The Iceni
Medical Moderator
Hi Mike,
It must have been, but I cannot fully explain it.
Cold + stress ??
It must have been, but I cannot fully explain it.
Cold + stress ??
Rescues and bouyancy control
- Thread starter Big-t-2538
- Start date
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holdingmybreath
Contributor
Interesting subject. Aren't there many reasons one might experience a laryngospasm with the bodies natural defense against taking water into the lungs?
Maybe a good way to find out if the airway is open is to do a simple mouth to mouth, or a heimlich manuever.
A good thread to have given me something to think about.
Maybe a good way to find out if the airway is open is to do a simple mouth to mouth, or a heimlich manuever.
A good thread to have given me something to think about.
The discussion above is interesting to me because it points out that a lack of knowledge of the "right" treatment might cause people to not act at all! As a former Pararescueman, we were taught to act in an emergency situation. There are two priorities:
1. Remove the victim from the life-threatening situation.
2. Treat the medical problems.
If a person, no matter the cause, is at depth, unconscious, with the regulator out of his or her mouth, then that person must be removed from the life-threatening situation. Replacing the regulator would be the first action, but it may not result in breathing on the victims part. At this point, the person should be moved to a place that can sustain life--probably the surface. Then the victim's medical problem can be treated. But if the person is not removed from the life-threatening environment, then there is no chance of survival.
Part of the problem I have with technical diving is that they dive decompression dives without the life-support equipment to sustain them if an emergency requires that they surface without the decompression they must have. Therefore, if something happens underwater, and there is no choice but to surface, they automatically are in double-jeopardy. The diver cannot live at depth (for one reason or another), and they also cannot surface; they are diving a razor's edge and have fallen off. In the safety language, this is a single-fault situation that can be catastrophic.
If the technical divers were really concerned about these things, there would be recompression chambers available on their boats, or at the cave sites. Hopefully, some do have recompression chambers now. But relying on oxygen and helicopter evacuations is not a real solution to this problem.
To illustrate this concept a bit better, let me give an example. One of the Pararescuemen who trained me in 1967 had already received the Silver Star for a rescue in the Gulf of Tonkin. He was an aircrew member in an HU-16B "Albatross" amphibian aircraft that had landed within sight of the North Vietnamese coast to pick up a pilot who had bailed out of his crippled jet. Eldridge "Butch" Neal swam from the plane after it had landed on the water to retrieve the pilot. The pilot panicked, and started fighting Butch (he probably was hurt, and in shock). It didn't help that there were artillary shells landing around the aircraft. SSgt. Neal took out his diving knife and hit the pilot in the jaw, knocking him out. He then towed the pilot to the aircraft, and it took off under fire. They made it out. After our training, I asked Neal about that, and asked him how he knew which end of the knife to hit the pilot with. He replied to me that at that point he didn't care. They needed to get him recovered, and get out of there.
To some extent, this applies to diving too. We go down with limited gas supplies, in a hostile environment, and are time-limited. At times, we simply cannot treat in the water. What I am seeing here are arguments about treatment, without first realizing that the victim must first be evacuated. We must get the person to a life-sustaining environment, then deal with the medical emergency.
SeaRat
1. Remove the victim from the life-threatening situation.
2. Treat the medical problems.
If a person, no matter the cause, is at depth, unconscious, with the regulator out of his or her mouth, then that person must be removed from the life-threatening situation. Replacing the regulator would be the first action, but it may not result in breathing on the victims part. At this point, the person should be moved to a place that can sustain life--probably the surface. Then the victim's medical problem can be treated. But if the person is not removed from the life-threatening environment, then there is no chance of survival.
Part of the problem I have with technical diving is that they dive decompression dives without the life-support equipment to sustain them if an emergency requires that they surface without the decompression they must have. Therefore, if something happens underwater, and there is no choice but to surface, they automatically are in double-jeopardy. The diver cannot live at depth (for one reason or another), and they also cannot surface; they are diving a razor's edge and have fallen off. In the safety language, this is a single-fault situation that can be catastrophic.
If the technical divers were really concerned about these things, there would be recompression chambers available on their boats, or at the cave sites. Hopefully, some do have recompression chambers now. But relying on oxygen and helicopter evacuations is not a real solution to this problem.
To illustrate this concept a bit better, let me give an example. One of the Pararescuemen who trained me in 1967 had already received the Silver Star for a rescue in the Gulf of Tonkin. He was an aircrew member in an HU-16B "Albatross" amphibian aircraft that had landed within sight of the North Vietnamese coast to pick up a pilot who had bailed out of his crippled jet. Eldridge "Butch" Neal swam from the plane after it had landed on the water to retrieve the pilot. The pilot panicked, and started fighting Butch (he probably was hurt, and in shock). It didn't help that there were artillary shells landing around the aircraft. SSgt. Neal took out his diving knife and hit the pilot in the jaw, knocking him out. He then towed the pilot to the aircraft, and it took off under fire. They made it out. After our training, I asked Neal about that, and asked him how he knew which end of the knife to hit the pilot with. He replied to me that at that point he didn't care. They needed to get him recovered, and get out of there.
To some extent, this applies to diving too. We go down with limited gas supplies, in a hostile environment, and are time-limited. At times, we simply cannot treat in the water. What I am seeing here are arguments about treatment, without first realizing that the victim must first be evacuated. We must get the person to a life-sustaining environment, then deal with the medical emergency.
SeaRat
leadweight
Contributor
Sea Rat,
Not only are some of the technical divers under a decompression ceiling, they are under 70 feet of limestone half a mile back in a cave someplace under Florida. If something goes wrong they must extract themselves before deco and surfacing.
Smoetimes people miss the obvious. Just tell them its dangerous and watch the flames.
By the way, I was tought at rescue to bring the diver up in a controlled ascent, if possible.
Not only are some of the technical divers under a decompression ceiling, they are under 70 feet of limestone half a mile back in a cave someplace under Florida. If something goes wrong they must extract themselves before deco and surfacing.
Smoetimes people miss the obvious. Just tell them its dangerous and watch the flames.
By the way, I was tought at rescue to bring the diver up in a controlled ascent, if possible.
As far as my training has gone the human body relaxes after a seizure. There has never been any information passed to me that after an o2 tox seizure the body locks up and blocks the air way.
I'm under the impression that the seizure works the body at such a fast pace that the muscules finally fatique and quit working. If that is the case they would be unable to contract small enough to close off the air way.
Also during the seizure the increased muscular activity is actually burning off as much oxygen as they can which would lower the levels below toxic. This leads me to believe that if the victim did not breath more in after the seizure and quit breathing all together a second seizure would be quite unlikely.
Obviously I missed something important. I understand the above is very simply stated and the human body is not that simple so could someone tell me what blocks the air after an o2 hit.
Thanks! Hallmac
I'm under the impression that the seizure works the body at such a fast pace that the muscules finally fatique and quit working. If that is the case they would be unable to contract small enough to close off the air way.
Also during the seizure the increased muscular activity is actually burning off as much oxygen as they can which would lower the levels below toxic. This leads me to believe that if the victim did not breath more in after the seizure and quit breathing all together a second seizure would be quite unlikely.
Obviously I missed something important. I understand the above is very simply stated and the human body is not that simple so could someone tell me what blocks the air after an o2 hit.
Thanks! Hallmac
I have attended to several people in a grand mal seisure. If my memory serves me right, I do not recall any of those victims of seisure (topside, not underwater) being cyanotic (blue from lack of breathing). I know that I had to control arm movements, and that the seisure lasted 3-5 minutes. I caution that these observations were for victims in epileptic grand mal seisure. They were in regular settings, not underwater.
If these observations hold true for the oxygen-induced seisure, then I cannot say that breathing would be impared during the seisure. This line of reasoning would seem to indicate that an embolism from moving a seizing diver may not be as inevitable as indicated by some on this thread. But, I am not a doctor, nor am I a researcher. These are simply observations from a one-time practitioner of emergency medicine as a paramedic.
The main problem then, would be loss of the mouthpiece grip on a regulator. This can be prevented by the use of a full-face mask (FFM).
All my rescue work relied heavily on highly coordinated communications between a team of individuals. In most cases, this was between the pararescuemen on the ground and an aircraft or helicopter. Sometimes, we gained the advise of a flight surgeon via radio communications. The point is that without these communications, more people would have died.
In my safety work in the forest products industry, I worked hard to have FM radio communications accepted by loggers. Up until the 1980s, the only communications were with whistle signals from a tower up on the hill. The people on the ground hooking the logs could give radio whistle signals, but they were limited to about 6 different signals for how to spool in or out the lines. With the advent of a FM radio net, all the individuals could talk to one another, coordinate activities, and get the job done much more safely.
I think it is time for the technical divers to consider using the more advanced technologies to aid their explorations, and their emergency responses. These technologies include radio communications and FFMs. Believe it or not, there are ways to make gas switches that do not involve taking off a FFM too (or if they have not yet been developed for dive equipment, they could be). These are quick disconnects on different hoses.
Remember, we did not get to the moon using pressure suits made for jet fighters. As technical divers push the limits of exploration, as stated above, they need to equip themselves according to the new hazards.
SeaRat
If these observations hold true for the oxygen-induced seisure, then I cannot say that breathing would be impared during the seisure. This line of reasoning would seem to indicate that an embolism from moving a seizing diver may not be as inevitable as indicated by some on this thread. But, I am not a doctor, nor am I a researcher. These are simply observations from a one-time practitioner of emergency medicine as a paramedic.
The main problem then, would be loss of the mouthpiece grip on a regulator. This can be prevented by the use of a full-face mask (FFM).
All my rescue work relied heavily on highly coordinated communications between a team of individuals. In most cases, this was between the pararescuemen on the ground and an aircraft or helicopter. Sometimes, we gained the advise of a flight surgeon via radio communications. The point is that without these communications, more people would have died.
In my safety work in the forest products industry, I worked hard to have FM radio communications accepted by loggers. Up until the 1980s, the only communications were with whistle signals from a tower up on the hill. The people on the ground hooking the logs could give radio whistle signals, but they were limited to about 6 different signals for how to spool in or out the lines. With the advent of a FM radio net, all the individuals could talk to one another, coordinate activities, and get the job done much more safely.
I think it is time for the technical divers to consider using the more advanced technologies to aid their explorations, and their emergency responses. These technologies include radio communications and FFMs. Believe it or not, there are ways to make gas switches that do not involve taking off a FFM too (or if they have not yet been developed for dive equipment, they could be). These are quick disconnects on different hoses.
Remember, we did not get to the moon using pressure suits made for jet fighters. As technical divers push the limits of exploration, as stated above, they need to equip themselves according to the new hazards.
SeaRat
I'm like you I have dealt with more seizures than I can remember and not once have the airways locked shut after the seizure.
This thread is about helping someone who has suffered an 02 hit and blacked out on the bottom. I keep hearing that the 02 causes a locked air way that prevents the victim from being brought/sent to the surface. I still can't believe that.
I understand that you don't send them up until the seizure has ended but once they have gone comotose the body relaxes and the airway opens. At least that is what I have experienced.
This is what I need clarification on.
Does the airway remain locked after 02 tox seizure has ended and for how long?
Hallmac
This thread is about helping someone who has suffered an 02 hit and blacked out on the bottom. I keep hearing that the 02 causes a locked air way that prevents the victim from being brought/sent to the surface. I still can't believe that.
I understand that you don't send them up until the seizure has ended but once they have gone comotose the body relaxes and the airway opens. At least that is what I have experienced.
This is what I need clarification on.
Does the airway remain locked after 02 tox seizure has ended and for how long?
Hallmac
OK! got my answer thanks again doc.
Hallmac
Hallmac
holdingmybreath
Contributor
And the answer was?
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