Jr. Coggin. Retrieved 2008-08-28. ISSN 0813-1988. K. Retrieved 2008-08-28.: (Divers Alert Network). com/ HPNS. "A brief history of diving and decompression illness. [19] staff (1937-12-13). Res. B. 2006. rubicon-foundation. Retrieved 2008-08-28. "Proceedings of Rebreather Forum 2. (1982). [13] Harlow. Shreeves. P.758630-1. rubicon-foundation. "The Last Dive of David Shaw" (http:/ / www. R. Retrieved 2009-07-29. ingentaconnect. techdiver. Bennett. P. org/ 9057).C. NE (eds). [14] "Continuous trimix blending with 2 nitrox sticks (English)" (http:/ / shadowdweller. "Decompression Sickness and Oxygen Toxicity in US Navy Surface-Supplied He-O2 Diving. "Fatal respiratory failure during a "technical" rebreather dive at extreme pressure" (http:/ / www. ws/ exotic_gases. naui. Time Magazine. scuba-doc. E. 1 (1): 1–28. [15] TDI Advanced Gas Blender manual [16] "NAUI Technical Courses: Helitrox Diver" (http:/ / www. "The causes. Retrieved 2008-08-28. . rubicon-foundation. . mechanisms and prevention of the high pressure nervous syndrome" (http:/ / archive. Undersea Biomed. Retrieved 2011-03-16. org/ 2661). Airspeed Press. In: Moon RE. Retrieved 2009-03-17. . Camporesi EM (eds.. techdiver. [11] Tech Diver. ISBN 0967887321. skynetblogs. N. . (eds). youtube. . Menduno. Chistopher (1999)." (http:/ / archive. com/ content/ asma/ asem/ 2007/ 00000078/ 00000002/ art00001). Durham. [10] Campbell. OCLC 2068005. McLeod. (1996). [22] David Shaw. shtml). M. W. "Science: Deepest Dive" (http:/ / www. (1969). 2004. NAUI Worldwide. OCLC 16986801.: 286. Albert R. . "The Atlantis Series and Other Deep Dives. [21] Mitchell SJ. ISSN 0093-5387. . rubicon-foundation. (Balliere Tindall Cassell): 226–251. com/ watch?v=mF4iFJ-G74o). DC). Res." (http:/ / archive. Bennett PB and Elliott DH. ISSN 0813-1988. OCLC 16986801. org/ 7555). . Held May 1. PMID 7168098. Retrieved 2009-11-29. WA (2006). PMID 17310877. be/ post/ 3924720/ continuous-trimix-blending-with-2-nitrox-stic). . org/ 2920). B. Dr. [9] Bennett. Undersea Biomed." (http:/ / archive. Diving Medicine Online. org/ technical_divers. South Pacific Underwater Medicine Society Journal 29 (3).Trimix (breathing gas) [6] Acott. "Exotic Gases" (http:/ / www. html)." (http:/ / archive. Cronjé FJ. Retrieved 2008-08-28. Retrieved 2008-08-28. com/ time/ magazine/ article/ 0.

X!. Rifleman 82. Taoster. Steamroller Assault. Watch Rider. Intermedichbo. Graham87. PaulGGraham. BAICAN XXX. Mceder. Fibrosis. SiobhanHansa. 120 anonymous edits Nitrox  Source: http://en. Kitsunedai. Skepticus. Ahpook. Michaelsbll.php?oldid=446788456  Contributors: . Jmh649. Scott Roy Atwood.delanoy. Anandology. Rdsmith4. TBloemink. Pearle.cashman.253. TachyonJack. Brianski. Xobnkaj. Paul A. Extraordinary. Alex. Crowsnest. Erich gasboy. Petterfs. Ashley Pomeroy. Docu. Gaius Cornelius. Omegatron. CommonsDelinker. 91 anonymous edits Rebreather  Source: http://en. Legis. DelanaSmall. Carlroller. Clotho. Sunapi386. Kurykh. TenOfAllTrades. Lx. Hqb.bastholm. Sirscuba. Axl. MichaelVernonDavis.murphy. V8rik. Moppet65535. Herd of Swine. Wellspring. Gene Nygaard.:Ajvol:. Gene Hobbs. Mbell. Jumping cheese. Ijustam. Gits (Neo). RexxS. Rep07. Gene Nygaard. MKoltnow. Piledhigheranddeeper. Eternal-sun. DiverDave. Davemarshall04. Kaal. Technopat.wikipedia. Walton One. Dulciana. Richard W. 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Billlion. BenFrantzDale.org/w/index. WriterHound. Anthony Appleyard. AdamantBMage. OnePt618. Nono64. JonathanDP81. JabberWok. Adashiel. Mentisock. Korath. Huw Powell. H Padleckas. Legis. ManHomewood. Eubulides. Danski14. PierreAbbat.wikipedia.190. Tempodivalse. Foobar. NikoSilver. Bryan Derksen. Spitfire26. Nono64. Mild Bill Hiccup. Leuko. Bigbuck. Chessphoon. Lexicon. Michael Hardy. Drphilharmonic. PierreAbbat. Dogosaurus. MichaelHaeckel. Abyssadventurer. Gene Hobbs. Fabiform. RexxS. Dbutler1986. David Fuchs. Attilios. Firien. GProcter. Mark. RexxS. Hatcat. Trovatore. Egmontaz. Túrelio. El C.wikipedia. Simon. Gambitq72. J Swarbrick.wikipedia. Mark. Deli nk. Mark. Youremyjuliet. Snigbrook. Thue. Owain. 2D. No bubbles. DavidCary. Eraserhead1. Basilicofresco. ChildofMidnight. Fgb. EncMstr. XHT5. ScottJ. Amore proprio. Mattmexico63. Peachypoh. Drpepper469. Ironholds. Dr. Thomei08. Dictabeard. AzaToth. Floaterfluss. Chzz. Seejyb. Atlant. Faradayplank. Countincr. Klparrot. Elysdir. Pinikas. Stubblyhead. Sceptre. GProcter. Laurascudder. Keenan Pepper. Deglr6328. Rjwilmsi. Keenan Pepper. Cloudo. Superm401. Mark.msc. Mygerardromance. Dekisugi. Mmoneypenny. Hike395. Chrislk02. Anderson. Herbee. OceanVortex. Mark. Cmdrjameson. Capricorn42. Milo99. Christian75. Jooler. BryanG. Davewild. Darthgriz98.sound. Crum375.php?oldid=442424026  Contributors: A More Perfect Onion.wikipedia. Nakon. Steinsky. Clovis Sangrail. Oleg Eterevsky.xxx. Vk steve. N5iln. Kbdank71. Chem-awb. Epbr123. D0762.51. 48 anonymous edits Maximum operating depth  Source: http://en. RichiH.murphy. Kaszeta. RexxS. Vary. Hut 8. Jamesdterry. Kingturtle. RexxS. Lowellian. Arcadian. Wizardman. Captain-n00dle. Cades of the Cove. Diverite. Gene Hobbs. Bluez57. PacificBoy. Hamiltondaniel. Bryan Derksen. Dazzamcnazzar. Animesouth. Gene Hobbs. Sir Vicious. Keenan Pepper. Legis. Can't sleep. Cyrius. Brianski. SpiderJon. RexxS. Malcolm Farmer. Frencheigh. Sitethief. Moondyne.murphy. Hede2000. 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Finavon. Triddle. Cybercobra. Crum375. Mav. Hamiltondaniel. Dolphin51. Algorithm. Spetzna-. Collabi.Newman.92. Breals. Rjwilmsi. Lightmouse. Hede2000. Mark. Vuonghn.64.org/w/index. RexxS. Woohookitty. SpiderJon. Pbsouthwood. Gorm. SteOsu. 49 anonymous edits 103 . Bryan Derksen. Jhog1978. Kpjas. Dsyzdek.wikipedia. SummerPhD. Conversion script. Michael Hardy. Leigh.murphy. Kintaro. Spiritia. Johan Lont.51. Sirscuba. Auntof6. 105 anonymous edits Trimix (breathing gas)  Source: http://en. LoverOfArt. Gerard. Tossmysalad. Gr0ff. KingTT. Gene Hobbs. SCEhardt. Sanspeur.253.wikipedia. Pengo. A2Kafir. Anthony Appleyard. Anthony Appleyard. Legis. Cryptic C62. TheJoby. Bento00. Aquanaut. Unixsage. DiverDave. Mfischman. Watch Rider. Krich.org. PontBrownJm. BillGarrett.php?oldid=441541942  Contributors: 62. EddEdmondson. Legis.uk. Mion.php?oldid=437697999  Contributors: Ali@gwc. 84user. Elf. Hike395. Lotje. PierreAbbat. Bluez57. RupertMillard. Michael Hardy. Lubos. AtonX. Bubbleboys. Destynova.xxx.murphy. SlipperyHippo. Rongen.org/w/index. Superm401. Hephaestos. Hu12. Mc2246. Evercat. Editus Reloaded. 62. SenorBeef. Lari-fari. Wasell. Tabletop. Michagal. KingScuba. Ehagerty. Maldivian. Laubzega. Nihiltres.Article Sources and Contributors Technical diving  Source: http://en. Pcpcpc. Finell. Gene Hobbs. Phirst. Dave3141592. Download. HaeB. Matt Gies. Alfie66. Cyrius. O'Dea. Rich Farmbrough. Gxdoyle.xxx. Extraordinary. Georgekwatson. Headbomb. Gorm. Nathan. Owain.davies. Mark. RexxS.

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