Editing Nitrogen narcosis (section)

== Diagnosis and management ==
The symptoms of narcosis may be caused by other factors during a dive: ear problems causing disorientation or [[nausea]];{{r |Molvaer2003}} early signs of oxygen toxicity causing visual disturbances;{{r |Clark2003}} carbon dioxide toxicity caused by rebreather scrubber malfunction, excessive work of breathing, or inappropriate breathing pattern, or [[hypothermia]] causing rapid breathing and shivering.{{r |Mekjavic2003}} Nevertheless, the presence of any of these symptoms can imply narcosis. Alleviation of the effects upon ascending to a shallower depth will confirm the diagnosis. Given the setting, other likely conditions do not produce reversible effects. In the event of misdiagnosis when another condition is causing the symptoms, the initial management&nbsp;– ascending to a shallower depth&nbsp;– is still beneficial in most cases, as it is also the appropriate response for most of the alternative causes for the symptoms.{{sfnp|U.S. Navy Diving Manual|2008|loc=vol.&nbsp;1, ch.&nbsp;3, p.&nbsp;40}} 

The management of inert gas narcosis is usually simply to ascend to shallower depths, where much of the effect disappears within minutes.{{sfnp|Lippmann|Mitchell|2005|p=106}} Divers carrying multiple gas mixtures will usually switch to a mixture with more helium before significant narcosis is noticeable during descent. In the event of complications or other conditions being present, ascending remains the correct initial response unless it would violate decompression obligations. Should problems persist, it may be necessary to abort the dive. The decompression schedule can and should still be followed unless other conditions require emergency assistance.{{sfnp|U.S. Navy Diving Manual|2008|loc=vol.&nbsp;2, ch.&nbsp;9, pp.&nbsp;35–46}}

Inert gas narcosis can follow a gas switch to a [[decompression gas]] with higher nitrogen fraction during ascent, which may be confused with symptoms of [[decompression sickness]], in a rare example of a situation in which it is not advisable to ascend immediately. If this is suspected to be the problem, it is better to switch back to the less narcotic gas if practicable, and adjust the decompression schedule to suit. This problem can be aggravated by the possibility of [[inert gas counterdiffusion]], which is most likely to affect the inner ear, and can usually be avoided by a better [[Scuba gas planning#Choice of breathing gas|selection of gas mixtures]] and [[Scuba gas management#Gas switching|switching depths]].<ref>{{Cite book |last=Program (U.S.) |first=NOAA Diving |url=https://books.google.com/books?id=hFsWUb54jzcC |title=NOAA Diving Manual: Diving for Science and Technology |date=2001 |publisher=National Oceanic and Atmospheric Administration, Office of Oceanic and Atmospheric Research, National Undersea Research Program, Office of Marine and Aviation Operations, NOAA Diving Program |isbn=978-0-941332-70-5 |language=en |access-date=2023-05-05 |archive-date=2024-04-16 |archive-url=https://web.archive.org/web/20240416051940/https://books.google.com/books?id=hFsWUb54jzcC |url-status=live }}</ref><!--there should be a ref in the ICD or gas planning article, but causation is logically obvious -->