Lift procedure?

[vjongene]

"Ok guys, throw some points my about what kinda things you've to do while lifting an unconscious diver from the bottom."

And then I hear...

"If the reg isn't in the divers mouth, put in your octopus and purge it".

So what about you lot? Are you gonna stick an octopus into the unconscious divers mouth and purge??

Here is what we are being taught (CMAS procedures), for a diver found unconscious 20-40 m below the surface without a reg in his mouth:

- grab diver from behind, and secure one arm through BC strap to make sure you don't lose hold
- check that the unconscious diver still has air, purge his reg to remove as much water as possible, then stick it into his mouth; use your own reg if he is also OOA or close
- start the ascent procedure while holding the reg in the diver's mouth and pulling his head slightly back, but never purge the reg
- keep visual contact by looking from above (remember, you are behind an unconscious diver), be ready to help with breathing if necessary
- when getting within 10 m of the surface, gently force exhalation to avoid AGE
- call for help and start towing as soon as you reach the surface

I don't think that you have much of a chance of safely getting an unconscious diver to the surface from 40 m if you don't give him a chance to breathe. From 10 m down, just grabbing him and getting him to the surface is certainly the best course.

 

[MookieMoose]

Getting people to the surface should be the priority, but the idea that you are probably going to force water and/or high pressure air into the lungs is a bit of a misnomer. It is possible, but with an open airway you are more likely to force things either into the stomach, or most likely up into the nasal cavity and out the nostrils. Air, like people is lazy, and will always take the path of least resistance. If the nose isn't plugged the usually means it will come back out the nose. That is why it is so important to plug the nose when performing artificial respiration.

Cam

 

[Rick Murchison]

The concerns about "blowing air into" anything with a purge are overblown (sorry about the pun ). Unless there is a stuck exhaust valve (unlikely in the extreme) the overpressure involved when you purge a reg is essentially nil. What you are providing is gas at just the tiniest bit above ambient, and all you can do is displace water with air, and then only if there's a place for the water to escape downhill or enough "splashing" of the water in the mouth/reg to get it to the exhaust valve (ever tried to purge an upside down reg? you can do it but it isn't easy).
But don't take my word for it - get in the pool and try it. Play with it. You'll quickly develop the confidence that you just can't hurt anything by putting a reg in the victim's mouth and purging, and you may save a life.
Rick

 

[michaelp68]

I just completed a Rescue course. The standard taught in the course is that if the reg is not in the unresponsive diver's mouth at depth, do not put it in that diver's mouth.

I understand what Rick said in his posts, but for whatever it's worth, the standard being taught in Rescue is what I stated above.

Michael

 

[Rick Murchison]

I just completed a Rescue course. The standard taught in the course is that if the reg is not in the unresponsive diver's mouth at depth, do not put it in that diver's mouth.

I understand what Rick said in his posts, but for whatever it's worth, the standard being taught in Rescue is what I stated above.

Michael

Standards and procedures provide a "baseline" or a "duty of care" minimum. That doesn't mean we're bound to be robots and not do things in addition to that minimum that make sense under the circumstances and don't detract from the minimum.
Standards also evolve over time to reflect the latest "best (educated) guess" on what will provide the most effective care to a victim under the most likely circumstances. Every case is different, and modification to the standard that makes sense is not only prudent but can in some cases save a life that would be lost by rigid adherence to "standards."
Of course you have to have no fear of lawyers to take non-standard life-saving steps.
Rick

 

[michaelp68]

Standards and procedures provide a "baseline" or a "duty of care" minimum. That doesn't mean we're bound to be robots and not do things in addition to that minimum that make sense under the circumstances and don't detract from the minimum.
Standards also evolve over time to reflect the latest "best (educated) guess" on what will provide the most effective care to a victim under the most likely circumstances. Every case is different, and modification to the standard that makes sense is not only prudent but can in some cases save a life that would be lost by rigid adherence to "standards."
Of course you have to have no fear of lawyers to take non-standard life-saving steps.
Rick

Fortunately for me, I'm not afraid of lawyers.

And I agree with you about baseline standards and then using your own intelligence, knowledge and experience to modify and improve them.

I was just stating in my post what that current evolved baseline standard is.

Michael

 

[Don Burke]

The concerns about "blowing air into" anything with a purge are overblown (sorry about the pun ). Unless there is a stuck exhaust valve (unlikely in the extreme) the overpressure involved when you purge a reg is essentially nil.

The couple of times I have breathed off a freeflowing regulator, it sure seemed like considerably more than nil overpressure.

What you are providing is gas at just the tiniest bit above ambient, and all you can do is displace water with air, and then only if there's a place for the water to escape downhill or enough "splashing" of the water in the mouth/reg to get it to the exhaust valve (ever tried to purge an upside down reg? you can do it but it isn't easy).

I do not know my way around the physiology well enough to make a call either way on this. I have been going with the guidance of the agencies since it sure seems like the overpressure I have seen could push water the couple of inches needed to cause problems.

But don't take my word for it - get in the pool and try it. Play with it. You'll quickly develop the confidence that you just can't hurt anything by putting a reg in the victim's mouth and purging, and you may save a life.
Rick

I have not tried purging a reg in my mouth while horizontal. I will try it next time I am in the water.

 

[Rick Murchison]

The couple of times I have breathed off a freeflowing regulator, it sure seemed like considerably more than nil overpressure.... the overpressure I have seen could push water the couple of inches needed to cause problems.

Damaging overpressures are in the neighborhood of three feet of water, not three inches. The standard oxygen mask in a jet fighter delivers gas at 2 inches water pressure standard, and at up to about twelve inches when pressure breathing at high altitude. You just aren't going to do any harm by purging a reg in someone's mouth.
Rick

 

[Diver0001]

So here I am last night with my 5 DM Candidates, who are doing very well, in the pool, and we're doing some rescue skills, the lift to be specific, so I start off...

"Ok guys, throw some points my about what kinda things you've to do while lifting an unconscious diver from the bottom."

And then I hear...

"If the reg isn't in the divers mouth, put in your octopus and purge it". :11:

So what about you lot? Are you gonna stick an octopus into the unconscious divers mouth and purge??

The soapbox is waiting...

Well.....If I did what i was taught to do then i wouldn't let it slow down getting him to the surface.

If it were my best friend, it would be hard to resist.

R..

 

[jonnythan]

Damaging overpressures are in the neighborhood of three feet of water, not three inches. The standard oxygen mask in a jet fighter delivers gas at 2 inches water pressure standard, and at up to about twelve inches when pressure breathing at high altitude. You just aren't going to do any harm by purging a reg in someone's mouth.
Rick

I think he meant by forcing water into the lungs.