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Carbon Dioxide – The Diver’s Nemesis Pt. 1 (Meduna’s Mixture)

Of all the gases humans excrete, the most bountiful, and arguably the most deadly, is exhaled carbon dioxide.

There is a forgotten bit of American medical history that reveals the bizarre features of the toxicity of carbon dioxide. In 1926, before the advent of modern psychiatric medications, some American psychiatrists began experimenting with the use of inhaled carbon dioxide for the treatment of schizophrenia and psychoses. At the time, there were no effective treatments other than electroshock.

One of the most successful of these researchers was Dr Ladislas J. Meduna, a Professor of Psychiatry at the University of Illinois College of Medicine in Chicago.

High levels of carbon dioxide (CO₂) did in fact have some success in treating schizophrenia, but it also produced Out of Body (OBE) and seemingly spiritual experiences. The following text is quoted from a book called Carbon Dioxide Therapy. A Neurophysiological Treatment of Nervous Disorders, published in 1950 and authored by Meduna.Meduna administered by mask between 20 and 30 breaths of a gas mixture of 30% CO₂, 70% O₂. From pg. 22 of his book we find,

“Any attempt to define the sensory phenomena during CO₂ anesthesia, in terms of dream, hallucination, illusions, etc., would be futile. The actual material would support any hypothesis. Some of the sensory phenomena would direct us to define them as hallucinations. Some of these phenomena are felt by the patients as “real dreams”; others obviously are dreamy repetitions of real events in the past or of past dreams. I believe therefore that any classification of these phenomena in terms of dream or hallucination would be not only meaningless, but directly misleading; the patient is not “sleeping” in the physiological sense, nor is he in the state of consciousness which we usually assume to be present in true hypnagogic hallucinations.”

“One subject, after 20 respirations of the gas, reported seeing a “bright light, like the sun.”

“It was a wonderful feeling. It was marvelous. I felt very light and didn’t know where I was. For a moment I thought: ‘Now isn’t that funny. I am right here and I don’t know whether I am dreaming or not.’ And then I thought that something was happening to me. This wasn’t at night. I was not dreaming. And then it felt as if there were a space of time when I knew something had happened to me and I wasn’t sure what it was. And then I felt a wonderful feeling as if I was out in space.”

“After the second breath” — reported a 29 year-old healthy female nurse who had taken a treatment – “came an onrush of color… then the colors left and I felt myself being separated; my soul drawing apart from the physical being, was drawn upward seemingly to leave the earth and to go upward where it reached a greater Spirit with Whom there was a communion, producing a remarkable, new relaxation and deep security. Through this communion I seemed to receive assurance that the petite problems or whatever was bothering the human being that was me huddled down on the earth, would work out all right and that I had no need to worry.”

“In this spirituelle I felt the Greater Spirit even smiling indulgently upon me in my vain little efforts to carry on by myself and I pressed close the warmth and tender strength and felt assurance of enough power to overcome whatever lay ahead for me as a human being.”

Meduna summarized that preceding case by stating, “In this beautiful experience we can discern almost all the constants of the CO₂ experience: (1) color; (2) geometric patterns; (3) movement; (4) doubleness of personality; and (5) divination or feelings of esoteric importance.”

Meduna went on to admit that “Not all of the sensory phenomena experienced by the patients are of celestial beauty and serenity. Some of them are horrifying beyond description.”

In 1971, Chris Lambertsen, M.D., Ph.D., from the University of Pennsylvania School of Medicine, and considered to be the father of special warfare diving by Navy SEALS, published a careful examination of the physiological consequences of the Meduna mixture. He found that inhalation of 30% CO₂ in oxygen would cause unconsciousness and convulsions within 1-3 min. The precipitating event for loss of consciousness seemed to be a catastrophic increase in the acidity of the blood due to the large amount of carbonic acid produced by the CO₂ inhalation. This raises the possibility that the experiences noted by Meduna were caused by pre-convulsive events within the brain.

Since then the medical community has deemed carbon dioxide “treatments” as not only dangerous but ineffective compared to modern psychiatric medication. Meduna’s mixture is no longer used.

While at the Naval Medical Research Institute, I was my own research subject in a study of the effects of rebreathing CO₂ concentrations up to 8%. That was a carbon dioxide concentration that some Navy SEALS had claimed could be tolerated without impairment.

DSCN7464 — The simplest scrubber canister in the simplest rebreather, Ocenco M20.2

I was not under water, but riding a stationary bicycle ergometer in the laboratory, simulating breathing on a closed-circuit underwater breathing apparatus (in diving vernacular, a rebreather.) Although oxygen was being added as I consumed it, there was no carbon dioxide scrubber (a container of carbon dioxide absorbing material), so the test was examining what happens when a scrubber canister is no longer functioning properly. At 7% inspired CO₂ I stopped the exercise, feeling a little abnormal. However, I was surprised at how unimpaired I seemed to be; that was, until I attempted to dismount the ergometer. I almost fell and needed help removing myself from the bicycle to a chair.

The single-minded and simple-minded task of exercising had hidden a growing central nervous system impairment. Like someone intoxicated with alcohol, I could not judge my level of impairment until a task requiring some coordination was required.

So we see that high levels of carbon dioxide intoxication can lead to profound disturbances of the central nervous system. In upcoming posts we’ll see how elevated carbon dioxide levels and the control of respiratory ventilation can interact to put rebreather divers at risk.

Much of the above is from a nonfiction book project currently under review. The working title for the book is “Collected Tales of the Spiritual and Paranormal.”

The Green Flash and Inspiration

Some say it is serendipity. In reality, maybe it is just the human ability to increase awareness once your attention has been attracted. For example, you’re thinking about buying a black Subaru when you suddenly notice how many black Subarus are on the road.

I had been thinking of late about the Green Flash, a rare optical phenomenon that I experienced once, years ago, on the Pacific shore at Monterey California. It was memorable not only because of its surprising appearance, and its brevity, but because it was one of the most monochromatically pure and intense visions I’ve experienced.

I have since watched many sunsets over the water, trying to witness again what I saw in Monterrey. I recently watched for it from the air, flying towards the Gulf of Mexico as the sun set. I have watched from an elevated pavilion at St. Andrews State Park in Panama City, Florida.

So far, nothing has come even close to matching what I once saw. That is one of the givens for the Green Flash; witnessing it is oftentimes considered a once-in-a-lifetime event.

The closest I’ve come recently was seeing a greenish tint on the top part of the sun as it appeared to be half way below the horizon. My wife confirmed what I was seeing, but the brilliant flash of emerald green I saw in Monterey has eluded me.

And then like the black Subaru, I saw the Green Flash again recently in a rented 2007 movie, “Pirates of the Caribbean: At World’s End.”

But it was not the same. The Green Flash appeared in the movie like the flash from a nuclear explosion, stretching from one side of the screen to the other. There were even sound effects.

That was not the Green Flash I know.

I don’t blame Hollywood for its hyperbole. After all, I don’t think the beauty of what I once saw would convey well on the silver screen, or the TV screen. In fact photographs, such as the ones above or on the Internet fail to capture the essence of it. The brilliance of color from the flash is otherworldly — it cannot be easily reproduced.

I chuckled at the point in the Pirates of the Caribbean script when the statement is made that the Green Flash means a soul is coming back from the dead.

“Ever gazed upon the green flash, Master Gibbs?”

“I reckon I’ve seen my fair share. Happens on rare occasion; the last
glimpse of sunset, a green flash shoots up into the sky. Some go their whole lives without ever seeing it. Some claim to have seen it who ain’t. And some say—”

“It signals when a soul comes back to this world, from the dead!”

I’m as intrigued with the paranormal as the next person, but I know what 18th century pirates could not know; the green flash is a physical phenomenon, not a metaphysical one.

According to some bloggers, and Wikipedia, the purported association between souls and the Green Flash was promulgated by Jules Verne through his fiction. Supposedly Verne claimed it to be an old Scottish legend in his 1882 novel Le Rayon-Vert, according to which, one who has seen the Green Ray is incapable of being “deceived in matters of sentiment,” so that “he who has been fortunate enough once to behold it is enabled to see closely into his own heart and to read the thoughts of others.”

Others have misquoted the passage to say that “if one were to peer in the light of the green flash they would gain the power to read the very souls of other people they met.” But that quotation is a no truer translation from the French.

As I said, Verne’s passage is a fictional myth. So, one good fiction leads to another. And of course a little Hollywood computer graphics and sound effects makes it that much better.

But what inspired me to write about the Green Flash is the resemblance, in my mind at least, between the Green Flash and inspiration.

Inspiration comes to me, and you as well I suspect, in a flash. It may be rare, but like the Green Flash it is all so clear, like a lucid dream; an “aha” moment. It is a revelation, perhaps.

Flashes of inspiration have power; they cause things to happen. Flashes of inspiration have led me to write poetry, science fiction, and non-fiction. Some would call it the writer’s Muse: I just call it that flash of inspiration that seemingly comes from outside me.

Through a flash of lucidity, inspiration caused me to invent a new type of rebreather underwater breathing apparatus. It also caused me, at a young age, to hop on a tiny 50 cc Honda motor-scooter and ride from Atlanta to almost my destination, Kansas City. (50 cc Honda scooters are not really built for long distance cruising, but that didn’t stop me from trying and almost succeeding.)

Inspiration has caused me to raise my hands to the heavens and feel the very presence of God.

Inspiration has propelled me to pull a union thug out of a courtroom and tell him I forgave him for the assault that broke my jaw. Like the cross-country motor scooter ride, not all inspired events would be considered sane except by the person inspired. But they can be life-changing.

Unlike the Green Flash, inspiration can come anytime, anywhere. But like the emerald flash of the setting sun, inspiration can occur when you least expect it.

Both are gifts to be treasured for a lifetime.

Computer Simulation as Art — or Rorschach Test

No one has ever confused me for an artist.

I might have been visually gifted as a 3rd-grader, as my parents told it, at least compared to my peers. However, I never seemed to progress beyond that point. I think my progress slowed about the time I saw my first Rorschach test.

I realized then that some people’s art is someone else’s diagnosis. After all, it is no fun to look at an ink blot abstraction, to voice an opinion about it, only to have an authority figure nod his head and write in his notebook as he says, “I see,” when obviously he didn’t.

Clinical trauma aside, I now know that all humanity looks instinctively for visual patterns and searches for meaning in patterns whether they be random or not. There is a survival aspect to that of course; if we detect a tiger’s stripes partly hidden in a confused background of woodland scenery, that offers a potential survival benefit.

Sometimes, even the most mundane things turn out to be “pretty”. Such were the images I saw being formed on my computer screen the other day. The more I looked at them, the more interesting they became. They were like my own Rorschach test, in a very literal way. They were random patterns based on random processes, but my brain refused to look at them that way. They appeared to me as images of natural things, representing anything except what they truly were.

The image to the left, for instance, looked to me like a view through a telescope of a star field with at least one galaxy situated near the center axis.

Or in a very biological way, it might be the view through an immunofluorescence microscope.

The next image looked to me like a view of a placid star seen in ultraviolet light. I could almost feel the blistering heat radiating through space.

Alternatively, it might be a view of a human egg waiting patiently for fertilization, an altogether different interpretation, but like the first, being a necessary component of creation.

The final image looked to me like a cooler star but with clearly visible solar prominences, magnetic storms arcing over the hellish nuclear surface.

I have no idea what others might see in these images, if anything, but I’m guessing each image can be interpreted differently based on one’s own life experiences.

And that after all is the whole point of art, and Rorschach tests.

The above images were created as part of a random, or stochastic, simulation of rebreather scrubber canisters. They are a view of the upstream end of an axial canister, and shows the state of the canister as heat producing carbon dioxide absorption reactions are beginning.

The cooler looking the canister, the less the amount of exhaled carbon dioxide entering the canister.

The simulation tracks chemical reactions and heat and mass transfer processes in an array of 272,000 finite elements making up a simple absorbent canister. Slicer Dicer and 3VO software (PIXOTEC, LLC) were used to visualize the three-dimensional data set acquired during one moment in time shortly after the simulated reactions began.

Another Rebreather Scrubber Thermokinetic Simulation

Compared to the previously posted video of a segment of a rebreather scrubber, this video shows a much larger, and therefore more realistic scrubber with axially aligned, CO₂rich gas flow passing from left to right. Due to the larger size of the simulation space, more widely distributed heat patterns are noticeable, as are fluctuations in heat. The flow of those fluctuations are most noticeable along the simulated boundary of the cylindrical scrubber bed.

The assumptions of this simulation are that CO₂production (diver workload) is constant throughout the simulation run, ventilatory flow through the canister is constant, the surrounding water temperature is constant at 50° F, and the canister was chilled to the water temperature before the “diver” started breathing through it.

The previous simulation conditions were similar except that the canister was toasty warm prior to immersion in frigid water.

To fully appreciate the fine detail of the imagery, click on the video frame then expand the video to full screen size (lower right symbol immediately after “You Tube”) and play back in 1080p High Definition mode.

A Look Inside Rebreather Scrubber Canisters, Part 1

If you’re diving a rebreather (closed-circuit breathing apparatus to be exact), then you know the scrubber removes carbon dioxide from your recirculated breath. Without the scrubber working, you’d go unconscious from carbon dioxide intoxication within a very few minutes of starting the dive.

But do you really know what’s going on inside that scrubber canister?

A stochastic computer simulation developed by the author gives as realistic a glimpse inside as we can get.

Loose granular and rolled sodalime. Click to enlarge.

Carbon dioxide scrubber canisters usually contain a chemical mixture called sodalime that chemically reacts with carbon dioxide in a diver’s expired breath. That material may be in granular form, or in a preformed roll. Sodalime is a mixture of calcium hydroxide and sodium hydroxide, which when it reacts by absorbing carbon dioxide is converted into calcium carbonate (CaCO_3,calcite), a major constituent of limestone.

The overall chemical reaction can be simplified to:

CO₂+ Ca(OH)₂ → CaCO₃ + H₂O + heat

In the following sequence of images we see a rectangular prism shaped scrubber canister arranged axially such that the diver’s expired breath enters the section from the left, passing completely through the canister section before exiting to the right. A portion of the canister was cut away digitally after the simulation was run to allow visualization of temperatures within the canister interior.

Beginning of the simulation. Click to enlarge.

Initially, the canister is at room temperature, and then is immersed in cold water as the diver begins his dive. Temperature is color coded: the coldest temperature is black, and increasing warmth is portrayed in an intuitive fashion from purple to red to yellow, and finally white, being the highest temperature.

In the first image, CO₂has just started reacting with the sodalime at the entrance to the canister section, with a slight heating resulting. Thermal conduction is cooling the exterior surface of the canister, but most of the inside still remains at room temperature.

In the second image, the reaction front has clearly formed, and the hottest portion of the canister has begun moving downstream. Convection carries heat rapidly downstream to heat the diver’s inspired breath, and is seen to offset canister cooling due to conduction from the surrounding cold water.

In the image to the left, the heating front is fully developed, and residual heat has spread almost completely throughout the downstream portion of the canister.

In the next image, to the right, the front is beginning to weaken in intensity.

Finally (lower left figure), the thermal heating in the reaction front, indicative of CO₂absorption effectiveness, is fading out, and the cooling of the canister from the surrounding cold water is beginning to win the tug of war between heat generation and conductive cooling.

At that point in time, the canister is spent, and essentially all of the exhaled CO₂is passing right through the canister without being absorbed. If the diver had not ended his dive before his canister reached this point, he would be at great risk of passing out due to CO₂accumulation.

The last figure (lower right) shows temperature readings at various locations, and at various times (reps) throughout the simulation run. The orange and brown traces marked “temp” are measured temperatures from locations near the entrance to the canister. They rise abruptly as the absorption reactions start, and fall quickly as the reaction front moves past them, downstream.

The curves that remain elevated longer represent the average exhaled gas temperature, and the average temperature within the absorbent bed. After reaching a peak, the average bed temperature steadily drops as cold gas from the inlet (exhaled) gas chills the portion of the bed behind the reaction front. Exhaled gas temperature, on the other hand, climbs more slowly, but remains more stable until the bed becomes depleted of absorbent activity.

The monitoring of absorbent canister temperature changes is what makes the rebreather scrubber canister monitors used in the Inspiration and Sentinel rebreathers possible. The Sentinel technology is licensed from the U.S. Navy Experimental Diving Unit.

In the next posting, we’ll see the surprising way that cold canisters fill up with calcium carbonate.

The following is a high definition video of the computer simulation of heat generation and loss in a short cylindrical canister. For best effect go to full screen and 1080p mode.

Further details about the computer simulation involved in the production of these images and video can be found in the paper “Computer Modeling of the Kinetics of CO2 Absorption in Rebreather Scrubber Canisters”, in MTS/IEEE OCEANS 2001 Conference Proceedings, published by the Marine Technology Society; Institute of Electrical and Electronics Engineers; Oceanic Engineering Society (U.S.); IEEE Xplore (Online service).

Diving Accident Investigation

Diving helmets waiting for accident investigations. Click for a larger image.

Compared to aircraft accident investigations, diving accident investigations are often ad hoc in nature, poorly conceived and poorly funded. Nevertheless, these investigations are just as important for the safety of the diving public as are similar investigations for the flying public. Unfortunately, no national regulations presently address how investigations of diving accidents should be conducted: volunteer investigators have no legal status for extracting information about an accident, and they have no legally binding protection from litigation based on the conduct of their investigation or on its results. That is, no business case can be made for conducting diving accident investigations, in spite of the moral authority for conducting them.

With the conviction that this untenable situation must eventually change, this presentation will describe one approach to diving accident investigations with particular emphasis on rebreathers and will draw some comparisons to aviation accident investigations by the National Transportation Safety Board (NTSB).

Aircraft accident investigations

The "black box" containing data recorded just prior to, and during, a commercial aircraft accident.

Pilots know that if they are involved in a fatal crash, the NTSB will investigate the accident by examining in excruciating detail everything those pilots did for hours, perhaps even days or weeks, leading up to that accident. It will investigate how often they called flight service to check on the weather. The NTSB will go through those pilots’ personal logbooks to check on their currency and proficiency, and it will check Federal Aviation Administration (FAA) records for a history of violations. NTSB investigators will also examine an aircraft’s logbooks to scrutinize its maintenance records. They will play back voice and radar data, and if a data recorder is available, they will analyze its contents.

Then they get personal. The NTSB and its FAA counterparts will talk to mechanics, surviving passengers, and friends to ask questions such as, “What were the aviators’ attitudes toward flying? Were they cavalier? Did they take unnecessary risks, or were they careful and methodical?”

Due to the detailed, scripted nature of NTSB procedures, the investigation may take up to a year to complete.

A few years ago a pilot’s engine failed and he was forced to make a water landing just off a beach. The ditching should have been survivable, but he lost consciousness on impact and sank with the airplane as it settled to the bottom in relatively shallow water. He drowned.

If he had been a diver, that would have been the end of the story. The public judgment would have been, “A diver drowned. He tried to breathe underwater; this is what happens.” But this victim happened to drown inside an airplane. So instead of the medical examiner simply saying that he drowned, the NTSB started its very thorough investigation procedures.

Fortunately, the pilot also had a surviving passenger. From the survivor’s statement, the aircraft’s maintenance records, and the mechanic’s testimony, an ugly story of reckless disregard for the most basic safety rules of flying began to emerge.

Do divers ever show a reckless disregard for basic safety rules? You bet. It’s unfortunate that the pilot died, but the events leading to his death were a useful reminder that the media in which we work and play, high-altitude air and water, are not forgiving. Humans are not designed for flying or diving, and nature only begrudgingly lets us trespass — on its terms.

The U.S. Navy and Coast Guard are chartered to investigate diving accidents. Unfortunately, there is a huge discrepancy in the number of personnel and the amount of funding for aviation accident investigations compared to diving accident investigations. The NTSB has hundreds of personnel and tens of millions in funding available, whereas the entire U.S. Navy has at most a handful of investigators with no investigation-specific funding.

Investigation team requirements

In the best of all worlds, an investigation team should have access to both a manned and an unmanned test facility, access to experts in all diving equipment (scuba, rebreathers, helmets), and the ability to conduct and interpret gas analyses — sometimes from minuscule amounts of remaining gas. At a minimum, such a team needs the ability to download and interpret dive computer/recorder data. Some investigations may require the simulation of UBA-human interactions for “re-enactment” purposes. An investigation team should also have diving medical expertise available to review medical examiner reports for consistency with known or discovered facts regarding the accident. Last, it should have in-depth knowledge of police investigative procedures, particularly of the procedures and documentation for maintaining “chain of custody”.

Do rebreather investigations have a future?

Considering the resources and time-frames required for laboratories such as the Navy Experimental Diving Unit (NEDU) to conduct diving equipment evaluations on a limited set of accident cases, and the unfunded costs associated with those investigations, it is difficult to imagine a resolution to an ever-increasing need for rebreather investigations. Almost certainly, no independent federal agency similar to the NTSB will ever be responsible for investigating diving accidents, simply because diving accidents lack national attention: the public at large is not being placed in jeopardy.

It is also unlikely that diving equipment manufacturers would welcome federal agency oversight and regulations comparable to those engendered by the FAA and NTSB. Diving might become exorbitantly expensive. For instance, if a $5 part available for purchase in an automotive store were to be used in an aircraft, it would become a $50–$500 part because of FAA required documentation that it meets airworthiness standards.

The U.S. Coast Guard initiates diving accident investigations and in some cases conducts hearings into those accidents; however, with its enhanced role in Homeland Security, the Coast Guard is unlikely to welcome any efforts to diversify its mission. The cost/benefit ratio would appear to be too great.

For the future, as Dick Vann of DAN has suggested, the resolution may ultimately depend on rebreather users funding a team of dedicated, professional accident investigators. The cost of conducting worthwhile investigations has yet to be determined, and therefore the amount of funding needed to support it is unknown. I suggest that obtaining those estimates should be a priority as we, rebreather users and the industry, decide the next steps in investigating rebreather accidents.

The above are highlights from this author’s publication of the same name, found in: Vann RD, Mitchell SJ, Denoble PJ, Anthony TG, eds. Technical Diving Conference, Proceedings. Durham, NC: Divers Alert Network; 2009; 394 pages. ISBN# 978-1-930536-53-1.

This book is available for download at no cost as a PDF file from the Divers Alert Network website (http://www.DiversAlertNetwork.org/) or from http://archive.rubicon-foundation.org/8300