Rescue scenario..

[Warhammer]

This discussion came up today with a co-worker and I was wandering what you’re views on it are. There are a few scenarios below, what would you do in each of them and why?

1. You plan, and execute, a chartered boat dive to 100’ with a buddy. As you approach your NDL, either planned or otherwise, you look over and see your buddy is in distress. You go to assist him. He passes out, but is still breathing and still has his reg in his mouth. You start up with him and notice that you’re at your NDL(requiring a 3 minute safety stop) but you haven’t exceeded it. Do you make the stop or not? And if so, what about your buddy, who is still passed out and breathing?
   
2. Same scenario, only you’ve exceeded your NDL and now require a decompression stop at 15’.
   
3. Same scenario as number 1, only now your buddy isn’t breathing.
   
4. Same scenario as number 1, only now your buddy isn’t breathing and you exceeded your NDL requiring a decompression stop.
   

What I think….Both 1 & 2, I’d make the stops, and keep my buddy with me, and the surface for further assistance. 3, I most likely would not make the safety stop and surface with my buddy. 4, I don’t really know. I guess it would depend on just how much decompression I require, but I’d hesitate to blow the deco stop. I'd probably check for a pulse and if I didn't find one, I wouldn't surface untill after completing the deco stop. If I did find a pulse, that's a tuff one. Question is should you send the unconscious buddy to the surface alone, where he may get help from the crew?

 

[Mario S Caner]

There are many other factors that would have some influence as to what I would do. Assuming there are no other divers in the immediate vicinity and you are fairly close to the boat, I would probably disregard the safety stop and get my buddy to the capable hands of a professional as soon as possible. A reventative chamber ride can always take care of DCS.

Since I'm not a Doctor, I wouldn't feel comfortable with trying to diagnose the problem, especially at depth. So to wrap it up, I would get my buddy to the surface smartly, in that I mean monitor his/her inhalation/exhalation rate and ascend when they are exhaling, monitoring the ascent rate carefully.

In a perfect world, both divers and the boat would have communication gear, and be able to get help into the water even before you get to the safety stop ceiling. The new diver assisting or the DM(whatever the case might be) would take over the extraction of the unconcious diver while you perform needed stops. A diver can be treated for other things while laying in a pressure pot.

Mario

 

[Beachman]

In scenario #1, I wouldn't hesitate to surface immediately and get him surface medical attention because a 100' dive within NDL's shouldn't give most folks any problem if the safety stop is missed. I view the 3 minutes as truly precautionary and conservative....but do myself always take 3-5 minutes under normal conditions.

Scenario #2 is tougher, because you don't say how long the NDL has been exceeded. If my computer required a deco stop of less than 10 minutes, I think I'd be inclined to abreviate the stop, maybe take 3-4 minutes, then get him up pronto. If the required deco stop was longer, I think I'd be inclined to stay down for most of it as long as my buddy had a good pulse and no other signs of distress than apparent unconsciousness.

Scenario #3 is just like #1 for me. No reason not to go right on up with the buddy as soon as possible.

Scenario #4 would be a truly a difficult decision for me. Regardless of the deco implications for both divers, the fact remains that the buddy is in real trouble. If he has no pulse, he's near death or dead. Any hope depends on immediate surface help, and I think I'd send him up alone to avoid any jeopardy to myself. (If I had a wreck reel and/or a safety sausage, I'd attach them to him.) If he still had a good pulse, I think I'd be inclined to keep him down with me to deco some before sending him up alone.

Sure hope I don't have to make this kind of decision for a long, long time! Wouldn't be much fun.

 

[rcohn]

When I reach or slightly exceed my NDL using my Suunto computer I'm still a long way from the NDL of the US Navy tables or even many less conservative computers. So the likelihood of suffering a DCS hit is very small, while unconsciousness is clearly a reason to immediately bring my buddy to the surface. I would perform no stops, but proceed directly to the surface keeping the ascent rate under 60 ft per minute if my buddy was breathing and aim for 60 fpm if he/she wasn't breathing.

IMO if you are not prepared to do this you have no business coming that close to the NDL in the first place or you should stick to solo diving.

Ralph

 

[Rick Murchison]

There is absolutely no doubt that I would bring the injured diver promptly to the surface at 60fpm in all four cases without any stop. Once turned over to the crew, in case two and four I'd go through the missed stop procedure dictated by the table or computer I was diving. In all four cases my diving would be over for the day.
Rick

 

[HERB KING]

Seems to me that this is a no brainer. I would get to the surface with my buddy where assistance could be rendered. Worry about the lost deco stop later. At worst it would mean a chamber ride for me and at best saving my buddies life. delaying for even a minute could mean life or death.

 

[Tom]

After recently retiring from 27 years in emergency services, most of it riding on the back of a fire engine, there isn't any thought involved in this one. Take him to the surface - now - and pass on any information you may have. How deep? How long unconsious? Known medical problems?
Then go back and decompress yourself if needed. From 100 feet it will take 2 minutes to get up. It probably took 2 minutes to realize there was a problem and get to him. It will take at least 2 minutes to get him out of the water and in the boat. You're at about the maximum time for a chance at a successful rescue and treatment hasn't started yet. I wouldn't hold him at fifteen feet. DCS is the least of his worries.

Tom

 

[Warhammer]

I guess I should have been more specific on the deco time.

I can see everyone's point on dive 1. My thinking on 1 was if they are breathing, but unconscious, that they were probably going to be ok, so why not complete the stops with them and then surface. But after further consideration, I can see where it's better to just skip the stop and surface as soon as possible since there is no way you tell what went wrong to cause the unconsciousness. Could have had a heart attack, or any number of other things that demands immediate medical attention. And worse case scenario for me is I get a slight case of the bends, but treatable.

Scenario 3...I'd definately surface and risk the slight case of DCS.

Scenario 2 & 4....This is where I should have been more specific as to the deco required. I agree, I'd surface in both cases if the deco time was minimal.
But if the deco time was considerable, say 2 hours, I'd find it very hard to skip the deco and most likely wouldn't in either case. My thinking here being, better 1 dead than 2 dead. That may seem cruel, but what good could I do by surfacing. Chances are my buddy couldn't survive both is current problem and the added problem of being severly bent. And I'd most likely die from DCS or be left crippled. What to do with my buddy? That's tuff, since if I send him up without me and without him completeing his deco, he'll most likely be severly bent and/or die. If I keep him down to complete his deco, then he may die as well.

Course I wouldn't be doing a dive that required 2 hours deco anyway, so that's kinda mute.

 

[rcohn]

I assumed from the way the question was phrased we were discussing recreational diving within the no decompression limits. A two hour decompression obligation is clearly major decompression diving and no one accidentally incurs such a large deco obligation. This is really an apples vs. oranges discussion, two hour decos are not recreational diving.

I don't do any decompression diving because circumstances may force one to the surface and I don't want to take the risk of a hit. However, if you were doing dives with substantial planned deco you should have a safety diver to assist with emergencies such as you describe. If you and your buddy were foolishly doing such dives without a safety diver you would need an understanding of how such emergencies will be handled. Clearly with a two hour obligation (I assume you will not be doing deco on air) you will risk death or permanent disability by directly surfacing. There certainly is no point in killing two divers.

Note that George Irvine of DIR and WKPP fame has said they limit bottom time for deep open ocean dives to 20 to 25 minutes to keep decompression obligation down to allow for changeable open sea conditions.

Ralph

 

[Rick Murchison]

Two HOURS???!!!
I'd turn him over to the safety diver at the deepest deco station.
What? No safety diver?
You have no business incurring a two hour deco obligation without a full team.
Rick