Rescue of an Unconscious Diver Underwater

[The Chairman]

Good things can come from ideas that many consider outrageous but you must take the time to prove your hypothesis before killing someone.

Or getting bent in the process.

This is like the Kabayashi Maru Scenario from Star Trek and it's little more than @Kevrumbo playing "gotcha". There are so many variables not specified that it's loaded. I believe that it's just Kev's way of garnering attention and trying to appear to be more knowledgeable than Dr Simon Mitchell. I'm going with the Good Doctor here especially since I would actually dive with him. It's a matter of trust.

 

[tbeck3579]

I think you know how I feel about trust from other threads -- it's everything. A man is only as good as his word...

 

[The Chairman]

A man is only as good as his word...

A man is only as good as how he keeps his word. Actions and results always speak louder than words and excuses.

 

[Kevrumbo]

I think you know how I feel about trust from other threads -- it's everything. A man is only as good as his word...

A man is only as good as how he keeps his word. Actions and results always speak louder than words and excuses.

Good things can come from ideas that many consider outrageous but you must take the time to prove your hypothesis before killing someone. Arguing with someone who refuses to take the time to research the theoretical concepts before forming an opinion is a lesson in futility.

Or getting bent in the process.

This is like the Kabayashi Maru Scenario from Star Trek and it's little more than @Kevrumbo playing "gotcha". There are so many variables not specified that it's loaded. I believe that it's just Kev's way of garnering attention and trying to appear to be more knowledgeable than Dr Simon Mitchell. I'm going with the Good Doctor here especially since I would actually dive with him. It's a matter of trust.

I actually have met Dr. Simon Mitchell in person -nice fellow!, have actually dived with him (2013 Bikini Atoll Expedition), and I am not at all intimidated to have a challenging Socratic argument & discussion with him. It's a matter of Patient-Doctor Trust as well: Dr. Mitchell was my attending Hyperbaric Physician on that 2013 Bikini Atoll Trip and administered IV fluids (Plasmalyte w/ Caldolor NSAID infusion), post elective IWR Therapy on Day 8 of the Expedition.

So when he renders an opinion

Hello Kev,

Can I be clear there is little room for hard dogma from anyone (including me) in relation to most aspects of this issue. So, I don't pretend to have definitive evidence based answers. However, I would like to make a couple comments about that video. . . There's a good chance that a rescuer would drown a diver in trying to do it [Toxing Diver Rescue]. Nevertheless, I refer back to my comment about dogma above, and have to admit that I cannot definitively claim it can't be done

. . .

I do know and fairly trust that Dr. Mitchell's comment has a lot more academic weight, and practical medical expertise, and relevant diving experience -than you can offer in this thread or anywhere else in Scubaboard for that matter, @The Chairman , Pete "NetDoc" Murray. . .

 

[The Chairman]

I do know and fairly trust that Dr. Mitchell's comment has a lot more academic weight, and practical medical expertise, and relevant diving experience -then anything you can offer in this thread, @The Chairman , Pete "NetDoc" Murray

Well, we agree on something... As for the "Socratic Method": you're doing it wrong.

 

[Kevrumbo]

Well, we agree on something... As for the "Socratic Method": you're doing it wrong.

Really? Not so Pete:

Simon, as trained in a witnessed actively toxing/seizing diver scenario, the motivation to replace the regulator in the victim's mouth with support and efforting a best seal as possible, and with a slight continuous reg purge --was to expel and prevent further water intrusion into the victim's airway.

Please elaborate and clarify further on this point, and in general give your assessment on the usefulness & viability of this procedure as demonstrated in the training video below:

Hello Kev,

Can I be clear there is little room for hard dogma from anyone (including me) in relation to most aspects of this issue. So, I don't pretend to have definitive evidence based answers. However, I would make a couple of comments about that video.

First, it is most unlikely to be as easy to replace a regulator in a seizing diver as portrayed. Most people suffering seizures clamp their mouths shut and messing around trying to get the mouth open and then accurately place a regulator is likely to waste valuable time and risks flooding the airway with water. What is most likely to keep the airway dry is to establish an ascent, and the expanding gas passing out of the airway will help prevent water passing in. It is remarkable how often we have seen unconscious divers brought to the surface quickly with little or no water contamination of the lungs.

Second, I can understand the logic behind continuous gentle purging of the regulator, but this is a potentially dangerous intervention. The difficulty is in knowing what gentle purging means and accurately maintaining it. If you overdo it there is a danger of increasing the risk of pulmonary barotrauma during the ascent. There was an Australian military case in which this occurred. With substantial regulator purge from moderate depth (I can't remember exactly - around 40m I think) there was gross introduction of air into the circulation and the diver died. Moreover, it contributes to task loading of the rescuer and if you get on with the ascent, it should not be necessary in preventing water entry to the airway for the reason I describe above.

Third, while I get that the video adheres to the UTD philosophy of trying to make everything look as relaxed as possible, the ascent is too unhurried and slow. If I was not overly concerned with my own decompression obligation I would have just grabbed the diver, put their head in a neutral position, and swum quickly to the surface. There is little doubt that this is what would be best for the unconscious diver. In the scenario depicted (a diver with reg in place, clearly breathing) the slow approach taken looks OK and maybe could work, but rescues are not usually like that. Also, the notion that an airway can be managed and well protected from water entry in a breathing but unconscious diver over the course of a nice relaxed ascent while the rescuer also adjusts multiple buoyancy controls is tenuous at best. There is a good chance that a rescuer would drown a diver in trying to do it. Nevertheless, I refer back to my comment about dogma above, and have to admit that I cannot definitively claim it can't be done.

Simon M

Perhaps if the toxing diver was at a 6m O2 stop, then just grabbing the diver's head in a neutral position & swimming quickly to the surface would be the best tactic -but what about from a deeper 21m Eanx50 deco stop?

Also if I knew that boat crew surface rescue support would be some distance away because of current and swells for instance, or especially visibility conditions that would preclude the boat crew from immediately spotting the unconscious victim on the surface (i.g. Fog or thick marine layer developing during the dive -both common weather phenomena here in offshore California diving), I would rather take a chance at performing the toxing diver rescue as depicted in the video, instead of sending the victim up alone on an uncontrolled buoyant ascent to ultimately embolize and drown on the surface. . .

And then you troll in Pete:

Your reasoning is flawed here. You treat that as a given when it's not.

 

[The Chairman]

Really?

You do realize that you're the "hard dogma" Dr Mitchell is referring to, n'est pas? No? Perhaps the nuance eluded you. You seem to handle the "Socratic Method" the same way you handle diving. Again, we are not simpatico in how we approach either.

 

[RayfromTX]

Accusing someone of trolling is not acceptable here. If you feel that is happening, report it. Please gentlemen, be respectful in your disagreements. I have recently seen members attack Pete or his positions in ways they know they couldn't get away with toward other members. I would appreciate it if all involved would use some of their keen intellect to craft their arguments in ways that are not offensive. I have yet to read Dr. Mitchell use harsh rhetoric in delivering his positions on these matters. Rather than attempting to use the good Dr as a weapon, perhaps you could channel his method of communication. I for one do my level best to never let people here see my inner jerk. If you only knew. It is a learned and practiced skill.

 

[Kevrumbo]

Accusing someone of trolling is not acceptable here. If you feel that is happening, report it. Please gentlemen, be respectful in your disagreements. I have recently seen members attack Pete or his positions in ways they know they couldn't get away with toward other members. I would appreciate it if all involved would use some of their keen intellect to craft their arguments in ways that are not offensive. I have yet to read Dr. Mitchell use harsh rhetoric in delivering his positions on these matters. Rather than attempting to use the good Dr as a weapon, perhaps you could channel his method of communication. I for one do my level best to never let people here see my inner jerk. If you only knew. It is a learned and practiced skill.

You should then see for comparison -read the "Good Dr" and Ross Hemingway's exchanges of "harsh rhetoric" here on Scubaboard and elsewhere regarding deepstops and VPM :-D

 

[Kevrumbo]

You do realize that you're the "hard dogma" Dr Mitchell is referring to, n'est pas? No? Perhaps the nuance eluded you. You seem to handle the "Socratic Method" the same way you handle diving. Again, we are not simpatico in how we approach either.

Really?

Hello Kev,

Can I be clear there is little room for hard dogma from anyone (including me) in relation to most aspects of this issue. So, I don't pretend to have definitive evidence based answers. However, I would like to make a couple comments about that video. . . There's a good chance that a rescuer would drown a diver in trying to do it [Toxing Diver Rescue]. Nevertheless, I refer back to my comment about dogma above, and have to admit that I cannot definitively claim it can't be done