Bring unresponsive diver to surface upside down??

[diveDavedive]

I just completed the Underwater Unresponsive Diver skill for PADI's Rescue Diver. Just as I read in the book, my instructor demonstrated how to bring to the unresponsive diver to the surface, from behind and heads up. Later that day at the shop, the shop owner reinforced the principle of bringing the unresponsive diver to the surface upside down. He stressed that many studies for many decades determined this upside down position forced the airway into an open position and that it prevented lung rupture injuries.
This was not mentioned anywhere in the PADI Rescue Diver manual nor has my instructor ever heard of it.
Has anyone else out there been taught this method? It would be nice to know if it is a valid technique or was once a valid, but now outdated, technique.

 

[lindenbruce]

If i remember correctly, when I did the class through SSI the diver was brought to the surface in the normal head up position. B.

 

[supergaijin]

Upside down as in feet up, head down? I can't imagine why that would be 'safer' for the victim. I've never come across the "many studies for many decades" regarding this... but that may just be from lack of looking.

If that were true though, a Google search should find them.

 

[Diver0001]

I just completed the Underwater Unresponsive Diver skill for PADI's Rescue Diver. Just as I read in the book, my instructor demonstrated how to bring to the unresponsive diver to the surface, from behind and heads up. Later that day at the shop, the shop owner reinforced the principle of bringing the unresponsive diver to the surface upside down. He stressed that many studies for many decades determined this upside down position forced the airway into an open position and that it prevented lung rupture injuries.
This was not mentioned anywhere in the PADI Rescue Diver manual nor has my instructor ever heard of it.
Has anyone else out there been taught this method? It would be nice to know if it is a valid technique or was once a valid, but now outdated, technique.

Couple of thoughts:

First of all, I've never heard anything similar to this advice outside of the occasional bit of tin-foil-hat philosophizing. I don't think there is *any* comparative evidence out there of successful vs. unsuccessful rescues where the conclusion was drawn that the manner in which an unconscious victim was lifted caused secondary injuries during the lift.

Secondly I think such advice is overthinking. If someone has drowned and is unconscious then they're extremely unlikely (I'd say it's virtually impossible) to be involuntarily able to tense the muscles required to hold their breath.

Third. In practice there IS one element that makes a huge difference to the victim's chances.... speed! The main thing is speed. Any screwing around you do that wastes time getting the victim to the help is going to reduce their chances of survival. This IS a well known fact.

There are two main reasons why they show you a controlled-buoyant lift. (1) for the safety of the rescuer. Control of the lift is as important (I would say more important) to avoiding injuries to the rescuer than it is to the victim. and (2) so you don't *lose* the victim during the lift. Those are the reasons you're taught to do a controlled buoyant lift. Various instructors/agencies show various different approaches to the CBL but the results they're after are the same. Get the victim on the surface, don't lose them and don't hurt yourself doing it.

So priority #1 is your own safety and priority #2 is getting the victim to help as fast as humanly possible without forgetting about priority #1.

R..

 

[Hickdive]

The "open the victim's airway to enable expanding gas to escape" thing is basically bunk and always has been. Unconscious or dead people DON'T hold their breath however the idea of extending their airway has been carried over from extending the airway of a non-breathing casualty on the surface as a first step in CPR and has consequently become enshrined in PADI's (and all the copy-cat agencies') overly-complex rescue procedures.

In the OP's case the shop owner is talking nonsense, if s(he) wasn't talking nonsense s(he) would be able to cite these "studies" that have been published in the appropriate and respected scientific journals.

On the other hand, there is such a study which proves that the shop-owner is talking nonsense, and here it is:

http://www.tech-ccr.com/pdf/S Mitchell - Rescue of an unresponsive diver - FINAL.pdf

pay particular attention to page 1104, paragraph 2. As long as the casualty's chin isn't positively pushed down onto their chest to obstruct their airway then expanding gas will escape passively.

 

[Lemna]

Has anyone else out there been taught this method? It would be nice to know if it is a valid technique or was once a valid, but now outdated, technique.

Ages ago the Belgian CMAS affiliate used to teach this. It was part of their instructor examination in the sixties: raise a 'victim' from 40m, first head down, then head up. In one dive!

 

[victorzamora]

One thing I could easily see is the Instructor either misspoke or misunderstood. I can totally see how bringing a diver to the surface "upside down" would help......if horizontal, face down is "upside up" (as my 3 yr old sister would say). If the mouth (practically an OPV in the case of an unconscious person) is the highest point, I can see there being a benefit in lung overexpansion injuries. As has been said before, the victim won't hold his/her breath....but it might help.

Having said that, after the research I've done, I advocate getting victims to the surface and onto a boat to start analysis/diagnosis/CPR the right way: ASAP.

 

[diveDavedive]

Yes, head down and feet up, vertical.
The weight of the head would extend the neck and open the airway
He did cite UCLA as one of the organizations

I will follow the book and my instructor and disregard the shop owners "wisdom". Not everyone will agree with the way PADI does everything but that's who I am certified under and that's how I will train and dive.

Thanks for the input

 

[victorzamora]

That kind of makes sense, actually. Thanks for the perspective. I wonder how it compares to on their back?

Also, I wonder if it's easier and less traumatic on the rescuer to pull a diver by their fins.

Sent from my Samsung Galaxy S4 using Tapatalk

 

[Diver0001]

Also, I wonder if it's easier and less traumatic on the rescuer to pull a diver by their fins.

Neither.

In my opinion if you try to lift them by pulling on the fin(s) then you will risk the fin(s) coming off during the lift and losing contact with the victim. Depending on visibility, current and whatnot, this can be very problematic and can cause huge delays in getting the victim to help. You want to avoid that at (almost) all costs.

In many cases you'll find that the diver, especially if they have run out of air, can be fairly negative on the bottom. Pulling them up, especially through the first few meters will be especially difficult if you're trying to pull them up via their fins. This is the point where I would think a fin strap could easily break. Moreover, once the buoyancy swings to positive you may have to dump some air out of the victim's BCD to keep the lift under control, which will be very difficult if the victim has floated up above you and you are holding onto the fins with no access to the inflator.

So in my judgement you should lift the diver by holding the BCD in some manner (different agencies/instructors will show you different grips). This gives you control over the victim's BCD (inflator) and gives you the best chances of nothing breaking loose which could cause you to lose your grip on the victim.

As for the trauma, it's horrible to have to lift an unresponsive diver who looks and acts dead (even if they can still be saved) regardless of what part of them you're holding onto.

R..