ascending with unconscious victim

[MikeFerrara]

Diver0001 once bubbled...


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..

Yes it wasn't a full quote. LOL They mention a couple of different options.

 

[The Chairman]

But dropping his belt will make him dead for sure if he wasn't already.

An unconscious person will not experience a barotrauma due to "holding their breath". That is a conscious effort on our part. While there might be a slight chance of an embolism, it is greatly outweighed by the immediacy of their unconsciousness. Real and present issues outweigh “possible” ones any day. Mucking around on the bottom trying to do this or that will insure their demise post haste. Lets face it... you can't initiate CPR at 60 fsw. Their butt needs to leave the environment which is causing their imminent death.

As for a diver who is catatonic due to oxygen toxicity... they will have to ascend to relieve the symptoms. They will only drown if you keep them under and wait for them to revive.

 

[MHK]

NetDoc once bubbled...


As for a diver who is catatonic due to oxygen toxicity... they will have to ascend to relieve the symptoms. They will only drown if you keep them under and wait for them to revive.

Doc,

With all due respect I disagree with you on this one. My view is that if a diver is convulsing as a result of oxygen toxicity what you'll have is a diver that as a result of the convulsions will "clog" his throat and be unable to breathe or exhale air. Accordingly, any air that is trapped in his lungs will expand as you ascend, so if you bring him to the surface irrespective it's more then likely he'll suffer an AGE anyway. The proper procedure, in my view, is to put the rescuing diver's reg up to the toxing diver's mouth and puring the reg.. As the diver ceases his convulsion you shoudl put your reg in his mouth, then you begin the ascent.. If he convulses again on the ascent, which is quite likely, then you stop the ascent repeat the procedure above until it's safe to ascend..

Hope that helps..

Later

 

[Diver0001]

NetDoc once bubbled...


An unconscious person will not experience a barotrauma due to "holding their breath". That is a conscious effort on our part. While there might be a slight chance of an embolism, it is greatly outweighed by the immediacy of their unconsciousness. Real and present issues outweigh “possible” ones any day. Mucking around on the bottom trying to do this or that will insure their demise post haste. Lets face it... you can't initiate CPR at 60 fsw. Their butt needs to leave the environment which is causing their imminent death.

As for a diver who is catatonic due to oxygen toxicity... they will have to ascend to relieve the symptoms. They will only drown if you keep them under and wait for them to revive.

I'm going to jump on the band-wagon here. An unconscious diver should always be treated as alive until proven otherwise. Sending him to the surface like bit of junk you found in a wreck isn't the right solution. Where will he be when you get to the surface? How long will it take you to find him? In all conditions? Even in rough conditions? Any time you waste looking for your victim on the surface after you send him there is time that you could have been spending trying to save him. It's better to ascend with him. You'll save time by knowing where he is.

R..

 

[MikeFerrara]

I guess there are acceptions to every rule but dropping weights at depth hasen't worked well fot a certain Fire department around here. They all came up spitting out their lungs. So much for an unconcious diver not embolizing.

That "stop drop blow and go" stuff was before bc's and buoyand exposure suits I think.

 

[Genesis]

The official "rescue class" line is actually dangerous to the rescuee's health!

Eek!

 

[Charlie99]

MikeFerrara once bubbled...
...dropping weights at depth hasn't worked well for a certain Fire department around here. They all came up spitting out their lungs.

This thread is beginning to show it's age, so hijacking it wouldn't be much of a crime...

Your comment above caught my attention since I was under the impression that a person can survive very, very rapid ascents without barotrauma or embolism provided you keep the airway open.

Do you have any more details that you can share on the Fire Department problems?

TIA,

Charlie

 

[The Chairman]

The proper procedure, in my view, is to put the rescuing diver's reg up to the toxing diver's mouth and puring the reg..

Once his reg is out, you have introduced water. One quick purge sending water to the back of the throat, and we have a pharyngospasm. Now you have a real possibility of the airway staying closed. BTW, most pharyngospasms allow air out... but not in. Rescue breathing will only inflate the stomach and not the lungs. Of course once air goes in to the stomach, a lot more than air will come back out.

As for the convulsions... yes, up slowly BUT UP! But I would hold HIS reg in. However, if I came upon an unconscious diver who was catatonic due to OxTox... how would I know? Not sure that you could make an accurate assessment of that at 60 fsw. If I could see breathing at all it changes the whole scenario, now doesn't it? No breathing=immediate ascent to the surface. You can NOT resolve a non breathing situation under water and the clock is ticking! Indications of breathing at the bottom or on the way up, and the game has changed for the better... we slow ascent WAY down.

Diver0001... who ever said to let them go up alone??? Re-read my first post.

As Walter so wisely pointed out... every rescue is different. You can't do them ALL in the same way. Where I am reading this to be a not only unconscious but a NOT BREATHING diver (which is how most unconscious under water human beings are) y'all are citing some exceptions.

The BEST rescuer sees the problem before it happens.

The BEST rescue is one that never has to happen.

The BEST rescuer can think in his fins and adapts to changes easily.

 

[Genesis]

Once his reg is out, you have introduced water. One quick purge sending water to the back of the throat, and we have a pharyngospasm. Now you have a real possibility of the airway staying closed. BTW, most pharyngospasms allow air out... but not in. Rescue breathing will only inflate the stomach and not the lungs. Of course once air goes in to the stomach, a lot more than air will come back out.

If his reg is out, you cannot make the situation WORSE by giving him another one (yours, which has a known good gas in it.) If he has spasm'd as a consequence of the water, he has. You can make it better, but not worse.

If he is tonic, then his airway is locked shut. If you take him up before he comes out of that, you will cause pulmonary barotrauma.

I'd argue that you have to play the percentages here.

1. If he has not toxed, then he's dead, statistically, already, or will be before you can get him to the surface at any speed that YOU can handle.

2. If he HAS toxed, and you take him up before he comes out of it, you will probably kill him for certain.

3. You have no way to know if he has toxed or not, EXCEPT to wait approximately one minute (the maximum he could reasonably be expected to stay in a tonic state post-hit) before ascending. During that time, giving him a KNOWN good gas supply, assuming he has no reg in his mouth, cannot hurt him (either he's already dead OR he's alive, toxed, and you are providing him a safe gas supply - which he does not have now, as evidenced by his tox hit.)

Is the one minute wait going to condemn someone who is already not breathing otherwise? I'd argue no - that if he is not toxed, the odds are OVERWHELMING that he's already gone.

All this assumes you do not SEE the tox hit itself.

As for the convulsions... yes, up slowly BUT UP! But I would hold HIS reg in. However, if I came upon an unconscious diver who was catatonic due to OxTox... how would I know? Not sure that you could make an accurate assessment of that at 60 fsw. If I could see breathing at all it changes the whole scenario, now doesn't it? No breathing=immediate ascent to the surface. You can NOT resolve a non breathing situation under water and the clock is ticking! Indications of breathing at the bottom or on the way up, and the game has changed for the better... we slow ascent WAY down.

You wouldn't know. If he has toxed he will not be breathing until the tonic phase passes. If you take him up even 5-10' and he has toxed, and is tonic, you will kill him. If you do not give him a reg with good gas in it before he starts breathing again, you will kill him.

If he is NOT toxing, he's probably already dead, no?

The question is "how do the probabilities work here"? You have no way to know, unless you WITNESS the event that causes the diver to go unconscious, WHY it happened. You can only guess at how long ago AND why. But if "how long ago" is anything over 2 minutes, he's gone - it will be 2 more, assuming 60' or so of depth, before you can get CPR started, and the "hard line" is at 4 minutes post-event.

Yes?

 

[lanun]

this is good discussion. the original quesiton was to help me sort out my 'rescue toolbox'. seems there's some items missing.

prior to poting in SB, my info source, aside fr the instructor, is the PADI RD manual/video, IANTD Adv EaN manual, Fundamentals book.

this is great learning. i thought i should have a standard 'start-up' procedure but it looks like that's not the case.

one thing - looks like i have to redo the pool work (6 day-long sessions and counting). it's no longer mechanical especially with the different ideas introduced here.

but do keep the discussion going. need more input on what folks do/train/teach.