Procedures question for unconscious underwater skin and scuba rescue

[Padiver22]

I'm in training to become a dive instructor! I have to assist in instructing a class on how to bring an unconscious skin and scuba diver to the surface but I can't find the procedure anywhere in my S&P book. I know to use the unconscious divers inflator to take us both to the surface but I can't find any details about what to do on the surface or if I'm missing any steps under water... Any ideas??

 

[Jim Lapenta]

Did you take a rescue class yet? That procedure is part of every rescue class I am aware of. I teach it as a Basic Open Water skill. Once on the surface you need to insure that both you and the vic are positive. Inflate their BC, inflate your BC, dump their weights, then assess and decide on your next move. Most advise checking for breathing and if not give 2 rescue breaths as you learned in your rescue class. (You'll need to have their mask and yours off but don't lose your mask!) Although the effectiveness of rescue breathing without compressions is questionable and is now being looked at and reassessed by a few people. The main goal is now to get the vic out of the water. And fast without tiring yourself to the point of uselessness. I always tell students they have a a split second to make a decision. IF the conditions are anything at all worse than flat calm, get em positive, get yourself positive, and haul butt for the shore or boat while at the same time making it as easy and fast as possible to get em out. That means stripping gear as you are towing and do it in a manner that does not slow the effort.

 

[Matt Sachs]

+1 what Jim said. However in our stress/ rescue class we skip the 2 rescue breathes on the surface and just haul butt to safety. As Jim said its being debated, either way will get you a passing grade with me.

 

[muddiver]

The class I assist does not teach using anyones BC inflator to reise the casulty to the surface. We dump the stricken divers weights and do a controlled ascent using inhearent buoyancy in the divers exposure suit and any air already in the BC.

 

[Jim Lapenta]

And if they are using 26-28 lbs of weight? Dumping that is very dangerous for the victim and the rescuer. How do you control the ascent when they were using that much lead? How do you know how much lead they have on period? Dumping lead at depth could kill a diver that may not be dead if they shoot up with a closed airway. If you get tangled up with them what good are you if you are hurt? What if you have a reverse block? A controlled ascent is accomplished using an inflated BC that you are able to control by venting. If one of my students dumped a divers weights at depth in class it would be an automatic fail and require a serious talk and redo of the skill. Dropping weights at depth is one of the most dangerous actions you can take for the vic and yourself.

 

[Matt Sachs]

If we are talking about an unconscious diver, then I assume the reg is out. In that case a rapid ascent is the only thing that might save his or her life. He or she needs CPR and that can only be done on the ground, and the expanding air in his lungs might just help to push some of the water out of the trachea and throat. If they are unconscious they cannot hold their breath so expansion injuries are not as big of a concern, although still a possibility. You are going to bend the diver, but bent is better than dead.
One of our instructors was diving a beach in Pennsicola 2 months ago when one of the divers in the group had a heart attack at 35-40 feet. They SHOT him to the surface and got to the beach with in 7 minutes. The diver was not breathing and didn't have a pulse. They did CPR for 20 minutes until EMT's got on scene. He survived and is home with his family today. You dont always get a happy ending like this one, but sometimes you do. Debbie you are my Shero.

 

[SeaCobra]

lung over expansion injury is still a real concern, the airway, if not properly managed, can trap air.

 

[Jim Lapenta]

Exactly. You cannot just shoot someone to the surface. You cannot just let them go. The head tilts forward, the airway closes, there possibly goes a lung. Unconscious does not mean and can never assume the reg was out for any length of time. Unconscious can still be breathing with the reg in. Unless the diver has been down for much longer than their air supply can possibly last, shooting them to the surface uncontrolled is stupid and may be the best way to make sure they are dead. The guy got lucky.

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[herbdb]

Rescue Diver is a requisite for PADI Divemaster/Instructor and your question is covered in that manual. What agency did your DM cert? Just curious.

 

[lv2dive]

If we are talking about an unconscious diver, then I assume the reg is out. In that case a rapid ascent is the only thing that might save his or her life. He or she needs CPR and that can only be done on the ground, and the expanding air in his lungs might just help to push some of the water out of the trachea and throat. If they are unconscious they cannot hold their breath so expansion injuries are not as big of a concern, although still a possibility. You are going to bend the diver, but bent is better than dead.
One of our instructors was diving a beach in Pennsicola 2 months ago when one of the divers in the group had a heart attack at 35-40 feet. They SHOT him to the surface and got to the beach with in 7 minutes. The diver was not breathing and didn't have a pulse. They did CPR for 20 minutes until EMT's got on scene. He survived and is home with his family today. You dont always get a happy ending like this one, but sometimes you do. Debbie you are my Shero.

Let me state that I am not an instructor so my comments should be taken in that in that context. I have, however, received training from multiple agencies regarding unconscious diver rescue (and off the top of my head, five instructors) so although I felt the need to qualify my opinion, I don't think I need to hold it back .

I had a few concerns with some basic premises in this post:

• I've never been taught to assume that second stage is out; rather, I check to see if it is out, if it is, leave it out, if it is not, hold it in and ensure the neck is extended.
• The standard I've been taught is to get negative and make a controlled ascent using the victim's BCD.. I would never consider dropping anyone's weights as the last thing I would want to do is create a situation that has the potential to be out-of-control.
• Finally, as this board is read by literally thousands of people, I have to weigh in on this idea of "shooting" people to the surface even though I am qualifying myself as just a diver and not an instructor or anything... Can I suggest looking at it differently? (and just for ease of math, let's assume the diver referenced was at 30 feet):
  • A normal ascent speed (without safety stop) from 30 feet would be, depending on one's opinion, 30 or 60 seconds (or somewhere in between). So let's take the faster of the two controlled ascent speeds, 30fpm.
  • Assuming "shooting" someone to the surface from 30 feet would take approximately, what - 10 seconds? So we are talking about a delta of 20 seconds.
  • So ... my question is, is the extra 20 seconds of benefit on the surface, that would be achieved from "shooting" someone to the surface in 10 seconds, really going to make a big difference, vs. taking 30 seconds for a controlled ascent? Risking AGE, certainly... and potentially (but less likely) some sort of bends... for 20 seconds... doesn't add up to me. Even when talking about deeper (recreational) dives, while I agree that getting someone up IS important, I would argue that getting them up in a controlled fashion is critical. And yes, you can cure bent but you can't cure drowned... but you also can't cure embolised (Not sure that is a word, but you know what I mean).

I am very very glad there was a good outcome for this person referenced in the quoted post, and perhaps I am just reacting strongly to the verb "shot"