I wasn't sure if she was certified and was going for addition instruction after her OW dives or was completing OW dives. I understand now..
Accident Report...
- Thread starter JT2
- Start date
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MakoSince70
Contributor
JT2, you and your dive partner did great. Hope you are around on the day I get in trouble.
There have been many comments on this string pertaining to instructor to student ratios. Bottom line is that the training standards dictate the maximum number of students. Conditions such as limited visibility call for common sense to intervene. The student number should then be reduced.
I AI and DM with a shop that does it right. We always have a minimum on one DM per 2 students on the platform. The instructor instructs. The DM is the safety factor, and, makes sure the student learns how to dive. You know the skills such as buoyancy that you need to practice to learn. After platform skills, each student dives with the DM or AI. By the end of the weekend, our students can dive on their own. If not, they come back until they are novice divers. Then and only then do our instructors certify them.
A good AI or DM with the subject instructor would have recovered the falling student before she was 5 ft below the platform.
I know because our platform is only 8 ft off the bottom. We have not let a student hit the mud yet.
Again: JT2 ya did great !!!!
There have been many comments on this string pertaining to instructor to student ratios. Bottom line is that the training standards dictate the maximum number of students. Conditions such as limited visibility call for common sense to intervene. The student number should then be reduced.
I AI and DM with a shop that does it right. We always have a minimum on one DM per 2 students on the platform. The instructor instructs. The DM is the safety factor, and, makes sure the student learns how to dive. You know the skills such as buoyancy that you need to practice to learn. After platform skills, each student dives with the DM or AI. By the end of the weekend, our students can dive on their own. If not, they come back until they are novice divers. Then and only then do our instructors certify them.
A good AI or DM with the subject instructor would have recovered the falling student before she was 5 ft below the platform.
I know because our platform is only 8 ft off the bottom. We have not let a student hit the mud yet.
Again: JT2 ya did great !!!!
I tend to think a good AI, DM, or instructor would know about how much lead a person needs....give or take a few pounds....then she wouldn't have been plummiting in the first place. I'm not trying to pick on anyone..this is just the way I see it.
As JT2 put it...she had 30 lbs....I never have had 30 on my belt...
anyway...still a marvelous story and effort from JT2, and his buddy. Not to mention the courage this girl has to try and get back into this.
MASS-Diver
Contributor
randyjoy,
A few questions since you are knowledgeable:
So, in texas I could use an AED on someone even if I'm not trained to use it? That's not the case in some places: for example check out this link (#2): http://www.club-mgmt.com/manager/032001/memberscorner/memberscorner.html
this is simliar to the MA law, if you aren't trained to use a defib the very act of using one makes you liable (which is BS since all you have to do is listen to the voice commands and make sure the person isn't lying in a puddle).
And again, as far as implied consent goes, it only is applicable for TRAINED personel right?
Here in MA, if you are found drunk on the streets, the police with place you in protective custody (you are a danger to yourself) they will transport you to hospital where they hold you untill you are out of danger, isn't this how it is in Texas? If you dying of a drug overdose, but, you still have the strenghth to say I refuse treatment, guess what, you are still going.
Read the last line of this too: put out those post dive cigars before you turn on that O2
http://www.drwitherspoon.com/articles/ercrew.htm
But, on the other hand, after reading this it looks like the laws just aren't that clear, clearly if you trained you can give O2, but, what counts as training? Sounds like though, from this article, things are starting to change a bit:
http://www.ibum.org/oxygen.htm
Good disscusion about this issue, I hope it I ever need it people won't hesistate to give me O2 because they may or may not be protected legally, put that mask on me, I need it!
A few questions since you are knowledgeable:
So, in texas I could use an AED on someone even if I'm not trained to use it? That's not the case in some places: for example check out this link (#2): http://www.club-mgmt.com/manager/032001/memberscorner/memberscorner.html
this is simliar to the MA law, if you aren't trained to use a defib the very act of using one makes you liable (which is BS since all you have to do is listen to the voice commands and make sure the person isn't lying in a puddle).
And again, as far as implied consent goes, it only is applicable for TRAINED personel right?
Here in MA, if you are found drunk on the streets, the police with place you in protective custody (you are a danger to yourself) they will transport you to hospital where they hold you untill you are out of danger, isn't this how it is in Texas? If you dying of a drug overdose, but, you still have the strenghth to say I refuse treatment, guess what, you are still going.
Read the last line of this too: put out those post dive cigars before you turn on that O2
http://www.drwitherspoon.com/articles/ercrew.htm
But, on the other hand, after reading this it looks like the laws just aren't that clear, clearly if you trained you can give O2, but, what counts as training? Sounds like though, from this article, things are starting to change a bit:
http://www.ibum.org/oxygen.htm
Good disscusion about this issue, I hope it I ever need it people won't hesistate to give me O2 because they may or may not be protected legally, put that mask on me, I need it!
No, that is not what he said, as indicated by this statement:
JT2, you and your buddy did a very good job on this rescue. As a former pararescueman, you covered just about everything.
The only comment about the rescue portion that I can give, just as a suggestion as it was probably out of your control, is that the instructor was actually in some jeopardy going back down to get his students after suffering severe cramping. Your rush to get into the water was well justified in light of the possibility that the instructor could also have problems. While it is not generally recognized, instructors in these situations can also be at risk.
Concerning the instruction, I would have been much more comfortable as an instructor (I was one once) with only one buddy team at a time going down when in visibility of only 5-6 feet. It seems this was the critical error. The other error was in not taking the time for a buoyancy check. This could easily have been a fatal accident if the water had been deeper; we had a similar situation that occurred in Clear Lake, Oregon (1970's) when a diver using an AtPak found his inflation system did not work, but only after entering the water. He was in deeper water (70-80 feet, I think), and this was a fatal accident.
Concerning the administration of oxygen, there is a lot of confusion. I'm going to ask Dr. Decon to weigh in on this. but I do have some comments. There has been mention both of Good Samaritin Laws, and of professionals (nurses, doctors, etc.) administering oxygen. My training dates back many years, but I don't think the human response to oxygen has changed in that time. I'd like to comment first on the physiology (Dr. Decon please look it over), then the administration.
Giving oxygen increases the saturation of hemoglobin in the red blood cells. If a person has suffered carbon monoxide poisoning, it will hasten the release of the CO, and increase the oxygenation of the blood, thereby alleviating the oxygen starvation symptoms. CO poisoning has occurred in diving accidents, and has resulted in heart attack-induced diving fatalities (at least one of which I know about). For decompression sickness, I think (someone correct me if I'm wrong) the administration of oxygen hastens the decrease in size of bubbles, as it decreases the nitrogen saturation in the lungs, then the blood, and thereby increases the diffusion of the nitrogen out of the body. I'm not sure of the same effect on air embolism, but anything that would decrease the size of any bubbles will help, and increasing the oxygenation of the blood will allow that blood which get by the bubbles to decrease the infarct area in the brain.
So, what can be bad about giving oxygen? Well, for people with decreased lung function, their body is used to a higher amount of carbon dioxide in the blood. It is carbon dioxide which triggers the "must breath" signal in the brin. Therefore, for people with COPD (chronic obstructive pulmonary disease, such as emphysema or chronic bronchitis), with bodies used to a high pCO2 (percentage carbon dioxide), giving oxygen can cause them to stop breathing. The treatment, remove the oxygen and they will start breathing again.
Aside from that, there is a potential for fire (don't let someone taking pure oxygen smoke, for instance!). Don't give oxygen in a confined space with an ignition source.
We've heard of oxygen toxicity, but this only occurs under pressure.
So what harm can come from giving a diver oxygen? Not much!
Why the reluctance? Because there is a great misunderstanding of the laws, and some states (apparently Massachutes being one) which are very unfair and litigous. The misunderstanding has to do with the Good Samaritin laws. Everyone should find out exactly what their state's Good Samaritin law says. But realize that the Good Samaritin law is there to protect us, not from suit, but from someone winning a suit. Anyone can sue anyone for anything. They just cannot win the suit if it is covered under the Good Samaritin law. In Oregon, where I've been teaching First Aid and CPR for over 20 years, there has never been a successful challenge to the Good Samaritin laws.
AEDs are now taught in American Red Cross courses, and the literature states that they are simple enough to use that a child can do it, which is why they are widely deployed.
Oxygen administration is not considered an advanced technique, but is also not generally taught in First Aid/CPR coures. As a trained person, who was in the past an EMT/Paramedic/USAF pararescueman, I would have no problem giving oxygen whenever I thought it appropriate. Because it is not my job to provide emergency car, be a nurse, doctor, etc., I would be covered under the Good Samaritin Law in Oregon. The American Red Cross First Aid/CPR course is considered the national standard, and is based upon the recommendations of the National Research Counsel of the National Academy of Sciences. The Red Cross also has oxygen administration courses for Life Guards, and professional rescuers. I would recommend that divers take this course, and all will be clear.
Even so, I don't see that someone trying his or her best in an emergency would loose in a suit simply because they tried to administer oxygen. There is somewhat of a moral delma here. Oxygen could potentiall save a life; on the other hand there is the potential for a suit. But could the person win...that is the question. I think not!
In 1975, as an EMT/Paramedic I attended to a heart attack victim in his home (a very tight bathroom). He was clearly having a heart attack, showing PVCs (premature ventricular contractions) on his ECG, and in danger of dying. But he was refusing treatment. We consulted with the ER physician, and he told us, "This is a case where you're damned if you do, and damned if you don't. Bring him in." It's an individual decision.
SeaRat
The only comment about the rescue portion that I can give, just as a suggestion as it was probably out of your control, is that the instructor was actually in some jeopardy going back down to get his students after suffering severe cramping. Your rush to get into the water was well justified in light of the possibility that the instructor could also have problems. While it is not generally recognized, instructors in these situations can also be at risk.
Concerning the instruction, I would have been much more comfortable as an instructor (I was one once) with only one buddy team at a time going down when in visibility of only 5-6 feet. It seems this was the critical error. The other error was in not taking the time for a buoyancy check. This could easily have been a fatal accident if the water had been deeper; we had a similar situation that occurred in Clear Lake, Oregon (1970's) when a diver using an AtPak found his inflation system did not work, but only after entering the water. He was in deeper water (70-80 feet, I think), and this was a fatal accident.
Concerning the administration of oxygen, there is a lot of confusion. I'm going to ask Dr. Decon to weigh in on this. but I do have some comments. There has been mention both of Good Samaritin Laws, and of professionals (nurses, doctors, etc.) administering oxygen. My training dates back many years, but I don't think the human response to oxygen has changed in that time. I'd like to comment first on the physiology (Dr. Decon please look it over), then the administration.
Giving oxygen increases the saturation of hemoglobin in the red blood cells. If a person has suffered carbon monoxide poisoning, it will hasten the release of the CO, and increase the oxygenation of the blood, thereby alleviating the oxygen starvation symptoms. CO poisoning has occurred in diving accidents, and has resulted in heart attack-induced diving fatalities (at least one of which I know about). For decompression sickness, I think (someone correct me if I'm wrong) the administration of oxygen hastens the decrease in size of bubbles, as it decreases the nitrogen saturation in the lungs, then the blood, and thereby increases the diffusion of the nitrogen out of the body. I'm not sure of the same effect on air embolism, but anything that would decrease the size of any bubbles will help, and increasing the oxygenation of the blood will allow that blood which get by the bubbles to decrease the infarct area in the brain.
So, what can be bad about giving oxygen? Well, for people with decreased lung function, their body is used to a higher amount of carbon dioxide in the blood. It is carbon dioxide which triggers the "must breath" signal in the brin. Therefore, for people with COPD (chronic obstructive pulmonary disease, such as emphysema or chronic bronchitis), with bodies used to a high pCO2 (percentage carbon dioxide), giving oxygen can cause them to stop breathing. The treatment, remove the oxygen and they will start breathing again.
Aside from that, there is a potential for fire (don't let someone taking pure oxygen smoke, for instance!). Don't give oxygen in a confined space with an ignition source.
We've heard of oxygen toxicity, but this only occurs under pressure.
So what harm can come from giving a diver oxygen? Not much!
Why the reluctance? Because there is a great misunderstanding of the laws, and some states (apparently Massachutes being one) which are very unfair and litigous. The misunderstanding has to do with the Good Samaritin laws. Everyone should find out exactly what their state's Good Samaritin law says. But realize that the Good Samaritin law is there to protect us, not from suit, but from someone winning a suit. Anyone can sue anyone for anything. They just cannot win the suit if it is covered under the Good Samaritin law. In Oregon, where I've been teaching First Aid and CPR for over 20 years, there has never been a successful challenge to the Good Samaritin laws.
AEDs are now taught in American Red Cross courses, and the literature states that they are simple enough to use that a child can do it, which is why they are widely deployed.
Oxygen administration is not considered an advanced technique, but is also not generally taught in First Aid/CPR coures. As a trained person, who was in the past an EMT/Paramedic/USAF pararescueman, I would have no problem giving oxygen whenever I thought it appropriate. Because it is not my job to provide emergency car, be a nurse, doctor, etc., I would be covered under the Good Samaritin Law in Oregon. The American Red Cross First Aid/CPR course is considered the national standard, and is based upon the recommendations of the National Research Counsel of the National Academy of Sciences. The Red Cross also has oxygen administration courses for Life Guards, and professional rescuers. I would recommend that divers take this course, and all will be clear.
Even so, I don't see that someone trying his or her best in an emergency would loose in a suit simply because they tried to administer oxygen. There is somewhat of a moral delma here. Oxygen could potentiall save a life; on the other hand there is the potential for a suit. But could the person win...that is the question. I think not!
In 1975, as an EMT/Paramedic I attended to a heart attack victim in his home (a very tight bathroom). He was clearly having a heart attack, showing PVCs (premature ventricular contractions) on his ECG, and in danger of dying. But he was refusing treatment. We consulted with the ER physician, and he told us, "This is a case where you're damned if you do, and damned if you don't. Bring him in." It's an individual decision.
SeaRat
Cave Diver is correct; you cannot exceed your training for the Good Sam Law to apply. Training is considered completion of a class or certification by or through a recognized organization. This includes basic first aid, CPR, O2 administration, AED, etc. Non-invasive first aid really doesn't need specific training, as "common sense" is actually recognized: i.e., direct pressure to stop bleeding, even if the person has never taken a first aid class.
A drunk in public is considered a danger to themselves or others, and I have two choices: I can arrest them and charge them with a criminal offense, or I can release them to a competent adult. The hospital is only an option if they are so drunk that they are actually uncounscious, and then they can be treated like a drug OD (see below).
When I worked on the ambulance, I had many drug OD patients (some accidental, some suicidal) refuse treatment. We just waited for them to become unconscious and then asked them again if they wanted treatment. Since they are now unconscious, they couldn't answer, and voila! - implied consent (we made sure to only give them enough meds to counteract breathing or cardiac problems and not wake them up!!).
Bottom line: if you don't make the patient WORSE by what you did, you don't get paid, and you know what you're doing, you are OK, at least in Texas!!
The references to COPD and oxygen administration is correct. Administering high concentrations of O2 to a chronic bronchitis or emphysema patient could trigger apnea. Removing the O2 may not restart breathing, but anyone administering O2 also should know how to administer artificial respiration. Withholding O2 from a hypoxemic (low oxygen in the blood) patient could cause brain death; I'd rather administer breaths for a patient than attempt to resuscitate a dead brain. The former is pretty easy, the latter never works.
The COPD problem is pretty moot in diving - what is a guy with emphysema doing diving???????
JT2: You did good.
A drunk in public is considered a danger to themselves or others, and I have two choices: I can arrest them and charge them with a criminal offense, or I can release them to a competent adult. The hospital is only an option if they are so drunk that they are actually uncounscious, and then they can be treated like a drug OD (see below).
When I worked on the ambulance, I had many drug OD patients (some accidental, some suicidal) refuse treatment. We just waited for them to become unconscious and then asked them again if they wanted treatment. Since they are now unconscious, they couldn't answer, and voila! - implied consent (we made sure to only give them enough meds to counteract breathing or cardiac problems and not wake them up!!).
Bottom line: if you don't make the patient WORSE by what you did, you don't get paid, and you know what you're doing, you are OK, at least in Texas!!
The references to COPD and oxygen administration is correct. Administering high concentrations of O2 to a chronic bronchitis or emphysema patient could trigger apnea. Removing the O2 may not restart breathing, but anyone administering O2 also should know how to administer artificial respiration. Withholding O2 from a hypoxemic (low oxygen in the blood) patient could cause brain death; I'd rather administer breaths for a patient than attempt to resuscitate a dead brain. The former is pretty easy, the latter never works.
The COPD problem is pretty moot in diving - what is a guy with emphysema doing diving???????
JT2: You did good.
Thanks for the update JT2,
As most know PADI standards require a weighting check at the start of each training dive.
No instructor should teach divers to descend by dumping all their air. Even correctly weighted a diver will be a few pounds neg to compensate for being lighter later in the dive when some of their air is used. Students should be tought to let out just enough air to begin their descent. In this way the diver is always as close to neutral as possible and in control. I know that what I just stated seems like a no brainer...so...why are there instructors out there who don't know how to get students weighted? Why are there instructors who don't know how to descend? Personally I would like PADI to explain this to me. I see those butt first out of control descents everytime I go to the quarry where there is a class. In fact I even see them performed by certified divers. If a student hasen't been tought to weight themself and hasn't learned the correct way to descend they shouldn't be in OW.
The root cause here was not the lack of assistants. Lack of an assistant caused the response to be slow but the problem began when the unprepared student entered the water with the incompetant instructor. An overweighted diver who is instructed to do a suicide descent will likely get hurt. I personally have cought many students for other instructors. The next time I will handle it much differently.
How does an instructor like this get through the system? I know the answer to that but maybe some of you should write, call or e-mail PADI and ask them!
As most know PADI standards require a weighting check at the start of each training dive.
No instructor should teach divers to descend by dumping all their air. Even correctly weighted a diver will be a few pounds neg to compensate for being lighter later in the dive when some of their air is used. Students should be tought to let out just enough air to begin their descent. In this way the diver is always as close to neutral as possible and in control. I know that what I just stated seems like a no brainer...so...why are there instructors out there who don't know how to get students weighted? Why are there instructors who don't know how to descend? Personally I would like PADI to explain this to me. I see those butt first out of control descents everytime I go to the quarry where there is a class. In fact I even see them performed by certified divers. If a student hasen't been tought to weight themself and hasn't learned the correct way to descend they shouldn't be in OW.
The root cause here was not the lack of assistants. Lack of an assistant caused the response to be slow but the problem began when the unprepared student entered the water with the incompetant instructor. An overweighted diver who is instructed to do a suicide descent will likely get hurt. I personally have cought many students for other instructors. The next time I will handle it much differently.
How does an instructor like this get through the system? I know the answer to that but maybe some of you should write, call or e-mail PADI and ask them!
But they are so much fun...are you boycotting suicide descents...are you saying I can't have my diver's depth charging the bottom....where's your sense of adventure....that's what PADI calls it right....Adventrues in Diving...
...Adventures in Overweighting?
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