Rescue Diver vs Stress and Rescue, any important differences?

[DeepSeaDan]

We did not really cover the first-aid skills, cpr, and defib. That is left to the separate courses. We did cover the five-minute neuro exam, but not the backboard. We covered shore-based rescue, including throwing a rope bag and running and managing search patterns from shore (a diver on a line). The emphasis was on getting a diver to the boat or shore and handing off to emergency services, which I think explains not covering some of the other material you cover.

Tranquility really was a great class. We talked about Zen and yoga and deep-breating exercises and spent 20 minutes just watching a video of dolphins at play. If you really understood that it was just as much about attitude and approach as it was about skills, you got a lot out of it. If you were just looking for the skills, I think you shorted yourself. I always say I am never as relaxed and peaceful as I am when I am underwater. People who think scuba is an adrenaline sport never understand that. Non-divers often think if you are a scuba diver you must be a thrill-seeker who also likes sky diving and bungee jumping.

...enriching your courses with practical 1st aid application. I know from years of teaching the subject that people rust-up on these basic skills very quickly ( I refuse to call renewal of a cert. "re-certification" - 99.9% of the time it's a "re-teach"! ). It is a real eye-opener for them when I spring the mannikin on them & they have to get down to it. Primary assessment, landmarking, compression rate & other basics are usually anywhere from poor to really poor. It makes them realize the necessity of keeping up on their skills. EMS will not always be waiting onshore for the instant hand-off, so they may be up to their ears in it. I also explain the huge difference between simply pushing on the chest & performing effective compressions, the difficulty, but absolute imperativeness of proper rescue breathing, & the general folly of in-water rescue breathing.

Again, reality rules.

Regards,
Dano

 

[RICoder]

No one has really bothered to spell out PADI's Rescue Course, as someone has for SSI, so I'll give it a go.

You are required to take an EFR course that will cover CPR and the like (defib, primary aid, yadda yadda) All very good and useful information for things in and out of water.

There is a good amount of time spent on analyzing stress and the cycle of it, but from the SSI info above, I'm not sure it is quite as much.

DCS is covered pretty well, so you can identify it...and you will go over providing oxygen post-rescue.

The rest of the course is different scenerios and types of rescue.

...having said all that, I agree with everyone else, its really about the instructor.

 

[divingjd]

...enriching your courses with practical 1st aid application. I know from years of teaching the subject that people rust-up on these basic skills very quickly ( I refuse to call renewal of a cert. "re-certification" - 99.9% of the time it's a "re-teach"! ). It is a real eye-opener for them when I spring the mannikin on them & they have to get down to it. Primary assessment, landmarking, compression rate & other basics are usually anywhere from poor to really poor. It makes them realize the necessity of keeping up on their skills. EMS will not always be waiting onshore for the instant hand-off, so they may be up to their ears in it. I also explain the huge difference between simply pushing on the chest & performing effective compressions, the difficulty, but absolute imperativeness of proper rescue breathing, & the general folly of in-water rescue breathing.

Again, reality rules.

Regards,
Dano

Certainly makes good sense. It's a question of how much you can cover and how much time you have.

 

[rongoodman]

Has anyone taken the SDI version?

 

[TheHobster]

I don't think many instructors put enough empasis on the fact that emergencies can happen anywhere, and that the people who are working together as a team might not necessarily have ever met before. Nor do they talk about having to keep spectators from being a hinderance, etc.

The guy I team teach with is brilliant at this - in fact, one class one of the DM's had a "problem" during our initial briefing, while he was setting the buoy for the OW class we had doing OW training at same time, so the game was on even before the class had equipt laid out!

we also integrated the OW class into the Rescue as victims and witnesses etc - in the Rescue/SLAM class I took in 1981, I was a "team" leader, and wouldn't ya know it, during the rescue I had a heart attack, at age 28!

and speaking of real life, during one rescue OW session while I was being "dumbass on the dock", a bystander at the quarry had an epileptic seizure

so IMHO, the instructor and their daemands of excellence make the rescue class what it is - PADI has beefed up theirs recently and while ours was great, with these new standards and what we need to do, it's even better

 

[slingshot]

Thanks for everybody's input. I'm taking the course to become a better diver, both for myself and my dive buddies. Sounds like some of your instructors were very inventive, I hope to have good luck with mine. I'll be taking rescue out on Catalina island in August, using a dive shop I've dived with before, and if I survive, I'll post my post-course thoughts.

 

[Quero]

<snip> the general folly of in-water rescue breathing.

Care to elaborate?

I know there has been debate, but as far as I can tell, the consensus is that the utility of in-water rescue breathing "depends"--particularly on how far from shore/help the rescuer is. That's pretty subjective, given that just about anywhere in the water seems far in a rescue situation.

I just trained a DM who got his rescue credentials from SDI. His instructor told him never to bother with in-water rescue breathing. Not sure if that's SDI standards, but that's what the student came to me with.

 

[DeepSeaDan]

Care to elaborate?

I know there has been debate, but as far as I can tell, the consensus is that the utility of in-water rescue breathing "depends"--particularly on how far from shore/help the rescuer is. That's pretty subjective, given that just about anywhere in the water seems far in a rescue situation.

I just trained a DM who got his rescue credentials from SDI. His instructor told him never to bother with in-water rescue breathing. Not sure if that's SDI standards, but that's what the student came to me with.

I wondered if that line would pique anyone's curiosity!

To be succinct, it is my belief that in-water rescue breathing, in most situations, is a waste of precious time; however, there are exceptions: witnessed near-drownings where the rescuer locates & surfaces the casualty within :5 of submersion; or, when a flat, hard surface is impossible to attain within :10 of casualty retrieval ( the patient will likely die due to the distance, thus an attempt can be made & a miracle hoped for ). If unsure of the time-line, attempt several breaths & look for response; if no response is observed, haul-*** to a location where effective resucitation can be performed.

Have you ever considered that ( to my knowledge ) no one actually ever practices REAL mouth-to-mouth resucitation in-water? Oh sure, they go through the steps, often blowing on the cheek, their own arm, or ( gasp! ) to the side of a pocket mask, to simulate breath delivery. From what I have observed over the years while watching people attempt this simulation, the efforts have been mostly farcial, with most participants simply going through the motions & hoping the Instructor will let them stop soon!

As someone who provides resucitative efforts on a regular basis, I can tell you that EFFECTIVE ventillation ( Read: "worthwhile" ) of a breathless & usually pulseless casualty is difficult to do, in the dry, with multiple rescuers! Up until recently ( the new rescue protocols are just going into effect now ), the goal of achieving a patent airway in a v.s.a. casualty via intubation was our #1 goal. Why? To protect the airway from possible intrusion of foriegn matter from the stomach through regurgitation - a potentialy deadly consequence of lung over-inflation during ventillation. What do you think the odds are that a diving casualty's lungs will be over-inflated by in-water rescue breathing?

If it is difficult for professionals to do properly in the dry, on a stable, flat hard surface, what chance do we have for proper delivery in the water? A well-trained, well-practiced individual ( your average Rescue Diver graduate? ) might possibly be able to provide adequate breaths off bottom, in mill-pond surface conditions, with warm-water gear configurations, for a short period of time ( the process would be exhausting ), while stationary. What percentage of the time would we operate in those conditions? Not often, I'd venture.

I polled several diving physicians & physiologists for their opinion on how long the AVERAGE person's heart would continue to effectively move blood after cessation of respiration. The answer was about :1 before the heart deteriorated into some form of non-circulating arrythmia. Athletes with excellent casdiovascular capacity might last several minutes.

That is precious little time. How effectively can we assess vital functions in-water? Can we effectively compress the chest in-water? If we can't, is there any point in attempting to oxygenate non-circulating blood?

For the casualty to have any chance of survival ( regretably, the odds are very poor; in Ontario, we remain at about a 3% success rate for resucitation with no neurological deficit ), the patient needs a flat, hard surface, EXCELLENT CPR, 100% O2, defibrillation & EMS a.s.a.p.

With the exception of the circumstances mentioned in my first paragraph, I believe it is in the casualtys best interest to be moved to shore / boat with all speed, & not waste precious time trying, however gallantly & well-intentioned, to breathe for the casualty in-water.

Regards,
DSD

 

[Quero]

I wondered if that line would pique anyone's curiosity!

To be succinct, it is my belief that in-water rescue breathing, in most situations, is a waste of precious time; however, there are exceptions: witnessed near-drownings where the rescuer locates & surfaces the casualty within :5 of submersion; or, when a flat, hard surface is impossible to attain within :10 of casualty retrieval ( the patient will likely die due to the distance, thus an attempt can be made & a miracle hoped for ). If unsure of the time-line, attempt several breaths & look for response; if no response is observed, haul-*** to a location where effective resucitation can be performed.
<snip>

Thanks for that excellent answer, Dan.