How to rescue a non-breathing diver?

[cdiver2]

I was taught the same methode as NetDoc by the BSAC.

 

[SquattingRadishDM]

Now just because everyone read it excellently explained by NetDoc on ScubaBoard.com it does NOT mean that you are now ready to rescue someone. Go out there and take a class. Dive theory can possibly be learnt online but practical experience can not.

 

[lamont]

And if this puts a feather in your cap Shaka, I decided after our last online conversation to do just as you have suggested, take the Rescue and Adv. Rescue class. I am already CPR and first aid certified, I need my AOW and then on to Rescue.

AOW isn't a preq for NAUI Rescue.

 

[JustJoe]

AOW isn't a preq for NAUI Rescue.

Well, I have a finite amount of time. I have paid for the AOW course (way back in early August, but hurricanes and problems with an instructor postponed it) so I need to finish this off then I will take the time and do both Rescue then Advanced Rescue with DAN O2 as well.

And probably a few other courses later on.

Joe

 

[Squalus]

Now just because everyone read it excellently explained by NetDoc on ScubaBoard.com it does NOT mean that you are now ready to rescue someone. Go out there and take a class. Dive theory can possibly be learnt online but practical experience can not.

Darn I was hoping for a certificate of training from that :1poke:
All Joking aside, SquattingRadishDM is right, you do need to take the class, get the practical experience and apply it whenever you dive.

 

[BigJetDriver]

Voop, you are right. That's why NAUI teaches every Open Water student how to perform this task (as well as assisting a panicked diver on the surface) and makes it a part of their OW skill set. You are not much of a "buddy" if you can't help your buddy out, now are you?

First, you need to realize that a non-breathing diver is DEAD already. You can't kill them twice. All you can hope to do is to revive them and that's only happening on the surface, and not at the bottom while you try and figure out the legal aspects of all of this.

So here is the simple chronological order that I teach my students... practice this until it becomes second nature for you.

1) Make sure they actually need help. That guy on the bottom just might be holding his breath as he waits to get the first picture of a Nimble Butt Bottom Sucker and won't appreciate a rescue attempt. A pull or two of the fin will let you know.

2) If they are prone, you must make them supine. A twist of the legs (Pull one to the left, and other to the right) will do this easily.

3) CHECK THE MASK. If there is ANY water in there discard the mask NOW. Boyle's law will cause water to be forced down the nasal passages resulting a pharyngeal spasm making it tough to ventilate.

4) Check the weights. For most wetsuits/bare chested divers (20 lbs or under), just pull the weight belt off at depth. If they are carrying more than that (dry suit diver), then see if you can move them, or if their inflator works. If not, get rid of the weight.

5) Left arm to left arm do-se-do tow, grab their inflator with your right hand and pull it back to the tank valve and hold both it and the tank valve.

6) Ascend quickly. A life is at stake so you can exceed 60 fpm. If the victim starts to run away with you vent their BC. Vent yours if needed. DO NOT violate any deco obligations, but you should blow off any safety stops. KEEP BREATHING.

7) As the victim starts to break the surface, NAIL their inflator. You do not want the face to dip back below the surface. Coming in contact with air can cause an involuntary gasp... you do not want their mouth below the surface if they do this. BTW, establish your own buoyancy here... no need to struggle.

8) Discard the mask (if present). and give two rescue breaths. These should be slow and deliberate. They should NOT be fast, and forceful! Look at the chest or feel for resistance. Do NOT over inspire. When the lungs are full you begin to ventilate the stomach. What goes in comes out in far greater quantities.

9) Tow them to boat or shore, giving 2 rescue breaths/10 seconds (or 1 in 5). Call for assistance and initiate EMS. Strip gear as you approach. When on shore or boat initiate full CPR, using an Oxygen mask if there is one available that will ventilate a non breathing victim.

There you have it... practice it until it's second nature and pray that you will never need to use it.

Those in the Orlando area that would like help with this skill need only contact me.

NetDoc,

That is one of the best, most concise statements about the problem that I have seen!! Well said!! :luxhello:

 

[Seadeuce]

Good advice being offered here I see.

Like to add a few points that will prompt some deep thinking by members, please consider the following:

1. An unconscious diver at depth may/may not have a pulse when not breathing, assume we all agree on that. The rescuer has no way of discerning which or whether, nor should he at this point.

2. If a pulse is present, and the rescuer should always assume there is, the higher PPO2 in the circulation will extend the time before the brain suffers reversible damage.

3. The unconscious diver may be convulsing. If so, the rescuer has to assume an O2 hit. A rescue lift at this stage will almost certainly do damage. Wait for the convulsions to cease before attempting the rescue lift. It might be prudent to do the lift from behind.

4. Weightbelt. The advantage of leaving it on is to keep the victim in an upright and stable position while the lift is being done.

5. If regulator is still in the mouth of the unconscious diver, little water has been inspired, and dry drowning may have commenced. Rescue lift can begin by inflating the victim's BC until positive buoyancy has been achieved. Hold Reg. in mouth on ascent, Etc. as in rescue training.

6. If reg. is out of mouth when found, some water has probably been inspired. Get victim upright on bottom, replace reg in mouth. A slight thump to the area of the solar plexus should help clear the airway, and help with reg. replacement. Begin rescue lift as above.

7. If victim should vomit while being lifted, keep purge valve pressed on reg., and turn mouthpiece sideways in the mouth. Detritus will be carried away on exit and air will be available should spontaneous breathing begin.

8. Ascend at a safe rate. ASAP rates will do nobody good. If victim starts breathing on ascent, STOP until you see he is breathing normally. Continue when he is, or isn't.

9. Water in mask on rescue lift. If spontaneous breathing occurs, the victim may be holding his breath between breaths because of the water in the mask. This is why you wait to see if breathing has returned to normal.

10. Be aware of the possibility of trapped air in the hood of the victim being rescued. Boyles Law will cause the air in the hood to expand on ascent, thereby causing mask to tighten, allowing water to enter the nasal area. This can cause the victim to begin to inspire water, hence hold his breath, and the rescue lift - if continued - could result in lung damage. Better to clear the hood of air if you feel it full.

11. Too often we hear of a rescue lift reaching the surface only for the victim to sink on separation from the rescuer. That is why the victim's BC should be used for buoyancy on the lift, not the rescuer's.

12. On reaching the surface, proceed with what is required as per rescue training.

Hope I haven't stood on any toes with the above, it was not the intention. No doubt some will disagree with parts of the advice given. It comes from a lot of diving, personal experience, and knowledge of some failed rescues.

I am not advocating that the above is a better, or the best method of completing the rescue of an unconscious diver, nor am I contradicting any method already described. My intention is that the above should serve to make a potential rescuer more aware of how the environment, equipment, and differing techniques, can affect a rescue situation, and, possibly, the outcome.

Stay Wet,

Seadeuce

 

[voop]

Voop, you are right. That's why NAUI teaches every Open Water student how to perform this task (as well as assisting a panicked diver on the surface) and makes it a part of their OW skill set. You are not much of a "buddy" if you can't help your buddy out, now are you?

I agree -- I wish that more agencies would follow NAUI on this respect.

<SNIP>

1) Make sure they actually need help. That guy on the bottom just might be holding his breath as he waits to get the first picture of a Nimble Butt Bottom Sucker and won't appreciate a rescue attempt. A pull or two of the fin will let you know.

ROTBLIMR (rolling on the bottom laughing in my reg)

<SNIP>

5) Left arm to left arm do-se-do tow, grab their inflator with your right hand and pull it back to the tank valve and hold both it and the tank valve.

<SNIP>

I usually instruct students to ensure that they can keep the victim's reg in his mouth and slightly tilt the victims head backwards (to ensure open air passage) while ascending. Typically, this involves sliding the left hand under the left BC strap of the victim and ever so gently pushing on to the regulator with the left hand. In case of a runaway where you can't vent fast enough, the hand easilly slides out and lets the victim up keeping you "safe" -- that is, if you keep your left arm free of entanglements (instruments -- they go on the right arm for that very reason).

But perhaps I just have a hard time visualizing what you're writing...?

Otherwise, I agree with your procedure (although I would be reluctant to ascent *much* faster than 60fpm....)

 

[DareDevil]

Voop, you are right. That's why NAUI teaches every Open Water student how to perform this task (as well as assisting a panicked diver on the surface) and makes it a part of their OW skill set. You are not much of a "buddy" if you can't help your buddy out, now are you?

First, you need to realize that a non-breathing diver is DEAD already. You can't kill them twice. All you can hope to do is to revive them and that's only happening on the surface, and not at the bottom while you try and figure out the legal aspects of all of this.

So here is the simple chronological order that I teach my students... practice this until it becomes second nature for you.

1) Make sure they actually need help. That guy on the bottom just might be holding his breath as he waits to get the first picture of a Nimble Butt Bottom Sucker and won't appreciate a rescue attempt. A pull or two of the fin will let you know.

2) If they are prone, you must make them supine. A twist of the legs (Pull one to the left, and other to the right) will do this easily.

3) CHECK THE MASK. If there is ANY water in there discard the mask NOW. Boyle's law will cause water to be forced down the nasal passages resulting a pharyngeal spasm making it tough to ventilate.

4) Check the weights. For most wetsuits/bare chested divers (20 lbs or under), just pull the weight belt off at depth. If they are carrying more than that (dry suit diver), then see if you can move them, or if their inflator works. If not, get rid of the weight.

5) Left arm to left arm do-se-do tow, grab their inflator with your right hand and pull it back to the tank valve and hold both it and the tank valve.

6) Ascend quickly. A life is at stake so you can exceed 60 fpm. If the victim starts to run away with you vent their BC. Vent yours if needed. DO NOT violate any deco obligations, but you should blow off any safety stops. KEEP BREATHING.

7) As the victim starts to break the surface, NAIL their inflator. You do not want the face to dip back below the surface. Coming in contact with air can cause an involuntary gasp... you do not want their mouth below the surface if they do this. BTW, establish your own buoyancy here... no need to struggle.

8) Discard the mask (if present). and give two rescue breaths. These should be slow and deliberate. They should NOT be fast, and forceful! Look at the chest or feel for resistance. Do NOT over inspire. When the lungs are full you begin to ventilate the stomach. What goes in comes out in far greater quantities.

9) Tow them to boat or shore, giving 2 rescue breaths/10 seconds (or 1 in 5). Call for assistance and initiate EMS. Strip gear as you approach. When on shore or boat initiate full CPR, using an Oxygen mask if there is one available that will ventilate a non breathing victim.

There you have it... practice it until it's second nature and pray that you will never need to use it.

Those n the Orlando area that would like help with this skill need only contact me.

Thanks a lot NetDoc... I really appreciate the effort you put in describing properly the entire procedure and not only a little step.

For what is worth, I think answers like yours are what makes this board really valuable and interesting.

DareDevil

 

[MXGratefulDiver]

I usually instruct students to ensure that they can keep the victim's reg in his mouth and slightly tilt the victims head backwards (to ensure open air passage) while ascending. Typically, this involves sliding the left hand under the left BC strap of the victim and ever so gently pushing on to the regulator with the left hand. In case of a runaway where you can't vent fast enough, the hand easilly slides out and lets the victim up keeping you "safe" -- that is, if you keep your left arm free of entanglements (instruments -- they go on the right arm for that very reason).

But perhaps I just have a hard time visualizing what you're writing...?

Otherwise, I agree with your procedure (although I would be reluctant to ascent *much* faster than 60fpm....)

There are variations on the unconscious diver lift ... and the effectiveness of the procedure depends far more on the rescuing diver's execution than on the mechanics of the lift itself.

For example, I don't teach the do-si-do lift. I do teach the rescuing diver to approach in the same manner as NetDoc. Once the need for rescue has been determined, I teach them to:

- Remove all the air from their own BCD and/or drysuit.
- Approach the diver from behind, reach their right arm under the right arm of the victim and gently hold the regulator in place.
- With their left arm, reach over the shoulder of the victim and get their inflator hose.
- Gently inflate their BCD to assist with the lift. Only enough to get the victim upright and neutral.
- Using the right arm to secure the victim and the left for buoyancy control, swim the victim up.

That's for a victim in singles ... someone wearing doubles requires a different technique ... more "over the top" of the victim rather than behind.

If your buddy is available to assist, that buddy can help with the lift by holding a BCD strap or D-ring and monitor the victim from the front. In either case, buoyancy control for both victim and rescuer(s) needs to be done using the victim's BCD ... in case for any reason you need to disengage, you don't want the victim sinking again.

Weights should not be dropped unless either you cannot get the victim off the bottom any other way or you've made a conscious decision to send the victim to the surface, rather than taking him/her there. A situation that may call for that is if there is a second victim that also requires immediate attention.

Rescue is a very situational activity, and the rescuer has to make decisions based on an assessment of the situation ... typically without much time to think about it. That's why you need to take a class. The class teaches you how to assess the situation, and provides tools for you to use once you determine the best course of action.

Once you've taken the class, regular practice is strongly advised. In truth, very few trained rescue divers ever actually practice their skills once class is completed ... which is a shame. Rescues typically require a compound set of actions and skills, which to be effective should be executed with some proficiency. Like any activity, you can only attain that proficiency through practice.

... Bob (Grateful Diver)