A question for rescue divers

[Divor]

Just found this from a 2005 AHA publication:
"Rescue Breathing
The first and most important treatment of the drowning victim is the immediate provision of ventilation. Prompt initiation of rescue breathing increases the victim’s chance of survival.10 Rescue breathing is usually performed when the unresponsive victim is in shallow water or out of the water. If it is difficult for the rescuer to pinch the victim’s nose, support the head, and open the airway in the water, mouth-to-nose ventilation may be used as an alternative to mouth-to-mouth ventilation. Untrained rescuers should not try to provide care while the victim is still in deep water.

Thanks for clearing it up.

I'm not too familiar with this as a non-American, but I take it the American Heart Association is pretty authoritative?

 

[tomboyy]

Nope first rule is, if the victim is not breathing get them to the surface as fast as you can safely. Meaning if you have to bypass the three minute safety stop, bypass it. Get them to the surface then do your ABC's (but save the chest compressions until you make it to land.) Our dive team teaches us that we are to administer rescue breathes all the way back to the shore.

Different instructors teach different things. I was taught rescue breathing and all but our instructor thought that it was a better thing to haul ass back to shore or boat first.... and as Jim mentioned dive professionals may be turning away from that.

 

[iztok]

I'm not too familiar with this as a non-American, but I take it the American Heart Association is pretty authoritative?

I believe that AHA is the source of pretty much most of the CPR advice in terms of how, when, how often etc. That then usually spreads around the US and rest of the world as recommendations.

What I was told is that:

1. You can't really do compressions in the water so best you can do is provide some air.

2. If nothing else on the solid surface (boat, shore, anywhere during surface interval provide compressions. Even if you don't have barrier, just do compressions. Don't withhold whole CPR if you are afraid you will catch something trying to do the breathing part.

 

[Diver0001]

Care to share the source of your data?



That is why one gets the training. To try and remain as calm as possible. I think your numbers are exaggerating "a bit" for dramatic effect. 8000 times? Care to share the source of info where they've measured 8000 times more adrenaline than normal?

I think if you're not willing to listen to the point that citing data is only going to make you question the data.

I'm talking from experience. Obviously those numbers are just made up but the principles behind them are not. If you've never been there, and I honestly hope you have never been there and (knock on wood) never have to be there, then it's *really* hard to sit behind a computer and imagine what it would be like.

I can honestly tell you that having to rescue a drowned diver is a worse experience than you can imagine.

R..

 

[DeepSeaDan]

If you had a unconscious diver would it be a good idea to give them a couple of rescue breaths first; if you can; before starting your controlled ascent
Or could this cause over inflation injury;and a waste of very important time!! just wondered

...some time ago - part of it speaks to your question, & others found it useful - I hope you do as well:

The most common sense approach to emergency response is to remember to refrain from locking one's thinking inside a box ( sorry, that metaphor is grossly over-used! ), by that I mean one must be able to adapt procedures to varying situations. Equally important is to remember your priorities:

> YOUR ( Rescuer ) safety comes absolutely FIRST.

> People live & die by way of A B C & bleeding.

With those primary criteria in mind, react as safely & as quickly as you can. With open circuit equipment, an "unconcious" casualty is likely a " v.s.a." ( vital signs absent ) casualty ( an exception could be a witnessed O2 tox. victim, where the buddy takes control instantly & protects the diver's airway while surfacing...), who has likely drowned. Such a casualty needs the surface & a flat, hard platform ( for resucitation ) as quickly as can be safely managed.

How you achieve your primary objectives can be analogised to a mechanic with a box full of tools, where you are the "Rescue Mechanic", & your "tool box" is your mind's store of retrievable procedural options, adapted to the circumstances you find yourself in.

Consider these thoughts:

> nature of casualty ( who is it? your buddy? An unknown diver you "happened upon?" )

If it is your buddy, you should have a good idea of the circumstances of their unconciousness, provided you were " buddy diving" - not "kinda diving together". You would then base your response on the known circumstances. Much of what you do will be based on your knowledge of your own personal capabilities & limitations. You MUST be honest with yourself, or risk personal injury in trying to do things beyond your limits. This may include allowing a casualty an unescorted trip to the surface because a controlled ascent together was beyond your abilities. Many a well-intentioned rescuer has suffered the consequences of striving to assist beyond what they can safely achieve, often with tragic results. Resist.

If you "happen upon" an unresponsive diver, they have likely drowned. You now must first consider your own circumstances:

> what is my buddy & mine's dive schedule? ( that's right - you SHOULD have another person along to assist in recovering this person to surface! ).

> How do "we" safely, effectively, get this person to the surface?

You priorities are now:

> your safety
> their airway ( protect it as best you can )
> their buoyancy ( control it as best you can )
> the surface ( as quickly & safely as possible )

Once on surface:

> all get positive

> check breathing. No breathing? Try several rescue breaths as best you can, if there is no response to ventillations, then...

...decide - how close is an adequate platform for c.p.r.? If your close, make all speed for it ( I personally wouldn't slow our speed up by trying to breathe for the casualty en route - they need circulating blood to move any O2 I give them, & I can't move their blood in the water ).

...if said platform is a long way off, tow & breathe for them the best you can, & hope for a miracle.

...then again, hope for a miracle always.

Best Fishes,
D.S.D.

 

[ktomlinson]

I'm not a rescue diver yet (that's next), so let me ask a question regarding giving two breaths while still in the water, as some have mentioned. Is the victims heart usually still beating even though they aren't breathing? If their heart isn't pumping blood and you can't do chest compressions until your on the boat, how would giving two breaths help them? (since the o2 wouldn't be pumped through their system)

 

[iztok]

I think if you're not willing to listen to the point that citing data is only going to make you question the data.

You would be surprised how open I am to scientific data. So by all means if you have them, let me know.

 

[Dirty-Dog]

I'm not a rescue diver yet (that's next), so let me ask a question regarding giving two breaths while still in the water, as some have mentioned. Is the victims heart usually still beating even though they aren't breathing? If their heart isn't pumping blood and you can't do chest compressions until your on the boat, how would giving two breaths help them? (since the o2 wouldn't be pumped through their system)

Ventilating them without circulation will do no good at all. Blowing more water into their lungs is clearly not helpful. The time spent determining if they have a pulse, especially given how unreliable a pulse check is going to be at depth, maybe wearing gloves, is going to be, would be far better spent getting them to the surface.

 

[fisheater]

I'm not a rescue diver yet (that's next), so let me ask a question regarding giving two breaths while still in the water, as some have mentioned. Is the victims heart usually still beating even though they aren't breathing? If their heart isn't pumping blood and you can't do chest compressions until your on the boat, how would giving two breaths help them? (since the o2 wouldn't be pumped through their system)

Ahh. There's the rub.

If there's no circulation, ventilation doesn't do any good. So, under those circumstances, rescue breaths would be a waste of precious time and effort. if there is circulation, those rescue breaths may make the difference between survival and death.

To make matters more complication and uncertain, it's extremely hard - if impossible - accurately to determine if an unconscious diver has a pulse while you're both in the water and wearing thermal protection.

So. The essence of rescue is making important decisions, in the face of considerable uncertainty, to mention intense emotional pressure and challenging physical obstacles.

 

[vladimir]

As to the adrenaline question, I can say from experience that it doesn't have to be a factor. Early in my diving career, and without any rescue training beyond what we got in open water (back then), I brought a drowning diver from depth to the surface and then to shore. There was no panic and no spike in adrenaline that I noticed. It's a given that I am a lot cooler than you guys, but still, most of you can probably manage it if the need arises.