Dunderberg Death

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It's possible to occlude the airway by extreme neck flexion -- try it yourself as you sit here. If you really bend your head down, you can feel the resistance to breathing increase.

However, there is no particular reason why a diver, suspended in water, will assume that extreme neck flexion position. That is a product of gravity, which is ameliorated by buoyancy. If you are retrieving an unconscious diver and ascending in a vertical orientation, there is some small amount of gravity encouraging neck flexion. But if you are sending someone up by flotation, there is no particular reason that they will remain in a position of neck flexion.

Airway occlusion is also variable, depending on whether you are trying to get air IN or OUT. Again, try this yourself -- flex your neck until it gets hard to inhale. Now exhale -- it's much easier, isn't it? Exhalation tends to expand the upper airway, where inhalation tends to collapse it. In cases of laryngospasm, patients may be able to exhale when they can't inhale at all.

But the bottom line is the one cerich keeps making. Someone who is at technical depths and is both unresponsive and not breathing is very unlikely to survive. Breathing is built deep into the brainstem; one of the tests for brain death is an apnea test. If someone is no longer making any respiratory efforts, the brainstem has been shut down, and that's really bad news. Either the brain isn't getting any circulation (likely) or the brain has been seriously depressed by hypoxia, hypercarbia, or possibly severe narcosis . . . although the stories I've read of people who are thought to have died from narcosis have indicated their tanks were empty, which suggests they continue to breathe long after they have lost the ability to conceive of an ascent.

The physiology is known . . . you just don't have much time to get an apneic patient to a place where circulation and ventilation can be restored. Each of us has to make an assessment of what risk to ourselves we are willing to take in such a situation, but make that assessment rationally -- don't assume that, if you blow off all your deco and use your carefully trained rescue skills, you're going to end up with a live, neurologically intact victim. Unless you witnessed the respiratory arrest event, it's vanishingly unlikely, and even if you did, it's not probable.
 
I believe you are speaking over your head. What type of medical training do you have? What are you basing your claims on? Have you ever taken a CPR class? Have you ever heard of the head tilt/chin lift, or modified jaw thrust? Just wondering.... I earn my money as a firefighter/paramedic and have seen first hand that it is completely possible for an unresponsive person to have their airway closed, whether above or below water doesn't matter. Please stop speaking about thinks you don't know, there are new divers reading this thread that might be impressionable.

Thanks to you, and to the EMTs that responded to my mother's situation, even though they were too late to be of help.

Ken
 
Good info. But, go back to the original situation. There is NO indication the diver was not breathing!


Ken

It's possible to occlude the airway by extreme neck flexion -- try it yourself as you sit here. If you really bend your head down, you can feel the resistance to breathing increase.

However, there is no particular reason why a diver, suspended in water, will assume that extreme neck flexion position. That is a product of gravity, which is ameliorated by buoyancy. If you are retrieving an unconscious diver and ascending in a vertical orientation, there is some small amount of gravity encouraging neck flexion. But if you are sending someone up by flotation, there is no particular reason that they will remain in a position of neck flexion.

Airway occlusion is also variable, depending on whether you are trying to get air IN or OUT. Again, try this yourself -- flex your neck until it gets hard to inhale. Now exhale -- it's much easier, isn't it? Exhalation tends to expand the upper airway, where inhalation tends to collapse it. In cases of laryngospasm, patients may be able to exhale when they can't inhale at all.

But the bottom line is the one cerich keeps making. Someone who is at technical depths and is both unresponsive and not breathing is very unlikely to survive. Breathing is built deep into the brainstem; one of the tests for brain death is an apnea test. If someone is no longer making any respiratory efforts, the brainstem has been shut down, and that's really bad news. Either the brain isn't getting any circulation (likely) or the brain has been seriously depressed by hypoxia, hypercarbia, or possibly severe narcosis . . . although the stories I've read of people who are thought to have died from narcosis have indicated their tanks were empty, which suggests they continue to breathe long after they have lost the ability to conceive of an ascent.

The physiology is known . . . you just don't have much time to get an apneic patient to a place where circulation and ventilation can be restored. Each of us has to make an assessment of what risk to ourselves we are willing to take in such a situation, but make that assessment rationally -- don't assume that, if you blow off all your deco and use your carefully trained rescue skills, you're going to end up with a live, neurologically intact victim. Unless you witnessed the respiratory arrest event, it's vanishingly unlikely, and even if you did, it's not probable.
 
Thank you for that. And under the circumstances you seewm to be assuming I won't argue. However, my point is back to the original situation. There is no indication the diver was not breathing. THAT is where I have the significant issue! IF the diver was breathing, I would not shoot them up. If I came across an unknown body not breathing, I probably would. This situation, as I read the release seems closer to the first, not the second. I do not see anything in the article that indicates it was a shoot them up scenario.

And, by the way, it is a MUCH more common cause of death than you would believe. It can also be a very expensive situation because of ICU time and the like. Yes, it does happen a LOT.


Ken

Hi Ken,

Didn't mean to offend, however the fact is that very few people die because their airway collapses during sleep to the extent of death. Sorry for your Mom.

To your second point, I agree circumstances are variable, read all my posts here and tell me if you really believe my protocol is unwise. I truly believe it gives the initial victim the best chance of survival. If the diver is unconscious and breathing with reg in certainly I wouldn't shoot him/her like a lift bag. They are coming with me after I shoot a emergency bag and I will hand off to my safety diver when they come meet me (as per protocol). Then provided the victim continues to breath on their own the safety diver will complete the stops for the victim, if the victim stops breathing then no more stops and a quick ride to the surface is in order.
 
I actually read the obit in the Saginaw News. They gave more detail on the accident and the diver in question.

The accounts that I have read so far indicate a situation much as the tech divers here have been talking about. They indicate that the diver was not breathing and had passed out somehow on the wreck. The decompression issue was never mentioned in that news article. Apparently, the victim was a member of the Bay County Sheriff's Dive Team.

Read here for further information...

Munger scuba diver was great dad, husband and friend, family members say | - MLive.com

and here...

Munger man's scuba gear checked out, mystery still surrounds his death | - MLive.com
 
Calm down Ken, for crying out loud, pleas stop being so adversarial about this.
 
And, by the way, it is a MUCH more common cause of death than you would believe. It can also be a very expensive situation because of ICU time and the like. Yes, it does happen a LOT.

Are you talking about people arresting because of airway collapse during sleep? I have to say that, during my 20 year tenure as an ER doc, I have never seen a case of this. Sleep apnea is common, and results in brief interruptions in breathing that, over the long term, can cause major complications. But major airway collapse during sleep? No.
 
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