Rescue diver, theory vs practice

[TSandM]

jeckyll, that's one of my all-time favorite scubaboard threads. There was SO much good information there.

 

[Diver0001]

You guys are making me blush...

 

[I Dive]

I agree with Diver0001. You never want to risk getting water into the victim's airway (even if they appear drowned).

The second (and maybe more frightening senario) is you put your octo in the victims mouth. You are doing a controlled ESA. The victim becomes responsive. Now they start to panic and you are attached to them. They are not about to give up their air source and they bolt to the surface. Now you have put yourself in grave danger as well. You want to keep the rescue as controlled as possible. If you put your octo in their mouth, you are giving them all the control in the case they become responsive.

The time it takes to ESA with the victim will only be slowed down by trying to put your octo in their mouth and trying to hold it there. In my rescue class I was taught - when you find an unresponsive diver: 1) check their mask in case it is partially filled with water (if so remove it) 2) let the air out of their BC 3) Ditch the weights 4) ESA 5) get the victim buoyant and yourself buoyant 6) GET HELP 7) start rescue breaths and get victim out of the water.

But the most important rule of all: DON'T BECOME ANOTHER VICTIM

I can see your points but I don't totally agree. As I already clarified, I did not mean that I would take a reg out of someone's mouth and replace it with my Octo. I was referring to a victim with no reg in mouth. I don't see how placing any reg, whether it's their reg or my octo, in a victims mouth is going to force water into their airway and it only takes a couple seconds. It seems much more important to have something in their mouth in the event their body engages in the reflex of breathing, hence my though that a reg known to have air is the best option. I am nearly certain that a person will inhale a ton more water if they breath with nothing in their mouth than they will by a reg being placed in their mouth. As far as them being attached to you and a dangerous situation erupting if they become concious and start panicking, I don't see it the way you do. Regardless of which reg is in their mouth, you are equally as close to them. If they become responsive, they are more likely to panic if they are not getting air than if they are, again hence my Octo theory. However, if they do panick, I don't see much difference in how to separate yourself from them between their reg and your Octo. Yeah, your Octo is attached to you, but not having your Octo in their mouth isn't going to make much of a difference to a panicked diver. Either way, they are still going after your air source if they need air and you are still going to have to deal with that. It's great we are able to debate this here and let's all hope this is where it ends for us, debate from the comfort of our own homes or work places and never has to be put into action.

Any sort of rescuing requires rehearsal and fine tuning to keep it as efficient and effective as possible and in my opinion the certifying agencies have kind of dropped the ball here. I think most of the Rescue class as we know it needs to be incorporated into the Open Water course so all divers have general exposure to it. From there, those that want more training in it could take a bit more advanced course and DM's and Instructors an even more advanced course, with regular refresher courses required.

 

[dumpsterDiver]

It sounds like you made very good use of the resources at hand. In my experience, during a real emergency all the divers are at risk due to the imperfect communication, I would be especially worried about a distracted boat operator rushing to aid the victim and running over another diver from another team who was forced to ascend due to air limits.

You could have mapped out a safer and more organized plan, but it sounds like even 60 seconds more of a delay would have resulted in the death of the victim.

I personally probably would have sent out a snorkeler rather than a scuba diver, but in this situation that would have been the WRONG strategy.

 

[peteytheweasel]

This is a real good learning experience for all divers. Perhaps one of the dive magazines will publish stories like this in addition to Lessons For Life.

 

[pgcosta]

Diver0001, thanks for your excellent post!! It is in real world situations, when we can't go backwards and do it again to correct a mistake, that we put all our skills and our experience in check. Looks like sometimes the book has some blank or missing pages and it falls on our hands to try to write them the best we can... no erasers, though!!

I'd like to ask for your permission to translate the original post (and maybe some reasonable questioning from other experienced divers) into Portuguese language, so that we can discuss it as a case study at the scuba school where I am currently undergoing my "going pro" training.

Glad to know the victim is alive. Hope for quick and complete recovery!

 

[Diver0001]

Diver0001, thanks for your excellent post!! It is in real world situations, when we can't go backwards and do it again to correct a mistake, that we put all our skills and our experience in check. Looks like sometimes the book has some blank or missing pages and it falls on our hands to try to write them the best we can... no erasers, though!!

I'd like to ask for your permission to translate the original post (and maybe some reasonable questioning from other experienced divers) into Portuguese language, so that we can discuss it as a case study at the scuba school where I am currently undergoing my "going pro" training.

Glad to know the victim is alive. Hope for quick and complete recovery!

Feel free. I put it out there so people could learn from it.

R..

 

[pgcosta]

Thank you very much!!!!

 

[rleslie]

R

You have presented an excellent, objective account of the rescue. As a fairly new diver (42 dives) I have never considered going beyond my present AOW cert. After reading this thread, my next dive vacation in Febuary WILL include taking the Rescue Diver course. You, and the other posters, have made it abundently clear that a recue involves much more than just the DM or instructor.

Thank you to all!!!!
Roger

 

[HBO MD]

This is an excellent and informative thread. The efforts made by Diver0001 and the participants are to be applauded : thank you.
I really just want to make a point regarding emergency situations which often eclipse the demands of the patient/victim, and that is our own level of anxiety and urgency. I can assure you that this occurs whether you are in an Intensive Care Unit or out in the community. Maintaining your senses is vital if life is to be saved. I have had the fortune/misfortune/misadventure or whatever you may call it to participate in rescues and cardiac emergencies for almost 30 years now on an almost daily level and nothing changes : people panic and chaos rules. Once the patient is oxygenated/ventilated you have much more time than you realize to thoughtfully respond to the demands of the clinical situation. This will not be neat as is experienced in a classroom with a mannequin. On the contrary, people will be struglling to assimilate the facts and hopefully the medical history of the patient. They will be battling to take charge or counter possible maneouvers. Again, this happens in the hospitals daily. Not through malice, but through panic.
If , I may :
firstly, try to identify those with experience to manage the medical resuscitation
secondly, try to pick a leader of the resuscitation
thirdly, give specific jobs to those individuals, such as airway, CPR, etc.
fourthly, be methodical, don't leap from one course of action to the next
fifthly, round up those privvy to the facts of both the incident and anyone who may know the patient
sixthly....be prepared for the reality of an emergency. The above case of bloody frothy sputum, is classic for pumonary edema, ie the fluid that fills the lungs after a cardiac arrest.
Seven, you may well have to improvise. Oxygen etc is not always available at catastrophes such as this. You may only have to rely upon wits and traditional CPR. Work with your buddies, switch if you get tired etc.
And finally...for most of you, none of this is reflex. It requires practice. Lots of practice and preparation. There is nothing worse than a well intentioned individual who administers CPR incorrectly and adds injury to insult.

This was all summarised some time ago by physicians who said, "...the first rule of a cardiac arrest is to take your own pulse."

Stay safe.