Coast Guard Triage Question (U-869)

[ClamBake]

Last month I finally read "Shadow Divers" and I am about to finish "The Last Dive." As those who have read both books may have noticed, there is a stark discrepancy between the accounts of whether the Coast Guard or the Seeker's crew made the call that both father and son were to be airlifted off the boat.

This raised in my mind the general question as to whether USCG policy is to triage diving accident victims where survivors are in clear need of a chamber - leaving behind others where vital signs are lost. My interest is from the perspective of a DM candidate looking toward my IDC and a future that will hopefully never involve the need to encounter such a situation first hand.

I would appreciate hearing from any current or former USCG personnel, licensed boat captains, or others who might have an insight into USCG policy.

As a disclaimer, I have not read "Shadow Divers Exposed" and do not wish this to turn into a debate over the facts as reported in any versions of the tragedy surrounding Chris and Chrissy Rouse.

 

[z3r0c00l]

Well having read all the scuba books out there (great when a hobby and job are combined into one obsession) I think the triage in this story sounds logical. Given a limited capacity, they chose the person who was still awake and talking (not a bad sign). Ideally they would be able to lift both divers and treat them both. A very sad story, and it seems that both men were already dead when they failed to do in water decomp.

 

[rawls]

I did a search regarding USCG victim evacuation policies and came up empty handed. In any event I don't know if it would help to solve the question, but it would definitely help to know what the policy is.

 

[bmcsteve]

I cant speak to USCG policies or procedures, but I know as a paramedic when doing triage, you have to consider who has the best chances of survivial, and direct your limited resources toward them. Typically in this type of scenario patients without vitals signs are beyond help. So with that said, it makes sense that if there was limited room in the aircraft, they would take the most viable patient.

 

[dashark]

I am a 12 year paramedic at a fire station that provides Paramedic services to the Coast Guard when needed. I have been flying with them when needed for over 6 years now.
As with any first responder, triage is the name of the game. If you have ever found yourself in a situation like this, it is logical.
I have personally had to triage patients while aboard a coast guard helicopter and return for the other patient later. Fuel and weight considerations are a big concern when considering if you can handle 2 patients. Not to mention manpower and space. It is pretty tight inside their helicopters.
Weather or not this is their SOP , I cannot say. I assume that triage is pretty much universal for anyone who is involved in rescue operations. I have seen no indication that the crews I have flown with for the past 6 years operate any differently.
Although I have read both books, I cannot remember exactly how the rescue went down.
Maybe we can scare up some coast guard personel on this site for more info.
Hope this helps.....

 

[Eris Lucan7*]

..the gui came in deco tent or tube aboard a Helicopter or a lager

coastguardcraft in europ then in deco chamber or esle,Many divrent names for

coastsecure magement here:Furezas Naval,Securta Civil,as Guardia Puertos in

France is it the a deparmet off the Gandameri National,Germany is it the German

Borderguard/Bundesgrenzschutz Amt See/the callsign have changed to German

Coastgurad by renaming the sevice in 2005... (That cost a lot mony..)


E.L.7*

 

[ClamBake]

Thanks to all for the insight. As has been expressed, I would expect that triage is the name of the game - especially given fuel and time considerations. You may remember from the U-869 books that the Rouse family, however, that the USCG choppered both son (conscious) and father (unconscious and reportedly without vitals) off the boat. I found this surprising - contrary to triage considerations and the thoughts expressed by others above.

Two follow-up questions: How much time could it take to lift an additional (unconscious, no vitals) diver from a boat in 6 - 8 foot seas? Could the loss of this time make a difference to a surviving diver in need of a chamber? I assume the answer to both is depends, but would again be interested in hearing from folks having witnessed or experienced this first hand.

Thanks again.

 

[dashark]

less than 5 minutes. these guys are really good.
Watching them perform a lift from a boat on the open ocean is very impressive. Since the rescue swimmer would probably already be on board from the first lift, it would save a lot of time for the second lift.
Granted, 5 minutes is a long time when you have a patient in full arrest. But it is nothing compared to the time it would have taken to get another helicopter out there.
More of a consideration would be patient care enroute.They must have really had their hands full. Also if they had to change the destination hospital to one a bit farther away with a chamber.
I am sure all of this was taken into consideration when they made the decision.
I had forgotten that they took both divers at once. That is suprising, considering the father was in full arrest. (is that correct?) I understand your curiosity.
I am sure they had good reasons for their decisions. I am no monday morning quarterback.

 

[JayJudge]

A few things came into play as to their deaths, let alone the whole book debate. First, as far as I know, and correct me if I am wrong, the Coast Gaurd will not administer O2 without a prescription. At that point in time, O2 therapy was not well known, either. Second, the chamber has to be able to take the diver back to theoretical depth, the one used was not capable of this (again I may be incorrect). Now, onto the book. The son supposedly ran out of air, yet the boat or swim platform cracked his maniflod- and huge hissing of air was released. In SD, Chatterbox immediately knows that Kooler's CPR card has expired- think about it, do you know when your buddy's card is set to expire, and even if you do, would you stop them from giving CPR? There are good samaratin laws (sp), that protect you....Chatterbox is also said to have argued with the rescue swimmer- from all accounts (including appearently a video taken on scene) this is not true. I have met some of the people involved, and all seem nice enough, leaving me to believe that the author is the problem in this (Kurson). His other books include nothing on diving, and the entire book portrays it as a dangerous sport that "constantly kills its young." Hmmm, when I help students through training, or am working on a wreck boat, I am always leary of which one is not coming back. Yeah....we lose 'em all the time....and this includes technical diving....However, when I see a morbidly obese diver get on, even when he has thousands of dives, I do tend to get nervous. (My friends knw exactly whom I am thinking of)...
Now, on to your question of what the Coast Gaurd does- they will grab as many as they can. Unless there is a doctor able to pronounce someone dead, it is like an ambulance- you always are pronounced dead on arrival..... Most boats do not have deaths on them, even when diving the Doria. A LOT of people do get bent however, or run the risk of it, so as a DM, be prepared with O2, knowledge of in water recompression, keep your skills up, and think through your emergency plans. In just the past season, my buddies and I have seen an increase in divers needing the above. Just to end this I'll give a few examples- guy got onboard, computer screaming a deco violation, and his arguement was "I still have plenty of air." Another got onboard, complained of a headache, and we later found out that he had gone from 60 ftsw to the surface in UNDER 30 seconds. These were both "advanced OW" divers- and neither was PADI, before anyone starts bashing agencies. Enough of my ranting, hope all this helps you, and like I said, I am not positive on the O2 thing, so maybe someone can help me on that.
Good luck on the IDC goal!
-J

 

[rjack321]

Couple of corrections: Hyperbaric chambers almost never take divers back down to the depth of their dive; its not required. O2 does not require a prescription in an emergency like the Rouses.

That said, if the events re-occurred today... Boat staff or other divers would almost certainly be jumping into the water with cylinders and attempting to help the divers to (at the very least) partially redo the deco. There's no way the chamber would have saved them given the specifics of their incident, both were doomed.

Knowing the government I doubt there are very many detailed policies about triage. Its most certainly practiced, but doubtful they would articulate a policy other than recognizing the discretion of the rescuer/crew to triage patients when forced to. I don't think the Rouse's rescue required that discretion since they had the capacity and the weather/conditions were not placing an atyipcal risk on the helo crew.