Hello Otter-Cat...
1)" For use in the possible instance where it may be the best or only option...I know this may be a rare case, and in fact I'm not sure what that case would be. Possibly at sea, while a rescue boat is coming to you??? When the boat is gone?"
I agree that in-water rescue breathing should still be taught, though with much less emphasis as is current practice. There are instances where the procedure might be effective:
> A witnessed near-drowning diving casualty who is retrieved shortly after cessation of breathing ( ie: a panicked diver on surface who slips below & drowns but is retrieved & resurfaced very quickly...in less than one minute )
> A situation where assistance is considerably delayed ( surfacing a long distance from the boat, no boat available, no immediate help available etc., etc. ). In such situations it is likely that cpr must be attempted as well. Such efforts are extremely exhausting & the rescuer must not compromise their own safety in what probably is a futile, though commendable attempt to render assistance.
Have you ever tried to do actual mouth-to mouth resucitation in the water? Forming a proper seal around the casualty's mouth is difficult on dry land; it is extraordinarily difficult to do it effectively in the water. Another problem is gastric distension. Too vigorous ventillation will put alot of air in the casualty's stomach. The danger of vomiting & aspiration of vomitus into the lungs is a very real possibility, as is choking...add the "Heimlich Manuever" to the list of tough techniques in-water. V.S.A. patients are intubated as quickly as possible in the field as it precludes the possibility of air entering the stomach.
"It's just more learning how to deal with gear better, and how to deal with complexity, which, while best minimized in a real rescue situation, is something which most real rescue situations will provide plenty of."
I disagree on this point Otter. I think the major problem with current rescue training is the complexity of the procedures themselves. We need to take a simpler, common sense approach to problem solving. If our over-riding concern is effective resucitation, then fascilitate that process by the most expedient method for those circumstances, which might mean stripping some or all of the casualty's gear &/or your gear to expedite casualty removal from the water. Or, it may mean a hard, fast tow to the boat without hesitation, or some combination of both. There are no hard & fast "thou shalt do this" kind of rules in these situations.
Another subject of contention for me is the inter-action of a rescuer with a fully panicked diver, either on surface or underwater. Under NO circumstances should a rescuer get within arms reach of such an individual. On surface, you have two choices: stand-off & wait till they exhaust themselves; or, if you are certain of your abilities, submerge, come in from behind, grasp the cylinder valve as you grip the cylinder with your knees, rear back & inflate your b.c.d., talk them calm as you inflate their b.c.d. ( ditch their belt only after they've relaxed ). Underwater, your options are very limited. If they come upon you from behind, your in a fight for your life ( there is an organization in Hawaii that teaches martial arts techniques to diving leaders for just such situations ). If you are facing them, its decision time. There is NO safe way to interact with someone who is insane with fear. All you may be able to safely do is stay with them at a safe distance as they claw their way to the surface. It is an extremely hazardous situation to be in.
I commend all divers who volunteer their time to learn rescue training. I applaud those who recertify regularly & practice occassionally to keep their skills up. With more such individuals, the recreational diving world would be a safer realm indeed.
Regards,
D.S.D.
1)" For use in the possible instance where it may be the best or only option...I know this may be a rare case, and in fact I'm not sure what that case would be. Possibly at sea, while a rescue boat is coming to you??? When the boat is gone?"
I agree that in-water rescue breathing should still be taught, though with much less emphasis as is current practice. There are instances where the procedure might be effective:
> A witnessed near-drowning diving casualty who is retrieved shortly after cessation of breathing ( ie: a panicked diver on surface who slips below & drowns but is retrieved & resurfaced very quickly...in less than one minute )
> A situation where assistance is considerably delayed ( surfacing a long distance from the boat, no boat available, no immediate help available etc., etc. ). In such situations it is likely that cpr must be attempted as well. Such efforts are extremely exhausting & the rescuer must not compromise their own safety in what probably is a futile, though commendable attempt to render assistance.
Have you ever tried to do actual mouth-to mouth resucitation in the water? Forming a proper seal around the casualty's mouth is difficult on dry land; it is extraordinarily difficult to do it effectively in the water. Another problem is gastric distension. Too vigorous ventillation will put alot of air in the casualty's stomach. The danger of vomiting & aspiration of vomitus into the lungs is a very real possibility, as is choking...add the "Heimlich Manuever" to the list of tough techniques in-water. V.S.A. patients are intubated as quickly as possible in the field as it precludes the possibility of air entering the stomach.
"It's just more learning how to deal with gear better, and how to deal with complexity, which, while best minimized in a real rescue situation, is something which most real rescue situations will provide plenty of."
I disagree on this point Otter. I think the major problem with current rescue training is the complexity of the procedures themselves. We need to take a simpler, common sense approach to problem solving. If our over-riding concern is effective resucitation, then fascilitate that process by the most expedient method for those circumstances, which might mean stripping some or all of the casualty's gear &/or your gear to expedite casualty removal from the water. Or, it may mean a hard, fast tow to the boat without hesitation, or some combination of both. There are no hard & fast "thou shalt do this" kind of rules in these situations.
Another subject of contention for me is the inter-action of a rescuer with a fully panicked diver, either on surface or underwater. Under NO circumstances should a rescuer get within arms reach of such an individual. On surface, you have two choices: stand-off & wait till they exhaust themselves; or, if you are certain of your abilities, submerge, come in from behind, grasp the cylinder valve as you grip the cylinder with your knees, rear back & inflate your b.c.d., talk them calm as you inflate their b.c.d. ( ditch their belt only after they've relaxed ). Underwater, your options are very limited. If they come upon you from behind, your in a fight for your life ( there is an organization in Hawaii that teaches martial arts techniques to diving leaders for just such situations ). If you are facing them, its decision time. There is NO safe way to interact with someone who is insane with fear. All you may be able to safely do is stay with them at a safe distance as they claw their way to the surface. It is an extremely hazardous situation to be in.
I commend all divers who volunteer their time to learn rescue training. I applaud those who recertify regularly & practice occassionally to keep their skills up. With more such individuals, the recreational diving world would be a safer realm indeed.
Regards,
D.S.D.
