What do you do when donating to a panicked diver who initiates a buoyant ascent?

[mcohen1021]

I am not sure why a panicked diver would think they are out of gas if they actually are not

Son in law (beginner level), grabbed me all panicked. Signaled out of air. It happened so fast I didn't give him my primary, I gave him the air2 I'd retrofitted to my BC.

I tested his regulator and it was working perfectly.

That's when I decided to go back to a traditional octopus.

So he must have winded himself somehow, idk what else it could have been?

 

[NW Dive Dawg]

I make it a point to only dive with people I know/trust. In other words, rule #1...

Me too...... His name is "Silent Bob".

 

[lostsheep]

Me too...... His name is "Silent Bob".

Silent bob reminds me of Quato from Total Recall; why not just dive doubles?

 

[kinoons]

<snip>
I grabbed his harness and ascended with him.
He was not exhaling, as the glottis was closed.
So I inserted two fingers in his mouth and forced the glottis to open, getting good bubbling.
Everything was fine in the end...
If I had left him going free, he had very easily ruptured his lungs.

I’m not familiar with the finger into the glottic opening technique to open an airway. Fingers wouldn’t be very effective in getting to the vocal cords. I’m not aware of any situation that stimulating a gag reflex would overcome a laryngospasm. Jamming fingers onto someone’s mouth also sounds like a good way to injure the oropharynx or your finger.

I’m also not sure if laryngospasm can crate enough pressure in the lungs to cause barotrauma vs active breath holding.

I’m not saying your technique didn’t work, but I’m not sure if that was the cause of the ending of the laryngospasm either. My guess is that jamming fingers into someone’s mouth is more likely to cause harm than good. Perhaps @Duke Dive Medicine can offer some more insight.

 

[NW Dive Dawg]

Silent bob reminds me of Quato from Total Recall; why not just dive doubles?

Because for me, a fully independent and redundant Pony is truly a buddy on my back. No valve drills or switching or isolation or equalization......or even much thinking involved. Just go right to BOB as a fully prepared and fully pressurized independant buddy, breath easy and head for the surface in a fully controlled manner. It's really every bit as simple as switching from your primary 2nd stage to an octo that's right there and available.

 

[PEDiver]

Guide/DM is no guarantee of a competent buddy.

True, but I like my odds better.

 

[ginti]

So he must have winded himself somehow, idk what else it could have been?

If a diver has two separate first stages, and the main stage fails, he may panic into believing he has lost all gas.

Furthermore, retention of CO2 in the blood (due to excessive effort or incorrect breathing patterns) could cause air hunger (I don't know if this is the correct name in English), and the diver could convince himself that he has problems with the regulator.

But as I said before, I'm just imagining and don't know how realistic these scenarios are. The reality is that any panicked individual is no longer rational and could have unpredictable reactions disconnected from reality.

 

[happy-diver]

Scuba is a highly physical pursuit where you perspire through exertion but you don't feel it
as you are already wet, and are able to continue due to the cooling properties of the water

It's 45 minutes of exercise

Imagine exercising on land where you reach your limit and cannot get enough air you stop, gasping

In water, you can not stop

 

[L13]

I was dragged to the surface from the deck of the Milwaukee Car Ferry (~100 FFW roughly) in Lake Michigan by an OOG diver. One of my scariest moments on scuba. All I could do was flare, dump gas from my wing/drysuit, and try and slow us down. Thank God it wasn't a deco dive.

I had almost an identical experience a not far from there on the Prince William (~80ft). Fortunately, we had just reached the wreck when it happened, so no significant nitrogen. The next day I dove the Milwaukee with a different buddy, a much safer experience.

Edit: I made a conscious decision to ascend with him. He was in a wetsuit so I was more confident I could control the ascent rate. I dumped air from my Drysuit and BC, and managed to keep the ascent rate reasonable (90ft/min max). I even managed to stall him for a 20 second safety stop. Total dive time was under five minutes.

I don't get people diving deep in the great lakes in a wetsuit. The dives are so much more fun if you aren't freezing.

 

[Duke Dive Medicine]

I’m not familiar with the finger into the glottic opening technique to open an airway. Fingers wouldn’t be very effective in getting to the vocal cords. I’m not aware of any situation that stimulating a gag reflex would overcome a laryngospasm. Jamming fingers onto someone’s mouth also sounds like a good way to injure the oropharynx or your finger.

I’m also not sure if laryngospasm can crate enough pressure in the lungs to cause barotrauma vs active breath holding.

I’m not saying your technique didn’t work, but I’m not sure if that was the cause of the ending of the laryngospasm either. My guess is that jamming fingers into someone’s mouth is more likely to cause harm than good. Perhaps @Duke Dive Medicine can offer some more insight.

Thanks for the add. It seems like @Angelo Farina somehow pulled off a good outcome, but a few things strike me about the interventions here. First, inserting digits into the mouth of a panicked individual is a good way to lose fingers and aggravate the panic. I concur with you that attempting to manually open a laryngospasm would not only be ineffective because the spasm occurs farther down in the airway than fingers can reach, it would also cause the individual to gag and compound the problem.

I do think that laryngospasm could result in air trapping and pulmonary barotrauma. The question is how to handle it. In a rescue situation like the OP described, there's no way to differentiate whether the individual is panic breath-holding or in a laryngospasm, and I don't know that it would matter. It would be reasonable to attempt to slow the ascent and offer a regulator, mindful that doing so would also put the rescuer at risk, especially if there's a decompression obligation (I'm reminded of a couple of fatal accidents I know of here). We used to train commercial divers to exert pressure on the chest to try to gently force air out on ascent, but that requires considerable forethought and presence of mind in the moment. Sometimes the best you can do is be ready to provide first aid and medical evacuation after the diver surfaces.

Also, not to belabor this point, but out-of-air accidents are much better prevented.

Best regards,
DDM