How to ascend with an unresponsive diver??

[Randy43068]

I don't think any accident situation is ever going to be textbook. You need to use your training and draw on your situations and skills to determine what the best course of action is.

This applies to diving as well as anything else.. cave rescue, EMT, high angle rescue, whatever.

Now that's a good answer. Just don't hurt yourself doing it. You may regret it when you're older. No kidding.

 

[scubatwinned]

Consider this ... if there is a high probability that help is readily available to you (the rescuer) once you reach the surface ... and EMS/hyperbaric facilities are within easy reach, then it may be a reasonable decision to risk DCS in order to provide a higher degree of care to the diver you are trying to rescue. If there is not, then you are weighing the potential benefit to the victim (by ignoring your own safety) against the potential harm (by turning the rescue into a two-victim scenario, which may put you in a position where you are unable to provide care once you reach the surface).

We ALL have to make those choices once we decide to intervene in a rescue ... often with a short time period in which to consider all the options.

How you respond will depend on a number of factors ... your level of training, the degree of risk involved, and your conscience being among the major ones.

... Bob (Grateful Diver)

If the diver is unresponsive but he is breathing on his own would/should one do the stops to get the rescuer to the surface safely?

 

[Don Burke]

Granted ... every event is situational.

However, in the context of how the question was asked I'm assuming the person doing the asking is (a) wearing a conventional, recreational rig, and (b) breathing air.

... Bob (Grateful Diver)

(a) All of the regulators with two second stages I have used had one hose longer than the other. The seven footer is a relatively new addition to my rig and really is a non-issue in this case.

(b) Air can be contaminated.

 

[ShakaZulu]

If the diver is unresponsive but he is breathing on his own would/should one do the stops to get the rescuer to the surface safely?

Nope, get him to medical care as soon as possible. Use your DAN for the chamber ride if you had a deco obligation.

 

[Atticus]

Based on input from several people, I have changed the way I do this to giving the victim my long hose regulator. The gas in his tank may be part of the problem.

I respectfully disagree - removing a reg from an unconscious divers mouth and replacing it with another is likely to a) allow water into the divers mouth where the original reg may have prevented it, and b) possibly force that water into the divers lungs if/when the purge is pressed. This is particularly true if the diver is unconscious but breathing (exhaust bubbles).

...If the diver is unresponsive but he is breathing on his own would/should one do the stops to get the rescuer to the surface safely?...
Nope, get him to medical care as soon as possible. Use your DAN for the chamber ride if you had a deco obligation.

Shaka - may I ask which decompression diving training program this advice came from?

 

[voop]

45 minutes deco and the boat is nowhere in site.

Not directed at you, Hank, but that'd be really really bad dive-planning anyways: to have loads of hang-time and no surface support.

If the boat has disappeared while submerged, then unless you've got really really good vertical viz, how will you know at depth that the boat is "nowhere in sight"? And even if you get to the surface with the victim and possibly yourself bent, what good is that going to do either of you? Nada.

If I dive where there're no surface support options (as in: shore-dives with long swim to shore), then I stay out of mandatory deco -- and thus would be able to get up with the victim without bringing myself in any additional risk.

If I plan to have mandatory deco, then I also plan to have someone on the surface. someone competent, that is.

As one who's been in a situation where it was "surface with unconscious buddy and probably get bent badly" as one of the options, here's what I did: shot lift-bag with up-line tied to wreck, and ascented with victim to my first deep stop. Decided to blow that stop in favor of extended deco on o2 later in deco schedule. Went to next stop, which I couldn't safely blow -- however was now relatively close to surface (compared to initial depth, at least). Clipped victim to up-line, thumped him below the chest and had him do a slightly bouyant ascent (much like you'd do with excess Al80's at that point) while crossing my fingers that he'd be ok. By clipping him to the up-line, the surface crew would know where to find him, and he'd not drift (there were surface currents). Shot second lift-bag (our signal for "big big problems"), and started deco. About a minute later, I heard the boat, and 7 min later I had company from a support diver with an extra stage of O2 for me and a slate which read "We're heading for shore, back for you in 1h30, are you OK?" I responded by sketching my now modified deco-schedule and off he went. 1h later, boat came back, new support-diver came in with a slate of good news ("Victim will be OK - non-diving related crisis") and for good measure, another AL80 of O2, in case I was thirsty

Another option I could have taken was to have sent up the two liftbags from depth, and waited for the support-diver to come pick up the victim from where I was. That would, however, have cost extra minutes...

Without a support-crew on the surface, there'd been at least one diver less in the world. Thanks to good planning and great people at the surface (the captain was also a medic) all went relatively well.

So my conclusion is simply: if I have any kind of overhead, hard or soft, then I also have someone on the surface -- and thus, the option of sending the victim up. If I do not have support on the surface, then I am not doing dives with a deco-overhead.

(Victim suffered some cardiac event at depth, but was lucky and both resussitated and decompressed succesfully. He's no longer doing deco-diving, though....)

 

[Snowbear]

Humm... Not disagreeing, but if for some reason you have to let him go to ride up, you have to pop it back out.
Interesting.

Why? won't the reg pop out on it's own if a negatively buoyant rescuer is using a positively buoyant victim's BC as the only source of positive buoyancy and loses control? I don't think my teeth are strong enough to prevent this from happening..... are yours?

 

[Snowbear]

45 minutes deco and the boat is nowhere in site.

:06: Oops, is this TDS? :06:

Oh.... whew... nope, still ScubaBoard. I guess I assumed we were talking about recreational, so-called "no-deco" dives?

 

[DeepSeaDan]

IMO, the most important message in this thread is the philosophy of flexibility & adaptability to a given set of circumstances. I can analogize this to teaching choking management in my 1st Aid courses. The Red Cross has standard protocols & techniques to address choking situations for adult, child, infant, obese, pregnant & disabled casualtys, as well as self-rescue techniques. Depending on the capability of the rescuer, some of these techniques can be used for choking casualtys of varying ages. If one method is ineffective, try another, & another, to the limit of your capability. The one that works is the "right one" for that situation.

Criteria for the rescue will vary with the condition of the casualty ( unresponsive & non-breathing; unresponsive & breathing; convulsing etc., etc. ); no one protocol can address every eventuality, thus having a toolbox of techniques to apply to differing circumstances will optimize the chances for a successful rescue. Knowing the key criteria for optimal rescuer & casualty safety is equally important. While rescuer safety is priority one, the management of one's own personal safety will be a judgement call on the day of the rescue. When we teach rescue courses, it is imperative the student be fully informed of the potential dangers, so that they may make informed choices.

Finally, it is crucial to keep these responses as uncomplicated as possible. There is safety in simplicity; further, no individual can be exactly sure how they will react in a life & death situation until their in the middle of one. Some people, by their very nature, will remain relatively cool & controlled; others will be paralysed by fear & uncertainty, & the majority will fall somewhere in between. In any case, one's natural response characteristics can be greatly influenced by practicing rescue techniques regulalry; regretably, I would suggest that most rescue-trained recreational divers do not practice regularly, thus the case for "simplified tools" in the toolbox is enhanced.

Ultimately - you do the best you can on that day & no one can ask for more.

Best,
D.S.D.

 

[vjongene]

Have you considered controlling the buoyancy for you as well as the victim? If you can do this and *truly* control the ascent, there's a better chance you will maintain control of the victim (not become seperated) and one or both won't be "rocketed to the surface." This takes a bit more doing on your part, but if you've already got the concept of neutral buoyancy for yourself down pat, with a little practice it's not as difficult as you're probably thinking

I just went over the standards for the CMAS 3-star certification, which includes an ascent from 40 m with an unconscious diver. They state that the rescuer should be able to control the ascent using either the victim's BC or his/her own. But I agree that the safer option is to use the victim's after emptying the rescuer's.