Dive Injury Treatment-Split from Catalina Diver Death

[Cave Diver]

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A ScubaBoard Staff Message...

Split from: http://www.scubaboard.com/forums/ac...catalina-diver-died-today-w-instructor-3.html

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Something that popped into my head here is that even with the close proximity to assistance by first class medical and evacuation teams the results of the accident were calamatious.

If I consider our very remote location, at least 130 odd miles from any kind of medical assistance, (and certainly not of the calibre of big city hospitals etc) on a rutted gravel road (3-4 hours driving usually) in the event of an accident, the time to medical help can "turn it" into a calamity. Certainly helicopter evacuation would only be able to happen from the medical facility not on site.

I think maybe divers in general are outdoors type folk who often actively seek remote sites and new areas to explore, and in the event of an emergency this "remoteness" could be an added issue.
Something else to consider, I guess, especially if the diver is still largely inexperienced.

Certainly true. I know two who would have died had it not been for DAN emergency evacuation benefits, and even then both cases were still close calls.

One was a member of a our group, diving the first day in Cozumel, passed out at the hotel after the third dive. Coz has pretty good medical facilities for divers but she was non-responsive. The next morning, we decided that Hurricane Dean was not going to veer off and the group started breaking up to leave. A plane was sent from Miami, flying around H.Dean to pick her up and get her out on the third or fourth day, returning her to Miami where she remained in ICU for several days. Survived, but it was close.

Later that year, a member of our group on a liveaboard on the far side of the Bahamas had a heart attack on the first days dive. He survived to get back to the boat, but the closet port was Exuma - not approachable until high tide. Luckily a speed boat from a nearby yacht came to our aid and delivered him to the harbor for minimum medical assistance until he could be flown out that night. I never learned why they flew him to Nassau rather than Florida, but he was finally flown to Ft. Lauderdale late the next day. Survived, but it was close.

Neither of these were all that remote, but obstacles came up, things went wrong. I've not dived anywhere but tourist destinations around North America, Central America, and the Caribbean, but the further I get from Miami, Houston, NYC, LA - the more I think about what we can do if caca hits the fan. Much further out and I don't think either of those survivors would still with us. Stay healthy, get check ups, go prepared for the worse.

I've got less than 400 dives but have seen 6 divers leave by ambulance so far.

Your post made me think about the fact that, even with the best possible care for a dive accident available close at hand (the Catalina dive chamber - I've been there, been inside it, and know that it is one of the best chamber facilities around) this diver did not survive. It's chilling.

I've been diving in some pretty remote locations, where competent medical care, much less a chamber, aren't always nearby. Rangiroa, Marquesas Islands, La Bufadora, Bali, and I just got back from Galapagos. When I'm diving in places like that, I have thought to myself that I need to be even MORE careful than usual, and I dive in the most conservative manner possible, because if I push a limit and my body reacts unexpectedly I might not have any nearby options for treatment.

But when I'm diving at home, I often have thought to myself how fortunate I am to know that the BEST dive medicine is right here, close at hand, should something go wrong.

Yet here in this situation, with a diver who I believe (based on the reports I have read in here...note that I don't know this for a fact, just basing this on what I've read) surfaced alive, and yet even with almost immediate and extremely competent dive medicine, did not survive.

It reinforces that I need to not dive any LESS conservatively when I'm home, than I do when I'm somewhere remote. I can't let my known access to chambers and expert treatment lull me in to a false sense of security. Because as this incident seems to illustrate, it doesn't always work.

 

[DwayneJ]

Your post made me think about the fact that, even with the best possible care for a dive accident available close at hand (the Catalina dive chamber - I've been there, been inside it, and know that it is one of the best chamber facilities around) this diver did not survive. It's chilling.

The worst injury to yourself scuba diving would be holding your breath from depth - Pretty much unsurvivable.

independent of the final analysis associated with this sad fatality, Advanced Certification as provided by PADI is a joke and allowing students to take this certification with less than 10 dives is worse.

 

[merxlin]

The worst injury to yourself scuba diving would be holding your breath from depth - Pretty much unsurvivable.

independent of the final analysis associated with this sad fatality, Advanced Certification as provided by PADI is a joke and allowing students to take this certification with less than 10 dives is worse.

DwayneJ, please see this thread : Speculation In my opinion your post pretty well epitomizes why that thread was started. Just in case someone is picking this thread up from here and hasn't read this entire thread: your first statement is inaccurate, and your second statement has nothing to do with the incident. You have a right to your opinion but this was not the right place to express it.

 

[Ken Kurtis]

Advanced Certification as provided by PADI is a joke and allowing students to take this certification with less than 10 dives is worse.

Dwayne, this isn't meant as a troll. I'm just curious to undertand your rationale.

Without addressing the first half of the sentence I quoted (no sense muddying this thread further), the second half of your statement has piqued my curiosity.

If you think allowing people to take the PADI AOW (NAUI has the same prerequisite, BTW) with less than 10 dives is not right, what do you suggest they do to get enough underwater time to be ready for the class? I'm assuming that you think they ought to have more than10 dives under their belt before they take the AOW.

And if I'm right, that begs this question: With whom do they do these other dives to get them to have enough logged dives so that, from your perspective, they're "ready" for AOW?

The reason this intrigues me is that you essentially seem to be saying that getting experience diving on their own with a buddy is going to be safer/preferable to getting that experience under the eye of an instructor.

And I don't think it would be fair to say that because, in this case, the diver died under the supervision of an instructor, that proves your point. The more salient question to ponder would be what would have happened had this same situation developed and the diver was with another new-ish diver.

From what I know of the particulars, the instructor here did everything she could to react to and alleviate the situation. I can't imagine a non professional-level person reacting as quickly. And even though the final outcome might have been the same, I'm still wrestling with what your logic might be.

Anyhow, just curious if you'd care to expand on your thoughts.

(But if what you meant to say was that calling someone - NAUI, PADI, or any other cert flavor - an "Advanced" diver with 10 dives under their belt is lunancy, then I'm in total agreement with you.)

- Ken

 

[bleeb]

The worst injury to yourself scuba diving would be holding your breath from depth - Pretty much unsurvivable.

independent of the final analysis associated with this sad fatality, Advanced Certification as provided by PADI is a joke and allowing students to take this certification with less than 10 dives is worse.

DwayneJ, please see this thread : Speculation In my opinion your post pretty well epitomizes why that thread was started. Just in case someone is picking this thread up from here and hasn't read this entire thread: your first statement is inaccurate, and your second statement has nothing to do with the incident. You have a right to your opinion but this was not the right place to express it.

merxlin, at the risk of dragging the discussion even further off topic,I am a bit uncertain what you mean when you said "your first statement is inaccurate". Are you talking about DwayneJ's comment about embolizing ("holding your breath from depth") or something else? I ask, since the results of a breath holding ascent will indeed probably not be very pleasant, or was the inaccuracy referring to the "worst" or "pretty much unsurvivable" parts? If you wouldn't mind clarifying, that would be appreciated.

 

[merxlin]

The "pretty much unsurvivable" part.

 

[DwayneJ]

The "pretty much unsurvivable" part.

What do you think happens to your lungs when you hold your breath from depth?

60ft?
30ft?
15ft?
3ft??


And how would a chamber help with this type trauma?

Check out:
http://www.scubaboard.com/forums/ask-dr-decompression/12151-lung-expansion.html

 

[Leejnd]

Y'know, DwayneJ, just for the record - since it was my post you quoted when you made your comment - I wasn't trying to suggest that a chamber would resolve a lung expansion injury. Nor was I making any kind of statement or judgment or speculation whatsoever as to what killed the diver in this incident.

My comment was more of a general nature - simply pointing out that this incident serves as a reminder that being close to even the best dive medicine and facilities is no reason to "let your guard down," so to speak, or get complacent, or dive any less conservatively than you might somewhere else, where you are not close to such facilities.

My point was that nearby chambers and expert medical care do not guarantee a good outcome in a dive accident.

In all these threads, what I try to do is find something to learn...some lesson to be gained that might help me or others. And that's one more little lesson to pull from this. That's all my post was about.

 

[merxlin]

What do you think happens to your lungs when you hold your breath from depth?

60ft?
30ft?
15ft?
3ft??


And how would a chamber help with this type trauma?

Check out:
http://www.scubaboard.com/forums/ask-dr-decompression/12151-lung-expansion.html

Not arguing the effects of breath holding, except that AGE and barotraumas can be survived. Many tox episodes are also very deadly, as can a bad case of DCS, but all have some survivors. And to be accurate, breath holding from any depth can be injurious. We all seem to know (based on the numerous posts before yours) that breath holding and AGE are to be avoided. I just didn't see any benefit for this discussion in your post.

To answer your second question- The chamber in and of itself would not be of benefit. However, in the case of the Catalina chamber, the rescue teams and the on site medical staff are all very well versed in diver trauma. If I had a problem, that's where I would want to go, and chance are I would get there quickly and be being worked on en route. So the chamber would not help, but the staff and available equipment sure could.

 

[Cave Diver]

Barotrauma definition - Medical Dictionary definitions of popular medical terms easily defined on MedTerms

Pulmonary barotrauma definition - Medical Dictionary definitions of popular medical terms easily defined on MedTerms

arterial gas embolism - definition of arterial gas embolism in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia.