Rescue Course -- Should it be changed?

[ktkt]

For all of you who say it takes just a few seconds -- zip/zap -- to take a BCD off a diver don't appear to have:

a. Done this in cold water;

b. Done this with dry gloves (or heavy wet gloves);

c. Done this with a diver in a dry suit; and

d. Done this with a BCD you've never seen before.

It really isn't that easy some times.

Actually, I did my rescue course in Monterey in a 7mm suit and thick gloves, and took gear off several divers with BCDs not quite like mine.

Granted, the drysuit hose would be an extra step, and I'm not sure someone with no drysuit experience would know what to do with it (it pops on/off just like your BC inflator hose, if you don't know), and I've previously worn gloves that made it something of a challenge to manage even my own gear (not dry gloves, but the lobster claws for really cold water), so I can see how those could pose problems.

But none of it is rocket science, and with a bit of practice it shouldn't be too hard to kick while using your hands and brain to do other stuff. Admittedly, I had an easier time of it than some of my classmates did, but I have also done more dives than all of them, and I still don't have a regular buddy, so I am checking out the equipment of new buddies a lot.

Still learning from the thread, though

You will, most likly, find a Z knife or shears on their rig and use that to cut off the rig off them. It can be faster than screwing around with buckles.

Hmm, or my own. I'm not sure that would have occurred to me, but of course it makes sense.

 

[jaycanwk]

I have said this before. Since breathing is installed deep in the brainstem (and patients in cardiac arrest will continue to show what's called agonal breaths for a period of time), a patient who is not making any attempt to breathe has experienced major central nervous system shutdown. Yes, this can occur from hypoxia or hypercarbia . . . but by the time the patient stops trying to breathe, generally he is either in cardiac arrest, or very close to it. The "close to it" part is why I think a couple of rescue breaths is completely appropriate -- not to mention the fact that stimulating the airway may cause some reflex to cough or gasp. But if two or three rescue breaths doesn't gain any response from the victim, I think you make the assumption that there's no circulation to the brain, and your next imperative is to restore that. You cannot do that in the water, so get the person OUT of the water as fast as you can.

I think the practice of giving rescue breaths while trying to tow is so unlikely to provide benefit to the victim that it should be dropped. JMHO.

As a Lifeguard, we were trained to do just that, get them out of the water ASAP, since chest comptressions in the water are not as effective than on a hard surface and you can also better deal with clearing airway obstruction.

 

[haumana ronin]

Very rarely will a diver be unsupported when conducting a rescue. There'll normally be people/staff on the boat. IMHO, removing kit in the water isn't critical under those circumstances - one or two grown men can easily haul a diver, with kit, out of the water. In many ways, having the kit in place makes it easier, because there is something to haul on.

IF unsupported and IF the rescuer is considerably outweighed by the victim, then yes... kit removal is something to be considered. IF not, it's a potential waste of time... and best deferred until proven necessary.

Its a cost-benefit analysis of probable time used vs probable time saved right? If the boat is near, then the time saved would likely not be enough to offset time used. If the boat and crew was RIGHT there, then maybe forget about everything and just get them on board for better breaths and compressions.

*slight hijack* Has anyone measured the O2 content of a freaked out, maybe tired, maybe breathing shallowly, probably ascended too quickly, rescuer buddy? I know the textbook answer is 16% but that is on land and maybe even relaxed deep breathing.

An assumption that could kill them.... if breathing shallow/slow and you don't notice that (easy).

That's a very rare thing and tends to involve very cold water. There's too many proven 'cons' and no certain 'pros' to it.

Putting the reg back in was attempting to cover this case. And the dive reflex is almost guaranteed to happen if the water is at least cool. I think around 70F is where it begins to kick in. I dont know if there is some kind of hysteris where its 70ish to turn on, and 75ish to turn off; maybe it turns off and on in a very narrow range. The water's temperature below that changes the speed and intensity of it. The only question is if its enough.

Every rescue course I run involves a stop-watch. Students learn pretty quickly that they don't have time to waste... and a 'few seconds here' and 'a few seconds there' makes a lot of difference over the whole scenario. Enough difference to potentially save, or cost, a life.

That is what I am wondering about; if there is a way to slow the stopwatch. Sorry to bring this from one side of the discussion to the other.

You will, most likly, find a Z knife or shears on their rig and use that to cut off the rig off them. It can be faster than screwing around with buckles.

Great idea, never thought of that one. Though with my regular knife, I might just end up stabbing the guy. Hope he has a better cutter.

3) EMS providers are taught to remove the victim from the hazard, prior to initiating care. Attempting medical procedures in atmospheres not conducive to human life not only adds more difficulty to a procedure with an already grim success rate, but also puts the rescuer at increased risk. A dead rescuer isn't a rescuer at all. They are another victim.

I think I would place myself at a little risk if it was someones only chance. As a non-pro, I would only be "rolling the dice" once or twice in my life as opposed to a pro rescuer who rolls the dice every time they go out.

For all of you who say it takes just a few seconds -- zip/zap -- to take a BCD off a diver don't appear to have:

a. Done this in cold water;

b. Done this with dry gloves (or heavy wet gloves);

c. Done this with a diver in a dry suit; and

d. Done this with a BCD you've never seen before.

It really isn't that easy some times.

You are right, I have never tried in the cold or with cold gear, though ktkt says it is not much harder. But as for point d, maybe add "hey where are your BCD quick releases?" to your insta-buddy check. I might start doing that actually. A few weeks ago I had an instabuddy in a Ranger and I would not have had a clue where anything was, now that I think about it. And as Bob DBF said above, one could use a cutting device.

Some interesting thinking. But keep it just at that. I would be VERY careful about conducting a rescue using unproven/unstudied techniques. CPR has and is been carefully studied and adjusted for best results. These ideas go way outside the bounds of the variations (strip gear, don't, breath through the whole tow, only for a few breaths) being discussed here.

Yeah, saying it was out of the box thinking might not have been enough of a disclaimer. Could have stated "This is a thought experiment, so..." and "dont try this at home." I would not attempt the face down approach if it actually happened near a boat or shore ...yet. But if we did a quarter to a half mile surface swim out, or if I surface and cannot find the boat in any direction....

Somebody give me 2 million dollars. I want to run this experiment. :geek:

:zen:

 

[ktkt]

You are right, I have never tried in the cold or with cold gear, though ktkt says it is not much harder. But as for point d, maybe add "hey where are your BCD quick releases?" to your insta-buddy check. I might start doing that actually.

Actually, I would even say that in one sense at least, things are easier in coldwater gear (at least wetsuits and neoprene drysuits) -- once you've stripped gear, buoyancy on the surface is trivial.

Peter, can you clarify how you would expect things to be harder? Of course unfamiliar equipment (especially something like a drysuit hose or a crotch strap, which many divers might not expect) takes a little extra time to process.

As for gloves... Well, I mentioned having used the lobster claws before, but I doubt I will use such gloves again, as I was very uncomfortable with the difficulty of using my hands to do anything. It seems to me that if it's too hard for you to quickly strip gear off someone else while wearing your gloves (or any other gear restricting your mobility noticeably), it's probably not very safe to be diving in them at all, as you'd have similar dexterity issues managing your own equipment.

 

[Peter Guy]

Re cold water gear dexterity: It is my experience, in diving in both cold water with dry gloves (usually) and wet gloves (some times) and warm water (bare hands) that cold water just makes hand dexterity harder. With dry gloves working with fasttex (sp?) clips I've found the gloves can make using the clips difficult (feeling is lost, gloves can get caught in clips, etc.). I certainly see students using gloves having difficulty with their clips -- and they know where everything is. Also, if toward the end of a dive, hands are typically cold and with a loss of feeling (something that students often mention when doing the Open Water "doff and don" exercise).

And yes, this DOES make for a possible safety issue if one needs to strip gear -- but it is one of those compromises I'm willing to make in order to dive in mid-40 degree F water.

Also, one shouldn't ignore the bulk of cold water exposure protection vs. warm water suits. Movement may well be more limited with heavy gear vs. warm water gear.

Maybe I'm just making excuses -- I don't think so but I'm willing to accept that premise.