Deep panicked diver procedure?

[Max Speed]

From the surface I witnessed an incident last weekend that made me realize I have some gaps in my training.

A group of divers (possibly training) were on an 85' training platform when one diver panicked and bolted for the surface. Reason for the panic is unknown to me but two of the divers on the platform thought it was "out of air" or "perceived out of air".

Two divers attempted to hold the diver down to slow the ascent.

The diver surfaced unresponsive and with bloody foam from the mouth.

My questions (for future reference):

A: Should a diver in this situation be restrained from surfacing too quickly? (apparently this led to more panic in this case)

B: If an incident like this occurs on a 100' plus dive where the PADI tables mandate a 3 minute safety stop; can/should a buddy omit the stop while chasing the diver to the surface? (Those three minutes could be critical if the surfaced diver is not breathing.)

 

[TSandM]

I think it is always advisable to prevent a diver from surfacing too fast, unless that diver is truly out of air and will NOT accept a regulator (better bent than drowned). But if you do allow someone to surface rapidly, you have to ensure they continue breathing, which is the biggest mortal risk of that situation (AGE can be immediately fatal; drowning can often be resucitated if not too much time has gone by). I would never make a safety stop, or even a brief deco stop, with someone who was either in full-blown panic or not breathing.

 

[cloudflint]

For A i would probably hold them back a bit since coming up to fast in a panic they would be highly likely to burst a lung which it sounds like this person did with the bloody foam coming out their mouth. If they are out of air and refuse to take your octopus i would still slow their ascent since they would have more chance of surviving passing out from lack of air than they would of surviving a burst lung.

For B i would skip the safety stop and go to the surface immediately since the first few minutes after an incident like this are likely to determine whether the person lives or dies. If they make it to the surface OK they may be calmed down enough to be able to go down and do a stop or you may be able to get them to safety then do a stop yourself. I always think that its better for you both to have to go to the chamber with a mild bend than one of you being fine and the other being dead.

Those are just my personal opinions however, what i just said is what i have done in the past in similar situations during a runaway ascent.

 

[divengolf]

Max:

Suggest that you consider taking the Rescue course. It will give you a good framework to deal with these questions.

If you haven't done AOW, you probably need to do that first. As I recall that was a prereq, for Rescue as it should be.

 

[ZenDiver.3D]

Lynn and the Scot have it.

 

[MXGratefulDiver]

Max:

Suggest that you consider taking the Rescue course. It will give you a good framework to deal with these questions.

If you haven't done AOW, you probably need to do that first. As I recall that was a prereq, for Rescue as it should be.

I agree with your first comment.

The second comment is only true with some agencies ... NAUI does not require AOW before Rescue ... nor is there any reason that it should be.

Rescue is the most important class a recreational diver can take once they are certified ... to my concern, it should either be included with basic skills training or should be allowed ... as NAUI does ... at any time after OW.

... Bob (Grateful Diver)

 

[reefduffer]

The second comment is only true with some agencies ... NAUI does not require AOW before Rescue ... nor is there any reason that it should be.

Rescue is the most important class a recreational diver can take once they are certified ... to my concern, it should either be included with basic skills training or should be allowed ... as NAUI does ... at any time after OW.
... Bob (Grateful Diver)

Bob,

I usually stay out of these discussions, as I know there are plenty of instructors and DMs etc., like yourself, that can provide a more in-depth answer. I've just completed PADI Rescue in the past few months, I could probably answer the OP question for a buddy or friend, but I'd rather the pros do it. I lurk and learn.

But with respect to the point you made that I've highlighted in bold - One component of the Rescue course was search, using compass navigation. While it was very briefly touched on in OW, there was no training in it until AOW. And note it's one of the two required parts of AOW. I had, previous to this thread, made this connection/observation to myself as to the AOW prerequisite for Rescue.

You could legitimately say that Rescue could be taught without compass navigation, it wasn't the biggest or most important part. Or that the nav skills should be part of OW. But that's not how PADI has carved it up.

Another point: OW requires 4 dives. There are some (certainly not me, I think it's the wrong way to do it) that just take the classes in sequence, without any actual diving in between. For those on that path, having at least another 5 dives after OW before starting Rescue seems prudent. Dealing with stress during diving when just diving is new and stressful seems like a bad idea.

It may not be the only way to organize the syllabus, but IMO it doesn't seem arbitrary or whimsical. And now I will return to listening and learning, very possibly as to why I'm wrong here. Tell me why.

 

[MXGratefulDiver]

Bob,

I usually stay out of these discussions, as I know there are plenty of instructors and DMs etc., like yourself, that can provide a more in-depth answer. I've just completed PADI Rescue in the past few months, I could probably answer the OP question for a buddy or friend, but I'd rather the pros do it. I lurk and learn.

But with respect to the point you made that I've highlighted in bold - One component of the Rescue course was search, using compass navigation. While it was very briefly touched on in OW, there was no training in it until AOW. And note it's one of the two required parts of AOW. I had, previous to this thread, made this connection/observation to myself as to the AOW prerequisite for Rescue.

You could legitimately say that Rescue could be taught without compass navigation, it wasn't the biggest or most important part. Or that the nav skills should be part of OW. But that's not how PADI has carved it up.

Another point: OW requires 4 dives. There are some (certainly not me, I think it's the wrong way to do it) that just take the classes in sequence, without any actual diving in between. For those on that path, having at least another 5 dives after OW before starting Rescue seems prudent. Dealing with stress during diving when just diving is new and stressful seems like a bad idea.

It may not be the only way to organize the syllabus, but IMO it doesn't seem arbitrary or whimsical. And now I will return to listening and learning, very possibly as to why I'm wrong here. Tell me why.

From a PADI perspective, those may be valid points.

NAUI's approach to OW and AOW are a bit different than PADI's ... although the course content is similar in many respects. Both have valid reasons for training the way they do. Under the NAUI program, we are required to teach some rescue skills in every class we teach ... my "Scuba Diver" class, which is analogous to PADI's OW class, for example, requires me to train my students to bring an unconscious diver to the surface. So students coming out of our entry-level class have already been exposed to some of the skills typically taught in Rescue. We also introduce compass skills in the Scuba Diver program, and therefore a student coming into the Rescue class would be expected to know how to use one for a Search and Recovery dive. What we emphasize, then, is how to perform the various search patterns that are covered in the curriculum. When I teach the Rescue course, if a student isn't already familiar with compass work, they learn that skill as part of the class. However, since most of my Rescue students have come through the NAUI OW class (usually with me) they already know how to use the compass, whether or not they opted to take the Advanced class first.

... Bob (Grateful Diver)

 

[Hawkwood]

I will just throw one other "tidbit" out here.

With regards to the PADI Rescue Diver class, a PADI Open Water Diver may participate in the Knowledge Development and Rescue Exercises in confined water.

They cannot participate in the Rescue Scenarios in open water until they have recieved thier Adventure Diver certification (with the Underwater Navigation Adventure Dive) or thier Advanced Open Water certificaton.

 

[flots am]

A: Should a diver in this situation be restrained from surfacing too quickly? (apparently this led to more panic in this case)

This is a really tough call with a few non-obvious points.

Depending on the nitrogen load, a diver who bolts for the surface and remembers to leave their airway open could quite possibly arrive on the surface un-injured. The catch is the open airway and nitrogen load. You really have no way of knowing either while watching the diver ascend.

Catching a bolting diver that isn't right next to you requires that you actually exceed their ascent rate to intercept and overtake, which could easily leave the "victim" OK and the "rescuer" injured.

Once you get there, you need to know what to do and do it. Your rescue plan should be pretty much a done deal in your mind before you ever make contact, since you're not going to have time to screw around figuring out what to do, and being within reach of the panicked diver puts you at great risk.

There are also other issues, such as the diver might actually be out of air, but unable to share for some reason. A panicked out of air diver headed for the surface might not have the presence of mind to remember how to do an air share, and might actually be safer on the surface.

The real answer is "it depends." It depends on your training, your assessment of the victim, your abilities and confidence that you can make things better and not worse, and not injure yourself or the victim in the process.

The best way to handle a panicked diver is to prevent the panic from occurring in the first place. Learn what to look for (check out "The Panic Cycle" which should be taught in any good rescue class), be a good buddy, know what to look for, watch for it, and stop the panic before it starts.

That said, if I'm any significant distance away and see someone bolt, I'll wave goodbye and do the fastest ascent I believe I can do without injuring myself and assist on the surface. If it happens nearby, I'll offer a known-working reg and if I beleive it's appropriate, will dump the victims BC air to prevent an ascent.

B: If an incident like this occurs on a 100' plus dive where the PADI tables mandate a 3 minute safety stop; can/should a buddy omit the stop while chasing the diver to the surface? (Those three minutes could be critical if the surfaced diver is not breathing.)

The "3 minute safety stop" is based on the ascent rate listed in the manual/tables, however a bolting diver can easily hit 300'/minute (guesstimate based on watching a 10' ascent in the pool that took about 2 seconds), which completely invalidates the tables and any recommended stops. With enough nitrogen and a really fast ascent, it's easy to get any number of injuries.

flots.