Dan - Human error in diving

[Teamcasa]

Indulge me Thal as I attempt to abbreviate both your post and Dan's article.

Most diving accidents are you own fault. If you don't want to experience this first hand, strive to be a better diver.

 

[Hatul]

I wonder how they define human error. If someone has a heart attack is that human error or what? I would think in some cases it's clear whether it's human error or now but in many it's a gray area.

A common problem in dive accidents I read is failure to monitor gas supply, which is an obvious human error. Another which is usually a compounding issue on top of another problem is buddy separation.

The 88% accident rate in first dives of a trip are interesting, but I would like this to go one step further and break it down to human error, equipment problems, medical issues etc. It's hard to know what this means.

 

[Thalassamania]

A credible diving agency's instructors follow protocol and rules to ensure that certified divers were taught at least the minimum skills to keep themselves safe in conditions that do not exceed those in which they were trained. If the individual goes out of their way to find the cheapest course available, they will generally find 'the cheapest course available'. Nothing looks like a cheap suit quite... like a cheap suit. It is still a suit but it is cheap and the quality will show through.

I don't know about other agencies but PADI has a statement of Safe Diving Practices which divers should sign before doing any type of diving. In the statement (Section 2) it says "if diving conditions are worse than in those in which I am experienced, postpone diving or select an alternate site with better conditions." However divers continue to expect to do dives with extreme conditions and will select operators that will give it to them.

Section 4: "Listen carefully to dive briefings and directions and respect the advice of those supervising my diving activities. Recognise that additional training is recommended for participation in specialty diving activities, in other geographic areas and after periods of inactivity that exceed 6 months."

At the end of the day, this is just another piece of paper but if you read it through it makes a lot of sense.

All of the Statement's 10 points are valid but many divers really need to be more honest when signing it, and more operators need to be prepared to refuse divers that do not show the appropriate level of skill/experience/awareness etc.

I guess I don't find PADI's "Statement of Safe Diving Practices" creditable since a significant number of their graduates do not appear to have sufficient knowledge or skill imparted to them to either understand what is being required or to competently perform the identified skill.

It's easy to dismiss what Mr. Orr is saying, but I found a couple of very interesting statistics in the talk.

Although it's very intuitive that the first dive of a trip would be higher risk, 88% is an extremely high number. This immediately suggests to me that we might be able to reduce fatalities by ensuring that first dive is done under very controlled circumstances, and I wonder if the numbers are different at resorts that require a "checkout dive" before taking people to the "real" dive sites. Or if the number would be different if we looked at folks who either had recent (say, within a month) dive experience, or a recent refresher.

"Checkouts" and workup dives are a really good idea.

The second reaction I have is that 41% of fatalities involved running out of gas. Except in the extremely rare case of massive gear malfunction, this is ALWAYS due to the most egregious kind of human error -- a chain of mistakes that starts with poor planning and continues through poor monitoring and possibly bad judgment, to boot. This is where education in gas management could be a powerful intervention. I'm used to the reaction from instructors and divers alike, "Why do we need to know this stuff?" but perhaps increasing diver awareness of the gas requirements for deeper diving might result in a little increase in vigilance?

Few entry level divers are taught anything about effective gas management or emergency ascent. That's a deadly cocktail the injuries and deaths resulting are not all the diver's fault.

Despite Thal's dismissal of the article, I think it's important that people realize that the majority of lethal risk in diving is well within the capacity of the individual diver to reduce or negate. Better skills, better education, and better procedures WILL reduce lives lost; this is true is many other fields, and it's true here. The information is widely available, and the training can be found as well.

That's my point, people, by and large, are not taught that diving can be deadly, they are taught how safe it is, and they are not equipped with the skills, taught and trained to the level required to be useful in an emergency.

I thought it was not really honest to lump the out of air accidents into "human error" when the major training agencies don't require serious gas management expertise for OW or even AOW certification. If the same amount of training was provided for calculating turnaround pressures given various combinations of divers with various SAC/RMV's as for using decompression tables and staying within the NDL, perhaps the fatality rate for gas mangement failures would be more similar to that for DCS.

Yup!

 

[TSandM]

Lack of gas management contributes to putting divers in situations where they will run low on gas . . . but running OUT of gas is bad monitoring or bad judgment. How many threads have we read where divers have signaled the dive guide that they were low on gas, and the guide continues the dive, and the diver FOLLOWS him? The argument that people make when forced to sit through a gas management lecture, that if they just monitor their gauges they'll be fine, has some merit.

As anyone who knows me knows, I don't have a high opinion of mainstream dive education. But we ARE taught to do buddy checks; we ARE taught to stay out of overheads, we ARE (or at least should be, by agency standards) taught to monitor our gauges. And, since gas is a finite resource, staying underwater and watching it disappear is definitely a judgment problem.

One of the great things about resources like ScubaBoard is the ability to disseminate information widely. Whether that's Bob's gas management ARTICLE, or the huge information repository that is the "Near Misses and Lessons Learned" subforum, we CAN spread ideas and concepts, and even help share ideas for improved technique. This article has some good wake-up calls in it. It was worth sharing.

 

[Hawkwood]

.... But we ARE taught to do buddy checks; we ARE taught to stay out of overheads, we ARE (or at least should be, by agency standards) taught to monitor our gauges. And, since gas is a finite resource, staying underwater and watching it disappear is definitely a judgment problem.....

Okay, so given the above, where (or with whom) does the problem lie.

Bill

 

[boulderjohn]

First of all, I agree with the concern that mainstream dive education does not focus enough on either gas management or an emergency response to OOA (emergency ascent). To me, these statistics clearly indicate that more instructional time should be spent there. Too many divers run out of air without a buddy nearby. When they do that, they perform a poor ascent that leads to embolism.

Now lets look at OW instruction. I know from a long written exchange that accompanied a Distinctive Specialty I wrote for Dive Planning, a Distinctive Specialty that includes gas management, that PADI believes that for the beginning OW diver, monitoring gauges and beginning an ascent at the appropriate PSI is all that needs to be taught at that level. OK, let's for the moment agree with that and ask the question: when is it taught at that level?

According to standards, it isn't. Look at the RSTC standards and ask yourself if t it is possible for a student to be certified at the OW level without ever being asked to look at a pressure gauge during a dive, without ever being asked to check their buddy's gas level, without ever being shown how to signal remaining gas level, and without ever being asked to make a decision about the appropriate amount of reserve gas for beginning an ascent. Correct! Not one of those skills is mentioned in the standards or the course requirements!

And so, in both the CW and OW work, I require my students to check each other's gas levels at several points while just free swimming. I include information on an appropriate PSI level for beginning an ascent. Finally, although it varies to some degree based on where I am doing the OW dives, I try on at least one dive to have the buddy teams swim independently while I watch and then initiate an ascent independently based on a specific PSI level rather than on my command. (I can't always do that.)

As for emergency ascents, I have said repeatedly in this and other forums that we teach the emergency swimming ascent badly; so badly, in fact, that it is counterproductive. Our instructional methodology is designed to give the student the impression that if there is caca on the fan, they will not be able to get to the surface using it, so they had better hold their breath. (I can explain this in more detail, but it would take something of an essay on its own.)

 

[Hawkwood]

First of all, I agree with the concern that mainstream dive education does not focus enough on either gas management or an emergency response to OOA (emergency ascent). To me, these statistics clearly indicate that more instructional time should be spent there. Too many divers run out of air without a buddy nearby. When they do that, they perform a poor ascent that leads to embolism.

Now lets look at OW instruction. I know from a long written exchange that accompanied a Distinctive Specialty I wrote for Dive Planning, a Distinctive Specialty that includes gas management, that PADI believes that for the beginning OW diver, monitoring gauges and beginning an ascent at the appropriate PSI is all that needs to be taught at that level. OK, let's for the moment agree with that and ask the question: when is it taught at that level?

According to standards, it isn't. Look at the RSTC standards and ask yourself if t it is possible for a student to be certified at the OW level without ever being asked to look at a pressure gauge during a dive, without ever being asked to check their buddy's gas level, without ever being shown how to signal remaining gas level, and without ever being asked to make a decision about the appropriate amount of reserve gas for beginning an ascent. Correct! Not one of those skills is mentioned in the standards or the course requirements!

And so, in both the CW and OW work, I require my students to check each other's gas levels at several points while just free swimming. I include information on an appropriate PSI level for beginning an ascent. Finally, although it varies to some degree based on where I am doing the OW dives, I try on at least one dive to have the buddy teams swim independently while I watch and then initiate an ascent independently based on a specific PSI level rather than on my command. (I can't always do that.)

As for emergency ascents, I have said repeatedly in this and other forums that we teach the emergency swimming ascent badly; so badly, in fact, that it is counterproductive. Our instructional methodology is designed to give the student the impression that if there is caca on the fan, they will not be able to get to the surface using it, so they had better hold their breath. (I can explain this in more detail, but it would take something of an essay on its own.)

I don't disagree, but I will provide a minor correction:

PADI 2012 Instructor Manual
Confined Water Dive 1 Performance Requirements
9. Locate and read the submersible pressure gauge and signal whether the air supply is adequate or low based on the gauge’s caution zone.

Bill

 

[flots am]

Although it's very intuitive that the first dive of a trip would be higher risk, 88% is an extremely high number.

It's not too surprising, since the first dive is usually deeper and generally more demanding than the second.

Notwithstanding the "reverse profile" issue, if a two tank dive was a 40' reef followed by a wall, instead of the other way around, the DM would get a chance to determine if everybody is actually qualified for the wall dive.

The way things are done now, divers are dropped on the wall, then if they survive, the next dive is an easy reef.

flots.

 

[boulderjohn]

I don't disagree, but I will provide a minor correction:

PADI 2012 Instructor Manual
Confined Water Dive 1 Performance Requirements
9. Locate and read the submersible pressure gauge and signal whether the air supply is adequate or low based on the gauge’s caution zone.

Bill

I stand corrected.

 

[boulderjohn]

Interestingly enough, Dan research in the past showed similar first dive statistics for DCS as well. That one's hard to explain.