'Clinically dead' rebreather diver dragged from quarry - and then revived

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Chest compressions WERE mentioned. The bit says "performed CPR" and CPR consists primarily of chest compression these days.

Not in drowning - not if you want to give the patient the best chance.

This case is a classic example of a drowning patient who was saved by ventilation alone and who probably would have died had the rescuers performed compression only CPR. Compression only CPR works for community cardiac arrest due to cardiac events. In this setting breathing stops because the heart stops, and the lungs contain moderate amounts of oxygen at the time. Providing only chest compressions will provide some benefit because the blood gets oxygenated, at least for a while, as it passes through the lungs. However, compression only CPR is wrong in drowning. In this setting breathing stops because of hypoxia and this precedes cardiac arrest. The only real chance the patient has is to prevent cardiac arrest in the first place - by providing rescue breaths and restoring oxygenation before the heart stops. That is clearly what has happened here. The fact that the patient resumed spontaneous breathing before any paramedical input makes it almost certain that breathing had stopped but cardiac arrest had not occurred at the time they began their resuscitation.

These perspectives have been clearly articulated in consensus guidelines released on management of drowning by the European Resuscitation Counsel and on rescue of an unresponsive diver by the Undersea and Hyperbaric Medical Society. I will post a copy of the UHMS guidelines tomorrow.

Simon M
 
Here is the current information from the Heart Association: Request Rejected

It's also interesting to read that according to some on this board, that association is "putting everyone at liability", because they say "In the majority of cases, any attempt to provide CPR to a victim is better than no attempt to provide help".
 
The more I hear and learn about rebreathers, the more nervous I become diving with people who use them.

Ditto. the damn things are deathtraps IMO.
 
Very interesting, Simon. I can appreciate that having the lungs full of water will of course prevent them from functioning, but I've never heard this discussed in a CPR class--including one given by a municipal parks department, which operates several pools. Presumably in a drowning rescue someone would have tried to empty the airway and put the victim in a rescue position before starting to whale away on them, but it seems that not "air enough"?

Can you point me to a link to those guidelines, so I can look further into them?
 
Ditto. the damn things are deathtraps IMO.

Absolutely 100% death traps IF you are not 100% committed to diving them properly, not beyond your training, and maintaining them meticulously. If you can not or will not follow checklists and your training, buy more life insurance.

If you assemble, maintain and dive them properly they are a great tool for diving. Are there hazards? Definitely. They are minimized by good training and proper procedures.
 
i believe some 30% of ccr deaths happen in less then 50 ft of water.... from low po2....

The surface can be a dangerous place. There was a near fatality at our local quarry a few years ago in knee deep water. Guy diving with his teenage daughter, I believe that the problem was a blocked O2 feed (shut off or stuck solenoid) and an inattention to PO2. Diver passed out and was revived...
 
If the responders were volunteers and certified in the past two years (the usual recertification requirement) under the new standards for the general public, they actually would not be allowed to perform CPR breathing at all--it would be exceeding their new training standard, and making them personally liable.
I don't believe that to be the case. The last one I took was breathing and compressions, 30/2. Hands Only CPR is being advocated as a solution that allows even people not trained in CPR all all to help, and yes, they're allowed to do so.


Absolutely 100% death traps IF you are not 100% committed to diving them properly, not beyond your training, and maintaining them meticulously.
Are you saying it's like a single-engine airliner - perfectly safe and a great fuel saver, if you're 100% focused on flying and maintain it 100% intact 100% of the time?
 
Are you saying it's like a single-engine airliner - perfectly safe and a great fuel saver, if you're 100% focused on flying and maintain it 100% intact 100% of the time?

It's not perfectly safe.

It obviously has some advantages over open circuit because otherwise why would anyone accept the additional cost, work of setup and breakdown, training and risk?

Scuba diving is not perfectly safe, and yet pretty much everyone in this thread has chosen to do it, at levels that are compatible with their personal interests, abilities and comfort. I hear a lot of this talk about CCRs but it's not so common for someone to come into the tech or cave forums and say that trimix or cave diving is a death trap.

Those comments are just pejoratives out of context, and I'm not sure what it adds to this conversation unless we know that the accident was caused by the rebreather. Even then... not something you would see in a discussion about an accident on a high risk OC dive (like the current one about the Australian diver in the Philippines).
 
Very interesting, Simon. I can appreciate that having the lungs full of water will of course prevent them from functioning, but I've never heard this discussed in a CPR class--including one given by a municipal parks department, which operates several pools. Presumably in a drowning rescue someone would have tried to empty the airway and put the victim in a rescue position before starting to whale away on them, but it seems that not "air enough"?

Can you point me to a link to those guidelines, so I can look further into them?

Sorry they omitted the key parts about ventilation for drowning victims. The compression only approach has long since been recognized as inappropriate for drownings:

CPR and Drowning

https://www.resuscitationjournal.com/article/S0300-9572(16)30043-0/pdf

European Resuscitation Council Guidelines for Resuscitation 2015: Section 4. Cardiac arrest in special circumstances - ScienceDirect (figure 4.6 is most succinct)

AHA Part 10.3: Drowning
 
Presumably in a drowning rescue someone would have tried to empty the airway and put the victim in a rescue position before starting to whale away on them, but it seems that not "air enough"?

Long time ago in a country that doesn't exist I was told about bending them over the knee while pulling their tongue out ("use a hanky, it's very slippery") and maybe a couple of slaps on the back before starting CPR. That instruction, however, also included "you may have to knock them out before rescuing because otherwise they'll try to climb on top of you and keep you under until you drown as well". I suspect such practices are no longer acceptable even if one doesn't get paid for it.
 
https://www.shearwater.com/products/teric/

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