Decompression sickness is a medical condition caused by dissolved gases emerging from solution as bubbles inside the body tissues during decompression. DCS most commonly occurs during or soon after a decompression ascent from underwater diving, but can also result from other causes of depressurisation, such as emerging from a caisson, decompression from saturation, flying in an unpressurised aircraft at high altitude, and extravehicular activity from spacecraft. DCS and arterial gas embolism are collectively referred to as decompression illness.
Barotrauma is physical damage to body tissues caused by a difference in pressure between a gas space inside, or in contact with, the body and the surrounding gas or liquid. The initial damage is usually due to over-stretching the tissues in tension or shear, either directly by an expansion of the gas in the closed space or by pressure difference hydrostatically transmitted through the tissue. Tissue rupture may be complicated by the introduction of gas into the local tissue or circulation through the initial trauma site, which can cause blockage of circulation at distant sites or interfere with the normal function of an organ by its presence. The term is usually applied when the gas volume involved already exists prior to decompression. Barotrama can occur during both compression and decompression events.
Saturation diving is diving for periods long enough to bring all tissues into equilibrium with the partial pressures of the inert components of the breathing gas used. It is a diving mode that reduces the number of decompressions divers working at great depths must undergo by only decompressing divers once at the end of the diving operation, which may last days to weeks, having them remain under pressure for the whole period. A diver breathing pressurized gas accumulates dissolved inert gas used in the breathing mixture to dilute the oxygen to a non-toxic level in the tissues, which can cause decompression sickness if permitted to come out of solution within the body tissues; hence, returning to the surface safely requires lengthy decompression so that the inert gases can be eliminated via the lungs. Once the dissolved gases in a diver's tissues reach the saturation point, however, decompression time does not increase with further exposure, as no more inert gas is accumulated.
A diving bell is a rigid chamber used to transport divers from the surface to depth and back in open water, usually for the purpose of performing underwater work. The most common types are the open-bottomed wet bell and the closed bell, which can maintain an internal pressure greater than the external ambient. Diving bells are usually suspended by a cable, and lifted and lowered by a winch from a surface support platform. Unlike a submersible, the diving bell is not designed to move under the control of its occupants, or to operate independently of its launch and recovery system.
A diving support vessel is a ship that is used as a floating base for professional diving projects. Basic requirements are the ability to keep station accurately and reliably throughout a diving operation, often in close proximity to drilling or production platforms, for positioning to degrade slowly enough in deteriorating conditions to recover divers without excessive risk, and to carry the necessary support equipment for the mode of diving to be used.
Underwater habitats are underwater structures in which people can live for extended periods and carry out most of the basic human functions of a 24-hour day, such as working, resting, eating, attending to personal hygiene, and sleeping. In this context, 'habitat' is generally used in a narrow sense to mean the interior and immediate exterior of the structure and its fixtures, but not its surrounding marine environment. Most early underwater habitats lacked regenerative systems for air, water, food, electricity, and other resources. However, some underwater habitats allow for these resources to be delivered using pipes, or generated within the habitat, rather than manually delivered.
A diving chamber is a vessel for human occupation, which may have an entrance that can be sealed to hold an internal pressure significantly higher than ambient pressure, a pressurised gas system to control the internal pressure, and a supply of breathing gas for the occupants.
Diver rescue, usually following an accident, is the process of avoiding or limiting further exposure to diving hazards and bringing a diver to a place of safety. A safe place generally means a place where the diver cannot drown, such as a boat or dry land, where first aid can be administered and from which professional medical treatment can be sought. In the context of surface supplied diving, the place of safety for a diver with a decompression obligation is often the diving bell.
In underwater diving, ascending and descending is done using strict protocols to avoid problems caused by the changes in ambient pressure and the hazards of obstacles near the surface such as collision with vessels. Diver certification and accreditation organisations place importance on these protocols early in their diver training programmes. Ascent and descent are historically the times when divers are injured most often when failing to follow appropriate procedure.
To prevent or minimize decompression sickness, divers must properly plan and monitor decompression. Divers follow a decompression model to safely allow the release of excess inert gases dissolved in their body tissues, which accommodated as a result of breathing at ambient pressures greater than surface atmospheric pressure. Decompression models take into account variables such as depth and time of dive, breathing gasses, altitude, and equipment to develop appropriate procedures for safe ascent.
There are several categories of decompression equipment used to help divers decompress, which is the process required to allow divers to return to the surface safely after spending time underwater at higher ambient pressures.
Surface supplied diving skills are the skills and procedures required for the safe operation and use of surface-supplied diving equipment. Besides these skills, which may be categorised as standard operating procedures, emergency procedures and rescue procedures, there are the actual working skills required to do the job, and the procedures for safe operation of the work equipment other than diving equipment that may be needed.
The following outline is provided as an overview of and topical guide to underwater diving:
Diving support equipment is the equipment used to facilitate a diving operation. It is either not taken into the water during the dive, such as the gas panel and compressor, or is not integral to the actual diving, being there to make the dive easier or safer, such as a surface decompression chamber. Some equipment, like a diving stage, is not easily categorised as diving or support equipment, and may be considered as either.
A built-in breathing system is a source of breathing gas installed in a confined space where an alternative to the ambient gas may be required for medical treatment, emergency use, or to minimise a hazard. They are found in diving chambers, hyperbaric treatment chambers, and submarines.
Middle ear barotrauma (MEBT), also known to underwater divers as ear squeeze and reverse ear squeeze, is an injury caused by a difference in pressure between the external ear canal and the middle ear. It is common in underwater divers and usually occurs when the diver does not equalise sufficiently during descent or, less commonly, on ascent. Failure to equalise may be due to inexperience or eustachian tube dysfunction, which can have many possible causes. Unequalised ambient pressure increase during descent causes a pressure imbalance between the middle ear air space and the external auditory canal over the eardrum, referred to by divers as ear squeeze, causing inward stretching, serous effusion and haemorrhage, and eventual rupture. During ascent internal over-pressure is normally passively released through the eustachian tube, but if this does not happen the volume expansion of middle ear gas will cause outward bulging, stretching and eventual rupture of the eardrum known to divers as reverse ear squeeze. This damage causes local pain and hearing loss. Tympanic rupture during a dive can allow water into the middle ear, which can cause severe vertigo from caloric stimulation. This may cause nausea and vomiting underwater, which has a high risk of aspiration of vomit or water, with possibly fatal consequences.
Work in compressed air, compressed air work or hyperbaric work is occupational activity in an enclosed atmosphere at a controlled ambient pressure significantly higher than the adjacent normal atmospheric pressure. There are many parallels with underwater diving, and a few significant differences.
Hyperbaric evacuation and rescue is the emergency transportation of divers under a major decompression obligation to a place of safety where decompression can be completed at acceptable risk and in reasonable comfort.
