Rescue Skills

[ancl]

Spent most of yesterday at Gildenburgh doing BSAC Sports Diver training with the branch I've just joined, got me thinking afterwards about rescue scenarios, doing controlled lifts, AV on the surface etc, its great having the victim lying on his side, reg in his mouth, breathing, but what would you do if you come across a diver on the bottom, motionless, no reg in mouth ?

From what I learnt yesterday and common sense ( but would I remember this in a real event ) I think I would do the following...what do you think ?

Check diver for a response ?

Check diver's SPG, if there's air, use diver's bcd for the CBL, if not use my bcd for the lift, whilst attempting to dump air from both bcds, suits.

Would you try and put the DV back into the diver's mouth and purge ? or not attempt this ?

Would air from the lungs exhale through the nose / mouth without some assistance from the rescuing diver ( pushing the stomach to get a reflex ? ) ?

Would you attempt a safety stop ?

Get to surface, get diver positive buoyant, administer first AV, then get yourself positively buoyant, call for help and continue AV whilst starting surface tow ?

Apologies if this is not the right time to discuss, I emailed the branch training officer last night asking the same sort of questions, but would be interested in hearing other peoples views.

Thanks and regards
Andy ( ancl )

[John N]

PADI is clear on some of these questions:

If they're motionless without the reg then the briefest of response checks would be needed I would think.

It's not worth putting the reg back.

You need to get the victim to the surface as rapidly as possible, however your safety is the most important thing.

You would take a judgement on any stops you need to make but a safety stop, as it is not necessary wouldn't usually be done. Obviously a safe ascent rate would be used.

You could use either BCD for lift, but I would use the victim's if possible.

The first thing I would do on the surface is make sure that we were both positively buoyant.

Enjoy.

[louigi]

youwill find that the victim will automaticaly vent air throughout the lift should the body still contain any.
you can try to reinsert the reg but only if you feel capable of holding onto so many bits of kit it becomes one hell of a juggleing act. You can control the lift from the back and hold in the reg this is actualy quite the easeyist of ways to undertake the controlled boyant lift. on reaching the surface you should first make sure you are both positively boyant. Befor comencing AV. another good reason for working from the back of the victim is that should they be lucky enough to regain conscouisness they may start to panic, they are less likely to injur you or knock your reg out. Safety stops can be missed that is only if you are in a non stop dive. However should you have gone into deco then you must make sure you compleate within reason your stops. As one victim/casualty is more than enough. that said you will always rely on your own judgement for this problem. Hope this helps a bit glad to see youve come in from the cold. Hope you enjoy your new club.
PS. there is never a wrong time to ask this sort of question.

[chrisch]

Originally Posted by ancl

what would you do if you come across a diver on the bottom, motionless, no reg in mouth ?

Pinch their kit.

[Dr Stevil]

Check diver for a response ?

I'd say that's fairly unnecessary

Check diver's SPG, if there's air, use diver's bcd for the CBL, if not use my bcd for the lift, whilst attempting to dump air from both bcds, suits.

No point in checking the SPG, you'll know as soon as you try his inflator, so it's just wasting time. You should have already been shown a way to do the CBL which automatically takes care of the two suits/two bcd conundrum. If you haven't and you're at Anglesey I'll show you what I mean as it'd take too long to describe in text.

Would you try and put the DV back into the diver's mouth and purge ? or not attempt this ?

Absolutely not

Would air from the lungs exhale through the nose / mouth without some assistance from the rescuing diver ( pushing the stomach to get a reflex ? ) ?

In the situation you've described the primary concern is excessive hypoxia and the neuronal damage that entails, so concerns over barotrauma are relatively inconsequential by comparison

Would you attempt a safety stop ?

If it's a non-deco situation, absolutely not. If you've got deco obligations then pop both your regular and emergency dSMBs which will (hopefully) attract the attention of your surface cover, then drop the casualty's weight belt when you're at your 6m stop and let the surface cover deal with it, no sense in creating two casualties

Get to surface, get diver positive buoyant, administer first AV, then get yourself positively buoyant, call for help and continue AV whilst starting surface tow ?

Make yourself buoyant first, call for help before starting AV - why? because the chances are that a few seconds delay in commencing AV isn't going to make much difference, eg how long has he been down there ? Over 5 mins hypoxia and you can expect significant neuronal damage (under normal conditions).

Apologies if this is not the right time to discuss, I emailed the branch training officer last night asking the same sort of questions, but would be interested in hearing other peoples views.

On the contrary, this years relative plethora of fatalities means this topic should be more frequently discussed.

Lets be candid about this, we are taught a bunch of correct procedures for certain situations, the one you've described is thankfully less common than the ones we train for, so it is acceptable, nay even mandatory, to change the procedure, as to stick to a fixed pattern of behaviour (which may later be seen to be a bit pointless) could be worse for the rescuer "If only I'd thought to do..."

One thing you probably haven't considered (and there's no reason it should occur to a diver with nothing more than agency-approved medical guidelines) is how to increase the possibility of halting his hypoxic neuronal damage. One fortunate aspect of UK waters is that they're cold, so in this situation you would help any possible recovery by getting his hood off ASAP, and I mean while you're underwater. The extra cold will increase that five minute window and could make the world of difference.

Why am I suggesting this ? Not only because this subject is something I've covered in my lab work, but also because a diver called Paul Thomas (himself a medical doctor) spent about 20mins without air in (IIRC) Stoney. It was believed by the medical staff that brain damage was inevitable. He made a full recovery (following a considerable period of coma) and attributed his good fortune to the hypoxic-protective factor of the cold water.

Before anyone starts, no this isn't official policy for BSAC nor any other agency AFAIK, but as someone who works in biomedical sciences, including some work on cellular effects of hypoxia, this is what I would want for myself should I be found unconcious and not-breathing and had likely been so for an undetermined period.

[Paul Oliver]

Hi Andy

Always a good time to ask this one. The emphasis with BSAC training is Buoyency, Vent AV, call for help. Remember the neck extension can by itself often solve the breathing problem. But you have to look at the situation each time, there are good arguments for a variety of priorities.

The vents are very important, as is their quality and the neck extension, but if there is no circulation they do nothing as the oxygen is not getting to the tissues that need it, so getting the case in a position for proper CPR is essential.

Remember DCI can be treated death cannot (generally), i have no problems ignoring safety stops, after all they are an extra stop, 5 min of deco, i'd probably ignore subject to my rate of assent, more i'd send them up. But its an at the time shout you have to make.

I'd also have to consider the amount of time the casualty has been there in my decision makeing process.

Dive Safe and practice those rescue skills,

Paul

[louigi]

Hi steve you out a couple of pointers in there that made me think a bit. especialy the cold one. I think most people have heard or red stories of how the cold shuts down cirtain reactions caused by the lack of oxygen.

However it is still bothering me that we dont seem to be getting the message across that prevention is better than cure.
I know YD has tried to address this problem a little but are we succeeding?
Worried for the future of diving I cirtainly am at present.

Why: I remember the Introduction of the crash helmet law, the restriction to 30mph for mopeds the seat belt law the removal of hand guns from licenced holders. Dont like guns any way, the introduction next year of thermostatic valves so you cant scold yourself.
so you know whats left.

Seems to me that unless we actively promote safety issues we could have it done for us by people who know squat.



Louigi.

[ancl]

Thanks for the responses, I hope I never have to use the drills for real, but think its worth continuing to practice just in case.

ATB Andy ( ancl )

[Odin]

A very close friend of mine was found by the shot line at 40m, unconcious.
His buddy (not me!) ditched the weightbelt inflated the bc and went up with him, letting go at 10m. The casualty was recovered into the boat, airlifted to DDRC. He is still alive and diving today. If a text- book CBL had been carried out it would have taken at least 3 mins to get the casualty to the surface, as opposed to the 1 minute it took.
Always think of ditching the weightbelt as soon as is reasonable to do so. I have seen people practicing/teaching rescue techniques, with no mention of weightbelt ditch.
Get rid of the bloody thing!
Paul

[Jules]

The one thing I remember from my First aid course was about drowning/near drowning... There's no such thing as cold and dead...

Havent ever heard about taking someone's hood off before, food for thought

Jules