Using resuscitation mask in water

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When you start requiring medical screening of divers, then you are regulating a sport. Where does it stop next? Bowling, ice skating, rock climbing?

It worked no problem at all here for decades and continues to work without issue in lots of europe. Its no different to asking someone to sign a self certify form.
Here every single instructor that makes a penny profit has to have a full medical every year to be legally allowed to teach and again its not a problem. If its for personal gain you are a commercial instructor therefore have to abide by commercial diving regulations and medicals. Mine costs me roughly £100/year.

EDIT:- Just for reference the instructor medical includes the following:

- FBC and LFT (blood tests) - checks for diabetes and other problems.
- Exercise test. Usually a step test for 10 minutes linked to a heart monitor with pulse recorded every 2 minutes. Recovery times also noted.
- Lung function and lung capacity tests - spiriometry and other tests.
- Hearing Test - Response to various frequency sounds and if you can detect them
- Eyesight test
- Colour vision test
- Urine sample (protein, blood and other problems)
- Blood pressure and more pulse work
- Full 12 lead ECG
- Co-ordination, reflex and strength test


Now im not suggest every diver needs that every year by any means but basic ones like exercise test and so on could be very useful. An ECG, lung function and other tests prior to starting diver training course again maybe very handy.

Driving a car is dangerous to yourself, and others. Diving is dangerous to yourself, and not others. If we don't require medical screening of drivers, why would we need medical screening of divers?

Im not all together sure that is a bad thing especially with regards to eyesight. Again, medical screening for drivers does exist in a lot of country and works without issue (germany comes to mind as an obvious example with mandatory medical and first aid).

I think society saves more money by letting older high risk divers dive. If they had an MI and cardiac arrest on a dive boat, the chance of saving them is almost nil. Therefore, society saves a bit of money by not prolonging their life in the ER, the intensive care unit, then cardiac rehab after bypass.

But places the lives of rescuers, boat crew, helicopter crews and everyone else at risk to sort out the problem.

If the dive boat had an AED, their chance of surviving increases. I really think, the nice thing about an AED is you could potentially save a healthy young person who's heart has stopped from near drowning.

AED and near drowning isn't that useful. In fact for near drowning compressions on their own have a far higher than normal rate of properly restarting the heart rhythm .

Accident stats here show that just under 50% per year are caused by heart attacks or medical problems. That figure has also gone up massively since celf cert was introduced just after the year 2000.


Mandatory medical isnt a bad thing and isn't over regulation. It works in many places. Agencies asking for that would be no different to insisting on their self-cert as current.

Malta has a system whereby you can dive with a self cert but need a medical certificate to enter into training for a course. Again, it works well.

 

[watercooled]

I have heard that rescue breathing may actually be on the way out altogether.

I understand that an experimental protocol in one metro area EMS has tried continuous fast compressions (100+ per minute) with no breathing, and patient survival rate increased. The thought here is that the chest compressions are also causing a bellows effect on the lungs resulting in adequate air exchange.

This might be an unfounded rumor, anyone else hear anything along this line.

not a rumor,
pg 67 ems mag tells alittle about it.the research work was done on pigs and with ems settings in rural wisconsin.
kellum w, dennedy k, ewy g
Am J Med 119; 335-40, 2006.

 

[Tigerman]

This is a very general question, but Id say get the person to the shore (or the boat) and do "proper CPR". mouth-to-mouth dont only depend on wether you choose to use a mask with one hands, two hands or simply not use a mask either. If the airways are not free youll have a hard time getting any effect of it to begin with...
There is of course the problem that you will die if you dont get oxygen within a certain, usually fairly short, timeframe so youll HAVE to perform CPR in the water, maybe on your way to the shore. In that case id just do mouth-to-mouth since I usually dont carry a mask with me in the first place..

 

[rick00001967]

i know this is an old thread but it is exactly the type of info i am looking for right now.

does anyone know of anywhere i can read more current info on this topic ?? not necessarily about the mask, but about in water rescue breaths in general
much appreciated
rick

 

[knotical]

from 2010 AHA guidelines at: Part 5: Adult Basic Life Support
on pages S695-696

… Mouth-to-mouth ventilation in the water may be helpful when administered by a trained rescuer. Chest compressions are difficult to perform in water; they may not be effective and they could potentially cause harm to both the rescuer and the victim. There is no evidence that water acts as an obstructive foreign body. Maneuvers to relieve foreign-body airway obstruction (FBAO) are not recommended for drowning victims because such maneuvers are not necessary and they can cause injury, vomiting, aspiration, and delay of CPR. Rescuers should remove drowning victims from the water by the fastest means available and should begin resuscitation as quickly as possible. …

In other words – it depends.

Of course it’s still being studied, e.g.: http://www.resuscitationjournal.com/article/S0300-9572(13)00107-X/fulltext

 

[TMHeimer]

I learned in Rescue that doing rescue breaths while towing to shore depends on distance--as does whether to remove equipment (unit) or not. I have also learned over the years that EFR (CPR) standards change. Now you do chest compressions before rescue breaths. Someone pointed out rescue breaths may be on the way out as well. Who knows? Has there not been enough data collected by computers the last quarter century to get a consensus?

 

[claymore]

Doing effective in-water CPR is basically impossible. Doing EFFECTIVE rescue breaths in water for most people is also very difficult.

PADI and the other agencies have gone to chest compressions only for CPR

 

[TSandM]

I just want to note that chest compression only resuscitation is NOT for drowning or near drowning victims. In those cases, attempting ventilation is still recommended. That said, I work in an ER, and I have seen how difficult it is to deliver effective breaths, even when standing on dry land, behind a dry patient, with a proper mask and training. The idea that someone in the water can rear up over the diver, establish a good mask seal, and deliver any kind of effective ventilation is to me completely absurd. If someone is in the water and not breathing, they're in really serious trouble, because they almost certainly don't have a pulse, either. GET THEM TO A SURFACE WHERE YOU CAN DO CPR.

 

[rick00001967]

Doing effective in-water CPR is basically impossible. Doing EFFECTIVE rescue breaths in water for most people is also very difficult.

PADI and the other agencies have gone to chest compressions only for CPR

i cannot say what padi is doing for "on land" CPR as i have never taken their EFR course. so you may be right. i can tell you they are teaching the two initial breaths once surfacing with an unconscious diver, followed by 1 breath every 5 secs during the surface tow. i was diving with some recent graduates of the padi IDC on grand cayman and it was a topic of conversation for us.

 

[Pinecube]

Chest compressions only is something relatively new. I'm not sure about PADI... but both Red Cross/Crescent and St. John's are starting to teach the no-breaths in their first-aid courses. The idea is that the act of compressing the chest should be enough to exchange air... and so that the rescuer only has to focus on compressions.

On another note, they've finally stopped telling people to check for a pulse; too many people couldn't find it in the best of conditions.