Teenager with DCS, mother in denial, treatment delayed

[DiveProKoko]

@DandyDon and @poseident, ........I guess there's at least one agency out there that covers what to do in case of suspected DCS, but I've just gone through my entire PADI OW manual, and it doesn't. ......

FWIW - A buddy who teaches PADI referred me to Chapter 5 of the PADI Open Water manual on this. We didn't have time to discuss, he just told me suspected DCS sickness response is covered in Chapter 5. Take a look there and see if it tells you anything. I have no idea what it say as I'm not a PADI instructor, LOL

 

[Esprise Me]

@Marie13 I'm not disagreeing. I'm just wondering why people are concluding these must not have been certified divers, given that my OW course was silent on the subject.

The purpose of the A&I forum is to learn from these tragedies in order to become safer divers ourselves. Certainly it's worth discussing the fact that attempting IWR is at best a last resort for trained professionals, not something for recreational divers to do in lieu of contacting emergency services. But in a larger sense, it's also worth asking why these folks did what they did, and if that exposed any systemic issues. Hypothetically, if OW courses often don't provide info that OW divers end up needing, perhaps we as divers should seek to change that, and in the meantime to educate those OW divers we have access to. OTOH, if the info is in the course but people are routinely forgetting or ignoring it, that might call for a different strategy. Or, perhaps the info is given and routinely followed, but there's always going to be the odd idiot who doesn't listen, and maybe that's a problem we just have to live with.

Regardless of whether OW courses teach people what to do in case of DCS, I find this family's actions in continuing to forge ahead with the graduation plans in the face of very obvious signs of a serious problem (kid couldn't walk!) to be quite alarming. Maybe no amount of training would have helped. But maybe it would have, or maybe it would help someone else in a similar situation.

@DiveProKoko you're right; there is a brief section on helping a diver with suspected DCI. It does not specifically mention IWR, though it does say the diver should stop all diving, which might reasonably be interpreted to exclude it (or might reasonably be interpreted not to exclude it, if you consider it a form of treatment rather than more diving.) It does also discuss administering oxygen and contacting emergency services, which is probably all the OW diver really needs to know.

 

[poseident]

The lack of formal class does not automatically mean the training was substandard, just as receiving a certification card does not mean a diver has proper training. Regardless training, whether formal or not, if a diver pays no attention to their training, there will be accidents. I have seen nothing that says whether the diver was certified or not.

That's fair. My first mistake in that post was starting that with the words "in fact" when the very next phrase included the word "guess." And making the statement that followed was hugely judgmental as others warned about earlier in the post.

I suppose what I was getting at was that much of what was described, as well as the mother's own statements on Facebook seem to me to indicate people who "didn't know any better," which I automatically assume means "no training" or "bad training" or at least "student no longer following training."

The first fatality that hit close to home in my diving career was that of a fellow airman who should never have been doing what she was. She'd been warned by myself, and others, and even given a formal order to stop diving with the people she was diving with. They were her friends, she ignored everyone, and was dead very shortly after. She wasn't certified.

Situations like this have really bothered me ever since, but they just don't stop.

 

[Belzelbub]

Don, I think you nailed it there. In fact, I'd hazard a guess that there were no formal classes, no computers, or reasonable dive planning of any sort. 100% by-the-seat-of-your-boardshorts action here.

@DandyDon and @poseident, I'm curious as to your reasoning. Do you believe certified divers could never do something like this? I guess there's at least one agency out there that covers what to do in case of suspected DCS, but I've just gone through my entire PADI OW manual, and it doesn't. Also, it seems he was diving from a boat. It may have been a private boat; the post doesn't say. But if it wasn't--if he paid to go out on a dive boat--I would think they'd require a C-card.

All three of you could be correct. The best training in the world doesn’t guarantee safe divers. Likewise, lack of official training doesn’t always equal incompetence. Training does definitely improve the odds of competence when compared to the other route.

Seems that there is disagreement on whether IWR is mentioned in OW or not. In my case,I do recall it being mentioned and explained as a bad idea. I can’t recall if this was in my PADI OW course or my YMCA/NAUI/CMAS course. It was definitely addressed and the students were advised that it was not a recommended practice.

This case makes so little sense. I’d like to think it was just a hoax, but I don’t think it is. I don’t see what the goal of the hoax would be, aside from attention.

A couple things are clear. If the divers were not certified, there really is no excuse. This area isn’t Wyoming where dive shops may be hard to find. They are literally all over the place down here. If they were certified, they need to go back and reread the manual. Someone clearly missed something important.

 

[Esprise Me]

So the IWR attempt was unwise, to say the least. But did it actually make things worse in this case? Or was the problem just their refusal to seek the proper treatment, which continued for hours after they returned to shore anyway?

A couple other thoughts:

-The post describes the kid surfacing after a safety stop, and says that after he got on board things went south quickly, so mom put him back in the water with a diver to sit at 25 feet and "simmer down." So a) she knew there was a problem, and b) she must have known what the problem was. What else could going back to 25 feet possibly be intended to accomplish? It wasn't that she thought he skipped a safety stop and should go back and do it just in case; she said he did one. It's not something you do for jellyfish stings or dehydration or any problem other than DCS. So how did she know, and act on that knowledge, and yet remain in denial?

-Maybe neither of them were certified, or maybe they both were. But at some point, someone who was not working off an OW textbook taught them something about IWR. I doubt she came up with the idea herself that day when she noticed things were quickly going south with her son. Perhaps someone told them that the symptoms we recognize as indicating DCS are just a normal thing that happens after some dives, and can be fixed with a quick and dirty "simmer down." Perhaps this wasn't the first time one of them had been bent, or attempted IWR, just the first time it didn't turn out OK.

-If this sort of thing is a widespread practice in some groups, maybe SSI* has the better approach by explicitly advising against it. I had a first aid manual once that specifically said not to treat burns with butter. It never would have occurred to me to do so, but apparently that's a thing people believe in.

-Seriously, though, what's the deal with this boat? Who was in charge? Did they know about the IWR attempt? Was it perhaps even their idea? Did they not have oxygen on board? Did nobody else notice anything amiss, or say anything to them, or call 911?

*edited; I originally wrote SDI but then double- checked and saw it was SSI that addresses it. SDI might also, or not.

 

[BlueTrin]

@Esprise Me i think one could argue that if she didn’t attempt IWR, she’d have probably gone to the chamber not assuming that everything was ok.

 

[Belzelbub]

So the IWR attempt was unwise, to say the least. But did it actually make things worse in this case? Or was the problem just their refusal to seek the proper treatment, which continued for hours after they returned to shore anyway?

Yeah, that is a possibility. without knowing more on the dive details, it’s impossible to know if the IWR made things worse in any way. It may have even helped some. Definitely didn’t fix the problem.

It wasn't that she thought he skipped a safety stop and should go back and do it just in case; she said he did one. It's not something you do for jellyfish stings or dehydration or any problem other than DCS. So how did she know, and act on that knowledge, and yet remain in denial?

Yeah, that’s the real puzzling part. She knew enough about DCI to know that something was wrong. Sent him down to do a deco stop. Then ignored the continuing severe symptoms as DCI.

-Seriously, though, what's the deal with this boat? Who was in charge? Did they know about the IWR attempt? Was it perhaps even their idea? Did they not have oxygen on board? Did nobody else notice anything amiss, or say anything to them, or call 911?

I believe this was their boat, or possibly a friend’s boat. I seriously doubt it was a chartered boat. I’ve seen posts on the FB group she and I are both on that included pictures of a boat that does Not look to be setup like a charter.

This is in FL. Lots of private boats here.

@Esprise Me i think one could argue that if she didn’t attempt IWR, she’d have probably gone to the chamber not assuming that everything was ok.

The actions after the unsuccessful IWR attempt, and her stated purpose of the IWR (Simmer Down) lead me to think that a chamber ride was way down the list of possibilities. Keep in mind that she stated this was a fairly typical dive. There were also continuing symptoms after arrival at home. Severe enough to warrant a visit to the chiropractor.

Also, we can’t forget that there were tacos.

 

[DandyDon]

The kid could not walk when they got to land and she did not call 911! Big fail.

 

[Marie13]

@Belzelbub

If you go to the mother’s FB page, as I did yesterday, there were posts talking about the son’s recovery. He’s driven the boat AND made tacos. Yes, they’ve got a taco obsession.

 

[Centrals]

@Belzelbub

If you go to the mother’s FB page, as I did yesterday, there were posts talking about the son’s recovery. He’s driven the boat AND made tacos. Yes, they’ve got a taco obsession.

So the boy has covered! Very lucky one.