Rescue of an Unconscious Diver Underwater

[BoltSnap]

The last one they published was seriously flawed in the opinion of most of the responders. I personally thought the information was shockingly incorrect and showed a stunning lack of knowledge on the part of the operation.

Which post please? Link?

 

[lermontov]

Which post please? Link?

Decompression Stop Guidelines - What we have to do if got deco alert?

 

[The Chairman]

Maybe we should all flame their link and fill it with useless info too... i just did.

Really? Two wrongs don't make a right.

First off, it's apparent that much of what passes for Scuba knowledge on this planet is apocryphal at best. I've heard a number of instructors spout the same instructions and I don't think that the agencies are in much of an agreement either. So, rather than harp on @IDCBali for posting threads that get us talking about what is right, I believe we should take the opportunity to post our best practices and stop bashing them for doing something that's within the ToS. If you don't like it, go read another thread. No need to hijack this one.

So, now to the RECOVERY of an unconscious diver at depth. At this point, you can safely assume that a non-responsive diver on the bottom is deceased. There is nothing you can do to really injure them further than that, and there is very little hope that they can come back from this. Very little, but there is some hope. Here's what I would do:

• Don't become the second victim
  • Check your air
  • Check your NDL
  • Assess the situation
• Act quickly, but not hastily
  • You should practice this until you are fluid at it.
• Ask for permission
  • Photographers often lie still on the bottom waiting for a critter.
    • Often, they are holding their breath
    • Please don't piss them off!
  • Approach from the back and tug on their fin three times.
  • No response gives you implied permission to assist
• Put the diver face up
  • If face down, simply cross their legs
• Check for water in the mask
  • Leave on, if clear
  • Remove if flooded or partially flooded
    • Boyles Law will force water up the nasall passage and on to the pharynx on ascent resulting in a pharyngospasm
    • It's almost impossible to ventilate a person with a pharyngospasm.
      • Any inspired air will go straight to their stomach which will soon cause them to vomit
• Ascend
  • Get into a Do-se-do with your left arm through theirs and then up to hold the tank valve
  • Hold their inflator with your right hand and start to ascend
  • You may need to ditch some or all of their weights to go up.
  • Use their inflator to vent gas in case of a runaway ascent.
    • Remember that they are already dead
    • Let them go rather than injure yourself
• Power inflate just before you breach!
  • When you are within 6 inches of the surface, press the inflator to overinflate their BCD
  • Contact with air might cause them to do an involuntary gasp
    • It's imperative to keep mouth above water at all times because of this
  • Inflate your own BCD on the surface: DON'T FORGET THIS IMPORTANT DETAIL!
• Get them to shore/on the boat!
  • Rescue breaths or no rescue breaths, you've got to move it, move it!
  • Ask for help!!!
  • Initiate EMS
  • Perform CPR until relieved or exhausted

Now, about seizures. In this case, the person is not dead and the procedure is a bit different.

• Don't become a second victim
  • Check your air
  • Check your NDL
  • Assess the situation
• Get/keep that regulator back in their mouth!
  • Approach from behind and immediately start your ascent
  • Purge their reg as you reinsert it into their mouth.
  • Hold regulator into their mouth as you ascend with right hand
  • Hold their inflator and their tank valve in your left hand
  • Prevent runaway ascents
    • This is a living breathing person
    • Don't forget your personal purges
  • Honor your Deco obligations
    • Again, there is no need to become the second victim
    • Most seizures are from OxTox and may abate as you ascend
    • Secondary onsets can occur, so keep your hand on the regulator until you surface.
  • Get them to the shore!
    • Ask for help!!!
    • Initiate EMS

 

[RyanT]

Thanks for the info Pete, a couple of things I would add. I wouldn't safely assume that an unconscious diver on the bottom is deceased. They could be in the tonic phase of an OX TOX seizure such that they are not moving. You're correct though that the odds are not good. Second if they are in the clonic phase of a seizure (actively jerking) watch to ensure they don't give you a face-butt with the back of their head when you get behind them.

 

[Wingy]

Actually this post did one thing - made me realise I hadn't thought about an unconscious person at depth in a long long while - regardless of what's wrong or right or how x y z would do it, it got me thinking.

I don't think very often - can't be a bad thing eh?

 

[The Chairman]

They could be in the tonic phase of an OX TOX seizure such that they are not moving.

Pulling the fin should still result in no response. At least I assume that it would. No or weird response is an assumed "yes" to your offer to help.

FWIW, I've never encountered an unconscious diver at depth. Ever. I was told during my ITC, that they are usually found face up. Is that true? Who knows.

Second if they are in the clonic phase of a seizure (actively jerking) watch to ensure they don't give you a face-butt with the back of their head when you get behind them.

This would be a problem in dealing with a sidemount diver. On a back mount diver, the distance created by the tank being in the way would probably keep you safe.

I don't think very often - can't be a bad thing eh?

Almost every post on a forum that engenders people discussing these kings of things will make you think. When I taught NAUI, this was a part of your OW training. I soon realized, it wasn't for the student as much as it was for the instructor. Teaching, demonstrating and evaluating others really makes you sharp in that regard. No, I don't teach that skill in OW anymore as NASE doesn't require it and I believe it detracts from the core skills, but the 7 or so years as a NAUI instructor ingrained it into me.

 

[Resqdivemedic]

Mr. Chairman, (nice ring)
Excellent reply with a ton of useful info. I would use some caution trying to get a regulator in the mouth of a seizing person. As EMS providers, we never put anything into a seizing persons mouth because it can be bitten and maybe bitten off resulting in a possible airway obstruction. I have had bystanders put their fingers in a seizure patient's mouth and they required some significant suturing. Fortunately, most seizures are short in duration and once they relax then the reg can be put into the mouth. Just my 2 cents.

 

[Joneill]

Really? Two wrongs don't make a right.

First off, it's apparent that much of what passes for Scuba knowledge on this planet is apocryphal at best. I've heard a number of instructors spout the same instructions and I don't think that the agencies are in much of an agreement either. So, rather than harp on @IDCBali for posting threads that get us talking about what is right, I believe we should take the opportunity to post our best practices and stop bashing them for doing something that's within the ToS. If you don't like it, go read another thread. No need to hijack this one.

So, now to the RECOVERY of an unconscious diver at depth. At this point, you can safely assume that a non-responsive diver on the bottom is deceased. There is nothing you can do to really injure them further than that, and there is very little hope that they can come back from this. Very little, but there is some hope. Here's what I would do:

• Don't become the second victim
  • Check your air
  • Check your NDL
  • Assess the situation
• Act quickly, but not hastily
  • You should practice this until you are fluid at it.
• Ask for permission
  • Photographers often lie still on the bottom waiting for a critter.
    • Often, they are holding their breath
    • Please don't piss them off!
  • Approach from the back and tug on their fin three times.
  • No response gives you implied permission to assist
• Put the diver face up
  • If face down, simply cross their legs
• Check for water in the mask
  • Leave on, if clear
  • Remove if flooded or partially flooded
    • Boyles Law will force water up the nasall passage and on to the pharynx on ascent resulting in a pharyngospasm
    • It's almost impossible to ventilate a person with a pharyngospasm.
      • Any inspired air will go straight to their stomach which will soon cause them to vomit
• Ascend
  • Get into a Do-se-do with your left arm through theirs and then up to hold the tank valve
  • Hold their inflator with your right hand and start to ascend
  • You may need to ditch some or all of their weights to go up.
  • Use their inflator to vent gas in case of a runaway ascent.
    • Remember that they are already dead
    • Let them go rather than injure yourself
• Power inflate just before you breach!
  • When you are within 6 inches of the surface, press the inflator to overinflate their BCD
  • Contact with air might cause them to do an involuntary gasp
    • It's imperative to keep mouth above water at all times because of this
  • Inflate your own BCD on the surface: DON'T FORGET THIS IMPORTANT DETAIL!
• Get them to shore/on the boat!
  • Rescue breaths or no rescue breaths, you've got to move it, move it!
  • Ask for help!!!
  • Initiate EMS
  • Perform CPR until relieved or exhausted

Now, about seizures. In this case, the person is not dead and the procedure is a bit different.

• Don't become a second victim
  • Check your air
  • Check your NDL
  • Assess the situation
• Get/keep that regulator back in their mouth!
  • Approach from behind and immediately start your ascent
  • Purge their reg as you reinsert it into their mouth.
  • Hold regulator into their mouth as you ascend with right hand
  • Hold their inflator and their tank valve in your left hand
  • Prevent runaway ascents
    • This is a living breathing person
    • Don't forget your personal purges
  • Honor your Deco obligations
    • Again, there is no need to become the second victim
    • Most seizures are from OxTox and may abate as you ascend
    • Secondary onsets can occur, so keep your hand on the regulator until you surface.
  • Get them to the shore!
    • Ask for help!!!
    • Initiate EMS

Actually, I just left a comment on their blog link to stop posting misinformation here.

And thank you for posting useful information.

 

[AlexL]

• Put the diver face up
  • If face down, simply cross their legs
• Ascend
  • Get into a Do-se-do with your left arm through theirs and then up to hold the tank valve
  • Hold their inflator with your right hand and start to ascend
  • You may need to ditch some or all of their weights to go up.
  • Use their inflator to vent gas in case of a runaway ascent.
    • Remember that they are already dead
    • Let them go rather than injure yourself

this seems to be where various different agencies and instructors tend to disagree. we were taught face to face vertical ascents with SSI and NAUI S/R, but taught 'rodeo' style in GUI fundies: right hand around the neck from behind to fix the airway and retain the reg, left hand removes power inflator from its retaining bungee loop, inflates to neutral, and then grabs the wing maintain position and vent on ascent. ascent is in trim, left hand managing the wing and when you're close to the surface, gentle back flip and lean on the inflator till the OPV starts popping.

 

[The Chairman]

Fortunately, most seizures are short in duration

I wonder if that includes oxygen overdose induced episodes.

Actually, I just left a comment on their blog link to stop posting misinformation here.

Here's a thought: if they didn't post their misinformation, then how would they ever hope to learn? I hate it when I see people getting clobbered for being wrong. We don't need to chase those people off: we need to engage them so they can learn a better way. As I pointed out, I think the subject is an awesome one and I am glad they brought it up. Anyone reading this can figure out which method is more reasonable.

Yeah, it can be frustrating when you see people talking out their butts, but really it's a great opportunity to set them straight. Recently we were discussing CO in CCRs. I erroneously assumed that since sorb took out CO2, that it would also take out CO. Whoa, was I wrong! Fortunately, the hospital stay was short after my drubbing and I good naturedly made and posted some memes to commemorate my faux pas. We can't know it all. Sometimes our collective understanding and even protocols change over time. Then there was the time I posted how/why I leave an arrow. WHOA! You'd have thought I had silted out a cave and was an accident waiting to happen. When I first started cave diving, line arrows were kind of new and cookies were just around the corner. Somehow, I missed the memo and I posted what you would call "misinformation". Thank goodness I did. I learned a lot from both of these threads even though I believe that some of them believed I was a stroke through and through.

So post what you believe fearlessly. You might get swatted down a bit if you're wrong... just don't get discouraged by it. You're here to learn, and this environment is far less harsh than many of the Scuba instructors of yore. Don't let it piss you off, rather be happy that you've been corrected. Those cyber wounds will heal.

And thank you for posting useful information.

Thank you for the kind words!