Deep Freediving’s Next Frontier: How to Close the Safety Gap and Prevent Decompression-Related Injury

Purpose

Freediving’s decompression-related injury prevention has become one of the most urgent conversations in our sport. While athletes continue to set continental records near 100 meters and world-class performances exceeding 130 meters, the infrastructure of competitions and the framework for free diving training has not kept pace with physiological risk. The aim of this article is to propose a clear roadmap that reduces decompression sickness (DCS) and cerebral arterial gas embolism (CAGE) risks without dampening the competitive spirit.

Our perspective is not to revisit tragedies, but to learn from them. Every incident is a signal that freediving safety protocols need modernization. In the same way medicine, aviation, or mountaineering evolved through structured safety, freediving must now integrate decompression management into both training and official rules.

With this essay, ApneaBoom contributes concrete suggestions for event organizers, federations like CMAS and AIDA, and everyday practitioners of freediving competition and training. It’s time to align freediving’s passion with science and medicine.

1. Framing the Issue

Across a single professional lifetime, competitive freediving has transformed from exploratory sport to a precision discipline with reproducible performances near abyssal thresholds. Continental records now cluster around the 100 m mark, while the world’s best—particularly in Constant Weight (CWT)—routinely press beyond 130 m. This rise is not accidental. It reflects a convergence of technique (streamlined hydrodynamics, advanced equalization), technology (high-fidelity depth lines, counterbalance systems, telemetry), and training science (periodized breath-hold conditioning, CO₂ and O₂ tolerance drills) that together reduce variability and nudge limits downward with each competitive cycle. In other words, depth is no longer the product of singular heroics; it is the outcome of systems.

Yet a stubborn asymmetry persists between performance and protection. Human physiology is demonstrably plastic for hypoxia tolerance, narcosis management, and thoracic compliance under pressure—domains where careful exposure and technique confer meaningful adaptation. But there is no validated human adaptation that reliably protects against decompression stress. Nitrogen kinetics are governed by physics, not willpower, and when ascent profiles, repetition, or individual cardiopulmonary anatomy permit bubbles or gas transit into the arterial circulation, the consequences can be sudden and devastating. Consensus medical sources remain unambiguous on this point: decompression illness (DCI)—which encompasses both decompression sickness (DCS) and arterial gas embolism—requires immediate oxygen, expert triage, and timely recompression when indicated, not “toughness” or breath-hold prowess. Authoritative overviews from Divers Alert Network and hyperbaric texts used in emergency medicine reinforce this stance and outline first-response priorities that competitions must plan for in advance rather than improvise after the fact. See DAN’s clinical guidance and condition summaries as a starting point for protocols Divers Alert Network: Decompression Illness, and the emergency-medicine primer on air embolism and barotrauma in NCBI StatPearls.

Events over the last seasons—without rehashing individual tragedies—have exposed structural gaps in freediving competition logistics: uneven access to hyperbaric therapy; evacuation plans that hinge on resources not actually on standby; delays in diagnosis and handover; and the absence of standardized decompression support after deep exposures. These are not moral failings; they are design problems. And design problems yield to design. A modern competition should assume a priori that freediving’s decompression-related injury prevention is part of the performance ecosystem, just as safety cars are part of modern motorsport. That means building around the real risk profile of today’s depth attempts: decompression pathology, pulmonary barotrauma, and cerebral arterial gas embolism (CAGE). Hyperbaric and dive-medicine communities have for decades codified how to recognize and treat these entities; our task is to translate that knowledge into rules, staffing, equipment, and timing that travel with the platform. For foundational terminology and mechanisms, see the CDC/NIOSH medical materials for diving professionals CDC NIOSH: Diving Publications and the position and education resources from the Undersea & Hyperbaric Medical Society UHMS.

Context

With routine CWT performances now at or above 130 m, competition organizers must plan not for the world as it was, but for the world as it is: one where ascent-phase risks include both inert-gas microbubble dynamics and mechanical failure modes of the lung near the surface. Unlike hypoxia tolerance—which improves with targeted respiratory training, technique, and peripheral conditioning—there is no known “training adaptation” that insulates athletes from decompression illness. Accordingly, any credible platform or training camp that courts elite depths should embed three premises into its operating model:

• Physics-first safety: Ascent speed, shallow-phase control, and standardized post-dive oxygen are non-negotiable controls, not optional “nice-to-haves.”
• Medical-grade readiness: On-site oxygen delivery, dive-medicine-literate clinicians, and guaranteed, timed access to recompression are part of the event’s core kit, not contingency fantasies. Refer to DAN’s recommendations for initial management and transport triggers DAN Health & Medicine.
• Rule-level alignment: If depth is pursued systematically, decompression support must be codified systematically—through discipline definitions, mandatory shallow stops, protocol verification, and exposure limits that reflect present-day depths and repetition patterns.

Bringing the safety architecture up to the standard of the performances it enables is not a brake on progress; it is the precondition for sustainable progress in free diving training and high-stakes meets alike. The remainder of this series will translate these premises into concrete rule changes, platform design, and medical pathways suitable for national-level pilots and world-class events.

2. Recent Incidents and Lessons Learned

The 2025 CMAS World Championship in Mytikas became a watershed moment for freediving safety, not because of the records set, but because of the urgent lessons revealed. For the first time at a global event, multiple high-profile athletes and even safety officers presented with confirmed or suspected decompression illness. These cases exposed the structural weaknesses of our current framework for freediving competition—and underscored that freediving’s decompression-related injury prevention must be integrated into both rules and logistics, not handled ad hoc.

Importantly, this section avoids sensationalism. Instead, it identifies what the incidents collectively show: that oxygen stations, while necessary, are insufficient; that safety personnel are equally exposed; and that medical evacuation protocols must be judged not by theoretical design but by real execution under pressure. Sources from DeeperBlue, Molchanovs, and the official CMAS responses provide authoritative documentation of what unfolded.

Case Study: Davide Carrera

Italian freediver Davide Carrera, a veteran of deep competition, followed protocol and stopped at the “Deco O₂ station” after his dive. Despite this, he reported decompression sickness symptoms including dizziness and neurological tingling. He was treated, discharged the same day, but was not cleared to continue competition. Carrera’s case is pivotal: it demonstrates that even when post-dive oxygen is used as prescribed, individual physiology, depth profiles, and repetition can still produce DCS. This underscores the need for stronger rules around dive frequency, surface intervals, and standardized post-dive monitoring.

Case Study: Roberto Butera

Roberto Butera, serving as a safety officer rather than a competing athlete, also developed decompression-related symptoms after repeated deep operations. He received care and recovered, but his case highlights a blind spot: safety divers face similar or greater risk exposure as athletes due to repeated mid-depth dives across the competition day. Freediving’s safety system must therefore include strict duty rotations, exposure limits, and decompression support for staff as well as competitors.

Case Study: Andrey Matveenko

Russian athlete Andrey Matveenko attempted 126 m Constant Weight in training. He surfaced with loss of consciousness and was evacuated to a local hospital. Critically, hyperbaric treatment was delayed by approximately 21 hours due to lack of on-site chamber access and slow inter-hospital transfer. In dive medicine, neurological DCS and CAGE demand treatment within minutes to hours for optimal recovery. After this delay, Matveenko suffered neurological sequelae. This case illustrates that evacuation plans cannot be aspirational; they must be guaranteed, practiced, and logistically feasible within the golden window of treatment.

Patterns Among Other Divers

Beyond these three high-profile incidents, DeeperBlue’s analysis noted that additional athletes and safety divers reported, or were suspected of, decompression-related symptoms following repeated deep or mid-depth dives. These patterns demonstrate that the risks are not limited to isolated cases but represent a systemic exposure whenever depth and repetition intersect without adequate decompression strategies.

Official CMAS Responses

In its September 18, 2025 statement, CMAS defended its planning, citing approval of medical protocols and oxygen stations. However, it also acknowledged that actual circumstances—such as unavailable helicopters and absence of local hyperbaric chambers—meant those plans did not achieve their intended effect. The official timeline provides valuable clarity: protocols existed but execution gaps rendered them ineffective when athletes most needed them.

Lesson learned: these incidents show that freediving’s rapid progression to extreme depths requires a new baseline of safety infrastructure. Oxygen alone is not sufficient. Evacuation capacity must be real, not theoretical. And freediving’s decompression-related injury prevention must extend equally to athletes and safety personnel. Only then will free diving training and competition achieve sustainable progress without repeating preventable failures.

3. Medical Definitions & Mechanisms

To design meaningful reforms for freediving’s decompression-related injury prevention, we must first be precise about the pathologies at stake. While the popular imagination often frames every freediving accident as a “blackout,” the reality is more complex. The most dangerous threats in today’s freediving competition and advanced free diving training environments involve decompression stress, pulmonary barotrauma, and the cerebral consequences of gas embolism. These are not speculative conditions—they are well-described in hyperbaric medicine and have clear diagnostic and therapeutic pathways.

Decompression Sickness (DCS)

Decompression Sickness (DCS) occurs when dissolved inert gas, primarily nitrogen, comes out of solution during ascent and forms microbubbles in blood or tissues. In scuba diving, this mechanism is widely recognized and modeled; in freediving, DCS was once considered rare. However, with repeated deep dives, shortened surface intervals, and attempts exceeding 100 m, documented cases are rising. Clinical presentations include neurological symptoms such as dizziness, visual changes, or loss of coordination; musculoskeletal pain often described as “the bends”; pulmonary complaints; and mottled or marbled skin manifestations. For an overview of the condition, Divers Alert Network (DAN) provides a comprehensive summary: DAN: Decompression Illness. Further regional guidance is available from DAN Southern Africa, which highlights freediver-specific risks.

The lesson for freediving is that even “single breath” exposure is not immune when depths exceed 80–90 m, especially with multiple attempts in a training day. DCS is not theoretical—it is increasingly a practical risk in modern competition.

Pulmonary Barotrauma & Cerebral Arterial Gas Embolism (CAGE)

Pulmonary barotrauma arises when the lungs are damaged by rapid volume expansion, usually during the last meters of ascent. Aggressive “packing” (glossopharyngeal insufflation) exacerbates this risk by raising intrathoracic pressure and stretching alveolar tissue to the edge of tolerance. When alveoli rupture, gas can escape into the arterial circulation. This results in Cerebral Arterial Gas Embolism (CAGE), one of the most catastrophic events a freediver can experience. Symptoms often appear immediately: unconsciousness, seizures, paralysis, or stroke-like deficits.

Unlike DCS, where symptom onset can be delayed, CAGE is abrupt and life-threatening. Rapid oxygen administration, airway management, and recompression therapy are essential. Two case reports illustrate the severity: a fatal arterial air embolism in a breath-hold diver and a pulmonary barotrauma with CAGE, both published in peer-reviewed medical journals. These cases demonstrate that CAGE is not hypothetical; it is a documented risk pathway.

Symptoms & First Aid Response

In both DCS and CAGE, early recognition and immediate intervention dramatically affect outcomes. Typical warning signs include:

• Tingling, numbness, or joint pain
• Weakness, fatigue, or unusual muscle heaviness
• Visual changes, dizziness, or loss of coordination
• Chest pain, cough, or shortness of breath
• Skin mottling, rash, or marbling

Immediate actions on the boat should follow established dive medicine standards:

• Administer 100% oxygen immediately via demand valve or non-rebreather mask
• Protect the airway, ventilate if needed, and keep the diver supine
• Maintain warmth and hydration as tolerated
• Conduct a rapid neurological exam and continuous monitoring
• Prepare for immediate transfer to a hyperbaric facility or use on-board chamber if available
• Communicate directly with a dive-medicine physician to guide triage

4. Gaps Exposed in Current CMAS / Competition Practice

While the freediving community celebrates its depth milestones, the 2025 CMAS World Championship in Mytikas highlighted serious operational gaps in the way competitions currently manage safety. These gaps demonstrate that freediving’s decompression-related injury prevention has not yet been built into the very architecture of competition, but remains treated as an emergency contingency. The result was avoidable delays, insufficient medical readiness, and uncertainty for both athletes and safety teams.

Perhaps the most striking example came from Andrey Matveenko’s case. Despite rapid recognition of his collapse after a 126 m attempt, hyperbaric treatment was delayed by approximately 21 hours. For decompression illness and cerebral arterial gas embolism, the medical consensus is unequivocal: treatment must begin within minutes to hours, not the following day. Such a delay, despite protocols existing on paper, meant that a critical therapeutic window was lost.

Why did this happen? The official CMAS Q&A reveals the uncomfortable truth: while medical procedures and oxygen stations were “approved,” the actual logistics failed in practice. Helicopter evacuation was unavailable. The designated hospital lacked a hyperbaric chamber. Ground transport introduced long delays. In essence, the plan had been certified, but it was not executable under real conditions. This discrepancy between “protocol on paper” and “protocol in action” is perhaps the most important lesson to emerge from Mytikas.

Another overlooked element was the health of safety personnel. The case of Roberto Butera, who developed decompression-related symptoms while serving as a safety diver, underscores the fact that repeated deep or mid-depth exposures accumulate risk. The prevailing assumption—that safety staff operate under lower physiological stress than athletes—was demonstrably false. In reality, the duties of support divers place them in harm’s way with similar or even greater cumulative nitrogen load, making them equally deserving of structured decompression support.

Finally, communication and accountability issues eroded confidence in the event. Several athletes withdrew voluntarily, citing incoherent or inconsistent medical response. In safety-critical domains, communication breakdowns are often as dangerous as the initial incident. Without a clear chain of command, transparent monitoring, and rehearsed response pathways, even competent medical staff can be undermined by confusion in the moment.

• Delay in hyperbaric treatment: 21 hours in a case where the medical standard is “within minutes to hours.”
• Logistical failure: helicopter unavailable, hospital without chamber, transport bottlenecks.
• Safety diver risk underestimated: support roles exposed to DCS symptoms from repetitive operations.
• Communication breakdown: unclear responsibility, leading to athlete withdrawals and loss of confidence.

The cumulative message is clear: current freediving competition practices cannot rely on aspirational documents. They must be stress-tested, resourced, and guaranteed in advance. Without structural fixes, even the best athletes and staff are left vulnerable to failures outside their control. If freediving is to advance sustainably, prevention must be engineered into every layer of event planning—not assumed to work itself out on the day.

5. Proposed Rule and Process Modifications

The experiences of Mytikas show that current safeguards are insufficient. If freediving’s decompression-related injury prevention is to become a practical reality, rules and processes must evolve. Below are proposed reforms—some incremental, some structural—that can reduce the incidence of DCS, CAGE, and barotrauma in both free diving training and freediving competition. These proposals combine established dive-medicine practices with innovations suited to the unique demands of single-breath diving.

Renaming or Creating New Disciplines with Built-in Decompression

One structural solution is to create explicit variants of depth disciplines that incorporate decompression. For example: CWT-OD (Constant Weight with Oxygen Decompression), FIM-OD (Free Immersion with Oxygen Decompression), and NLT-OD (No-Limits with Oxygen Decompression). Any attempt beyond 80–90 m would require a defined decompression protocol before surfacing. This move would:

• Clarify expectations: athletes know in advance what post-dive procedures are mandatory.
• Encourage safety-built disciplines: records and recognition are tied to safer structures.
• Potential drawback: purists may resist the “oxygen-assisted” category, fearing dilution of traditional freediving ethos.

Mandatory Shallow Stop at 5 m

Introducing a standardized stop at approximately 5 m would slow ascent rates and allow time for nitrogen off-gassing. For OD categories, divers would breathe oxygen; for Classic, a 15–30 second pause without breathing could be enforced. Benefits include:

• Reducing inert-gas bubble formation near the surface.
• Creating a controlled zone where safety divers and cameras can monitor the athlete.
• Requiring logistical support: a fixed 5 m station, trained staff, and timing enforcement.

Oxygen Support at Decompression Stops

Providing 100% oxygen at the 5 m station is aligned with standard dive-medicine treatment for suspected DCS. Breathing pure O₂ accelerates nitrogen elimination, reducing bubble load. Key considerations:

• Benefit: faster off-gassing, improved safety margins for repeated attempts.
• Drawback: risks of oxygen toxicity (though limited by short exposure at 1.5 ATA) and logistical challenges of supplying oxygen to offshore platforms.

AI-Assisted Underwater Protocol Verification

To reduce confusion during critical recovery seconds, athletes could perform the OK sign and gaze into a camera at the 5 m station. AI software would verify compliance and timestamp the gesture. Judges could then accept this as a valid performance indicator, rather than waiting until the athlete surfaces.

This method would:

• Reduce surface crowding and chaos during rescue-sensitive seconds.
• Create redundancy: underwater confirmation supplements surface protocol.
• Require robust technology and training, and may face issues in low visibility conditions.

On-Board Decompression Chambers and Paramedics

No competition at depths beyond 100 m should proceed without a portable hyperbaric chamber on the mothership or within guaranteed minutes of access. Additionally, paramedics trained in dive medicine must be present, equipped to deliver oxygen, airway support, and advanced neurological monitoring. These changes would drastically improve survival and recovery from acute DCS or CAGE events. The obvious drawback is cost and regulatory complexity, but these are minor compared to the consequences of untreated neurological injury.

Limiting Dive Time and Daily Exposure

Rules should cap total dive time, including ascent and decompression stop. For Classic disciplines, this could be ~4:30 minutes; OD variants could allow ~5:30 minutes due to oxygen stops. In addition:

• Limit deep attempts to one ≥90 m dive per day.
• Enforce surface intervals of at least 4–6 hours between deep dives.
• Prohibit back-to-back deep attempts on consecutive days without medical clearance.

These measures reflect the realities of nitrogen kinetics: repetition is a multiplier of risk.

Speed Controls and Packing Management

The last 10–15 m of ascent are where barotrauma risk peaks. A speed cap of ≤0.7 m/s could be enforced via smart counterbalance telemetry. In addition, aggressive glossopharyngeal packing should be regulated or paired with a mandatory controlled exhale in the final meters. Such measures directly target the causes of CAGE, reducing catastrophic embolic events.

Screening, Monitoring, and Data Registries

Preventive screening for Patent Foramen Ovale (PFO) should be offered to elite athletes, as right-to-left shunts are strongly associated with increased risk of embolic DCS. Routine Doppler bubble checks pre- and post-dive could help monitor nitrogen stress. A central incident registry would create the evidence base needed to refine exposure rules in the future. While these interventions increase cost and may exclude some athletes, they elevate the sport to medical transparency similar to other high-risk disciplines like boxing or motorsport.

Operational Redundancies

Perhaps the most important shift is ensuring that evacuation and treatment protocols are not merely aspirational. Competition organizers should guarantee access to helicopters, ambulances, and hyperbaric chambers, and rehearse these pathways with local health systems. Routine drills must test whether the plan works under time pressure. This approach reduces single-point failures and ensures that every element of the safety system can deliver when needed.

In sum: these proposed reforms integrate medicine, logistics, and technology into freediving’s evolving landscape. They are not luxuries—they are prerequisites for sustainable growth in both freediving competition and high-performance training environments.

6. Specific Proposals

Building upon the broad framework outlined in the previous section, we can distill a set of specific proposals that are both actionable and directly applicable to freediving competition and advanced free diving training. These measures, many already discussed within the community, move safety from aspiration to enforceable rule. Their common thread is clear: freediving’s decompression-related injury prevention must be standardized, codified, and universally applied at depth-oriented events.

Core Proposals

• Rename disciplines with decompression integrated: Establish categories such as CWT-OD (Constant Weight with Oxygen Decompression) or FIM-OD. These labels make decompression protocols explicit parts of the discipline, ensuring fairness in record-keeping while rewarding safer pathways.
• Mandatory 5 m decompression stop: For all attempts at or beyond ~80–90 m, introduce a stop at 5 m. This pause should be codified into CMAS and AIDA rulebooks, not left to individual discretion.
• Oxygen support at the stop: Provide 100% O₂ tanks at the 5 m station. Breathing pure oxygen accelerates nitrogen elimination and minimizes microbubble formation, a standard practice in diving medicine.
• AI-camera verification: Athletes should perform an OK sign and direct gaze into an underwater camera at the decompression stop. AI software validates the gesture, providing a time-stamped confirmation that counts toward judging.
• Judges accepting underwater protocols: Protocol verification should not depend solely on the surface. Accepting underwater signals reduces pressure on divers and ensures fair evaluation even when surface conditions are chaotic.

Medical Infrastructure

• Decompression chamber on the boat or nearby: A portable hyperbaric chamber should be available at the competition site. Where portability is not feasible, a chamber within rapid access distance (under 30 minutes) must be secured.
• Paramedics trained in dive medicine: Every competition platform should include at least one physician or paramedic with hyperbaric expertise, equipped for oxygen administration, airway management, and neurological triage.

Dive Time and Exposure Limits

• Time caps: Maximum dive + ascent + decompression duration of ~4:30 minutes for Classic categories, slightly longer allowances for OD categories. These caps reflect physiological limits while discouraging excessive decompression loading.
• Repetitive dive limits: Limit the number of deep dives (≥90 m) per day to one, and enforce recovery intervals of 4–6 hours. Prohibit back-to-back deep attempts on consecutive days without medical clearance.
• Safety diver exposure limits: Safety staff performing repeated deep or near-deep assists must rotate duties, with rest enforced to avoid cumulative nitrogen stress.

Additional Preventive Measures

• Environmental & stress management: Cold exposure, dehydration, fatigue, and poor rest all exacerbate decompression risk. Organizers should provide hydration stations, enforce rest periods, and avoid scheduling multiple late-night and early-morning sessions in a row.
• Post-dive symptom monitoring: Introduce a standardized checklist after every deep dive to screen for early DCS signs—neurological, musculoskeletal, and dermatological. Symptomatic divers must be evaluated immediately and withdrawn from further dives until cleared.
• Athlete education: All divers should undergo pre-event briefings on decompression pathology, symptom recognition, and first-aid response. This empowers divers to self-report and peer-monitor effectively.

Taken together, these proposals offer a multi-layered safety system. They define new categories of depth performance, embed decompression procedures into the competition structure, and ensure medical-grade readiness on site. By targeting both athletes and safety staff, they acknowledge that freediving’s decompression-related injury prevention is not just about individuals but about sustaining the community as a whole. These measures may increase logistical complexity and cost, but they are proportional to the risks inherent in pushing human performance past 130 m.

7. Table: Nitrogen Saturation / Exposure Estimate

Before examining the values, note that this simplified comparison models a triangular breath-hold profile for a 75 kg diver with total descent+ascent time fixed at 1 minute and no bottom time. The “N₂ exposure index” is a comparative heuristic derived from ambient pressure at peak depth (P_amb ≈ 1 + depth/10) and the corresponding nitrogen partial pressure (P_n2 ≈ 0.79 × P_amb). It is not a decompression algorithm and must not be used for medical decisions; rather, it illustrates why freediving’s decompression-related injury prevention should scale with depth and repetition. Although single breath-hold dives generally load far less inert gas than scuba, the combination of extreme depths (≥ 100–130 m), short surface intervals, and multiple attempts can push bubble risk meaningfully higher—supporting the case for oxygen-assisted shallow stops, exposure limits, and post-dive monitoring in both freediving competition and free diving training.

*Estimates assume no bottom time, descent+ascent in 1 minute, rest at surface. These indices are comparative, not clinical.

8. Q&A

What exactly happened with Davide Carrera & Roberto Butera?

Davide Carrera complied with the event’s post-dive procedure and stopped at the designated “Deco O₂ station.” Despite that, he reported symptoms consistent with decompression illness (DCS) and withdrew; he was discharged the same day but was not cleared to keep competing. Roberto Butera, serving as a safety officer, also developed decompression-related symptoms during repeated operational dives and received medical care. These paired cases highlight two systemic realities: (1) post-dive oxygen helps but does not guarantee protection when depth, repetition, and individual physiology combine; and (2) safety personnel accumulate substantial exposure and must be included in any framework for freediving’s decompression-related injury prevention. See coverage in DeeperBlue.

What about Andrey Matveenko’s case?

Andrey Matveenko attempted ≈126 m CWT in training, lost consciousness on ascent, and was evacuated to shore. Critically, first hyperbaric treatment was reported after an estimated ≈21 hours, far outside the ideal treatment window for neurological DCS/CAGE. The result was documented neurological sequelae. This case underscores that protocols are only as good as their execution—access to a chamber and rapid transfer must be guaranteed in minutes to hours, not “as available.” See the Molchanovs event blog and additional reporting via DeeperBlue.

What is DCS and how is it different from (and similar to) CAGE / barotrauma?

Decompression Sickness (DCS) is tissue injury caused by inert-gas bubbles forming during/after ascent as ambient pressure falls. In freediving, risk rises with greater depth, short surface intervals, and repetition. By contrast, Cerebral Arterial Gas Embolism (CAGE) is usually a consequence of pulmonary barotrauma: alveolar rupture allows gas to enter the arterial circulation, producing abrupt, stroke-like deficits. The two syndromes can overlap clinically and both demand oxygen and rapid hyperbaric consultation. Authoritative overviews: DAN: Decompression Illness; peer-reviewed case evidence for arterial air embolism/CAGE in breath-hold diving: PMC case report.

What are the early warning signs of decompression injury?

Symptoms range from subtle to dramatic and may be delayed. Watch for:

• Tingling, numbness, joint or muscular pain (“bends”), unusual fatigue or heaviness
• Visual/coordination changes, dizziness, confusion, imbalance, headache
• Chest pain, cough, or shortness of breath (pulmonary involvement)
• Skin mottling or marbling, rashes, unusual itch

Freedivers, teammates, and safety staff should all be trained to screen for these signs after deep or repetitive dives. Regional guidance tailored to freedivers: DAN Southern Africa.

What first aid / immediate responses should protocols include?

Adopt the dive-medicine standard of care on the platform:

• 100% oxygen immediately via demand valve or non-rebreather mask
• Protect airway; ventilate if needed; keep the patient warm and supine
• Rapid neurological exam and continuous monitoring (document findings and times)
• Immediate contact with a dive-medicine physician/hyperbaric center
• Prepare rapid transfer to recompression therapy or use on-board chamber if present

Clear, authoritative protocols from Divers Alert Network should be integrated into event SOPs and drills.

Why did evacuation / treatment delays happen in Mytikas?

According to the official CMAS responses, planning documents were in place (oxygen stations, medical procedures), but critical logistics failed in real time: helicopter assets were unavailable; the receiving hospital did not have a hyperbaric chamber; ground transfers were prolonged. In safety-critical sports, a plan is only credible if timed, resourced, and rehearsed with the responsible agencies. See the CMAS Q&A (Sep 18, 2025).

What can organizers do now to address these gaps?

Translate lessons into enforceable structure—precisely what Section 5 proposes:

• Codify oxygen-decompression variants (CWT-OD/FIM-OD/NLT-OD) and a mandatory 5 m stop
• Install AI-verified underwater protocol to reduce surface chaos and speed medical access
• Guarantee on-board or minutes-away chamber and dive-medicine paramedics
• Enforce time caps, repetition limits, and exposure rotations (athletes and safety divers)
• Adopt screening/monitoring (e.g., PFO pathways, Doppler checks) and a central incident registry

These steps align elite performance with modern risk management for both freediving competition and high-exposure free diving training, turning isolated fixes into a coherent system for freediving’s decompression-related injury prevention.

9. Conclusion

Freediving has become one of the most striking demonstrations of human adaptability. Depths once thought impossible—100 m, 120 m, 130 m—are now performed with consistency, precision, and grace. Yet the last seasons have also made one truth unavoidable: performance has outpaced protection. Without equal progress in safety infrastructure, competition rules, and medical readiness, every new record risks becoming a test not only of human physiology but of systemic fragility.

The incidents in Mytikas are not anomalies. They are signals that the current framework of freediving competition and advanced free diving training is incomplete. Decompression sickness, pulmonary barotrauma, and cerebral arterial gas embolism must be considered core threats, not rare exceptions. Freediving’s decompression-related injury prevention therefore demands the same rigor as depth training itself: structured, standardized, and embedded into every stage of the event.

To achieve this, ApneaBoom calls on CMAS, AIDA, national federations, event organizers, and sponsors to lead the next phase of evolution. Pilot programs should be launched at lower-stakes or national-level competitions to trial new “OD” disciplines (oxygen-decompression variants), mandatory 5 m stops, on-site oxygen protocols, portable chambers, and AI-assisted underwater judging. These trials will provide the data, feedback, and refinements needed before scaling to world championships.

Above all, the wellbeing of athletes and safety divers must become central. Records are meaningful only if the divers who set them are protected to return safely, ready to dive again. The sport’s credibility, sustainability, and future growth depend on building an ecosystem where ambition and safety rise together.

Call to action: If you are inspired to pursue depth responsibly and learn the best practices that safeguard both performance and health, we invite you to join us. Enroll in Apnea Boom Freediving School in Cabo Verde. Train with expert instructors, master the skills for depth and recovery, and become part of a community committed to progress with safety at its core.

10. References & Supporting Medical Literature

• CMAS Official Responses / Mytikas competition reports: scubadiving.news (Sep 18, 2025)
• DeeperBlue coverage and analysis: CMAS Responds • Is Safety Broken? • Matveenko Emergency
• Event context: Molchanovs blog
• DAN resources on DCS in freediving: Freediving: Not a Free Pass out of DCS • DAN SA: Getting DCS while Freediving
• Medical literature (CAGE / barotrauma): Fatal air embolism in a breath‑hold diver • Pulmonary barotrauma with CAGE • Commentary: Technical freediving risks
• Background reading: Freediving and DCS (PFI/TDI‑SDI)