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Breathing gas Decompression sickness Deep diving Equivalent air depth Equivalent narcotic depth High-pressure nervous syndrome List of diving hazards and precautions Maximum operating depth Nitrogen narcosis Nitrox Oxygen toxicity Partial pressure Rebreather Technical diving Trimix (breathing gas) 1 8 23 28 29 30 32 38 40 49 56 72 77 91 97
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Breathing gas is a mixture of gaseous chemical elements and compounds used for respiration. Air is the most common and only natural breathing gas. Other artificial gases, either pure gases or mixtures of gases, are used in breathing equipment and enclosed habitats such as SCUBA equipment, surface supplied diving equipment, recompression chambers, submarines, space suits, spacecraft and anaesthetic machines.   Most breathing gases are a mixture of oxygen and one or more inert gases.  Other breathing gases have been developed to improve on the performance of air by reducing the risk of decompression sickness, reducing the duration of decompression stops, reducing nitrogen narcosis or allowing safer deep diving.  A safe breathing gas has three essential features: • it must contain sufficient oxygen to support the life, consciousness and work rate of the breather.   • it must not contain harmful gases. Carbon monoxide and carbon dioxide are common poisons in breathing gases. There are many others.   • it must not become toxic when being breathed at high pressure such as when underwater. Oxygen and nitrogen are examples of gases that become toxic under pressure.   The techniques used to fill diving cylinders with gases other than air are called gas blending. 
Common diving breathing gases
Common diving breathing gases are: • Air is a mixture of 21% oxygen, 78% nitrogen, and approximately 1% other trace gases; to simplify calculations this last 1% is usually treated as if it were nitrogen. Being cheap and simple to use, it is the most common diving gas.   As its nitrogen component causes nitrogen narcosis it is considered to have a safe depth limit of about 40 metres (130 feet) for most divers, although the maximum operating depth of air is 66.2 metres (218 feet). 
• Pure oxygen is mainly used to speed the shallow decompression stops at the end of a military, commercial or technical dive and is only safe down to a depth of 6 meters (maximum operating depth) before oxygen toxicity steps in.    It was much used in frogmen's rebreathers.    • Nitrox is a mixture of oxygen and air, and generally refers to mixtures which are more than 21% oxygen. It can be used as a tool to accelerate in-water decompression stops or to decrease the risk of decompression sickness and thus prolong a dive (a common misconception is that the diver can go deeper, this is not true owing to a shallower maximum operating depth than on conventional air).    • Trimix is a mixture of oxygen, nitrogen and helium and is often used at depth in technical diving and commercial diving instead of air to reduce nitrogen narcosis and to avoid the dangers of oxygen toxicity.   • Heliox is a mixture of oxygen and helium and is often used in the deep phase of a commercial deep dive to eliminate nitrogen narcosis.    • Heliair is a form of trimix that is easily blended from helium and air without using pure oxygen. It always has a 21:79 ratio of oxygen to nitrogen; the balance of the mix is helium.  • Hydreliox is a mixture of oxygen, helium, and hydrogen and is used for dives below 130 metres in commercial diving.     • Hydrox, a gas mixture of hydrogen and oxygen is used as a breathing gas in very deep diving.     • Neox (also called neonox) is a mixture of oxygen and neon sometimes employed for in deep commercial diving. It is rarely used due to its cost. Also, DCS symptoms produced by neon ("neox bends") have a poor reputation, being widely reported to be more severe than those produced by an exactly equivalent dive-table and mix with helium.   
  Oxygen has historically been obtained by fractional distillation of liquid air.    Partial pressure of oxygen The concentration of oxygen in a gas mix depends on both the fraction and the pressure of the mixture.    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 . strictly. This depth is called the maximum operating depth.  The fraction of the oxygen determines the deepest the mixture gas can safely be used to avoid oxygen toxicity. Fraction of oxygen The fraction of the oxygen component of a breathing gas mixture is sometimes used when naming the mix: • hypoxic mixes. As oxygen supports combustion and causes rust in diving cylinders. Enriched Air Nitrox (EANx) is a typical hyperoxic breathing gas. unconsciousness and death result. 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. The human body cannot store oxygen for later use as it does with food. it should be handled with caution when gas blending. • hyperoxic mixes have more than 21% oxygen. and are designed only to be breathed at depth as a "bottom gas" where the higher pressure increases the partial pressure of oxygen to a safe level.  The maximum operating depth of a normoxic mix could be as shallow as 47 metres (155 feet).   This is because it is essential to the human body's metabolic process. which sustains life.   Hyperoxic mixtures. 21%. contain less than 21% oxygen. but is increasingly obtained by non cryogenic technologies such as pressure swing adsorption (PSA) and vacuum-pressure swing adsorption (VPSA) technologies. The tissues and organs within the body (notably the heart and brain) are damaged if deprived of oxygen for much longer than four minutes.  • normoxic mixes have the same proportion of oxygen as air.   Trimix. It is expressed by the partial pressure of oxygen (ppO2).Breathing gas 2 Individual component gases Oxygen Oxygen (O2) must be present in every breathing gas. although often a boundary of 16% is used. Heliox and Heliair create typical hypoxic mixes and are used in technical diving as deep breathing gases. If the body is deprived of oxygen for more than a few minutes. when compared to air. NEDU gas analysis lab Filling a diving cylinder with pure oxygen costs around five times more than filling it with compressed air. Trimix with between 17% and 21% oxygen is often described as normoxic because it contains a high enough proportion of oxygen to be safe to breathe at the surface.
In the Netherlands.     Nitrogen in a gas mix is almost always obtained by adding air to the mix.S.    Equivalent air depth is used to estimate the decompression requirements of a nitrox (oxygen/nitrogen) mixture. Equivalent narcotic depth is used to estimate the narcotic potency of trimix (oxygen/helium/nitrogen mixture). the cheapest and most common breathing gas used for diving. depending on factors including individual physiology and level of exertion. Divox "Divox" is oxygen. In most countries. . the level of exercise and the security of the breathing equipment being used. Many divers find that the level of narcosis caused by a 30 m (100 ft) dive. Navy has been known to authorize dives with a ppO2 of as much as 180 kPa (1. and is only available on medical prescription. in order to more easily identify the exact manufacturing trail of a "lot" of oxygen.8 bar). Nitrogen can cause decompression sickness. in case problems are later found with its purity. The maximum safe ppO2 in a breathing gas depends on exposure time.6 bar) but for dives of less than three hours is commonly considered to be 140 kPa (1. such as that used in welding. The chief difference between them is that the paper record-keeping trail is much more extensive for medical oxygen. 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.  Each breathing gas has a maximum operating depth that is determined by its oxygen content. It is typically between 100 kPa (1 bar) and 160 kPa (1.     At high ppO2 or longer exposures. Nitrogen Nitrogen (N2) is a diatomic gas and the main component of air. It causes nitrogen narcosis in the diver. When a hypoxic mix is breathed in shallow water it may not have a high enough ppO2 to keep the diver conscious. whilst breathing air. although the U.4 bar). there is no difference in purity in medical oxygen and industrial oxygen. as they are produced by exactly the same methods and manufacturers. pure oxygen for breathing purposes is regarded as medicinal as opposed to industrial oxygen. the diver risks oxygen toxicity including a seizure.     Oxygen analysers measure the ppO2 in the gas mix.16 bar). but labeled and tanked differently.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. For this reason normoxic or hyperoxic "travel gases" are used at medium depth between the "bottom" and "decompression" phases of the dive. so its use is limited to shallower dives. Below this partial pressure the diver may be at risk of unconsciousness and death due to hypoxia. is a comfortable maximum.
from which it is extracted at low temperatures by fractional distillation.   This is because the speed of sound is faster in a lower molecular weight gas.  Helium's low molecular weight (monatomic MW=4.    It is sometimes used for dry suit inflation by divers whose primary breathing gas is helium-based. helium also causes High Pressure Nervous Syndrome.    This limits use of hydrogen to deep dives and imposes complicated protocols to ensure that oxygen is cleared from the lungs. Argox is used for decompression research. which increases the resonance frequency of the vocal cords. it does not distort the diver's voice. Neon Neon (Ne) is an inert gas sometimes used in deep commercial diving but is very expensive.Breathing gas 4 Helium Helium (He) is an inert gas that is less narcotic than nitrogen at equivalent pressure (in fact there is no evidence for any narcosis from helium at all). Helium is found in significant amounts only in natural gas. it increases the timbre of the diver's voice. because of argon's good thermal insulation properties.  Helium is equally able to cause decompression sickness. The hydrogen-oxygen mix when used as a diving gas is sometimes referred to as Hydrox. helium. making it more of an insulator). compared with diatomic nitrogen MW=28) increases the timbre of the breather's voice. which is a CNS irritation syndrome which is in some ways opposite to narcosis. but unlike helium. the blood stream and the breathing equipment before breathing hydrogen starts. so it is more suitable for deeper dives than nitrogen. .    Helium fills typically cost ten times more than an equivalent air fill. so is not generally suitable as a diving breathing gas. present in a diving environment:  Here is an incomplete list of gases commonly Argon Argon (Ar) is an inert gas that is more narcotic than nitrogen. 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. but considerably less expensive than helium.  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. it is less narcotic than nitrogen. At high pressures.    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). Like helium. which may impede communication. Unwelcome components of breathing gases Many gases are not suitable for use in diving breathing gases. Argon is more expensive than air or oxygen.
quickly conducts heat from the surrounding water to the cold. In hot climates.  This is good for corrosion prevention in the cylinder but means that the diver inhales very dry gas. Moisture content The process of compressing gas into a diving cylinder removes moisture from the gas. 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 . Four • Internal combustion engine exhaust gas containing CO in the air being drawn into a diving air compressor. where cylinders are filled. • Inhaling oil mist can damage the lungs and ultimately cause the lungs to degenerate with severe lipid pneumonia or emphysema. If the compressor air filter(s) fail. • Heating of lubricants inside the compressor may vaporize them sufficiently to be available to a compressor intake or intake system line. or due to incomplete combustion near the air intake. The exhausts of all internal combustion engines running on petroleum fuels contain some CO. It is for this reason that SCUBA regulators are generally constructed from brass. especially in cylinders which are used for hyperoxic gas mixtures. and chrome plated (for protection).     • They can act as a fuel in combustion increasing the risk of explosion. Brass. and this is a particular problem on boats. CO in the intake air cannot be stopped by any filter. ordinary dust will be introduced to the cylinder. This problem is reduced in rebreathers because the soda lime reaction to remove carbon dioxide puts moisture back into the breathing gas.especially when not atomized properly . with its good thermal conductive properties. newly decompressed air. open circuit diving can accelerate heat exhaustion because of dehydration. leaks. which contains "organic" (carbon-containing) matter. It is also uncomfortable. The dry gas extracts moisture from the diver's lungs while underwater contributing to dehydration. common sources are:    See carbon monoxide poisoning. also due to the decompression can cause the moisture to solidify as ice. which is also thought to be a predisposing risk factor of decompression sickness. this coupled with the extreme reduction in temperature. and the oil may (and usually will) then undergo combustion. which contains organic matter (since it usually contains humus).Breathing gas 5 Carbon dioxide Carbon dioxide (CO2) is produced by the metabolism in the human body and can cause carbon dioxide poisoning. They can enter diving cylinders as a result of contamination.   Carbon monoxide Carbon monoxide (CO) is produced by incomplete combustion. . • In some cases hydrocarbon lubricating oil may be drawn into the compressor's cylinder directly through damaged or worn seals. especially in high-oxygen gas mixtures. causing a dry mouth and throat and making the diver thirsty. Another concern with regard to moisture content is the tendency of moisture to condense as the gas is decompressed while passing through the regulator. • A similar process is thought to potentially happen to any particulate material. Hydrocarbons Hydrocarbons (CxHy) are present in compressor lubricants and fuels. being ignited by the immense compression ratio and subsequent temperature rise. and these represent a more severe CO danger when introduced into a cylinder.incomplete combustion will result in carbon monoxide production. A more severe danger is that air particulates on boats and industrial areas. helping to prevent icing up. where the intake of the compressor cannot be arbitrarily moved as far as desired from the engine and compressor exhausts. often contain carbon-particulate combustion products (these are what makes a dirt rag black).
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DCS most commonly refers to a specific type of scuba diving hazard but may be experienced in other depressurisation events such as caisson working. its potential severity is such that much research has gone into preventing it. and extra-vehicular activity from spacecraft. may still be used today.120. Following changes to treatment methods. DCS can produce many symptoms. and scuba divers use dive tables or dive computers to set limits on their exposure to pressure and their ascent speed. . the bends or caisson disease) describes a condition arising from dissolved gases coming out of solution into bubbles inside the body on depressurization.Decompression sickness 8 Decompression sickness Caisson disease [decompression sickness] Classification and external resources Two United States Navy sailors prepare for training inside a decompression chamber. since neurological symptoms may develop after the initial presentation. and different individuals under the same conditions may be affected differently or not at all. musculoskeletal system. 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. there is a significantly higher chance of successful recovery. In 1960. Although DCS is not a common event.248 Decompression sickness (DCS.3 3491      emerg/121 C21. "chokes" for breathing problems. Golding et al. Individual susceptibility can vary from day to day.3 993. The earliest descriptions of DCS used the terms: "bends" for joint or skeletal pain. The classification of types of DCS by its symptoms has evolved since its original description over a hundred years ago. ICD-10 ICD-9 DiseasesDB eMedicine MeSH T70. introduced a simpler classification using the term "Type I ('simple')" for symptoms involving only the skin. If treated early. with minor modifications. Classification DCS is classified by symptoms. Treatment is by hyperbaric oxygen therapy in a recompression chamber. and "Type II ('serious')" for symptoms where other organs (such as the central nervous system) are involved. or lymphatic system. This system. and "staggers" for neurological problems. also known as divers' disease. flying in unpressurised aircraft. this classification is now much less useful in diagnosis. Type II DCS is considered more serious and usually has worse outcomes.866. Since bubbles can form in or migrate to any part of the body.
Neurological symptoms are present in 10% to 15% of DCS cases with headache and visual disturbances the most common symptom. usually around the ears. Signs and symptoms While bubbles can form anywhere in the body. arterial gas embolism. Itching. • ankles) • • Cutaneous Skin • • • • Neurologic Brain • • • • • Neurologic Spinal cord • • • • • • • • • • • • Constitutional Whole body Audiovestibular Inner ear   Pulmonary Lungs . and ankles. arms. knees. DCS and arterial gas embolism are treated very similarly because they are both the result of gas bubbles in the body. 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. unconsciousness Ascending weakness or paralysis in the legs Girdling abdominal or chest pain Urinary incontinence and fecal incontinence Headache Unexplained fatigue Generalised malaise. but rarely a sharp pain. poorly localised aches Loss of balance Dizziness. Joint pain ("the bends") accounts for about 60% to 70% of all altitude DCS cases. neck. although those from arterial gas embolism are generally more severe because they often arise from an infarction (blockage of blood supply and tissue death). ranging from mild to excruciating. vertigo. DCS is most frequently observed in the shoulders. Active and passive motion of the joint aggravates the pain. face. knees. accompanied by tiny scar-like skin depressions (pitting edema) Altered sensation. Navy prescribes identical treatment for Type II DCS and arterial gas embolism. and barotrauma. The U. Their spectra of symptoms also overlap. whereas decompression sickness and arterial gas embolism are commonly classified together as decompression illness when a precise diagnosis cannot be made.Decompression sickness 9 Decompression illness and dysbarism The term dysbarism encompasses decompression sickness. increased sensitivity hyperesthesia Confusion or memory loss (amnesia) Visual abnormalities Unexplained mood or behaviour changes Seizures. hip. The table below shows symptoms for different DCS types. nausea. elbows. shoulders. The pain may be reduced by bending the joint to find a more comfortable position. aggravated by breathing Shortness of breath Musculoskeletal Mostly large joints (elbows. Sometimes a dull ache. If caused by altitude. and upper torso Sensation of tiny insects crawling over the skin (formication) Mottled or marbled skin usually around the shoulders. tingling or numbness paresthesia. Skin manifestations are present in about 10% to 15% of cases. pain can occur immediately or up to many hours later.S. wrists. Signs and symptoms of decompression sickness DCS type Bubble location • Signs & symptoms (clinical manifestations) Localized deep pain. vomiting Hearing loss Dry persistent cough Burning chest pain under the sternum. with itching Swelling of the skin. with the shoulder being the most common site. upper chest and abdomen.
Navy and Technical Diving International. 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 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). have published a table that indicates onset of first symptoms. 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. 2. It may happen when leaving a high-pressure environment. The table does not differentiate between types of DCS.3% 1.  DCS has been confirmed in rare cases of breath-holding divers who have made a sequence of many deep dives with short surface intervals. The specific risk factors are not well understood and some divers may be more susceptible than others under identical conditions.   or types of symptom. .S. The U. Navy are as  follows: Although onset of DCS can occur rapidly after a dive. causing these gases to come out of solution and form "micro bubbles" in the blood. or ascending to altitude. The risk of DCS increases when diving for extended periods or at greater depth. Two principal factors control the risk of a diver suffering DCS: 1. owing to the pressure of the surrounding water. 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. 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. without ascending gradually and making the decompression stops needed to slowly reduce the excess pressure of inert gases dissolved in the body. a leading technical diver training organization.3% 0. DON can develop from a single exposure to rapid decompression.3% 2.S. ascending from depth. rapid pressure change can cause permanent bone injury called dysbaric osteonecrosis (DON). in extreme cases even before a dive has been completed.6% 1. in more than half of all cases symptoms do not begin to present until over an hour following the 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. Even when the change in pressure causes no immediate symptoms.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.
they will experience a significant reduction in ambient pressure. there is increased risk for divers flying in any aircraft shortly after diving. and some people may be predisposed to the drop in pressure that occurs even in pressurized aircraft. this term was used in the 19th century. 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. Workers spending supply. 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. where the pressure in his spacesuit is lower than the pressure in the vehicle. since the pressure in the cabin is not actually maintained at sea-level pressure. Ascent to altitude Passengers may be at risk of DCS when an unpressurized aircraft ascends to high altitude.  There is no specific altitude threshold that can be considered safe for everyone and below which no one will develop altitude DCS.  A similar pressure reduction occurs when an astronaut exits a space vehicle to perform a space-walk or extra-vehicular activity. However. Individual exposures to pressure altitudes between 5500 m (18000 ft) and 7500 m (24600 ft) have shown a low occurrence of altitude DCS. The higher the altitude of exposure the greater is the risk of developing altitude DCS. . allowing safe flights at 12000 m (39000 ft) or more. such as bridge supports and tunnels. Today.   Altitude DCS became a common problem in the 1930s with the development of high-altitude balloon and aircraft flights. 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. Although exposures to incremental altitudes above 5500 m (18000 ft) show an incremental risk of altitude DCS. there is still a risk of DCS in individuals having dived recently. Nevertheless.    Likewise. cabin pressurization systems maintain commercial aircraft cabin pressure at the equivalent altitude of 2400 m (7900 ft) or less. Also. when 15 workers died from what was then a mysterious illness. pressurised by an external air flooding the excavations. where caissons under pressure were used to keep water from The principal features of a caisson are the workspace.    The original name for DCS was "caisson disease".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. DCS was a major factor during construction of Eads Bridge. and later during construction of the Brooklyn Bridge. DCS is very rare in healthy individuals who experience pressures equivalent to this altitude. 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. they do not show a direct relationship with the severity of the various types of DCS. 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). cabin pressurization systems still fail occasionally. in large engineering excavations below the water table.
Therefore. the greater is the risk of DCS.  Individual . They may be considered as either environmental or individual.   • 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. carry a greater risk of altitude DCS.Decompression sickness 12 Predisposing factors Although the occurrence of DCS is not easily predictable. The US Navy Dive Manual indicates that ascent rates greater than about 20 m/min (66 ft/min) when diving increase the chance of DCS. Dive tables make provisions for post-dive time at surface level before flying to allow any residual excess nitrogen to outgas. especially to altitudes of 5500 m (18000 ft) and above. while recreational dive tables such as the Bühlmann tables require an ascent rate of 10 m/min (33 ft/min) with the last 6 m (20 ft) taking at least one minute.   • repetitive exposures – repetitive dives within a short period of time (a few hours) increase the risk of developing DCS. An individual exposed to a rapid decompression (high rate of ascent) above 5500 metres (18000 ft) has a greater risk of altitude DCS than being exposed to the same altitude but at a lower rate of ascent. Environmental The following environmental factors have been shown to increase the risk of DCS: • the magnitude of the pressure reduction ratio – a large pressure reduction ratio is more likely to cause DCS than a small one. the assumption that the dive table surface interval occurs at normal atmospheric pressure is invalidated by flying during that surface interval. However. many predisposing factors are known. Longer flights.  • the duration of exposure – the longer the duration of the dive.  • the rate of ascent – the faster the ascent the greater the risk of developing DCS. for example. scuba divers in Eritrea who drive from the coast to the Asmara plateau at 2400 m (7900 ft) increase their risk of DCS. • scuba diving before flying – divers who ascend to altitude soon after a dive increase their risk of developing DCS even if the dive itself was within the dive table safe limits. and an otherwise-safe dive may then exceed the dive table limits. • diving at altitude – diving in water whose surface altitude is above 300 m (980 ft) — for example. 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. Repetitive ascents to altitudes above 5500 metres (18000 ft) within similar short periods increase the risk of developing altitude DCS. Lake Titicaca is at 3800 m (12500 ft) — without using versions of decompression tables or dive computers that are modified for high-altitude.
where the bubbles would otherwise be filtered out by the lung capillary system. • alcohol consumption and dehydration – although alcohol consumption increases dehydration and therefore may increase susceptibility to DCS.  • ambient temperature – there is some evidence suggesting that individual exposure to very cold ambient temperatures may increase the risk of altitude DCS. • patent foramen ovale – a hole between the atrial chambers of the heart in the fetus is normally closed by a flap with the first breaths at birth. Atrial septal defect (PFO) showing left-to-right shunt. In the arterial system. and the high surface tension of water is generally regarded as helpful in controlling bubble size. and in the spinal cord it may result in paralysis. spinal cord and heart). In about 20% of adults the flap does not completely seal. bubbles (arterial gas embolism) are far more dangerous because they block circulation and cause infarction (tissue death. • body type – typically.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. Studies by Walder concluded that decompression sickness could be reduced in aviators when the serum surface tension was raised by drinking isotonic saline. and return directly to the arterial system (including arteries to the brain. . Maintaining proper hydration is recommended. In diving. however.  • previous injury – there is some indication that recent joint or limb injuries may predispose individuals to developing decompression-related bubbles. In the brain.  This is due to nitrogen's five times greater solubility in fat than in water. a 2005 study concluded that alcohol consumption did not increase the risk of DCS. due to local loss of blood flow). but stores about half of the total amount of nitrogen (about 1 litre) at normal pressures. this can allow venous blood with microbubbles of inert gas to bypass the lungs.  Decompression sickness risk can be reduced by increased ambient temperature during decompression following dives in cold water. 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. allowing blood through the hole when coughing or during activities that raise chest pressure. infarction results in stroke. A right-to-left shunt may allow bubbles to pass into the arterial circulation. a person who has a high body fat content is at greater risk of DCS.
 For example. so different decompression schedules are required. sensory dysfunction. 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. chamber to avoid decompression sickness. and presents a problem for very deep dives.Decompression sickness 14 Mechanism Depressurisation causes inert gases. to come out of physical solution and form gas bubbles within the body. The most severe types of DCS interrupt — and This surfacing diver must enter a decompression ultimately damage — spinal cord function. but. Breathing gas mixtures such as trimix and heliox include helium. Helium both enters and leaves the body faster than nitrogen. or death. Most divers do longer decompressions. Any inert gas that is breathed under pressure can form bubbles when the ambient pressure decreases. it is preferred over nitrogen in gas mixtures for deep diving. This is known as isobaric counterdiffusion. inert gas comes out of solution in a process called "outgassing" or "offgassing". when the pressure of a gas in contact with a liquid is decreased. but nitrogen is not the only gas that can cause DCS. The formation of bubbles in the skin or joints results in milder symptoms. most offgassing occurs by gas exchange in the lungs. venous bubbles may enter the arterial system. while large numbers of bubbles in the venous blood can cause lung damage. There is some debate as to the decompression requirements for helium during short-duration dives. which can also cause decompression sickness.65 times slower than helium. a diver will switch to mixtures containing progressively less helium and more oxygen and nitrogen during the ascent. which were dissolved under higher pressure. These bubbles produce the symptoms of decompression sickness. since helium does not cause narcosis. however some groups like the WKPP have been pioneering the use of shorter decompression times by including deep stops. which indicates that. such as a patent foramen ovale. Inert gases The main inert gas in air is nitrogen. but controlled decompression is still required to avoid DCS. leading to paralysis. when water vapour forms bubbles in body fluids due to a dramatic reduction in environmental pressure. 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. after using a very helium-rich trimix at the deepest part of the dive. but is about 4. The amount of gas dissolved in a liquid is described by Henry's Law.  A similar effect. Very deep dives have been made using hydrogen-oxygen mixtures (hydrox). Nitrogen diffuses into tissues 2. as . the amount of that gas dissolved in the liquid will also decrease proportionately. known as ebullism.  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. This is often found to provoke inner ear decompression sickness. resulting in an arterial gas embolism. On ascent from a dive. may occur during explosive decompression. but not all bubbles result in DCS. In the presence of a right-to-left shunt of the heart. Under normal conditions.  Bubbles may form whenever the body experiences a reduction in pressure.5 times more soluble.
 In 1995. 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. Prevention Underwater diving To prevent the excess formation of bubbles that can lead to decompression sickness.  Although MRI or CT can frequently identify bubbles in DCS. 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. . decompression software. This will result in a shorter available time under water or an increased decompression time during the subsequent dive. This schedule requires the diver to ascend to a particular depth. in particular. but divers usually schedule a short "safety stop" at 3 metres (10 ft). within 24 hours of diving. and tables will indicate the time at normal pressures that is required. or none at all. 15 Diagnosis Decompression sickness should be suspected if any of the symptoms associated with the condition occurs following a drop in pressure.  The decompression schedule may be derived from decompression tables. but do not reduce it to zero. Following a decompression schedule does not completely protect against DCS. and a schedule for a given bottom time and depth may contain one or more stops. The algorithms used are designed to reduce the probability of DCS to a very low level. and carry out a decompression schedule as necessary. they are not as good at determining the diagnosis as a proper history of the event and description of the symptoms. depending on the training agency. Since divers on the surface after a dive still have excess inert gas in their bodies. whereas the likelihood of bubble formation depends on the difference between the inert gas partial pressure in the diver's body and the ambient pressure. and remain at that depth until sufficient gas has been eliminated from the body to allow further ascent. These models. Reduction in decompression requirements can also be gained by breathing a nitrox mix during the dive. are designed to fit empirical data and provide a decompression schedule for a given depth and dive duration. which may be up to 18 hours. Each of these is termed a "decompression stop". The total elimination of excess gas may take many hours. 95% of all cases reported to Divers Alert Network had shown symptoms within 24 hours. 4. 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. The diagnosis is confirmed if the symptoms are relieved by recompression.Decompression sickness the ear seems particularly sensitive to this effect.6 metres (15 ft). 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). or from dive computers. such as the Bühlmann decompression algorithm. dive time. divers limit their ascent rate to about 10 metres (33 ft) per minute. or 6 metres (20 ft). and decompression information. since less nitrogen will be taken into the body than during the same dive done on air. Dives that contain no decompression stops are called "no-stop dives". 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. release of inert gas as pressure changes.
as analgesics may mask symptoms.  However.Decompression sickness 16 Exposure to altitude One of the most significant breakthroughs in the prevention of altitude DCS is oxygen pre-breathing.66 bar) in the suits to lessen the pressure reduction. and has since become the standard of care for treatment of DCS. Evidence of the effectiveness of recompression therapy utilizing oxygen was first shown by Yarbrough and Behnke. Recompression is normally carried out in a recompression chamber. a riskier alternative is in-water recompression. and mottled or marbled skin lesions should be treated with hyperbaric oxygen therapy if seen within 10 to 14 days of development. It is no longer recommended to administer aspirin.70 bar).3 psi (0. Neurological symptoms. provides effective protection upon exposure to low-barometric pressure environments. unless advised to do so by medical personnel. if continued without interruption. Recompression on room air was shown to be an effective treatment for minor DCS symptoms by Keays in 1909. it increases the success of recompression therapy as well as a decrease the number of recompression treatments required. Therefore. 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. en route. 10. pulmonary symptoms. It is also used by flight test crews involved with certifying aircraft. however. it is logistically complicated and expensive for the protection of civil aviation flyers. 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.5 psi (0.2 psi (0.30 bar). it is recommended that these cases still be evaluated. spending eight sleeping hours in the Quest airlock chamber before their spacewalk. as this helps reduce dehydration.   Oxygen first aid has been used as an emergency treatment for diving injuries for years. although research has examined the possibility of using 100% O2 at 9. breathing pure oxygen during flight alone (ascent. During the EVA they breathe 100% oxygen in their spacesuits. or the recovery position if vomiting occurs. either commercial or private. it is currently used only by military flight crews and astronauts for protection during high-altitude and space operations.  Although pure oxygen pre-breathing is an effective method to protect against altitude DCS. At a dive site. It is beneficial to give fluids. both the Trendelenburg position and the left lateral decubitus position (Durant's maneuver) have been suggested as beneficial where air emboli are suspected. which operate at 4. and hence the risk of DCS. but are no longer recommended for extended periods. descent) does not decrease the risk of altitude DCS. Breathing pure oxygen significantly reduces the nitrogen loads in body tissues and. Mild cases of the "bends" and some skin symptoms may disappear during descent from high altitude. If given within the first four hours of surfacing. Astronauts aboard the International Space Station preparing for extra-vehicular activity (EVA) "camp out" at low atmospheric pressure. owing to concerns regarding cerebral edema. In the past.  . People should be made comfortable and placed in the supine position (horizontal). The recompression chamber at the Neutral Buoyancy Lab.
four-hour working shifts. During this project. Emily. "not a man escaped the repeated attacks of rheumatism and cold". From 1998 to 2002. permanent long-term injury from DCS is possible. In 1999. • 1870: Bauer published outcomes of 25 paralyzed caisson workers.Decompression sickness 17 Prognosis Immediate treatment with 100% oxygen. will in most cases result in no long term effects. and vascular stasis caused by decompression. commented that. who was involved in the recovery of the sunken warship HMS Royal George. • 1840: Colonel William Pasley. He battled the after-effects of the disease for the rest of his life.150 dives. From 1870 to 1910.  History • 1670: Robert Boyle demonstrated that a reduction in ambient pressure could lead to bubble formation in living tissue.) Washington's wife. The project chief engineer Washington Roebling suffered from caisson disease.  The project employed 600 compressed air workers. the Divers Alert Network (DAN) created "Project Dive Exploration" to collect data on dive profiles and incidents. DCS affects approximately 1.000 U. Three-month follow-ups on diving accidents reported to DAN in 1987 showed 14. followed by recompression in a hyperbaric chamber. • 1841: First documented case of decompression sickness. they recorded 50. • 1871: The Eads Bridge in St Louis employed 352 compressed air workers including Dr. • 1873: Dr. scuba divers per year.3% of the 268 divers surveyed "still had residual signs and symptoms from Type II DCS and 7% from Type I DCS". Explanations at the time included: cold or exhaustion causing reflex spinal cord damage. or organ congestion.000 dives. • 1769: Giovanni Morgagni described the post mortem findings of air in cerebral circulation and surmised that this was the cause of death. Alphonse Jaminet as the physician in charge. Epidemiology The incidence of decompression sickness is rare. 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. 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. all prominent features were established. with 16% having permanent neurological sequelae. estimated at 2. electricity cause by friction on compression. However. He suggested that intravascular gas was released by rapid decompression and recommended: slow compression and decompression. limit to maximum depth 44. Dr. helped manage the construction of the bridge after his sickness confined him to his home in Brooklyn. using only healthy workers. and recompression treatment for severe cases. reported by a mining engineer who observed pain and muscle cramps among coal miners working in mine shafts air-pressurized to keep water out. with the risk 2. Jaminet developed decompression sickness and his personal description was the first such recorded. Recompression treatment was not used. There were 30 seriously injured and 12 fatalities.S. from which 28 recompressions were required — although these will almost certainly contain incidents of arterial gas embolism (AGE) — a rate of about 0.1 psig (4 ATA).8 cases per 10. of those having made frequent dives. 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.  Long-term follow-ups showed similar results. (He took charge after his father John Augustus Roebling died of tetanus.6 times greater for males than females.05%.
was introduced. experimented with oxygen for recompression therapy.  Hill advocated linear or uniform decompression profiles. or as historian David McCullough asserts in The Great Bridge it was a crude reference to "Greek" or anal sex. 1984: Albert A Bühlmann released his book "Decompression-Decompression Sickness.   • • • • • • • • 18 An early recompression chamber 1937: Behnke introduced the “no-stop” decompression tables. • 1930s: Albert R Behnke separated the symptoms of Arterial Gas Embolism (AGE) from those of DCS. These tables were accepted for use by the Royal Navy. • 1935: Behnke et al. Society and culture Economics In the United States. 1960: FC Golding et al. • 1924: The US Navy published the first standardized recompression procedure. split the classification of DCS into Type 1 and 2. 1957: Robert Workman established a new method for calculation of decompression requirements (M-values). A typical stay in a recompression chamber will easily cost several thousand dollars. even before emergency transportation is included. ." which detailed his deterministic model for calculation of decompression schedules. a personal dive computer. treatment of DCS is provided by the National Health Service. either at a specialised facility or at a Hyperbaric Centre based within a general hospital. Boycott and Damant recommending staged decompression. 1982: Paul K Weathersby. it is common for medical insurance not to cover treatment for the bends that is the result of recreational diving. • 1908: "The Prevention of Compressed Air Illness" was published by JS Haldane. a submersible mechanical device that simulated nitrogen uptake and release. 1959: The "SOS Decompression Meter". 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. 1983: Orca produced the "EDGE". In the United Kingdom.Decompression sickness arched their backs: this is possibly reminiscent of a then fashionable women's dance maneuver known as the Grecian Bend. 1941: Altitude DCS is treated with hyperbaric oxygen for the first time. As a result.  This type of decompression is used today by saturation divers. This is because scuba diving is considered an elective and "high-risk" activity and treatment for decompression sickness is expensive. using a microprocessor to calculate nitrogen absorption for twelve tissue compartments. Louis D Homer and Edward T Flynn introduce survival analysis into the study of decompression sickness. • 1900: Leonard Hill used a frog model to prove that decompression causes bubbles and that recompression resolves them. His work was financed by Augustus Siebe and the Siebe Gorman Company.
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(Compagnie maritime d'expertises) using hydrox and also nitrogen trimix attained far greater depths than any recreational technical diving. This eliminates the problems associated with breathing high pressure gases.A.org/medical/articles/index.rubicon-foundation.html) Deep diving The meaning of the term deep diving is a form of technical diving. ISBN 1-905492-07-3. Deep diving may have quite a different meaning in the commercial diving field. asp) • Dive Tables from the NOAA (http://www. breathing gas.org) • Divers Alert Network: diving medicine articles (http://www.gov/dp_forms. Deco for Divers. These suits are capable of withstanding the pressure at great depth permitting the diver to remain at normal atmospheric pressure. Philadelphia.30 metres / 100 feet as a "deep dive" (other diving organisations vary) • in technical diving. John (2010). • Powell.noaa. One example being the Comex Janus IV open-sea dive to 500 metres.ndc. For instance the early experiments carried out by Comex S. It is defined by the level of the diver's diver training. 23 External links • Environmental Physiology Medical Literature (http://archive. Rosen's emergency medicine: concepts and clinical practice (7th ed. ISBN 978-0-323-05472-0.Decompression sickness • Marx. 60 metres / 200 feet may be a "deep dive" • in surface supplied diving. 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. Mark (2008). Diver returning from a 600 ft/180 metres dive . diving equipment.). An atmospheric diving suit allows very deep dives of up to 700 metres. 100 metres / 330 feet may be a "deep dive" This definition essentially relates to recreational diving. Southend-on-Sea: Aquapress. and surface support: • in recreational diving.diversalertnetwork. PA: Mosby/Elsevier. in 1977. These divers needed to breathe special gas mixtures because they were exposed to very high ambient pressure (more than 50 times atmospheric pressure). PADI define anything from 18 metres / 60 feet .
so at 50 metres (160 ft). A diver at 6 metres (20 ft) may be able to dive for many hours without needing to do decompression stops.Deep diving 24 Deep Diving Depth  Comments Recreational diving limit for divers aged under 12 years old and beginner divers. 660 feet/200 meters Absolute limit for surface light penetration sufficient for plant growth.  Particular problems associated with deep dives Deep diving has more consequences and dangers than basic open water diving. The diver needs a disciplined approach to planning and conducting dives to minimise these additional risks. Coping with the physical and physiological stresses of deep diving requires good physical conditioning. . Depth at which compressed air results in an unacceptable risk of oxygen toxicity. or the “bends”.083 feet/330 meters 2.4 ATA. Nitrogen narcosis. a diver may have only a few minutes at the deepest part of the dive before decompression stops are needed.  Navy diver in Atmospheric Diving System (ADS) suit . when excess inert gas leaves solution in the blood and tissues and forms bubbles. Recommended recreational diving limit for divers. breathing gas consumption is proportional to ambient pressure . an excess of carbon dioxide in the blood. The effects tend to be delayed until reaching the surface. adults. and presents the additional risk of oxygen toxicity. leading to increasing risk of hypercapnia.   330 feet/100 meters Technical diving training limit for divers breathing trimix. Air embolism causes loss of consciousness and speech and visual problems. starts with feelings of euphoria and over-confidence but then leads to numbness and memory impairment similar to alcohol intoxication. 1. Decompression sickness. Very deep diving using a helium–oxygen mixture (heliox) carries a risk of high pressure nervous syndrome. can happen if a diver ascends too fast. where the pressure is 6 bar. At depths greater than 40 metres (130 ft). most commonly the upper arm and the thighs. which may lead to a convulsion underwater. a diver breathes 6 times as much as on the surface (1 bar). This tends to be life threatening. and gas becomes denser requiring increased effort to breathe with depth. Bone degeneration (dysbaric osteonecrosis) is caused by the bubbles forming inside the bones. In the event of an emergency the diver cannot make an immediate ascent to the surface without risking decompression sickness. The need to do decompression stops increases with depth. Using normal scuba equipment. though minimal visibility possible farther down. the “narks” or “rapture of the deep”. 509 feet/155 meters Record depth for scuba dive on compressed air. Technical diving limit for "extended range" dives breathing air to a maximum ppO2 of 1. All of these considerations result in the amount of breathing gas required for deep diving being much greater than for shallow open water diving. Recreational diving limit for divers with Open Water certification but without greater training and experience. Heavy physical exertion causes even more gas to be breathed.000 feet/610 meters World record for deepest dive on SCUBA. Recommended technical diving limit. These bubbles produce mechanical and biochemical effects that lead to the condition.  Average depth at which nitrogen narcosis symptoms begin to appear in 40 feet/12 meters 60 feet/18 meters 100 feet/30 meters 130 feet/40 meters 180 feet/55 meters 218 feet/65 meters Absolute recreational diving limit for divers specified by Recreational Scuba Training Council (RSTC). and requires a recompression chamber for treatment. Deep diving involves a much greater danger of all of these.
Ultra-deep diving Verified SCUBA dives below 800 feet Name Nuno Gomes Location Red Sea Red Sea South Africa South Africa Depth 1044 feet (318 m) 890 feet (270 m) 927 feet (283 m) 826 feet (252 m) Year 2005 2004 1996 1994 Pascal Bernabé Mediterranean Mediterranean 1083 feet 2005 (330 m) 2005 873 feet (266 m) 888 feet (271 m) 2004 898 feet (274 m) 2002 1010 feet 2001 (310 m) 2001 833 feet (254 m) 925 feet (282 m) 825 feet (251 m) 1994 1993 David Shaw  South Africa Gilberto M de Oliveira Brazil John Bennett  Philippines Philippines Jim Bowden Mexico Mexico South Africa Mexico South Africa Andaman Sea Thailand Sheck Exley Don Shirley  863 feet (263 m) 1993 867 feet (264 m) 1989 820 feet (250 m) 2005 1026 feet 2003 (313 m) 2003 850 feet (260 m) Mark Ellyatt Amongst technical divers.Deep diving 25 Dealing with depth • Divers carry larger volumes of breathing gas to compensate for the increased gas consumption and decompression stops. fitness and surface support. • Use of helium-based breathing gases such as trimix reduces nitrogen narcosis and stays below the limits of oxygen toxicity. but are inherently more complex than open circuit scuba. • A diving shot. 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. Philippines. Note the backplate and wing setup with sidemounted stage tanks containing EAN50 (left side) and pure oxygen (right side). experience. • Rebreathers manage gas much more efficiently than open circuit scuba.    That is fewer . Ultra-deep diving requires extraordinarily high levels of training. Technical divers preparing for a mixed-gas decompression dive in Bohol. there are certain elite divers who participate in ultra-deep diving on SCUBA (using closed circuit rebreathers and heliox) below 660 feet (200 m). a decompression trapeze or a decompression buoy can help divers return to their surface safety cover at the end of a dive.
Since the recent introduction of depth gauges capable of reading to 330m it is unlikely that such records will be attempted in the future." (William Beebe. 1994. 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. Unusually. and it should be noted that Dr Marion's second dive computer only registered a depth of 490 feet.6 bar ppO2. Paul Raymeakers and Pim van der Horst. NOAA recommends that divers do not expose themselves to breathing oxygen at greater than 1. Some examples are David Shaw. individual physiology. This created an extreme risk of both narcosis and oxygen toxicity in the divers and. In his book.  Hydra 8: Pre-commercial Hydrogen Diving Project (http:/ / www. not blackness. 660. HYDRA 8 and HYDRA 10 test projects (http:/ / www.) . and has only been achieved five times since. first achieved by John Bennett in 2001. Minimal visibility is still possible far deeper. Don Shirley. surface light may disappear completely at much shallower depths in murky conditions. a colleague of Jacques Cousteau. • 1994 Dan Manion set the current record for a deep dive on air at 509 feet (155 m). Bret Gilliam chronicles the various fatal attempts to set records as well as the smaller number of successes. • 1990 Bret Gilliam dived to a depth of 452 feet (138 m) on air. The Holy Grail of deep SCUBA diving was the 1000 ft (300 m) mark. • 1993 Bret Gilliam extended his own world record to 475 feet (145 m). In 2003 Mark Ellyatt claimed dives to depths of 260m and 313m. google.Deep diving than the number of people who have walked on the surface of the moon. before the popularity of Trimix attempts were made to set world record depths using conventional air. p. ISBN 0-922769-31-1. A. June 1931.A. Marco Reis. Manion reported he was almost completely incapacitated by narcosis and has no recollection of time at depth. at 1400 feet (424 meters). ISBN 1878663011. References  Brylske. contributed to an astonishingly high fatality rate amongst those attempting records.proof being as tangible as faith more often than not. Besides scuba. (2006). html)  All depths specified for sea water. Alessandro Scuotto.  Set by Dr Dan Marion on March 18. dived to 307 feet (94 m) on air 1959 Ennie Falco reported having reached a depth of 435 feet (133 m) on air. 3rd edition. Deep Diving. United States: PADI. See generally Deep Diving by Bret Gilliam. fr/ suite/ ceh/ histo/ histo anglais. "A Round Trip to Davey Jones's Locker. Encyclopedia of Recreational Diving. Watson reported that he had no recollection at all of what transpired at the bottom of the descent due to narcosis. Mario Marconi. "I peered down and again I felt the old longing to go farther. Dives of this nature have been impossible to verify . at pages 35 and following. org/ mslib/ servlet/ onepetropreview?id=SUT-AUTOE-v14-107& soc=SUT& speAppNameCookie=ONEPETRO)  Comex S. onepetro. there is a small group of divers who have reached depths below 200 meters on closed-circuit rebreathers." The National Geographic Magazine. Deep sea explorer William Beebe reported seeing blueness. 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. perhaps unsurprisingly. Fractionally deeper depths may apply in relation to freshwater due to its lower density  Oxygen toxicity depends upon a combination of partial pressure and time of exposure. (http:/ / books. and other factors not fully understood. From the comparatively few who survived extremely deep air dives: • • • • • 1947 Frédéric Dumas. although it looked like the black pit-mouth of hell itself---yet still showed blue. 26 Ultra deep air While extreme deep diving on air is extremely dangerous. which occurs at 218 feet breathing air. the Guinness World Records ceased to publish records on deep air dives. comex. again reporting no ill effects from narcosis or oxygen toxicity. The record is not officially recognised anywhere. vg/ books?id=HVbjgdorRXAC& lpg=PA35& ots=TjUeuuvLmB& dq="bret gilliam" record air& pg=PA35#v=onepage& q="bret gilliam" record air& f=false)  Assuming crystal clear water. In deference to the high death rate.
"Verified dives below 200 metres" (http:/ / www. org/ 7423). ME (1989). scubarecords. W (2006). htm). google. MA and Smith. In: Lang. US Naval Experimental Diving Unit Technical Report NEDU-8-89. It was a Turkish Navy experimental dive. In: Lang. za/ rec. "EX 19 Performance Testing at 850 and 450 FSW (Feet of Seawater)" (http:/ / archive. External links • Recreational Deep Diving (http://www.  Deep Diving. . dived to a depth of 998 feet (304 m) off the coast of Cyprus. However. rubicon-foundation. "Historic Perspective: Scientific Deep Diving and the Management of the Risk" (http:/ / archive. DG (2006).  Navy diver sets world record (http:/ / www. Proceedings of Advanced Scientific Diving Workshop (Washington. htm). an advanced guide to physiology.htm) . N. com/ DeepRecords. Proceedings of Advanced Scientific Diving Workshop (Washington.083 feet was the depth reportedly achieved by Pascal Bernabé in 2005. but that dive has not been independently verified. 27 Footnotes Further reading • Dent. "Medical Fitness at 300 FSW" (http:/ / archive. 1995-01-25. org/ 4653).  In 2007 Erdogan Bayburt. nunogomes. co. He used a closed-circuit rebreather. military. com/ ?id=HVbjgdorRXAC& pg=PT1& lpg=PT1& dq=Bret+ Gilliam+ deep+ diving#v=onepage& q=& f=false). . NE (eds). rubicon-foundation. html)  Egstrom GH (2006). com/ features/ 0. Retrieved 2008-07-05. ISBN 9780922769315. --Knafelc. . and commercial divers (although commercial diving to that depth is unknown on SCUBA). Retrieved 2008-06-14. NE (eds). His dive was aborted due to equipment failure.  Southerland. org/ 4659). procedures and systems (http:/ / books.108883. a former Turkish Navy diver.  Statistics exclude military divers (classified). "Recorded Deep Dives Below 200 m" (http:/ / www. rubicon-foundation. MA and Smith.Deep diving  1. Retrieved 2008-07-05. Retrieved 2008-07-05. MA and Smith. DC). 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.  Scubarecords. .00.15240. DC). Proceedings of Advanced Scientific Diving Workshop (Washington.044 feet dive by Nuno Gomes earlier in the same year as the current official world record. Bret Gilliam.com.rubicon-foundation. DC).com/RecreationalDeepDiving. "AAUS Deep Diving Standards" (http://archive. .  Gomes. Retrieved 2008-07-24.  Subsequently died during diving accidents. . Retrieved 2008-06-14. Retrieved 2009-11-19.divinglore. the Guinness World Records still recognises the 1.org/4669). NE (eds). In: Lang.
79 − 33 EAD = 123 × 0. org/ 2835). This shows that using EAN36 for a 27 metre dive can give a 75% increase in bottom time over using air. Durham. . McCraken TM (December 1979). org/ 3835). org/ 4855).79 − 33 Working the earlier example. "Equivalent air depth: fact or fiction" (http:/ / archive. rubicon-foundation.64 / 0.  Berghage Thomas E.79 − 10 EAD = 37 × 0. for a nitrox mix containing 64% nitrogen (EAN36) being used at 90 feet. the diver would calculate their decompression requirements as if on air at 20 metres. known as nitrox. the EAD is: EAD = (90 + 33) × 0. Michael A. So. p. for example.  Lang.   The equivalent air depth. Retrieved 2008-05-01.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.64 / 0. . the Bühlmann tables are suitable for use with these kind of calculations. United States Navy Experimental Diving Unit Technical Report NEDU-RR-01-61. "An evaluation of the equivalent air depth theory" (http:/ / archive. for a nitrox mix containing 64% nitrogen (EAN36) being used at 27 metres. (2001). JA (1961). the diver would calculate their decompression requirements as if on air at 67 feet.81 − 10 EAD = 30 − 10 EAD = 20 metres So at 27 metres on this mix. While at 20 metres the no-stop time is 35 minutes. 197. is the depth of a dive when breathing air that would have the same partial pressure of nitrogen. 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. At 27 metres the Bühlmann 1986 table (0–700 m) allows 20 minutes bottom time without requiring a decompression stop. a gas mix containing 36% oxygen (EAN36) being used at 27 metres (89 ft) has an EAD of 20 metres (66 ft).79 − 10 Working the earlier example. . rubicon-foundation. References  Logan. Retrieved 2008-05-02. Dive tables Although not all dive tables are recommended for use in this way. NC: Divers Alert Network. PMID 538866. for a given nitrox mix and depth.81 − 33 EAD = 100 − 33 EAD = 67 feet So at 90 feet on this mix. the EAD is: EAD = (27 + 10) × 0. Retrieved 2008-05-01. Calculations in metres The equivalent air depth can be calculated for depths in metres as follows: EAD = (Depth + 10) × Fraction of N2 / 0. DAN Nitrox Workshop Proceedings (http:/ / archive. Undersea Biomedical Research 6 (4): 379–84. .
it is likely that some of the oxygen is metabolised. since it is more conservative. thus reducing its effect to a level similar to that of nitrogen. . it is assumed that the narcotic potentials of nitrogen and oxygen are similar.6 − 10 END = 42 − 10 END = 32 metres So at 60 metres on this mix. 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. Feet The equivalent narcotic depth can be calculated for depths in feet as follows: END = (Depth + 33) × (1 − Fraction of helium) − 33 Working the earlier example. The method is. the diver would feel the same narcotic effect as a dive on air to 32 metres. for a given mix and depth. to calculate the depth which would produce the same narcotic effect when breathing air. This is now preferred to the previous method of considering only nitrogen as narcotic. The equivalent narcotic depth of a breathing gas mix at a particular depth is calculated by finding the depth of a dive when breathing air that would have the same total partial pressure of nitrogen and oxygen as the breathing gas in question. Although oxygen has greater lipid solubility than nitrogen and therefore should be more narcotic (Meyer-Overton correlation).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.4) − 10 END = 70 × 0. the END is: END = (200 + 33) × (1 − 0. In this analysis.4) − 33 END = 233 × 0. Oxygen Narcosis Since there is evidence that oxygen plays a part in the narcotic effects of a gas mixture. the diver would feel the same narcotic effect as a dive on air to 107 feet. 40% nitrogen (trimix 20/40) being used at 60 metres (200 ft) has an END of 32 metres (105 ft). 40% helium. the NOAA diving manual recommends treating oxygen and nitrogen as equally narcotic. the END is: END = (60 + 10) × (1 − 0. for a gas mix containing 40% helium being used at 60 metres. for a gas mix containing 40% helium being used at 200 feet. such as heliox and trimix. a trimix containing 20% oxygen.6 − 33 END = 140 − 33 END = 107 feet So at 200 feet on this mix. For example.
somnolence.  Causes HPNS has two components.  Russian scientist G. org/ 2810).  Breathing Mixture Including other gases in the mix. electroencephalography (EEG) changes. PMID 734806. and decreased mental performance. one resulting from the speed of compression and the other from the absolute pressure. since oxygen has some narcotic properties. dizziness. 2002. but has little variation between different dives by the same diver.e. NOAA Diving Manual. L.1. rubicon-foundation. nausea. 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. The compression effects may occur when descending below 500 feet (150 m) at rates greater than a few metres per minute. Retrieved 2008-05-01. Undersea Biomed Res 5 (4): 391–400. EEG changes. Unfortunately these reports were not available in the West until 1967. but reduce within a few hours once the pressure has stabilised. 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.  Rate of Compression Utilizing slow rates of compression or adding stops to the compression have been found to prevent large initial decrements in performance.  "Mixed-Gas & Oxygen". National Oceanic and Atmospheric Administration. Zal'tsman also reported on helium tremors in his experiments from 1961. myoclonic jerking. The effects depend on the rate of descent and the depth. The non-helium portion (i. such as nitrogen (creating trimix) or hydrogen (hydreliox) suppresses the neurological effects. The susceptibility of divers and animals to HPNS varies over a wide range depending on the individual.. The effects from depth become significant at depths exceeding 1000 feet (300 m) and remain regardless of the time spent at that depth. Bennett. HPNS is a limiting factor in future deep diving.." 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.Equivalent narcotic depth 30 References  Hesser CM. "[16. 4th. and carbon dioxide in compressed-air narcosis" (http:/ / archive. "Roles of nitrogen.   . and somnolence that appeared during a 1189-foot (362 m) chamber dive in Marseilles. who also founded the Divers Alert Network.3.2. Adolfson J (December 1978). 1977.1978). "Helium tremors" were first widely described in 1965 by Royal Navy physiologist Peter B. . regardless of the proportions of oxygen and nitrogen. Diving for Science and Technology.4] . oxygen. Symptoms Symptoms of HPNS include tremors.. it is appropriate to include the oxygen in the END calculation when using trimixes (Lambersten et al. Fagraeus L. visual disturbance. The term high pressure nervous syndrome was first used by Brauer to describe the combined symptoms of tremor.
M. (1968). pp. A. MD Thesis (Toulouse University). (1974). (1979).  Zal'tsman.  Brauer. Bennett and Elliott's physiology and medicine of diving. (1988). mechanisms and prevention of the high pressure nervous syndrome" (http:/ / archive. 5th Rev ed.  Vigreux..rubicon-foundation. org/ 2661). 9 (4): 335–51. External links • Select publications about HPNS (http://archive.. Foreign Technology Division. M. (1982). Retrieved 2008-04-07. "The use of Non-Explosive mixtures of hydrogen and oxygen for diving". Gosset. Fructus. rubicon-foundation.. ISSN 0093-5387. B. Dimov.  Bennett. 323–57.. . anesthetics and anticonvulsant drugs have had varying results in suppressing HPNS with animals. In Brubakk. Tom S. "Effects of a H2-He-O2 mixture on the HPNS up to 450 msw" (http:/ / archive. Texas A&M University Sea Grant TAMU-SG-79-201. Ohio). J. P. X. Naquet. C. Underwater Physiology Subcommittee Report No. . W. W. org/ 2487). org/ 2920).  Bennett. PMID 5378824. Gardette-Chauffour. OCLC 2068005. Royal Navy Personnel Research Committee.High-pressure nervous syndrome 31 Drugs Alcohol. P. "The High Pressure Nervous Syndrome". (1967). AD655 360 (Wright Patterson Air Force Base. B. B. "Psychological principles of a sojourn of a human in conditions of raised pressure of the gaseous medium (in Russian. Coggin. . (1970). P. Bennett. C. Lemaire. P.  Fife. United States: Saunders.  Brauer. Neuman. P. "Psychometric impairment in men breathing oxygen-helium at increased pressures". Undersea Biomed. OCLC 2068005. W. English translation. Res. rubicon-foundation. Jean Claude (2003). rubicon-foundation. OCLC 2068005. Res. 251 (London). R. G.org/dspace/simple-search?query=high+ pressure+nervous+syndrome) hosted by the Rubicon Foundation . J. PMID 4619860.  Rostain. Rev Neurol (Paris) 121 (3): 264–5. "Syndrome neurologique et electrographique des hautes pressions". C. Undersea Biomedical Research 15 (4): 257–70. Fructus. R. (1968). Ocean Industry (London) 3: 28–33. Naquet. L. R. ISSN 0093-5387.. Alf O. References  Bennett. S. "Effect of compression rate on use of trimix to ameliorate HPNS in man to 686 m (2250 ft)" (http:/ / archive. Retrieved 2008-04-07. R. ISSN 0093-5387. (1965). L. R. 1961)". Retrieved 2008-04-07. None are currently in use for humans. McLeod. PMID 7168098. "Seeking man's depth level". Peter B. ISBN 0702025712. PMID 3212843. "Contribution to the study of the neurological and mental reactions of the organism of the higher mammal to gaseous mixtures under pressure". Undersea Biomed. "The causes.  Hunger Jr.. 1 (1): 1–28. W. Rostain.
More disciplined attitude when underwater. Oxygen toxicity Breathing gas at too high a partial pressure of oxygen. empty it and refill it. Proper training before using mixed gases. with scuba or other diving equipment) or use high pressure breathing gases. If a cylinder has stood full for months. Some deep diving breathing gases such as trimix and heliox can be hypoxic at shallow depths Don't breathe hypoxic gas in shallow water. 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. or dive tool/knife. Click on the boldface links to find symptoms and more information for each topic. Types of this sort of diving disorder. 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. using up oxygen in the contained air.g. Some of these conditions also affect people who work in raised pressure environments out of water. but where the oxygen partial pressure is too low to sustain normal activity or consciousness.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. every hour of recreational diving is 36 to 62 times riskier than automobile driving. e. Carry a diver's net cutter. in caissons. According to a North American 1970 study. According to a 2000 Japanese study. hypoxic gas Proper training before using a rebreather. Keep cylinders routinely checked and tested.g. 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. Better awareness underwater. Better training and leadership. Corerect identification of cylinder gases and safe procedures for gas changes. Keep equipment routinely checked and in good condition Better training of divers. before the diver uses the cylinder Anoxia due to having no air or gas to breathe Equipment failure . partial pressure depends upon proportion of oxygen and depth Hypoxia or anoxia occurs while having gas to breathe.g. 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 . See cave diving and wreck diving. diving was (on a man-hours based criteria) 96 times more dangerous than driving an automobile. 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. A faulty or misused rebreather can provide the diver with Keep rebreathers properly maintained.particularly in rebreathers that monitor and maintain oxygen content Running out of air due to a number of factors. Specific training and leadership for such types of diving.
British naval divers called it shallow water blackout. 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. never wear earplugs. Keep rebreathers properly maintained. such as the paranasal sinuses. Minimise the volume of any enclosed spaces which the diver breathes through. Do not dive with eyes-only goggles. Re-inhaling carbon dioxide-laden exhaled gas Use proper filters in the air pump or air compressor. 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. Check conditions where you have your cylinders refilled. this hazard can happen with diving with a large "bubblehead" helmet. and how to avoid them Type Eardrum damage. For example. Proper diver training in clearing the ears. 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 . The pressure in the outer ear not equalizing with surrounding pressure Damage to other body air spaces.g. e. See Rebreather#Carbon dioxide scrubber. This can happen from losing control of buoyancy causing excessive vertical speed during descent. This is a particular risk with a pumped surface air feed. Put the proper gas identification markings on cylinders. 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. causing dizziness and disorientation etc. Types of this sort of diving disorder. Click on the boldface links to find symptoms and more information for each topic.List of diving hazards and precautions 33 Air cylinder filled by a compressor which sucked in products of combustion. Cold water in the middle ear chills the inner ear. 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. Carbon dioxide poisoning: hypercapnia With a rebreather. Do not dive with conditions such as the common cold Let air into the mask through the nose. the diver re-inhales carbon dioxide because the soda lime scrubber cannot absorb the exhaled carbon dioxide as fast as the diver produces it. often its own engine's exhaust gas Oil getting into the air feed and firing in the air compression cylinder. Proper training before using a rebreather. with the common cold.
this requires substantial pressure difference caused by aforementioned failures in the air supply and the non-return valve (which was absent from the earliest models of this type of diving suit). Air or other gas in the blood stream. Click on the boldface links to find symptoms and more information for each topic. and how to avoid them Type Cause How to avoid it Never hold your breath while diving with breathing apparatus Pulmonary barotrauma: "burst lung" Holding the breath while ascending This can cause: Pneumothorax Interstitial emphysema Subcutaneous emphysema Gas embolism Collapsed lung. Proper training in its use. Blockage of the sinus's duct Blocked Eustachian tube Pain in a sinus Eardrum bursting outwards Do not dive with nasal congestion. e. On ascent Air spaces within the body expand when the outside pressure decreases. Its effects can be very similar to decompression sickness. with the old standard diving dress. In severe cases much of the diver's body could be mangled and compacted inside the helmet. . the common cold. however. This can happen from holding the breath on ascent. 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. air loose in the pleural cavity Gas trapped in the chest after burst lung Gas loose under the skin.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.g. Types of this sort of diving disorder. 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. or from losing control of buoyancy causing excessive vertical speed during ascent. Effects of breathing gas at high pressure Click on the boldface links to find symptoms and more information for each topic.
etc. Uncommon but known. particularly in caves or shipwrecks.List of diving hazards and precautions 35 Types of this sort of diving disorder. 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. Provide something for the diver to hold onto while ascending and decompressing to maintain accurate depth during stops and correct ascent rate. some dangerous Fire coral Some jellyfish . Reduce the number of deep dives. Many deep dives in succession. arterial gas embolism. Avoid diving in bare skin. ascending too quickly will cause gas to supersaturate and form bubbles in tissues depending on time and depth of the dive. This hazard is well known with closed circuit rebreathers when the control of the mixture fails. a boilersuit could be worn in very warm water. After dive. e. Water carries heat away far better than air. Do not get too close to coral. with scuba) or use high pressure breathing gases. Type Hypothermia Cause Losing body heat to the water. Stings Stings. do not miss or cut short decompression stops. and how to avoid them. such as an ROV. Avoid diving with bare skin. See decompression sickness for a detailed list of the symptoms. in caissons. Divers face specific physical and health risks when they go underwater (e. Click on the boldface links to find symptoms and more information for each topic. Other risks encountered by people in water Types of this class of diving disorder. much heat can be lost from a head without a hood. Learn about the dangerous species. Also. How to avoid it In cool or cold water.g. Use an underwater breathing apparatus and ascend at a rate determined by decompression tables or computer. Training in using diving tables and a dive computer. See taravana. 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. Maintain cardiovascular fitness. Avoid dehydration and hypothermia. 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. Use another diving technique. sometimes with Coral coral tissue left in them Cuts Rock. use the correct breathing gas mixture to limit the equivalent narcotic depth to an acceptable level for the planned depth. Learn to identify it. Some of these conditions also affect people who work in raised pressure environments out of water. Know how long you can stay at the planned depth and still make a normal ascent. wear an adequately warm diving suit for the conditions. eg Nitrox. How to avoid it Plan your dive.g. Avoid diving with bare skin. metal. increase surface interval or reduce dive depth. Where it says "Avoid diving with bare skin". Bends in snorkellers. Cuts. If stops are necessary. or add a little nitrogen as described at HPNS. Dont dive deep on air. and how to avoid them Type Decompression sickness ("the bends") Cause Gas dissolves in tissues under pressure according to Henry's Law over time. and barotrauma. It is yellow. Nitrogen narcosis Breathing a high partial pressure of nitrogen (or other gas. With mixed gas diving.
Get proper information on them. 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. Care when wading. in some tropical waters Attack by Titan Triggerfish Attack by an unusually large grouper. currents moved a shore dive the diver away from a safe exit. For example hydrogen sulfide in some lakes and caves can be absorbed through the skin.   Electric eel. See Underwater Port Security System. 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. Avoid large ships' ordinary sonar. Carry a signalling mirror and/or sound signalling device. Learn the frog kick. Ensure that boat uses a positive check system to identify each diver is on board after a dive. This includes sunburn. some sea urchins in warm seas Blue ringed octopus. A deep cut which leaves poison in the wound Reef rash sting ray (its self-defence reaction) A generic catch-all term that refers to the various cuts. Carry a yellow flag or surface marker buoy to attract attention. lionfish. Keep away from them. fire coral inflammation and other skin injuries that a diver may gain from using a shorty wetsuit or no diving suit. where protected from attack by sharks. 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. Care when wading. in some South American fresh water Electric ray. Get proper information on them. Wave action on the shore. surface weather on the shore make the sea too rough to safely exit. crown of thorns starfish. In affected water. Avoid waters known to be inhabited by crocodiles. likelihood of risk is location dependent Wear a full-body exposure suit to prevent direct skin to environment contact. bleeding wounds and other trauma Use Surface detection aids or a diving shot to mark surfacing position and aid searchers. Keep out of armed forces areas. scrapes. Colliding with a boat or its propeller. There have been cases    of very large groupers trying to swallow humans. Plan a safe exit point and check weather and tidal conditions. Carry a personal submersible EPIRB or submersible vhf radio. Left behind due to inaccurate check by boat crew Diver lost at sea after Big waves made it unsafe to leave the water. good weather forecasts. . in parts of the Pacific Ocean Sharks.List of diving hazards and precautions 36 Do not poke about in sand where they live. Consult location-specific information to determine risk. never molest even seemingly-tame sharks underwater. stonefish. sea lice bites. Sudden loss of underwater visibility Silt out: stirring up silt or other light loose material Training in diving in zero visibility. 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. Poison-injecting spines Poison injection Shark bites Learn to identify them. jellyfish stings. 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. Local knowledge. bruises and skin conditions that result from diving in tropical waters. Keep a lookout for the fish and move away if they act aggressively Crocodile attack Crocodiles.
 Allard. Use low snag equipment configurations (avoid dangling gear and snap hooks that can snag on lines) Entrapment Snagging on lines.  "Goliath grouper attacks" (http:/ / www. Cyber Diver News Network. Sri Lanka External links • Diving Diseases Research Centre (http://www. in the sunken Admiralty floating dock in Trincomalee. Retrieved 2009-08-08. Retrieved 2009-08-08. . html). Evan T (2002-01-04). directional markers.com. .List of diving hazards and precautions 37 Carry at least one line cutting implement. info/ eco/ e020104/ e020104. jacksonville.org) . Florida Museum of Natural History. html). Reefs of Taprobane. . "Did fish feeding cause recent shark. page 138: 15 feet long. "Deaths During Skin and Scuba Diving in California in 1970".  Alevizon. James M (1972). Retrieved 2009-08-08. ISBN 0-7434-4502-3. org/ science_body4. Ashida. Reef Relief. nets. References  Lansche. 2005-06-19. PMID 5031739. "A Case for Regulation of the Feeding of Fishes and Other Marine Wildlife by Divers and Snorkelers" (http:/ / www. grouper attacks?" (http:/ / www. "Big Grouper Grabs Diver On Keys Reef" (http:/ / www. Correct use of reels and route to the surface lines. flmnh.com (Florida Times-Union). Dive with a buddy who is capable of helping to free you and will stay close enough to notice.  Arthur C. Train in wreck diving and cave diving techniques. edu/ fish/ InNews/ grouperattack2005. Clarke. FloridaToday. 4 feet side side to side. . wrecks. Backup lights. ufl. PMC 1518314. "Is recreational diving safe?" (http:/ / archive. cdnn. shtml). rubicon-foundation. Retrieved 2009-08-08. . Undersea and Hyperbaric Medical Society. org/ 6770).  Sargent. 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.  Ikeda. H (2000).DDRC. Jacksonville. Bill (2005-06-26). California Medicine 116 (6): 18–22. T. shtml). com/ tu-online/ stories/ 061905/ spo_19030958. Retrieved 2009-08-08. Bill (July 2000). reefrelief.
the MOD (fsw) is 33 feet (10 m) x [(1. .3 feet (29.5. There is a risk of oxygen toxicity if the MOD is exceeded.0 m).36) .1] = 28. This safe limit varies depending on the diver training agency.4 / 0. the level of underwater exertion planned and the planned duration of the dive. Formulas To calculate the MOD for a specific ppO2 and percentage of oxygen. Of this total pressure which can be tolerated by the diver.4 bar. 150 minutes at 1.4 bar.4 / 0. The remaining part in each formula merely converts pressure in atm produced by depth in water. 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. and the rest is due to depth in water.2 to 1. The tables below show MODs for a selection of oxygen mixes. but is normally in the range of 1. etc. Note that 21% is the concentration of oxygen in normal air. so divide by 0.6 bar.Maximum operating depth 38 Maximum operating depth In technical diving and nitrox diving.).2 bar. to give the rest of the pressure added by water (in atmospheres). if a gas contains 36% oxygen and the maximum ppO2 is 1. the MOD (m) is 10 metres x [(1. 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.36) . So the 1 atm for the air is subtracted out. 120 minutes at 1. to the depth. 180 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.4 bar.6 bar. if a gas contains 36% oxygen and the maximum ppO2 is 1. 1 atmosphere is due to the Earth's air. 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. 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.1] = 95. For example. For example. Safe limit of partial pressure of oxygen The maximum single exposure limits recommended in the NOAA Diving Manual are 45 minutes at 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.3 bar and 210 minutes at 1.9 metres. 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.5 bar.
3 70.3 20.9 16.2 38.5 6.5 490.6 1727 847 553 407 319 260 218 187 162 143 127 113 102 92 84 72 63 54 48 42 37 33 29 25 93 1.7 14.4 456.8 7.8 123.2 to 1. MOD table in metres Maximum Operating Depth (MOD) in metres of sea water for ppO2 1.0 13.3 2.4 52.6 11.6 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) 1.6 22.7 115.6 523.0 19.5 34.3 423.4 76.7 28.0 1.0 90.5 1617 792 517 379 297 242 202 173 150 132 117 104 95 1.3 256.0 (bar) 8.4 26.4 30.7 47.3 15.0 90.7 5.7 48.1 18.4 23.1 6.9 36.7 83.5 7.7 78.7 49.5 5.0 240.0 28.3 29.0 7.0 156.4 1507 737 480 352 275 223 187 159 138 121 107 97 1.3 1.0 8.6 7.Maximum operating depth 39 MOD table in feet Maximum Operating Depth (MOD) in feet of sea water for ppO2 1.4 31.3 4.3 21.9 44.7 32.1 25.6 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 1.0 73.8 56.9 23.3 1397 682 443 324 253 205 171 145 125 110 99 1.0 11.1 33.3 61.3 6.7 223.3 96.8 18.2 51.0 18.0 123.3 11.0 8.1 11.1 16.2 56.3 43.5 25.7 23.5 31.3 67.0 15.9 25.0 35.6 12.7 134.8 1.3 145.6 6.1 23.7 10.6 4.4 10.7 167.0 5.4 28.0 17.2 390.6 16.7 14.7 62.0 8.0 13.9 11.0 7.6 40.0 190.0 56.0 .3 38.1 40.5 10.1 3.0 34.5 13.2 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.8 6.3 41.3 20.3 10.3 21.3 206.4 3.3 5.0 8.9 66.2 to 1.0 26.5 45.0 98.8 10.6 106.0 4.7 1.
inert gas narcosis. DiseasesDB MeSH 30088   C21. predicting the depth at which narcosis will affect a diver is difficult. Martini effect). . and can occur during shallow dives.Maximum operating depth 40 References  Lang.1 20. Apart from helium. org/ 4855). numbness". DAN Nitrox Workshop Proceedings (http:/ / archive.455. M. helium and nitrogen for deep dives to avoid the effects of narcosis.3 0.A.571 Some components of breathing gases. p. NC: Divers Alert Network. While narcosis affects all divers.7 2. is a reversible alteration in consciousness that occurs while scuba diving at depth. As depth increases. beyond 30 meters (100 ft). raptures of the deep. and their relative narcotic potentcies  Gas Ne H2 N2 O2 Ar Kr CO2 Xe Relative narcotic potency 0.3 7. Retrieved 2008-06-24. Although divers can learn to cope with the effects.6 Narcosis while diving (also known as nitrogen narcosis. The Greek word ναρκωσις (narcosis) is derived from narke.6 1. 197. as susceptibility varies widely from dive to dive and amongst individuals.0 1. but usually does not become noticeable until greater depths.0 25. the effects may become hazardous as the diver is increasingly impaired. it is not possible to develop a tolerance. and probably neon. A cylinder label shows the maximum operating depth and mixture (oxygen/helium). which is greater as the lipid solubility of the gas increases. . (2001). a term used by Homer and Hippocrates. all gases that can be breathed have a narcotic effect. rubicon-foundation. Nitrogen narcosis Inert gas narcosis [Nitrogen narcosis] Classification and external resources Divers breathe a mixture of oxygen. Narcosis produces a state similar to alcohol intoxication or nitrous oxide inhalation.613. "temporary decline or loss of senses and movement. Durham.
giddiness. 41 Classification Narcosis results from breathing gases under elevated pressure and may be classified by the principal gas involved. making it difficult to read multiple gauges The most dangerous aspects of narcosis are the loss of decision-making ability and focus. The relation of depth to narcosis is sometimes informally known as "Martini's law". only worsening if the diver ventures deeper.a feeling of tranquility and mastery of the environment. the onset of narcosis may be hard to recognize. Such effects are not harmful unless they cause some immediate danger not to be recognized and addressed. Other effects include vertigo. or paranoia. disregarding normal safe diving practices. except helium and probably neon. comparing a situation they may be more familiar with. 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. krypton. The effects of carbon dioxide consistently result in a decrease of both mental and psychomotor function. and xenon anesthesia systems are still being proposed and designed. as well as nitrogen. The noble gases. Signs and symptoms Due to its perception-altering effects. but it has been successfully used for surgical operations. depending on the individual diver and the diver's medical or personal history. These effects are essentially identical to various concentrations of nitrous oxide. Once stabilized. the effects generally remain the same at a given depth.Nitrogen narcosis The condition is completely reversed by ascending to a shallower depth with no long-term effects. extreme anxiety. Narcosis can produce tunnel vision. narcosis results in relief of anxiety . Xenon has historically been too expensive to be used very much in practice. For this reason. and impaired judgement. or for standard diving safety guides. When more serious. The syndrome may cause exhilaration. They also resemble (though not as closely) the effects of alcohol and the familiar benzodiazepine drugs such as diazepam and alprazolam. depression. The noble gases argon. Reported signs and symptoms are summarized against typical depths in meters and feet of sea water in the following table: . Diving beyond 40 m (130 ft) is considered outside the scope of recreational diving: as narcosis and oxygen toxicity become critical factors.  At its most benign. and xenon has so much anesthetic activity that it is actually a usable anesthetic at 80% concentration and normal atmospheric pressure. This is a very rough guide. and xenon are more narcotic than nitrogen at a given pressure. Professional divers use such a calculation only as a rough guide to give new divers a metaphor. the diver may feel overconfident. specialist training is required in the use of various gas mixtures such as trimix or heliox. narcosis while diving in open water rarely develops into a serious problem as long as the divers are aware of its symptoms and ascend to manage it. and visual or auditory disturbances. multi-tasking and coordination. oxygen and hydrogen cause a decrement in mental function. but their effect on psychomotor function (processes affecting the coordination of sensory or cognitive processes and motor activity) varies widely. and not a substitute for an individual diver's known susceptibility.
confusion. More recently. Increased intensity of vision and hearing.  Rapid compression potentiates narcosis. a sense of levitation. as the effect may vary from dive to dive (even on the same day). Over-confidence and sense of well-being. Stupefaction with some decrease in dexterity and judgment. Mild impairment of performance of unpracticed tasks. Modern theories have suggested that inert gases dissolving in the lipid bilayer of cell membranes cause narcosis. Anxiety (common in cold murky water). increased excitability. impaired judgment. 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. Unconsciousness. or no symptoms at all. 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. .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. owing to carbon dioxide retention. Because of these incidents. loss of memory. Terror in some. Loss of memory. Mild euphoria possible.  A number of divers have died in attempts to set air depth records below 120 m (400 ft). researchers have been looking at neurotransmitter receptor protein mechanisms as a possible cause of the narcosis. the Guinness Book of World Records no longer reports on this figure. Severe delay in response to signals. Sleepiness. Reasoning and immediate memory affected more than motor coordination. manic or depressive states. Sense of impending blackout. changes in facial appearance. but the changes are not usually noticeable. The breathing gas mix entering the diver's lungs will have the same pressure as the surrounding water. Poor concentration and mental confusion. 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. However there is no reliable method to predict the depth at which narcosis becomes noticeable. For any given depth. euphoria. or the severity of the effect on an individual diver. corresponding to an ambient pressure of about 4 bar (400 kPa).  Significant impairment due to narcosis is an increasing risk below depths of about 30 m (100 ft). Idea fixation. Calculation errors and wrong choices. hysteria (in chamber). Occasional dizziness. dizziness. Mildly impaired reasoning. Laughter and loquacity (in chambers) which may be overcome by self control. Hallucinations. and unconsciousness. Delayed response to visual and auditory stimuli. as a result of the elevated pressures at depth (Henry's law).  A divers' cognition may be affected on dives as shallow as 10 m (33 ft). Death. disorganization of the sense of time. Uncontrolled laughter. Hallucinations. Most sport scuba training organizations recommend depths of no more than 40 m (130 ft) because of risk of narcosis. known as the ambient pressure. instructions and other stimuli.
or because of poor gas exchange in the lungs. or hypothermia causing rapid breathing and shivering. In the rare event of misdiagnosis when another condition is causing the symptoms. causing direct mechanical interference with the transmission of signals from one nerve cell to another. 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. Similar to the mechanism of ethanol's effect. and carbon dioxide retention all increase the risk and severity of narcosis. remains largely unchallenged.  Carbon dioxide has a high narcotic potential and also causes increased blood flood to the brain. heavy work.   More recently. krypton and hydrogen cause very similar effects at higher than atmospheric pressure. Other sedative and analgesic drugs. similar to the mechanism of nonpolar anesthetics such diethyl ether or ethylene. the Meyer-Overton hypothesis suggested that narcosis happens when the gas penetrates the lipids of the brain's nerve cells. shallow or skip breathing. the basic and most general underlying idea. other likely conditions do not produce reversible effects. 43 Mechanism The precise mechanism is not well understood. specific types of chemically-gated receptors in nerve cells have been identified as being involved with anesthesia and narcosis. increasing the effects of other gases. . Thermal cold. the effects then disappear within minutes. However. The partial pressure of a gas required to cause a measured degree of impairment correlates well with the lipid solubility of the gas: the greater the solubility. stress. However. the less partial pressure is needed. Given the setting. Alleviation of the effects upon ascending to a shallower depth will confirm the diagnosis. the increase of gas dissolved in nerve cell membranes may cause altered ion permeability properties of the neural cells' lipid bilayers. In the event of complications or other conditions being present.Nitrogen narcosis Narcosis has been compared with altitude sickness insofar as its variability (though not its symptoms). but it appears to be the direct effect of gas dissolving into nerve membranes and causing temporary disruption in nerve transmissions. 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. other gases including argon. the initial management—ascending closer to the surface—is still essential. 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. Trudell et al. fatigue. typical of a cell reproduction by the very chemically inactive gas argon makes them membrane. its effects depend on many factors.  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). such as opiate narcotics and benzodiazepines. The management of narcosis is simply to ascend to shallower depths. add to narcosis. have suggested non-chemical binding due to the attractive van der Waals force between proteins and inert gases. Some of these effects may be due to antagonism at NMDA receptors and potentiation of GABAA receptors. Increased risk of narcosis results from increasing the amount of carbon dioxide retained through heavy exercise. with variations between individuals. While the effect was first observed with air.  Diagnosis and management The symptoms described may be caused by other factors during a dive: ear problems causing disorientation or nausea. An early theory. Nevertheless the presence of any of these symptoms should imply narcosis. Narcosis is known to be additive to even minimal alcohol intoxication. early signs of oxygen toxicity causing visual disturbances. ascending is always the correct initial response. their Illustration of a lipid bilayer.
however. and at these depths narcosis does not present a large risk. and this training should include a discussion of narcosis. and is not suitable as a breathing gas for diving (it is used as a drysuit inflation gas. The decompression schedule can still be followed unless other conditions require emergency assistance.  The use of these gases forms part of technical diving and requires further training and certification. and strongly encourage helium. If narcosis does occur. list conversion factors for narcotic effect of other gases. Further training is normally required for certification up to 30 m (100 ft) on air. for example.33 times the narcotic effect of nitrogen. Although severe narcosis may interfere with the judgment necessary to take preventive action. then it is necessary to abort the dive. 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. 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. based on relative lipid solubilities. so in principle it should be usable at nearly four times the depth. Although helium is the . Standard tables. may forbid diving with gases that cause too dive cylinders with a gas mixture containing much narcosis at depth in the average diver. Some diver training agencies offer specialty training to prepare recreational divers to go to depths of 40 m (130 ft). Argon. high-pressure oxygen can lead to oxygen toxicity. and that the sound which their exhaled bubbles make becomes different. owing to its low thermal conductivity). 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.Nitrogen narcosis Should problems remain. Equivalent narcotic depth (END) is a commonly used way of expressing the narcotic effect of different breathing gases. 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. For example. Since narcosis becomes more severe as depth increases. Some divers report that they have hearing changes. the effects disappear almost immediately upon ascending to a shallower depth. which are somewhat more repeatable than for the average group of divers.  Scuba organizations which train for diving beyond Narcosis while deep diving is prevented by filling recreational depths. a diver who remains calm and is alert to the danger will be capable of resolving these problems at an earlier stage. Deep dives should be made only after a gradual training to gradually test the individual diver's sensitivity to increasing depths. Specialist training may help divers in identifying these personal onset signs. and these may then be used as a signal to ascend to shallower depths. one diver may have trouble with eye focus (close accommodation for middle-aged divers). the first symptoms of narcosis for any given diver are often more predictable and personal. has 2. another may experience feelings of euphoria. Helium is stored in brown cylinders. often consisting of further theory and some practice in deep dives with close supervision. The National Oceanic and Atmospheric Administration (NOAA) Diving Manual now states that both oxygen and nitrogen should be considered equally narcotic. its effects. with careful supervision and logging of reactions. For example. and another feelings of claustrophobia. While the individual diver cannot predict exactly at what depth the onset of narcosis will occur on a given day. Some gases have other dangerous effects when breathed at pressure. and cure.28 times that pressure. neon at a given pressure has a narcotic effect equivalent to nitrogen at 0. Most recreational dive schools will only certify basic divers to depths of 18 m (60 ft).
makes nitrogen narcosis more likely. combined with the reduced physical capacity that goes with it.   These effects are particularly dangerous because a diver may feel they are not experiencing narcosis. 45 Prognosis and epidemiology Narcosis is potentially one of the most dangerous conditions to affect the scuba diver below about 30 m (100 ft). Meyer in 1899. hypothesized in 1881 that pressure forced blood to inaccessible parts of the body and the stagnant blood then resulted in emotional changes.  Nevertheless. noting "the functions of the brain are activated.Nitrogen narcosis least intoxicating of the breathing gases. . the effects of narcosis are entirely reversible by ascending and therefore pose no problem in themselves. symptoms of intoxication are present. cost. Walter Moxon (1836–1886). Experts recommend total abstinence from alcohol at least 12 hours before diving. and other factors are also important. chronic or acute exposure. What became known as the Meyer-Overton Hypothesis is illustrated in the diagram to the right. Inert gas narcosis is only one factor which influences the choice of gas mixture. Because of similar and additive effects. thoughts have a peculiar charm and. the underlying behavioral effects remain. a still-mysterious but apparently unrelated phenomenon. but due to the much longer half-life of the active agent of this drug in the body. History French researcher Victor T. Except for occasional amnesia of events at depth. Junod was the first to describe symptoms of narcosis in 1834. Two years later a similar theory was published independently by Charles Ernest Overton. A hangover. even for repeated. entitled Zur Theorie der Alkoholnarkose. the risks of decompression sickness and oxygen toxicity. as the result of illogical behavior in a dangerous environment. the severity of narcosis is unpredictable and it can be fatal while diving. such as marijuana and alcohol before any dive. Abstinence time needed for marijuana is unknown. Tests have shown that all divers are affected by nitrogen narcosis. it is likely to be longer than for alcohol. divers should avoid sedating medications and drugs."  Junod suggested that narcosis resulted from pressure causing increased blood flow and hence stimulating nerve centers. at greater depths it can cause high pressure nervous syndrome. yet still be affected by it. 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. though some are less affected than others. a prominent Victorian physician. and longer for other drugs. imagination is lively. Even though it is possible that some divers can manage better than others because of learning to cope with the subjective impairment. in some persons.
Nitrogen narcosis In 1939. rubicon-foundation. com/ xenon-anaesthesia. 613. ISBN 0702025712. Behnke and O. Albert R. 29th Undersea and Hyperbaric Medical Society Workshop (Bethesda. Ramoutsaki. OCLC 66524750. revision 6. . For an inert gas the narcotic potency was found to be proportional to its lipid solubility. p.  Hobbs M (2008). . RP. full). Balon N (2006). and shows similar results for anesthetic potency as the measurements of lipid solubility.  Lippmann. John.S. Inc) 30 (4): 293–303. Navy Supervisor of Diving (2008) (PDF). Victoria. Mitchell. org/ pdf/ DiveMan_rev6.S. PMID 734806. KW (eds) (1985). p. p. OCLC 51607923. (Value for Krypton from 4th Edition. . 571  Bennett. Eleni (April 12. . "Etymology and Literary History of Related Greek Words" (http:/ / www. Leonard. 308  Paton. Anesteziol Reanimatol (6): 56–60. Liu. Jean Claude (2003). Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society. 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"Neuropsychological performance in long-term cannabis users" (http:/ / archpsyc. Retrieved 2008-10-31. United States: Saunders Ltd. Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society 12 (4): 369–402. 430–1  St Leger Dowse.. Alf O.). Gerhard. EI (1998). org/ cgi/ content/ full/ 58/ 10/ 909). OCLC 51607923. since oxygen has some narcotic properties. Bennett and Elliott's physiology and medicine of diving (5th ed. doi:10. com/ iantd3.  IANTD (1 January 2009).1978). PMID 11094015.e. PMID 3307084.). ama-assn. bsac. Aviation. 374. Bennett and Elliott's physiology and medicine of diving (5th ed. SAA and other European training agencies teach recreational diving to a depth limit of 50 m (160 ft). p. Matti. "Nitrogen narcosis and alcohol consumption--a scuba diving fatality".10. Eberhard (December 2000). "Subjective and behavioral effects associated with repeated exposure to narcosis". Peter.  Fowler. org/ 2199). Deborah (2001). Retrieved 2009-07-29. Heslegrave. Neuman. "A molecular description of how noble gases and nitrogen bind to a model site of anesthetic action" (http:/ / www. Schreiner. Retrieved 2008-06-10. Haseneder. Alf O.1001/archpsyc. org/ 3019). Bennett and Elliott's physiology and medicine of diving (5th ed. United States: Saunders Ltd. James M. .  Hamilton Jr. EB (July 1987). ISSN 1066-2936. Hamilton. Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society. Hudson. 1977. "Narcotic factors of gases" (http:/ / www. Jean Claude (2003). Schneck.  Clark. Tom S. "The effects of altered arterial tensions of carbon dioxide and oxygen on cerebral blood flow ans cerebral oxygen consumption of normal young men". PMID 3775969. Retrieved 2009-07-29.909. doi:10. tdisdi. Rainer. Zieglgänsberger. 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. "Diving Officer's Conference presentations" (http:/ / www. 110–3  Fowler. org/ 4498). Alf O. Ola (2003).Nitrogen narcosis  Kety.  Lippmann & Mitchell 2005. techdiver. ch. DD. .  Mekjavic. Anesthesia and Analgesia 87 (2): 411–8. Rostain. . Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society 22 (1): 41–9. anesthesia-analgesia. PSCR & SCR Rebreather Diver Programs (Recreational Trimix Diver)" (http:/ / www. HR (eds) (1975). anesthesia-analgesia. Patsalis.3. Tipton. Retrieved 2008-12-23. p. it is appropriate to include the oxygen in the END calculation when using trimixes (Lambersten et al. Schmidt. In Brubakk. . 9th Undersea and Hyperbaric Medical Society Workshop (Bethesda. ISBN 0702025712. Neuman. pp. . MF. Tom S. Otto I (2003). NOAA Diving Manual. B.  Bennett. . "Nitrous oxide and xenon increase the efficacy of GABA at recombinant mammalian GABA(A) receptors" (http:/ / www. Yurgelun-Todd. Koblin.1097/00000539-200012000-00045. Eiken.  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"Development of Decompression Procedures for Depths in Excess of 400 feet" (http:/ / archive. NP.  Hamilton. Gruber. Porlier.  Michalodimitrakis. 4th. "[16.). Michael J. Retrieved 2009-07-29. Retrieved 2008-12-01. p. Huestis. PMID 16695569. B (1995). In Brubakk. Anesthesia and Analgesia 91 (6): 1542–9. com/ index." (http:/ / archive.  Franks. International Training. Marilyn A. Undersea Biomedical Research 13 (3): 345–54. Neuman. Nature 367 (6464): 607–14. United States: Saunders Ltd. "The High Pressure Nervous Syndrome". G (1985). PMID 11576028. RW. php?did=80& site=2). rubicon-foundation. Neuman. PMID 9706942. 2. The non-helium portion (i. org/ 3050). doi:10. Stephen R (2003). iantd.1038/367607a0. shtml#6). Thom. British Sub-Aqua Club. "Effects of inert gas narcosis on behavior--a critical review. R (1992). Journal of Forensic Sciences 32 (4): 1095–7. pp. doi:10. "Dissociation of the behavioral and subjective components of nitrogen narcosis and diver adaptation" (http:/ / archive. WR (1994). Tom S. Bennett and Elliott's physiology and medicine of diving (5th ed. "Thermal considerations in diving". 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. A (1987). B. "Oxygen under pressure".. Laliberté. National Oceanic and Atmospheric Administration.2. ISSN 0021-9738. Retrieved 2009-07-02. Harrison G. PMID 7742709. regardless of the proportions of oxygen and nitrogen. 129. PMC 439519.
com/ smpp/ content~content=a789031692~db=all). (2009-02-01). British Medical Journal 1: 491–7. Retrieved 2009-07-29.3 MPa".uhms. p. (2009-06-25). OCLC 2068005. mc. 48 References External links • Undersea and Hyperbaric Medical Society (http://www. Revue médicale française et étrangère: journal des progrès de la médecine hippocratique (Chez Gabon et compagnie): 350–368. Diving with Deep-Six. p. doi:10. EI. Retrieved 2009-07-29. 306  Moxon.  Behnke. ISSN 0347-7665. Retrieved 2009-03-22. PMID 20749857.ddrc.com/alch.Nitrogen narcosis ISSN 0093-5387. ScubaDoc's overview of alcohol and diving.com/page74. "Effect of brief. FOA Rapport C58015-H1 (Stockholm: National Defence Research Institute). Gelfand.  Brubakk & Neuman 2003. Victor T (1834). . Anesthesiology 26 (6): 756–63.com/marij. • Diving Diseases Research Centre (DDRC) (http://www. Moeller. Ernest S. Jacques-Yves.htm).  Overton. "Minimum alveolar anesthetic concentration: a standard of anesthetic potency". PMID 4082343. LJ.  Eger.deep-six. Retrieved 2009-08-25. Frédéric (1953). com/ ?id=K5XREXyDSQoC). ScubaDoc's overview of marijuana and diving. Yarborough. PMID 5844267. repeated hyperbaric exposures on susceptibility to nitrogen narcosis" (http:/ / archive. "Hydrogen-Oxygen (Hydrox) breathing at 1.  Ornhagen. "Respiratory resistance. duke.1097/00000542-196511000-00010. org/ 2522). Allgemeiner Pharmakologie (Institut für Pharmakologie). • Campbell. American Journal of Physiology (126): 409–15. ISSN 0093-5387. 300  Junod.  Rogers. "Nitrogen Narcosis" (http://www. edu/ uhmsupiemr. Brandstater. • Campbell. . . OD (1939).1057. (2009-05-03). publications about nitrogen narcosis.1. H (1984). Charles Ernest (1901). pp. oil-water solubility and mental effects of argon compared with helium and nitrogen".  Brubakk & Neuman 2003. "Studien Über Die Narkose" (in German). "University of Pennsylvania Institute for Environmental Medicine report. 1978" (http:/ / archives. Walter (1881).org/) UK charity dedicated to treatment of diving diseases. informaworld. doi:10. "Alcohol and Diving" (http://scuba-doc. "Recherches physiologiques et thérapeutiques sur les effets de la compression et de la raréfaction de l'air" (http:/ / books. . R. Institute for Environmental Medicine. • Campbell.org/) Searchable repository of Diving and Environmental Physiology Research. AR. G (1989). PMID 2741255. Retrieved 2009-08-25. "Croonian lectures on the influence of the circulation on the nervous system" (http:/ / www. . JM (1978). B (1965).htm). rubicon-foundation. Dumas.1136/bmj.491. • Rubicon Research Repository (http://archive. html). The Silent World: A Story of Undersea Discovery and Adventure. University of Pennsylvania. Saidman. ISBN 0792267966.  Cousteau. Retrieved 2009-08-25. Ernest S. Harper & Brothers Publishers. "Diving While Using Marijuana" (http://scuba-doc. Christian J. George D. Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society 16 (3): 227–32.org) Scientific body.html).  Lambertsen. Retrieved 2009-03-22. OCLC 2068005. Retrieved 2009-06-04. Clark.rubicon-foundation. 266. WH. google. . 583–5.
 Further studies with a number of different dive profiles. For example. nitrox is normally Typical Nitrox cylinder marking differentiated and handled differently from air. or allows extended dive times without increasing the need for decompression stops for the same risk. some suggestion that post dive fatigue is due to sub-clinical decompression sickness (DCS) (i. divers tend not to utilize nitrox at greater depths where more pronounced narcosis symptoms are more likely to occur. 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. However. Breathing nitrox is not thought to reduce the effects of narcosis. gases which also contain helium. it should be noted that because of risks associated with oxygen toxicity. micro bubbles in the blood insufficient to cause symptoms of DCS). there are people in the diving community who insist that they feel reduced narcotic effects at depths breathing nitrox. There is anecdotal evidence that the use of nitrox reduces post-dive fatigue. particularly in older and or obese divers. and 1% other gases. Nitrox is not a safer gas than compressed air in all respects. a study was published using wet divers at the same depth and confirmed that no statistically significant reduction in reported fatigue is seen. showing adjusted no-decompression times. are generally used by divers. this includes normal air which is approximately 78% nitrogen. In 2008.   Nonetheless. where the reduced percentage of nitrogen is advantageous in reducing nitrogen uptake in the body's tissues and so extending the possible dive time. 21% oxygen. nitrox with an oxygen content above 21%.  There was. which are further discussed below. however. in scuba diving. would be necessary to fully investigate this issue. thus one should not expect a reduction in narcotic effects due only to the use of nitrox. however a double-blind study to test this found no statistically significant reduction in reported fatigue. Enriched Air Nitrox diving tables. For a reduction in narcotic effects trimix or heliox. Reducing the proportion of nitrogen by increasing the proportion of oxygen reduces the risk of decompression sickness for the same dive profile.   However. and/or reducing the risk of decompression sickness (also known as the bends).Nitrox 49 Nitrox Nitrox refers to any gas mixture composed (excluding trace gases) of nitrogen and oxygen. there is much better scientific evidence that breathing high-oxygen gases .e. it increases the risk of oxygen toxicity and fire. although its use can reduce the risk of decompression sickness. and also different levels of exertion. Purpose Enriched Air Nitrox. as oxygen seems to have equally narcotic properties under pressure as nitrogen. The most common use of nitrox mixtures containing higher than normal levels of oxygen is in scuba. This may be due to a dissociation of the subjective and behavioural effects of narcosis. primarily argon. is mainly used in scuba diving to reduce the proportion of nitrogen in the breathing gas mixture.
Nitrox increase exercise tolerance, during aerobic exertion. Though even moderate exertion while breathing from the regulator is a relatively uncommon occurrence in scuba, as divers usually try to minimize it in order to conserve gas, episodes of exertion while regulator-breathing do occasionally occur in sport diving. Examples are surface-swimming a distance to a boat or beach after surfacing, where residual "safety" cylinder gas is often used freely, since the remainder will be wasted anyway when the dive is completed. It is possible that these so-far un-studied situations have contributed to some of the positive reputation of nitrox.
Nitrox is known by many names: Enhanced Air Nitrox, Oxygen Enriched Air, Nitrox, EANx or Safe Air.  The name "nitrox" may be capitalized when referring to specific mixtures such as Nitrox32, which contains 68% nitrogen and 32% oxygen. When one figure is stated, it refers to the oxygen percentage, not the nitrogen percentage. The original convention, Nitrox68/32 became shortened as the first figure is redundant. Although "nitrox" usually refers to a mixture of nitrogen and oxygen with more than 21% oxygen, it can refer to mixtures that are leaner in oxygen than air. "Enriched Air Nitrox", "Enriched Air" or "EAN" are used to emphasise richer than air mixtures. In "EANx", the "x" indicates the percentage of oxygen in the mix and is replaced by a number when the percentage is known; for example a 40% oxygen mix is called EAN40. The two most popular blends are EAN32 and EAN36 (also named Nitrox I and Nitrox II, respectively, or Nitrox68/32 and Nitrox64/36).
In its early days of introduction to non-technical divers, nitrox has occasionally also been known by detractors by less complimentary terms, such as "devil gas" or "voodoo gas" (a term now sometimes used with pride). These percentages are what the gas blender aims for in partial-pressure blending, but the final actual mix in such cases will be unique, and so a small flow of gas from the cylinder must be measured with a handheld oxygen analyzer, before the diver breathes from the cylinder underwater.
Richness of mix
The two most common recreational diving nitrox mixes contain 32% and 36% oxygen, which have maximum operating depths (MODs) of 34 metres (112 ft) and 29 metres (95 ft) respectively when limited to a maximum partial pressure of oxygen of 1.4 bar (140 kPa). Divers may calculate an equivalent air depth to determine their decompression requirements or may use nitrox tables or a nitrox-capable dive computer.    Nitrox with more than 40% oxygen is uncommon within recreational diving. There are two main reasons for this: the first is that Technical divers preparing for a mixed-gas decompression dive in Bohol, Philippines. Note the backplate and wing setup with sidemounted stage tanks all pieces of diving equipment that come containing EAN50 (left side) and pure oxygen (right side). into contact with mixes containing higher proportions of oxygen, particularly at high pressure, need special cleaning and servicing to reduce the risk of fire.  The second reason is that richer mixes extend the time the diver can stay underwater without needing decompression stops far further than the duration of typical diving cylinders. For example, based on the PADI nitrox recommendations, the maximum operating depth
Nitrox for EAN45 would be 21 metres (69 ft) and the maximum dive time available at this depth even with EAN36 is nearly 1 hour 15 minutes: a diver with a breathing rate of 20 litres per minute using twin 10 litre, 230 bar (about double 85 cu. ft.) cylinders would have completely emptied the cylinders after 1 hour 14 minutes at this depth. Usage of nitrox mixtures containing 50% to 80% oxygen is common in technical diving as a decompression gas, which by virtue of its lower partial pressure of inert gases such as nitrogen and helium, allows for more efficient (faster) elimination of these gases from the tissues than leaner oxygen mixtures. In deep open circuit technical diving, where hypoxic gases are breathed during the bottom portion of the dive, a Nitrox mix with 50% or less oxygen called a "travel mix" is sometimes breathed during the beginning of the descent in order to avoid hypoxia. Normally, however, the most oxygen-lean of the diver's decompression gases would be used for this purpose, since descent time spent reaching a depth where bottom mix is no longer hypoxic is normally small, and the distance between this depth and the MOD of any nitrox decompression gas is likely to be very short, if it occurs at all.
Any cylinder containing any blend of gas other than the standard air content is required by most diving training organizations to be clearly marked. Some organizations, e.g. GUE, argue that it does not make sense to have a permanent marking on a gas tank that can be filled with any gas. The standard nitrox cylinder is yellow in color and marked with a green band around the shoulder of the tank, with Nitrox or "Enriched air" marked in white or yellow letters inside. Tanks of any other color are generally marked with six inch band around the shoulder, with a one inch yellow band on the top and bottom, with four inches of green in the middle. This green band will also have the designation of "NITROX" or something similar inside, in yellow or white letters. Every nitrox cylinder should also have a sticker stating whether or not the cylinder is oxygen clean and suitable for partial pressure blending. Any oxygen clean cylinder may have any mix up to 100% oxygen inside. If by some accident an oxygen clean cylinder is filled at a station which does not supply gas to oxygen-clean standards it is then considered contaminated and must be re-cleaned before a gas containing more than 40% oxygen may again be added. Cylinders marked as not-oxygen clean may only be filled with enriched oxygen mixtures from membrane or stick blending systems where the gas is mixed before being added to the cylinder. Finally, all nitrox cylinders should have a tag that, at minimum, states the oxygen content of the cylinder, the date it was blended, the gas blender's name, and the maximum operating depth along with the partial pressure this depth was calculated with. Other requirements Cylinder showing Nitrox band and sticker marked with MOD and O2% may be made as to what is marked on the cylinder, but these markings are considered standard and safe by the diving community, and any cylinders lacking these markings should be considered possibly unsafe. Training for nitrox certification suggests this tag be verified by the diver himself by using an oxygen analyzer.
Diving and handling nitrox raises a number of potentially fatal dangers due to the high partial pressure of oxygen (ppO2).  Nitrox is not a deep-diving gas mixture owing to the increased proportion of oxygen, which becomes toxic when breathed at high pressure. For example, the maximum operating depth of nitrox with 36% oxygen, a popular recreational diving mix, is 29 metres (95 ft) to ensure a maximum ppO2 of no more than 1.4 bar (140 kPa). The exact value of the maximum allowed ppO2 and maximum operating depth varies depending on factors such as the training agency, the type of dive, the breathing equipment and the level of surface support, with professional divers sometimes being allowed to breath higher ppO2 than those recommended to recreational divers. To dive safely with nitrox, the diver must learn good buoyancy control, a vital part of scuba diving in its own right, and a disciplined approach to preparing, planning and executing a dive to ensure that the ppO2 is known, and the maximum operating depth is not exceeded. Most dive shops, dive operators, and gas blenders require the diver to have a nitrox certification card before selling nitrox to divers. Some training agencies, such as Technical Diving International, teach the use of two depth limits to protect against oxygen toxicity. The shallower depth is called the "maximum operating depth" and is reached when the partial pressure of oxygen in the breathing gas reaches 1.4 bar (140 kPa). The deeper depth, called the "contingency depth", is reached when the partial pressure reaches 1.6 bar (160 kPa). Diving at or beyond this level exposes the diver to the risk of central nervous system (CNS) oxygen toxicity. This can be extremely dangerous since its onset is often without warning and can lead to drowning, as the regulator may be spat out during convulsions, which occur in conjunction with sudden unconsciousness (general seizure induced by oxygen toxicity). Divers trained to use nitrox memorise the acronym VENTID-C (which stands for Vision (blurriness), Ears (ringing sound), Nausea, Twitching, Irritability, Dizziness, and Convulsions). However, evidence from non-fatal oxygen convulsions indicates that most convulsions are not preceded by any warning symptoms at all. Further, many of the suggested warning signs are also symptoms of nitrogen narcosis, and so may lead to misdiagnosis by a diver. A solution to either is to ascend to a shallower depth.
Precautionary procedures at the fill station
Many training agencies such as PADI, CMAS, SSI and NAUI train their divers to personally check the oxygen percentage content of each nitrox cylinder before every dive. If the oxygen percentage deviates by more than 1% from the value written on the cylinder by the gas blender, the scuba diver must either recalculate his or her bottom times with the new mix, or else abort the dive to remain safe and avoid oxygen toxicity or decompression sickness. Under IANTD and ANDI rules for use of nitrox, which are followed by most dive resorts around the world, filled nitrox cylinders are signed out personally in a gas blender log book, which contains, for each cylinder and fill, the cylinder number, the measured oxygen percent composition, the signature of the receiving diver (who should have personally measured the oxygen percent with an instrument at the fill-shop), and finally a calculation of the maximum operating depth for that fill/cylinder. All of these steps minimize danger but increase complexity of operations (for example, personalized cylinders for each diver must generally be kept track of on dive boats with nitrox, which is not the case with generic compressed air cylinders).
and when DEMA relented. This was considered dangerous by some. In 1991. in the USN Diving Manual. in a watershed moment. regulation intended for commercial divers (not recreational divers) years ago. began instituting diving procedures for oxygen-enriched air. A few facilities have begun to fill cylinders with air which has been enriched with oxygen by a pre-mixing process. the annual DEMA show (held in Houston.. formed IAND (International Association of Nitrox Divers) and began teaching nitrox use for recreational diving. In 1979 NOAA published Wells' procedures for the scientific use of nitrox in the NOAA Diving Manual.  In 1985 Dick Rutkowski. even if a recognized fire does not happen. For many years Dr. 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. 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. In 1970. However. Texas that year) banned nitrox training providers from the show. oxygen "servicability"). who was the first director of the National Oceanographic and Atmospheric Administration (NOAA) Diving Center. Morgan Wells. Partial blending using pure oxygen is often used to provide nitrox for multiple dives on live-aboard dive boats. and met with heavy skepticism by the diving community. At present. Dr. nitrox which is mixed before being put into the cylinder) below 40% oxygen does not require a specially cleaned cylinder or other equipment.PADI .e.5% oxygen should be treated as nitrox (which is to say. History In the 1920s or 1930s Draeger of Germany made a nitrox backpack independent air supply for a standard diving suit. any gas which contains a significantly larger percentage of oxygen than air is a fire hazard. a number of organisations took the opportunity to present nitrox workshops outside the show. a former NOAA diving safety officer. Some of the controversy comes from a single U. This created a backlash. In the 1950s the United States Navy (USN) documented enriched oxygen gas procedures for military use of what we today call nitrox. 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. Furthermore. such gases can also react with hydrocarbons or incorrect lubricants inside a dive cylinder to produce carbon monoxide.is still teaching that pre-mixed nitrox (i. For a history of this controversy see Luxfer cylinders  . In 1992 BSAC banned its members from using nitrox. However.   Most nitrox fill stations which supply pre-mixed nitrox will fill non-oxygen clean cylinders with mixtures below 40%. However.S. Compressed Gas Association (CGA) and two international nitrox teaching agencies (IANTD and ANDI) now support the standard that any gas containing more than 23. 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.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).S.e. . These developments were kept secret until independently duplicated by civilians in the 1960s. the largest training agency . the U. so that it is pressurized as nitrox for the first time in the diving cylinder. He also developed a process for mixing oxygen and air which he called a continuous blending system. Wells' invention was the only practical alternative to partial pressure blending. In World War II or soon after. but it is also used in some smaller diver shops. no differently from pure oxygen) for purposes of oxygen cleanliness and oxygen compatibility (i.
which does not happen with gases with have greater narcotic qualities.  "How does nitrox make you feel?" (http:/ / www. Fagraeus. in 1992 NAUI became the first existing major sport diver training agency to sanction nitrox. pp.. 800. uk/ encyc/ 1008. Adolfson. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society) 22 (1): 41–9. . ScubaBoard. L. Pollock NW. PMID 14756231. but instead of cheap or free tank fills with compressed air.  Hesser. United States: Saunders Ltd. "Measurement of fatigue following 18 msw dry chamber dives breathing air or enriched air nitrox" (http:/ / archive." (http:/ / archive. org/ 4855). T. com/ forums/ basic-scuba-discussions/ poll-1630-a.  Hamilton K. "Dissociation of the behavioral and subjective components of nitrogen narcosis and diver adaptation" (http:/ / archive. including Ed Betts' American Nitrox Divers International (ANDI) . Retrieved 2008-05-02. 5th Rev ed. Retrieved 2008-05-02. Fowler B (March 1995). (2001). 5th Rev ed. . Laliberté MF. it was PADI's endorsement that put nitrox over the top as a standard sport diving "option.7 times more narcotic than nitrogen . Retrieved 2009-01-27. html).  Lang. In: Brueggeman P. oxygen. Helium is considered to have very little narcotic effect. In 1993 Skin Diver magazine. Retrieved 2008-04-08. Retrieved 2009-05-21. (2001).A. htm) .. Md: Undersea and Hyperbaric Medical Society) 5 (4): 391–400. diving stores were finding a purely economic reason to offer nitrox: not only was an entire new course and certification needed to use it. Tom S (2003). scubaboard. PMID 7742709. With the new dive computers which could be programmed to allow for the longer bottom-times and shorter residual nitrogen times which nitrox gave. J (1978).  Harris RJ.g. the T being added when the European Association of Technical Divers (EATD) merged with IAND.  Ergogenic Aids (http:/ / www. 304. rubicon-foundation. An intersection of economics and scientific validity had occurred. 660. PMID 734806. Alf O.. Undersea Biomedical Research (Bethesda. Against this trend. Diving for Science 2008.and Bret Gilliam's Technical Diving International (TDI) gave scientific credence to nitrox.which invented the term "Safe Air" for marketing purposes . org/ 2810). It is clear that different gases result in different narcotic effects at depth. In the early 1990s. rubicon-foundation. published a three part series arguing that nitrox was unsafe for sport divers.. pponline. but results in HPNS when breathed at high pressures. CM.  Oxygen has the potential to be 1. Measurement of Fatigue following 18 msw Open Water Dives Breathing Air or EAN36. 197. pp. "Roles of nitrogen." 54 Nitrox in nature Sometimes in the geologic past the Earth's atmosphere contained much more than 20% oxygen: e. DAN Nitrox Workshop Proceedings (http:/ / archive. United States: Best Publishing. eds. NC: Divers Alert Network. OCLC 2068005. the Professional Association of Diving Instructors (PADI) announced full educational support for nitrox. ISBN 0702025712. called the Bridge. Neuman (2003). Retrieved 2009-05-21. dive shops found they could charge premium amounts of money for custom-gas blending of nitrox to their ordinary moderately experienced divers. ISSN 0093-5387. NOAA Diving Manual: Diving for Science and Technology. Doolette DJ. org/ 8005.see relevant narcotic potency of gases  Although oxygen appears chemically more narcotic at the surface. Proceedings of the American Academy of Underwater Sciences 27th Symposium. up to 35% in the Upper Carboniferous. M. Fourth Edition. Bennett and Elliott's physiology and medicine of diving.. the leading recreational diving publication at the time. org/ 2199). S. United States: Saunders Ltd. 2007. In 1993 Dive Rite manufactured the first nitrox compatible dive computer. the incentive for the sport diver to use the gas increased. While other main line scuba organizations had announced their support of nitrox earlier. A. Williams DJ (2003). Plato PA. J.  References  Brubakk. Meanwhile. . ISBN 0702025712. Bennett and Elliott's physiology and medicine of diving. rubicon-foundation. O. relative narcotic effects at depth have never been studied in detail. rubicon-foundation. Neuman. and carbon dioxide in compressed-air narcosis. Wilkinson DC. pp. . This let animals absorb oxygen more easily and influenced evolution. org/ 3975).  Brubakk. In 1996. T. New organizations. the agencies teaching nitrox were not the main scuba agencies. Durham. Undersea and Hyperbaric Medicine (Undersea and Hyperbaric Medical Society) 30 (4): 285–91.Nitrox In 1992 the name was changed to the International Association of Nitrox and Technical Divers (IANTD). rubicon-foundation. http:/ / archive. p. co.  Chapman SD. .  Joiner. ISBN 0941332705.
"Guide for Oxygen Compatibility Assessments on Oxygen Components and Systems. South Pacific Underwater Medicine Society Journal 26 (3). com/nitrox_calc.  A position which it would formally maintain until in 1995 magazine editor Bill Gleason was reported to say that nitrox was "all right". United States: US Naval Sea Systems Command. 6th revision (http:/ / www. .Nitrox  Elliott. Balboa. John. Retrieved 2011-01-11. "Equivalent air depth: fact or fiction" (http:/ / archive.) Proceedings of the American Academy of Underwater Sciences Twelfth Annual Scientific Diving Symposium "Diving for Science 1992". org/ 00c3_publications. LB. (1992). D (1996). Alan W. 375. . Steven J. Alf O. Robert W. Tom S. reprinted in South Pacific Underwater Medicine Society Journal 26 (3).co. United States: Saunders. asp?destPage=00c3& pageID=3. Retrieved 2008-04-24. "Nitrox" (http:/ / archive. at pages 9-11  Allen. warns if a critical limit is reached (http://www. (American Academy of Underwater Sciences). University of Texas. ISSN 0813-1988. 40(5) May: 35-36.  TDI. Diver 1995. rubicon-foundation.htm) • Useful Luxfer FAQ on the CGA and "40% rule" controversy (http://www. JA (1961). "28". In Brubakk. americandivecenter. Retrieved 2008-05-01. Shoffstall MS. "The PADI Enriched Air Diver course and DSAT oxygen exposure limits. In: Cahoon. TX 78712.  Richardson.  Berghage Thomas E. OCLC 66524750. Nitrox Gas Blending Manual. pp. Republic of Panama Accepted 28 October 1997. 1992 at the University of North Carolina at Wilmington.uk/pages/misc/Nitrox. AMERICAN JOURNAL OF SCIENCE 289. McCraken TM (December 1979). org/ 6309). Undersea Biomedical Research 6 (4): 379–84. Publications. ROBERT DUDLEY* Department of Zoology.luxfercylinders.  http:/ / www. org/ 3835).dive-hive. Glen L. United States Navy Experimental Diving Unit Technical Report NEDU-RR-01-61. org/ 9033). htm  R.gasdiving. Simon J (October 2005). Wilmington. org/ 2835). K (1996). NASA Johnson Space Center Technical Report NASA/TM-2007-213740. com/ nitrox/ preview_p03. Held September 24-27. OCLC 51607923. luxfercylinders. Bennett and Elliott's physiology and medicine of diving (5th ed. Austin. rubicon-foundation. Mastro.  Butler. A NEW MODEL FOR ATMOSPHERIC OXYGEN OVER PHANEROZOIC TIME.html) .php?lang=en) • Diving Nitrox (http://dive-center. C (1996). Thom. rubicon-foundation.  ATMOSPHERIC OXYGEN." (http:/ / archive. ISSN 0813-1988.A. html  Rosales KR.CANFIELD (1989. pp. Retrieved 2008-05-02. 2006.shtml) • Online Nitrox calculator for EAD. . . rubicon-foundation.org/diving-nitrox.  http:/ / www. 55 Footnotes External links • Nitrox . NC. 403–4. Hulbert. PO Box 2072.). Victoria. . org/ 6310). org/ 6275). MOD and PPO2. "Oxygen under pressure"." (http:/ / archive. ISBN 097522901X. Retrieved 2008-05-01. supsalv. 9). Stephen R (2003).333-361. ISBN 0702025712. OCLC 16986801.BERNER AND D. Skin Diver would later go into bankruptcy. Deeper into Diving (2 ed. Neuman.  Logan. OCLC 16986801.L. Hamilton Jr. com/ support/ faq/ aluminumoxygen. p. James M.). Retrieved 2008-06-05. rubicon-foundation. Mitchell. "Oxygen safety in the production of enriched air nitrox breathing mixtures. com/ pages/ mainpage.  Lippmann. . OCLC 16986801. shtml  US Navy Diving Manual. Australia: J. Stoltzfus JM (2007). (ed. rubicon-foundation. Retrieved 2008-05-02. . published on WWW 24 March 1998. org/ 4861). USA and Smithsonian Tropical Research Institute. ISSN 0813-1988. andihq.frequently asked questions (http://www.E. .  Clark. "An evaluation of the equivalent air depth theory" (http:/ / archive. PMID 538866. "BSAC gives the OK to nitrox.com/support/faq/ aluminumoxygen. D and Shreeves." (http:/ / archive. rubicon-foundation." (http:/ / archive. GIANT PALEOZOIC INSECTS AND THE EVOLUTION OF AERIAL LOCOMOTOR PERFORMANCE.  http:/ / www. Retrieved 2008-05-02. South Pacific Underwater Medicine Society Journal 26 (3).
those on high concentrations of supplemental oxygen (particularly premature babies). It is also known as oxygen toxicity syndrome. in the long term. The US Food and Drug Administration has warned those suffering from problems such as heart or lung disease not to use oxygen bars. The result of breathing elevated concentrations of oxygen is hyperoxia. after the researchers who pioneered its discovery and description in the late 19th century. Severe cases can result in cell damage and death. oxygen intoxication. These protocols have resulted in the increasing rarity of seizures due to oxygen toxicity.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.8 987. the central nervous system condition was called the Paul Bert effect. Studies show that. The  subject in the centre is breathing 100% oxygen from a mask. and the pulmonary condition the Lorrain Smith effect. Symptoms may include disorientation. the collapse of the alveoli in the lungs. . In recent years. Protocols for avoidance of hyperoxia exist in fields where oxygen is breathed at higher-than-normal partial pressures.8    D018496 Oxygen toxicity is a condition resulting from the harmful effects of breathing molecular oxygen (O2) at elevated partial pressures. with pulmonary and ocular damage being mainly confined to the problems of managing premature infants. and vision changes such as myopia. Pulmonary and ocular toxicity result from longer exposure to elevated oxygen levels at normal pressure. The chamber is pressurised with air to 3. with effects most often seen in the central nervous system. and seizures. breathing problems.7 bar. lungs and eyes. Historically. retinal detachment. an excess of oxygen in body tissues. Prolonged or very high oxygen concentrations can cause oxidative damage to cell membranes. hyperbaric medicine. Central nervous system toxicity is caused by short exposure to high concentrations of oxygen at greater than atmospheric pressure. oxygen has become available for recreational use in oxygen bars. and oxygen poisoning. and should have specific training in using such gases. Oxygen toxicity is managed by reducing the exposure to elevated oxygen levels. a robust recovery from most types of oxygen toxicity is possible. ICD-10 ICD-9 MeSH T59. and those undergoing hyperbaric oxygen therapy. Scuba divers use breathing gases containing up to 100% oxygen. The body is affected in different ways depending on the type of exposure. Oxygen toxicity is a concern for scuba divers. neonatal care and human spaceflight. including underwater diving using compressed breathing gases.
3 bar (30 kPa). particularly to newborn infants. high oxygen concentrations may contribute to bone damage. effects on other tissues may be observed: it is suspected that during spaceflight. Oxygen toxicity is not associated with hyperventilation. Oxidative damage may occur in any cell in the body but the effects on the three most susceptible organs will be the primary concern. and general damage to cells. and thyroid). because breathing air at atmospheric pressure always has a partial pressure of oxygen (ppO2) of 0. and is of concern to divers who encounter greater than atmospheric pressures.  damage to liver (hepatic). Pulmonary and ocular damage are most likely to occur when supplemental oxygen is administered as part of a treatment. Central nervous system oxygen toxicity can cause seizures. producing three principal forms:   • Central nervous system. but are also a concern during hyperbaric oxygen therapy.  In unusual circumstances. • Ocular (retinopathic conditions). gonads. . endocrine glands (adrenal. occurring when breathing elevated pressures of oxygen for extended periods. characterised by alterations to the eyes. • Pulmonary (lungs). causing pain and difficulty in breathing. Hyperoxia can also indirectly cause carbon dioxide narcosis in patients with lung ailments such as chronic obstructive pulmonary disease or with central respiratory depression. characterised by convulsions followed by unconsciousness. occurring when breathing elevated pressures of oxygen for extended periods. occurring under hyperbaric conditions. brief periods of rigidity followed by convulsions and unconsciousness. heart (myocardial). Pulmonary oxygen toxicity results in damage to the lungs.   or kidneys (renal).21 bar (21 kPa) and the lower limit for toxicity is more than 0. It may also be implicated in red blood cell destruction (hemolysis).Oxygen toxicity 57 Classification The effects of oxygen toxicity may be classified by the organs affected. characterised by difficulty in breathing and pain within the chest. Oxidative damage to the eye may lead to myopia or partial detachment of the retina.
  Tests in animals have indicated a variation in tolerance similar to that found in central nervous system toxicity. irritability (personality changes. lip-twitching. confusion.   This begins as a mild tickle on inhalation and progresses to frequent coughing. exposure time before onset is unpredictable. as tests have shown a wide variation. many external factors. When the exposure to oxygen above 0.   In addition. Nausea and vertigo. twitch L arm. However. increase tolerance in test animals. spasmodic respiration. paraesthesiae. If breathing elevated partial pressures of oxygen is not discontinued. patients experience a mild burning on inhalation along with uncontrollable coughing and occasional shortness of breath (dyspnea). both amongst individuals. such as darkness and caffeine. anxiety. Decrease of tolerance is closely linked to retention of carbon dioxide.   Other factors. Nausea and confusion Dazed and lip-twitching. epigastric aura. and increased blood flow to the lining of the nose (hyperemia of the nasal mucosa). Dazed Nausea. Severe nausea Central nervous system Central nervous system oxygen toxicity manifests as symptoms such as visual changes (especially tunnel vision). but these effects have not been proven in humans. such as underwater immersion. . "Diaphragmatic spasm". twitching (especially of the face). followed by rapid spasms of alternate muscle relaxation and contraction producing convulsive jerking (clonic). etc. and dizziness.  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).  Pulmonary function measurements are reduced. Inspiratory predominance. nausea. amnesia Convulsed. exposure to cold. Dazzle. Blubbering of lips. epigastric aura. Drowsiness. The radiological finding from the lungs shows inflammation and swelling (pulmonary edema). fever. vertigo. Severe lip-twitching. Euphoria. as well as significant variations between species. lip-twitching and syncope. fell asleep.). 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. ringing in the ears (tinnitus).) 96 60–69 50–55 31–35 21–30 16–20 11–15 6–10 Num. of Subjects 1 3 4 4 6 8 4 6 Symptoms Prolonged dazzle. severe spasmodic vomiting Severe lip-twitching.Oxygen toxicity 58 Signs and symptoms Oxygen Poisoning at 90 ft (27 m) in the Dry in 36 Subjects in Order of Performance – K W Donald Exposure (mins.  The onset of seizure depends upon the partial pressure of oxygen (ppO2) in the breathing gas and exposure duration. and in the same individual from day to day. Vertigo and severe lip twitching. The symptoms appear in the upper chest region (substernal and carinal regions). arm twitch Severe lip-twitching. Physical findings related to pulmonary toxicity have included bubbling sounds heard through a stethoscope (bubbling rales). it permits the lungs to recover and delays the onset of toxicity. Convulsed Convulsed.5 bar (50 kPa) is intermittent. The seizure ends with a period of unconsciousness (the postictal state). and exercise will decrease the time to onset of central nervous system symptoms. vertigo. This may be followed by a tonic–clonic seizure consisting of two phases: intense muscle contraction occurs for several seconds (tonic).
 Experiments on rats show pulmonary manifestations of oxygen toxicity are not the same for normobaric conditions as they are for hyperbaric conditions. with evidence of diffuse alveolar damage and the onset of acute respiratory distress syndrome usually occurring after 48 hours on 100% oxygen.  Divers breathing air at depths greater than 60 m (200 ft) face an increasing risk of an oxygen toxicity "hit" (seizure). Causes Oxygen toxicity is caused by exposure to oxygen at partial pressures greater than those to which the body is normally exposed. (II) the demarcation becomes a ridge. or ROP) are observed via an ophthalmoscope as a demarcation between the vascularized and non-vascularised regions of an infant's retina. to partial pressures of oxygen above 1. particularly to premature infants. where ambient pressure is above normal. (III) growth of new blood vessels occurs around the ridge. the risk factors are markedly different. corresponding to an oxygen fraction of 50% at normal atmospheric pressure. Therefore. Since atmospheric pressure is about 1 bar (100 kPa). Preterm newborns are known to be at higher risk for bronchopulmonary dysplasia with extended exposure to high concentrations of oxygen. are exposed to the highest concentration of oxygen in the human body and are therefore the first organs to show toxicity. Other groups at higher risk for oxygen toxicity are patients on mechanical ventilation with exposure to levels of oxygen greater than 50%. typically nitrogen. after an asymptomatic period between 4 and 22 hours at greater than 95% oxygen. Central nervous system toxicity Exposures. current guidelines for patients on mechanical ventilation in intensive care suggests keeping oxygen concentration less than 60%. and patients exposed to chemicals that increase risk for oxygen toxicity such the chemotherapeutic agent bleomycin.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. 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. (IV) the retina begins to detach from the inner wall of the eye (choroid). Divers breathing a gas mixture enriched with oxygen. This occurs in three principal settings: underwater diving. in addition to any oxygen exposure during the dive. should they descend below the maximum depth allowed for the mixture. Breathing 100% oxygen also eventually leads to collapse of the alveoli (atelectasis).5 bar (50 kPa). will prevent this effect. as well as the remainder of the respiratory tract. central nervous system toxicity can only occur under hyperbaric conditions. signs of damage to the eye (retinopathy of prematurity. 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. Likewise. . 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. such as nitrox. Pulmonary toxicity The lungs.Oxygen toxicity 59 Ocular In premature babies. while—at the same partial pressure of oxygen—the presence of significant partial pressures of inert gases. Signs of pulmonary toxicity begins with evidence of tracheobronchitis. with some studies suggesting symptoms usually begin after approximately 14 hours at this level of oxygen. can similarly suffer a seizure at shallower depths. The degree of this demarcation is used to designate four stages: (I) the demarcation is a line. hyperbaric oxygen therapy and the provision of supplemental oxygen. Pulmonary toxicity occurs with exposure to concentrations of oxygen greater than 0. or inflammation of the upper airways. In each case. from minutes to a few hours.
  While all the reaction mechanisms of these species within the body are not yet fully understood. High concentrations of oxygen also increase the formation of other free radicals. When oxygen is breathed at high partial pressures. and trioxidane.Oxygen toxicity 60 Ocular toxicity Prolonged exposure to high inspired fractions of oxygen causes damage to the retina.  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.  It is usually reversible with time. is not the main risk factor for development of this disease. which can initiate a damaging chain reaction of lipid peroxidation in the unsaturated lipids within cell membranes. one of the most reactive products of oxidative stress is the hydroxyl radical (·OH). and the blood supplies it to all parts of the body. During times of environmental stress. and the rate of cell damage exceeds the capacity of the systems that prevent or repair it. most vulnerable. since axial length and keratometry readings do not reveal a corneal or length basis for a myopic shift. Higher than normal concentrations of oxygen lead to increased levels of reactive oxygen species. a hyperoxic condition will rapidly spread. such as nitric oxide.  In preterm infants. peroxynitrite. Supplemental oxygen exposure. Retinopathy of prematurity occurs when the development of the retinal vasculature is arrested and then proceeds abnormally. these systems are eventually overwhelmed at very high concentrations of free oxygen. which can damage cell structures and produce oxidative stress. Hyperoxic myopia has occurred in closed circuit oxygen rebreather divers with prolonged exposures. and may raise the risk of hypoxia-related systemic complications. the retina is often not fully vascularised.   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. Associated with the growth of these new vessels is fibrous tissue (scar tissue) that may contract to cause retinal detachment. Restricting supplemental oxygen use does not necessarily reduce the rate of retinopathy of prematurity.  Hyperoxia may be a contributing factor for the disorder called retrolental fibroplasia or retinopathy of prematurity (ROP) in infants.   It also occurs frequently in those undergoing repeated hyperbaric oxygen therapy. .   Cell damage and cell death then result. levels of reactive oxygen species can increase dramatically. the superoxide anion (O2–). 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.  This is due to an increase in the refractive power of the lens. One species produced by the body. is possibly involved in iron acquisition. which harm DNA and other biomolecules. which are natural by-products of the normal metabolism of oxygen and have important roles in cell signalling. while a risk factor.  Although the body has many antioxidant systems such as glutathione that guard against oxidative stress. Oxygen is necessary for cell metabolism.
divers are taught to plan and monitor what is called the oxygen clock of their dives. Premature infants commonly require supplemental oxygen to treat complications of preterm birth. The diver may experience no warning symptoms.2 bar (120 kPa). 180 minutes at 1. unless there is a prior history of epilepsy or tests indicate hypoglycemia. and cylinders containing such mixtures must be clearly marked with that depth. long dives and dives where oxygen-rich breathing gases are used. low birth weight and a history of oxygen exposure are the principal indicators. 120 minutes at 1.6 bar (160 kPa). However. 150 minutes at 1. a seizure occurring in the setting of breathing oxygen at partial pressures greater than 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. 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.  In some diver training courses for these types of diving. 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. 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.4 bar (140 kPa) suggests a diagnosis of oxygen toxicity. Both underwater and in space. However.  Many Nitrox-capable dive computers calculate an oxygen loading and can track it across multiple dives.3 bar (130 kPa) and 210 minutes at 1. 28 metres. Prevention The prevention of oxygen toxicity depends entirely on the setting. As there is an marked with a maximum operating depth of increased risk of central nervous system oxygen toxicity on deep dives. In either case. blood tests and x-rays may be used to confirm bronchopulmonary dysplasia. dizziness. This is a notional alarm clock. congestion and coldness.  For the following partial pressures of oxygen the limit is: 45 minutes at 1.5 bar (150 kPa). As the ppO2 depends on the fraction of oxygen in the breathing gas and the depth of the dive. Diagnosis of bronchopulmonary dysplasia in new-born infants with breathing difficulties is difficult in the first few weeks. if the infant's breathing does not improve during this time. The diagnosis of retinopathy of prematurity in infants is typically suggested by the clinical setting. the diver obtains more time on the oxygen clock by diving at a shallower depth. divers are taught to calculate a maximum operating depth for oxygen-rich breathing gases. In addition. Prematurity. while no hereditary factors have been shown to yield a pattern. but is impossible to predict with any reliability whether or when toxicity symptoms will occur. an echocardiogram can help to eliminate other possible causes such as congenital heart defects or pulmonary arterial hypertension. ear problems. Underwater A seizure caused by oxygen toxicity to the central nervous system is a deadly but avoidable event while diving. during which victims can lose their regulator and The label on the diving cylinder shows that it drown. proper precautions can eliminate the most pernicious effects.Oxygen toxicity 61 Diagnosis Diagnosis of central nervous system oxygen toxicity in divers prior to seizure is difficult as the symptoms of visual disturbance.4 bar (140 kPa). these symptoms may be helpful in diagnosing the first stages of oxygen toxicity in patients undergoing hyperbaric oxygen therapy. The effects are sudden convulsions and unconsciousness. confusion and nausea can be due to many factors common to the underwater environment such as narcosis. by .
because the oxygen partial pressure is not allowed to chronically exceed 0.9 atm (190 kPa) over 30 minutes on oxygen. One or two days of exposure without oxygen breaks are needed to cause such damage. The National Cooperative Study in 1954 showed a causal link between supplemental oxygen and retinopathy of prematurity.Oxygen toxicity breathing a less oxygen-rich gas. . This is illustrated by modern pure oxygen use in spacesuits.4 bar (140 kPa). producing a trimix. table 6 requires 75 minutes (three periods of 20 minutes oxygen/5 minutes air) at an ambient pressure of 2. which must operate at low pressure (also historically. Retinopathy of prematurity is largely preventable by screening.S. The U. The patient then remains at that pressure for a further 150 minutes. For example. The limited duration and naturally intermittent nature of most diving makes this a relatively rare (and even then. equivalent to a depth of 18 metres (60 ft). In such applications as extra-vehicular activity.3 lb) should be screened for retinopathy of prematurity at least every two weeks. so a gas mixture must be used which contains less than 21% oxygen (a hypoxic mixture).3 bar (4. high-fraction oxygen is non-toxic. Normobaric setting Bronchopulmonary dysplasia is reversible in the early stages by use of break periods on lower pressures of oxygen. helium is not narcotic.8 standard atmospheres (280 kPa).N. not merely by high oxygen fraction. U.   62 Hyperbaric setting The presence of a fever or a history of seizure is a relative contraindication to hyperbaric oxygen treatment.4 psi). for example. even at breathing mixture fractions approaching 100%. Pulmonary oxygen toxicity is an entirely avoidable event while diving. Increasing the proportion of nitrogen is not viable. but subsequent curtailment of supplemental oxygen caused an increase in infant mortality. or by shortening the duration of exposure to oxygen-rich gases. Guidelines have been established that allow divers to calculate when they are at risk of pulmonary toxicity. 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. but it may eventually result in irreversible lung injury if allowed to progress to severe damage. reversible) complication for divers. Hypobaric setting In low-pressure environments oxygen toxicity may be avoided since the toxicity is caused by high partial pressure of oxygen. and therefore prevent retinal changes following repetitive hyperbaric oxygen exposures. and a usable mixture may be blended either by completely replacing nitrogen with helium (the resulting mix is called heliox). consisting of two periods of 15 minutes air/60 minutes oxygen. before the pressure is reduced to atmospheric over 30 minutes on oxygen. Vitamin E and selenium were proposed and later rejected as a potential method of protection against pulmonary oxygen toxicity. modern protocols now require monitoring of blood oxygen levels in premature infants receiving oxygen. since it would produce a strongly narcotic mixture.  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. or by replacing part of the nitrogen with helium.   There is however some experimental evidence in rats that vitamin E and selenium aid in preventing in vivo lipid peroxidation and free radical damage. This is followed by a slow reduction in pressure to 1. Current guidelines require that all babies of less than 32 weeks gestational age or having a birth weight less than 1.5 kg (3. To balance the risks of hypoxia and retinopathy of prematurity.S. Navy uses treatment tables based on periods alternating between 100% oxygen and air. the Gemini and Apollo spacecraft). However. very high percentage oxygen and lower than normal atmospheric pressure was used in early spacecraft.
Upon reaching the surface. owing to the danger of arterial gas embolism. thereby dropping the partial pressure of oxygen inspired below 0. Where supplemental oxygen is required for treatment of another disease (particularly in infants). Seizures during the therapy are managed by removing the mask from the patient. 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 an increase in the break periods where normal air is supplied. Reductions in pressure and exposure will be made progressively and medications such as bronchodilators and pulmonary surfactants may be used. 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).Oxygen toxicity 63 Management During hyperbaric oxygen therapy.  . Retinopathy of prematurity may regress spontaneously. both cryosurgery and laser surgery have been shown to reduce the risk of blindness as an outcome. However. An overview of these studies by Bitterman in 2004 concluded that following removal of breathing gas containing high fractions of oxygen. This brings the wall of the eye respiratory distress syndrome is treated by lowering the fraction of into contact with the detached retina. the patient will usually breathe 100% oxygen from a mask. Prognosis Although the convulsions caused by central nervous system oxygen toxicity may lead to incidental injury to the victim. Although for many years the recommendation has been not to raise the diver during the seizure itself. and carry out a controlled buoyant lift. blue) is placed The occurrence of symptoms of bronchopulmonary dysplasia or acute around the eye. Rescuers need to ensure that their own safety is not compromised during the convulsive phase. no long-term neurological damage from the seizure remains.S. 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. while inside a hyperbaric chamber pressurised with air to about 2. Lifting an unconscious body is taught by most diver training agencies. but should the disease progress beyond a threshold (defined as five contiguous or eight cumulative hours of stage 3 retinopathy of prematurity). The U. They then ensure that the victim's air supply is established and maintained. along with a reduction in the periods of exposure retina to re-attach. allowing the oxygen administered. A seizure underwater requires that the diver is brought to the surface as soon as practicable. Where the disease has progressed further. emergency services are always contacted as there is a possibility of further complications requiring medical attention.6 bar (60 kPa). a ventilator may be needed to ensure that the lung tissue remains inflated. techniques such as scleral buckling and vitrectomy surgery may assist in re-attaching the retina. The silicone band (scleral buckle. The retina (red) is detached at the top of the eye. Navy has procedures for completing the decompression stops where a recompression chamber is not immediately available. they are likely be more susceptible to respiratory infections for the rest of their lives and the severity of later infections is often greater than that in their peers.  The majority of infants who have survived following an incidence of bronchopulmonary dysplasia will eventually recover near-normal lung function.8 bar (280 kPa).
Oxygen toxicity Retinopathy of prematurity (ROP) in infants frequently regresses without intervention and eyesight may be normal in later years. Where the disease has progressed to the stages requiring surgery, the outcomes are generally good for the treatment of stage 3 ROP, but are much worse for the later stages. Although surgery is usually successful in restoring the anatomy of the eye, damage to the nervous system by the progression of the disease leads to comparatively poorer results in restoring vision. The presence of other complicating diseases also reduces the likelihood of a favourable outcome.
The incidence of central nervous system toxicity among divers has decreased since the Second World War, as protocols have developed to limit exposure and partial pressure of oxygen inspired. In 1947, Donald recommended limiting the depth allowed for breathing pure oxygen to 7.6 m (25 ft), or a ppO2 of 1.8 bar (180 kPa). This limit has been reduced, until today a limit of 1.4 bar (140 kPa) during a recreational dive and 1.6 bar (160 kPa) during shallow decompression stops is accepted. Oxygen toxicity has now become a rare occurrence other than when caused by equipment malfunction and Retinopathy of prematurity (ROP) is more common in middle income countries where neonatal intensive care services are increasing; but greater awareness of the problem, human error. Historically, the U.S.  leading to preventive measures, has not yet occurred. Navy has refined its Navy Diving Manual Tables to reduce oxygen toxicity incidents. Between 1995 and 1999, reports showed 405 surface-supported dives using the helium–oxygen tables; of these, oxygen toxicity symptoms were observed on 6 dives (1.5%). As a result, the U.S. Navy in 2000 modified the schedules and conducted field tests of 150 dives, none of which produced symptoms of oxygen toxicity. Revised tables were published in 2001. The variability in tolerance and other variable factors such as workload have resulted in the U.S. Navy abandoning screening for oxygen tolerance. Of the 6,250 oxygen-tolerance tests performed between 1976 and 1997, only 6 episodes of oxygen toxicity were observed (0.1%).  Central nervous system oxygen toxicity among patients undergoing hyperbaric oxygen therapy is rare, and is influenced by a number of a factors: individual sensitivity and treatment protocol; and probably therapy indication and equipment used. A study by Welslau in 1996 reported 16 incidents out of a population of 107,264 patients (0.015%), while Hampson and Atik in 2003 found a rate of 0.03%.  Yildiz, Ay and Qyrdedi, in a summary of 36,500 patient treatments between 1996 and 2003, reported only 3 oxygen toxicity incidents, giving a rate of 0.008%. A later review of over 80,000 patient treatments revealed an even lower rate: 0.0024%. The reduction in incidence may be partly due to use of a mask (rather than a hood) to deliver oxygen. Bronchopulmonary dysplasia is among the most common complications of prematurely born infants and its incidence has grown as the survival of extremely premature infants has increased. Nevertheless, the severity has decreased as better management of supplemental oxygen has resulted in the disease now being related mainly to
Oxygen toxicity factors other than hyperoxia. In 1997 a summary of studies of neonatal intensive care units in industrialised countries showed that up to 60% of low birth weight babies developed retinopathy of prematurity, which rose to 72% in extremely low birth weight babies, defined as less than 1 kg (2.2 lb) at birth. However, severe outcomes are much less frequent: for very low birth weight babies—those less than 1.5 kg (3.3 lb) at birth—the incidence of blindness was found to be no more than 8%.
Central nervous system toxicity was first described by Paul Bert in 1878.  He showed that oxygen was toxic to insects, arachnids, myriapods, molluscs, earthworms, fungi, germinating seeds, birds, and other animals. Central nervous system toxicity may be referred to as the "Paul Bert effect". Pulmonary oxygen toxicity was first described by J. Lorrain Smith in 1899 when he noted central nervous system toxicity and discovered in experiments in mice and birds that 0.43 bar (43 kPa) had no effect but 0.75 bar (75 kPa) of oxygen was a pulmonary irritant. Pulmonary toxicity may be referred to as the "Lorrain Smith effect". The first recorded human exposure was undertaken in 1910 by Bornstein when two men breathed oxygen at 2.8 bar (280 kPa) for 30 minutes while he went on to 48 minutes with no symptoms. In 1912, Bornstein developed cramps in his hands and legs while breathing oxygen at Paul Bert, a French physiologist, first described oxygen toxicity in 1878. 2.8 bar (280 kPa) for 51 minutes. Smith then went on to show that intermittent exposure to a breathing gas with less oxygen permitted the lungs to recover and delayed the onset of pulmonary toxicity. Albert R. Behnke et al. in 1935 were the first to observe visual field contraction (tunnel vision) on dives between 1.0 bar (100 kPa) and 4.1 bar (410 kPa).  During World War II, Donald and Yarbrough et al. performed over 2,000 experiments on oxygen toxicity to support the initial use of closed circuit oxygen rebreathers.  Naval divers in the early years of oxygen rebreather diving developed a mythology about a monster called "Oxygen Pete", who lurked in the bottom of the Admiralty Experimental Diving Unit "wet pot" (a water-filled hyperbaric chamber) to catch unwary divers. They called having an oxygen toxicity attack "getting a Pete".  In the decade following World War II, Lambertsen et al. made further discoveries on the effects of breathing oxygen under pressure as well as methods of prevention.  Their work on intermittent exposures for extension of oxygen tolerance and on a model for prediction of pulmonary oxygen toxicity based on pulmonary function are key documents in the development of standard operating procedures when breathing elevated pressures of oxygen. Lambertsen's work showing the effect of carbon dioxide in decreasing time to onset of central nervous system symptoms has influenced work from current exposure guidelines to future breathing apparatus design.   Retinopathy of prematurity was not observed prior to World War II, but with the availability of supplemental oxygen in the decade following, it rapidly became one of the principal causes of infant blindness in developed countries. By 1960 the use of oxygen had become identified as a risk factor and its administration restricted. The resulting fall in retinopathy of prematurity was accompanied by a rise in infant mortality and hypoxia-related complications. Since then, more sophisticated monitoring and diagnosis have established protocols for oxygen use which aim to balance between hypoxic conditions and problems of retinopathy of prematurity. Bronchopulmonary dysplasia was first described by Northway in 1967, who outlined the conditions that would lead to the diagnosis. This was later expanded by Bancalari and in 1988 by Shennan, who suggested the need for supplemental oxygen at 36 weeks could predict long-term outcomes. Nevertheless, Palta et al. in 1998 concluded that radiographic evidence was the most accurate predictor of long-term effects.
Oxygen toxicity Bitterman et al. in 1986 and 1995 showed that darkness and caffeine would delay the onset of changes to brain electrical activity in rats.  In the years since, research on central nervous system toxicity has centred on methods of prevention and safe extension of tolerance. Sensitivity to central nervous system oxygen toxicity has been shown to be affected by factors such as circadian rhythm, drugs, age, and gender.    In 1988, Hamilton et al. wrote procedures for the National Oceanic and Atmospheric Administration to establish oxygen exposure limits for habitat operations.   Even today, models for the prediction of pulmonary oxygen toxicity do not explain all the results of exposure to high partial pressures of oxygen.
Society and culture
Recreational scuba divers commonly breathe nitrox containing up to 40% oxygen, while technical divers use pure oxygen or nitrox containing up to 80% oxygen. Divers who breathe oxygen fractions greater than in air (21%) need to be trained in the dangers of oxygen toxicity and how to prevent them. In order to buy nitrox, a diver has to show evidence of such qualification. Since the late 1990s the recreational use of oxygen has been promoted by oxygen bars, where customers breathe oxygen through a nasal cannula. Claims have been made that this reduces stress, increases energy, and lessens the effects of hangovers and headaches, despite the lack of any scientific evidence to support them. There are also devices on sale that offer "oxygen massage" and "oxygen detoxification" with claims of removing body toxins and reducing body fat. The American Lung Association has stated "there is no evidence that oxygen at the low flow levels used in bars can be dangerous to a normal person's health", but the U.S. Center for Drug Evaluation and Research cautions that people with heart or lung disease need their supplementary oxygen carefully regulated and should not use oxygen bars. Victorian society had a fascination for the rapidly expanding field of science. In "Dr. Ox's Experiment", a short story written by Jules Verne in 1872, the eponymous doctor uses electrolysis of water to separate oxygen and hydrogen. He then pumps the pure oxygen throughout the town of Quiquendone, causing the normally tranquil inhabitants and their animals to become aggressive and plants to grow rapidly. An explosion of the hydrogen and oxygen in Dr Ox's factory brings his experiment to an end. Verne summarised his story by explaining that the effects of oxygen described in the tale were his own invention. There is also a brief episode of oxygen intoxication in his "From the Earth to the Moon".
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The Practice of Oxygen Measurement for Divers. United States: Saunders Ltd. Retrieved 2009-06-29. (1999). New York: Thieme. Harry W. ISBN 0-946020-18-3. • Regillo. OCLC 44018369. Alf O. Navy Supervisor of Diving (2008) (PDF). ISBN 0-86577-761-6. ISBN 0-7020-2571-2. mp4. (1947). "Pulmonary oxygen tolerance in man and derivation of pulmonary oxygen tolerance curves" (http://archive. 1-70 (Philadelphia.667. 358–418. The Diving Emergency Handbook. 693 pages. In Brubakk. (1998). "Oxygen poisoning in man—part I".Oxygen toxicity 71 Sources • Clark. John. Durham. 86MB).. Oxygen and the diver.org/dspace/simple-search?query=oxygen+ toxicity&submit=Go). Retrieved 2008-09-20. Naval Sea Systems Command. revision 6. Thom. OCLC 39170393.. ISBN 0-9752290-1-X. – Wide and detailed discussion of the effects of breathing oxygen on the respiratory system.). Victoria. "Oxygen poisoning in man—part II". U.htm). Flynn.4507. 237 pages. Retrieved 2008-04-29.712. Stan (1993).org/3863). Gary C. (1947). UK: Harley Swan. (1992).1. doi:10. John S..S. SS521-AG-PRO-010. Lambertsen.rubicon-foundation. Revised version of Donald's articles also available as: Donald. Simon (2005). Mitchell. Further reading • Lamb. John M. – 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. • Lippmann.org/FastAccess/ 2008TechnicalDiving. (2003). Flagstaff: Best Publishing. • Lang. "Oxygen under pressure".. Michael A.S. British Medical Journal 1 (4507): 712–7. IFEM Report No. British Medical Journal 1 (4506): 667–72. Institute for Environmental Medicine.rubicon-foundation. • Donald. "Oxygen". 121–4.org/ 4855). Carl D. Neuman. . Christian J. Vitreoretinal Disease: The Essentials. • Donald. • Clark. External links General The following external site is a compendium of resources: • Rubicon Research Repository (http://archive. U.aspx). Publications. DAN nitrox workshop proceedings (http://archive. • U. Tom S. (ed. OCLC 66524750. Richard Vann (free download. ISBN 0-941332-68-3. • Lippmann. – Video of "Oxygen Toxicity" lecture by Dr. pp. Australia: J. UK: Underwater World Publications. Teddington..lib. pp.1136/bmj. PMC 2053400. Deeper into Diving (2nd ed.diversalertnetwork. Kenneth W.mcg. ISBN 1-85421-176-5.). PA: Environmental Biomedical Stress Data Center. (1970). 197 pages. 120 pages. OCLC 51607923. James M. Kenneth W. Stephen R. • Physiology at MCG 4/4ch7/s4ch7_7 (http://www. PMC 2053251. Navy Diving Manual (http://supsalv. NC: Divers Alert Network.L. OCLC 26894235. Brown. doi:10.S. University of Pennsylvania Medical Center).pdf). Kenneth W. OCLC 52056845. John.edu/edu/eshuphysio/program/section4/4ch7/ s4ch7_7.1. Bennett and Elliott's physiology and medicine of diving (5th ed.org/pdf/ DiveMan_rev6. Bugg.4506. PMID 20248086.) (2001). PMID 20248096.1136/bmj.rubicon-foundation.
This general property of gasses is also true of chemical reactions of gasses in biology. the necessary amount of oxygen for human respiration. For example.Oxygen toxicity • Rajiah. the partial pressure of a gas in a mixture of gases is defined as above. given an ideal gas mixture of nitrogen (N2). eMedicine. Prabhakar (2009-03-11). This is true across a very wide range of different concentrations of oxygen present in various inhaled breathing gases.com/article/ 406564-overview). The partial pressure of a gas is a measure of thermodynamic activity of the gas's molecules. is set by the partial pressure of oxygen alone. 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. Gases dissolve. the faster the flow. and not according to their concentrations in gas mixtures or liquids. and the amount that is toxic.medscape. For example. 72 Partial pressure In a mixture of ideal gases. "Bronchopulmonary Dysplasia" (http://emedicine. 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) . diffuse. In chemistry. Retrieved 2009-06-29. each gas has a partial pressure which is the pressure which the gas would have if it alone occupied the volume. Gases will always flow from a region of higher partial pressure to one of lower pressure. – Concise clinical overview with extensive references. Actual real-world gases come very close to this ideal. and react according to their partial pressures. 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. the larger this difference. This is because ideal gas molecules are so far apart that they don't interfere with each other at all. The total pressure of a gas mixture is the sum of the partial pressures of each individual gas in the mixture. or dissolved in blood. 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.
the mole fraction of an individual gas component in an ideal gas mixture can be expressed in terms of the component's partial pressure or the moles of the component: and the partial pressure of an individual gas component in an ideal gas can be obtained using this expression: where: = mole fraction of any individual gas component in a gas mixture = partial pressure of any individual gas component in a gas mixture = moles of any individual gas component in a gas mixture = total moles of the gas mixture = total pressure of the gas mixture The mole fraction of a gas component in a gas mixture is equal to the volumetric fraction of that component in a gas mixture. to focus on one particular gas component. That is.g. oxygen. e.g. It can be approximated both from partial pressure and molar fraction:  • • • • • • Vx is the partial volume of any individual gas component (X) Vtot is the total volume in gas mixture Px is the partial pressure of gas X Ptot is the total pressure in gas mixture nx is the amount of substance of a gas (X) ntot is the total amount of substance in gas mixture .Partial pressure 73 Ideal gas mixtures Ideally the ratio of partial pressures is the same as the ratio of molecules. 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. and is useful in gas mixtures. e. with unchanged pressure and temperature.
e. As can be seen in the chart. The vapor pressure chart to the right has graphs of the vapor pressures versus temperatures for a variety of liquids. such as: the equilibrium constant of the reaction would be: . liquid or solid). the lower the normal boiling point of the liquid.Partial pressure 74 Vapor pressure Vapor pressure is the pressure of a vapor in equilibrium with its non-vapor phases (i. It also has the lowest normal boiling point (-43. The higher the vapor pressure of a liquid at a given temperature. Most often the term is used to describe a liquid's tendency to evaporate. 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. It is a measure of the tendency of molecules and atoms to escape from a liquid or a solid. the liquids with the highest vapor pressures have the lowest normal boiling points.7 °C). For a reversible reaction involving gas reactants and gas products. propane has the highest vapor pressure of any of the liquids in the chart.. 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. 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. at any given temperature. For example.
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. As can be seen by comparing equations (1) and (2) is the reciprocal of . changes in the total pressure. the reaction kinetics may either oppose or enhance the equilibrium shift. This statement is known as Henry's Law and the equilibrium constant is quite often referred to as the Henry's Law constant. Since both may be 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. . is also 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. 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. However. Henry's Law is an approximation that only applies for dilute. 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). In some cases. the reaction kinetics may be the over-riding factor to consider. The equilibrium constant for that equilibrium is: (1) where: = the equilibrium constant for the solvation process = partial pressure of gas = the concentration of gas in equilibrium with a solution containing some of the gas in the liquid solution The form of the equilibrium constant shows that the concentration of a solute gas in a solution is directly proportional to the partial pressure of that gas above the solution.   Henry's Law is sometimes written as: (2) where above.
16 bar (16 kPa) absolute. of 120 minutes at 1. ca. owlnet. = 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. pdf) Rice University chemistry class notes (http:/ / www. Hypoxia and sudden unconsciousness becomes a problem with an oxygen partial pressure of less than 0.16 bar 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. D. us/ webdocs/ GasLaw/ Gas-Dalton. of 180 minutes at 1. ac. based on an equivalent narcotic depth of 35 metres (115 ft). uk/ sciences/ reference/ plambeck/ chem2/ p01182. 1 bar of atmospheric pressure + 5 bar of water pressure) and the partial pressures of the main components of air. becomes a problem when oxygen partial pressure is too high. edu/ pchem/ C443/ Lectures/ Lecture33.79 = 4. edu/ ~mccarthy/ che0035/ MB/ single/ ideal. intute. ISBN 0-07-049841-5. Oxygen toxicity. Perry's Chemical Engineers' Handbook (7th ed.H. McGraw-Hill. pitt.W.e. of 150 minutes at 1. involving convulsions. htm) University of Delaware physical chemistry lecture (http:/ / www. 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. edu/ ~chem312/ Class Summaries/ Class12. 2008.2 bar absolute.21 = 1. rice. html) Pittsburgh University chemical engineering class notes (http:/ / granular.5 bar absolute.). Perry.6 bar absolute. at 50 metres (165 feet).4 bar absolute. Nitrogen narcosis is a problem when breathing gases at high pressure. html) Page 200 in: Medical biophysics. Dalton's Law of Partial Pressures (http:/ / dbhs. (Editors) (1997). the total absolute pressure is 6 bar (600 kPa) (i.. the maximum total partial pressure of narcotic gases used when planning for technical diving is 4. 6th Edition. Typically.7 bar absolute ppO2 = 6 bar x 0. chem. Using diving terms. and Green. The NOAA Diving Manual recommends a maximum single exposure of 45 minutes at 1. References          Charles Henrickson (2005). in the terms used in this article = volume fraction of gas component i = mole fraction. html) . udel.5 bar absolute. Cliffs Notes. html) University of Arizona chemistry class notes (http:/ / www. che. The partial pressure of oxygen determines the maximum operating depth of a gas mixture. edu/ ~salzmanr/ 103a004/ nts004/ l41/ l41. Flemming Cornelius.3 bar absolute and of 210 minutes at 1. k12. Chemistry. wvusd.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 . oxygen 21% by volume and nitrogen 79% by volume are: ppN2 = 6 bar x 0. R. ISBN 0-764-57419-1. Oxygen toxicity becomes a risk when these oxygen partial pressures and exposures are exceeded. arizona. Intute University Introductory Chemistry (http:/ / www.
As the diver goes deeper. which has to be replaced from the air supply. Thus. the body consumes oxygen and makes carbon dioxide. This recycling reduces the volume of breathing gas used. 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. Because exhaled air can contain as much as 79% nitrogen (which is not utilized in the body) and 16% (or more) unused oxygen. The rebreather adds oxygen. to replace the oxygen that was consumed. for all intents and purposes. • Hospital anaesthesia breathing systems – to supply controlled proportions of gases to patients without letting anaesthetic gas get into the atmosphere that the staff breathe. . which otherwise would accumulate and cause carbon dioxide poisoning.  It absorbs the carbon dioxide. The remaining oxygen is exhaled along with nitrogen and carbon dioxide. which represents an increasingly smaller fraction of the compressed air breathed in. 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. roughly the same quantity of oxygen is used. Everest in 1938. or CCUBA = "closed circuit underwater breathing apparatus". A high rate of system failures due to extreme cold has not been solved. a vacuum where there is no oxygen to support life. Both chemical and compressed oxygen has been used in experimental closed-circuit oxygen systems—the first on Mt. "semi closed scuba". In the armed forces it is sometimes called "CCUBA" (Closed Circuit Underwater Breathing Apparatus). "closed circuit scuba". potentially useful gas volume. SCR = "semi closed rebreather". The rebreather recirculates the exhaled gas for re-use and does not discharge it to the atmosphere or water. Here the rebreather is big and is connected to the air in the habitat. • Mine rescue and in industry – where poisonous gases may be present or oxygen may be absent.Rebreather 77 Rebreather A rebreather is a type of breathing set that provides a breathing gas containing oxygen and recycled exhaled gas. 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). Rebreather technology is used in many environments: • Underwater – where it is sometimes known as CCR = "closed circuit rebreather". At shallow depths. every exhaled breath from an open-circuit scuba set represents at least 95% wasted. which is known as "open circuit scuba". the gas in the rebreather's circuit remains breathable and supports life and the diver needs only a fraction of the gas that would be required for an open-circuit system. Theory As a person breathes. • Himalayan mountaineering. • Crewed spacecraft and space suits – outer space is. as opposed to Aqua-Lung-type equipment. It removes the carbon dioxide by a process called scrubbing.
Another systematic use of rebreathers for diving was by Italian sport spearfishers in the 1930s. That may explain how Drebbel's men were not affected by carbon dioxide build-up as much as would be expected. to rescue mineworkers who were trapped by water. the Siebe Gorman Salvus and the Siebe Gorman Proto. . both invented in the early 1900s) were descended from it. as in the illustration below. invented some years sooner by an engineer of the Dräger company. 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). which developed its frogman unit Decima Flottiglia MAS.N. The first recorded mass production of rebreathers started in 1912 with the Dräger rebreathers. were those used by the German helmet divers during World War II. their fullface masks were the type intended for the Siebe Gorman Salvus. he likely generated oxygen by heating saltpetre (potassium nitrate) in a metal pan to make it emit oxygen. In 1853 Professor T. R.  The Davis Escape Set was the first rebreather which was practical for use and produced in quantity. It was designed about 1900 in Britain for escape from Royal Navy frogman in 1945 sunken submarines. which is a form of sodium peroxide (Na2O2) or sodium dioxide (NaO2). Records show that. Cornelius Drebbel made an early oar-powered submarine. he accidentally made a crude rebreather more than two centuries before Saint Simon Sicard's patent. to re-oxygenate the air inside it. Some British armed forces divers used bulky thick diving suits called Sladen suits. invented Oxylithe. Schwann designed a rebreather in Belgium.. the Royal Navy accepted it. Rees. If so. leading to a fullface mask with one big face window. he exhibited it in Paris in 1878. In World War II captured Italian frogmen's rebreathers influenced design of British frogmen's rebreathers. it was used in the first filming (1907) of Twenty Thousand Leagues Under the Sea. in front they had a rubber collar that was clamped around the absorbent canister. 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.  In 1903 to 1907 Professor Georges Jaubert. It was used for shallow water diving but never in a submarine escape.Rebreather 78 History of rebreathers Around 1620 in England..N. Various industrial oxygen rebreathers (e. O. That would turn the saltpetre into potassium oxide or hydroxide. later British frogman's rebreathers had a square recess in the top so they could extend further up onto his shoulders. In 1909 Captain S. The Dräger rebreathers. but the ends curved back to allow more vision sideways). The oldest known rebreather used an oxygen reservoir and relates to the 1849 patent from the Frenchman Pierre Aimable De Saint Simon Sicard. As it absorbs carbon dioxide it emits oxygen. Early British frogman's rebreathers had rectangular breathing bags on the chest like Italian frogman's rebreathers. developed a submarine escape apparatus using Oxylithe. which would tend to absorb carbon dioxide from the air around. This practice came to the attention of the Italian Navy. at first oval like in this image. Those first breathing sets may have been modified Davis Submarine Escape Sets.g. Hall. R. especially the DM40 model series. Hermann Stelzner. which was used effectively in World War II.S. Many British frogmen's breathing sets' oxygen cylinders were German pilot's oxygen cylinders recovered from shot-down German Luftwaffe planes. this link shows a Draeger rebreather used for mines rescue in 1907. But in later operations different designs were used. and later rectangular (mostly flat. and Dr.
the diver is not using any more of the O2 gas supply than when shallower. For example. the amount of O2 consumption doesn't change. This leaves the available oxygen utilization at about 25%. It is not uncommon for a 3 litre (19 cubic foot) diluent cylinder to last for eight 40 m (130 ft) dives. the remaining 75% is lost. Most modern rebreathers have a system of very sensitive oxygen sensors. which then supports the growth of rust. This means that at depth. Christian J. the advantage of a rebreather is even more marked.6 bar is toxic . A breath inhaled from an open circuit scuba system whose cylinders are filled with ordinary air is about 21% oxygen. in order to shorten decompression times. 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. This can offer a dramatic advantage at the end of deeper dives. 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 lack of exhale also allows shipwreck divers to enter enclosed areas on sunken ships and avoid slowly filling them with air. Care must be taken that the ppO2 is not set to a level where it can become toxic though. this can conceal military divers and allow divers engaged in marine biology and underwater photography to avoid alarming marine animals and thereby get closer to them. closed circuit rebreathers produce no bubbles and make no bubble noise and much less gas hissing. Research has shown that a ppO2 of 1. by maintaining a specific and relatively high oxygen partial pressure (ppO2) at all depths. unlike open-circuit scuba. The economy of gas consumption is also useful when the gas mix being breathed contains expensive gases. the diver on open-circuit scuba only uses about 5% of his cylinders' contents.5% of O2 is converted to CO2 on exhalation). it has an oxygen level in the range of 15 to 16% when the diver is at atmospheric pressure. A very small amount of trimix would then last for many dives. When that breath is exhaled back into the surrounding environment. due to venting of the gas on ascent.  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. Since the generation of CO2 is directly related to the body's consumption of O2 (about ~99. where a diver can raise the partial pressure of oxygen somewhat at shallower depth. they could turn off their diluent. such as helium.  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. however most of that in circuit is lost. the entire breath is expelled into the surrounding water when the diver exhales. The fully closed circuit rebreather is able to minimise the proportion of inert gases in the breathing mix. Lambertsen for underwater warfare and is considered by the US Navy as "the father of the Frogmen". no diluent is added. As the remaining 79% of the breathing gas (mostly nitrogen) is inert. a closed circuit rebreather diver effectively doesn't use any of their diluent gas once they've reached the bottom phase of the dive.Rebreather In the early 1940s US Navy rebreathers were developed by Dr. which allow the diver to adjust the partial pressure of oxygen. At depth. only oxygen is consumed: small volumes of expensive inert gases are reused during (only) one dive. In normal use. With open circuit scuba. Other advantages Except on ascent. This is a marked difference from open circuit where the amount of gas used is directly proportional to the depth. On ascent. and therefore minimise the decompression requirements of the diver. therefore CO2 generation doesn't change.
Oxygen rebreathers are also sometimes used when decompressing from a deep open-circuit dive. and enters the lungs at a much higher volume than it occupied in the cylinder. 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. As the oxygen in the vented gas cannot be separated from the inert gas. The only gas that it supplies is oxygen. However. have a deeper maximum operating depth than oxygen rebreathers and are fairly simple and cheap. they are still the most commonly used for industrial applications on the surface. and the diver had to operate the valve at intervals to refill the breathing bag as he used the oxygen.g. some say 9 meters (30 ft). Some simple oxygen rebreathers had no constant-flow valve. In the Salvus there is no second stage and the gas is turned on and off at the cylinder. Simplified diagram of the loop in a semi-closed circuit rebreather . because the diver is circulating a roughly constant volume of gas between his lungs and the breathing bag. When an open-circuit scuba diver inhales. the Siebe Gorman Salvus. As pure oxygen is toxic when inhaled at pressure. Simplified diagram of the loop in an oxygen rebreather The diving pioneer Hans Hass used Dräger oxygen rebreathers in the early 1940s. In some rebreathers. Oxygen rebreathers are no longer commonly used in diving because of the depth limit imposed by oxygen toxicity. e. Oxygen rebreathers can be remarkably simple designs. the oxygen cylinder has two first stages in parallel. This does not happen to a rebreather diver. but only the bypass. due to their simplicity and compact size. In the past they have been used deeper (up to 20 meters) but such dives were more risky than what is now considered acceptable. a quantity of highly compressed gas from his cylinder is reduced in pressure by a regulator. and lower slightly with each exhalation. as breathing pure oxygen makes the nitrogen diffuse out of the blood more rapidly. The gas is injected into the loop at a constant rate to replenish oxygen consumed from the loop by the diver.Rebreather with extended exposure One major difference between rebreather diving and open-circuit scuba diving is in keeping neutral buoyancy. and their invention predates that of open-circuit scuba. the other is a plain on-off valve called a bypass. This means that the diver has a tendency to rise slightly with each inhalation. (SCBA) such as in mines. One is constant flow. Excess gas must be constantly vented from the loop in small volumes to make space for fresh. Semi-closed circuit equipment generally supplies one breathing gas such as air or nitrox or trimix. Semi-closed circuit rebreather Military and recreational divers use these because they provide better underwater duration than open circuit. oxygen rebreathers are currently limited to a depth of 6 meters (20 ft). semi-closed circuit is wasteful of oxygen. 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. oxygen-rich gas. both feed into the same exit pipe which feeds the breathing bag.
which gives off oxygen as it absorbs carbon dioxide: 4KO2 + 2CO2 = 2K2CO3 + 3O2. Adding diluent can prevent the loop's gas mixture becoming too oxygen rich. In fully automatic closed-circuit systems. Tests on the IDA71 at the United States Navy Experimental Diving Unit in Panama City. leading to oxygen toxicity. known as the oxygen partial pressure. Non-simplified diagram of the loop in a semi-closed circuit rebreather Fully closed circuit rebreather Military. The diver may be able to manually control the mixture by adding diluent gas or oxygen. the Oxylite) which had an absorbent canister filled with potassium superoxide. Florida showed that the IDA71 could give significantly longer dive time with superoxide in one of the canisters than without. This system is dangerous because of the explosively hot reaction that happens if water gets on the potassium superoxide. Manually adding oxygen is risky as additional small volumes of oxygen in the loop can easily raise the partial pressure of oxygen to dangerous levels. a mechanism injects oxygen into the loop when it detects that the partial pressure of oxygen in the loop has fallen below the required level. Too low a concentration of oxygen results in hypoxia leading to sudden unconsciousness and ultimately death. A higher gas injection rate reduces the likelihood of hypoxia but consumes more gas and wastes more oxygen.g. . it had a very small oxygen cylinder to fill the loop at the start of the dive. in the loop and to warn the diver if it is becoming dangerously low or high.Rebreather 81 As the amount of oxygen required by the diver increases with work rate. 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. 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. The Russian IDA71 military and naval rebreather was designed to be run in this mode or as an ordinary rebreather. Too high a concentration of oxygen results in hyperoxia. the gas injection rate must be carefully chosen and controlled to prevent unconsciousness in the diver due to hypoxia. and can lead to drowning. photographic. 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. The concentration of oxygen in the loop depends on two factors: depth and the proportion of oxygen in the mix. The major task of the fully closed circuit rebreather is to control the oxygen concentration. and recreational divers use these because they allow long dives and produce no bubbles. a condition causing convulsions which can make the diver lose the mouthpiece when they occur underwater.
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.g. Cryogenic rebreathers were widely used in Soviet oceanography in the period 1980 to 1990. • This link  describes an experimental drysuit (with built-in hood and fullface mask) and rebreather combination where the drysuit acts as the breathing bag. Its ppO2 could be set to anything from 0. Cryogenic rebreather A cryogenic rebreather has a tank of liquid oxygen and no absorbent canister. corresponding to an oxygen consumption of 2 liters per minute. • Aerorlox  • Cryogenic rebreather: see below.  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.Rebreather 82 Rebreathers which store liquid oxygen If used underwater. thus controlling the equilibrium pressure of oxygen gas above the liquid. like in an old Draeger standard diving suit variant which had a rebreather pack attached.2 bar to 2 bar without electronics. As a result. . They include these types: • Aerophor. The set could freeze out 230 grams of carbon dioxide per hour from the loop. The diluent could be either liquid nitrogen or helium depending on the depth of the dive. industrial sets of this type may not be suitable for diving. the Siebe Gorman CDBA) had a backpack weight pouch instead of the diver having a separate weight belt. The set's liquid oxygen tank must be filled immediately before use. • Some British naval rebreathers (e. by controlling the temperature of the liquid oxygen. a regular scrubber was needed. and diving sets of this type may not be suitable for use out of water. It had a duration of 6 hours and a maximum dive depth of 200 meters of salt water. If oxygen was consumed faster (high workload). The carbon dioxide is frozen out in a "snow box" by the cold produced as the liquid oxygen expands to gas as the oxygen is used and is replaced from the oxygen tank. the liquid-oxygen tank must be well insulated against heat coming in from the water.
such as pure nitrogen or helium.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. and is breathable. Depending on the rebreather design variant. There may be valves allowing venting of gas from the loop. with the casing opened Pure oxygen is not considered to be safe for recreational diving deeper than 6 meters. Attached to the loop there will be at least one valve allowing injection of gases. The diver breathes through a mouthpiece or a fullface mask (or with industrial breathing sets. it may be used in an emergency either to flush the loop with breathable gas or as a bailout. This holds gas when it is not in the diver's lungs. such as oxygen and perhaps a diluting gas. or if the diver's lips get slack letting water leak in. Back of a closed circuit rebreather. Nearly always. this oxygen is stored in a gas cylinder. all types have a gas-tight loop that the diver inhales from and exhales into. The diluent reduces the percentage of oxygen breathed and increases the maximum operating depth of the rebreather. 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. from a gas source into the loop. Regardless of whether the rebreather in question has the facility to trap any ingress of water. This diluent cylinder may be filled with compressed air or another diving gas mix such as nitrox or trimix. . The loop consists of components sealed together. so recreational rebreathers and many professional diving rebreathers also have a cylinder of diluent gas. It is important that the diluent is not an oxygen-free gas. 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. where the inhaled and exhaled gas passes through the same tube in opposite directions. This is connected to one or more tubes bringing inhaled gas and exhaled gas between the diver and a counterlung or breathing bag. Some have a single pendulum hose. sometimes a mouth-and-nose mask). any training on a rebreather will feature procedures for removing any excess water. to stop large volumes of water from entering the loop if the diver removes the mouthpiece underwater without closing the valve. the oxygen source will either be pure or a breathing gas mixture. The loop also includes a scrubber containing carbon dioxide absorbent to remove from the loop the carbon dioxide exhaled by the diver. 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.
but is not useful on diving equipment. 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. thus preventing CO2 from reaching the scrubber material. However. There are several ways that the scrubber may fail or become less efficient: • Complete consumption of the active ingredient ("break through"). Failure prevention • An indicating dye in the soda lime. Dragersorb. this type of carbon dioxide poisoning was called shallow water blackout. a canister full of some suitable carbon dioxide absorbent such as a form of soda lime. of the unreacted soda lime that is exposed to carbon dioxide-laden gas. are not cleaned or lubricated or fitted properly. The carbon dioxide passing through the scrubber absorbent is removed when it reacts with the absorbent in the canister. and the US Navy to describe Micropore's absorbent curtains for emergency submarine use. Some absorbent chemical designed for diving applications are Sofnolime. This front moves through the scrubber canister. It gives rise to a chalky taste. which removes the carbon dioxide from the gas mixture and leaves the oxygen and other gases available for re-breathing. this chemical reaction is exothermic. a rebreather absorbent called "Protosorb" supplied by Siebe Gorman had a red dye. This is useful in dry open environments. or spacers that prevent bypassing of the scrubber. 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. or outside water or gas may get in circuit. In larger environments. because of this effect. This allows the exhaled gas to bypass the absorbent. and then more recently RPC has been used on the web to describe their Reactive Plastic Cartridges – ExtendAir . this may be able to show the position of the reaction "front". the scrubber needs to be bigger than is needed for a shallow-water or industrial oxygen rebreather. which should prompt the diver to switch to an alternative source of breathing gas and rinse his or her mouth out with water. • in below-freezing operation (primarily mountain climbing) the wet scrubber chemicals can freeze when oxygen bottles are changed. Some systems use a prepackaged Reactive Plastic Curtain (RPC) based cartridge: Reactive Plastic Curtain (RPC) was first used between Micropore Inc. Among British naval rebreather divers. and then time to penetrate to the middle of each grain of absorbent as the outside of the grain becomes exhausted.Rebreather 84 Carbon dioxide scrubber The exhaled gases are directed through the chemical scrubber. this front would be a wide zone. as the reaction consumes the active ingredients. • The scrubber canister has been incorrectly packed or configured. If any of the seals. such as recompression chambers. which was said to go white when the absorbent was exhausted. because the carbon dioxide in the gas going through the canister needs time to reach the surface of a grain of absorbent. where: . or Sodasorb. This reaction occurs along a "front" which is a cross section of the canister. Many modern diving rebreather absorbents are designed not to produce "cocktail" if they get wet. from the gas input end to the gas output end. In a rebreather. Scrubber failure The term "break through" means the failure of the "scrubber" to continue removing carbon dioxide from the exhaled gas mix. such as o rings. the scrubber will be less efficient. For example. It changes the colour of the soda lime after the active ingredient is consumed. • A Caustic Cocktail – Soda lime is caustic and can cause burns to the eyes and skin. With a transparent canister. Color indicating dye was removed from US Navy fleet use in 1996 when it was suspected of releasing chemicals into the circuit. In deep diving with a nitrox or other gas-mixture rebreather. a fan is used to pass gas through the canister. • When the gas mix is under pressure caused by depth. A "caustic cocktail" is a mixture of water and soda lime that occurs when the "scrubber" floods.
depending on the granularity and composition of the soda lime. If not enough new oxygen is being added. such as a recompression chamber or a hospital. for example. Effectiveness In rebreather diving. 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. As the reaction between carbon dioxide and soda lime is exothermic. Divers are trained to monitor and plan the exposure time of the soda lime in the scrubber and replace it within the recommended time limit. The diver must monitor the exposure of the scrubber and replace it when necessary. In some dry open environments. along the length of the scrubber can be used to measure the position of the front and therefore the life of the scrubber. Narked at 90 Ltd – Deep Pursuit Advanced electronic rebreather controller. the ambient temperature. • The canister is usually out of sight of the user. 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 resulting serious hypoxia causes sudden blackout with little or no warning. it may be possible to put fresh absorbent in the canister when break through occurs. the urge to breathe is normally caused by a build-up of carbon dioxide in the blood. Such systems are not useful as a tool for monitoring scrubber life when underwater as the onset of scrubber "break through" occurs quite rapidly. the first CO2 detector to be produced for rebreathers in a diving application was patented by Clive Wilcox of Amphilogic. • Temperature monitoring.g. the proportion of oxygen in the loop may be too low to support life. injecting more oxygen if necessary or issuing an audible warning to the diver if the ppO2 reaches dangerously high or low levels. Counterlung . the pressure in the breathing bag controls the oxygen flow like the demand valve in open-circuit scuba. In some modern rebreathers. the design of the rebreather. temperature sensors.Rebreather • A transparent canister would likely be brittle and easily cracked by knocks. 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. • Opening the canister to look inside would flood it with water or let unbreathable external gas in. e. and the size of the canister.  • Diver training. trying to breathe in from an empty bag makes the cylinder release more gas. which monitor the ppO2. At present. • Carbon dioxide gas sensors exist. inside the breathing bag or inside a backpack box. In humans. In others the oxygen flow is kept constant by a pressure-reducing flow valve like the valves on blowtorch cylinders. 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. most likely digital. the set also has a manual on/off valve called a bypass. rather than lack of oxygen. 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 typical effective duration of the scrubber will be half an hour to several hours of breathing. This makes hypoxia a deadly problem for rebreather divers. The loop often has a pressure relief valve to prevent over-pressure injuries caused by over-pressure of the loop.
While this option has the advantages of being permanently mounted on the rebreather and not heavy. In this case the diver needs an alternative breathing source: the bailout. Some are designed as over-the-shoulder lungs (e. Although some rebreather divers—referred to as "alpinists"—do not carry bailouts. in an industrial version of the Siebe Gorman Salvus the breathing bag hangs down by the left hip. has an effect on the ease of breathing. 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. • An independent open-circuit system.g. For use out of water. This is due to the pressure difference between the counterlung and the diver's lung caused by the vertical distance between the two. 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. bailout strategy becomes a crucial part of dive planning. 86 Bailout While the diver is underwater. The design of the rebreathers' counterlungs can also affect the swimming diver's streamlining due to location of the counterlungs themselves. while others incorporate the counter lungs into a solid case (e. The KISS Classic).g. which is designed to change in size by the same volume as the diver's lungs when breathing.Rebreather The counterlung is a flexible part of the loop. 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. the position of the breathing bag. particularly for long dives and deeper dives in technical diving. It is easier to inhale from a front mounted counterlung and exhale to a back mounted counterlung for diver swimming facedown and horizontally. should be sheltered from sunlight when not in use. to prevent the rubber from perishing due to UV light. over the shoulders. • An open-circuit demand valve connected to the rebreather's oxygen cylinder. . • An independent closed-circuit system. or on the back. Underwater. The extra cylinders are heavy and cumbersome but larger cylinders let the diver carry more gas providing protection for the ascent from deeper and long dives. Often the planned dive is limited by the capacity of the bailout and not the capacity of the rebreather. A rebreather whose counterlung is rubber and not in an enclosed casing. the rebreather may fail and be unable to provide a safe breathing mix for the duration of the ascent back to the surface. The breathing gas mix must be carefully chosen to be safe at all depths of the ascent. this does not matter so much: for example. the quantity of gas held by the rebreather is small so the protection offered is low. Innerspace Systems Megalodon). on the chest.
aging oxygen sensors may become "current limited" and fail to measure high partial pressures of oxygen resulting in dangerously high oxygen levels. The scrubber efficiency may be reduced at depth where the increased concentration of other gas molecules. and procedural. which helps to conceal the diver's presence by masking the release of bubbles. In fully closed circuit equipment. The solution to this is to slow down and let the absorbent catch up.) Closed circuit disorders In addition to the other diving disorders suffered by divers. including a hole at the bottom to drain the water out when the diver comes out of water.Rebreather 87 Casing Many rebreathers have their main parts in a hard backpack casing. In closed circuit rebreathers. which raises the partial pressure of oxygen to hyperoxic levels. e. In mountaineering. is completely sealed.g. which reduces the partial pressure of oxygen to hypoxic levels leading to what is sometimes called deep water blackout. for example. such a seal could conceivably cause an unconscious user to suffocate when the oxygen ran out or the scrubber became exhausted. Disadvantages of rebreather diving Risks The percentage of deaths that involve the use of a rebreather among United States and Canadian residents increased from approximately 1 to 5% of the total diving fatalities collected by the Divers Alert Network from 1998 through 2004. except for a large vent panel covered with metal mesh. Divers need to lose any air conservation habits that may have been developed while diving with open-circuit scuba. • Disorientation. panic. to keep the exhaled gas flowing over the carbon dioxide absorbent. 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 is used for mine rescue. headache. The danger is that a sick climber using a rebreather might become unconscious. Because an absolute atmospheric seal is required for rebreathers to work correctly. in the IDA71 and Cis-Lunar. not with the theory of rebreathing): • Sudden blackout due to hypoxia caused by too low a partial pressure of oxygen in the loop. A particular problem when using a closed circuit rebreather is the drop in ambient pressure caused by the ascent phase of the dive. this also has the . 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. failure or inefficiency of the scrubber. Investigations into rebreather deaths focus on three main areas: medical. due to pressure. • The rebreather diver must keep breathing in and out all the time. it must be packed and sealed correctly. so the absorbent can work all the time. and holes for the oxygen cylinder's on/off valve and the cylinder pressure gauge. Diffuser Some military rebreathers have a diffuser over the blowoff valve. (Because there has been very little use of mountaineering rebreathers. In a diving rebreather this needs fairly large holes. • Seizures due to oxygen toxicity caused by too high a partial pressure of oxygen in the loop. equipment. this danger is still only theoretical. to keep grit and stones out of its working. Underwater the casing also serves for streamlining. This can be caused by the rise in ambient pressure caused by the descent phase of the dive. Another problem is the diver producing carbon dioxide faster than the absorbent can handle. closed-circuit rebreathers are ideal to treat various altitude related illnesses as the user is brought back to sea level in terms of oxygen pp. The SEFA. and hyperventilation due to excess of carbon dioxide caused by incorrect configuration. stops all the carbon dioxide molecules reaching the active ingredient of the scrubber. The scrubber must be configured so that no exhaled gas can bypass it. during hard work or fast swimming.
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. rebreathers have some disadvantages including expense. or it may allow carbon dioxide to build up to dangerous levels. These are expensive and susceptible to failure.Rebreather advantage of mixing the gases preventing oxygen-rich and oxygen-lean spaces developing within the loop. Sport diving rebreather technology innovations Over the past ten or fifteen years rebreather technology has advanced considerably. • 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. 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. • Integrated decompression computers – these allow divers to take advantage of the content and generate a schedule of decompression stops. A safe response is to bail out to "open circuit" and rinse the mouth out. An important safety device when carbon dioxide poisoning occurs. such as when using a normoxic diluent and observing the diluent's maximum operating depth. Innovations include: • The electronic. 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. often driven by the growing market in recreational diving equipment. but instead rely on the rebreather. The technique involves simultaneously venting the loop and injecting diluent. The first ever system that was proved to function correctly was patented by Clive Wilcox of Amphilogic. 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. sensors and alarm systems. • 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. complexity of operation and maintenance. • 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. . A malfunctioning rebreather can supply a gas mixture which contains too little oxygen to sustain life. It only works when partial pressure of oxygen in the diluent alone would not cause hypoxia or hyperoxia. improper configuration and misuse. Some rebreather divers prefer not to carry enough bailout for a safe ascent breathing open circuit. The diver is normally alerted to this by a chalky taste in the mouth. and fewer failsafes. believing that an irrecoverable rebreather failure is very unlikely. 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. which may give inaccurate readings to the oxygen control system. Typically rebreathers try to solve these problems by monitoring the system with electronics. • "Caustic cocktail" in the loop if water comes into contact with the soda lime used in the carbon dioxide scrubber.
RANSUM-1-70. Retrieved 2008-04-25. nl/ Zuurstofrebreathers/ German/ theodore_schwann.32:1005-1020. (http:/ / www. org/ research/ treks/ palautz97/ rb. June 1969. N7. ru/ article/ 5567-zhidkaya-voda-zhidkiy-vozduh/ ). . Phillip S (2005). com/ rebreathers/ vision/ scrubbermonitor/ • . "Some limitations of simi-closed rebreathers" (http:/ / archive. org/ 9011). K and Richardson. a specialised website. . popmech. 79. (1996). com/ specials/ special_drebbel. W and Horn.  Warkander. Diving For Science 2005. high altitude oxygen" (http:/ / www. P. "Theoretical Considerations in the Design of Closed Circuit Oxygen Rebreathing Equipment" (http:/ / archive. Retrieved 19 September 2010. Michael. WW. (American Academy of Underwater Sciences). Retrieved 2008-04-25. rubicon-foundation. extendair. PMID 8653065. US Naval Submarine Medical Research Center Technical Report NSMRL-TR-1228. rubicon-foundation. rubicon-foundation. Retrieved 2008-02-23. rubicon-foundation. DE (2007). . org/ 4958). therebreathersite. htm Fischel H. "Chemical safety of U. uk/ rescue/ glossary/ aerorlox. Tolworth. htm)  Vann RD (2004)." (http:/ / archive. Proceedings of the American Academy of Underwater Sciences Symposium on March 10-12. NE (eds. Karl (eds). The Blast 32 (1). In: Godfrey. rubicon-foundation. Vet Clin North Am Small Anim Pract 2002. Retrieved 2008-10-24. Retrieved 2008-06-09. L. org/ 4667). htm). .. dutchsubmarines. nl/ 06_Homebuilders/ secret_rebreather. Surbiton. "Lambertsen and O2: beginnings of operational physiology" (http:/ / archive.  Shreeves. Retrieved 2008-06-13. ru/ biblioteka/ Knigi/ sportsmen_podvodnik_046. School of Underwater Medicine. Closed circuit cryogenic SCUBA. com/ scaphandre/ autonomie/ autonomes_sans_detendeur. "Scuba Bubble Noise and Fish Behavior: A Rationale for Silent Diving Technology. healeyhero. Velocity Press. rubicon-foundation.  Manning AM. JS. Dean. org/ 6039). shtml). "Closed-circuit oxygen diving in the U. (1970). rubicon-foundation. Retrieved 2008-04-25. MA and Smith. №7(81) June 2009" (http:/ / www. RANSUM-4-69. "Mixed-Gas Closed-Circuit Rebreathers: An Overview of Use in Sport Diving and Application to Deep Scientific Diving" (http:/ / archive. Gummin DD. "A History Of Closed Circuit Oxygen Underwater Breathing Apparatus" (http:/ / archive. Marine Technology Society 1970:229-244. nl/ Zuurstofrebreathers/ German/ photos_draeger_1907_rescue_apparatus. Proceedings of Advanced Scientific Diving Workshop Smithsonian Institution. DC. south of France) (http:/ / www. . D. Washington." (http:/ / archive.com. Retrieved 2008-06-14. .  Reynolds. com/ drager. "Seeking New Depths". Undersea Hyperb Med 31 (1): 3–20. South Pacific Underwater Medicine Society Journal 27 (1). • Cushman. Caldwell JM (March 1996). Oxygen therapy and toxicity. School of Underwater Medicine. org/ 7555). org/ 3451).  http:/ / www. html  Elliott.  http:/ / www. D (2006). Connecticut. ISBN 20060725.). Navy Fleet soda lime" (http:/ / archive.  Saint Simon Sicard's invention as mentioned by the Musée du Scaphandre website (a diving museum in Espalion. Retrieved 2008-07-17. . org/ 2238).0. RH (1955). (1997). htm). Surrey: Siebe Gorman & Company Ltd.  Goble." (http:/ / archive. htm  Norfleet. org/ 3986). org/ 3987). . velocitypress. "Closed circuit oxygen system. JM.Rebreather 89 References  Richardson. bishopmuseum. Herron. Royal Australian Navy. USA. Retrieved 2009-01-31. pdf). Undersea Hyperb Med 23 (1): 43–53.  Butler FK (2004). US Navy Experimental Diving Unit Technical Report NEDU-Evaluation-11-68. 2005 at the University of Connecticut at Avery Point. "Carbon Dioxide Scrubbing Capabilities of Two New Non-Powered Technologies" (http:/ / archive. Washington. Drew. . Steve (2003). Undersea Hyperb Med 31 (1): 21–31. Retrieved 2008-06-14. . "Rebreathers" (http:/ / archive.S.  Quick.  Lobel. rubicon-foundation. Sundstrom. apdiving.  http:/ / www. . Retrieved 2011-01-09. and reprinted in Aqua Corps magazine. Retrieved 2008-08-20.  Davis. Shumway. "Proceedings of Rebreather Forum 2.  "Popular mechanics (ru). Popular Mechanics 183 (12): 58. D. Cryogenic Rebreather. . Retrieved 2009-07-17. htm)  Bech. "DEVELOPMENT OF A SCRUBBER GAUGE FOR CLOSED-CIRCUIT DIVING. Dutch Submarines. Retrieved 2008-06-09. rubicon-foundation. Retrieved 2008-06-14. v. ISSN 0813-1988. PMID 15233157. com/ closedcircuit.: 286. p. (1969).  "Sportsmen-podvodnik journal.). rubicon-foundation. Tom (2006). org/ 4960). "Mechanical and Operational Tests of a Russian 'Superoxide' Rebreather. Skin Diver magazine. Deep Diving and Submarine Operations (6th ed. PMID 15233156. rubicon-foundation. JM. (abstract)" (http:/ / archive. Journal of the South Pacific Underwater Medicine Society 33 (2): 98–102.  Holzel. "Theodor Schwann" (http:/ / www.  Hawkins T (1st Quarter 2000). Menduno. com/ productfrm. Navy" (http:/ / archive. OCLC 16986801.  "Cornelius Drebbel: inventor of the submarine" (http:/ / www.. Groton. Undersea Hyperb Med Society Annual Meeting. Ruby A. org/ 5110). In: Lang. 28.  http:/ / www. "OSS Maritime".  Older. Glen Harlan (December 2006). Porter WR. Royal Australian Navy. scubadiving. Retrieved 2008-02-23.  http:/ / www. 693. therebreathersite. W (2003). .S. rubicon-foundation. espalion-12. html  Lillo RS. Janwillem. Shreeves. . "Equipment for the working diver" 1970 symposium. ISSN 0032-4558. 1977" (http:/ / www.  Kelley. org/ 4992). . . co. EB (1968). org/ 7782). SE.  http:/ / www. . htm  Drägerwerk page in Divingheritage. DC. divingheritage. therebreathersite. . rubicon-foundation. Diving Science and Technology Workshop.
. . Ala. ISBN 0-9800423-1-3. Lee DA (2008).  Verdier C.a  Vann RD. may be slow to download • Information on shallow water blackout (http://www. org/ 5110).2. . "Rebreather Fatality Investigation" (http:/ / archive. Nitrox Rebreather Diving. org/ 4855). nl/ 01_Informative/ BOV_page/ BOV_page.  Liddiard. Retrieved 2011-07-30. www. org/ 7981).  "OC – DSV – BOV – FFM page" (http:/ / www. 90 External links • RebreatherPro (http://www. rubicon-foundation. Eaton.com) Free searchable multimedia resource for rebreather divers • Image gallery of LAR-6 and LAR-7 and FGT II and LAR V rebreathers. Motor skills learning and current bailout procedures in recreational rebreather diving. rubicon-foundation.rebreatherpro. Michael A. rubicon-foundation. . and Denoble PJ (2007). John. "Bailout" (http:/ / www.org/ 4960). DAN nitrox workshop proceedings (http:/ / archive. html) and many useful references in its "Further Reading" section • A history of closed circuit oxygen underwater breathing apparatus (http://archive. Defence R&D Canada Technical Report (Defence R&D Canada) (DCIEM 92-06). In: NW Pollock and JM Godfrey (Eds.specwargear. Retrieved 2009-03-31. . Retrieved 2010-12-29. (http:/ / archive. DIRrebreather publishing.  Warkander Dan E (2007). JCB. therebreathersite.: American Academy of Underwater Sciences) Proceedings of the American Academy of Underwater Sciences (Twenty-sixth annual Scientific Diving Symposium).) (2001). including mountaineering rebreathers. NC: Divers Alert Network. and other combat frogman's kit (http:// www. htm).org/research/treks/palautz97/rb. Retrieved 2009-03-03.com/dive&swim.Rebreather  Lang. section 1. rubicon-foundation.co. Undersea and Hyperbaric Medicine Abstract 34. . "Development of a scrubber gauge for closed-circuit diving" (http:/ / archive.com/latenthypoxia. Retrieved 2008-04-25. org/ 7282). rubicon-foundation. uk/ old_site/ photoix/ bailout/ bailout.html) . Retrieved 2009-03-03.nl. Retrieved 2008-06-14.therebreathersite.html) • In-depth explanation on how rebreathers work (http://www. (ed.) the Diving for Science…2007 (Dauphin Island. org/ 6997).rubicon-foundation. 8 November 2010. Pollock NW. jlunderwater." (http:/ / archive. Durham.  Chapple. co. plenty of images. jlunderwater. published in 1970. "Development of the Canadian Underwater Mine Apparatus and the CUMA Mine Countermeasures dive system.uk. . David J. 197 pages. html).scuba-doc.bishopmuseum.
defines technical diving as "diving other than conventional commercial or recreational diving that takes divers beyond recreational diving limits. • PADI. or by the length of time that the diver intends to spend underwater. whereas others contend that penetrating overhead environments should be regarded as a separate type of diving. Definition of technical diving There is some professional disagreement as to what the term should encompass. are both relatively recent Technical diver during a decompression stop. nitrox diving was considered technical. during which the diver may change breathing gas mixes at least once.   Until recently. the largest recreational diver training agency in North America. The term technical diving has been credited to Michael Menduno." NOAA does not address issues relating to overhead environments in its definition. Technical divers require advanced training. Certain minority views contend that certain non-specific higher risk factors should cause diving to be classed as technical diving. although divers have been engaging in what is now commonly referred to as technical diving for decades. specialized equipment and often breathe breathing gases other than air or standard nitrox. Technical diving almost always requires one or more mandatory decompression "stops" upon ascent. The type of gas mixture used is determined either by the maximum depth planned for the dive. However. technical diving." • 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. It is further defined as an activity that includes one or more of the following: diving beyond 40 meters/130 feet. Others seek to define technical diving solely by reference to the use of decompression. extensive experience. technical divers may work in the range of 170 ft to 350 ft. accelerated stage decompression and/or the use of multiple gas mixtures in a single dive.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). Technical diving often involves the use of special gas mixtures (other than compressed air) for breathing. . required stage decompression. The concept and term. diving in an overhead environment beyond 130 linear feet from the surface. Even those who agree on the broad definitions of technical diving may disagree on the precise boundaries between technical and recreational diving. sometimes even deeper. Some say that technical diving is any type of scuba diving that is considered higher risk than conventional recreational diving. but this is no longer the case. some advocate that this should include penetration diving (as opposed to open-water diving). The following table tries to describe the differences between technical and recreational diving. who was editor of the (now defunct) diving magazine AquaCorps in 1991. While the recommended maximum depth for conventional scuba diving is 130 ft. advents.
In many cases. For this reason. Heliox. NAUI  Solo diving Depth Technical dives may be defined as being dives deeper than about 130 feet (40 m) or dives in an overhead environment with no direct access to the surface or natural light. Such environments may include fresh and saltwater caves and the interiors of shipwrecks. PADI  Cave diving Deeper penetration Ice diving Rebreathers Solo diving others as technical diving. The depth-based definition is derived from the fact that breathing regular air while experiencing pressures causes a Diver returning from a 600ft dive progressively increasing amount of impairment due to nitrogen narcosis that normally becomes serious at depths of 100 feet (30 m) or greater.Technical diving 92 Technical Diving Activity Deep diving Decompression  diving Mixed gas diving Gas switching Recreational Maximum depth of 40 metres (130 ft) No decompression  Technical Beyond 40 metres (130 ft) Decompression diving Air and Nitrox Single gas used Trimix. Increasing pressure at depth also increases the risk of oxygen toxicity based on the partial pressure of oxygen in the breathing mixture. technical dives also include planned decompression carried out over a number of stages during a controlled ascent to the surface at the end of the dive. Heliair and Hydrox May switch between gases to accelerate decompression and/or "travel mixes" to permit descent carrying hypoxic gas mixes Deeper penetration Wreck diving Penetration limited to "light zone" or 30 metres (100 ft) depth/penetration Penetration limited to "light zone" or 30 metres  (100 ft) depth/penetration Some agencies regard ice diving as recreational diving. technical diving often includes the use of breathing mixtures other than air. NAUI    Some agencies regard use of semi-closed rebreathers as recreational diving. These factors increase the level of risk and training required for technical diving far beyond that required for recreational diving. PADI Recreational diving requires buddy system others as technical diving. This is a fairly conservative definition of technical diving. .
Free floating decompression stop. In recent years. reducing the risk of "the bends. Wreck diving . it is common to use trimix which adds helium to replace nitrogen in the diver's breathing mixture.diving into greater depths. shallow stops. are absorbed into body tissues when inhaled under high pressure during the deep phase of the dive.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. Metabolically inert gases in the diver's breathing gas. 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." Surface intervals (time spent on the surface between dives) are usually required to prevent the residual nitrogen from building up to dangerous levels on subsequent dives.diving into a cave system. Ice diving .diving under ice. Physical ceiling These types of overhead diving can prevent the diver surfacing directly: • • • • Cave diving . also known as the "bends". Deep diving .diving inside a shipwreck. This form of diving implies a much larger reliance on redundant equipment and training since the diver must stay underwater until it is safe to ascend or the diver has left the overhead environment. most technical divers have greatly increased the depth of the first stops to reduce the risk of bubble formation before the more traditional. long. These dissolved gases must be released slowly from body tissues by pausing or "doing stops" at various depths during the ascent to the surface. Decompression stops A diver at the end of a long or deep dive may need to do decompression stops to avoid decompression sickness. Most technical divers breathe enriched oxygen breathing gas mixtures such as nitrox during the beginning and ending portion of the dive. such as nitrogen and helium. .
and while it is not used for deep diving. Breathing normal air (with 21 percent oxygen) at depths greater than 180 feet (55 m) creates a high risk of oxygen toxicity. saying that helium mixes should be used for dives beyond a certain limit (100–130 feet (30–40 m). GUE. Accordingly. caused by silt or depth. such as trimix. Sometimes the diver may get warning symptoms prior to the convulsion. IANTD and DSAT/PADI). Increasing pressure containing EAN50 (left side) and pure oxygen (right side). nausea. Deep air proponents base the proper depth limit of air diving upon the risk of oxygen toxicity. resulting in a reduced ability to react or think clearly (see nitrogen narcosis). and because vision is often reduced by water currents. heliox. These gas mixes can also lower the level of oxygen in the mix to reduce the danger of oxygen toxicity. Note the backplate and wing setup with sidemounted stage tanks swings. as there are multiple oxygen percentages available in nitrox. Nitrox is another common gas mix. twitching (especially Technical divers preparing for a mixed-gas decompression dive in Bohol. in the face and hands). and dizziness. irritability and mood Philippines. depending upon agency). 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. Such courses used to be referred to as "deep air" courses.Technical diving 94 Extremely limited visibility Technical dives in waters where the diver's vision is severely impeded by low-light conditions. Further training and knowledge is required in order to use safely and understand the effects of these gases on the body during a dive. This reduces the nitrogen percentage. divers can reduce these effects. The first sign of oxygen toxicity is usually a convulsion without warning which usually results in death. and suggest that when . Helitrox/triox proponents argue that the defining risk should be nitrogen narcosis. a minority (NAUI Tec. as the breathing regulator falls out and the victim drowns. as helium does not have the same narcotic properties at depth. as well as allowing for a greater number of multiple dives compared to standard air. but are now commonly called "extended range" courses. These can include visual and auditory hallucinations. which occurs at about 186 feet (57 m). The combination of low visibility and swift current make these technical dives extremely risky to all but the most skilled and well-equipped divers. they view the limit as being the depth at which partial pressure of oxygen reaches 1. While mainstream training agencies still promote and teach such courses (TDI. The depth limit of nitrox is governed by the percentage of oxygen used. UTD) argue that diving deeper on air is unacceptably risky. and heliair. due to depth also causes nitrogen to become narcotic. By adding helium to the breathing mix.4 ATA. 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). require greater knowledge and skill to operate in such an environment. it decreases the build up of nitrogen within the diver's body by increasing the percentage of oxygen. Gas mixes Technical dives may also be characterised by the use of hypoxic breathing gas mixtures other than air.
The stage cylinders are normally carried using an adaptation of a sidemount configuration. helium is necessary to offset the effects of the narcosis. each with its own regulator. It has also recently introduced trimix qualifications and continues to develop closed circuit training. which occurs at about 130 feet (40 m). Technical divers usually carry at least two tanks. or become tolerant of it. There are many technical training organisations: see the Technical Diving section in the list of diver training organizations. Technical Diving International (TDI). and nitrox training will become mandatory. Divers trained and experienced in deep air diving report less problems with narcosis than those trained and experienced in mixed gas diving trimix/heliox. known as stage bottles. Because required decompression stops act as an obstacle preventing a diver in difficulty from surfacing immediately. British Sub-Aqua Club (BSAC) training has always had a technical element to its higher qualifications. Typically. with a reserve for bail-out in case of failure of their primary breathing gas. the technical arm of Professional Association of Diving Instructors (PADI). for example. there is a need for redundant equipment. In the event of a failure. Recent entries into the market include Unified Team Diving (UTD). .Technical diving the partial pressure of nitrogen reaches approximately 4. The Divers Alert Network does not formally reject deep air diving per se. 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. Profesional Scuba Association International(PSAI). technical dives last longer than average recreational scuba dives. International Association of Nitrox and Technical Divers (IANTD) and National Association of Underwater Instructors (NAUI) were popular as of 2009. The Scuba Schools International (SSI) Technical Diving Program (TechXR – Technical eXtended Range) was launched in 2005. Both sides of the community tend to present self-supporting data. however. although scientific evidence does not show that a diver can train to overcome any measure of narcosis at a given depth. 95 Equipment Technical divers may use unusual diving equipment.0 ATA. The technical diver may also carry additional cylinders. Training Technical diving requires specialised equipment and training. and Diving Science and Technology (DSAT). but indicates the additional risks involved. the second tank and regulator act as a back-up system. Global Underwater Explorers (GUE). to ensure adequate breathing gas supply for decompression. Technical diver with decompression gases in side mounted stage cylinders. Technical divers therefore increase their supply of available breathing gas by either connecting multiple high capacity diving cylinders and/or by using a rebreather.
Scuba Schools International. Gary Gentile. com/ padi/ en/ kd/ semiclosedrebreather. . . Dr. org/ medical/ articles/ article. tdisdi. MF. . Des F (1992). "How deep is too deep?" (http:/ / www. "Safe Limits: A International Dive Symposium.html) .liquidtravel. com/ techxr)  Some certification agencies prefer to the term "cavern diving" to cave penetration within recreational diving limits.  Gorman. rubicon-foundation. and Gary Gentile published a further book in 1999 entitled The Technical Diving Handbook. . Retrieved 2008-09-25. South Pacific Underwater Medicine Society Journal 26 (1). Aviation." (http:/ / archive. aspx  http:/ / www. Heslegrave. org/ 6425).rubicon-foundation. au/ modx/ bluebeyond-dive-deep-air-is-stupidity. rubicon-foundation.C. Retrieved 2009-09-03. asp?articleid=29).com • http://www. and suggest an absolute limit of 40 metres (130 ft).TechDivingMag. p.). Advanced Wreck Diving. html). Durham. SDI (http:/ / www. Retrieved 2009-08-07. "What is technical diving? (letter to editor)" (http:/ / archive. Retrieved 2011-01-15. com/ english/ common/ courses/ rec/ continue/ deepdiver. Held May 1. DAN. bluebeyond. N. Introduction.  Many recreational diving agencies recommend diving no deeper than 30 metres (100 ft). Retrieved 2009-08-07. aspx  Some training agencies regard solo diving within the "recreational" sphere. "Subjective and behavioral effects associated with repeated exposure to narcosis". divessi. com/ padi/ en/ kd/ icedivercourse. rubicon-foundation. com/ txr). Piantadosi CA.Technical diving program" (http:/ / www.com • Select publications on technical diving and technical diving history (http://archive. . NOAA.  As most technical diving training agencies point out. . Retrieved 2009-09-03.: (Divers Alert Network). the term decompression diving is often used to describe diving which involves one or more mandatory decompression stops prior to surfacing.  "TDI . SJ (2007). R (1992). aspx  http:/ / www.org/ dspace/simple-search?query=technical+diving&submit=Go) . RW (1996). org/ technical_divers. Retrieved 2009-09-14.TechnicalDiving. Peter Bennett Symposium Proceedings.Hosted by the Rubicon Foundation • RebreatherPro (http://www. html). Enriched Air Diving. padi.  Bret Gilliam (1995-01-25). "Taking 'tec' to 'rec': the future of technical diving" (http:/ / archive. Retrieved 2009-06-22. Revised editions use the term technical diving. February 24. "Technical Diving. padi. asp)  There is a reasonable body of professional opinion that considers decompression diving to be the sole differentiator for "technical" diving. page 91. author and leading technical diver. In: Moon RE. php?did=60& site=3)  Mitchell. ISBN 978-1-878663-31-3  "Technical Diving" (http:/ / oceanexplorer.  John Lippmann. Retrieved 2009-09-03. However. . org/ 8125). . South Pacific Underwater Medicine Society Journal 22 (1).  PADI. 2004. naui. PMID 1417647. commented that there was no accepted term for divers who dived beyond agency-specified recreational limits for non-professional purposes. com. "High-tech diving". tdisdi..  Gorman. South Pacific Underwater Medicine Society Journal 33 (4). com/ index. ISBN 9780922769315. org/ 6266). and environmental medicine 63 (10): 865–9. divessi. php?did=80& site=2). references to "decompression diving" is a misnomer. org/ 9061). gov/ technology/ diving/ technical/ technical.org/transitioning-to-technical-diving. google.  http:/ / www. . 2006.  "SSI TechXR . Laliberté. space. South Pacific Underwater Medicine Society Journal 25 (1). diversalertnetwork.  Hamilton Jr. rubicon-foundation. SSI (http:/ / www. com/ index. 15.Technical diving 96 References  Richardson.  In his 1989 book. noaa. as all dives involve an element of decompression as the diver off-gases.  Hamilton. .com) Jill Heinerth's interactive multimedia technical diving site • Transitioning to technical diving (http://www." (http:/ / archive.rebreatherpro. Deep Diving (http:/ / books. Footnotes External links • http://www. (http:/ / www. Drew (2003). K. Camporesi EM (eds.  "Deep Air IS Stupdity" (http:/ / www. Retrieved 2009-08-07.Extended Range Diver" (http:/ / www. com/ ?id=HVbjgdorRXAC& pg=PT1& lpg=PT1& dq=bret+ gilliam+ deep+ diving& q=). padi. Des F (1995).
 Dry suits (if used together with a buoyancy compensator) still require a minimum of inflation to avoid "squeezing". helium is a faster gas to saturate and desaturate. where it is often recycled to save the expensive helium component. Disadvantages of helium in the mix Helium conducts heat six times faster than air. Mixes Advantages of helium in the mix The main reason for adding helium to the breathing mix is to reduce the proportions of nitrogen and oxygen below those of air. This is frequently used as a breathing gas in deep commercial diving operations. damage to skin caused by pressurizing dry suit folds. and is often used in deep commercial diving and during the deep phase of dives carried out using technical diving techniques.e. connected only to the inflator of the drysuit is preferred to air. helium does not load tissues as heavily as nitrogen. Some divers suffer from hyperbaric arthralgia during descent. . where the increased rate of off-gassing is largely counterbalanced by the equivalently increased rate of on-gassing. but less so in bounce diving. to allow the gas mix to be breathed safely on deep dives. 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. carried in a small. Analysis of two-component gases is much simpler than three component gases. A lower proportion of oxygen reduces the risk of oxygen toxicity on deep dives. The mixture of helium and oxygen with a 0% nitrogen content is generally known as Heliox. The lower density of helium reduces breathing resistance at depth. consisting of oxygen. This is to avoid the risk of hypothermia caused by using helium as inflator gas. separate tank. since air conducts heat 50% faster than argon. Helium dissolves into tissues more rapidly than nitrogen as the ambient pressure is increased (this is called on-gassing). i.  Because of its low molecular weight. which is a distinct advantage in saturation diving. and helium is more likely to come out of solution and cause decompression sickness following a fast ascent. Argon.Trimix (breathing gas) 97 Trimix (breathing gas) Trimix is a breathing gas.  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. In effect. helium enters and leaves tissues more rapidly than nitrogen as the pressure is increased or reduced (this is called on-gassing and off-gassing). often helium breathing divers carry a separate supply of a different gas to inflate drysuits. Helium has very little narcotic effect. 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. helium and nitrogen. but at the same time the tissues can not support as high an amount of helium when super-saturated.
 A normoxic mix such as "19/30" is used in the 30 to 60 m (100 to 200 ft) depth range. To ensure an accurate mix.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. See breathing gas for more information on the composition and choice of gas blends. In fully closed circuit rebreathers that use trimix diluents. 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.18 at the surface. 20% nitrogen is suitable for a 100-metre (330 ft) dive. consisting of 10% oxygen. so as to achieve the rough mix. two classes of trimix are commonly used: normoxic trimix—with a minimum PO2 at the surface of 0. This process often takes hours and is sometimes spread over days at busy blending stations. a problem that can occur when breathing heliox at depths beyond about 130 metres (430 ft). the mix is named by its oxygen percentage. as a bottom gas only. 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. At 100 m (330 ft). The oxygen and helium are fed into the air stream using flow meters. helium and air are blended on the intake side of a compressor.2 depending on the depth. In open-circuit scuba. The low pressure mixture is analyzed for oxygen content and the oxygen and helium flows adjusted accordingly. A second method called 'continuous blending' is now gaining favor.18 bar. 70% helium.4 and may reduce the PO2 further to 1.    Nitrogen is also much less expensive than helium. a mix named "trimix 10/70" or trimix 10/70/20. a hypoxic mix such as "10/50" is used for deeper diving. Hyperoxic trimix is sometimes referred to as Helitrox or TriOx. 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. For example. nitrogen. its pressure is measured and further gas is decanted until the correct pressure is achieved. Most trimix divers limit their working oxygen partial pressure [PO2] to 1.18 and hypoxic trimix—with a PO2 less than 0. after each helium and oxygen transfer.3 bar and an equivalent narcotic depth of 43 m (141 ft).6 bar and maximum equivalent narcotic depth of 30 to 50 m (100 to 160 ft). the mix is allowed to cool.3 or 1. and cannot safely be breathed at shallow depths where the ppO2 is less than 0. helium percentage and optionally the balance percentage. hyperoxic trimix is sometimes used on open circuit scuba. Oxygen.0 to 1. "12/52" has a PPO2 of 1. . the duration and the kind of breathing system used [open circuit vs closed circuit rebreather]    Advantages of keeping some nitrogen in the mix Retaining nitrogen in trimix can contribute to the prevention of High Pressure Nervous Syndrome. Less commonly. The ratio of gases in a particular mix is chosen to give a safe maximum operating depth and comfortable equivalent narcotic depth for the planned dive. Blending Gas blending of trimix involves decanting oxygen and helium into the diving cylinder and then topping up the mix with air from a diving air compressor. the mix can be hyperoxic in shallow water because the rebreather automatically adds oxygen to maintain a specific ppO2. This is important mainly because of the high cost of helium. Naming Conventionally.
4 ATA or below at the deepest point of the dive. The effects from narcosis was not proven until the salvage of the USS Squalus in 1939.the desire to keep that equivalent narcotic depth (END) of the mix at approximately 34 metres (112 ft). 80% helium) had been successfully decompressed from deep dives. hence the fractions of the three components are easily calculated. normoxic and hyperoxic. where it has an equivalent narcotic depth of 35 metres (115 ft). This allows diving throughout the usual recreational range. The "standard" mixes evolved because of three coinciding factors .  99 "Standard" mixes Although theoretically trimix can be blended with almost any combination of helium and oxygen. and the fact that many dive shops stored standard 32% enriched air nitrox in banks. The method of mixing a known nitrox mix with helium allows analysis of the fractions of each gas using only an oxygen analyser. and the usual forms for indicating constituent gas fraction. Heliox was used with air tables resulting in a high incidence of decompression sickness so the use of helium was discontinued. 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. 26% oxygen. 1937 Several test dives are conducted with helium mixtures. and feel that the term Trimix is sufficient. 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. 18/45 and 15/55). and then topping the mix with 32% enriched air nitrox. Helitrox requires decompression stops similar to Nitrox-I (EAN28) and has a maximum operating depth of 44 metres (144 ft).Trimix (breathing gas) Drawbacks may be that the high heat of compression of helium results in the compressor over-heating (especially in tropical climates) and that the hot trimix entering the analyzer on the high pressure side can affect the reliability of the analysis. which simplified mixing. while decreasing decompression obligation and narcotic effects compared to air. Soon. the requirement to keep the partial pressure of oxygen at 1. GUE and UTD also promote hyperoxic trimix. 57% nitrogen.e. a number of "standard" mixes have evolved (such as 21/35. Other divers question whether this proliferation of terminology is useful.only helium and banked nitrox needs to be used to top up the residual gas from the last fill. Most of these mixes originated from filling the cylinders with a certain percentage of helium. but prefer the term "TriOx". 17% helium. DIY versions of the continuous blend units can be made for as little as $200 (excluding analyzers). 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. including salvage diver Max "Gene" Nohl's dive to 127 meters. Hyperoxic trimix The National Association of Underwater Instructors (NAUI) uses the term "helitrox" for hyperoxic 26/17 Trimix. human subjects breathing heliox 20/80 (20% oxygen. i. History as a diving gas 1919 Professor Elihu Thompson speculates that helium could be used instead of nitrogen to reduce the breathing resistance at great depth.  . The use of standard mixes makes it relatively easy to top up diving cylinders after a dive using residual mix . modified as appropriate with the terms hypoxic.
. 2002. using Trimix. Tom Mount develops first trimix training standards (IANTD). Bennett at the Duke University Medical Center Hyperbaric Laboratory began the "Atlantis Dive Series" which proved the mechanisms behind the use of trimix to prevent High Pressure Nervous Syndrome symptoms. dying while repeating the dive. Retrieved 2008-08-28. Proceedings of Advanced Scientific Diving Workshop (Washington. 2010. .. Bishop Museum. NC. . 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. Cave divers Sheck Exley and Jochen Hasenmayer use heliox to a depth of 212 meters. bordeninstitute. bishopmuseum.  "Diving Physics and "Fizzyology"" (http:/ / www. html). "Argon:0. In: Lang. Bennett and Elliott's physiology and medicine of diving. 1997. United States: Saunders Ltd. 2001 The Guinness Book of records recognises John Bennett as the first scuba diver to dive to 1000 ft. rubicon-foundation. MA and Smith. 5th Rev ed. 2005 David Shaw sets depth record for using a trimix rebreather. 1994 Combined UK/USA team. mil/ published_volumes/ harshEnv2/ HE2ch31. Retrieved 2008-08-28. NE (eds). Exley teaches non-commercial divers in relation to trimix usage in cave diving. 1970 Hal Watts performs dual body recovery at Mystery Sink (126 m).  "Thermal conductivity of some common materials" (http:/ / www. Air:0. S. html). T. NOAA's mix.016. Medical Aspects of Harsh Environments. 1979 A research team headed by Peter B. initially called "Monitor Mix" became NOAA Trimix I. 1987 First mass use of trimix and heliox: Wakulla Springs Project.  Gernhardt. org/ 4655). O. pp. Retrieved 2008-10-07. engineeringtoolbox. DC).Trimix (breathing gas) 1939 US Navy used heliox in USS Squalus salvage operation.142 W/mK"  Vann RD and Vorosmarti J (2002). Volume 2 (Borden Institute): p980. pdf). com/ thermal-conductivity-d_429. Use of trimix spreads rapidly to North East American wreck diving community.024. A. ML (2006).  Source: "Trimix and heliox diving" . "Military Diving Operations and Support" (http:/ / www. 800. . Helium:0. The Engineering ToolBox. February 14. Retrieved March 9. Retrieved 2008-08-28. .. 100 References  Brubakk.. "Biomedical and Operational Considerations for Surface-Supplied Mixed-Gas Diving to 300 FSW. 2005. 1991 Billy Deans commences teaching of trimix diving for recreational diving. 1965 First saturation dives using heliox. ISBN 0702025712. army. org/ research/ treks/ palautz97/ phys. with decompression tables published in the NOAA Diving Manual." (http:/ / archive. successfully complete a series of wreck dives on the RMS Lusitania expedition to a depth of 100 meters using trimix. including leading wreck divers John Chatterton and Gary Gentile. Neuman (2003).
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Andreas Ravn. SomeStranger.tan. Yobol.davies. Nick Number. Mark. Headbomb. Gr0ff. Circeus. Kosebamse. Rjwilmsi. Bogdangiusca. Danski14. LWF. Anthony Appleyard. Julesd. Momet. Lightmouse. Arrenlex. Anthony Appleyard. Heyydude12. Hawkeye1444. Marsian. Ianjm. ZayZayEM. SDC. Scubadoc. Pflatau. Elendil's Heir. Alansohn. Rich Farmbrough. Pbsouthwood.253.php?oldid=442424026 Contributors: A More Perfect Onion. Jeus. Swpb.murphy. Casliber. Jones. Cyclonenim. J. GoatOverlord.xxx. VernoWhitney. 151. Skepticus. Nimur. Axl. Marokwitz.92. Roadrunner.xxx. Nono64. JamesMLane. Bluez57. Vasiľ. AtonX. MKoltnow. EncMstr. Ynhockey. RexxS. D0762. Kbh3rd. Maeglin Lómion. Bcorr. 96 anonymous edits Decompression sickness Source: http://en. Kosebamse. Casrenooij.cashman. Scott Roy Atwood. Taoster. Banaticus. Graham87. Xianggang.xxx. Jonathan654321. ErelOnline. Auntof6. Otsykes. Huw Powell. Foobar. GProcter. Peterlin. Wabernat. Fgb. Gogo Dodo. Tide rolls. Александър.murphy. Mark. MeltBanana. Plutonium27. BD2412. Leuko. Zvn. Chrislk02. Arcadian. Gene Hobbs. Mingfx. Xanzzibar. Harland1. David Fuchs. Erich gasboy. Moondyne. Gaius Cornelius. Xobnkaj. Dabomb87. Hmoul. UnbiasedHistory. AzaToth.php?oldid=446788456 Contributors: . GProcter. Brianski.55 דודanonymous edits Partial pressure Source: http://en. Owain. Crowsnest.cashman. Porqin. Neutrality. Snigbrook. Nicholasjarvie. Lexicon. Eraserhead1. TBloemink. 5 anonymous edits Nitrogen narcosis Source: http://en. JonathanDP81. Amatulic. Alfie66. Graham87. Sirius683. Foobar. Mpeisenbr. Idiosyncrat. Peachypoh. Rosarinagazo.wikipedia.55 דודanonymous edits Deep diving Source: http://en. Xanzzibar. Rmhermen. Tarquin. Famously Sharp. Thumperward. Crum375. Anthony Appleyard. Tony1. Herbee. Expyram. Bodybagger. Trevor MacInnis. Btyner. Franamax. Arcadian. Mnation2. MeltBanana. Serpent's Choice. Bryan Derksen. SiobhanHansa. PaulHanson. Phrasecloud. Blofeld. RobertAlanHarris. Mentifisto. Excirial. Nakon. Keenan Pepper. BitterMan. Bbtommy. 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