PHYSIOLOGY

COURSE MANUAL

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Table of Contents

TABLE OF CONTENTS
INTRODUCTION TO PHYSIOLOGY Prevention ........................................................... 12
IN SCUBA DIVING ....................................................... 3
Decompression Illness (DCI) ............................... 12
Introduction and Chapter Objectives .................... 3 Barotrauma ............................................................ 13
THE HUMAN BODY AND SCUBA DIVING ................ 4 Arterial Gas Embolism (AGE) .............................. 14
Diving Physiology ................................................... 4 Symptoms ........................................................... 14
Respiratory and Circulatory Systems ................... 4 Treatment ............................................................ 14

Breathing Stimulation ............................................. 5 Ear and Sinus Spaces .......................................... 15

DIVING-RELATED INJURIES ..................................... 6 EQUALIZATION......................................................... 16

Terminology ............................................................. 6 Understanding Equalization ................................ 16

Hypercapnia ............................................................. 6 Valsalva Maneuver ................................................ 16
Shallow Water Blackout ......................................... 6 Guidelines for Equalization ................................. 16
Effects of Oxygen.................................................... 7 Reverse Block ....................................................... 17
Hyperoxia ................................................................. 7 Mask Squeeze ....................................................... 17
Overexertion ............................................................ 8 PERSONAL DIVE COMPUTERS .............................. 18
Overheating and Hypothermia............................... 9 Personal Dive Computer Guidelines .................. 18
Effects of Nitrogen ................................................ 10 Emergency Ascents ............................................. 19
Nitrogen Narcosis ................................................. 10 PDC Limitations .................................................... 19
Nitrogen Narcosis ................................................ 10 ADDITIONAL PRECAUTIONS .................................. 20
What Should You Do When
No Decompression Limits (NDL) ........................ 20
Nitrogen Narcosis Strikes? .................................. 10
Diving After Medical Treatment ........................... 21
Decompression Sickness (DCS) ......................... 11
Signs and Symptoms .......................................... 11
Treatment ............................................................ 11

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Introduction to Physiology in Scuba Diving

INTRODUCTION TO
PHYSIOLOGY IN SCUBA
DIVING
INTRODUCTION AND CHAPTER
OBJECTIVES
Physiology is defined as “the biological study of the functions
of living organisms and their parts.” To be a qualified diver,
you need to understand how being underwater affects your
body. If you have questions regarding any of the following
points that you feel may affect you, seek professional medical
advice from a diving doctor—a physician who is trained in
diving medicine.

In the “Physics” chapter, you learned about several issues

but, most importantly, the impact of increased water pressure
on the gases you breathe underwater. You will now learn
about the effects these changes can have on your body.

The following are the chapter objectives.

• Describe the respiratory and circulatory systems in

the body and special concerns for divers
• Describe the effects of various gases that divers
inhale and exhale
• Define the effects of temperature change on the
body including the effects of hypothermia and
hyperthermia
• Explain the effects of pressure-related changes on
the diver
• Explain the terms nitrogen narcosis, decompression
sickness (DCS), and decompression illness (DCI)

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The Human Body and Scuba Diving

THE HUMAN BODY AND SCUBA DIVING

DIVING PHYSIOLOGY
Diving physiology informs you about several things about the underwater environment and how these play an important role in your
continued comfort and well-being when you dive. As a new diver—and even as you build experience—you need to understand and
take notice of how increased water pressure can impact you, what can happen to your body at depth, why it can happen, how to
recognize any adverse symptoms, and what to do in case of an incident.

Diving physiology also includes some information about things that can happen before you go underwater and even after your dive.

Even though diving is said to be 60% mental and 40% physical, there may be times when the diver needs to work hard and exert a
lot of physical effort—for example, swimming against a current, climbing up a beach or steep hill, or getting back onto a dive boat
after the in-water phase of a dive is over.

A certain amount of physical strength and good cardiovascular health is required. This does not mean that you have to be an
Olympic athlete, but at the same time, being overweight and being short of breath after a short walk is not good for diving. So, if you
are not doing so already, start to make an effort to keep yourself healthy and do regular exercise to build up the efficiency of your
cardiovascular system. This will help make you a better and a safer diver.

RESPIRATORY AND CIRCULATORY SYSTEMS

The cardiovascular/circulatory system and respiratory system are two systems in the human body that are vital. They continuously
provide the body with a flow of nutrients and oxygen and remove waste products. Any breakdown of or interruption to these systems
can result in permanent damage to your body, sometimes within minutes. In addition, these two systems are the ones most
influenced by the underwater environment.

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The Human Body and Scuba Diving

Every part of the human body constantly needs oxygen. Oxygen is needed for what is called the oxidative metabolism: the oxidation
of nutrients in order to supply energy required to live. Every cell in your body needs oxygen. The respiratory system brings oxygen
into the body and removes carbon dioxide from the body via the lungs. The cardiovascular system governs the circulation of blood
and transport of oxygen and carbon dioxide. It mainly consists of the heart, arteries, veins, and capillaries.

BREATHING STIMULATION

Carbon dioxide (CO2) is one of the main stimuli triggering your urge to breathe. It’s not required for you to understand what the exact
mechanism within your body that controls partial pressures of carbon dioxide and oxygen (O2) is or how the changes in the blood’s
acidity affects the urge to breathe. However, as a diver, you should understand the basics of breathing. You can also improve your
diving enjoyment by using some of the breathing exercises taught in yoga, martial arts, and meditation.

At rest, the average breathing rate is between 10 to 20 breaths per minute. Under normal conditions, this breathing rate and the
depth of your breathing is automatically and unconsciously controlled by respiratory centers deep in the brain.

An increased demand for oxygen by the body as a result of exercise or anxiety proportionally increases the levels of carbon dioxide
in the blood, and the breathing rate will increase in relation.

As the carbon dioxide levels reduce (at rest), the breathing rate will return to normal. If oxygen levels are too low but the respiratory
centers do not detect overabundance of carbon dioxide, it is possible that breathing is not stimulated. This is what happens in the
case of shallow water blackout, mostly breath-hold diving. The important lesson for you in this instance is that lack of oxygen alone
will not make a diver breathe.

When diving, the high-oxygen partial-pressure level is more than enough for the body to function. However, as the partial pressure
of oxygen drops on ascent, possible symptoms of light-headedness, dizziness, nausea, and headache might occur. In extreme
cases, there may be loss of consciousness. The simple solution to this problem is to take three or four normal full breaths before
ascent.

Did you know? It’s worth noting that every unit of oxygen metabolized in a diver’s body is converted to almost the same volume of
carbon dioxide.

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Diving-Related Injuries

DIVING-RELATED INJURIES
TERMINOLOGY
The following terms relate to conditions that may occur while diving. The prefix hyper- means “too much.” The prefix hypo- means
“too little.”

• Hypercapnia: Too much carbon dioxide

• Hyperoxia: Too much oxygen
• Hyperthermia: Too hot
• Hypocapnia: Too little carbon dioxide
• Hypoxia: Too little oxygen
• Hypothermia: Too cold

HYPERCAPNIA
Hypercapnia is a potentially fatal condition for divers that can be caused by an excessive build-up of carbon dioxide in the
respiratory and circulatory systems. Elevated levels of carbon dioxide lead to headache, confusion, a feeling of breathlessness, and,
eventually, loss of consciousness.

Hypercapnia is sometimes associated with full-face masks, rebreathers, and skip-breathing (open circuit). It is not very common in
recreational open circuit diving, although it may still occur, especially when skip-breathing or hyperventilating at depth. Therefore, we
recommend breathing slowly and deliberately when diving and taking two or three slow, full breaths before ascending and keeping a
close watch on your buddy or dive professional.

SHALLOW WATER BLACKOUT

Shallow water blackout can occur when a diver is not using scuba equipment, that is, freediving or snorkeling. It is the opposite of
hypercapnia. Excessive hyperventilation (more than five repetitions of deep inhaling and exhaling) before breath-hold diving may
lead to shallow water blackout. Three to four normal, full breaths are enough for most people.

When a diver hyperventilates excessively before a breath-hold dive, carbon dioxide levels will become extremely low. Because the
carbon dioxide level stimulates breathing (and not low oxygen levels), this stimulus will not be present even when oxygen levels
become too low. At depth, the increased oxygen partial pressure in the lungs of the diver allows the respiratory system to receive
oxygen. However, when the diver makes an ascent (or goes to shallow depths), the partial oxygen pressure in his or her lungs will
drop. As a result, the delivery of sufficient oxygen is interrupted, which will lead to a blackout and possible drowning. If you feel light-
headed, nauseated, or the beginnings of a headache, you should stop and rest. Get your breathing back to normal before deciding
to continue or to stop and get out of the water.

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Diving-Related Injuries

EFFECTS OF OXYGEN

Oxygen is required to sustain life and the body requires quite a specific amount of oxygen to function properly. Too much, too little,
or more than average amounts of oxygen over a long duration can each cause serious health problems.

In the “Physics” chapter, you learned about partial pressure. For the sake of scuba-diving calculations, air is considered to be made
up of 21% oxygen and 79% nitrogen at sea level. So, the partial pressure of oxygen at sea level is 0.21. As you descend
underwater, the pressure increases, and so do the partial pressures of each gas.

In basic terms. your respiratory and circulatory systems will operate within an oxygen partial-pressure limit of 1.6 bar/ata (maximum)
and 0.16 bar/ata (minimum). Going above or below these parameters carries very real risks.

HYPEROXIA
Hyperoxia is when the oxygen partial pressure exceeds 1.6 bar/ata (considered the maximum upper limit for recreational diving) or
when a diver is exposed to elevated partial pressures of oxygen for a number of minutes exceeding those recommended in the
universally used NOAA (National Oceanographic Atmospheric Administration) diving tables. (The RAID nitrox specialty teaches
divers to use oxygen-enriched gases and covers this and related topics in detail.)

This exposure may lead to any number of the following symptoms:

• Convulsions
• Visual disturbance
• Ringing in the ears
• Muscle twitching
• Dizziness

The symptoms may be sudden or gradual. Generally, open circuit air divers will be unlikely to experience this. Your depth limits and
your no decompression limit (NDL) will not allow you to build up a partial pressure of oxygen that could be harmful.

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Diving-Related Injuries

With 21% oxygen in your normal air mix, you would need to descend to around 8 atmospheres (ata) of pressure to take you over the
partial pressure of oxygen limit. (21% = 0.21 ata partial pressure of oxygen at the surface)

• The following demonstrates the effects of depth on oxygen pressure.

− For a 40-meters/130-feet dive, you are now at 5 ata of pressure: 5 × 0.21 = 1.05 ata.
− For 60 meters/200 feet, you are now at 7 ata of pressure: 7 × 0.21 = 1.47 ata.
• These examples are way over the RAID limit for this course program but illustrate how the oxygen pressure increases with
depth. You can stay safe by not exceeding these limits. The maximum recreational depth limit is 40 meters/130 feet for
divers who have the appropriate training and experience.

It is, however, possible with nitrox-certified divers who are trained to use higher concentrations of oxygen in their breathing gas to
approach closer to the limits where oxygen toxicity is a tangible problem. Specialized training is required for nitrox diving.

IMPORTANT
The oxygen partial-pressure limit of 1.6 is reached or even passed if uncontrolled descents are not stopped.

OVEREXERTION
You can experience overexertion by swimming against a current for long distances or carrying excessive weight. You may feel tired,
short of breath, and weak. You may also have a tendency for your muscles to cramp and for you to feel panicky. What should you
do?

STOP, BREATHE, AND THINK ABOUT THE SITUATION.

To counteract the results of overexertion, work out a rational approach and implement it. For example, overexertion at the surface
requires you to establish buoyancy, rest, catch your breath, signal for help, and move slowly to the boat or shore. If overexertion
occurs underwater, stop, breathe, and think. And do not neglect to signal that you have a problem to your buddy or dive
professional.

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Diving-Related Injuries

OVERHEATING AND HYPOTHERMIA

In an ideal world, it would be wonderful to be neither hot nor cold underwater. To achieve this, wear exposure protection suitable to
the conditions you’ll be diving in. If you don’t wear appropriate exposure protection, you could suffer from overheating (hyperthermia)
and/or cold (hypothermia). Just 2° Celsius/3.5º Fahrenheit above or below the standard body temperature can lead to either of these
conditions.

Water will conduct heat away from your body 20 times faster than air. So, what feels like a mild temperature out of the water can be
an effective cold temperature in the water. Further, even with exposure protection, the length of submersion will eventually cool you
down to the extent it becomes uncomfortable. As soon as this happens, get out the water and warm up!

Overheating can also be a problem, especially before diving. Your exposure suit should be put on after getting your dive gear ready,
just before the actual dive, and taken off right after exiting the water because a suit limits the normal emission of heat in the air.
Remember, if you are not feeling comfortable for the environmental conditions that you are in, notify your buddy, divemaster, or
instructor, and take appropriate action to either cool down or, in the case of cold, warm up.

REMEMBER…
Exposure protection is one of the most important considerations in diving. Make sure you get good advice from your
dive center, and choose an exposure suit that is best for the environment you are diving in.

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Diving-Related Injuries

EFFECTS OF NITROGEN

Nitrogen represents almost 79% of standard breathing air and has specific properties that can lead to two important dive maladies:
nitrogen narcosis and decompression sickness.

NITROGEN NARCOSIS

Nitrogen Narcosis
Many experienced divers have felt the effects of what has been called “rapture of the deep” or getting the “narks” at around 30
meters/100 feet. In many cases, mild nitrogen narcosis is a fairly harmless phenomenon. And as long as you are aware of its
existence, you can manage its effects at the depths covered in the course. Narcosis develops primarily as the partial pressure of
nitrogen increases; however, it’s thought that several other factors—fatigue, cold exposure, poor visibility, mental stress, high
workload—can all contribute to the effects.

Signs of nitrogen narcosis can include the following:

• Feeling a false sense of security

• Exercising poor judgment
• Becoming uncoordinated
• Having euphoric feelings, fixations, and anxiety

All symptoms are similar to being drunk on alcohol. The onset of nitrogen narcosis varies from diver to diver and for each diver from
day to day. Inadequate hydration and the use of some prescription and recreational drugs—among other things—can worsen
symptoms.

What Should You Do When Nitrogen Narcosis Strikes?

Unlike the effects of alcohol, nitrogen narcosis can be “turned down” or “turned off” simply by ascending a few meters—maybe 3
meters/10 feet. So, the correct action if you feel a little “narced” is to get your buddy’s or dive professional’s attention. Slowly ascend
until the feeling subsides while keeping an eye on your buddy or dive professional to make sure he or she is OK and is ascending
with you.

As with getting drunk, there is a “funny side.” However, nitrogen narcosis should be taken seriously. Everyone reacts differently, and
it is important you are on the lookout for symptoms in yourself and others. Always ascend if significant symptoms present
themselves.

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Diving-Related Injuries

DECOMPRESSION SICKNESS (DCS)

Decompression sickness (DCS), also known as “the bends,” is a condition caused by bubbles of gas forming in a diver’s
bloodstream during ascent. Their size and number overwhelm the body’s ability to eliminate them without complications.

As soon as you take a breath of air (or nitrox) at depth, gas will start to be dissolved in your body tissues. This is a function of the
increased ambient pressure. Oxygen is metabolized (used by the body to create energy) as you descend; however, nitrogen is not
used in the metabolic process and instead is absorbed by your body tissues as the surrounding pressure increases. When the
tissues have absorbed an internal gas pressure equal to the surrounding water pressure, they are said to be “saturated.”

The actual process of gas uptake (on-gassing) in a diver’s body and gas elimination (off-gassing) is complicated by each individual’s
body type, fitness level, and other considerations in conjunction with depth, duration, and the gas being used on the dive. Some
experts suggest there are more than three dozen factors at play.

Luckily, you can follow a simple guideline and consider the way compressed gas interacts with your body in very simple terms.

While under pressure, any increased gas circulating in your blood stream is contained; but as you ascend, excess gas needs to be
eliminated from your body. If the pressure is released slowly (if you ascend at the prescribed rate and under control), the nitrogen
outgases slowly and will safely travel to the lungs where it is exhaled without any further action from you. However, if the pressure
drops too quickly (typically from a rapid ascent), it is believed that nitrogen forms larger bubbles in the blood than your body can
eliminate and that can be harmful. While tiny bubbles generated by slow and controlled ascent are harmless, larger bubbles can get
stuck and create blockages in your circulatory system. To complicate the issue further, these bubbles may activate your body’s
immune system, causing more complications. Quite obviously, this situation is one you should strive to avoid at all costs.

Signs and Symptoms

Signs and symptoms of DCS vary from skin irritation, a dull soreness in the joints, tingling, and minor swelling, to incapacitating pain,
paralysis, and unconsciousness.

Divers suffering from DCS may say that they have the bends or have been bent or taken a “hit.” This happens when nitrogen
bubbles block parts of the circulatory system (small veins of joints, elbows, knees, or shoulders), causing pain that divers may seek
to relieve by bending those joints. Even very experienced divers can get bent, so take this very seriously.

If you suspect you, a buddy, or a dive professional has suffered DCS, remember the most common sign is denial, and denial will
delay treatment. This can result in more serious complications. Another form of denial is to brush minor symptoms off as “only a mild
hit” and thinking they will resolve on their own in time. Regardless of the severity of signs and symptoms, consider all cases of
decompression sickness to be serious.

Treatment
Treatment is simple: discontinue diving, administer 100% oxygen, and seek professional medical attention as soon as possible. It is
important to have the correct contact information for the closest diving emergency facility or re-compression chamber because
treatment by such a facility will most likely be necessary.

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Diving-Related Injuries

Prevention
By following safe and proper diving procedures, you can reduce the risk of DCS. While it is very difficult to exactly predict how much
nitrogen is absorbed by the wide range of human bodies, there are models and algorithms that give fairly accurate approximations.
Also, modern personal dive computers (PDCs) provide a very acceptable guideline for your ascent behavior from your dives.

Current open circuit dive tables—the kind used by modern PDCs—inform divers of how much nitrogen they have absorbed
(decompression status), how long they can safely remain at their current depth, and how quickly they may dive again. Although
printed dive tables are available for divers who want to plan dives in the traditional way and calculate nitrogen loading manually,
PDCs do the same thing only more quickly and more accurately, and they are recommended for this diving course. You will be
trained to make a safety stop on every dive as a precaution to help reduce the risk of DCS.

The following are a few precautions you can take to stay as safe as possible.

• Make sure you ascend slowly—9 meters/30 feet per minute or less.
• Stay well hydrated before and after the dive.
• Do not exceed your NDLs.
• Be more conservative with cold or strenuous dives.
• Do not dive if you are unwell.

DECOMPRESSION ILLNESS (DCI)

Decompression illness (DCI) refers to both DCS and lung overexpansion injuries (arterial gas embolism or AGE). Although the
term DCI is sometimes used interchangeably with DCS, you should be aware that there is a difference.

DCS refers to the condition caused by inert gas coming out of solution and forming bubbles within the body, and AGE is a pressure-
related injury or problem. However, in an emergency, the first-aid provider will follow the same procedural response for either DCS
or AGE.

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Diving-Related Injuries

BAROTRAUMA

Body air spaces, such as the lungs, ears, and sinuses, can suffer barotrauma (pressure injury) when descending or ascending.
During descent or ascent, the hydrostatic pressure changes, and trouble occurs if the diver fails to equalize the air space. During
descent, a barotrauma is called a squeeze. During ascent, a barotrauma is called a reverse block, reverse squeeze, or expansion
injury.

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Diving-Related Injuries

ARTERIAL GAS EMBOLISM (AGE)

As air in the diver’s lungs expands on ascent, increasing volume proportionally to keep the pressure equal to the surrounding
pressure (Boyle’s law in action), the expanded gas must be able to escape. This is achieved by continuously breathing or breathing
out during an ascent. If the maximum volume of the lungs is reached by holding your breath on ascent, the lungs get over-
pressurized and may start to tear or rupture.

Arterial gas embolism, abbreviated as AGE, occurs if air escapes through tears in lung alveoli and goes into the bloodstream
(pulmonary capillaries). Air can enter tissue or the bloodstream, which may lead to serious injury or death. Over-pressurizing can
easily happen: Even ascending 1 to 1.5 meters/3 to 5 feet with full lungs can give rise to lung injuries. Especially in shallow water,
the pressure drop (respiratory volume increase) per ascended 1 meter/3 feet is greatest as you get closer to the surface.

Symptoms
The following symptoms are symptoms of AGE:

• Confusion
• Dizziness
• Disorientation
• Shock
• Paralysis
• Loss of consciousness

Although these symptoms are comparable to those of DCS, AGE symptoms are rapid and dramatic, whereas DCS symptoms are
somewhat delayed. Symptoms occur during and immediately after surfacing.

Treatment
The early management of AGE and DCS is the same. Although a diver with severe DCS or AGE requires urgent re-compression for
definitive treatment, it is essential that they be stabilized at the nearest medical facility before transportation to a chamber. Early
oxygen first aid is important and may reduce symptoms substantially, but this should not change the treatment plan.

Symptoms of AGE and serious DCS often clear after initial oxygen breathing, but they may reappear later. Because of this, always
contact your country’s diving emergency services or a dive physician in cases of suspected DCS or AGE—even if the symptoms
and signs appear to have resolved.

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Diving-Related Injuries

EAR AND SINUS SPACES

There are air pockets in your ears and sinuses. As you descend, water pressure squeezes the air in these spaces causing
discomfort (and if ignored, it can cause potential harm). Therefore, you must equalize the pressure by the various methods taught by
your instructor. Never dive with a cold or sinus infection, because this will impair your ability to equalize, and it may result in damage
to your ears or sinuses. You can have blockages caused by mucus buildup that can damage ears or lung alveoli. You also do not
want to spread the cold to other divers.

You may get a squeeze as you descend. A squeeze is a pressure imbalance in which pressure outside an air space exceeds
pressure inside an air space, resulting in discomfort and pain. To reduce the risk of this, you need to equalize. Although very rare,
you may have airspaces in filled teeth where a filling has eroded. If this is a problem, seek medical advice because this space
cannot be equalized.

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Equalization

EQUALIZATION
UNDERSTANDING EQUALIZATION
It is very important to maintain equal pressure in your air spaces to the surrounding pressure. This is known as equalization and
involves adding air to these spaces as you descend. You will most likely already have experienced these changes in pressure at
some point in your life—whether going over a mountain, traveling in a plane, or being at the bottom of a swimming pool. Small
changes in pressure may be managed by simply swallowing or wiggling the jaw. You will typically hear a pop or crackling sensation
in your ears when the pressure equalizes. During a scuba dive, pressure changes rapidly. The fastest change is in the first few
meters or feet. Therefore, it is very important to equalize early, often, and approximately every 1 meter/3 feet on the way down.

VALSALVA MANEUVER

The easiest and best way to equalize for most people is called the Valsalva maneuver. This simply involves holding the nose
closed and blowing gently. This process forces air into the Eustachian tubes, and from there, to equalize the space behind the
eardrum, this procedure simultaneously forces air into the sinus cavity to equalize these spaces.

GUIDELINES FOR EQUALIZATION

It is always a good idea to equalize before you enter the water. This helps open up the spaces and helps ensure you can, in fact,
equalize. Do not force or blow too hard because it may cause damage. If you feel discomfort or pain on descent, follow these
guidelines.

• Ascend about 1 meter/3 feet and try equalizing again. Swallowing and wiggling the jaw can also help. Do not overdo it.
• If you continue to feel pain or discomfort, it is better to abort the dive. Make sure you let your buddy, divemaster, or
instructor know you are having issues by using the correct hand signal.
• If you need to abort the dive, ensure you follow correct ascent procedures. Do not rush, but follow a slow and controlled
ascent.
• If pain persists or if you have a full feeling in your ears or sinuses, trouble hearing or dizziness, or blood in your mask after
a dive, seek immediate medical advice. While most ear or sinus problems will be relatively minor and resolve themselves in
a few weeks or so, seeking medical advice is very important to prevent further complications.

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Equalization

If a diver does not equalize early or often enough, the pressure differential can force the soft tissues together, closing the ends of the
Eustachian tubes. Forcing air against these soft tissues just locks them shut. No air gets to the middle ears, which do not equalize,
so a barotrauma results. Even worse, blowing too hard during a Valsalva maneuver can rupture the round and oval windows of the
inner ear.

REMEMBER…
Do not dive if you are unwell or congested. Consult a qualified diving physician before taking any treatment for
sinus or ear problems related to diving. Inform your dive professional about any medical advice or treatment you
may be receiving.

REVERSE BLOCK
A less common occurrence is what is known as reverse block. This occurs when an air space closes off during a dive, perhaps as
a result of inflammation or mucus forming. As you ascend, the expanding air will cause discomfort if it cannot escape. If this
happens, try descending, equalizing, and starting to ascend very slowly. Repeat if needed. The expanding air will typically find an
escape route if you ascend slowly enough. If pain persists after the dive, seek immediate medical advice.

MASK SQUEEZE
Most of the time, the air inside the mask will equalize from small amounts of air coming from your nose during respiration. It is a
good idea to consciously breathe out through your nose every 1 meter/3 feet during descent. If you feel any pressure on your face,
breathe out through your nose. If this does not work, ascend 1 meter/3 feet and try again. Rarely, mask squeeze can cause blood
vessels in the eyes or face to burst. This looks much worse than it really is, but a trip to the doctor is recommended as a safety
precaution.

A helpful tip is not to over-tighten your mask strap. Once it is secured on your face, water pressure will help keep it in place.

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Personal Dive Computers

PERSONAL DIVE COMPUTERS

PERSONAL DIVE COMPUTER GUIDELINES
As mentioned previously, a great way to more accurately monitor your safe dive times and to track nitrogen loading during your dive
and surface interval is to use a personal dive computer (PDC). Modern PDCs are helpful and easy to use, but there are a few rules
and safety tips relating to PDCs and how to use one.

• Follow established safe depth limits, and dive times must remain within NDLs.
• Ascend slowly to allow plenty of time for the nitrogen to outgas, recommended 9 meters/30 feet a minute.
• Follow the PDC’s required safety stops.
• Ensure the correct gas mix is loaded into the PDC, even if it is normal air.
• Make a 3- to 5-minute safety stop at 5 meters/15 feet, or follow the required stops displayed by the PDC.
• Even after additional training and experience with deeper dives, limit repetitive dives to 30 meters/100 feet or shallower.
• Ensure you read and understand the manufacturer’s guidelines on the use of the PDC, or have an experienced operator
show you how to use it.
• Maintain good cardiovascular fitness.
• Never dive dehydrated. Drink sufficient water at least one day before diving and during your diving adventures.
• Allow extra surface interval time between dives if possible.
• Allow 12 to 24 hours before you fly in a commercial airplane after diving, or follow the no-fly dive time displayed on your
PDC.
• It is strongly recommended that divers limit their depths to their certification level or the depth calculated by the PDCs—
whichever is more conservative.
• Divers within the recreational program range should ascend before any required decompression stops are required.
Decompression diving requires specialized training, equipment, and procedures.
• Perform pre-checks. Turn on the PDC. Check all the functions to make sure that device will work properly. Always check
battery energy levels.
• A PDC should never be shared among divers.
− Your physiology changes every day. PDCs and dive tables can help you determine how long you can dive. But they do
not take into account how your body functions each day. It is almost impossible for two divers to have the same dive
profile. They will often have different surface interval times and different previous dives. Therefore, sharing a PDC is
dangerous. And it can lead to symptoms of DCI.
− If you complete a dive without your PDC, refer to the PDC manufacturer’s guidelines. All the dive information contained
within the PDC will be incorrect.
• When diving with nitrox, make sure the analyzed value of the gas in the cylinder is entered into the PDC. You should also
obtain the correct training for nitrox diving by attending a nitrox specialty program.
• Select the correct altitude adjustment setting. Altitude diving is considered to be any dive greater than 300 meters/1,000
feet above sea level. Many PDCs automatically adjust to altitude. However, consult the manufacturer’s guidelines for
adjusting your PDC for altitude. If you fail to set the correct altitude, your PDC will give you incorrect information. This can
lead to serious injury and symptoms of DCI.
• In general diving and when first starting out, select a conservative setting. Later, you may adjust this setting to be less or
more conservative. Dives can vary greatly. They can have different workloads, temperatures, durations, etc. Being able to
change how conservative your PDC calculations can be is important. You can take into account what kind of dive you are
doing. This adjustment will make the dive safer. And it may reduce your chance of getting DCI. Refer to the manufacturer’s
guidelines for help.

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Personal Dive Computers

SAFETY TIP
Read the manufacturer’s user manual thoroughly before diving with your PDC.

EMERGENCY ASCENTS
In the unlikely event that the PDC malfunctions during a dive, follow these emergency procedures.

1. Assess the situation calmly and then ascend at a rate of 9 meter/30 feet per minute to a depth between 3 meters and 6
meters/10 feet and 20 feet.
2. Stay there for as long as your air supply will safely allow and conditions permit.
3. After reaching the surface, do not dive for at least 24 hours.

PDC LIMITATIONS

While the PDC’s calculations are based on current decompression research and technology, it is important to realize that the PDC
cannot monitor the actual physiological functions of an individual diver. All decompression schedules currently known to the authors,
including the U.S. Navy tables, are based on theoretical mathematical models that are intended to serve as a guide to reduce the
probability of DCI.

Diving with nitrox may provide you with an opportunity to increase bottom times or possibly reduce the risk of DCI by reducing the
nitrogen content in the gas mix. This requires specialized training that is not covered in this program.

Freediving, in combination with scuba diving, may present risks that have not been researched and are not commonly known. It is
recommended to wait a minimum of 24 hours after scuba diving before freediving.

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Additional Precautions

ADDITIONAL PRECAUTIONS
NO DECOMPRESSION LIMITS (NDL)
The no decompression limit (NDL) is the maximum allowable dive time that you can remain at a specific depth and ascend directly
to the surface without requiring staged decompression stops on the way up. Remember the higher the partial pressure of nitrogen
(ppN2), the shorter the dive time (NDL).

You can use air dive tables to determine your NDL, but the best way is to consult your PDC and plan the depth for your dive. It is
important to know how to manually calculate NDL in case the PDC is not working or has a dead battery before the dive.

The table below shows the sliding open circuit partial pressure of both oxygen and nitrogen as applied to air.

Table 1

NITROGEN TOTAL
DEPTH PRESSURE OXYGEN (%) OXYGEN (PP) NITROGEN (%)
(PP) PRESSURE

Sea Level 1 bar/ata 21% 0.21 79% 0.79 1 bar/ata

10 m/33 ft. 2 bar/ata 21% 0.42 79% 1.58 2 bar/ata

20 m/66 ft. 3 bar/ata 21% 0.63 79% 2.37 3 bar/ata

30 m/99 ft. 4 bar/ata 21% 0.84 79% 3.16 4 bar/ata

40 m/132
5 bar/ata 21% 1.05 79% 3.95 5 bar/ata
ft.

If you accidentally exceed your NDL, follow the recommended stops displayed by the PDC. If required decompression stops were
omitted, exit the water. Explain your situation to the surface support (boat crew or your dive buddy, for example). Do not continue
diving, breathe 100% oxygen, drink plenty of water, and monitor for signs and symptoms of DCS. Seek medical attention by
contacting emergency services or the closest medical facility as soon as possible.

NEVER DELAY MEDICAL TREATMENT

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Additional Precautions

DIVING AFTER MEDICAL TREATMENT

If you received any type of medical treatment during training or anytime thereafter, medical clearance from a registered diving doctor
must be obtained before continuing to dive. If you fail to do this, you will put not only yourself at risk but also the lives of other divers,
divemasters, and instructors. It is your obligation to seek professional advice after receiving medical treatment before undertaking
further diving.

REMEMBER…
In scuba diving, there are two golden rules: Never hold your breath while scuba diving. Know how much gas you
have at all times so that you always have something to breathe.

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