An adjustable pressure-limiting valve (commonly abbreviated to APL valve, and also referred to as an expiratory valve, relief valve or spill valve) is a type of flow control valve used in anaesthesiology as part of a breathing system. It allows excess fresh gas flow and exhaled gases to leave the system while preventing ambient air from entering. [1]
Such valves were first described by the American dentist Jay Heidbrink, who used a thin disc that was held in place by a spring. [2] The valve is adjustable and spring-loaded, allowing the opening pressure of the valve to be controlled by screwing the valve top which modifies the pressure on the spring. [1] A very light spring is used, so that at its minimum setting the valve can be opened by the patient's breathing alone using low pressures. [3] In contemporary APL valves, three orifices or "ports" are present: one for intake of gas, one for return of gas to the patient, and an exhaust port for waste gas which can be connected to a scavenging system. [1] [4]
A scuba set, originally just scuba, is any breathing apparatus that is entirely carried by an underwater diver and provides the diver with breathing gas at the ambient pressure. Scuba is an anacronym for self-contained underwater breathing apparatus. Although strictly speaking the scuba set is only the diving equipment that is required for providing breathing gas to the diver, general usage includes the harness or rigging by which it is carried and those accessories which are integral parts of the harness and breathing apparatus assembly, such as a jacket or wing style buoyancy compensator and instruments mounted in a combined housing with the pressure gauge. In the looser sense, scuba set has been used to refer to all the diving equipment used by the scuba diver, though this would more commonly and accurately be termed scuba equipment or scuba gear. Scuba is overwhelmingly the most common underwater breathing system used by recreational divers and is also used in professional diving when it provides advantages, usually of mobility and range, over surface-supplied diving systems and is allowed by the relevant legislation and code of practice.
A ventilator is a type of breathing apparatus, a class of medical technology that provides mechanical ventilation by moving breathable air into and out of the lungs, to deliver breaths to a patient who is physically unable to breathe, or breathing insufficiently. Ventilators may be computerized microprocessor-controlled machines, but patients can also be ventilated with a simple, hand-operated bag valve mask. Ventilators are chiefly used in intensive-care medicine, home care, and emergency medicine and in anesthesiology.
A rebreather is a breathing apparatus that absorbs the carbon dioxide of a user's exhaled breath to permit the rebreathing (recycling) of the substantially unused oxygen content, and unused inert content when present, of each breath. Oxygen is added to replenish the amount metabolised by the user. This differs from open-circuit breathing apparatus, where the exhaled gas is discharged directly into the environment. The purpose is to extend the breathing endurance of a limited gas supply, and, for covert military use by frogmen or observation of underwater life, eliminating the bubbles produced by an open circuit system and in turn not scaring wildlife being filmed. A rebreather is generally understood to be a portable unit carried by the user. The same technology on a vehicle or non-mobile installation is more likely to be referred to as a life-support system.
A breathing gas is a mixture of gaseous chemical elements and compounds used for respiration. Air is the most common and only natural breathing gas, but other mixtures of gases, or pure oxygen, are also used in breathing equipment and enclosed habitats. Oxygen is the essential component for any breathing gas. Breathing gases for hyperbaric use have been developed to improve on the performance of ordinary air by reducing the risk of decompression sickness, reducing the duration of decompression, reducing nitrogen narcosis or allowing safer deep diving.
A diving regulator or underwater diving regulator is a pressure regulator that controls the pressure of breathing gas for underwater diving. The most commonly recognised application is to reduce pressurized breathing gas to ambient pressure and deliver it to the diver, but there are also other types of gas pressure regulator used for diving applications. The gas may be air or one of a variety of specially blended breathing gases. The gas may be supplied from a scuba cylinder carried by the diver, in which case it is called a scuba regulator, or via a hose from a compressor or high-pressure storage cylinders at the surface in surface-supplied diving. A gas pressure regulator has one or more valves in series which reduce pressure from the source, and use the downstream pressure as feedback to control the delivered pressure, or the upstream pressure as feedback to prevent excessive flow rates, lowering the pressure at each stage.
Surface-supplied diving is a mode of underwater diving using equipment supplied with breathing gas through a diver's umbilical from the surface, either from the shore or from a diving support vessel, sometimes indirectly via a diving bell. This is different from scuba diving, where the diver's breathing equipment is completely self-contained and there is no essential link to the surface. The primary advantages of conventional surface supplied diving are lower risk of drowning and considerably larger breathing gas supply than scuba, allowing longer working periods and safer decompression. Disadvantages are the absolute limitation on diver mobility imposed by the length of the umbilical, encumbrance by the umbilical, and high logistical and equipment costs compared with scuba. The disadvantages restrict use of this mode of diving to applications where the diver operates within a small area, which is common in commercial diving work.
A full-face diving mask is a type of diving mask that seals the whole of the diver's face from the water and contains a mouthpiece, demand valve or constant flow gas supply that provides the diver with breathing gas. The full face mask has several functions: it lets the diver see clearly underwater, it provides the diver's face with some protection from cold and polluted water and from stings, such as from jellyfish or coral. It increases breathing security and provides a space for equipment that lets the diver communicate with the surface support team.
Oxygen therapy, also referred to as supplemental oxygen, is the use of oxygen as medical treatment. Supplemental oxygen can also refer to the use of oxygen enriched air at altitude. Acute indications for therapy include hypoxemia, carbon monoxide toxicity and cluster headache. It may also be prophylactically given to maintain blood oxygen levels during the induction of anesthesia. Oxygen therapy is often useful in chronic hypoxemia caused by conditions such as severe COPD or cystic fibrosis. Oxygen can be delivered via nasal cannula, face mask, or endotracheal intubation at normal atmospheric pressure, or in a hyperbaric chamber. It can also be given through bypassing the airway, such as in ECMO therapy.
An anaesthetic machine or anesthesia machine is a medical device used to generate and mix a fresh gas flow of medical gases and inhalational anaesthetic agents for the purpose of inducing and maintaining anaesthesia.
Respiratory arrest is a serious medical condition caused by apnea or respiratory dysfunction severe enough that it will not sustain the body. Prolonged apnea refers to a patient who has stopped breathing for a long period of time. If the heart muscle contraction is intact, the condition is known as respiratory arrest. An abrupt stop of pulmonary gas exchange lasting for more than five minutes may permanently damage vital organs, especially the brain. Lack of oxygen to the brain causes loss of consciousness. Brain injury is likely if respiratory arrest goes untreated for more than three minutes, and death is almost certain if more than five minutes.
A breathing apparatus or breathing set is equipment which allows a person to breathe in a hostile environment where breathing would otherwise be impossible, difficult, harmful, or hazardous, or assists a person to breathe. A respirator, medical ventilator, or resuscitator may also be considered to be breathing apparatus. Equipment that supplies or recycles breathing gas other than ambient air in a space used by several people is usually referred to as being part of a life-support system, and a life-support system for one person may include breathing apparatus, when the breathing gas is specifically supplied to the user rather than to the enclosure in which the user is the occupant.
A scuba manifold is a device incorporating one or more valves and one or more gas outlets with scuba regulator connections, used to connect two or more diving cylinders containing breathing gas, providing a greater amount of gas for longer dive times or deeper dives. An isolation manifold allows the connection between the cylinders to be closed in the case of a leak from one of the cylinders or its valve or regulator, conserving the gas in the other cylinder. Diving with two or more cylinders is often associated with technical diving. Almost all manifold assemblies include one cylinder valve for each cylinder, and the overwhelming majority are for two cylinders.
A pressure regulator is a valve that controls the pressure of a fluid to a desired value, using negative feedback from the controlled pressure. Regulators are used for gases and liquids, and can be an integral device with a pressure setting, a restrictor and a sensor all in the one body, or consist of a separate pressure sensor, controller and flow valve.
Freeflow in underwater diving apparatus is a continuous flow of gas from a storage or supply unit. In scuba diving it is usually undesirable and considered a malfunction, while in surface supplied diving it may be a malfunction or a user selected option in demand systems, or the standard mode of operation in freeflow systems.
An orinasal mask, oro-nasal mask or oral-nasal mask is a breathing mask that covers the mouth and the nose only. It may be a complete independent item, as an oxygen mask, or on some anaesthetic apparatuses, or it may be fitted as a component inside a fullface mask on underwater breathing apparatus, a gas mask or an industrial respirator to reduce the amount of dead space. It may be designed for its lower edge to seal on the front of the lower jaw or to go under the chin.
A breathing circuit is those parts of a breathing apparatus, which direct the flow of supplied breathing gas to, and sometimes from, the user. The breathing circuit may be open, closed, or semi-closed, depending on whether breathing gas is recycled. A closed or semi-closed circuit will include components which remove carbon dioxide from the exhaled gas and add oxygen before it is delivered for inhalation, so that the mixture remains stable and suitable for supporting life. Terminology may vary slightly between fields of application. In diving and industrial rebreathers, the closed or semi-closed breathing circuit may also be called the loop, or breathing loop. In medical equipment the closed or semi-closed circuit may be called the circle system.
Scuba gas management is the aspect of scuba diving which includes the gas planning, blending, filling, analysing, marking, storage, and transportation of gas cylinders for a dive, the monitoring and switching of breathing gases during a dive, efficient and correct use of the gas, and the provision of emergency gas to another member of the dive team. The primary aim is to ensure that everyone has enough to breathe of a gas suitable for the current depth at all times, and is aware of the gas mixture in use and its effect on decompression obligations, nitrogen narcosis, and oxygen toxicity risk. Some of these functions may be delegated to others, such as the filling of cylinders, or transportation to the dive site, but others are the direct responsibility of the diver using the gas.
Diving hazards are the agents or situations that pose a threat to the underwater diver or their equipment. Divers operate in an environment for which the human body is not well suited. They face special physical and health risks when they go underwater or use high pressure breathing gas. The consequences of diving incidents range from merely annoying to rapidly fatal, and the result often depends on the equipment, skill, response and fitness of the diver and diving team. The classes of hazards include the aquatic environment, the use of breathing equipment in an underwater environment, exposure to a pressurised environment and pressure changes, particularly pressure changes during descent and ascent, and breathing gases at high ambient pressure. Diving equipment other than breathing apparatus is usually reliable, but has been known to fail, and loss of buoyancy control or thermal protection can be a major burden which may lead to more serious problems. There are also hazards of the specific diving environment, and hazards related to access to and egress from the water, which vary from place to place, and may also vary with time. Hazards inherent in the diver include pre-existing physiological and psychological conditions and the personal behaviour and competence of the individual. For those pursuing other activities while diving, there are additional hazards of task loading, of the dive task and of special equipment associated with the task.
The mechanism of diving regulators is the arrangement of components and function of gas pressure regulators used in the systems which supply breathing gases for underwater diving. Both free-flow and demand regulators use mechanical feedback of the downstream pressure to control the opening of a valve which controls gas flow from the upstream, high-pressure side, to the downstream, low-pressure side of each stage. Flow capacity must be sufficient to allow the downstream pressure to be maintained at maximum demand, and sensitivity must be appropriate to deliver maximum required flow rate with a small variation in downstream pressure, and for a large variation in supply pressure, without instability of flow. Open circuit scuba regulators must also deliver against a variable ambient pressure. They must be robust and reliable, as they are life-support equipment which must function in the relatively hostile seawater environment, and the human interface must be comfortable over periods of several hours.
A breathing apparatus or breathing set is equipment which allows a person to breathe in a hostile environment where breathing would otherwise be impossible, difficult, harmful, or hazardous, or assists a person to breathe. A respirator, medical ventilator, or resuscitator may also be considered to be breathing apparatus. Equipment that supplies or recycles breathing gas other than ambient air in a space used by several people is usually referred to as being part of a life-support system, and a life-support system for one person may include breathing apparatus, when the breathing gas is specifically supplied to the user rather than to the enclosure in which the user is the occupant.