Diving Accident, Self-Responsibility and Balance

[wetb4igetinthewater]

Thea,

I am glad you've reached out to the scuba community here to sort this out and to also provide a lesson that we all learn from your experience.

I'm a new diver. I've completed PADI's Rescue Diver course, as well as the Emergency Oxygen Provider (where I learned that you as a conscious breathing diver, you should have been given a mask with a manually triggered resuscitator valve that would give you 100% O2 with no waste. It sounds like you were given a simple mask? Is that correct? Or did you have a non-rebreather mask - has a reservoir bag). I'm scheduled for next week to take SSI Stress & Rescue and then the React Right courses (they teach things a bit differently, and for me, different angles, some repetition is great).

There is one thing that I did not read, as that was about nitrox. Were there any enriched air tanks on board? When the O2 ran out, that could have been used to give you a bit more than just what is in the air.

I don't have any advice beyond what has been given and what you already know what to do.

See you under water. Hope to see you there soon.

 

[Wannabedivebum]

I think TC has it right, EIB is notoriously hard to diagnose and it is usually diagnosed in athletes with a history of asthma. From your own descriptions of yourself I wouldnt consider your fitness level to be athletic. In fact closer to the other end. This entire incident sounds like over exertion leading to hyperventilation/tachypnea and then the corresponding anxiety/panic attack. You were essentially increasing the CO2 in your own lungs by breathing too fast and not allowing a complete exhale or inhale. That would account for your low 02 saturation. All the oxygen in the world wont do you any good if you are not breathing it in and off-gassing the co2. The high BP is consistent with anxiety, as well as the decrease with appropriate aid and your relief at what you fixated to be your "cure", as someone mentioned this is somewhat of a placebo effect. However, I was not there and I am not a doctor. I am an EMT however. It is good that you are accepting responsibility for this event, as from your description I can see no other person to hold accountable. Now you just need to dive some more! More experience will lead to better judgement, and a higher level of fitness wouldnt be harmful either. I wouldnt worry to much about this event. live, learn and dive.

 

[Darnold9999]

Not going to add much here, but my first experience with getting overloaded with CO2 came much later in my diving. It was still pretty terrifying and sounds very much like what happened here. Once you get CO2 overloaded panic is right around the corner. As terrifying as it was, it does sound like you did alot of smart things and not too many not so smart things. Don't beat yourself up too much. As a lawyer you are used to using your smarts to get yourself out of trouble. Problem is when CO2 overloaded you are not smart any more. Primitive reflexes take over and the brain is focused on survival - not figuring out how to survive. Really uncomfortable to lose control.


Go diving again, now you know what CO2 stress feels like, you just have to figure out how to stop it before it gets to the point where panic takes over. It is pretty simple but hard to do. Stop exerting yourself, take deep slow breaths making sure you exhale all the way out. You must do both and know that it will take a few breaths to resolve the issue. (Stopping smoking will help as well!)

 

[DandyDon]

You're getting lots of answers and advice better than I could give, except no one mentioned the camera. Mine has got me into trouble before. Leave yours at home until you get everything else sorted out well, and good luck.

 

[Thea Strassburg]

No, I am not doctor. But the physician they called to the clinic on the island was, as well as my primary care physician at Washington University Medical Center here in St Louis. Panic attacks do not cause O2 sats to plummet to 85%, or raise your BP to 180/140. Nor do they cause your feet to turn blue from lack of oxygen. EIB is caused by extreme exertion in environments with little moisture and dehydration (Google it). Below is a link. Basically it is an environmentally caused asthma attack in people with no history of asthma.

Exercise-induced bronchoconstriction - Wikipedia, the free encyclopedia

There is no shame in having a panic attack. Had that been the case, I would not have posted this. Panic attacks are quite real and quite terrifying in people prone to experiencing them. I am quite familiar with and sympathetic to how debilitating and painful these episodes can be. Luckily, I have never had one.

---------- Post added February 23rd, 2014 at 06:48 PM ----------

Thank you, and will do. This forum has cleared up so many things for me. I hugged and thanked and apologized to all the staff on the boat that day, for getting myself into that position. I understand now what happened. I feel lots better. And will in the future pay heed to all this information. Scuba simply rocks.

 

[T.C.]

First, complaining about the boat and the O2 supply is not useful. The boat had sufficent O2. You just hoovered it down faster than a diver in an emergency would have. Wookie was not "defending" (in your sense) the crew; he was explaining their actions. The crew reacted properly. Your reaction was off, and it does not help to attack him.

No, I am not doctor. But the physician they called to the clinic on the island was, as well as my primary care physician at Washington University Medical Center here in St Louis. Panic attacks do not cause O2 sats to plummet to 85%, or raise your BP to 180/140.

Again, I think you're seeking a medical reason to blame this on when none exists. I find it hard to believe that a doctor on an island diagnosed you with this; or that your doctor did over the phone. The diagnostic testing is rather involved. A doctor will never state a certain cause unless they've diagnosed you, due to the risks of malpractice this can open up. As well, your understanding of it as "environmentally caused asthma attack" is not consistant with published medical literature on the subject. I believe you're seeking out another factor that paints you as not to blame.

Has a Medical Doctor examined and tested you, and given you a primary diagnosis of EIB? I think that when you doctor does examine you, they will find something more sinister than EIB- They'll find COPD caused by smoking.

However, prolonged shallow hyperventilation can lower 02 levels and stress induced panic can raise BP that high (especially if aggravated by smoking, and poor physical condition). As well, panic attacks are well known to cause vasioconstriction in the capillaries; which will cause blue extremities and low O2 Sat levels (because the pulse-ox sensor measures the capillaries for O2 saturation.

Like I said; I think you're seeking a medical reason for this instead of accepting that it was a classic panic attack. Take the advice of the board. But if you're going to deny it was a panic attack and seek out a non-existant medical condition to blame it on, you won't be doing much to solve the underlying problem.

 

[Wannabedivebum]

I have seen someone in a full blown panic attack ineffectively breath themselves completely unconscious. So yes it does manifest as a vasoconstrictor and increased heart rate and correspondingly drop your o2 sats from tachypnea and can do so shockingly fast. Im not saying you didnt have an EIB episode, however given its rarity and difficulty in being diagnosed accurately, I am saying that It would be an irrational diagnosis after presenting the symptoms only once in your life time. Im not trying to attack your diagnosis or say you are wrong, it just seems odd. That being said, I know nothing of your medical history and I am not your physician. Happy diving. Seems TC beat me too it, but also interesting enough. If you were to be diagnosed with COPD is would explain your low level o2 sat and why It did not improve with the administration of oxygen. In some COPD patients you can induce hypercapnic respiratory failure due to a increased co2 retention when presented with high flow o2. This has to do with the Haldane effect and hemoglobins affinities for co2 and o2. Off topic a bit but interesting non the less.

 

[Wookie]

However, after researching this issue and your statement, saying "We can't plan or be equipped for every contingency. They carried enough O2 to get a normally bent or embolised diver back to the dock and into the hands of the nurse", is not an accurate description of what the PADI EMERGENCY OXYGEN PROVIDER SPECIALTY COURSE, is all about. This course is available to ALL divers and non-divers. Attaching a mask and a hose to a cylinder, then placing said mask in the appropriate position on a disoriented or unresponsive diver, are easy skills to learn.

I hope most on this forum can simply ensure they have emergency oxygen on board (maybe even 2 bottles?) and staff are trained to put it together and smack on that mask. It is so easy, and may save someones life, even yours, one day.
Please, I am begging you all.

Well sorry, but I don't believe in PADI first aid courses, and they aren't the only ones out there. DAN courses are far superior. What PADI says is of no interest.

I routinely carry many thousands of cubic feet of oxygen on my boat, along with 3 complete sets of first stage regulators and demand valves. I carry enough O2 and equipment to get 9 divers back to shore 12 hours away.

But what would you say if I had 10 divers who needed oxygen? Would you call me unprepared?

 

[Mike]

Wookie hit every point pages ago. The lessons here don't have anything to do with dive sites, dive conditions, dive operators or oxygen...

Many incidents like yours end very differently, they end as a report of a missing diver, many times no body recovered and no answers to what happened and most of the time it's all about speculation of some mystery dive condition that was unsafe and killed somebody. But the truth is more likely what was revealed in your report of the incident since you survived it, which was

1) a diver diving without a buddy, or a diver diving with a buddy and the diver and the buddy having Zero buddy skills.
2) a diver on the razor's edge of physical fitness and when the SHTF the lacking in physical fitness almost kills the diver through a compounding of 2 or more events that drown them - yours was a triple - a lack of absolute ideal diving conditions combined with poor physical condition combined with a panic attack.

You're so lucky to be alive, thank God you did have the presence of mind to drop your weights and thank God your dive operation saved your life.

Please stop diving unless you can increase your physical condition and learn what proper buddy diving protocols and procedures are. It's only a matter of time before you aren't this lucky if you keep doing what you're doing.

I'm very glad you survived this and I applaud you for whatever the self-preservation little voice you have in your head that drove you to post this and try to seek answers to the nagging question you had/have in your head that is what did I almost do to myself, and how did it happen so quickly? You scared the crap out of yourself and this is probably your one and only wake up call. You're getting a do over, and I hope you learn from it and take advantage of it. And as Don said, leave the camera on shore, you're not anywhere near ready to have one with you on a dive. Cameras can get you into a lot of trouble, splitting your concentration is called task loading and it's what allows divers to suddenly be thrown into an uncontrolled situation before they know what is happening. Without the camera you are spending more of your concentration on situation awareness, air supply, depth gauge and watching other divers observing how conditions are effecting them. That situational awareness can be the difference of what happened to you or ending up back on the boat with just a story of "hey, that was some interesting surge down there that I've never experienced before, but I handled it!"

 

[vincent54]

I will assume the tanks had "clean" air with no CO contamination. The lingering headache and unable to focus may point towards something other than CO2, panic or EIB. Were the tanks tested before use?