This paradise is located 342 miles (550 km) from the Costa Rican mainland. The island itself is only 10 square miles, so diving at Cocos is only possible from a liveaboard. Cocos Island live aboards depart from Puntarenas and take approximately 36 hours to reach their destination. Generally, itineraries range from 8 to 10 nights.
Decompression illness is a poorly understood risk for scuba divers and especially for technical divers. Conservative diving practices are the best way to lower the risk of DCI. Despite these practices, some divers have recurrent Type II or skin bends — the types associated with PFO — and should consider being evaluated for PFO. The best screening test is a “regular” transthoracic echocardiogram with the injection of agitated saline (“bubble study”).