Charlie99
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It's gems of info like this that make this board worthwhile. Like a lot of things, this is obvious, but only after it's been pointed out the first time.
Thanks,
Charlie
ascending with unconscious victim
- Thread starter lanun
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It's gems of info like this that make this board worthwhile. Like a lot of things, this is obvious, but only after it's been pointed out the first time.
Thanks,
Charlie
The Chairman
Chairman of the Board
I have read with interest the various methods y'all are using. Most of them will probably work (and that is good). After all, the point is to get the diver to the surface and out of the water.
This is how I teach it for OW No-stop diving (no required deco obligation).
Approach... pull a fin to make sure the diver is not a photographer etc waiting to catch that pic of a lifetime.
Leg twist to upright if needed.
Look... Check mask for ANY water... remove if results are positive (Boyle's law will force any water down the nasal passages as you ascend resulting in a pharyngospasm)
Equipment... dis-entangle (if needed) and remove weights (belts or pockets) COMPLETELY from the diver. Hold them at arms length to avoid fouling and drop. Victim should now be bouyant.
Remove and Rescusitate... Using the dosey-doe, start swimming to the surface @ 60fpm. My left hand is threaded front to back between their left arm and body and reaching back to hold onto their BC. My right hand has their inflator valve and is holding on to their tank valve. Just as I make it to the surface I hit their inflator and bring them up supine. Lots of buoyancy is important here as their face MUST NOT GO BELOW WATER again. Two unhurried rescue breaths and its...
Treat and Transport... 2 rescue breaths every ten seconds (Or 1/5 secs) as you make it to the exit. Initiate EMS. Initiate CPR.
This makes for an ALERT diver.
This is how I teach it for OW No-stop diving (no required deco obligation).
Approach... pull a fin to make sure the diver is not a photographer etc waiting to catch that pic of a lifetime.
Leg twist to upright if needed.
Look... Check mask for ANY water... remove if results are positive (Boyle's law will force any water down the nasal passages as you ascend resulting in a pharyngospasm)
Equipment... dis-entangle (if needed) and remove weights (belts or pockets) COMPLETELY from the diver. Hold them at arms length to avoid fouling and drop. Victim should now be bouyant.
Remove and Rescusitate... Using the dosey-doe, start swimming to the surface @ 60fpm. My left hand is threaded front to back between their left arm and body and reaching back to hold onto their BC. My right hand has their inflator valve and is holding on to their tank valve. Just as I make it to the surface I hit their inflator and bring them up supine. Lots of buoyancy is important here as their face MUST NOT GO BELOW WATER again. Two unhurried rescue breaths and its...
Treat and Transport... 2 rescue breaths every ten seconds (Or 1/5 secs) as you make it to the exit. Initiate EMS. Initiate CPR.
This makes for an ALERT diver.
In my admittedly limited experience, this will send them on the express train to the surface. If you hold on youre going too! I would only drop the weights at the surface!
Mike
about the weight removal at depth. This is something that many warm water divers may not have to deal with since they may not be used to the amount of exposure protection that us cold water divers usually wear.
Divers taking the rescue courses of the various agencies need to develope an awareness of the exposure protection being worn by the people they are diving with.
Divers taking the rescue courses of the various agencies need to develope an awareness of the exposure protection being worn by the people they are diving with.
The Chairman
Chairman of the Board
If I see more than 20 lbs then I might re-evaluate this. Still how fast do you think you will ascend at that? In a rescue situation I would go 60-80 fpm without a quibble. You aren't stopping for a safety stop if you are doing no-stop diving. Get their butt up and out of the water ASAP.
Why are they unconscious?
Are they breathing?
Well.....sort of. They say you should use your own BCD but then go on to say something to the effect that if the victim is heavy you might need to use their bcd but it makes it hard to control the ascent.
I practice this a lot because I like doing rescue scenarios and I personally think that PADI makes this recommendatino because they were looking for a one-size-fits-all solution, not because it generally works better. My personal experience is that you at least need to get the victim neutral (or even slightly positive) before you can do much with them at depth and if the victim's bcd is working you're much better off using that one for the lift.
When I play rescue victim I sometimes unclip my inflator to simulate an unconscious diver OOA on the bottom and these lifts are, without fail, slower and more difficult for the rescuer.
R..
Let me think this one through here out loud and see if it still makes sense.
1. Approach. Ok, you're there. Is the victim BREATHING from a regulator? If he IS, then he's alive. The most important thing is thus not to make him dead by my actions!
If he is NOT breathing, or has no reg, then either (1) he is likely already dead and beyond help, and we are doing a body recovery (he has 4 minutes from the cessation of breathing until its all over), or (2) he just toxed and is tonic.
Run the numbers folks. What are the odds you can get effective CPR begun on someone who stops breathing at depth RIGHT NOW within 4 minutes without killing yourself in the process? A fast ascent will cause barotrauma or an AGE, and a slow one will run the clock. If the incident did not happen right in front of you, the clock has probably already expired. A fast ascent with the victim puts YOU at risk for someone who is probably already dead!
If he has TOXED, then you need to get him something SAFE to breathe. The assumption must be that his gas supply is bad (hot, etc). The only KNOWN good gas is YOURS, because you are not toxing.
So explain to me why you don't give the non-breathing victim YOUR reg (replacing his reg with yours, or inserting yours if he has none) on the POSSIBILITY that he has toxed, is tonic, and will shortly resume breathing? If he does resume breathing and does not have a regulator in his mouth at that instant, he's dead!
2. Ok, the victim now has a supply of gas which he may or may not be using. We've established the most important thing - something safe to breathe. You now need to ascend with the victim.
If he has gas in his tank(s), the best option is probably an ascent with a balance between your BC and his, with you remaining negative and his BC being used for the "lift." If you "lose" him, you don't want him sinking and you playing Polaris! Back to Rule #1 - don't make a second victim. You'll live if you sink back down - you might kill yourself if you do the rocket ship imitation.
3. Once on the surface, make sure you are BOTH buoyant, drop the victim's weights, and initiate CPR. The rest is egress, EMS activation, etc.
Now given I've not had Rescue, but I take issue with a few of the "recommendations" I have had related to me.
Specifically:
1. Dropping the victim's weight belt. Why? You're guaranteed that he will go up all right - at an unsafe rate. Why would you do that when there are other options? Unless you follow him at that same unsafe rate, you won't be there to provide CPR and extraction once he gets there!
2. NOT replacing an ejected regulator. Why not? What is the possible downside of doing so? If he's dead, you can't kill him any worse! If he's NOT dead, but has toxed, and you don't replace the reg he WILL DIE when he resumes breathing. If you replace the reg with HIS, and he toxed, he'll tox AGAIN, since he's again breathing the same (bad) gas that caused the trouble in the first place. So why don't you insert YOUR known good gas supply? If he doesn't resume breathing, you haven't hurt him by supplying him with something he doesn't use. If he DOES, he better have a gas supply.
The mask removal is something I hadn't though of, but here's another question related to that - if you remove the mask, won't the stricken diver potentially inhale water anyway and spasm? After all, if he's unconscious he won't be controlling his breath to go only via the mouth.... so isn't this a "Hobson's choice" problem?
Help me out here....
1. Approach. Ok, you're there. Is the victim BREATHING from a regulator? If he IS, then he's alive. The most important thing is thus not to make him dead by my actions!
If he is NOT breathing, or has no reg, then either (1) he is likely already dead and beyond help, and we are doing a body recovery (he has 4 minutes from the cessation of breathing until its all over), or (2) he just toxed and is tonic.
Run the numbers folks. What are the odds you can get effective CPR begun on someone who stops breathing at depth RIGHT NOW within 4 minutes without killing yourself in the process? A fast ascent will cause barotrauma or an AGE, and a slow one will run the clock. If the incident did not happen right in front of you, the clock has probably already expired. A fast ascent with the victim puts YOU at risk for someone who is probably already dead!
If he has TOXED, then you need to get him something SAFE to breathe. The assumption must be that his gas supply is bad (hot, etc). The only KNOWN good gas is YOURS, because you are not toxing.
So explain to me why you don't give the non-breathing victim YOUR reg (replacing his reg with yours, or inserting yours if he has none) on the POSSIBILITY that he has toxed, is tonic, and will shortly resume breathing? If he does resume breathing and does not have a regulator in his mouth at that instant, he's dead!
2. Ok, the victim now has a supply of gas which he may or may not be using. We've established the most important thing - something safe to breathe. You now need to ascend with the victim.
If he has gas in his tank(s), the best option is probably an ascent with a balance between your BC and his, with you remaining negative and his BC being used for the "lift." If you "lose" him, you don't want him sinking and you playing Polaris! Back to Rule #1 - don't make a second victim. You'll live if you sink back down - you might kill yourself if you do the rocket ship imitation.
3. Once on the surface, make sure you are BOTH buoyant, drop the victim's weights, and initiate CPR. The rest is egress, EMS activation, etc.
Now given I've not had Rescue, but I take issue with a few of the "recommendations" I have had related to me.
Specifically:
1. Dropping the victim's weight belt. Why? You're guaranteed that he will go up all right - at an unsafe rate. Why would you do that when there are other options? Unless you follow him at that same unsafe rate, you won't be there to provide CPR and extraction once he gets there!
2. NOT replacing an ejected regulator. Why not? What is the possible downside of doing so? If he's dead, you can't kill him any worse! If he's NOT dead, but has toxed, and you don't replace the reg he WILL DIE when he resumes breathing. If you replace the reg with HIS, and he toxed, he'll tox AGAIN, since he's again breathing the same (bad) gas that caused the trouble in the first place. So why don't you insert YOUR known good gas supply? If he doesn't resume breathing, you haven't hurt him by supplying him with something he doesn't use. If he DOES, he better have a gas supply.
The mask removal is something I hadn't though of, but here's another question related to that - if you remove the mask, won't the stricken diver potentially inhale water anyway and spasm? After all, if he's unconscious he won't be controlling his breath to go only via the mouth.... so isn't this a "Hobson's choice" problem?
Help me out here....
The Chairman
Chairman of the Board
an unconscious diver at depth is not breathing. They are probably already dead from drowning.
An unconscious swimmer in a pool is possibly a neck injury and should be treated as such.
Every situation requires observation... I guess you had best LOOK (the second part of my mnemonic) and if on the surface add LISTEN to that section.
An unconscious swimmer in a pool is possibly a neck injury and should be treated as such.
Every situation requires observation... I guess you had best LOOK (the second part of my mnemonic) and if on the surface add LISTEN to that section.
But dropping his belt will make him dead for sure if he wasn't already. There is the possibility that he toxed and is tonic - he'll look very dead, but shortly will resume breathing, and if he doesn't have a known good gas supply when he does.....
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