# Asphyxia

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Severely deficient supply of oxygen

"Oxygen deprivation" redirects here. For other uses, see [Hypoxia (disambiguation)](/source/Hypoxia_(disambiguation)) and [Asphyxia (disambiguation)](/source/Asphyxia_(disambiguation)).

"Smother" and "Suffocation" redirect here. For other uses, see [Smother (disambiguation)](/source/Smother_(disambiguation)) and [Suffocation (disambiguation)](/source/Suffocation_(disambiguation)).

Medical condition

Asphyxia Other names Asphyxiation The neck contains several vulnerable targets for compression, including the carotid arteries and the trachea. Specialty Critical care medicine Complications Coma, muteness Frequency 9.8 million unintentional worldwide (2015)[1] Deaths 35,600 worldwide (2015)[2]

**Asphyxia** or **asphyxiation** is a condition of deficient supply of [oxygen](/source/Oxygen) to the [body](/source/Human_body) which arises from abnormal [breathing](/source/Breathing).[3][4] Asphyxia causes [generalized hypoxia](/source/Generalized_hypoxia), which affects all the tissues and organs, some more rapidly than others. There are many circumstances that can induce asphyxia, all of which are characterized by the inability of a person to acquire sufficient oxygen through breathing for an extended period of time. Asphyxia can cause coma or death. In 2015, about 9.8 million cases of unintentional suffocation occurred which resulted in 35,600 deaths. The word asphyxia is from [Ancient Greek](/source/Ancient_Greek) α- "without" and σφύξις *sphyxis*, "squeeze" (throb of heart).[5]

## Causes

Situations that can cause asphyxia include but are not limited to: [airway obstruction](/source/Airway_obstruction) (such as from [asthma](/source/Asthma), [laryngospasm](/source/Laryngospasm), or simple blockage from the presence of foreign materials); from being in environments where oxygen is not readily accessible: such as underwater, in a low oxygen atmosphere, or in a vacuum; environments where sufficiently oxygenated air is present, but cannot be adequately breathed because of air contamination such as excessive smoke.

Other causes of oxygen deficiency include but are not limited to:

- [Acute respiratory distress syndrome](/source/Acute_respiratory_distress_syndrome)

- [Alcohol poisoning](/source/Alcohol_intoxication)

- [Carbon monoxide inhalation](/source/Carbon_monoxide_poisoning), such as that from a [car exhaust](/source/Car_exhaust) and the smoke produced by a lit [cigarette](/source/Cigarette): carbon monoxide has a higher affinity than oxygen to the [hemoglobin](/source/Hemoglobin) in the blood's red blood corpuscles, bonding with it tenaciously, and, in the process, displacing oxygen and preventing the blood from transporting oxygen around the body

- Contact with certain chemicals, including [pulmonary agents](/source/Pulmonary_agent) (such as [phosgene](/source/Phosgene)) and [blood agents](/source/Blood_agent) (such as [hydrogen cyanide](/source/Hydrogen_cyanide))

- [Choking](/source/Choking) by obstruction of a foreign body in the airway (for example: when eating)

- [Cyanide poisoning](/source/Cyanide_poisoning)

- [Drowning](/source/Drowning)

- [Drug overdose](/source/Drug_overdose)

- Exposure to extreme low pressure or [vacuum](/source/Vacuum) from [spacesuit](/source/Spacesuit) damage (see [space exposure](/source/Space_exposure))

- [Hanging](/source/Hanging), whether suspension or short drop hanging

- Self-induced [hypocapnia](/source/Hypocapnia) by [hyperventilation](/source/Hyperventilation), as in [shallow water](/source/Freediving_blackout#Shallow_water_blackout) or [deep water blackout](/source/Freediving_blackout#Ascent_blackout) and the [choking game](/source/Choking_game)

- [Inert gas asphyxiation](/source/Inert_gas_asphyxiation)

- [Congenital central hypoventilation syndrome](/source/Congenital_central_hypoventilation_syndrome), or primary alveolar hypoventilation, a disorder of the autonomic nervous system in which a patient must consciously breathe; although it is often said that people with this disease will die if they fall asleep, this is not usually the case.

- [Respiratory diseases](/source/Respiratory_disease)

- [Sleep apnea](/source/Sleep_apnea)

- A [seizure](/source/Seizure) which stops breathing activity

- An [allergic reaction](/source/Allergy)

- [Strangling](/source/Strangling)

- Breaking the [wind pipe](/source/Wind_pipe)

- Prolonged exposure to [chlorine gas](/source/Chlorine)

### Smothering

"Smother" redirects here. For other uses, see [Smother (disambiguation)](/source/Smother_(disambiguation)).

Smothering is a mechanical obstruction of the flow of air from the environment into the mouth or nostrils.[6] Smothering can be either partial or complete, where partial indicates that the person being smothered is able to inhale some air, although less than required. In a normal situation, smothering requires at least partial obstruction of both the nasal cavities and the mouth to lead to asphyxia. Smothering with the hands or chest is used in some [combat sports](/source/Combat_sport) to distract the opponent, and create openings for [transitions](/source/Transition_(grappling)), as the opponent is forced to react to the smothering.

In some cases, when performing certain routines, smothering is combined with simultaneous compressive asphyxia. One example is overlay, in which an adult accidentally rolls over onto an infant during [co-sleeping](/source/Co-sleeping), an accident that often goes unnoticed and is mistakenly thought to be [sudden infant death syndrome](/source/Sudden_infant_death_syndrome).[6]

Other accidents involving a similar mechanism are [cave-ins](/source/Cave-in), or when an individual is buried in sand, snow, dirt, or grain.

In [homicidal](/source/Homicide) cases, the term burking describes a killing method that involves simultaneous smothering and compression of the torso.[7] The term "burking" comes from the method [William Burke and William Hare](/source/William_Burke_and_William_Hare) used to kill their victims during the [West Port murders](/source/Burke_and_Hare_murders). They killed the usually intoxicated victims by sitting on their chests and suffocating them by putting a hand over their nose and mouth, while using the other hand to push the victim's jaw up. The corpses had no visible injuries, and were supplied to medical schools for money.[8]

### Compressive asphyxia

See also: [Positional asphyxia](/source/Positional_asphyxia)

Compressive asphyxia (also called chest compression) is mechanically limiting expansion of the lungs by compressing the torso, preventing breathing. "[Traumatic asphyxia](/source/Traumatic_asphyxia)" or "crush asphyxia" usually refers to compressive asphyxia resulting from being crushed or pinned under a large weight or force, or in a [crowd crush](/source/Crowd_collapses_and_crushes).[9] An example of traumatic asphyxia is a person who [jacks](/source/Jack_(mechanical)) up a car to work on it from below, and is crushed by the vehicle when the jack fails.[7] Constrictor snakes such as [boa constrictors](/source/Boa_constrictor) kill through slow compressive asphyxia, tightening their coils every time the prey breathes out rather than squeezing forcefully. In cases of an adult co-sleeping with an infant ("overlay"), the heavy sleeping adult may move on top of the infant, causing compression asphyxia.

In fatal crowd disasters, compressive asphyxia from being crushed against the crowd causes all or nearly all deaths, rather than [blunt trauma](/source/Blunt_trauma) from trampling. This is what occurred at the [Ibrox disaster](/source/1971_Ibrox_disaster) in 1971, where 66 [Rangers](/source/Rangers_F.C.) fans died; the [1979 The Who concert disaster](/source/1979_The_Who_concert_disaster) where 11 died; the [Luzhniki disaster](/source/Luzhniki_disaster) in 1982, when 66 [FC Spartak Moscow](/source/FC_Spartak_Moscow) fans died; the [Hillsborough disaster](/source/Hillsborough_disaster) in 1989, where 97 [Liverpool](/source/Liverpool_F.C.) fans were crushed to death in an overcrowded terrace, 95 of the 97 from compressive asphyxia, 93 dying directly from it and 3 others from related complications; the [2021 Meron crowd crush](/source/2021_Meron_crowd_crush) where 45 died; the [Astroworld Festival crowd crush](/source/Astroworld_Festival_crowd_crush) in 2021, where 10 died; and the [Seoul Halloween crowd crush](/source/Seoul_Halloween_crowd_crush) in 2022, where at least 159 died during [Halloween](/source/Halloween) celebrations.[10][11]

In confined spaces, people are forced to push against each other; evidence from bent steel railings in several fatal crowd accidents has shown horizontal forces over 4500 N (equivalent to a weight of approximately 450 kg or 1000 lbs). In cases where people have stacked up on each other in a human pile, it has been estimated that those at the bottom are subjected to around 380 kg (840 lbs) of compressive weight.[12]

"Positional" or "restraint" asphyxia is when a person is restrained and left alone prone, such as in a police vehicle, and is unable to reposition themself in order to breathe. The death can be in the vehicle, or following loss of consciousness to be followed by death while in a coma, having presented with anoxic brain damage. The asphyxia can be caused by facial compression, neck compression, or chest compression. This occurs mostly during restraint and handcuffing situations by law enforcement, including psychiatric incidents. The weight of the restraint(s) doing the compression may contribute to what is attributed to positional asphyxia. Therefore, passive deaths following custody restraint that are presumed to be the result of positional asphyxia may actually be examples of asphyxia occurring during the restraint process.

Chest compression is a technique used in various [grappling](/source/Grappling) combat sports, where it is sometimes called wringing, either to tire the opponent or as complementary or distractive moves in combination with [pinning holds](/source/Grappling_hold#Pinning_hold),[13] or sometimes even as [submission holds](/source/Grappling_hold#Submission_hold). Examples of chest compression include the [knee-on-stomach position](/source/Knee-on-stomach_position); or techniques such as leg scissors (also referred to as body scissors and in [budō](/source/Bud%C5%8D) referred to as *do-jime*;[14] 胴絞, "trunk strangle" or "body triangle")[15] where a participant wraps his or her legs around the opponent's midsection and squeezes them together.[16]

[Pressing](/source/Pressing_(execution)) is a form of [torture](/source/Torture) or [execution](/source/Execution) using compressive asphyxia.

### Perinatal asphyxia

Main article: [Perinatal asphyxia](/source/Perinatal_asphyxia)

Perinatal asphyxia is the medical condition resulting from deprivation of [oxygen](/source/Oxygen) ([hypoxia](/source/Hypoxia_(medical))) to a newborn infant long enough to cause apparent harm. It results most commonly from a drop in maternal [blood pressure](/source/Blood_pressure) or interference during [delivery](/source/Childbirth) with blood flow to the infant's [brain](/source/Brain). This can occur as a result of inadequate [circulation](/source/Circulatory_system) or [perfusion](/source/Perfusion), impaired respiratory effort, or inadequate [ventilation](/source/Ventilation_(physiology)).[17] There has long been a scientific debate over whether [newborn infants with asphyxia should be resuscitated](/source/Neonatal_resuscitation) with 100% oxygen or normal air.[17] It has been demonstrated that high concentrations of oxygen lead to generation of oxygen [free radicals](/source/Free_radicals), which have a role in [reperfusion injury](/source/Reperfusion_injury) after asphyxia.[18] Research by [Ola Didrik Saugstad](/source/Ola_Didrik_Saugstad) and others led to new international guidelines on newborn resuscitation in 2010, recommending the use of normal air instead of 100% oxygen.[19][20]

### Mechanical asphyxia

Accidental deaths in the United States

**2020**

**2004**

  [Poisoning](/source/Accidental_poisoning)

  [Motor-vehicle](/source/Motor_vehicle_fatality_rate_in_U.S._by_year)

  [Falls](/source/Falling_(accident))

  [Choking](/source/Choking)

  [Drowning](/source/Drowning)

  [Fires, flames, smoke](/source/Structure_fire)

  [Suffocation](/source/Perinatal_asphyxia)

Classifications of different forms of asphyxia vary among literature, with differences in defining the concept of mechanical asphyxia being the most obvious.[21]

In DiMaio and DiMaio's 2001 textbook on forensic pathology, mechanical asphyxia is caused by pressure from outside the body restricting respiration.[21] Similar narrow definitions of mechanical asphyxia have occurred in Azmak's 2006 literature review of asphyxial deaths and Oehmichen and Auer's 2005 book on forensic neuropathology.[21] According to DiMaio and DiMaio, mechanical asphyxia encompasses positional asphyxia, traumatic asphyxia, and "human pile" deaths.[21]

In Shkrum and Ramsay's 2007 textbook on forensic pathology, mechanical asphyxia occurs when any mechanical means cause interference with the exchange of oxygen and carbon dioxide in the body.[21] Similar broad definitions of mechanical asphyxia have occurred in Saukko and Knight's 2004 book on asphyxia, and Dolinak and Matshes' 2005 book on forensic pathology.[21] According to Shkrum and Ramsay, mechanical asphyxia encompasses smothering, choking, positional asphyxia, traumatic asphyxia, wedging, strangulation and drowning.[21]

Sauvageau and Boghossian propose in 2010 that mechanical asphyxia should be officially defined as caused by "restriction of respiratory movements, either by the position of the body or by external chest compression", thus encompassing only positional asphyxia and traumatic asphyxia.[21]

## First aid

If there are symptoms of mechanical asphyxia, it is necessary to call the [Emergency Medical Services](/source/Emergency_Medical_Services).[22] In some countries, such as the US, there may also be self-acting groups of voluntary first responders who have been trained in first aid.[23] In case of mechanical asphyxia, first aid can be provided on your own.

### First aid for choking on food

Main article: [First aid for choking on food](/source/Choking#General_strategy:_"five_and_five")

In case of choking on a foreign body:

- Stand behind the affected person and wrap your arms around him/her.

- Push inwards and upwards under the ribs with a sudden movement by your second hand.

- If the performed actions were not effective, repeat them until you free respiratory tract of the affected person from a foreign body.

## See also

- [Asphyxiant gas](/source/Asphyxiant_gas) – Nontoxic or minimally toxic gas which can displace oxygen in breathing air

- [Erotic asphyxiation](/source/Erotic_asphyxiation) – Intentional restriction of oxygen to the brain for sexual arousal

- [Hypercapnia](/source/Hypercapnia) – Abnormally high tissue carbon dioxide levels

- [Respiratory acidosis](/source/Respiratory_acidosis) – Decrease in blood pH due to insufficient breathing

## References

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## Further reading

- [Kay-Shuttleworth JP](/source/James_Phillips_Kay-Shuttleworth) (1834). [*The Physiology, Pathology, and Treatment of Asphyxia*](https://archive.org/details/b21306588). Longman, Rees, Orme, Brown, Green & Longman.

- Elsner R (September 1989). ["Perspectives in diving and asphyxia"](https://web.archive.org/web/20100808091233/http://archive.rubicon-foundation.org/2500). *Undersea Biomedical Research*. **16** (5): 339–44. [PMID](/source/PMID_(identifier)) [2678664](https://pubmed.ncbi.nlm.nih.gov/2678664). Archived from the original on 8 August 2010. Retrieved 4 July 2008.

## External links

Look up ***[smother](https://en.wiktionary.org/wiki/smother)*** in Wiktionary, the free dictionary.

- Media related to [Asphyxia](https://commons.wikimedia.org/wiki/Category:Asphyxia) at Wikimedia Commons

- [Cross-side to chest compression choke](https://web.archive.org/web/20060904214839/http://lockflow.com/article_view.php?id=782)

Classification D ICD-10: R09.0, T71 ICD-9-CM: 799.0 MeSH: D001237 DiseasesDB: 969

v t e Signs and symptoms relating to the respiratory system Auscultation Stethoscope Respiratory sounds Stridor Wheeze Crackles Rhonchi Stertor Squawk Pleural friction rub Fremitus Bronchophony Death rattle Elicited findings Percussion Pectoriloquy Whispered pectoriloquy Egophony Breathing Rate Apnea Prematurity Sleep Dyspnea Hyperventilation Hypoventilation Hyperpnea Tachypnea Hypopnea Bradypnea Pattern Agonal respiration Biot's respiration Cheyne–Stokes respiration Kussmaul breathing Ataxic respiration Other Respiratory distress Respiratory arrest Orthopnea/Platypnea Trepopnea Aerophagia Asphyxia Breath holding Mouth breathing Snoring Vocal fold Aphonia Muteness Selective Phoneme Dysphonia Hypophonia Other Chest pain In children Precordial catch syndrome Pleurisy Nail clubbing Cyanosis Cough Sputum Hemoptysis Epistaxis Silhouette sign Post-nasal drip Hiccup COPD Hoover's sign asthma Curschmann's spirals Charcot–Leyden crystals chronic bronchitis Reid index sarcoidosis Kveim test pulmonary embolism Hampton hump Westermark sign pulmonary edema Kerley lines Hamman's sign Golden S sign

v t e Consequences of external causes Temperature Elevated Burn Heat cramps Hyperthermia Heatstroke Heat exhaustion Heat syncope Reduced Aerosol burn Acrocyanosis Chilblains Cold intolerance Erythrocyanosis crurum Frostbite Hypothermia Non-freezing cold injury Radiation Chronic radiation keratosis Eosinophilic, polymorphic, and pruritic eruption associated with radiotherapy Radiation acne Radiation burn Radiation-induced cancer Radiation-induced erythema multiforme Radiation-induced hypertrophic scar Radiation-induced keloid Radiation-induced morphea Radiation poisoning Radiation recall reaction Sunburn Oxygen Asphyxia Hypoxia Oxygen toxicity Pressure Barotrauma Arterial gas embolism Aerosinusitis Middle ear barotrauma Pneumothorax Decompression sickness Inner ear decompression sickness High altitude Altitude sickness Chronic mountain sickness Death zone High-altitude cerebral edema (HACE) High-altitude pulmonary edema (HAPE) Food Starvation Water Dehydration Drowning Immersion foot syndromes Trench foot Tropical immersion foot Warm water immersion foot Water intoxication Maltreatment Physical abuse Psychological abuse Sexual abuse Travel Motion sickness Airsickness Carsickness Seasickness Space adaptation syndrome Adverse effect Adverse drug reaction Hypersensitivity Allergy Anaphylaxis Angioedema Arthus reaction Other Electrical injury Lightning injuries Ungrouped skin conditions resulting from physical factors Dermatosis neglecta Pinch mark Pseudoverrucous papules and nodules Sclerosing lymphangitis Tropical anhidrotic asthenia UV-sensitive syndrome environmental skin conditions Electrical burn frictional/traumatic/sports Black heel and palm Equestrian perniosis Fissure of the nipple Pulling boat hands Runner's rump Surfer's knots Tennis toe Vibration white finger Weathering nodule of ear Wrestler's ear Painful fat herniation Uranium dermatosis iv use Skin pop scar Skin track Slap mark Pseudoacanthosis nigricans Narcotic dermopathy Category Commons Glossary Outline Portal

v t e Underwater diving Diving activities Diving modes Atmospheric pressure diving Freediving Saturation diving Scuba diving Snorkeling Surface oriented diving Surface-supplied diving Unmanned diving Diving equipment Cleaning and disinfection of personal diving equipment Human factors in diving equipment design List of diving equipment manufacturers Basic equipment Diving mask Snorkel Swimfin Breathing gas Bailout gas Bottom gas Breathing air Decompression gas Emergency gas supply Heliox Hydreliox Hydrox Nitrox Oxygen Travel gas Trimix Buoyancy and trim equipment Avelo diving system Buoyancy compensator Power inflator Dump valve Variable buoyancy pressure vessel Diving weighting system Ankle weights Integrated weights Trim weights Weight belt Decompression equipment Decompression buoy Decompression chamber Decompression cylinder Decompression tables Decompression trapeze Dive computer Diving bell Diving shot Diving stage Jersey upline Jonline Diving suit Atmospheric diving suit JIM suit Newtsuit Dry suit Sladen suit Standard diving suit Rash vest Wetsuit Dive skins Hot-water suit Helmets and masks Anti-fog Diving helmet Free-flow helmet Lightweight demand helmet Orinasal mask Reclaim helmet Shallow water helmet Standard diving helmet Diving mask Band mask Full-face diving mask Half mask Instrumentation Bottom timer Depth gauge Dive computer Dive timer Diving watch Helium release valve Electro-galvanic oxygen sensor Pneumofathometer Submersible pressure gauge Mobility equipment Diver propulsion vehicle Human torpedo Wet sub Diving bell Closed bell Wet bell Diving stage Swimfin Monofin PowerSwim Towboard Safety equipment Alternative air source Octopus regulator Pony bottle Bolt snap Buddy line Dive light Diver's cutting tool Diver's knife Diver's telephone Through-water communications Underwater acoustic communication Diving bell Diving safety harness Emergency gas supply Bailout block Bailout bottle Lifeline Screw gate carabiner Emergency locator beacon Rescue tether Safety helmet Shark-proof cage Snoopy loop Navigation equipment Distance line Diving compass Dive reel Line marker Surface marker buoy Silt screw Underwater breathing apparatus Atmospheric diving suit Diving cylinder Burst disc Scuba cylinder valve Diving helmet Reclaim helmet Diving regulator Mechanism of diving regulators Regulator malfunction Regulator freeze Single-hose regulator Twin-hose regulator Full-face diving mask Open-circuit scuba Scuba set Bailout bottle Decompression cylinder Independent doubles Manifolded twin set Scuba manifold Pony bottle Scuba configuration Sidemount Sling cylinder Diving rebreathers Carbon dioxide scrubber Carleton CDBA Clearance Divers Life Support Equipment Cryogenic rebreather CUMA DSEA Dolphin Halcyon PVR-BASC Halcyon RB80 IDA71 Interspiro DCSC LAR-5 LAR-6 LAR-V LARU Mark IV Amphibian Porpoise Ray Siebe Gorman CDBA Salvus Siva Surface-supplied diving equipment Air line Diver's umbilical Diving air compressor Gas panel Hookah Scuba replacement Snuba Standard diving dress Diving equipment manufacturers AP Diving Apeks Aqua Lung America Aqua Lung/La Spirotechnique Beuchat René Cavalero Cis-Lunar Cressi-Sub Dacor DESCO Dive Xtras Divex Diving Unlimited International Drägerwerk Faber Fenzy Maurice Fernez Technisub Oscar Gugen Heinke HeinrichsWeikamp Johnson Outdoors Mares Morse Diving Nemrod Oceanic Worldwide Porpoise Shearwater Research Siebe Gorman Submarine Products Suunto Diving support equipment Access equipment Boarding stirrup Diver lift Diving bell Diving ladder Diving platform (scuba) Diving stage Downline Jackstay Launch and recovery system Messenger line Moon pool Breathing gas handling Air filtration Activated carbon Hopcalite Molecular sieve Silica gel Booster pump Carbon dioxide scrubber Cascade filling system Diver's pump Diving air compressor Diving air filter Water separator High pressure breathing air compressor Low pressure breathing air compressor Gas blending Gas blending for scuba diving Gas panel Gas reclaim system Gas storage bank Gas storage quad Gas storage tube Helium analyzer Nitrox production Membrane gas separation Pressure swing adsorption Oxygen analyser Electro-galvanic oxygen sensor Oxygen compatibility Decompression equipment Air-lock Built-in breathing system Decompression tables Diving bell Bell cursor Closed bell Clump weight Launch and recovery system Wet bell Diving chamber Diving stage Recreational Dive Planner Saturation diving system Platforms Dive boat Canoe and kayak diving Combat rubber raiding craft Liveaboard Subskimmer Diving support vessel HMS Challenger (K07) Underwater habitat Aquarius Reef Base Continental Shelf Station Two Helgoland Habitat Scott Carpenter Space Analog Station SEALAB Tektite habitat Remotely operated underwater vehicles 8A4-class ROUV ABISMO Atlantis ROV Team COTSBot CURV Deep Drone Épaulard Global Explorer ROV Goldfish-class ROUV Kaikō ROV Kaşif ROUV Long-Term Mine Reconnaissance System Mini Rover ROV OpenROV ROV KIEL 6000 ROV PHOCA Scorpio ROV Sea Dragon-class ROV Seabed tractor Seafox drone SeaPerch SJT-class ROUV T1200 Trenching Unit VideoRay UROVs Safety equipment Diver down flag Diving shot ENOS Rescue-System Hyperbaric lifeboat Hyperbaric stretcher Jackstay Jonline Reserve gas supply General Diving spread Air spread Saturation spread Hot water system Sonar Underwater acoustic positioning system Underwater acoustic communication Freediving Activities Aquathlon Apnoea finswimming Freediving Haenyeo Pearl hunting Ama Snorkeling Spearfishing Underwater football Underwater hockey Underwater rugby Underwater target shooting Competitions Nordic Deep Vertical Blue Disciplines Constant weight (CWT) Constant weight bi-fins (CWTB) Constant weight without fins (CNF) Dynamic apnea (DYN) Dynamic apnea without fins (DNF) Free immersion (FIM) No-limits apnea (NLT) Static apnea (STA) Skandalopetra diving Variable weight apnea (VWT) Variable weight apnea without fins Equipment Diving mask Diving suit Hawaiian sling Polespear Snorkel (swimming) Speargun Swimfins Monofin Water polo cap Freedivers Deborah Andollo Simone Arrigoni Peppo Biscarini Michael Board Sara Campbell Derya Can Göçen Goran Čolak Carlos Coste Robert Croft Mandy-Rae Cruickshank Yasemin Dalkılıç Leonardo D'Imporzano Flavia Eberhard Şahika Ercümen Emma Farrell Francisco Ferreras Pierre Frolla Flavia Eberhard Mehgan Heaney-Grier Elisabeth Kristoffersen Andriy Yevhenovych Khvetkevych Loïc Leferme Enzo Maiorca Jacques Mayol Audrey Mestre Karol Meyer Kate Middleton Stéphane Mifsud Alexey Molchanov Natalia Molchanova Dave Mullins Patrick Musimu Guillaume Néry Herbert Nitsch Umberto Pelizzari Liv Philip Annelie Pompe Stig Severinsen Tom Sietas Martin Štěpánek Walter Steyn Tanya Streeter William Trubridge Devrim Cenk Ulusoy Fatma Uruk Danai Varveri Alessia Zecchini Nataliia Zharkova Kateryna Sadurska Hazards Barotrauma Drowning Freediving blackout Deep-water blackout Shallow-water blackout Hypercapnia Hypothermia Historical Ama Octopus wrestling Swimming at the 1900 Summer Olympics – Men's underwater swimming Organisations AIDA International Scuba Schools International Australian Underwater Federation British Freediving Association Confédération Mondiale des Activités Subaquatiques Fédération Française d'Études et de Sports Sous-Marins Performance Freediving International Professional diving Occupations Ama Commercial diver Commercial offshore diver Hazmat diver Divemaster Diving instructor Diving safety officer Diving superintendent Diving supervisor Haenyeo Media diver Police diver Public safety diver Scientific diver Underwater archaeologist Military diving Army engineer diver Canadian Armed Forces Divers Clearance diver Frogman Minentaucher Royal Navy ships diver United States military divers U.S. Navy diver U.S.Navy master diver Military diving units 7th Marine Brigade Clearance Diving Branch (RAN) Commando Hubert Combat Divers Service (Lithuania) Comando Raggruppamento Subacquei e Incursori Teseo Tesei Decima Flottiglia MAS Frogman Corps (Denmark) Fuerzas Especiales Fukuryu GRUMEC Grup Gerak Khas Jagdkommando JW Formoza JW GROM JW Komandosów Kommando Spezialkräfte Marine KOPASKA MARCOS Marine Commandos Marinejegerkommandoen Marine Raider Regiment Minedykkerkommandoen Namibian Marine Corps Operational Diving Unit Naval Diving Unit (Singapore) Naval Service Diving Section Naval Special Operations Command Operational Diving Division (SA Navy) Royal Engineers Russian commando frogmen Sappers Divers Group Shayetet 13 Special Air Service Special Air Service Regiment Special Actions Detachment Special Boat Service Special Boat Squadron (Sri Lanka) Special Forces Command (Turkey) Special Forces Group (Belgium) Special Operations Battalion (Croatia) Special Service Group (Navy) Special Warfare Diving and Salvage Tactical Divers Group US Marine Corps Force Reconnaissance US Marine Corps Reconnaissance Battalions US Navy SEALs Underwater Construction Teams Underwater Demolition Command Underwater Demolition Team Underwater Offence (Turkish Armed Forces) UNGERIN Underwater work Commercial offshore diving Dive leader Diver training Recreational diver training Hazmat diving Hyperbaric welding Marine construction Offshore construction Underwater construction Media diving Pearl hunting Police diving Potable water diving Public safety diving Scientific diving Ships husbandry Sponge diving Submarine pipeline Underwater archaeology Archaeology of shipwrecks Underwater cutting and welding Underwater demolition Underwater inspection Nondestructive testing Underwater logging Underwater photography Underwater search and recovery Underwater searches Underwater videography Underwater survey Salvage diving SS Egypt Kronan La Belle SS Laurentic RMS Lusitania Mars Mary Rose USS Monitor HMS Royal George Vasa Diving contractors COMEX Helix Energy Solutions Group International Marine Contractors Association Tools and equipment Abrasive waterjet Airlift Baited remote underwater video In-water surface cleaning Brush cart Cavitation cleaning Pressure washing Pigging Hot stab Lifting bag Remotely operated underwater vehicle Thermal lance Tremie Underwater weapons Limpet mine Speargun Hawaiian sling Polespear Underwater firearm Gyrojet Mk 1 Underwater Defense Gun Powerhead Underwater pistols Heckler & Koch P11 SPP-1 underwater pistol Underwater revolvers AAI underwater revolver Underwater rifles ADS amphibious rifle APS underwater rifle ASM-DT amphibious rifle QBS-06 Recreational diving Recreational dive sites Index of recreational dive sites List of wreck diving sites Outline of recreational dive sites Children in scuba diving Specialties Altitude diving Cave diving Deep diving Ice diving Muck diving Open-water diving Rebreather diving Sidemount diving Solo diving Technical diving Underwater photography Wreck diving Diver organisations British Sub-Aqua Club (BSAC) Cave Divers Association of Australia (CDAA) Cave Diving Group (CDG) Comhairle Fo-Thuinn (CFT) Confédération Mondiale des Activités Subaquatiques (CMAS) Federación Española de Actividades Subacuáticas (FEDAS) Fédération Française d'Études et de Sports Sous-Marins (FFESSM) International Association for Handicapped Divers (IAHD) Quintana Roo Speleological Survey (QRSS) Woodville Karst Plain Project (WKPP) Diving tourism industry Dive center Diving in Timor-Leste Diving in the Maldives Environmental impact of recreational diving Scuba diving tourism Scuba diving in the Cayman Islands Shark tourism Sinking ships for wreck diving sites Underwater diving in Guam Diving events and festivals Diversnight Underwater Bike Race Diving safety Human factors in diving equipment design Human factors in diving safety Life-support system Safety-critical system Scuba diving fatalities Underwater diving emergency Water safety Water surface searches Diving hazards List of diving hazards and precautions Environmental Current Delta-P Entanglement hazard Overhead Silt out Wave action Equipment Freeflow Use of breathing equipment in an underwater environment Failure of diving equipment other than breathing apparatus Single point of failure Physiological Cold shock response Decompression Nitrogen narcosis Oxygen toxicity Seasickness Uncontrolled decompression Diver behaviour and competence Incompetence Overconfidence effect Panic Task loading Trait anxiety Willful violation Consequences Barotrauma Decompression sickness Drowning Hypothermia Hypoxia Hypercapnia Hyperthermia Non-freezing cold injury Diving procedures Ascending and descending Emergency ascent Boat diving Canoe and kayak diving Buddy diving buddy check Decompression Decompression practice Pyle stop Ratio decompression Dive briefing Dive log Dive planning Rule of thirds Scuba gas planning Diver communications Diver rescue Diver training Doing It Right Drift diving Gas blending for scuba diving Night diving Rebreather diving Scuba gas management Solo diving Wall diving Risk management Checklist Hazard identification and risk assessment Hazard analysis Job safety analysis Risk assessment Hyperbaric evacuation and rescue Risk control Hierarchy of hazard controls Incident pit Lockout–tagout Permit To Work Redundancy Safety data sheet Situation awareness Diving team Bellman Chamber operator Diver medical technician Diver's attendant Diving supervisor Diving systems technician Gas man Life support technician Stand-by diver Equipment safety Breathing gas quality Testing and inspection of diving cylinders Hydrostatic test Sustained load cracking Diving regulator Breathing performance of regulators Occupational safety and health Association of Diving Contractors International International Marine Contractors Association Code of practice Contingency plan Diving regulations Emergency response plan Diving safety officer Diving superintendent Diving supervisor Operations manual Standard operating procedure Diving medicine Diving disorders List of signs and symptoms of diving disorders Cramp Motion sickness Surfer's ear Pressure related Alternobaric vertigo Barostriction Barotrauma Air embolism Aerosinusitis Barodontalgia Dental barotrauma Middle ear barotrauma Pulmonary barotrauma Compression arthralgia Decompression illness Dysbarism Oxygen Freediving blackout Hyperoxia Hypoxia Oxygen toxicity Inert gases Avascular necrosis Decompression sickness Dysbaric osteonecrosis Inner ear decompression sickness Isobaric counterdiffusion Taravana High-pressure nervous syndrome Hydrogen narcosis Nitrogen narcosis Carbon dioxide Hypercapnia Hypocapnia Breathing gas contaminants Carbon monoxide poisoning Immersion related Asphyxia Drowning Hypothermia Immersion diuresis Instinctive drowning response Laryngospasm Salt water aspiration syndrome Swimming-induced pulmonary edema Treatment Demand valve oxygen therapy First aid Hyperbaric medicine Hyperbaric treatment schedules In-water recompression Oxygen therapy Therapeutic recompression Personnel Diving Medical Examiner Diving Medical Practitioner Diving Medical Technician Hyperbaric nursing Screening Atrial septal defect Effects of drugs on fitness to dive Fitness to dive Psychological fitness to dive Research Researchers in diving physiology and medicine Arthur J. Bachrach Albert R. Behnke Peter B. Bennett Paul Bert George F. Bond Robert Boyle Alf O. Brubakk Albert A. Bühlmann John R. Clarke Guybon Chesney Castell Damant Kenneth William Donald William Paul Fife John Scott Haldane Robert William Hamilton Jr. Henry Valence Hempleman Leonard Erskine Hill Brian Andrew Hills Felix Hoppe-Seyler Christian J. Lambertsen Simon Mitchell Charles Momsen Neal W. Pollock John Rawlins Charles Wesley Shilling Edward D. Thalmann Jacques Triger Diving medical research organisations Aerospace Medical Association Divers Alert Network (DAN) Diving Diseases Research Centre (DDRC) Diving Medical Advisory Council (DMAC) European Diving Technology Committee (EDTC) European Underwater and Baromedical Society (EUBS) National Board of Diving and Hyperbaric Medical Technology Naval Submarine Medical Research Laboratory Royal Australian Navy School of Underwater Medicine Rubicon Foundation South Pacific Underwater Medicine Society (SPUMS) Undersea and Hyperbaric Medical Society (UHMS) United States Navy Experimental Diving Unit (NEDU) Law Civil liability in recreational diving Diving regulations Duty of care List of legislation regulating underwater diving Investigation of diving accidents Convention on the Protection of the Underwater Cultural Heritage History of underwater diving History of decompression research and development History of dive computers History of Diving Museum History of scuba diving List of researchers in underwater diving Lyons Maritime Museum Man in the Sea Museum Timeline of atmospheric diving suits Timeline of diving technology Pearling in Western Australia US Navy decompression models and tables Archeological sites SS Commodore USS Monitor Queen Anne's Revenge Whydah Gally Underwater art and artists The Diver Jason deCaires Taylor Engineers and inventors Jerónimo de Ayanz y Beaumont William Beebe Georges Beuchat Giovanni Alfonso Borelli Joseph-Martin Cabirol John R. Clarke Jacques Cousteau Charles Anthony Deane John Deane Louis de Corlieu Auguste Denayrouze Ted Eldred Henry Fleuss Émile Gagnan Karl Heinrich Klingert Peter Kreeft Christian J. Lambertsen Yves Le Prieur John Lethbridge Ernest William Moir Joseph Salim Peress Auguste Piccard Joe Savoie Willard Franklyn Searle Gordon Smith Augustus Siebe Pierre-Marie Touboulic Jacques Triger Historical equipment Aqua-Lung RV Calypso SP-350 Denise Magnesium torch Nikonos Porpoise regulator Standard diving dress Sub Marine Explorer Vintage scuba Diver propulsion vehicles Advanced SEAL Delivery System Cosmos CE2F series Dry Combat Submersible Human torpedo Motorised Submersible Canoe Necker Nymph R-2 Mala-class swimmer delivery vehicle SEAL Delivery Vehicle Shallow Water Combat Submersible Siluro San Bartolomeo Welfreighter Wet Nellie Military and covert operations Raid on Alexandria (1941) Sinking of the Rainbow Warrior Scientific projects 1992 cageless shark-diving expedition Mission 31 Awards and events Hans Hass Award International Scuba Diving Hall of Fame London Diving Chamber Dive Lectures NOGI Awards Women Divers Hall of Fame Incidents Dive boat incidents Sinking of MV Conception Diver rescues Alpazat cave rescue Tham Luang cave rescue Early diving John Day (carpenter) Charles Spalding Ebenezer Watson Freediving fatalities Stephen Keenan Loïc Leferme Audrey Mestre Nicholas Mevoli Natalia Molchanova Offshore diving incidents Byford Dolphin diving bell accident Drill Master diving accident Star Canopus diving accident Stena Seaspread diving accident Venture One diving accident Waage Drill II diving accident Wildrake diving accident Professional diving fatalities Roger Baldwin John Bennett Victor F. Guiel Jr. Francis P. Hammerberg Craig M. Hoffman Peter Henry Michael Holmes Johnson Sea Link accident Edwin Clayton Link Gerard Anthony Prangley Per Skipnes Robert John Smyth Albert D. Stover Richard A. Walker Lothar Michael Ward Joachim Wendler Bradley Westell Arne Zetterström Scuba diving fatalities 1973 Mount Gambier cave diving accident Ricardo Armbruster Allan Bridge David Bright Berry L. Cannon Cotton Coulson Cláudio Coutinho E. Yale Dawson Deon Dreyer Milan Dufek Sheck Exley Maurice Fargues Fernando Garfella Palmer Guy Garman Steve Irwin death Jim Jones Henry Way Kendall Artur Kozłowski Yuri Lipski Kirsty MacColl Agnes Milowka François de Roubaix Chris and Chrissy Rouse Dave Shaw Wesley C. Skiles Dewey Smith Rob Stewart Esbjörn Svensson Josef Velek Publications Manuals NOAA Diving Manual U.S. Navy Diving Manual Basic Cave Diving: A Blueprint for Survival Underwater Handbook Bennett and Elliott's physiology and medicine of diving Encyclopedia of Recreational Diving The new science of skin and scuba diving Professional Diver's Handbook Basic Scuba Standards and Codes of Practice Code of Practice for Scientific Diving (UNESCO) DIN 7876 IMCA Code of Practice for Offshore Diving ISO 24801 Recreational diving services — Requirements for the training of recreational scuba divers General non-fiction The Darkness Beckons Goldfinder The Last Dive Shadow Divers The Silent World: A Story of Undersea Discovery and Adventure Research List of Divers Alert Network publications Dive guides Training and registration Diver training Competence and assessment Competency-based learning Refresher training Skill assessment Diver training standard Diving instructor Diving school Occupational 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(IDRCF) International Diving Schools Association (IDSA) International Marine Contractors Association (IMCA) List of diver certification organizations National Oceanic and Atmospheric Administration (NOAA) Nautical Archaeology Society Recreational diver course referral World Recreational Scuba Training Council (WRSTC) Commercial diver certification authorities Australian Diver Accreditation Scheme (ADAS) Commercial diver registration in South Africa Divers Institute of Technology Health and Safety Executive (HSE) Department of Employment and Labour Commercial diving schools Divers Academy International Norwegian diver school Free-diving certification agencies AIDA International (AIDA) Confédération Mondiale des Activités Subaquatiques (CMAS) Performance Freediving International (PI) Scuba Schools International (SSI) Recreational scuba certification agencies American Canadian Underwater Certifications (ACUC) American Nitrox Divers International (ANDI) Association nationale des moniteurs de plongée (ANMP) British Sub-Aqua Club (BSAC) Comhairle Fo-Thuinn (CFT) Confédération Mondiale des Activités Subaquatiques (CMAS) Federación Española de Actividades Subacuáticas (FEDAS) Fédération Française d'Études et de Sports Sous-Marins (FFESSM) Federazione Italiana Attività Subacquee (FIAS) Global Underwater Explorers (GUE) International Association for Handicapped Divers (IAHD) International Association of Nitrox and Technical Divers (IANTD) International Life Saving Federation (ILS) Israeli Diving Federation (TIDF) National Academy of Scuba Educators (NASE) National Association of Underwater Instructors (NAUI) Nederlandse Onderwatersport Bond (NOB) Professional Association of Diving Instructors (PADI) Professional Diving Instructors Corporation (PDIC) Professional Technical and Recreational Diving (ProTec) Rebreather Association of International Divers (RAID) Sub-Aqua Association (SAA) Scuba Diving International (SDI) Scuba Educators International (SEI) Scuba Schools International (SSI) Türkiye Sualtı Sporları Federasyonu (TSSF) United Diving Instructors (UDI) YMCA SCUBA Program Scientific diver certification authorities American Academy of Underwater Sciences (AAUS) CMAS Scientific Committee Technical diver certification agencies American Nitrox Divers International (ANDI) British Sub-Aqua Club (BSAC) Confédération Mondiale des Activités Subaquatiques (CMAS) Diving Science and Technology (DSAT) Federazione Italiana Attività Subacquee (FIAS) International Association of Nitrox and Technical Divers (IANTD) Professional Association of Diving Instructors (PADI) Professional Diving Instructors Corporation (PDIC) Professional Technical and Recreational Diving (ProTec) Rebreather Association of International Divers (RAID) Trimix Scuba Association (TSA) Cave diving Cave Divers Association of Australia (CDAA) Cave Diving Group (CDG) Global Underwater Explorers (GUE) National Speleological Society#Cave Diving Group (CDG) National Association of Underwater Instructors (NAUI) Technical Diving International (TDI) Military diver training centres Defence Diving School Navy Diving Salvage and Training Center Underwater Escape Training Unit Military diver training courses United States Marine Corps Combatant Diver Course Underwater sports Surface snorkeling Finswimming Snorkeling/breath-hold Spearfishing Underwater football Underwater hockey Australia Turkey Underwater rugby Colombia United States Underwater target shooting Breath-hold Aquathlon Apnoea finswimming Freediving Open Circuit Scuba Immersion finswimming Sport diving Underwater cycling Underwater orienteering Underwater photography Rebreather Underwater photography Sports governing organisations and federations International AIDA International Confédération Mondiale des Activités Subaquatiques) National AIDA Hellas Australian Underwater Federation British Freediving Association British Octopush Association British Underwater Sports Association Comhairle Fo-Thuinn Federación Española de Actividades Subacuáticas Fédération Française d'Études et de Sports Sous-Marins South African Underwater Sports Federation Türkiye Sualtı Sporları Federasyonu Underwater Society of America) Competitions 14th CMAS Underwater Photography World Championship Underwater Hockey World Championships Underwater Orienteering World Championships Underwater Rugby World Championships Underwater divers Pioneers of diving Eduard Admetlla i Lázaro Aquanaut John Bevan Mary Bonnin Amelia Behrens-Furniss James F. Cahill Jacques Cousteau Billy Deans Dottie Frazier Trevor Hampton Hans Hass Hannes Keller Dick Rutkowski Teseo Tesei Arne Zetterström Underwater scientists archaeologists and environmentalists Michael Arbuthnot Robert Ballard George Bass Mensun Bound Louis Boutan Jeffrey Bozanic Hugh Bradner Cathy Church Eugenie Clark James P. Delgado Sylvia Earle John Christopher Fine George R. Fischer Anders Franzén Honor Frost Fernando Garfella Palmer David Gibbins Graham Jessop Swietenia Puspa Lestari Pilar Luna Robert F. Marx Anna Marguerite McCann Innes McCartney Charles T. Meide Mark M. Newell Lyuba Ognenova-Marinova John Peter Oleson Mendel L. Peterson Richard Pyle Andreas Rechnitzer William R. Royal Margaret Rule Gunter Schöbel Stephanie Schwabe Myriam Seco E. Lee Spence Robert Sténuit Peter Throckmorton Cristina Zenato Scuba record holders Pascal Bernabé Jim Bowden Mark Ellyatt Sheck Exley Nuno Gomes Claudia Serpieri Krzysztof Starnawski Underwater filmmakers and presenters Samir Alhafith David Attenborough Ramón Bravo Jean-Michel Cousteau Richie Kohler Paul Rose Andy Torbet Ivan Tors Andrew Wight James Cameron Underwater photographers Doug Allan Tamara Benitez Georges Beuchat Adrian Biddle Jonathan Bird Eric Cheng Neville Coleman Jacques Cousteau John D. Craig Ben Cropp Bernard Delemotte David Doubilet Candice Farmer John Christopher Fine Rodney Fox Ric Frazier Stephen Frink Peter Gimbel Monty Halls Hans Hass Henry Way Kendall Rudie Kuiter Joseph B. MacInnis Luis Marden Agnes Milowka Noel Monkman Pete Oxford Steve Parish Zale Parry Pierre Petit Leni Riefenstahl Fred Roberts Peter Scoones Brian Skerry Wesley C. Skiles E. Lee Spence Philippe Tailliez Ron Taylor Valerie Taylor Albert Tillman John Veltri Stan Waterman Michele Westmorland John Ernest Williamson J. Lamar Worzel Underwater explorers Caves Graham Balcombe Sheck Exley Martyn Farr Jochen Hasenmayer Jill Heinerth Jarrod Jablonski Brian Kakuk William Hogarth Main Tom Mount Jack Sheppard Bill Stone Reefs Arthur C. Clarke Wrecks Leigh Bishop John Chatterton Clive Cussler Bill Nagle Valerie van Heest Aristotelis Zervoudis Aquanauts Andrew Abercromby Joseph M. Acaba Clayton Anderson Richard R. Arnold Serena Auñón-Chancellor Michael Barratt (astronaut) Robert A. Barth Robert L. Behnken Randolph Bresnik Timothy J. Broderick Justin Brown Berry L. Cannon Scott Carpenter Gregory Chamitoff Steve Chappell Catherine Coleman Robin Cook Craig B. Cooper Fabien Cousteau Philippe Cousteau Timothy Creamer Jonathan Dory Pedro Duque Sylvia Earle Jeanette Epps Sheck Exley Albert Falco Andrew J. Feustel Michael Fincke Satoshi Furukawa Ronald J. Garan Jr. Michael L. Gernhardt Christopher E. Gerty David Gruber Chris Hadfield Jeremy Hansen José M. Hernández John Herrington Paul Hill Akihiko Hoshide Mark Hulsbeck Emma Hwang Norishige Kanai Les Kaufman Scott Kelly Karen Kohanowich Timothy Kopra Dominic Landucci Jon Lindbergh Kjell N. Lindgren Michael López-Alegría Joseph B. MacInnis Sandra Magnus Thomas Marshburn Matthias Maurer K. Megan McArthur Craig McKinley Jessica Meir Simone Melchior Dorothy Metcalf-Lindenburger Andreas Mogensen Karen Nyberg John D. Olivas Takuya Onishi Luca Parmitano Nicholas Patrick Tim Peake Thomas Pesquet Marc Reagan Garrett Reisman Kathleen Rubins Dick Rutkowski Tara Ruttley David Saint-Jacques Josef Schmid Robert Sheats Dewey Smith Steve Squyres Heidemarie Stefanyshyn-Piper Robert Sténuit Hervé Stevenin Nicole Stott James Talacek Daniel M. Tani Robert Thirsk Bill Todd Mark T. Vande Hei Koichi Wakata Rex J. Walheim Shannon Walker John Morgan Wells Joachim Wendler Douglas H. 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Adapted from the Wikipedia article [Asphyxia](https://en.wikipedia.org/wiki/Asphyxia) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Asphyxia?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.