Deep Intoxication (nitrogen Anesthesia, Inert Gas Anesthesia - IGN)

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-11-27 18:19

Deep intoxication

Deep intoxication is responsible for about six percent of fatal diving accidents. It can occur from a depth of about 30 meters. The further away a diver is from the surface of the water, the more pronounced the symptoms can be. These include drowsiness, anxiety or pronounced feelings of happiness (euphoria), hallucinations and loss of consciousness. The deep intoxication is caused in deep waters by the influence of nitrogen on the brain. Carbon dioxide seems to increase its effects.

The susceptibility to developing deep intoxication varies greatly from person to person. It depends, among other things, on the daily constitution of a diver and the ambient conditions. The danger of deep intoxication is inadequate acting and reacting in emergency situations, very similar to driving a car in an alcoholic state.

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• What are the causes of deep intoxication?
• What are the symptoms?
• How is deep intoxication treated?
• How can a deep intoxication be prevented?
• Whom can I ask?
• How are the costs going to be covered?

What are the causes of deep intoxication?

Nitrogen is inhaled as part of the breathing gas through the diving bottle. It gets into the blood through the lungs. It is dissolved in the blood and transported to the brain. Due to the high ambient pressure in deep waters, it is increasingly stored in the cell walls (cell membranes) of nerve cells in the brain. This seems to affect the metabolism in the brain. Exactly how nitrogen affects the functions of the brain has not yet been fully understood. If psychoactive substances (drugs, alcohol or centrally acting medication - e.g. psychotropic drugs) are taken, the risk of deep intoxication is higher. Stressful situations also favor the development of deep intoxication.

What are the symptoms?

The symptoms increase with the depth. Usually the first signs of deep intoxication appear from a depth of 30 meters. For some divers, they already start above 30 meters. From 50 to 60 meters, the symptoms become more and more pronounced. The symptoms resemble an acute state of confusion (delirium).

The following symptoms can occur:

• Drowsiness,
• Panic attacks or increased well-being up to euphoria,
• Thinking disorders - e.g. reduced ability to concentrate, poor decision-making, wrong decisions, attention disorders, memory gaps (partial amnesia),
• increased risk behavior,
• Disorientation,
• obsessive insistence on ideas that are often not appropriate to the situation (fixation of ideas),
• Movement disorders,
• Misjudgments or hallucinations,
• uninterrupted repetition of actions (automatisms),
• complete loss of control as well
• Unconsciousness.

A deep intoxication is often not perceived by those affected. Divers can then often not correctly assess their situation and possibly make dangerous wrong decisions. In most cases, a deep intoxication is first recognized by diving partners due to a changed behavior or situation-inadequate reactions of the person concerned.

If the diver is exposed to stressful situations, he / she can suddenly panic, lose control and no longer react appropriately to the demands of the situation. If unconsciousness occurs, the person concerned can lose the breathing apparatus, inhale water, sink into the depths or not appear independently. If s / he does not have a buddy or if he / she is unable to save the person affected, both complications can be fatal.

In addition, ascending quickly can lead to a decompression sickness. Diving partners can also be endangered by panic actions and wrong decisions by the person concerned.

How is deep intoxication treated?

When a deep intoxication develops, keeping calm comes first. Fear of a deep intoxication worsens the symptoms. Symptoms of deep intoxication are relieved as the depth decreases. Ascending too quickly should be avoided to prevent the development of decompression sickness. The deep intoxication itself does not need medical treatment. If a deep intoxication is accompanied by complications - e.g. with the development of decompression sickness or decompression syndrome - first aid is provided by diving partners and subsequently by an emergency doctor.

How can a deep intoxication be prevented?

The deeper you dive, the higher the risk of developing deep intoxication. For recreational divers, a diving limit at a depth of 30-40 meters is therefore recommended. Breathing gas that contains helium instead of nitrogen can be used for diving in deeper regions. In principle, a dive should never be undertaken alone, so that a rescue in the event of an incident can be carried out by a diving partner.

Whom can I ask?

In Austria, the public rescue service (Tel.: 144) coordinates the procedure for diving accidents. When calling, the password "diving accident" should be given. After the initial assessment or care by the emergency doctor, the rescue control centers ensure the emergency transport to the nearest pressure chamber (decompression chamber) if necessary. Before diving abroad, information on country-specific procedures in the event of diving accidents should be obtained.

Several emergency hotlines are available around the clock for questions about a diving accident. Current telephone numbers can be found on the websites of the Austrian Society for Diving and Hyperbaric Medicine (www.oegth.at) and the Austrian Society for Underwater and Hyperbaric Medicine (www.oeguhm.at).

How are the costs going to be covered?

All necessary and appropriate diagnostic and therapeutic measures are taken over by the accident and health insurance carriers. Your doctor will generally settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible (treatment contribution) (BVAEB, SVS, SVS, BVAEB). However, you can also use a doctor of your choice (ie doctor without a health insurance contract). For more information, see Costs and Deductibles.

For certain examinations (e.g. MRI), approval from the health insurance provider responsible (medical service - "chief physician") may be required, as well as for certain drug or non-drug treatments (e.g. physical therapy), in some cases only when the disease has reached a certain extent. For certain services (e.g. inpatient stays, aids and medical aids) - depending on the health insurance provider - patient co-payments are provided. Most health insurance providers provide for a permit, sometimes depending on the type of medical aid. The prescription fee has to be paid for medication on a “cash prescription”.

For information on the respective provisions, please contact your health insurance provider, which you can find on the social security website.