GAS INTOXICATION IN

DIVING MEDICINE
FERDY ALVIANDO
111.0211.028

Pressure Related Problems

(indirect)
Decompression sickness
Nitrogen partial pressures
Solubility

Nitrogen narcosis
Oxygen toxicity

NITROGEN NARCOSE
Is also known as Raptures of the deep, Martini effect
Is a reversible alteration in consciousness that occurs while diving at
depth
Narcosis produces a state similar to drunkenness
It is caused by the anesthetic effect of Nitrogen at high gas pressure
All gases that can be breathed have a narcotic effect
It had much greater effect in inert gas

Risk Factors
Factors which are known to increase the effects of nitrogen narcosis
include:

Low intelligence
Fatigue or heavy work
Anxiety , inexperience or apprehension
Cold (hypothermia)
Recent alcohol intake or use of sedative drugs (includes seasickness
medications), marijuana etc.
Poor visibility

Factors which tend to reduce the effects of narcosis include:

strong motivation to perform a given task
acclimatisation following prolonged or repeated exposures
tolerance to heavy alcohol intake

PREVENTION
The most straightforward way to avoid nitrogen narcosis is for a diver
to limit the depth of dives
dont ascend and descent too fast
Know your limit as diver

Oxygen Toxicity
Oxygen toxicity occurs when the partial pressure of alveolar O2 (PAO2)
exceeds that which is breathed under normal conditions.
Under hyperoxic pathological conditions, a large influx of reactive
O2 species (ROS) are produced.
In intracellular and extracellular biological systems, the mass effect of
ROS elevation, caused by O2 overexposure, disrupts the balance
between oxidants and antioxidants, and this disruption of
homeostasis can result in damage to cells and tissues
Exposure time, atmospheric pressure, and fraction of inspired
O2 (FIO2) determine the cumulative O2 dose leading to toxicity

Lorraine Smith effect

Oxygen is toxic to the lungs when high FIO2 (>0.60) is administered
over extended exposure time (24 hours) at normal barometric
pressure (1 atmospheres absolute (ATA)). This type of exposure is
referred to as low pressure O2 poisoning, pulmonary toxicity
Oxygen exposure after approximately 12 hours leads to lung
passageway congestion, pulmonary edema, and atelectasis caused by
damage to the linings of the bronchi and alveoli
The reason for this effect in the lungs but not in other tissues is that
the air spaces of the lungs are directly exposed to the high
O2 pressure

Paul Bert effect

Toxicity also occurs when the ATA is high and the high FIO2 exposure
time is short
Is toxic to the central nervous system (CNS)
Central nervous system toxicity results in seizures followed by coma in
most people within 30 to 60 minutes. Seizures often occur without
warning and are likely to be lethal. Other symptoms include nausea,
muscle twitching, dizziness, disturbances of vision, irritability, and
disorientation
Oceanic divers are more likely to experience CNS toxicity

 Exposures, from minutes to a few hours, to partial pressures of

oxygen above 1.6 bars (160 kPa)about eight times the standard
atmospheric partial pressureare usually associated with central
nervous system oxygen toxicity