Preventing Breathing- Gas Contamination
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The Use of Heliox in Treating Decompression Illness
The Diving Medical Advisory Committee DMAC, Eighth Floor, 52 Grosvenor Gardens, London SW1W 0AU, UK www.dmac-diving.org Tel: +44 (0) 20 7824 5520 [email protected] The Use of Heliox in Treating Decompression Illness DMAC 23 Rev. 1 – June 2014 Supersedes DMAC 23, which is now withdrawn There are many ways of treating decompression illness (DCI) at increased pressure. In the past 20 years, much has been published on the use of oxygen and helium/oxygen mixtures at different depths. There is, however, a paucity of carefully designed scientific studies. Most information is available from mathematical models, animal experiments and case reports. During a therapeutic compression, the use of a different inert gas from that breathed during the dive may facilitate bubble resolution. Gas diffusivity and solubility in blood and tissue is expected to play a complex role in bubble growth and shrinkage. Mathematical models, supported by some animal studies, suggest that breathing a heliox gas mixture during recompression could be beneficial for nitrogen elimination after air dives. In humans, diving to 50 msw, with air or nitrox, almost all cases of DCI can be adequately treated at 2.8 bar (18 msw), where 100% oxygen is both safe and effective. Serious neurological and vestibular DCI with only partial improvements during initial compression at 18 msw on oxygen may benefit from further recompression to 30 msw with heliox 50:50 (Comex therapeutic table 30 – CX30). There have been cases successfully treated on 50:50 heliox (CX30), on the US Navy recompression tables with 80:20 and 60:40 heliox (USN treatment table 6A) instead of air and in heliox saturation. -
Optimal Breathing Gas Mixture in Professional Diving with Multiple Supply
Proceedings of the World Congress on Engineering 2021 WCE 2021, July 7-9, 2021, London, U.K. Optimal Breathing Gas Mixture in Professional Diving with Multiple Supply Orhan I. Basaran, Mert Unal compressors and cylinders, it was limited to surface air Abstract— Professional diving existed since antiquities when supply lines. In 1978, Fleuss introduced the first closed divers collected resources from the bottom of the seas and circuit oxygen breathing apparatus which removed carbon lakes. With technological advancements in the recent century, dioxide from the exhaled gas and did not form bubbles professional diving activities also increased significantly. underwater. In 1943, Cousteau and Gangan designed the Diving has many adverse effects on human physiology which first proper demand-regulated air supply from compressed are widely investigated in order to make dives safer. In this air cylinders worn on the back. The scuba equipment with study, we focus on optimizing the breathing gas mixture minimizing the dive costs while ensuring the safety of the the high-pressure regulator on the cylinder and a single hose divers. The methods proposed in this paper are purely to a demand valve was invented in Australia and marketed theoretical and divers should always have appropriate training by Ted Eldred in the early 1950s [1]. and certificates. Also, divers should never perform dives With the use of Siebe dress, the first cases of decompression without consulting professionals and medical doctors with expertise in related fields. sickness began to be documented. Haldane conducted several experiments on animal and human subjects in Index Terms—-professional diving; breathing gas compression chambers to investigate the causes of this optimization; dive profile optimization sickness and how it can be prevented. -
Respiration (Physiology) 1 Respiration (Physiology)
Respiration (physiology) 1 Respiration (physiology) In physiology, respiration (often mistaken with breathing) is defined as the transport of oxygen from the outside air to the cells within tissues, and the transport of carbon dioxide in the opposite direction. This is in contrast to the biochemical definition of respiration, which refers to cellular respiration: the metabolic process by which an organism obtains energy by reacting oxygen with glucose to give water, carbon dioxide and ATP (energy). Although physiologic respiration is necessary to sustain cellular respiration and thus life in animals, the processes are distinct: cellular respiration takes place in individual cells of the animal, while physiologic respiration concerns the bulk flow and transport of metabolites between the organism and the external environment. In unicellular organisms, simple diffusion is sufficient for gas exchange: every cell is constantly bathed in the external environment, with only a short distance for gases to flow across. In contrast, complex multicellular animals such as humans have a much greater distance between the environment and their innermost cells, thus, a respiratory system is needed for effective gas exchange. The respiratory system works in concert with a circulatory system to carry gases to and from the tissues. In air-breathing vertebrates such as humans, respiration of oxygen includes four stages: • Ventilation, moving of the ambient air into and out of the alveoli of the lungs. • Pulmonary gas exchange, exchange of gases between the alveoli and the pulmonary capillaries. • Gas transport, movement of gases within the pulmonary capillaries through the circulation to the peripheral capillaries in the organs, and then a movement of gases back to the lungs along the same circulatory route. -
Development of Ventilatory Response to Transient Hypercapnia and Hypercapnic Hypoxia in Term Infants
0031-3998/04/5502-0302 PEDIATRIC RESEARCH Vol. 55, No. 2, 2004 Copyright © 2004 International Pediatric Research Foundation, Inc. Printed in U.S.A. Development of Ventilatory Response to Transient Hypercapnia and Hypercapnic Hypoxia in Term Infants SIGNE SØVIK AND KRISTIN LOSSIUS Department of Physiology, Institute of Basic Medical Sciences, University of Oslo, NO-0317 Oslo [S.S.], and Section of Neonatology, Department of Pediatrics, Rikshospitalet, NO–0027 Oslo [K.L.], Norway ABSTRACT Whereas peripheral chemoreceptor oxygen sensitivity in- was unchanged for hypoxia. Response magnitude was unchanged creases markedly after birth, previous studies of ventilatory for hypercapnia, but increased for the two hypoxic stimuli. In responses to CO2 in term infants have shown no postnatal conclusion, an interaction between the effects of hypercapnia and development. However, the hypercapnic challenges applied have hypoxia on ventilatory response rate emerged between postnatal usually been long-term, which meant that the effect of central d 2 and wk 8 in term infants. Concomitantly, stimulus-response chemoreceptors dominated. Oscillatory breathing, apneas, and time to hypercapnic stimuli declined markedly. The development sighs cause transient PCO2 changes, probably primarily stimulat- of a prompt response to transient hypercapnia may be important ing peripheral chemoreceptors. We wanted to assess whether the for infant respiratory stability. (Pediatr Res 55: 302–309, 2004) immediate ventilatory responses to step changes in inspired CO2 and O2 in term infants undergo postnatal developmental changes. Twenty-six healthy term infants were studied during natural Abbreviations sleep 2 d and 8 wk postnatally. Ventilatory responses to a FiCO2, fraction of inspired carbon dioxide randomized sequence of 15 s hypercapnia (3% CO2), hypoxia fR, respiratory rate ϩ (15% O2), and hypercapnic hypoxia (3% CO2 15% O2) were PaCO2, partial pressure of arterial carbon dioxide recorded breath-by-breath using a pneumotachometer. -
Keys Traveler Magazine, Diving Edition
Keys TravelerDIVE EDITION Dive Volunteerism Reef Etiquette Wrecks and Reefs fla-keys.com Learn to Dive A diver explores the egardless of experience, divers Spiegel Grove off Key Largo. in the Florida Keys exercise caution and awareness of Pam Murph Stephen Frink R Be an Ocean Advocate their surroundings – reef etiquette extends to snorkelers and even participants in SNUBA, a cross Florida Keys Reef between snorkeling and scuba. Every day Keys dive operators help enforce – through continued Etiquette for Divers education and shared information – guidelines from boat etiquette to the “no touch” rules that are strictly enforced for all divers and snorkelers visiting the coral reefs within the Florida Keys National Marine Sanctuary. Many dive shops have a low divers- to-guide ratio when they are in the water with their divers, ensuring they employ proper reef etiquette – a procedure that is especially important among beginner divers such as open-water students or newly certified divers just learning to control their buoyancy underwater. Late spring and summer are among the best times to explore the Keys Programs Spotlight Wrecks and Reefs undersea world of the Florida Keys, but it’s crucial to practice important or thousands of scuba diving the Spiegel Grove and Gen. Hoyt S. reef etiquette: and snorkeling enthusiasts who Vandenberg. Before hitting the water, apply visit the Florida Keys annually, Advanced, wreck-certified divers Keys Traveler environmentally safe sunscreens F DIVE EDITION two unique programs spotlight the who complete at least one wreck both for skin protection and to Editor: Andy Newman Managing eliminate harmful chemicals such as Keys’ shipwrecks and coral reefs dive with a participating dive op Editor: Julie Botteri Copy Editor: between Key Largo and Key West. -
The Bahamas and Florida Keys
THE MAGAZINE OF DIVERS ALERT NETWORK FALL 2014 A TASTE OF THE TROPICS – THE BAHAMAS AND FLORIDA KEYS THE UNDERWATER WILD OF CRISTIAN DIMITRIUS CULTURE OF DIVE SAFETY PROPELLER HAZARDS Alert_DS161.qxp_OG 8/29/14 11:44 AM Page 1 DS161 Lithium The Choice of Professionals Only a round flash tube and custom made powder-coated reflector can produce the even coverage and superior quality of light that professionals love. The first underwater strobe with a built-in LED video light and Lithium Ion battery technology, Ikelite's DS161 provides over 450 flashes per charge, instantaneous recycling, and neutral buoyancy for superior handling. The DS161 is a perfect match for any housing, any camera, anywhere there's water. Find an Authorized Ikelite Dealer at ikelite.com. alert ad layout.indd 1 9/4/14 8:29 AM THE MAGAZINE OF DIVERS ALERT NETWORK FALL 2014 Publisher Stephen Frink VISION Editorial Director Brian Harper Striving to make every dive accident- and Managing Editor Diana Palmer injury-free. DAN‘s vision is to be the most recognized and trusted organization worldwide Director of Manufacturing and Design Barry Berg in the fields of diver safety and emergency Art Director Kenny Boyer services, health, research and education by Art Associate Renee Rounds its members, instructors, supporters and the Graphic Designers Rick Melvin, Diana Palmer recreational diving community at large. Editor, AlertDiver.com Maureen Robbs Editorial Assistant Nicole Berland DAN Executive Team William M. Ziefle, President and CEO Panchabi Vaithiyanathan, COO and CIO DAN Department Managers Finance: Tammy Siegner MISSION Insurance: Robin Doles DAN helps divers in need of medical Marketing: Rachelle Deal emergency assistance and promotes dive Medical Services: Dan Nord safety through research, education, products Member Services: Jeff Johnson and services. -
Carbon Monoxide Poisoning Claims Impact Upon a Number of Parties Including Owner Occupiers, Gas Engineers, House Builders and Housing Authorities
CARBON MONOXIDE POISONING OCCUPATIONAL DISEASE GUIDE 8 OCCUPATIONAL DISEASE OCCUPATIONAL Carbon Monoxide Poisoning Occupational disease series – Guide 8 Contents Introduction 1. Insurance 2. Damages and the Reserve 3. The Landlord’s Duty 4. Investigations 5. Medical Causation 6. Expert evidence 7. CRU 8. Making a decision 1 Introduction Carbon monoxide (“CO”) is a colourless, tasteless, odourless non-irritant gas which, if inhaled, is acutely toxic. It can be formed when any type of fuel, such as gas, wood or coal, is burned. As a result, any fuel-burning appliance, such as a fireplace, woodstove and gas appliance, has the potential to produce dangerous levels of CO. Whilst only very small amounts of CO are produced by gas appliances which have been installed and maintained correctly, dangerous levels of CO can be emitted if gas burns incompletely – this is known as incomplete combustion. This can occur, for example, if the appliance has inadequate ventilation. There are a number of potential sources for the production of CO within the home (see figure 1), and given the difficulty in detecting the fumes, CO poisoning is a major domestic health hazard and a leading cause of death by poisoning throughout the world. The NHS estimates that CO poisoning causes approximately 50 deaths in the home per year in the UK. There are over 200 cases of non-fatal injuries per year including temporary or permanent brain damage. Incidents increase during the winter when the use of gas boilers and fires escalates. This guide is drafted from the perspective of a landlord/tenant claim. However, carbon monoxide poisoning claims impact upon a number of parties including owner occupiers, gas engineers, house builders and housing authorities. -
New Zealand Sharkwater
Spring Dive Fashion & Accessories Protecting the Sharks Indonesia Ambon Dive & Kayak GLOBAL EDITION New Apr :: May 2007 Number 16 Zealand Science Black Sea Portfolio Jeroen Verhoeff Dive Medicine Vitamins Help Divers PHILIPPINES Rob Stewart’s TheCOVER PHOTO BY WOLFGANG VisayasLEANDER 1 X-RAY MAG : 16 : 2007 Sharkwater silver cinema of dreams www.seacam.com 2 X-RAY MAG : 16 : 2007 DIRECTORY X-RAY MAG is published by AquaScope Underwater Photography Spring Dive Fashions & Accessories Copenhagen, Denmark - www.aquascope.biz www.xray-mag.com For the Well-Dressed Diver... page 54 “LIFESAVER” SCUBADIVER DIVE FLAVORS AIR TANK SHIRT AVAILABLE FROM DIVE TONIGHT AT WWW.DIVINGTOYSFROMDIVETONIGHT.COM PUBLISHER CO- EDITORS (continued) & EDITOR-IN-CHIEF Arnold Weisz - News, Features Peter Symes Willy Volk - News, Interviews Caribbean reefshark. Photo by Wolfgang Leander [email protected] Millis Keegan - Opinions, MANAGING EDITOR Brian Keegan - Equipment contents & CREATIVE DIRECTOR Michael Arvedlund - Ecology Gunild Pak Symes Jason Heller - Photography [email protected] Dan Beecham - Videography ASSOCIATE EDITORS Michel Tagliati - Medicine & REPRESENTATIVES: Leigh Cunningham - Tech USA: Millis Keegan Edwin Marcow - Sharks [email protected] Russia: Andrey Bizyukin CORRESPONDENTS [email protected] John Collins - Ireland Jordi Chias - Spain South East Asia Rep & editor: Enrico Cappeletti - Italy Catherine GS Lim, Singapore Tomas Knutsson - Iceland [email protected] Gary Myors - Tasmania Marcelo Mammana - Argentina ADVERTISING Svetlana Murashkina -
(CH 13) Part 2 – Control of Breathing / Gas Exchange and Transport *Normal Breathing Is Rhythmic and Involuntary
NOTES: Respiratory System (CH 13) Part 2 – Control of Breathing / Gas Exchange and Transport *Normal breathing is rhythmic and involuntary. Respiratory Center: ● the respiratory center is in the brain stem and includes portions of the PONS and MEDULLA OBLONGATA FACTORS AFFECTING BREATHING: 1) respiratory center in the brain 2) chemical concentrations (gases, ions, pH, etc.) 3) stretching of lung tissue 4) emotional state EXAMPLES: *when chemoreceptors in the walls of certain large arteries detect low O2 levels (or high CO2 levels), breathing rate increases *fear and pain typically increase the normal breathing pattern ALVEOLAR GAS EXCHANGES *Gas exchange between air and blood occurs in the alveoli. ● ALVEOLI: tiny air sacs in the lungs clustered at the ends of alveolar ducts ALVEOLAR GAS EXCHANGES ● Gases (O2 and CO2) diffuse from regions of HIGH concentration (and partial pressure) to regions of LOW concentration (partial pressure) ● OXYGEN diffuses from alveolar air into blood ● CARBON DIOXIDE diffuses from blood into alveolar air Partial Pressure in Partial Pressure in Gas Action Blood Alveolar Space Carbon Dioxide 45 mm Hg exit 40 mm Hg enter Oxygen 40 mm Hg 104 mm Hg blood GAS TRANSPORT IN THE BLOOD / BODY *Blood transports gases between the lungs and body cells. OXYGEN TRANSPORT: ● oxygen binds to the protein hemoglobin in the blood - heme = group that surrounds an atom of iron - globin = protein made up 574 amino acids in 4 polypeptide chains ● the resulting molecule, oxyhemoglobin, is unstable and readily releases oxygen in regions -
6. TOXICOKINETICS and METABOLISM 6.1 Introduction
6. TOXICOKINETICS AND METABOLISM 6.1 Introduction The binding of carbon monoxide to haemoglobin, producing car- boxyhaemoglobin, decreases the oxygen carrying capacity of blood and interferes with oxygen release at the tissue level; these two main mechanisms of action underlie the potentially toxic effects of low- level carbon monoxide exposure. Impaired delivery of oxygen can interfere with cellular respiration and result in tissue hypoxia. Hypoxia of sensitive tissues, in turn, can affect the function of many organs, including the lungs. The effects would be expected to be more pronounced under conditions of stress, as with exercise, for example. Although the principal cause of carbon monoxide-induced toxicity at low exposure levels is thought to be increased carboxyhaemoglobin formation, the physiological response to carbon monoxide at the cellu- lar level and its related biochemical effects are still not fully under- stood. Other mechanisms of carbon monoxide-induced toxicity have been hypothesized and assessed, such as hydroxyl radical production (Piantadosi et al., 1997) and lipid peroxidation (Thom, 1990, 1992, 1993) in the brain of carbon monoxide-poisoned rats, but none has been demonstrated to operate at relatively low (near-ambient) carbon monoxide exposure levels. 6.2 Endogenous carbon monoxide production In addition to exogenous sources, humans are also exposed to small amounts of carbon monoxide produced endogenously. In the process of natural degradation of haemoglobin to bile pigments, in concert with the microsomal reduced nicotinamide adenine dinucleo- tide phosphate (NADPH) cytochrome P-450 reductase, two haem oxygenase isoenzymes, HO-1 and HO-2, catalyse the oxidative break- down of the "-methene bridge of the tetrapyrrol ring of haem, leading to the formation of biliverdin and carbon monoxide. -
COVID-19 Technical Specifications for Procurement of Oxygen Therapy and Monitoring Devices
WHO/2020-nCoV/MedDev/TS/O2T.V1 17 June 2020 Final draft 10-07-2020 pending integration to a single publication with all other technical specifications COVID-19 Technical specifications for procurement of oxygen therapy and monitoring devices Contents Abbreviations 1. Context and considerations 2. Definitions and intended use 2.1 Oxygen sources devices Oxygen concentrator Oxygen cylinder 2.2 Oxygen delivery devices Nasal oxygen cannula with prongs Mask with reservoir bag Venturi mask 2.3 Devices for oxygen regulation and conditioning Flowmeter, Thorpe tube Flow splitter Non-heated bubble humidifier Tubing (for medical gases) 2.4 Manual ventilation devices Self-inflating resuscitation bag with mask Heat and moisture exchanger filter (HMEF) Colourimetric end-tidal CO2 (EtCO2) detector 2.5 Patient monitoring devices Pulse oximeter: handheld; tabletop; fingertip Patient monitor multiparametric: basic; intermediate; advanced 3. Technical specifications for procurement 3.1 Oxygen sources devices Oxygen concentrator Oxygen cylinder 3.2 Oxygen delivery devices Nasal oxygen cannula with prongs Mask with reservoir bag Venturi mask 3.3 Devices for oxygen regulation and conditioning Flowmeter, Thorpe tube Flow splitter 1 WHO/2020-nCoV/MedDev/TS/O2T.V1 17 June 2020 Final draft 10-07-2020 pending integration to a single publication with all other technical specifications COVID-19 Technical specifications for procurement of oxygen therapy and monitoring devices Non-heated bubble humidifier Tubing (for medical gases) 3.4 Manual ventilation devices Self-inflating resuscitation bag with mask Heat and moisture exchanger filter (HMEF) Colourimetric end-tidal CO2 (EtCO2) detector 3.5 Patient monitoring devices Pulse oximeter: handheld; tabletop; fingertip Patient monitor multiparametric: basic; intermediate; advanced 4. -
Diving Physics and "Fizzyology"
Phys Diving Physics and "Fizzyology" Introduction Like all animals, human beings need oxygen in order to survive. When we breathe, we extract oxygen from the air, and use that oxygen for metabolism, which is how we convert the food we eat into useable energy to do the things that we do. One of the by-products of metabolism is carbon dioxide; whenever we exhale, we are getting rid of the carbon dioxide that our bodies produce. The main purpose of breathing, therefore, is to provide our bodies with oxygen, and rid our bodies of carbon dioxide. We humans are terrestrial (land-dwelling) mammals, and as such, our lungs are designed to breathe gas. Unlike fishes, we have no gills, so we cannot breathe water. Therefore, the first problem we must overcome to explore the underwater realm is a means to provide breathing gas. However, if this were the only barrier humans must overcome to enter the sea, we would have long-ago discovered most of the mysteries of the ocean. All we would need to remain underwater indefinitely would be a long tube going to the surface -- a huge snorkel -- through which we could breathe. Unfortunately, there is another problem we must over come when descending to the depths -- a problem with far more complex and difficult consequences. That problem is pressure. Pressure Have you ever wondered why nobody makes snorkels that are ten, or twenty, or a hundred feet long? The answer becomes obvious as soon as you try to breathe through a snorkel when your body is more than two or three feet (~1 meter) beneath the surface of the water.