Singapore doctor dead - Bali

[Kevrumbo]

I am having a very hard time understanding how a diver (presumably using an AL 80) could succumb to DCS during a dive to 20 meters. It would be very unusual. I would be surprised about it happening after such a dive, but it is amazing that symptoms so severe they led to a fatality occurred during the dive. I have to believe there must be something we don't know.

AGE and DCS are both expressions of DCI, and I can easily see a newspaper getting that wrong. And AGE can kill you perfectly adequately with an Al80 at 20 meters. Not saying it did...

I can see AGE clearly, and I can see how a newspaper can get it wrong. That may also explain their explanation of DCS as bubbles in the blood.

Rule Out Hypercapnia in Scuba in 48 year-old female as precipitating cause.

• Physical activity/exertion or Skip-Breathing at depth 20m resulting metabolic Carbon Dioxide retention and build-up. Inefficient ventilatory response to eliminate excess CO2 and inability to recover normal breathing rate during exercise of ascent, resulting in vicious cycle of quickly spiraling hyperventilation (Tachypnea), difficulty in breathing (Dyspnea), further CO2 poisoning with possible developing cardiac arrhythmia, and finally leading into unconsciousness.
• Rule Out DCS/AGE as secondary comorbid condition due to unconscious rapid ascent to the surface.

Also Rule Out Laryngospasm as cause due to inadvertent water inhalation at depth.

Symptoms and signs of early hypercapnia include flushed skin, full pulse, tachypnea, dyspnea, extrasystoles. . . reduced neural activity, and possibly a raised blood pressure. According to other sources, symptoms of mild hypercapnia might include headache, confusion and lethargy. Hypercapnia can induce increased cardiac output, an elevation in arterial blood pressure, and a propensity toward arrhythmias. Hypercapnia may increase pulmonary capillary resistance. In severe hypercapnia. . . symptomatology progresses to disorientation, panic, hyperventilation, convulsions, unconsciousness, and eventually death.

And so the accident scenario plays out as reported by the dive guide:
. . .they were about 20m deep when she gestured for help. The dive leader led her to the surface, but she was unconscious by then. . .

As the victim is lapsing into unconsciousness, AGE would likely then occur on the ascent.

 

[PygmySeahorse]

It gives lots of fish and sharks but the currents can be strong and there can be downcurrents...

It's also a very good place to spot mola-mola (oceanic sunfish) and WAY less crowded than Crystal Bay - because of heavy surge, and strong currents, including whirlpools, and both down and up currents.

 

[Scubamat]

Padang Bai blue Lagoon is a relatively easy dive but I don't have much comparison didn't notice much in the way of surge and current. We did get warned of the potential for surge and current and to stick close to the guide and not wander off. This doesn't seem to be a factor. Blue Lagoon was the second dive of the day both times I went, so might be factor.

 

[Dan]

 

[Dan]

And so the accident scenario plays out as reported by the dive guide:
. . .they were about 20m deep when she gestured for help. The dive leader led her to the surface, but she was unconscious by then. . .

As the victim is lapsing into unconsciousness, AGE would likely then occur on the ascent.

We don't know how fast the ascent rate was. It would be interesting to see their dive computers' dive profile during emergency ascent on how fast the ascent rate was.

When the deceased diver gesturing for help, basically in panic mode, would it be possible that she was holding her breath while being pulled up to the surface?

May be the better course of action for the dive leader would be to calm her down in place, check her gas or any equipment failure. If she had breathing problem, replaced her 2nd stage with his octopus, instead of dragging her up in a hurry.

 

[Jack Hammer]

We don't know how fast the ascent rate was. It would be interesting to see their dive computers' dive profile during emergency ascent on how fast the ascent rate was.

When the deceased diver gesturing for help, basically in panic mode, would it be possible that she was holding her breath while being pulled up to the surface?

May be the better course of action for the dive leader would be to calm her down in place, check her gas or any equipment failure. If she had breathing problem, replaced her 2nd stage with his octopus, instead of dragging her up in a hurry.

Where have you seen it stated she panicked or was dragged up in a hurry?

 

[Dan]

Where have you seen it stated she panicked or was dragged up in a hurry?

From my wild imagination. I'm thinking if I were her, having a chest pain underwater, I might do that. A concerned rescue diver would rush me up.

 

[charlier]

I live in Singapore and commute to Bali - I have yet to hear a first-hand description or reliable account of the accident. Without reliable information, it seems me that we are all speculating without data. In late May, I teach a coral reef diversity class at Blue Lagoon. Depending on the direction of the swell, its nice site to teach and OW or refresher class. From my distant memory, at 20m depth conditions vary from sandy bottom with coral bommies and rocks. Nearby by is a drop-off to about 30m.

 

[Dan]

The video (link below) is not too clear, but the message above is clear. Stay calm.

I was lucky enough to experience it while working on my yard (feeling weak with cold sweat & short of breath), not while diving. If I was diving, I would probably be dead too.

 

[Kay Dee]

May be the better course of action for the dive leader would be to calm her down in place, check her gas or any equipment failure. If she had breathing problem, replaced her 2nd stage with his octopus, instead of dragging her up in a hurry.

As another poster said, much of what happened in the accident in question seems to be speculation, but the above is not, it is just very good sound advice in any similar situation for any dive 'leader', dive 'buddy / companion' or even an instructor; whether the one in distress is a he or a she (that 'starts out / begins' as this accident / fatality is reported to have done).