Definition, Description, Causes and symptoms, Diagnosis, Treatment, Prognosis, Prevention
Nitrogen narcosis is a condition that occurs in divers breathing compressed air. When divers go below depths of approximately 100 ft, increase in the partial pressure of nitrogen produces an altered mental state similar to alcohol intoxication.
Nitrogen narcosis, commonly referred to as "rapture of the deep, " typically becomes noticeable at 100 ft underwater and is incapacitating at 300 ft, causing stupor, blindness, unconsciousness, and even death. Nitrogen narcosis is also called "the martini effect" because divers experience an effect comparable to that from one martini on an empty stomach for every 50 ft of depth beyond the initial 100 ft.
Causes and symptoms
Nitrogen narcosis is caused by gases in the body acting in a manner described by Dalton's Law of partial pressures: the total pressure of a gas mixture is equal to the sum of the partial pressures of gases in the mixture. As the total gas pressure increases with increasing dive depth, the partial pressure of nitrogen increases and more nitrogen becomes dissolved in the blood. This high nitrogen concentration impairs the conduction of nerve impulses and mimics the effects of alcohol or narcotics.
Symptoms of nitrogen narcosis include: wooziness; giddiness; euphoria; disorientation; loss of balance; loss of manual dexterity; slowing of reaction time; fixation of ideas; and impairment of complex reasoning. These effects are exacerbated by cold, stress, and a rapid rate of compression.
A diagnosis must be made on circumstantial evidence of atypical behavior, taking into consideration the depth of the dive and the rate of compression. Nitrogen narcosis may be differentiated from toxicity of oxygen, carbon monoxide, or carbon dioxide by the absence of such symptoms as headache, seizure, and bluish color of the lips and nail beds.
The effects of nitrogen narcosis are totally reversed as the gas pressure decreases. They are typically gone by the time the diver returns to a water depth of 60 ft. Nitrogen narcosis has no hangover or lasting effects requiring further treatment. However, a doctor should be consulted whenever a diver has lost consciousness.
When a diver returns to a safe depth, the effects of nitrogen narcosis disappear completely. Some evidence exists that certain divers may become partially acclimated to the effects of nitrogen narcosis with frequency— the more often they dive, the less the increased nitrogen seems to affect them.
Helium may be used as a substitute for nitrogen to dilute oxygen for deep water diving. It is colorless, odorless, tasteless, and chemically inert. However, it is more expensive than nitrogen and drains body heat from a diver. In diving with rapid compression, the helium-oxygen mixture may produce nausea, dizziness, and trembling, but these adverse reactions are less severe than nitrogen narcosis.
Nitrogen narcosis can be avoided by limiting the depth of dives. The risk of nitrogen narcosis may also be minimized by following safe diving practices, including proper equipment maintenance, low work effort, proper buoyancy, maintenance of visual cues, and focused thinking. In addition, no alcohol should be consumed within 24 hours of diving.
Martin, Lawrence. Scuba Diving Explained: Questions and Answers of Physiology and Medical Aspects of Scuba Diving. Flagstaff, AZ: Best Publishing, 1997.
American College of Hyperbaric Medicine. P.O. Box 25914-130, Houston, Texas 77265. (713) 528-0657. <http://www.hyperbaricmedicine.org>.
Divers Alert Network. The Peter B. Bennett Center, 6 West Colony Place, Durham, NC 27705. (800) 446-2671. <http://www.diversalertnetwork.org>.
Undersea and Hyperbaric Medical Society. 10531 Metropolitan Ave., Kensington, MD 20895. (301) 942-2980. <http://www.uhms.org>.
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