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SCUBA DIVING EXPLAINED

Questions and Answers on
Physiology and Medical Aspects of Scuba Diving

Lawrence Martin, M.D. Copyright 1997

Scuba Diving Explained is no longer in print

The book was originally published by Best Publishing Co., but is no longer in print. For the time being it exists only this web site.


TABLE OF CONTENTS for Scuba Diving Explained

Preface 1

Myths & Misconceptions 3

Disclaimer 5

An Invitation 5

Short Scuba Quiz 6



SECTION Page

A. A Brief History of Diving, from Antiquity to the Present

What is the early history of diving? A1

What are the different types of diving? A2

What are some important events in the history of diving? A3



B. Recreational Scuba Diving: An Overview

What does "Scuba" stand for? B1

How popular is Scuba diving? B1

What makes up Scuba equipment B1

What is Scuba certification? B3

Who teaches Scuba? B4

How does recreational Scuba diving differ from other

forms of Scuba diving? B5

What is the buddy system? B6

Why is 130 feet the maximum depth in recreational diving? B6

What is manadatory decompression and why is it not part

of recreational Scuba diving? B6

Are there different levels of recreational diving? B8

What is sport surface-supplied compressed air diving

and how does it differ from scuba? B9

What is the future of RSD? B12



C. The Respiratory System: A Brief Review

Why this Chapter? C1

What is the function of the respiratory system? C1

How does gas exchange occur? C3

Does the respiratory system have functions besides

gas exchange? C10

Do fish sleep? C12

How long do fish live? C12



D. An Explanation of Pressure and the Laws of

Dalton, Boyle, Charles and Henry

What is pressure? D1

What is air pressure? D3

What is the difference between ambient, barometric and

atmospheric pressure? D5

What are the measurement units for the ambient pressure? D6

What is an "atmosphere" of pressure? D6

What is the difference between absolute pressure and

gauge pressure? D7

What casues changes in atmospheric pressure? D9

What is the composition of air? D10

What are the gas laws and why are they important

to diving? D11

What is Boyle's Law? D12

What is Charles' Law? D13

What is Dalton's Law? D14

What is partial pressure? D15

What does Dalton's Law predict about changes in partial

pressure with changes in ambient pressure? D15

What is Henry's Law? D17



E. Water and the Physical Laws That Affect

All Divers

What are the important differences between air and water? E1

What does Boyle's Law predict about changes in

pressure with depth? E4

What does Boyle's Law predict about breath-hold diving? E6

What does Boyle's Law predict for the diver breathing

compressed air? E8

How much air is in a scuba tank? E9

How does air pressure change from the scuba tank to the

diver's lungs? E9

What is buoyancy? E13

What is buoyancy control? E14

What causes weightlessness under water? E16

How does one learn to acquire proper buoyancy? E16



F. Effects of Unequal Air Pressures While Scuba Diving:

Ear Squeeze, Sinus Squeeze, Air Embolism and

Other Forms of Barotrauma

What does Boyle's Law predict about unequal

pressures? F1

What is the difference between scuba diving with the

Glottis closed and open? F4

What is barotrauma? F6

What barotrauma problems can occur on descent? F6

What is the cause of middle-ear squeeze and how can

it be prevented? F6

What is the treatment of middle-ear squeeze? F9

What other forms of barotrauma occur on descent? F9

What barotrauma problems can occur on ascent? F9

What is pulmonary barotrauma? F10

How does pulmonary barotrauma occur? F13

Why does pulmonary barotrauma occur? F14

What is arterial gas embolism? F15

What is treatment of AGE? F16



G. Effects of Increased Dissolved Nitrogen From Scuba

Diving: Decompression Sickness

What happens to inhaled air at depth? G1

How does the increased pressure at depth affect gas

in the body? G2

Is there risk of oxygen toxicity in diving? G3

How does nitrogen differ from oxygen and CO2? G4

What is the history of decompression sickness? G4

What causes decompression sickness? G6

Is "the bends" the same thing as DCS? G8

What are the differences between DCS and AGE? G8

What is the treatment for DCS? G9

What is decompression illness? G11

What is a patent foramen ovale? G11

Should divers be checked for a patent foramen ovale? G13

Why is it unsafe to fly soon after diving? G14

How long should a diver wait before flying? G15

Why don't whales get the bends? G18

H. Oxygen Therapy for Diving Accidents: At Atmospheric

and Hyperbaric Pressure

What is oxygen therapy? H1

What is oxygen toxicity? H1

What is the difference between oxygen therapy for bubble

disease and other medical conditions? H2

Why is 100% oxygen recommended for all victims of

a scuba diving accident? H4

How is oxygen used at atmospheric pressure? H5

What are atmospheres of oxygen? H5

How is oxygen used at the dive site? H8

What are the types of oxygen masks available for dive

accident victims? H10

What are the advantages of supplemental oxygen therapy

for dive accident victims? H12

What is the physiologic basis for oxygen therapy? H13

Why does a PaO2 six times normal provide only 7%

more oxygen in the blood? H13

Why does replacing nitrogen with oxygen shrink bubbles? H15

How is oxygen therapy used at hyperbaric pressures? H18

What else is hyperbaric therapy used for? H21

What is a hyperbaric treatment table? H23

Are divers hurting reefs? H25



I. Effects of Gas Pressures at Depth: Nitrogen Narcosis

CO2 Narcosis, CO and Oxygen Toxicity

What happens to gas pressures at depth? I1

What is nitrogen narcosis? I1

What is oxygen toxicity, and can it develop while diving? I2

What exactly determines risk of oxygen toxicity? I4

How do atmospheres of O2 relate to oxygen toxicity? I5

How can oxygen toxicity be minimized? I6

How does carbon monoxide toxicity occur in scuba diving? I7

What is carbon dioxide toxicity? I9

What causes headache under water? I11

What is shallow-water blackout? I11

Aren't you afraid of sharks? I15



J. Dive Tables and Dive Computers: Their History

and Utility

Why do divers not routinely use dive tables? J1

How is a dive table used? J2

What is the origin of dive tables? J6

What is the theory behind dive tables? J7

What is "saturation"? J9

How do half times affect nitrogen loading and unloading? J10

So what do half-times and saturation have to do with

dive tables? J12

What is supersaturation? J13

Have the tables been modified for recreational diving? J15

What is doppler ultrasound? J15

Does diving "by the tables" guarantee a diver won't

develop DCS? J16

What is the difference between square wave and multi-

level diving? J17

What is the origin of dive computers? J19

What do dive computers do? J19

Are dive computers preferred over dive tables? J20

How accurate are dive computers? J21

What are odd dive patterns? J22

How are computers abused? J23



K. Stress, Hyperventilation, and Hypothermia

What is stress? K1

Why is an understanding of stress important for divers? K1

What is a panic reaction? K2

How do I know when I'm in a stressful situation? K4

What is hyperventilation? K5

What is hypothermia? K7

What is the treatment of hypothermia? K10

What is hyperthermia? K11



L. Diving with Non-air Gas Mixtures: Nitrox, Heliox,

Trimix, et. al.

What is nitrox? L1

Why nitrox? L2

What are the hazards of nitrox? L2

Why isn't nitrox routinely used by recreational divers? L3

But is nitrox dangerous? L4

Who certifies for nitrox diving? L6

What is heliox? L6

What is trimix? L6

Are there other gas mixtures used for scuba diving? L6



M. Women and Diving

Does one's sex affect scuba diving? M1

Are women at greater risk than men for developing

decompression illness? M1

What about psycological differences between men and

women regarding scuba diving? M2

Do changes during menstruation pose any risk? M2

Do oral contraceptives pose a risk to women divers? M3

What about diving during pregnancy? M3

How soon can one dive after pregnancy? M4

What should be done if a woman inadvertently dives

while pregnant? M4

Should women expect special treatment when scuba diving? M4



N. Medical Fitness for Diving: Guidelines Real and

Imagined

Are there regulations regarding who may scuba dive? N1

Who is fit for diving? N1

Can one dive while taking a decongestant? N2

What conditions should prohibit diving? N3

Why are some conditions controversial for diving? N6

Why are some conditions considered prohibitive for scuba

diving? N9



O. Should Asthmatics Not Scuba Dive?

Should asthmatics not scuba dive? O1

Why is there a wide range of opinion on asthma

and diving? O3

What is the informed consent approach? O12

What about medicolegal concerns? O14



P. But Is Recreational Scuba Diving Safe? The

Great Debate

Is scuba diving safe? P1

Is recreational scuba diving safe? P3



GLOSSARY AND APPENDICES

Q. Glossary Q1

R. All About DAN, or: Where are the Hyperbaric Chambers? R1

S. U.S. Scuba Training Agencies S1

T. U.S. Scuba Magazines and Newsletters T1

U. Distributors of Scuba Books and Videos U1


Diving Odds N' Ends



Historical Diving Society A15

Scuba in Jules Verne's 20,000 Leagues Under the Sea A16

Seven Underwater Wonders of the World B13

Do Fish Sleep? C12

How Long Do Fish Live? C12

Great Lakes Shipwrecks C12

Some Famous Wrecks D20

Selected Non-documentary Movies with Diving Themes/Scenes E19

The Great White Shark E20

Earth's Most Venomous Creature E20

Top 10 Diving Destinations F18

Diving the Bikini Atoll F18

World's Highest Mountain 110

The BIGGEST Animals in the Sea G17

Lloyd Bridges G17

Why Don't Whales Get The Bends? G18

There Has To Be a Better Ending (The Big Blue) G18

Cousteau's Pneumothorax H24

Philipe and Jean-Michel Cousteau H25

There Has To Be a Better Ending (Abyss) H25

Homo Aquaticus Revisited H26

Most Frequently Asked Question of Scuba Divers I15

ama Divers of Japan and Korea I15

There Has To Be a Better Ending (Sphere) I16

Sheck Exley and Jim Bowden I16

Scuba Diving in Hawaii J28

Cold Water Diving K12

The Compleat Goggler Guy Gilpatric L8

Highest-altitude Dives L8

Ocean Facts L7

Coral Reef Facts M5

Ciguatera & Scombroid Poisoning M6

Deepest Dives on Compressed Air N14

Eugiene Clark O15

"Pipin" Ferreras and the Deepest Breath-hold Dive O16


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e-mail: larry.martin@adelphia.net.net