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A breathing gas is a mixture of gaseous chemical elements and compounds used for
respiration Respiration may refer to: Biology * Cellular respiration, the process in which nutrients are converted into useful energy in a cell ** Anaerobic respiration, cellular respiration without oxygen ** Maintenance respiration, the amount of cellul ...
. 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 such as
scuba equipment Scuba diving is a mode of underwater diving whereby divers use breathing equipment that is completely independent of a surface air supply. The name "scuba", an acronym for "Self-Contained Underwater Breathing Apparatus", was coined by Christ ...
,
surface supplied diving Surface-supplied diving is diving using equipment supplied with breathing gas using 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 scub ...
equipment,
recompression chamber 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 ...
s, high-altitude mountaineering, high-flying
aircraft An aircraft is a vehicle that is able to flight, fly by gaining support from the Atmosphere of Earth, air. It counters the force of gravity by using either Buoyancy, static lift or by using the Lift (force), dynamic lift of an airfoil, or in ...
,
submarine A submarine (or sub) is a watercraft capable of independent operation underwater. It differs from a submersible, which has more limited underwater capability. The term is also sometimes used historically or colloquially to refer to remotely op ...
s,
space suit A space suit or spacesuit is a garment worn to keep a human alive in the harsh environment of outer space, vacuum and temperature extremes. Space suits are often worn inside spacecraft as a safety precaution in case of loss of cabin pressure, ...
s,
spacecraft A spacecraft is a vehicle or machine designed to fly in outer space. A type of artificial satellite, spacecraft are used for a variety of purposes, including communications, Earth observation, meteorology, navigation, space colonization, ...
, medical life support and first aid equipment, and
anaesthetic machine An anaesthetic machine (British English) or anesthesia machine (American English) 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 ana ...
s. Oxygen is the essential component for any breathing gas, at a
partial pressure In a mixture of gases, each constituent gas has a partial pressure which is the notional pressure of that constituent gas as if it alone occupied the entire volume of the original mixture at the same temperature. The total pressure of an ideal g ...
of between roughly 0.16 and 1.60
bar Bar or BAR may refer to: Food and drink * Bar (establishment), selling alcoholic beverages * Candy bar * Chocolate bar Science and technology * Bar (river morphology), a deposit of sediment * Bar (tropical cyclone), a layer of cloud * Bar ( ...
at the
ambient pressure Ambient or Ambiance or Ambience may refer to: Music and sound * Ambience (sound recording), also known as atmospheres or backgrounds * Ambient music, a genre of music that puts an emphasis on tone and atmosphere * ''Ambient'' (album), by Moby * ...
. The oxygen is usually the only metabolically active component unless the gas is an anaesthetic mixture. Some of the oxygen in the breathing gas is consumed by the metabolic processes, and the inert components are unchanged, and serve mainly to dilute the oxygen to an appropriate concentration, and are therefore also known as diluent gases. Most breathing gases therefore are a mixture of
oxygen Oxygen is the chemical element with the symbol O and atomic number 8. It is a member of the chalcogen group in the periodic table, a highly reactive nonmetal, and an oxidizing agent that readily forms oxides with most elements ...
and one or more metabolically
inert gas An inert gas is a gas that does not readily undergo chemical reactions with other chemical substances and therefore does not readily form chemical compounds. The noble gases often do not react with many substances and were historically referred to ...
es. Breathing gases for hyperbaric use have been developed to improve on the performance of ordinary air by reducing the risk of
decompression sickness Decompression sickness (abbreviated DCS; also called divers' disease, the bends, aerobullosis, and caisson disease) is a medical condition caused by dissolved gases emerging from solution as bubbles inside the body tissues during decompressio ...
, reducing the duration of
decompression stops The decompression of a diver is the reduction in ambient pressure experienced during ascent from depth. It is also the process of elimination of dissolved inert gases from the diver's body, which occurs during the ascent, largely during ...
, reducing
nitrogen narcosis Narcosis while diving (also known as nitrogen narcosis, inert gas narcosis, raptures of the deep, Martini effect) is a reversible alteration in consciousness that occurs while diving at depth. It is caused by the anesthetic effect of certain g ...
or allowing safer
deep diving Deep diving is underwater diving to a depth beyond the norm accepted by the associated community. In some cases this is a prescribed limit established by an authority, while in others it is associated with a level of certification or training, an ...
. A safe breathing gas for
hyperbaric Hyperbaric medicine is medical treatment in which an ambient pressure greater than sea level atmospheric pressure is a necessary component. The treatment comprises hyperbaric oxygen therapy (HBOT), the medical use of oxygen at an ambient pressure ...
use has four essential features: * It must contain sufficient oxygen to support life, consciousness and work rate of the breather. * It must not contain harmful contaminants.
Carbon monoxide Carbon monoxide ( chemical formula CO) is a colorless, poisonous, odorless, tasteless, flammable gas that is slightly less dense than air. Carbon monoxide consists of one carbon atom and one oxygen atom connected by a triple bond. It is the simpl ...
and
carbon dioxide Carbon dioxide ( chemical formula ) is a chemical compound made up of molecules that each have one carbon atom covalently double bonded to two oxygen atoms. It is found in the gas state at room temperature. In the air, carbon dioxide is t ...
are common poisons which may contaminate breathing gases. There are many other possibilities. * It must not become toxic when being breathed at high
pressure Pressure (symbol: ''p'' or ''P'') is the force applied perpendicular to the surface of an object per unit area over which that force is distributed. Gauge pressure (also spelled ''gage'' pressure)The preferred spelling varies by country a ...
such as when underwater. Oxygen and
nitrogen Nitrogen is the chemical element with the symbol N and atomic number 7. Nitrogen is a nonmetal and the lightest member of group 15 of the periodic table, often called the pnictogens. It is a common element in the universe, estimated at se ...
are examples of gases that become
toxic Toxicity is the degree to which a chemical substance or a particular mixture of substances can damage an organism. Toxicity can refer to the effect on a whole organism, such as an animal, bacterium, or plant, as well as the effect on a sub ...
under pressure. * It must not be too dense to breathe.
Work of breathing Work of breathing (WOB) is the energy expended to inhale and exhale a breathing gas. It is usually expressed as work per unit volume, for example, joules/litre, or as a work rate (power), such as joules/min or equivalent units, as it is not particu ...
increases with
density Density (volumetric mass density or specific mass) is the substance's mass per unit of volume. The symbol most often used for density is ''ρ'' (the lower case Greek letter rho), although the Latin letter ''D'' can also be used. Mathematicall ...
and
viscosity The viscosity of a fluid is a measure of its resistance to deformation at a given rate. For liquids, it corresponds to the informal concept of "thickness": for example, syrup has a higher viscosity than water. Viscosity quantifies the int ...
. Maximum ventilation drops by about 50% when density is equivalent to air at 30 msw, and carbon dioxide levels rise unacceptably for moderate exercise with a gas density exceeding 6 g/litre. Breathing gas density of 10 g/litre or more may cause runaway
hypercapnia Hypercapnia (from the Greek ''hyper'' = "above" or "too much" and ''kapnos'' = "smoke"), also known as hypercarbia and CO2 retention, is a condition of abnormally elevated carbon dioxide (CO2) levels in the blood. Carbon dioxide is a gaseous p ...
even at very low work levels, with potentially fatal effects. The techniques used to fill
diving cylinder A diving cylinder or diving gas cylinder is a gas cylinder used to store and transport high pressure gas used in diving operations. This may be breathing gas used with a scuba set, in which case the cylinder may also be referred to as a sc ...
s with gases other than air are called
gas blending Gas blending is the process of mixing gases for a specific purpose where the composition of the resulting mixture is specified and controlled. A wide range of applications include scientific and industrial processes, food production and storage and ...
. Breathing gases for use at ambient pressures below normal atmospheric pressure are usually pure oxygen or air enriched with oxygen to provide sufficient oxygen to maintain life and consciousness, or to allow higher levels of exertion than would be possible using air. It is common to provide the additional oxygen as a pure gas added to the breathing air at inhalation, or though a life-support system.


For diving and other hyperbaric use

These common diving breathing gases are used: *
Air The atmosphere of Earth is the layer of gases, known collectively as air, retained by Earth's gravity that surrounds the planet and forms its planetary atmosphere. The atmosphere of Earth protects life on Earth by creating pressure allowing f ...
is a mixture of 21%
oxygen Oxygen is the chemical element with the symbol O and atomic number 8. It is a member of the chalcogen group in the periodic table, a highly reactive nonmetal, and an oxidizing agent that readily forms oxides with most elements ...
, 78%
nitrogen Nitrogen is the chemical element with the symbol N and atomic number 7. Nitrogen is a nonmetal and the lightest member of group 15 of the periodic table, often called the pnictogens. It is a common element in the universe, estimated at se ...
, and approximately 1% other trace gases, primarily
argon Argon is a chemical element with the symbol Ar and atomic number 18. It is in group 18 of the periodic table and is a noble gas. Argon is the third-most abundant gas in Earth's atmosphere, at 0.934% (9340 ppmv). It is more than twice a ...
; to simplify calculations this last 1% is usually treated as if it were nitrogen. Being freely available and simple to use, it is the most common diving gas. As its nitrogen component causes
nitrogen narcosis Narcosis while diving (also known as nitrogen narcosis, inert gas narcosis, raptures of the deep, Martini effect) is a reversible alteration in consciousness that occurs while diving at depth. It is caused by the anesthetic effect of certain g ...
, it is considered to have a safe depth limit of about 40 metres (130 feet) for most divers, although the maximum operating depth of air taking an allowable oxygen partial pressure of 1,6 bar is 66.2 metres (218 feet). Breathing air is air meeting specified standards for contaminants. * Pure oxygen is mainly used to speed the shallow decompression stops at the end of a
military A military, also known collectively as armed forces, is a heavily armed, highly organized force primarily intended for warfare. It is typically authorized and maintained by a sovereign state, with its members identifiable by their distinct ...
,
commercial Commercial may refer to: * a dose of advertising conveyed through media (such as - for example - radio or television) ** Radio advertisement ** Television advertisement * (adjective for:) commerce, a system of voluntary exchange of products and s ...
, or technical dive. Risk of acute
oxygen toxicity Oxygen toxicity is a condition resulting from the harmful effects of breathing molecular oxygen () at increased partial pressures. Severe cases can result in cell damage and death, with effects most often seen in the central nervous system, l ...
increases rapidly at pressures greater than 6 metres sea water. It was much used in frogmen's
rebreather 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 i ...
s, and is still used by attack swimmers. * ''
Nitrox Nitrox refers to any breathing gas, gas mixture composed (excepting trace gases) of nitrogen and oxygen. This includes atmospheric air, which is approximately 78% nitrogen, 21% oxygen, and 1% other gases, primarily argon. In the usual applicatio ...
'' is a mixture of oxygen and air, and generally refers to mixtures which are more than 21% oxygen. It can be used as a tool to accelerate in-water decompression stops or to decrease the risk of
decompression sickness Decompression sickness (abbreviated DCS; also called divers' disease, the bends, aerobullosis, and caisson disease) is a medical condition caused by dissolved gases emerging from solution as bubbles inside the body tissues during decompressio ...
and thus prolong a dive (a common misconception is that the diver can go deeper, this is not true owing to a shallower maximum operating depth than on conventional air). * '' Trimix'' is a mixture of oxygen, nitrogen and
helium Helium (from el, ἥλιος, helios, lit=sun) is a chemical element with the symbol He and atomic number 2. It is a colorless, odorless, tasteless, non-toxic, inert, monatomic gas and the first in the noble gas group in the periodic ta ...
and is often used at depth in
technical diving Technical diving (also referred to as tec diving or tech diving) is scuba diving that exceeds the agency-specified limits of recreational diving for non- professional purposes. Technical diving may expose the diver to hazards beyond those normal ...
and
commercial diving Commercial diving may be considered an application of professional diving where the diver engages in underwater work for industrial, construction, engineering, maintenance or other commercial purposes which are similar to work done out of the wate ...
instead of air to reduce nitrogen narcosis and to avoid the dangers of oxygen toxicity. * '' Heliox'' is a mixture of oxygen and helium and is often used in the deep phase of a commercial deep dive to eliminate nitrogen narcosis. * '' Heliair'' is a form of trimix that is easily blended from helium and air without using pure oxygen. It always has a 21:79 ratio of oxygen to nitrogen; the balance of the mix is helium. * '' Hydreliox'' is a mixture of oxygen, helium, and
hydrogen Hydrogen is the chemical element with the symbol H and atomic number 1. Hydrogen is the lightest element. At standard conditions hydrogen is a gas of diatomic molecules having the formula . It is colorless, odorless, tasteless, non-to ...
and is used for dives below 130 metres in commercial diving. * ''
Hydrox Hydrox is a cream-filled chocolate sandwich cookie currently owned and manufactured by Leaf Brands. It debuted in the United States in 1908, and was manufactured by Sunshine Biscuits for over 90 years. Hydrox was largely discontinued in 1999, ...
'', a gas mixture of
hydrogen Hydrogen is the chemical element with the symbol H and atomic number 1. Hydrogen is the lightest element. At standard conditions hydrogen is a gas of diatomic molecules having the formula . It is colorless, odorless, tasteless, non-to ...
and
oxygen Oxygen is the chemical element with the symbol O and atomic number 8. It is a member of the chalcogen group in the periodic table, a highly reactive nonmetal, and an oxidizing agent that readily forms oxides with most elements ...
, is used as a breathing gas in very
deep diving Deep diving is underwater diving to a depth beyond the norm accepted by the associated community. In some cases this is a prescribed limit established by an authority, while in others it is associated with a level of certification or training, an ...
. * ''Neox'' (also called neonox) is a mixture of oxygen and
neon Neon is a chemical element with the symbol Ne and atomic number 10. It is a noble gas. Neon is a colorless, odorless, inert monatomic gas under standard conditions, with about two-thirds the density of air. It was discovered (along with krypt ...
sometimes employed in deep commercial diving. It is rarely used due to its cost. Also, DCS symptoms produced by neon ("neox bends") have a poor reputation, being widely reported to be more severe than those produced by an exactly equivalent dive-table and mix with helium.


Breathing air

Breathing air is atmospheric air with a standard of purity suitable for human breathing in the specified application. For hyperbaric use the partial pressure of contaminants is increased in proportion to the absolute pressure, and must be limited to a safe composition for the depth or pressure range in which it is to be used.


Classification by oxygen fraction

Breathing gases for diving are classified by oxygen fraction. The boundaries set by authorities may differ slightly, as the effects vary gradually with concentration and between people, and are not accurately predictable. ;Normoxic: where the oxygen content does not differ greatly from that of air and allows continuous safe use at atmospheric pressure. ;Hyperoxic, or oxygen enriched: where the oxygen content exceeds atmospheric levels, generally to a level where there is some measurable physiological effect over long term use, and sometimes requiring special procedures for handling due to increased fire hazard. The associated risks are oxygen toxicity at depth and fire, particularly in the breathing apparatus. ;Hypoxic: where the oxygen content is less than that of air, generally to the extent that there is a significant risk of measurable physiological effect over the short term. The immediate risk is usually hypoxic incapacitation at or near the surface.


Individual component gases

Breathing gases for diving are mixed from a small number of component gases which provide special characteristics to the mixture which are not available from atmospheric air.


Oxygen

Oxygen (O2) must be present in every breathing gas. This is because it is essential to the
human body The human body is the structure of a human being. It is composed of many different types of cells that together create tissues and subsequently organ systems. They ensure homeostasis and the viability of the human body. It comprises a hea ...
's metabolic process, which sustains life. The human body cannot store oxygen for later use as it does with food. If the body is deprived of oxygen for more than a few minutes, unconsciousness and death result. The tissues and
organ Organ may refer to: Biology * Organ (biology), a part of an organism Musical instruments * Organ (music), a family of keyboard musical instruments characterized by sustained tone ** Electronic organ, an electronic keyboard instrument ** Hammond ...
s within the body (notably the heart and brain) are damaged if deprived of oxygen for much longer than four minutes. Filling a diving cylinder with pure oxygen costs around five times more than filling it with compressed air. As oxygen supports combustion and causes rust in
diving cylinder A diving cylinder or diving gas cylinder is a gas cylinder used to store and transport high pressure gas used in diving operations. This may be breathing gas used with a scuba set, in which case the cylinder may also be referred to as a sc ...
s, it should be handled with caution when
gas blending Gas blending is the process of mixing gases for a specific purpose where the composition of the resulting mixture is specified and controlled. A wide range of applications include scientific and industrial processes, food production and storage and ...
. Oxygen has historically been obtained by
fractional distillation Fractional distillation is the separation of a mixture into its component parts, or fractions. Chemical compounds are separated by heating them to a temperature at which one or more fractions of the mixture will vaporize. It uses distillation ...
of liquid air, but is increasingly obtained by non-cryogenic technologies such as
pressure swing adsorption Pressure swing adsorption (PSA) is a technique used to separate some gas species from a mixture of gases (typically air) under pressure according to the species' molecular characteristics and affinity for an adsorbent material. It operates at ne ...
(PSA) and
vacuum swing adsorption Pressure swing adsorption (PSA) is a technique used to separate some gas species from a mixture of gases (typically air) under pressure according to the species' molecular characteristics and affinity for an adsorbent material. It operates at nea ...
(VSA) technologies. The fraction of the oxygen component of a breathing gas mixture is sometimes used when naming the mix: * ''hypoxic'' mixes, strictly, contain less than 21% oxygen, although often a boundary of 16% is used, and are designed only to be breathed at depth as a "bottom gas" where the higher pressure increases the
partial pressure In a mixture of gases, each constituent gas has a partial pressure which is the notional pressure of that constituent gas as if it alone occupied the entire volume of the original mixture at the same temperature. The total pressure of an ideal g ...
of oxygen to a safe level. Trimix, Heliox and Heliair are gas blends commonly used for hypoxic mixes and are used in professional and
technical diving Technical diving (also referred to as tec diving or tech diving) is scuba diving that exceeds the agency-specified limits of recreational diving for non- professional purposes. Technical diving may expose the diver to hazards beyond those normal ...
as deep breathing gases. * ''normoxic'' mixes have the same proportion of oxygen as air, 21%. The maximum operating depth of a normoxic mix could be as shallow as 47 metres (155 feet). Trimix with between 17% and 21% oxygen is often described as normoxic because it contains a high enough proportion of oxygen to be safe to breathe at the surface. * ''hyperoxic'' mixes have more than 21% oxygen. Enriched Air Nitrox (EANx) is a typical hyperoxic breathing gas. Hyperoxic mixtures, when compared to air, cause
oxygen toxicity Oxygen toxicity is a condition resulting from the harmful effects of breathing molecular oxygen () at increased partial pressures. Severe cases can result in cell damage and death, with effects most often seen in the central nervous system, l ...
at shallower depths but can be used to shorten
decompression stop The practice of decompression by divers comprises the planning and monitoring of the profile indicated by the algorithms or tables of the chosen decompression model, to allow asymptomatic and harmless release of excess inert gases dissolved in ...
s by drawing dissolved inert gases out of the body more quickly. The fraction of the oxygen determines the greatest depth at which the mixture can safely be used to avoid
oxygen toxicity Oxygen toxicity is a condition resulting from the harmful effects of breathing molecular oxygen () at increased partial pressures. Severe cases can result in cell damage and death, with effects most often seen in the central nervous system, l ...
. This depth is called the maximum operating depth. The concentration of oxygen in a gas mix depends on the fraction and the pressure of the mixture. It is expressed by the
partial pressure In a mixture of gases, each constituent gas has a partial pressure which is the notional pressure of that constituent gas as if it alone occupied the entire volume of the original mixture at the same temperature. The total pressure of an ideal g ...
of oxygen (PO2). The partial pressure of any component gas in a mixture is calculated as: :''partial pressure = total absolute pressure × volume fraction of gas component'' For the oxygen component, :PO2 = P × FO2 where: :PO2 = partial pressure of oxygen :P = total pressure :FO2 = volume fraction of oxygen content The minimum safe partial pressure of oxygen in a breathing gas is commonly held to be 16  kPa (0.16 bar). Below this partial pressure the diver may be at risk of unconsciousness and death due to hypoxia, depending on factors including individual physiology and level of exertion. When a hypoxic mix is breathed in shallow water it may not have a high enough PO2 to keep the diver conscious. For this reason normoxic or hyperoxic "travel gases" are used at medium depth between the "bottom" and "decompression" phases of the dive. The maximum safe PO2 in a breathing gas depends on exposure time, the level of exercise and the security of the breathing equipment being used. It is typically between 100 kPa (1 bar) and 160 kPa (1.6 bar); for dives of less than three hours it is commonly considered to be 140 kPa (1.4 bar), although the U.S. Navy has been known to authorize dives with a PO2 of as much as 180 kPa (1.8 bar). At high PO2 or longer exposures, the diver risks oxygen toxicity which may result in a
seizure An epileptic seizure, informally known as a seizure, is a period of symptoms due to abnormally excessive or synchronous neuronal activity in the brain. Outward effects vary from uncontrolled shaking movements involving much of the body with lo ...
. Each breathing gas has a maximum operating depth that is determined by its oxygen content. For therapeutic recompression and hyperbaric oxygen therapy partial pressures of 2.8 bar are commonly used in the chamber, but there is no risk of drowning if the occupant loses consciousness. For longer periods such as in saturation diving, 0.4 bar can be tolerated over several weeks. Oxygen analysers are used to measure the oxygen partial pressure in the gas mix. Divox is breathing grade oxygen labelled for diving use. In the
Netherlands ) , anthem = ( en, "William of Nassau") , image_map = , map_caption = , subdivision_type = Sovereign state , subdivision_name = Kingdom of the Netherlands , established_title = Before independence , established_date = Spanish Netherl ...
, pure oxygen for breathing purposes is regarded as medicinal as opposed to industrial oxygen, such as that used in
welding Welding is a fabrication process that joins materials, usually metals or thermoplastics, by using high heat to melt the parts together and allowing them to cool, causing fusion. Welding is distinct from lower temperature techniques such as b ...
, and is only available on
medical prescription A prescription, often abbreviated or Rx, is a formal communication from a physician or other registered health-care professional to a pharmacist, authorizing them to dispense a specific prescription drug for a specific patient. Historicall ...
. The diving industry registered Divox as a
trademark A trademark (also written trade mark or trade-mark) is a type of intellectual property consisting of a recognizable sign, design, or expression that identifies products or services from a particular source and distinguishes them from ot ...
for breathing grade oxygen to circumvent the strict rules concerning medicinal oxygen thus making it easier for (recreational)
scuba divers This is a list of underwater divers whose exploits have made them notable. Underwater divers are people who take part in underwater diving activities – Underwater diving is practiced as part of an occupation, or for recreation, where t ...
to obtain oxygen for blending their breathing gas. In most countries, there is no difference in purity in medical oxygen and industrial oxygen, as they are produced by exactly the same methods and manufacturers, but labeled and filled differently. The chief difference between them is that the record-keeping trail is much more extensive for medical oxygen, to more easily identify the exact manufacturing trail of a "lot" or batch of oxygen, in case problems with its purity are discovered. Aviation grade oxygen is similar to medical oxygen, but may have a lower moisture content.


Diluent gases

Gases which have no metabolic function in the breathing gas are used to dilute the gas, and are therefore classed as diluent gases. Some of them have a reversible narcotic effect at high partial pressure, and must therefore be limited to avoid excessive narcotic effects at the maximum pressure at which they are intended to be breathed. Diluent gases also affect the density of the gas mixture and thereby the
work of breathing Work of breathing (WOB) is the energy expended to inhale and exhale a breathing gas. It is usually expressed as work per unit volume, for example, joules/litre, or as a work rate (power), such as joules/min or equivalent units, as it is not particu ...
.


= Nitrogen

=
Nitrogen Nitrogen is the chemical element with the symbol N and atomic number 7. Nitrogen is a nonmetal and the lightest member of group 15 of the periodic table, often called the pnictogens. It is a common element in the universe, estimated at se ...
(N2) is a
diatomic Diatomic molecules () are molecules composed of only two atoms, of the same or different chemical elements. If a diatomic molecule consists of two atoms of the same element, such as hydrogen () or oxygen (), then it is said to be homonuclear. O ...
gas and the main component of
air The atmosphere of Earth is the layer of gases, known collectively as air, retained by Earth's gravity that surrounds the planet and forms its planetary atmosphere. The atmosphere of Earth protects life on Earth by creating pressure allowing f ...
, the cheapest and most common breathing gas used for diving. It causes
nitrogen narcosis Narcosis while diving (also known as nitrogen narcosis, inert gas narcosis, raptures of the deep, Martini effect) is a reversible alteration in consciousness that occurs while diving at depth. It is caused by the anesthetic effect of certain g ...
in the diver, so its use is limited to shallower dives. Nitrogen can cause
decompression sickness Decompression sickness (abbreviated DCS; also called divers' disease, the bends, aerobullosis, and caisson disease) is a medical condition caused by dissolved gases emerging from solution as bubbles inside the body tissues during decompressio ...
. Equivalent air depth is used to estimate the decompression requirements of a
nitrox Nitrox refers to any breathing gas, gas mixture composed (excepting trace gases) of nitrogen and oxygen. This includes atmospheric air, which is approximately 78% nitrogen, 21% oxygen, and 1% other gases, primarily argon. In the usual applicatio ...
(oxygen/nitrogen) mixture.
Equivalent narcotic depth Equivalent narcotic depth (END) is used in technical diving as a way of estimating the narcotic effect of a breathing gas A breathing gas is a mixture of gaseous chemical elements and compounds used for respiration. Air is the most common and ...
is used to estimate the narcotic potency of trimix (oxygen/helium/nitrogen mixture). Many divers find that the level of narcosis caused by a dive, whilst breathing air, is a comfortable maximum. Nitrogen in a gas mix is almost always obtained by adding air to the mix.


= Helium

=
Helium Helium (from el, ἥλιος, helios, lit=sun) is a chemical element with the symbol He and atomic number 2. It is a colorless, odorless, tasteless, non-toxic, inert, monatomic gas and the first in the noble gas group in the periodic ta ...
(He) is an inert gas that is less narcotic than nitrogen at equivalent pressure (in fact there is no evidence for any narcosis from helium at all), and it has a much lower density, so it is more suitable for deeper dives than nitrogen. Helium is equally able to cause
decompression sickness Decompression sickness (abbreviated DCS; also called divers' disease, the bends, aerobullosis, and caisson disease) is a medical condition caused by dissolved gases emerging from solution as bubbles inside the body tissues during decompressio ...
. At high pressures, helium also causes
high-pressure nervous syndrome High-pressure nervous syndrome (HPNS – also known as high-pressure neurological syndrome) is a neurological and physiological diving disorder which can result when a diver descends below about using a breathing gas containing helium. The eff ...
, which is a central nervous system irritation syndrome which is in some ways opposite to narcosis. Helium mixture fills are considerably more expensive than air fills due to the cost of helium and the cost of mixing and compressing the mix. Helium is not suitable for dry suit inflation owing to its poor
thermal insulation Thermal insulation is the reduction of heat transfer (i.e., the transfer of thermal energy between objects of differing temperature) between objects in thermal contact or in range of radiative influence. Thermal insulation can be achieved with ...
properties – compared to air, which is regarded as a reasonable insulator, helium has six times the thermal conductivity. Helium's low molecular weight (monatomic MW=4, compared with diatomic nitrogen MW=28) increases the timbre of the breather's voice, which may impede communication. This is because the speed of sound is faster in a lower molecular weight gas, which increases the resonance frequency of the vocal cords. Helium leaks from damaged or faulty
valve A valve is a device or natural object that regulates, directs or controls the flow of a fluid (gases, liquids, fluidized solids, or slurries) by opening, closing, or partially obstructing various passageways. Valves are technically fitting ...
s more readily than other gases because atoms of helium are smaller allowing them to pass through smaller gaps in
seals Seals may refer to: * Pinniped, a diverse group of semi-aquatic marine mammals, many of which are commonly called seals, particularly: ** Earless seal, or "true seal" ** Fur seal * Seal (emblem), a device to impress an emblem, used as a means of a ...
. Helium is found in significant amounts only in
natural gas Natural gas (also called fossil gas or simply gas) is a naturally occurring mixture of gaseous hydrocarbons consisting primarily of methane in addition to various smaller amounts of other higher alkanes. Low levels of trace gases like carbon d ...
, from which it is extracted at low temperatures by fractional distillation.


= Neon

=
Neon Neon is a chemical element with the symbol Ne and atomic number 10. It is a noble gas. Neon is a colorless, odorless, inert monatomic gas under standard conditions, with about two-thirds the density of air. It was discovered (along with krypt ...
(Ne) is an inert gas sometimes used in deep
commercial diving Commercial diving may be considered an application of professional diving where the diver engages in underwater work for industrial, construction, engineering, maintenance or other commercial purposes which are similar to work done out of the wate ...
but is very expensive. Like helium, it is less narcotic than nitrogen, but unlike helium, it does not distort the diver's voice. Compared to helium, neon has superior thermal insulating properties.


= Hydrogen

=
Hydrogen Hydrogen is the chemical element with the symbol H and atomic number 1. Hydrogen is the lightest element. At standard conditions hydrogen is a gas of diatomic molecules having the formula . It is colorless, odorless, tasteless, non-to ...
(H2) has been used in deep diving gas mixes but is very explosive when mixed with more than about 4 to 5% oxygen (such as the oxygen found in breathing gas). This limits use of hydrogen to deep dives and imposes complicated protocols to ensure that excess oxygen is cleared from the breathing equipment before breathing hydrogen starts. Like helium, it raises the timbre of the diver's voice. The hydrogen-oxygen mix when used as a diving gas is sometimes referred to as
Hydrox Hydrox is a cream-filled chocolate sandwich cookie currently owned and manufactured by Leaf Brands. It debuted in the United States in 1908, and was manufactured by Sunshine Biscuits for over 90 years. Hydrox was largely discontinued in 1999, ...
. Mixtures containing both hydrogen and helium as diluents are termed Hydreliox.


Unwelcome components of breathing gases for diving

Many gases are not suitable for use in diving breathing gases. Here is an incomplete list of gases commonly present in a diving environment:


Argon

Argon Argon is a chemical element with the symbol Ar and atomic number 18. It is in group 18 of the periodic table and is a noble gas. Argon is the third-most abundant gas in Earth's atmosphere, at 0.934% (9340 ppmv). It is more than twice a ...
(Ar) is an inert gas that is more narcotic than nitrogen, so is ''not'' generally suitable as a diving breathing gas.
Argox Argox is the informal name for a scuba diving breathing gas consisting of argon and oxygen. Occasionally the term ''argonox'' has been used to mean the same mix. The blend may consist of varying fractions of argon and oxygen, depending on its inte ...
is used for decompression research. It is sometimes used for dry suit inflation by divers whose primary breathing gas is helium-based, because of argon's good thermal insulation properties. Argon is more expensive than air or oxygen, but considerably less expensive than helium. Argon is a component of natural air, and constitutes 0.934% by volume of the Earth's atmosphere.


Carbon dioxide

Carbon dioxide Carbon dioxide ( chemical formula ) is a chemical compound made up of molecules that each have one carbon atom covalently double bonded to two oxygen atoms. It is found in the gas state at room temperature. In the air, carbon dioxide is t ...
(CO2) is produced by the
metabolism Metabolism (, from el, μεταβολή ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run ...
in the
human body The human body is the structure of a human being. It is composed of many different types of cells that together create tissues and subsequently organ systems. They ensure homeostasis and the viability of the human body. It comprises a hea ...
and can cause
carbon dioxide poisoning Hypercapnia (from the Greek ''hyper'' = "above" or "too much" and ''kapnos'' = "smoke"), also known as hypercarbia and CO2 retention, is a condition of abnormally elevated carbon dioxide (CO2) levels in the blood. Carbon dioxide is a gaseous pr ...
. When breathing gas is recycled in a
rebreather 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 i ...
or
life support system A life-support system is the combination of equipment that allows survival in an environment or situation that would not support that life in its absence. It is generally applied to systems supporting human life in situations where the outsid ...
, the carbon dioxide is removed by scrubbers before the gas is re-used.


Carbon monoxide

Carbon monoxide Carbon monoxide ( chemical formula CO) is a colorless, poisonous, odorless, tasteless, flammable gas that is slightly less dense than air. Carbon monoxide consists of one carbon atom and one oxygen atom connected by a triple bond. It is the simpl ...
(CO) is a highly toxic gas that competes with dioxygen for binding to hemoglobin, thereby preventing the blood from carrying oxygen (see
carbon monoxide poisoning Carbon monoxide poisoning typically occurs from breathing in carbon monoxide (CO) at excessive levels. Symptoms are often described as " flu-like" and commonly include headache, dizziness, weakness, vomiting, chest pain, and confusion. Large ...
). It is typically produced by incomplete
combustion Combustion, or burning, is a high-temperature exothermic redox chemical reaction between a fuel (the reductant) and an oxidant, usually atmospheric oxygen, that produces oxidized, often gaseous products, in a mixture termed as smoke. Combus ...
. Four common sources are: *
Internal combustion engine An internal combustion engine (ICE or IC engine) is a heat engine in which the combustion of a fuel occurs with an oxidizer (usually air) in a combustion chamber that is an integral part of the working fluid flow circuit. In an internal co ...
exhaust gas Exhaust gas or flue gas is emitted as a result of the combustion of fuels such as natural gas, gasoline (petrol), diesel fuel, fuel oil, biodiesel blends, or coal. According to the type of engine, it is discharged into the atmosphere through an ...
containing CO in the air being drawn into a
diving air compressor A diving air compressor is a gas compressor that can provide breathing air directly to a surface-supplied diver, or fill diving cylinders with high-pressure air pure enough to be used as a breathing gas. A low pressure diving air compressor us ...
. CO in the intake air cannot be stopped by any filter. The exhausts of all internal combustion engines running on petroleum fuels contain some CO, and this is a particular problem on boats, where the intake of the compressor cannot be arbitrarily moved as far as desired from the engine and compressor exhausts. * Heating of
lubricant A lubricant (sometimes shortened to lube) is a substance that helps to reduce friction between surfaces in mutual contact, which ultimately reduces the heat generated when the surfaces move. It may also have the function of transmitting forces, t ...
s inside the compressor may vaporize them sufficiently to be available to a compressor intake or intake system line. * In some cases hydrocarbon lubricating oil may be drawn into the compressor's cylinder directly through damaged or worn seals, and the oil may (and usually will) then undergo combustion, being ignited by the immense compression ratio and subsequent temperature rise. Since heavy oils don't burn well – especially when not atomized properly – incomplete combustion will result in carbon monoxide production. *A similar process is thought to potentially happen to any particulate material, which contains "organic" (carbon-containing) matter, especially in cylinders which are used for hyperoxic gas mixtures. If the compressor air filter(s) fail, ordinary
dust Dust is made of fine particles of solid matter. On Earth, it generally consists of particles in the atmosphere that come from various sources such as soil lifted by wind (an aeolian process), volcanic eruptions, and pollution. Dust in ...
will be introduced to the cylinder, which contains organic matter (since it usually contains
humus In classical soil science, humus is the dark organic matter in soil that is formed by the decomposition of plant and animal matter. It is a kind of soil organic matter. It is rich in nutrients and retains moisture in the soil. Humus is the Lati ...
). A more severe danger is that air particulates on boats and industrial areas, where cylinders are filled, often contain carbon-particulate combustion products (these are what makes a dirt rag black), and these represent a more severe CO danger when introduced into a cylinder. Carbon monoxide is generally avoided as far as is reasonably practicable by positioning of the air intake in uncontaminated air, filtration of particulates from the intake air, use of suitable compressor design and appropriate lubricants, and ensuring that running temperatures are not excessive. Where the residual risk is excessive, a
hopcalite Hopcalite is the trade name for a number of mixtures that mainly consist of oxides of copper and manganese, which are used as catalysts for the conversion of carbon monoxide to carbon dioxide when exposed to the oxygen in the air at room temper ...
catalyst can be used in the high pressure filter to convert carbon monoxide into carbon dioxide, which is far less toxic.


Hydrocarbons

Hydrocarbon In organic chemistry, a hydrocarbon is an organic compound consisting entirely of hydrogen and carbon. Hydrocarbons are examples of group 14 hydrides. Hydrocarbons are generally colourless and hydrophobic, and their odors are usually weak or ...
s (C''x''H''y'') are present in compressor lubricants and
fuel A fuel is any material that can be made to react with other substances so that it releases energy as thermal energy or to be used for work. The concept was originally applied solely to those materials capable of releasing chemical energy b ...
s. They can enter diving cylinders as a result of contamination, leaks, or due to incomplete combustion near the air intake. * They can act as a
fuel A fuel is any material that can be made to react with other substances so that it releases energy as thermal energy or to be used for work. The concept was originally applied solely to those materials capable of releasing chemical energy b ...
in combustion increasing the risk of
explosion An explosion is a rapid expansion in volume associated with an extreme outward release of energy, usually with the generation of high temperatures and release of high-pressure gases. Supersonic explosions created by high explosives are known ...
, especially in high-oxygen gas mixtures. * Inhaling oil mist can damage the
lung The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side of ...
s and ultimately cause the lungs to degenerate with severe lipid pneumonia or
emphysema Emphysema, or pulmonary emphysema, is a lower respiratory tract disease, characterised by air-filled spaces ( pneumatoses) in the lungs, that can vary in size and may be very large. The spaces are caused by the breakdown of the walls of the alv ...
.


Moisture content

The process of compressing gas into a diving cylinder removes moisture from the gas. This is good for
corrosion Corrosion is a natural process that converts a refined metal into a more chemically stable oxide. It is the gradual deterioration of materials (usually a metal) by chemical or electrochemical reaction with their environment. Corrosion engi ...
prevention in the cylinder but means that the diver inhales very dry gas. The dry gas extracts moisture from the diver's lungs while underwater contributing to
dehydration In physiology, dehydration is a lack of total body water, with an accompanying disruption of metabolic processes. It occurs when free water loss exceeds free water intake, usually due to exercise, disease, or high environmental temperature. Mil ...
, which is also thought to be a predisposing risk factor of
decompression sickness Decompression sickness (abbreviated DCS; also called divers' disease, the bends, aerobullosis, and caisson disease) is a medical condition caused by dissolved gases emerging from solution as bubbles inside the body tissues during decompressio ...
. It is also uncomfortable, causing a dry mouth and throat and making the diver thirsty. This problem is reduced in
rebreather 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 i ...
s because the
soda lime Soda lime is a mixture of NaOH and CaO chemicals, used in granular form in closed breathing environments, such as general anaesthesia, submarines, rebreathers and recompression chambers, to remove carbon dioxide from breathing gases to prevent ...
reaction, which removes carbon dioxide, also puts moisture back into the breathing gas, and the relative humidity and temperature of exhaled gas is relatively high and there is a cumulative effect due to rebreathing. In hot climates, open circuit diving can accelerate
heat exhaustion Heat exhaustion is a severe form of heat illness. It is a medical emergency. Heat exhaustion is caused by the loss of water and electrolytes through sweating. The United States Department of Labor makes the following recommendation, "Heat illness ...
because of dehydration. Another concern with regard to moisture content is the tendency of moisture to condense as the gas is decompressed while passing through the regulator; this coupled with the extreme reduction in temperature, also due to the decompression, can cause the moisture to solidify as ice. This icing up in a regulator can cause moving parts to seize and the regulator to fail or free flow. This is one of the reasons that scuba regulators are generally constructed from brass, and chrome plated (for protection). Brass, with its good thermal conductive properties, quickly conducts heat from the surrounding water to the cold, newly decompressed air, helping to prevent icing up.


Gas analysis

Gas mixtures must generally be analysed either in process or after blending for quality control. This is particularly important for breathing gas mixtures where errors can affect the health and safety of the end user. It is difficult to detect most gases that are likely to be present in diving cylinders because they are colourless, odourless and tasteless. Electronic sensors exist for some gases, such as
oxygen analyser An electro-galvanic fuel cell is an electrochemical device which consumes a fuel to produce an electrical output by a chemical reaction. One form of electro-galvanic fuel cell based on the oxidation of lead is commonly used to measure the concen ...
s, helium analyser,
carbon monoxide detector A carbon monoxide detector or CO detector is a device that detects the presence of the carbon monoxide (CO) gas to prevent carbon monoxide poisoning. In the late 1990s Underwriters Laboratories changed the definition of a single station CO d ...
s and
carbon dioxide Carbon dioxide ( chemical formula ) is a chemical compound made up of molecules that each have one carbon atom covalently double bonded to two oxygen atoms. It is found in the gas state at room temperature. In the air, carbon dioxide is t ...
detectors. Oxygen analysers are commonly found underwater in
rebreather 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 i ...
s. Oxygen and helium analysers are often used on the surface during
gas blending Gas blending is the process of mixing gases for a specific purpose where the composition of the resulting mixture is specified and controlled. A wide range of applications include scientific and industrial processes, food production and storage and ...
to determine the percentage of oxygen or helium in a breathing gas mix. Chemical and other types of gas detection methods are not often used in recreational diving, but are used for periodic quality testing of compressed breathing air from diving air compressors.


Breathing gas standards

Standards for breathing gas quality are published by national and international organisations, and may be enforced in terms of legislation. In the UK, the Health and Safety Executive indicate that the requirements for breathing gases for divers are based on the BS EN 12021:2014. The specifications are listed for oxygen compatible air, nitrox mixtures produced by adding oxygen, removing nitrogen, or mixing nitrogen and oxygen, mixtures of helium and oxygen (heliox), mixtures of helium, nitrogen and oxygen (trimix), and pure oxygen, for both open circuit and reclaim systems, and for high pressure and low pressure supply (above and below 40 bar supply). Oxygen content is variable depending on the operating depth, but the tolerance depends on the gas fraction range, being ±0.25% for an oxygen fraction below 10% by volume, ±0.5% for a fraction between 10% and 20%, and ±1% for a fraction over 20%. Water content is limited by risks of icing of control valves, and corrosion of containment surfaces – higher humidity is not a physiological problem – and is generally a factor of
dew point The dew point is the temperature to which air must be cooled to become saturated with water vapor, assuming constant air pressure and water content. When cooled below the dew point, moisture capacity is reduced and airborne water vapor will ...
. Other specified contaminants are carbon dioxide, carbon monoxide, oil, and volatile hydrocarbons, which are limited by toxic effects. Other possible contaminants should be analysed based on risk assessment, and the required frequency of testing for contaminants is also based on risk assessment. In Australia breathing air quality is specified by Australian Standard 2299.1, Section 3.13 Breathing Gas Quality.


Diving gas blending

Gas blending (or gas mixing) of breathing gases for diving is the filling of
gas cylinder A gas cylinder is a pressure vessel for storage and containment of gases at above atmospheric pressure. High-pressure gas cylinders are also called ''bottles''. Inside the cylinder the stored contents may be in a state of compressed gas, vap ...
s with non-
air The atmosphere of Earth is the layer of gases, known collectively as air, retained by Earth's gravity that surrounds the planet and forms its planetary atmosphere. The atmosphere of Earth protects life on Earth by creating pressure allowing f ...
breathing gases. Filling cylinders with a mixture of gases has dangers for both the filler and the diver. During filling there is a risk of fire due to use of oxygen and a risk of explosion due to the use of high-pressure gases. The composition of the mix must be safe for the depth and duration of the planned dive. If the concentration of oxygen is too lean the diver may lose consciousness due to hypoxia and if it is too rich the diver may develop
oxygen toxicity Oxygen toxicity is a condition resulting from the harmful effects of breathing molecular oxygen () at increased partial pressures. Severe cases can result in cell damage and death, with effects most often seen in the central nervous system, l ...
. The concentration of inert gases, such as nitrogen and helium, are planned and checked to avoid nitrogen narcosis and decompression sickness.
Methods Method ( grc, μέθοδος, methodos) literally means a pursuit of knowledge, investigation, mode of prosecuting such inquiry, or system. In recent centuries it more often means a prescribed process for completing a task. It may refer to: *Scien ...
used include batch mixing by partial pressure or by mass fraction, and continuous blending processes. Completed blends are analysed for composition for the safety of the user. Gas blenders may be required by legislation to prove competence if filling for other persons.


Density

Excessive density of a breathing gas can raise the work of breathing to intolerable levels, and can cause carbon dioxide retention at lower densities. Helium is used as a component to reduce density as well as to reduce narcosis at depth. Like partial pressure, density of a mixture of gases is in proportion to the volumetric fraction of the component gases, and absolute pressure. The ideal gas laws are adequately precise for gases at respirable pressures. The density of a gas mixture at a given temperature and pressure can be calculated as: :ρm = (ρ1 V1 + ρ2 V2 + .. + ρn Vn) / (V1 + V2 + ... + Vn) where :ρm = density of the gas mixture :ρ1 ... ρn = density of each of the components :V1 ... Vn = partial volume of each of the component gases Since gas fraction Fi (volumetric fraction) of each gas can be expressed as Vi / (V1 + V2 + ... + Vn ) by substitution, :ρm = (ρ1 F1 + ρ2 F2 + .. + ρn Fn)


Hypobaric breathing gases

Breathing gases for use at reduced ambient pressure are used for high altitude flight in unpressurised
aircraft An aircraft is a vehicle that is able to flight, fly by gaining support from the Atmosphere of Earth, air. It counters the force of gravity by using either Buoyancy, static lift or by using the Lift (force), dynamic lift of an airfoil, or in ...
, in
space flight Spaceflight (or space flight) is an application of astronautics to fly spacecraft into or through outer space, either with or without humans on board. Most spaceflight is uncrewed and conducted mainly with spacecraft such as satellites in ...
, particularly in
space suits A space suit or spacesuit is a garment worn to keep a human alive in the harsh environment of outer space, vacuum and temperature extremes. Space suits are often worn inside spacecraft as a safety precaution in case of loss of cabin pressure, ...
, and for high altitude
mountaineering Mountaineering or alpinism, is a set of outdoor activities that involves ascending tall mountains. Mountaineering-related activities include traditional outdoor climbing, skiing, and traversing via ferratas. Indoor climbing, sport climbing, ...
. In all these cases, the primary consideration is providing an adequate
partial pressure In a mixture of gases, each constituent gas has a partial pressure which is the notional pressure of that constituent gas as if it alone occupied the entire volume of the original mixture at the same temperature. The total pressure of an ideal g ...
of oxygen. In some cases the breathing gas has oxygen added to make up a sufficient concentration, and in other cases the breathing gas may be pure or nearly pure oxygen. Closed circuit systems may be used to conserve the breathing gas, which may be in limited supply – in the case of mountaineering the user must carry the supplemental oxygen, and in space flight the cost of lifting mass into orbit is very high.


Medical breathing gases

Medical use of breathing gases other than air include oxygen therapy and anesthesia applications.


Oxygen therapy

upA person wearing a simple face mask for oxygen therapy Oxygen is required by people for normal
cell metabolism Metabolism (, from el, μεταβολή ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run c ...
. Air is typically 21% oxygen by volume. This is normally sufficient, but in some circumstances the oxygen supply to tissues is compromised.
Oxygen therapy Oxygen therapy, also known as supplemental oxygen, is the use of oxygen as medical treatment. Acute indications for therapy include hypoxemia (low blood oxygen levels), carbon monoxide toxicity and cluster headache. It may also be prophylactic ...
, also known as supplemental oxygen, is the use of
oxygen Oxygen is the chemical element with the symbol O and atomic number 8. It is a member of the chalcogen group in the periodic table, a highly reactive nonmetal, and an oxidizing agent that readily forms oxides with most elements ...
as a
medical treatment A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis. As a rule, each therapy has indications and contraindications. There are many differen ...
. This can include for low blood oxygen, carbon monoxide toxicity,
cluster headache Cluster headache (CH) is a neurological disorder characterized by recurrent severe headaches on one side of the head, typically around the eye(s). There is often accompanying eye watering, nasal congestion, or swelling around the eye on the af ...
s, and to maintain enough oxygen while
inhaled anesthetics An inhalational anesthetic is a chemical compound possessing general anesthetic properties that can be delivered via inhalation. They are administered through a face mask, laryngeal mask airway or tracheal tube connected to an anesthetic vapo ...
are given. Long term oxygen is often useful in people with chronically low oxygen such as from severe
COPD Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce ...
or
cystic fibrosis Cystic fibrosis (CF) is a rare genetic disorder that affects mostly the lungs, but also the pancreas, liver, kidneys, and intestine. Long-term issues include difficulty breathing and coughing up mucus as a result of frequent lung infections. Ot ...
. Oxygen can be given in a number of ways including
nasal cannula The nasal cannula (NC) is a device used to deliver supplemental oxygen or increased airflow to a patient or person in need of respiratory help. This device consists of a lightweight tube which on one end splits into two prongs which are place ...
, face mask, and inside a
hyperbaric chamber 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 ...
. High concentrations of oxygen can cause
oxygen toxicity Oxygen toxicity is a condition resulting from the harmful effects of breathing molecular oxygen () at increased partial pressures. Severe cases can result in cell damage and death, with effects most often seen in the central nervous system, l ...
such as lung damage or result in
respiratory failure Respiratory failure results from inadequate gas exchange by the respiratory system, meaning that the arterial oxygen, carbon dioxide, or both cannot be kept at normal levels. A drop in the oxygen carried in the blood is known as hypoxemia; a rise ...
in those who are predisposed. It can also dry out the nose and increase the risk of fires in those who
smoke Smoke is a suspension of airborne particulates and gases emitted when a material undergoes combustion or pyrolysis, together with the quantity of air that is entrained or otherwise mixed into the mass. It is commonly an unwanted by-produc ...
. The target
oxygen saturation Oxygen saturation (symbol SO2) is a relative measure of the concentration of oxygen that is dissolved or carried in a given medium as a proportion of the maximal concentration that can be dissolved in that medium at the given temperature. It ca ...
recommended depends on the condition being treated. In most conditions a saturation of 94-98% is recommended, while in those at risk of
carbon dioxide retention Hypercapnia (from the Greek ''hyper'' = "above" or "too much" and ''kapnos'' = "smoke"), also known as hypercarbia and CO2 retention, is a condition of abnormally elevated carbon dioxide (CO2) levels in the blood. Carbon dioxide is a gaseous pr ...
saturations of 88-92% are preferred, and in those with carbon monoxide toxicity or
cardiac arrest Cardiac arrest is when the heart suddenly and unexpectedly stops beating. It is a medical emergency that, without immediate medical intervention, will result in sudden cardiac death within minutes. Cardiopulmonary resuscitation (CPR) and possi ...
the saturation should be as high as possible. The use of oxygen in medicine become common around 1917. It is on the
World Health Organization's List of Essential Medicines The WHO Model List of Essential Medicines (aka Essential Medicines List or EML), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health s ...
. The cost of home oxygen is about US$150 a month in Brazil and US$400 a month in the United States. Home oxygen can be provided either by
oxygen tanks An oxygen tank is an oxygen storage vessel, which is either held under pressure in gas cylinders, or as liquid oxygen in a cryogenic storage tank. Uses Oxygen tanks are used to store gas for: * medical breathing at medical facilities and at home ...
or an
oxygen concentrator An oxygen concentrator is a device that concentrates the oxygen from a gas supply (typically ambient air) by selectively removing nitrogen to supply an oxygen-enriched product gas stream. They are used industrially and as medical devices for oxy ...
. Oxygen is believed to be the most common treatment given in hospitals in the
developed world A developed country (or industrialized country, high-income country, more economically developed country (MEDC), advanced country) is a sovereign state that has a high quality of life, developed economy and advanced technological infrastruct ...
.


Anaesthetic gases

upAn anaesthetic machine. The most common approach to
general anaesthesia General anaesthesia (UK) or general anesthesia (US) is a medically induced loss of consciousness that renders the patient unarousable even with painful stimuli. This effect is achieved by administering either intravenous or inhalational general ...
is through the use of inhaled general anesthetics. Each has its own potency which is correlated to its solubility in oil. This relationship exists because the drugs bind directly to cavities in proteins of the central nervous system, although several theories of general anaesthetic action have been described. Inhalational anesthetics are thought to exact their effects on different parts of the central nervous system. For instance, the immobilizing effect of inhaled anesthetics results from an effect on the
spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the sp ...
whereas sedation, hypnosis and amnesia involve sites in the brain. An
inhalational anaesthetic An inhalational anesthetic is a chemical compound possessing general anesthetic properties that can be delivered via inhalation. They are administered through a face mask, laryngeal mask airway or tracheal tube connected to an anesthetic vapo ...
is a chemical compound possessing
general anaesthetic General anaesthetics (or anesthetics, see spelling differences) are often defined as compounds that induce a loss of consciousness in humans or loss of righting reflex in animals. Clinical definitions are also extended to include an induced com ...
properties that can be delivered via inhalation. Agents of significant contemporary clinical interest include volatile anaesthetic agents such as
isoflurane Isoflurane, sold under the brand name Forane among others, is a general anesthetic. It can be used to start or maintain anesthesia; however, other medications are often used to start anesthesia rather than isoflurane, due to airway irritation ...
,
sevoflurane Sevoflurane, sold under the brand name Sevorane, among others, is a sweet-smelling, nonflammable, highly fluorinated methyl isopropyl ether used as an inhalational anaesthetic for induction and maintenance of general anesthesia. After desfluran ...
and
desflurane Desflurane (1,2,2,2-tetrafluoroethyl difluoromethyl ether) is a highly fluorinated methyl ethyl ether used for maintenance of general anesthesia. Like halothane, enflurane, and isoflurane, it is a racemic mixture of (''R'') and (''S'') optical is ...
, and anaesthetic gases such as
nitrous oxide Nitrous oxide (dinitrogen oxide or dinitrogen monoxide), commonly known as laughing gas, nitrous, or nos, is a chemical compound, an oxide of nitrogen with the formula . At room temperature, it is a colourless non-flammable gas, and ha ...
and
xenon Xenon is a chemical element with the symbol Xe and atomic number 54. It is a dense, colorless, odorless noble gas found in Earth's atmosphere in trace amounts. Although generally unreactive, it can undergo a few chemical reactions such as the ...
.


Administration

Anaesthetic gases are administered by anaesthetists (a term which includes
anaesthesiologist Anesthesiology, anaesthesiology, or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, ...
s, nurse anaesthetists, and anaesthesiologist assistants) through an anaesthesia mask,
laryngeal mask airway A laryngeal mask airway (LMA), also known as laryngeal mask, is a medical device that keeps a patient's Respiratory tract, airway open during anaesthesia or while they are Unconsciousness, unconscious. It is a type of supraglottic airway device. ...
or
tracheal tube A tracheal tube is a catheter that is inserted into the trachea for the primary purpose of establishing and maintaining a patent airway and to ensure the adequate exchange of oxygen and carbon dioxide. Many different types of tracheal tubes are ...
connected to an anaesthetic vaporiser and an anaesthetic delivery system. The
anaesthetic machine An anaesthetic machine (British English) or anesthesia machine (American English) 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 ana ...
(UK English) or anesthesia machine (US English) or Boyle's machine is used to support the administration of
anaesthesia Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), a ...
. The most common type of anaesthetic machine in use in the developed world is the continuous-flow anaesthetic machine, which is designed to provide an accurate and continuous supply of medical gases (such as
oxygen Oxygen is the chemical element with the symbol O and atomic number 8. It is a member of the chalcogen group in the periodic table, a highly reactive nonmetal, and an oxidizing agent that readily forms oxides with most elements ...
and
nitrous oxide Nitrous oxide (dinitrogen oxide or dinitrogen monoxide), commonly known as laughing gas, nitrous, or nos, is a chemical compound, an oxide of nitrogen with the formula . At room temperature, it is a colourless non-flammable gas, and ha ...
), mixed with an accurate concentration of anaesthetic vapour (such as
isoflurane Isoflurane, sold under the brand name Forane among others, is a general anesthetic. It can be used to start or maintain anesthesia; however, other medications are often used to start anesthesia rather than isoflurane, due to airway irritation ...
), and deliver this to the patient at a safe
pressure Pressure (symbol: ''p'' or ''P'') is the force applied perpendicular to the surface of an object per unit area over which that force is distributed. Gauge pressure (also spelled ''gage'' pressure)The preferred spelling varies by country a ...
and flow. Modern machines incorporate a
ventilator A ventilator is a piece 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 ...
, suction unit, and
patient monitoring In medicine, monitoring is the observation of a disease, condition or one or several medical parameters over time. It can be performed by continuously measuring certain parameters by using a medical monitor (for example, by continuously measuri ...
devices. Exhaled gas is passed through a scrubber to remove carbon dioxide, and the anaesthetic vapour and oxygen are replenished as required before the mixture is returned to the patient.


See also

* * * * *


References


External links

* * * * {{DEFAULTSORT:Breathing Gas Industrial gases