Diving Accident, Self-Responsibility and Balance

[flots am]

So, please do a lot of us a favor, either learn from the lession or at least tell us which dive you are doing so that we are no where near you. I value my family and my ass a lot more than trying to rescue you.

I kind of like the unknown. It keeps my rescue skills sharp.


flots.

 

[Mike]

Over exertion + Panic attack + panic breathing = over breathing your regulator = hyperventilation = searching for a phantom medical condition

Overbreathing a reg simply means you are demanding more gas than you can get from the reg. This is felt as a perceived lag between the time you demand air and the time the reg delivers it. Regrettably once this starts the important anxiety level of the diver increases, so the air demand increases, which makes the feeling worse, which increases the demand... It's a nasty circle of feedback that often ends in a diver panicked or dead. Note that the reg is STILL providing air, it's just at a slower rate than you want it.

A case in point is overbreathing--demanding more from the regulator than it can supply. Overbreathing is implicated in a large number of diving accidents. On investigation the regulator works within specifications, but the evidence suggests the diver was not getting enough air. What happened? Adapting successfully to scuba includes breathing in a slow, deep and relaxed manner, paying particular attention to a deliberate and complete exhale--even in stressful situations. Otherwise, the result could be overbreathing a regulator..

 

[gianaameri]

You may want to create this into a medical situation and it might have been but evidence shows other wise. She did not drop the weight and she even adds that the other divers inflated her BC. On the surface, without an inflated BC and carrying 18 lbs of weight creates a bad situation.

Do you think you'd do much better if you could not breathe to start-up with?

---------- Post added February 26th, 2014 at 02:21 AM ----------

Oh for heavens sake, you guys are killing me! I unlatched the weight belt on my own, but it hung up on something and I had to struggle to get it off OR my wonderful rescuers got it off for me.

You need to grab, unlatch, AND extend your arm holding the belt and then let go of the belt (just pointing this out for the future).

Bear in mind the divers below may be seriously injured.

---------- Post added February 26th, 2014 at 02:28 AM ----------

It also varies beat to beat, and when the probe comes loose, or when the skin is dirty, etc...

Here's another thing, if she actually did have peripheral cyanosis (for any reason, suggested by the isolated cyanosis in the extremities) that could affect the pulse ox reading (which is often put on a finger or toe), and not accurately reflect the central O2 sat.

Again, not saying ANYTHING about what happened, I still have no idea what went on, too much drama. But if you are going to throw around a number like it's the key to the diagnosis, you should at least understand how that number is generated and what its clinical significance is (see my previous post).

Well, a trained nurse would know how to take a reading correctly and take action to rule out a faulty/erroneous reading.

Not to say that nurses and doctors cannot make mistakes and some may even be somewhat below standards...

---------- Post added February 26th, 2014 at 02:30 AM ----------

Thea, we are just tyring to help you. It really is as simple as that. You posted the situation and asked for help and when it comes to you, you want to blame other things. Much like you tried to blame the other divers on the trip. Your mistake does not create an emergency to others which you tried to blame. So you now have a cardio / pulmonary defect? Don't dive again until you have it repaired. The other dive members might have helped you out this time but until you come to realize that you had a panic attack you are sure to repeat it again. Next time there might not be help available. You state that you know what to do but you did not do a safety stop, you did not inflate your BC and you did not drop your weight! So, please do a lot of us a favor, either learn from the lession or at least tell us which dive you are doing so that we are no where near you. I value my family and my ass a lot more than trying to rescue you.

This is so uncalled for.

 

[Greenjuice]

Thea, we are just tyring to help you.

Thea, please don't think we are just trying to beat up on you. We owe everything on this thread to the information you provided because you were brave enough to post. We were not there.

Whilst there may be a position that panic did play a significant part in this, I still agree with DDM that you need a medical. I do hope that they do not find anything because that will allow you to get back in the water.

We can all read how much you enjoy diving and having someone who gets that much out of diving back in the dive community is a good thing. That part we can help with and I think that you have already acknowledged many risk reducing actions you can take on your return.




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[TONY CHANEY]

Do you think you'd do much better if you could not breathe to start-up with?

---------- Post added February 26th, 2014 at 02:21 AM ----------




You need to grab, unlatch, AND extend your arm holding the belt and then let go of the belt (just pointing this out for the future).

Bear in mind the divers below may be seriously injured.

---------- Post added February 26th, 2014 at 02:28 AM ----------



Well, a trained nurse would know how to take a reading correctly and take action to rule out a faulty/erroneous reading.

Not to say that nurses and doctors cannot make mistakes and some may even be somewhat below standards...

---------- Post added February 26th, 2014 at 02:30 AM ----------



This is so uncalled for.

For your first question she could breath just fine starting out and if I could not then I would not do the dive.

Yes it was called for!

 

[gianaameri]

For your first question she could breath just fine starting out and if I could not then I would not do the dive.

Yes it was called for!

Yes, fact is she started the dive breathing fine and enjoying herself and unexpectedly she could not breathe properly and was umable to self-rescue.

None of this is her fault.

It would have been prudent for her, as for any diver, to do an annual Fit-for-diving medical.

Some countries require it, even then most Dive Centers "waive" the requirement.


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[ferris213]

No. You did NOT have a medical event underwater ....... You have not been diagnosed with any medical cause; you self-diagnosed from the internet, and you are not qualified to do so.

Can you not see the irony dripping from this post? You attack Thea for self diagnosis, then say with absolute certainty that she did not have a medical problem.

In my opinion she needs to get fully checked out by a real doctor. Then perhaps some fitness/dive training would help after that.

 

[Peter69_56]

Thea,

Thank you for sharing your event with the rest of the world. I think you have done the right thing for your own sanity. Unfortunately we as a group (like many in this world) can be somewhat mercilessly rake over and pull apart someone's event without emotion or feeling in a very clinical way.

Having the duty of analysing peoples mistakes and errors in my industry, I do know there is the clinical method, but also an emotional side to it too which all investigators should take into account. Unfortunately sometimes the analysis here can be quite clinical and thus hard on the emotions.

My thoughts on where to from here is simply; see a good doctor and ensure your health is ok to continue diving, go through all the posts and take from it what makes sense to you and leave the rest where it lies.

Don't get too upset by what some say, just think about it and either take it on board or discount it and move on. You will never please everyone here and some "may" wish to cane you until you bleed if you let them, and some will never be happy no matter what is said. I think most here try and analyse with the best intent, however it doesn't always come over that way.

Go get checked out, and analyse yourself with relation to the incident and all the posts and then go diving and enjoy life. Its far too short to be worrying about what someone has written here.

 

[doctormike]

It would have been prudent for her, as for any diver, to do an annual Fit-for-diving medical.

If her problem was EIB, a standard medical evaluation might not have been helpful. A little background about bronchospasm, to help people here sort out all of these conflicting opinions. Remember, all of this speculation is based on incomplete data, and self reporting by an admittedly upset, anxious and possibly disoriented reporter. Thea, please understand that this last point isn’t an “attack” on you, it’s just that from your narrative and from the video, it’s hard to assume that what we have to go on is an objective, third-party report of all of the events and clinical data. Whether the inciting event was medical or panic, either way you certainly were upset when you wrote the OP, and it sounds like you were more so during that day. I myself had a lot of trouble precisely reconstructing the chain of events leading up to my DCS episode, and it took a long time to get it right.


The large airways (the trachea and proximal bronchi) that bring gas to the part of the lungs that actually exchange oxygen and CO2 (the alveoli) are made of cartilage, and have muscle in their walls. That muscle contracts normally in response to a number of stimuli. Sometimes, the contraction is excessive, causing bronchospasm (in which the muscle clamps down and narrows the tubes). This makes it harder to move air in and out of the lungs. Reduced bulk gas flow primarily affects CO2 elimination, since O2 diffuses more rapidly and its transfer to the blood is less dependent on ventilation. However, severe bronchospasm can also cause low oxygen saturation as well.


Now everybody has this muscle in the wall of the airway, and everybody will go into some degree of bronchospasm given the right stimulation. Three classic triggers are cold air, dry air and dirty air. This is why people with nasal obstruction are prone to bronchospasm - the nose warms, humidifies and cleans the air of dust and other particles. Hopefully, the air in our tanks is clean, but it’s still relatively cold and dry. People who have “asthma” (the modern term is “reactive airway disease”) are simply those people who are excessively sensitive to triggers like this, but if you take almost any person and have them run on a treadmill in a cold, dry coal mine they may wheeze as well. EIB is simply bronchospasm associated with exertion, in a patient who doesn’t have asthma at baseline.


To really diagnose EIB, or any sort of RAD, you need to do pulmonary function tests (like measurements of a flow-volume loop), often with and without a “challenge” (a drug that induces bronchospasm). Just like a stress test for the heart, you are looking for an event that might not happen commonly but that you want to study in a controlled setting.


Treatment of bronchospasm relies on bronchodilators - drugs that reverse the excessive muscle activity in the airway wall. O2 can help someone who is hypoxic to feel better, but it wouldn’t necessarily reverse the underlying problem. People who are chronic asthmatics, or who are prone to EIB can also take medication to stabilize the airway muscle and prevent these problems.


So Thea, if you might have had EIB, and you really want to continue diving, you need to have this formally evaluated by a pulmonologist and determine if the diagnosis is correct and if your condition is something that can be managed medically before you get in the water again.


But I would add my voice to the others who have pointed out that there is more to your story than just an unanticipated medical event that hit you out of the blue. For what it’s worth, if you are to return to diving, think about dive planning, the role of your buddy, the role of the DM, the implications of an overhead environment, the implications of buoyancy control and an uncontrolled ascent, and the need for the ability to do standard procedures like inflating your BC on the surface and dropping your weight belt, even if you are experiencing discomfort from other sources.

 

[T.C.]

Can you not see the irony dripping from this post? You attack Thea for self diagnosis, then say with absolute certainty that she did not have a medical problem.

In my opinion she needs to get fully checked out by a real doctor. Then perhaps some fitness/dive training would help after that.

There is no irony or contradiction here. NONE.

Why? Because there is ZERO evidence pointing to a medical event. She panicked, and that caused her shallow breathing, resulting in CO2 buildup and shortness of breath- which escaberated her panic.

In my opinion, she does need to see a doctor- to be checked out for COPD, and to stop smoking; not here mythical 'EIB'.

---------- Post added February 26th, 2014 at 09:36 AM ----------

None of this is her fault.

No, you are ignoring the real problems here. Actually, it is all her fault. She panicked, she forgot her training, and she failed to drop her weight belt, inflate her BCD, and become positively buoyant.