[Jay]

Imported post

Ok - hypothetical scenario:

You are diving with a buddy and have both incurred a 30 min deco penalty. Your buddy suddenly loses consciousness and you start effecting rescue procedures. Do you:

1. Take him to your deco depth and keep him there for the duration of the deco requirements?

2. Both surface immediately and risk getting bent?

3. Go to your deco depth, ensure his reg is in and send him to the surface while staying to complete your deco and hope that the surface support will take over?

4. Do something else?

Lets assume that this is a boat dive so you have surface cover.

I can't think of any RIGHT answer for this one because I don't believe there is one. Your thoughts please!

 

[Big Steph]

Imported post

Good question Heads Up.  I would risk bringing the unconcious diver to the surface at the correct rate of ascent, get the skipper to radio coastguard regarding deco chamber.

Reasons are:

1. The diver could have had a heart attack, therefore may be dead already.  However if the divers condition improves at or near the deco stop, it may be feasable to do stops.

2. Bends can be treated, death can't.

3. Definately not.

It would be interesting to hear responses from others regarding this dilema.

Big Steph.



(Edited by Big Steph at 1:14 am on Nov. 1, 2002)

 

[andy2tanx]

Imported post

you've got surface cover, you have a dsmb in the correct emergency colour (yeah right!), so go for the surface, dump your buddy with the guys on top and head back down to finish your deco.

 

[MATTBIN]

Imported post

Totally hypothetical for me as my Buddy is my son and we dont do deco, BUT I'd have to take him to the surface and risk getting a hit myself. However if it was not him and it was a mate I knew well then same rules. Some guy I just met on the boat, I think I'd make the call at the time and I'd have to know more about the penalty I was going to pay, its selfish but better one dead than two, trouble is my personal style is always to be the damnn hero and do the 'correct' thing which is obviously to get the buddy to the surface and attempt resuscitation. I think you'd make the call at the time and it would be difficult to evaluate it before the event. My boy went into a slightly quick ascent the other day and I instinctively grabbed him, we could then both of got a hit but I didnt even give it a moments thought.
Matt

 

[Lou]

Imported post

I have to add the caveat that I would never (currently) clock up 30 mins deco (or any, deliberately) BUT I would take them to the surface.  It would be as slow an ascent as I assessed was achievable but there is no way i would send them to the surface unattended.  What if they lost their reg on the way?  If they are unconscious and floating face down on the surface those seconds for the rib to arrive could be the end for them.  You are also submitting an already compromised diver to an uncontrolled, accelerating ascent which is likely to add to their troubles still further.

Keeping a diver down to complete deco is too risky.  You could be just delaying the inevitable (that you have to get him to the surface), you could be killing them (by delaying necessary treatment) and all for the sake of risking a bend, which is treatable.

As for going back down....isn't that, in effect, in-water recompression?  Why bother, if you have O2 on board and one of you is heading for the chamber anyway?

Another interesting dilemma.  Will be good to see the range of views!

 

[Hobby]

Imported post

IMHO,I'd bring them up.I take the liberty of presuming here that we're talking of a "straightfoward" OW dive here,if such a thing indeed exists,as opposed to being 1000ft into a sump etc.
Step one before you do anything is,STOP and THINK.Get the situation assessed rather than flying in feet first.This is common sense so I won't go over it again but it's easy to over react when stressed.
Basically I'd always bring them up.If the casualty is breathing then bring them up at a normal ascent rate (if you're stuck with that just ascend slowly and ensure you don't overtake your exhaled gas,use it as a rough guide).If the casualty is breathing it's tempting I suppose to make a breif stop,however I reckon our main duty is to get medical attention and as Steph says,you can treat a bend......
If the casualty is not breathing an emergency ascent is the call,what other option is there?
Either way the ascent should be assisted,as Bruce Springsteen said,"It's the price you pay!"Seriously speaking though,if we've planned our dives correctly we know where the nearset chamber is etc.and surface cover will immediately swing into carefully rehearsed action...won't they?
This is obviously breif,for more (better)reading on this please look at the below link,it's written by and for US Public Service(Rescue)divers but the basic info's there.Regards all,take care,Hobby.
<a href="http://www.rescuediver.org/rescue-tech/resc-toc.htm

(Edited" target="_blank">http://www.rescuediver.org/rescue-tech/resc-toc.htm

(Edited</a> by Hobby at 10:51 am on Nov. 1, 2002)

 

[Guest]

Imported post

The Scenario is well intentioned but we can only learn or make decisions with specifics.
The scenario is much too vague so the answers will be vague and many so we can't really learn without a very narrow band of what are right or wrong.
Plus are you the diver or Divemaster/Cox / because if you're the diver and I am the COX/Divemaster my decision goes what ever you think. So who are we?
Let's have two realistic well-defined scenarios.
1.Where diving the Pilsidski 20 miles east of Bridlington.
When in a 6m RIB with VHF, SATNAV the full biz.
Twin 50hp Mariners 30knots full speed with our load of divers.
Plenty of Oxygen for two.
All divers have been down and have maximum decompression penalties.
No other boats in the area.
Sea state calm. Light winds.
RAF Leoconfield heliport, standby 15mins. 20 mins average contact time.
I hour to the pot.
Billy the techy wanabe surfaces with his unconscious buddy 30 mins deco to do.
Probable heart attack.  What do you do? You're the Divemaster the surfaced diver wants to go back down?
   





(Edited by Geoff Woodhead at 11:05 am on Nov. 1, 2002)

 

[Hobby]

Imported post

Mmm,off the top of my head.Recall all divers,inform Coastguard and request LOW FLYING bird to medevac out casualties as both will need a table 5 at least,the casualty at this point for certain will also require medical attention.Bird's time is 20mins avge flying time.(Again I'm going to presume that there is'nt enough gas on board for the sufaced diver to complete deco,this would be largely irrelevant really as you would'nt want to sit there for ages even if you had.)Slap the casualty on O2 and proceed with medical assistance.As for your surfaced diver(the Buddy),you could theoretically send him back to 30ft for 15mins and hold him at 15ft till the bird's in sight(aprox 5 mins) while accompanied by another diver(or clipped to a line?).It obviously WILL NOT supplement his deco but it will allow him to continue to off-gas till he could be air lifted out.Alternatively you could put him on surface O2 too,but personally(I stress that!)were it me,I'd rather be off-gassing something.Problem would come if he wanted to re descend alone,you could'nt actually stop him if he was adamant.If you did ie.smacked him and dragged him in,he could potentially drag you to court esp.if he suffers any ill effects in form afterwards.There was a case in the Bahamas I think in the 70's/80's where a US tourist suffered a spinal bend.Unfortunately he did it as a hurricane hit the island and they could'nt fly him out.A military diver from a nearby RAF base collected all the cylinders he could find,tied the Yank to a dining chair and using a RIB wentout to sea.He then threw the paralysed Yank in the drink on a line and accompanied him while he completed a deco schedule.All in a hurricane.The guys lived and altough the Yank has a slight limp he's largely OK!Sadly I forget the names altough the story was covered in detail in Diver during the mid 80's.This is however the exception not the rule,take care all.Hobby.

 

[Jay]

Imported post

Good answers and good refined scenario Geoff - the post was hypothetical to stimulate some debate and was more fixed around the dilema of whether or not to risk a bend yourself and to make us think a bit more about planning what to do if the unthinkable happens. I agree Geoff that while on the boat the skipper is boss but tbh, I follow Hobby's thoughts that, if I am risking a bend and we are waiting for evac anyway, I'd rather be back in the water off-gassing something rather than fizzing in the boat trying to LIMIT the effects by breathing O2.

 

[MATTBIN]

Imported post

In water re/decompressing, Hmm. Few comments made about that somewhere else (Handbagnet) and it would seem modern philosophy suggests its a BAD idea as the recompressed bubbles cause significant problems when you come up for a second time. Obviously better than zilch, but O2 would  be a better idea I believe. Not that I am an expert as I dont do deco (yet/ever?), just what I have read by several people.
Matt

 

[Hobby]

Imported post

I think one of the main factors in in-water re-decompessing is that of the sheer no.of cylinders required as discussed before.I'm vaguely aware of the newer findings Matt refers to but not in detail.It refers to the danger of the re-compressed bubbles causing a problem,but this must be considered and weighed against the alternatives.As Heads says,being on the O2 at surface will merely limit the effects.What are the chances of doing more damage by continuing to off-gas in the water,I don't really know so can't say.
When working,much of the decompression was surface deco on O2.In effect this amounts to much the same thing,you surface,get in a chamber and get blown back down to start your deco.This as per USN tables which are generally reckoned to be about as safe as anything else at present(?)and is thus used favourably by the commercial and military ops all over the world.There are other tables and advancements of course which may eclipse this but outside rec.circles this practice remains the norm.(Bear in mind though that a chamber is in use anyway,not really an option for rec.divers)
As I said,it was an exception to the rule and my view was personal one.Given what I know I'd stick with my orig.decision to off-gas at least something.I'm not saying I would'nt modify that in the face of new info/experience that I become familiar with,but at present I'd have to go with my albeit limited knowledge in this difficult field and what I've experienced.Take care,Hobby.

 

[Dr Stevil]

Imported post

OK answering this without reading the other posts so apologies for any repetition

My choice would be to send them up ASAP while staying for my own deco, pref after launching the two dSMBs to signal "trouble".
Reasons: the faster they are on the surface the faster they'll get medical treatment. plus no point in turning one definate casualty into two casualties by coming up yourself - it'll only halve the O2 supply.

Re:
</span>

Quote[/b] ]
Lets assume that this is a boat dive so you have surface cover.

<span =''>
Having done most of my previous diving in a bsac (uni) club, we always use/esed surface cover even with shore dives, be they Abbs or Ellerton. sure it takes a litle longer to do the days diving but with lots of relatively inexperienced divers you want to be as safe as possible.
Having had to call upon "our best buddy" (RNLI) once due to getting swept out to sea from a shore dive (with two trainees) I can assure you that having surface cover on shore dives is not namby-pamby!

Out of interest - how many YD-ers are O2 Admin qualified?
how many have done Rescue management stuff?
Regards
Steve
PS having now read the other posts, I too _would_ risk a hit for someone very close to me, but I can't imagine a 30 minute deco penalty as I've never done a dive like that - yet. Also I can't imagine doing a dive that would incur such a risk if I was not quite 'close' to my buddy
 

(Edited by Steve W at 2:57 pm on Nov. 1, 2002)

 

[Guest]

Imported post

In the refined scenario I think it would be throttles on full and be heading straight to shore with flares on the ready and an updated position being given every few mins.
The reason being if I am bombing on at least 20 miles an hour the Seakings on it's way towards me doing 70-80 where cutting the distance down.
If it takes 15 mins to scramble and maybe another 10 mins to clear the coastline we have cut the medivac time down a fair bit that's if the ride was reasonable and the patients could take it.
BUT if we where in the med no pot and plenty of boats about to help some spare gas it would be in water deco for me.
It's good that Heads up brought it up as it made me think about risks and a firm set of guide lines governing certain  dives and equipment must haves.
As it happens I have read some good articles from an old Aqua Corps mag regarding EID thanks it would be in most cases back in the water for me.

 

[Big Steph]

Imported post

Hi, just had to phone my mate regarding this interesting post.  He's an ex Commercial diver(Saturation)and was my Instructor 18 years ago.  
I hope I have got this correct, so don't quote me.  

Do not recompress in water for the following reasons:

The bubble(s)may not have compressed fully, ie went back to solution. A bends victim would normaly be in the pot with a medic, who would monitor the victims condition, i.e still feeling some pain in a joint or wherever, if so, he/she would be 'blown down' or compressed further until all pain is aleviated, then slowly brought to surface which could take 15 hours or longer.

Another thing, a diver may be prosecuted if he did not do everything he could to save a life, something about "Duty of Care". This of course would be for any legal eagles out there, and of course there are too many variables involved.

Hope this is of some help.

Big Steph

 

[John Gulliver]

Imported post

The US Navy Diving Manual chapter on in-water recompression (thanks Hobby!) states that it should only be considered  when "there is no prospect of reaching a recompression facility within 12 hours" and that "In divers with severe type II symptoms, or symptoms of arterial gas embolism (e.g. unconsciousness, paralysis, vertigo, respiratory distress, shock, etc), the risk of increased harm to the diver from in-water recompression probably outweighs any anticipated benefit. Generally, these individuals should not be recompressed in the water, but should be kept at the surface on 100 per cent oxygen, if available, and evacuated to a recompression facility regardless of the delay. To avoid hypothermia, it is important to consider water temperature when performing in-water recompression."
For in-water recompression using air, Treatment Table 1A has to be used, which requires a total in-water recompression time of  7 hours 52 minutes!! Anybody still want to try it? :sofa:

 

[Hobby]

Imported post

Quite,one (of the most important things actually)that I neglected to mention when doing the above described "surface deco" in the chamber is that it was on O2,again as per.USN tables.(Actually I think I did,Christ I'm apparently having a bad day,think I'll give it a rest now!)
As said it is a last resort,but I'd still consider it unless I knew I was actually going to get to that chamber "in time".
Geoff's post in particular brought up another often overlooked point that I brought up on Dnet a while ago.When requesting a helcopter to evacuate divers you MUST specify that is "low flying".There have been cases in the Uk where divers have died as a result of this not being so.I had this drummed into me by one of ny ex-supervisors on a salvage op.When I looked into it I found there are different interpretations of what low-flying actually means.For eg. Casualty Doc's handbook at the time stated it as no more than 350 ft,which to me sounds a little high(?).I'll make a point of finding out from Anglesey what the rescue crews actually work to.Please bear it in mind though.Hobby.

(Edited by Hobby at 10:37 am on Nov. 4, 2002)

 

[Dominic]

Imported post

Not an answer, but a question.

On some reports of deco, you hear of the recompression treatment being done over a period of days or even weeks of follow-up visits.

Why? Surely even the hardiest bubbles won't last more than a day or two?

 

[Hobby]

Imported post

Here's a link which(especially for Dominic re.the above post)should make fascinating reading for any diver.The extended treatment,in this case a week is self explanatory.The more technical details however are not and one can only presume that as "bubbles"are responsible for the signs and symptoms it must be that in some cases they don't shift without extended treatment.
http://www.photo.net/travel/diving/decompression-illness


(Edited by Hobby at 1:19 pm on Nov. 4, 2002)

 

[Dr Stevil]

Imported post

Seems odd, I know people who did saturation diving (ie based around 30 metres for about 10 days), their deco started about 24 hours before surfacing with bouts of pure O2 every few hours, once on the surface they were on "chamber watch" for 24 hours, ie taking it easy with instructions to contact the medic at the slightest symptom (though not actually inside a chamber). After that there was no further deco concerns.
Regards

 

[darthmoll]

Imported post

You are diving with a buddy and have both incurred a 30 min deco penalty. Your buddy suddenly loses consciousness and you start effecting rescue procedures. Do you:

The thirty min deco penalty would never happen, unless i had a chamber at the surface on standby.

1. Take him to your deco depth and keep him there for the duration of the deco requirements?

might do if it was safe, for me

2. Both surface immediately and risk getting bent?

Never

3. Go to your deco depth, ensure his reg is in and send him to the surface while staying to complete your deco and hope that the surface support will take over?

I am not sure if that would work.

4. Do something else?

stay calm, keep myself safe.


When i dive all my mates know my family, and i know theirs, when i dive with them i expect them to put safety first, even if that means leaving me behind to ensure they get to the surface alive, one death is hard enough without two. Our sport is a high risk pastime, i do not expect someone to risk death to save me, my buddies know the way i feel about this.

DM