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Why Do Divers Run Out Of Gas?

Not surprising, the answer is more complicated than simply, they neglected to look at their gauges. Here Aussie diving medical researcher and former editor of DAN’s Annual Diving Report, Peter Buzzacott dives into several deep datasets including DAN’s Incident Reporting System (DIRS) and nearly four decades of cave diving incident data, to tease out some insights on gas emergencies and get a handle on the risks. Don’t stop those S-drills!

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by Peter Buzzacott

See companion story for a guestimate of the risk: What is the Risk of Running Out of Gas?

Next year it will be 30 years since I first learned to dive. At the time, I had no idea that diving would occupy such a large part of my life. I distinctly remember kneeling on the sandy bottom end of the Great Barrier Reef, sharing a regulator with my buddy, and seeing sunlight rippling down through crystal clear water. On one of these “confined water” dives we had to swim horizontally for 10 m/30 ft holding our regulators out of our mouths and blowing a steady stream of bubbles. This wasn’t as easy as it sounds and we had to ration our bubbles to make it the whole way. Then, on an open water dive, the instructor took turns holding us with one hand and gripping a rope with the other while we took a breath, took the second stage out of our mouths, and then went for the surface, breathing out all the way. Up, down, up, down, the instructor went, with each student—one at a time. 

Courtesy PADI Worldwide. Copyright 2021, used with permission.

Most of today’s recreational dive courses do not include buddy breathing, they teach gas sharing with an alternate air source (AAS). Even before COVID-19, the buddy breathing skill had disappeared from most recreational training programs. The controlled emergency swimming ascent (CESA) has also disappeared from some programs. 

When I became an instructor, I made many hundreds of these but, now that I think about it, I don’t recall ever seeing anyone actually make one for real after running out of gas. These days everyone dives with two second stage regulators. In technical diving, we even dive with at least two cylinders; so, I wonder, do technical divers run out of gas and, if they do, then why?

What Do The Experts Say?

Some years ago, I asked a panel of 27 diving experts a similar question regarding recreational divers in general.1 The panel consisted of nine diving/hyperbaric doctors who had treated hundreds of injured divers; nine expert dive guides, most of whom were instructors; and nine expert recreational divers who had dived all over the world and written hundreds of feature articles for dive magazines. 

At the time, I suspected divers mostly ran out of gas because they didn’t pay attention to their gauge. But, to my surprise, the experts suggested about 20 reasons, such as diving deeper than usual, diving in a current, not wanting to end the dive for their buddy, using a smaller tank than their buddy, being underweighted, and many others, all of which sounded plausible. 

I sent the whole list of potential causes back to the group and asked them to rank, in their opinion, the five most likely causes. Then I gave five points to everyone’s most likely potential cause, four points to the second most likely, and so on. I added up all of the points and then ranked all the causes according to the total score. Then I sent this ranked list back to the group for one last review and asked them to consider the “weight of opinion” from the group as a whole, and to reconsider their top five reasons. 

As an expert panel, the group moved toward consensus. Just as I’d suspected, failing to monitor the gauge was the number one proposed potential cause of running out of gas, followed by inexperience, overexertion, inadequate training, and poor dive planning. Other than perhaps an unexpected current or underweighting leading to overexertion, the proposed reasons leaned toward human factors rather than the other two types of factors in the classic diving injury causal triad—those being environmental factors and equipment factors (Figure 1).2,3,4

Figure 1: The classic diving injury causal factors triad 2,3,4

The process I’d followed to gather expert consensus of opinion is called a “Delphi” process, which was originally developed by International Business Machines Corporation (IBM) to make forecasts on matters about which there was considerable uncertainty i.e. where there is little data. Opinions aren’t solid evidence; however, they can point towards a direction worth investigating. 

Next, I visited Divers Alert Network(DAN) as an intern and worked on an analysis of diving fatalities within a subset of technical divers—cave divers. More on that later, but while there, I had the opportunity to examine a large dataset of recorded dives from Project Dive Exploration, headed by Drs. Richard Vann and Petar Denoble. 

The dataset we had at that time revealed over 50,000 dives recorded by more than 5,000 recreational divers, (including an unknown number of technical divers). We examined these data in two ways. First, to control for environmental and equipment factors, and to focus on demographic (or human) factors, we counted each diver just once and compared those divers who had reported running out of gas, (during any recorded dive in that dataset), with divers who had not run out of gas. Surprisingly (to me), having run out of gas was more common than expected among older females (males were more likely to report other problems, like rapid ascent). 



Next, to control for the human factors, we looked at just the dives made by divers who had made both at least one dive where they ran out of gas, and at least one dive where they did not run out of gas. I wanted to know what it was about those dives that might have caused the divers to run out of gas. Well, it turned out the out-of-gas dives were deeper, shorter (probably because they were deeper), often made from a live-aboard or charter boat, and involved a higher perceived workload.5 Hmmm… Perhaps overexertion was a factor after all.

After returning to Western Australia to undertake a PhD researching this, I spent the next few years recording 1,000 recreational dive profiles made by 500 divers. I recorded their start and end pressures, tank size, and noted factors such as current, how they felt their workload was (resting/light, moderate, or severe/exhausting), how many dive experiences they had, and what previous dive training they had completed. For the analysis, dives made by divers who exited with <50 bar/725 psi of pressure (needle in the red zone, n=183) were compared with other dives recorded at the same time at the same dive site (n=510) by divers who exited with >50 bar/725 psi pressure remaining (needle not in the red zone). 

Ending a dive low on gas was correlated with younger males with a longer break since their last dive, fewer lifetime dives, at deeper depth, and a higher rate of gas consumption (adjusted to an equivalent surface air consumption (SAC) rate, for comparison between dives made at different depths). Perhaps more tellingly, compared with 1% of the dives with >50 bar/725 psi at the exit, 11% of the low-on-gas divers reported being surprised at the end of the dive by how low their remaining gas pressure was.6 A more detailed analysis of the average workload associated with recreational diving, using this same dataset, identified that higher perceived SAC rate was not associated with sex but was associated with older age, lower dive certification, fewer years of diving, higher perceived workload, and other factors.7 

Technically Out of Gas

Returning to the topic of technical diving, a colleague and I re-examined the DAN cave diving fatality reports collection that I had worked with as an intern, and this time we concentrated on the previous 30 years of data: 1985-2015. Dividing it into two equal halves which we referred to as the “early” and “late” groups, reading each report carefully, and using a reliable cave diving fatality factors flow-chart previously developed,5 we classified factors associated with each cave diving fatality and then compared the two groups. 

In the late (more recent) group, the proportion of cave divers who were trained in cave diving had significantly improved, perhaps due to increased awareness of the need for proper cave diver training before entering a flooded cave. The majority of the 67 trained cave divers in our dataset were diving with two cylinders on their back (doubles), and the late group was diving further into the cave than the early group. Of the 67 trained cave divers, 41 (62%) had run out of gas. Looking at the five “golden rules” of cave diving, the “rule of thirds” was the most common (n=20) rule that was suspected to have been broken by the trained cave divers: the most lethal.9

So, it would seem that some technical divers do run out of gas, though thankfully that appears rare. We should bear in mind that cave divers may differ from other types of technical divers in their procedures, demography, and equipment; their environment (by definition) certainly differs from that of wreck divers. 

Currently, I know of no ongoing research into out-of-gas incidents among technical divers, other than the current Diving Incident Reporting System, hosted by DAN. An analysis of the first 500 reported incidents recently examined every incident—recreational and/or technical—during which the diver ran out of gas.10 The sample (n=38) was divided into two groups: those who made a controlled ascent (e.g. on a buddy’s donated regulator) and those who made rapid ascent (e.g. a bolt to the surface). 

Among divers who reported having run out of gas, but survived to report the incident, 57% of the rapid ascents resulted in a reported injury. Among the 24 controlled ascents, just 29% reported an injury.10

Among divers who reported having run out of gas, but survived to report the incident, 57% of the rapid ascents resulted in a reported injury. Among the 24 controlled ascents, just 29% reported an injury.10 This modern finding is in line with the statistics reported 27 years ago by Dr. Chris Acott when he analyzed more than 1,000 diving incident reports. Examining 189 out-of-gas incident reports, Dr. Acott found 89 made a rapid ascent, and 58% of those reported an injury. Among the 79 controlled ascents, only 6% reported an injury.11 

Table 1 shows the total number of dive incidents in each category, after adding both studies together. It seems to me that, while we have moved on from buddy-breathing and the controlled emergency swimming ascent, in the last 30 years the problem of running out of gas has not gone away. 

No Injury
(row %)
Injury
(row %)
Total
(col %)
Non-rapid ascent 91 (88)12 (12)103 (50)
Rapid ascent43 (42)60 (58)103 (50)
Total134 (65)72 (35)206 (100)
Table 1: Injuries among 206 out-of-gas dive incidents by ascent rate10,11

In conclusion, the evidence confirms what we all know: running out of gas is associated with diving injuries and fatalities. It appears that the level of correlation of demography information (like age and sex) with out-of-gas incidents may depend upon the study design, the pool of divers studied, and/or the specific potential causes of running out of gas being investigated. For example, in one study, older females were more likely to self-report out of gas problems; in another study, young males’ remaining gas was measured and observed to be low. In yet another study, SAC rate increased when perceived workload increased, regardless of sex. 

Therefore, I’d suggest it is prudent to consider everyone potentially at risk of running out of gas and, in order to mitigate this risk, both recreational and technical divers should be proficient in gas planning and monitoring their remaining gas, regardless of age and/or sex. 

[Ed.note—Most agencies today require some level of proficiency in managing emergency out of gas scenarios. For example, GUE requires divers at all levels to train regularly for this eventuality. This training also emphasizes gas management strategies like “minimum gas reserves” and the related “one third” rule to ensure divers always have enough supply to share gas aka buddy breathe from any point in the dive, and all the way to the surface. Violation of these strategies risks insufficient gas in all environments.]

Influencers

The influence of workload is interesting, and technical divers who perceive an elevated workload may well remember that this has been associated with both higher rates of gas consumption and unexpectedly running low on gas. So, when detecting a current or perceiving an elevated workload, I recommend keeping a closer-than-usual eye on the remaining gas and, if a current is suspected before the dive, then plan for an elevated SAC rate. 

The influence of training/certification consistently appears to be associated with the risk of running out of gas, as does having made fewer lifetime dives. Highly trained and experienced divers might bear this in mind when diving with buddies who are newer to our sport. Offer them opportunities to gain experience and recommend additional training when they are ready. We were all inexperienced once.

Technology has improved in recent years; for example, tank pressure transponders are more reliable today than ever before. It is possible that in the future these resources, coupled with audible alarms, may prove to be highly effective at preventing technical divers from running out of gas. Until we know how effective such alarms are at preventing out-of-gas dives, our best course of action is to dive within the limits of our training and experience, and to keep an eye on our remaining gas. 

See companion story for an estimate of the risk: What is the Risk of Running Out of Gas?

Do you think that it could it happen to you?

References

1. Buzzacott P, Rosenberg M, Pikora T. Using a Delphi technique to rank potential causes of scuba diving incidents. Diving and Hyperbaric Medicine. 2009;39(1):29-32.

2. Edmonds, C. and Walker, D. Scuba diving fatalities in Australia and New Zealand: The human factor. SPUMS J. 1989;19(3): 94-104.

3. Edmonds, C. and Walker, D. Scuba diving fatalities in Australia and New Zealand: The environmental factor. SPUMS J. 1990;20(1): 2-4.

4. Edmonds, C. and Walker, D. Scuba diving fatalities in Australia and New Zealand: The equipment factor. SPUMS J. 1991;21(1): 2-5.

5. Buzzacott P, Denoble P, Dunford R, Vann R. Dive problems and risk factors for diving morbidity. Diving and Hyperbaric Medicine. 2009;39(4):205-9.

6. Buzzacott P, Rosenberg M, Heyworth J, Pikora T. Risk factors for running low on gas in recreational divers in Western Australia. Diving and Hyperbaric Medicine. 2011;41(2):85-9.

7. Buzzacott P, Pollock NW, Rosenberg M. Exercise intensity inferred from air consumption during recreational scuba diving. Diving and Hyperbaric Medicine. 2014;44(2):74-8.

8. Buzzacott P, Zeigler E, Denoble P, Vann R. American cave diving fatalities 1969-2007. International Journal of Aquatic Research and Education. 2009;3:162-77.

9. Potts L, Buzzacott P, Denoble P. Thirty years of American cave diving fatalities. Diving and Hyperbaric Medicine. 2016;46(3):150-4.

10. Buzzacott P, Bennett C, Denoble P, Gunderson J. The Diving Incident Reporting System. In: Denoble P, editor. DAN Annual Diving Report 2019 Edition: A Report on 2017 Diving Fatalities, Injuries, and Incidents. Durham (NC): Divers Alert Network; 2020. p. 49-67.

11. Acott C. Diving incidents – Errors divers make. Safe Limits: An international dive symposium; 1994; Cairns: Division of Workplace Health and Safety.

12. Buzzacott P, Schiller D, Crain J, Denoble PJ. (2018). Epidemiology of morbidity and mortality in US and Canadian recreational scuba diving. Public Health 155: 62-68. 

13. Buzzacott P. (editor) (2016). DAN Annual Diving Report 2016 Edition: A report on 2014 data on diving fatalities, injuries, and incidents. Durham, NC, Divers Alert Network

14. Buzzacott P (editor) (2017). DAN Annual Diving Report 2017 Edition: A Report on 2015 Diving Fatalities, Injuries, and Incidents. Durham (NC), Divers Alert Network.

15. Buzzacott P and Denoble PJ. (editors) (2018). DAN Annual Diving Report 2018 Edition: A report on 2016 data on diving fatalities, injuries, and incidents. Durham, NC, Divers Alert Network

16. Denoble PJ. (editor) (2019). DAN Annual Diving Report 2019 Edition: A Report on 2017 Diving Fatalities, Injuries, and Incidents. Durham (NC), Divers Alert Network.

You can add a diving incident to the DAN database by name or anonymously here: Diving Incident Reporting System (DIRS).


Dr. Peter Buzzacott MPH, PhD, FUHM, is a former PADI Master Instructor and TDI Advanced Nitrox/Decompression Procedures instructor, having issued >500 diver certifications. Today he is an active cave diver, holding various advanced cave diver certifications including advanced (hypoxic) trimix diver, and he is gradually gaining experience with CCR diving. To finance this, he conducts research into diving injuries and decompression/bubble modeling at Curtin University in Perth, Western Australia.

Cave

Close Calls: I Ripped My Drysuit a Kilometer Back In The Cave

It’s a potentially life-threatening equipment failure that most divers have thought but, but outside of minor leaks, few have experienced, and almost none have trained for. It certainly got the attention of photographer Fan Ping as he felt the chilly Florida spring water rush into his suit. Here’s how he survived the dive.

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By Fan Ping

🎶🎶 Pre-dive Clicklist: 平凡之路 (The Ordinary Road) by Pu Shu

Finally I had to say goodbye to my six-year old drysuit, in an unexpected way.

It was a cloudy day in January. There were not many people at Ginnie Springs in Florida as the temperature there was still too cold for the inflatable unicorns and flamingos with their masters in swimsuits that you see so often at the park. My friend Derek Dunlop and I met at the parking lot in front of Devil’s underwater cave system, and we started preparing for our photo shoot in Berman’s Room, at about 1006 m/3400 ft on the main line.

I sidemount my camera to the right.

As usual, we had first talked about the shooting plan with a storyboard and had decided to go in with six video lights since Berman’s Room is pretty big and fairly tall. Then we started preparing our rebreathers, but things did not go smoothly. Derek had a leak in his DSV, and then one of his O2 sensors stopped working for an unknown reason. Fortunately, he managed to fix both problems, but by then it was almost 2 pm already. I am a firm believer of ‘Rule of Three’ (If you have three major problems before you start the dive, then you should quit for the day), but I am also a photographer who was eager to capture the last piece of my Ginnie Springs project.

Berman’s Room
The Henkel

We got on our scooters and started diving. When I have many lights, I usually put two on the camera, which is side mounted on my right like a tank, two in my left thigh pocket, and the rest on my buddy. We dropped our own sidemount bailout tanks at Stage Bottle Rock at 1800’ and arrived at our destination 45 minutes into the dive as planned. We spent about 60 minutes playing with the lights and shooting, and then turned the dive happily at 105 minutes.

I was leading on the way out, riding in the high flow and thinking about the photos. When I passed the restricted tunnel before the Henkel restriction, the third problem of the day finally came. Scootering with the flow at perhaps  1 m/sec, the corner of my left pocket on my drysuit got caught on the tip of a rock and ripped a 3cm x 3cm hole. I could feel the chilly water flooding into my suit, so I stopped immediately, and within 10 seconds I lost my trim and buoyancy and was kneeling on the floor like in my Open Water class.

I told myself to “stop and think!” As in all the training we have done, I realized this was not an immediate life threatening situation, but the snowball could start rolling if I did not act correctly in a calm way. I checked my computers and used my primary light to get Derek’s attention and told him my drysuit was done for with the universal hand signal. Then I put some gas into the wing, but I was still on the floor. With more gas into the drysuit, I started moving again, in a vertical fashion. 

As you all can imagine, I had to put myself on the floor again at the Henkel. It is not extremely tight if you choose the right path, but with the DPV and camera and the Global Underwater Explorers (GUE)-configured JJ-CCR on my back, I was worried that I might not get out of the cave smoothly. Usually I stay very calm during a dive, but the depth was 32 m/105 ft, and the clock was ticking I was unsure of what would happen with that hole in my drysuit. I dumped all the gas in my suit and carefully crawled out of the restriction. Luckily, visibility is not a problem in Ginnie’s main tunnel because of the flow, and I can verify that a v-drill is easier when you have your belly on the ground.

To be honest, this was when I just completely got out of the panic mode. I knew I was getting closer to the surface, and I would be fine as long as I stayed focused. I inflated my suit, but as soon as I tried to stay horizontal, the gas leaked out from the hole. So, I put more gas into the loop and started being dragged by my scooter like SLAVE I in Star Wars, while still having to kick the whole time against the weight of my feet. 

That was when I started to feel cold. I could not imagine what this would have been like if I had been in a freezing cold cave like Orda, where the low temperature would have already killed me. All I could do was focus on scootering and choosing the taller passage if possible, in order to avoid messing with my buoyancy. Derek retrieved my bailout tank on the way out, and we made it back to the cavern in about 145 minutes, which is almost twice the time it usually takes.

My dive profile

There was no one else in the cavern when we started doing our longer-than-planned deco. I inflated my suit and knelt down on the rock at 6 m/20 ft so I could at least keep my torso relatively dry. I was getting colder and colder since I was not moving at all, but thanks to the 21ºC/70ºF degree spring water, my mind was still clear enough to think about getting a rental drysuit at Extreme Exposure and coming back in two days. After about 40 minutes of deco, we got back to the surface, and I had a really hard time walking back to my truck with all the water in my suit. What is worse, even the clouds started crying for me (or perhaps for my drysuit).

Drysuit full of water with the hole. Notice the rip on the top of the left pocket.

A fully flooded drysuit is something we always had talked about in our training but would never practice on purpose. When it actually happens, one can lose his trim and buoyancy within seconds, resulting in much more serious problems; for example, navigation, extended deco time, and hypothermia. 

In retrospect, I think there are 3 reasons why it happened to me:

  1. I was diving a Kirby Morgan M48 Mod-1 full face mask to facilitate better communication with my model, but the vision was relatively limited,and I did not pay enough attention to the surroundings;
  2. I had two big video lights in my pocket, and the pocket was exposed as I dropped my sidemount bailout tank;
  3. I should have gone slowly or maybe swum in more restricted areas.

I consider myself lucky that I got nothing but cold and lost nothing but an old drysuit, and thanks to Derek who made the process easier. It could have been a totally different story in another cave with a silty bottom or freezing cold water. However, out with the old, in with the new; it was time to get another drysuit.

Have you or a teammate ever had a “close call” while diving? Please take a few minutes to complete our new survey: Close Calls in Scuba Diving 


Fan Ping is a Chinese photographer and filmmaker based in Atlanta, Georgia, USA, and is dedicated to showing the beauty of the underwater world to people through his lens. He is specialized in combining artistic elements with nature and complex lighting skills in overhead environments, and this artistic style has brought him international acclaim, including awards from many major underwater photo/video competitions. You can follow his work on Facebook and Instagram: Be Water Imaging.

The best of Fan Ping’s work can be purchased at: www.bewaterimaging.com

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