Death of a recreational diver after a fall on board MV Elaine

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Given that he did not sense any problem for a while, it might have been the case that if he had kitted down and gone into the bunk for a nap while his friends did a 3 hour dive, he might not have survived as well.

While of course this is all speculation, as a surgeon I would be extremely surprised to read of an otherwise healthy adult who fell from a standing position (even wearing heavy dive gear), and subsequently sustained sufficient blunt trauma to cause fatal intra-abdominal hemorrhage or some other fatal injury.

Yes, there is a bell curve for everything. And I'm not saying that something like that has NEVER happened. But if you are trying to make a guess based on statistics, I would say that the dive to 300 feet was more likely to blame for his death than the fall. The lack of significant traumatic injury on autopsy, and the presence of the gas embolism support this hypothesis.



Ken Kurtis:
I think the conclusion is that if you fall, don't immediately get up and say you're fine and proceed.

I'm not trying to be snarky, but how long would you say that he should had waited (given that he and his buddies were just then descending on a big dive)..? We have all fallen at one time or another, and I think that we have a pretty good idea about how injured we are from how we feel at the time. The one exception to this might be someone who has a clotting problem, either from a disease associated with a coagulopathy, or someone who is taking anticoagulants. This is especially true if they suffer a head injury (there is the notorious "lucid interval" with epidural hematoma). I think that would have been mentioned in the report, though. These are not minor problems, and most people in such a situation would probably not be doing 300 foot dives...

I agree, it's a good idea to make sure that you haven't damaged your gear or yourself after a fall. I just don't think that there is evidence that this diver didn't do that...
 

This is one reason to use safety divers for tech dives....so that if an emergency occurs, you would be able to rapidly ( without deco stops) run the unresponsive diver to 100 or even to 50 feet, where they could be handed off to a safety divers, then you could rapidly return to a practical staged deep stop depth again prior to significant DCS damage manifesting.....Real buddies will endanger themselves to save a team mate....insta-buddies will most likely watch the un-responsive diver die.

This is also another indictment against crazy long bottom times at 220 to 300 feet or deeper.....keep to 25 minutes bottom time or less, and the danger of a life and death rescue to the assisting buddy, is no where near as great as for 35 minute or longer bottom time plans.
 
While of course this is all speculation...

I can only speak to personal experience and say that "shock" can do screwy things to your good judgement. Smacked myself up pretty badly once and immediately after the incident I was "ready to go". Fortunately I was held back by others. 10-15 minutes passed and the pain set in and the realization that both me and my equipment were damaged and if I have I had committed, I would have likely hurt or killed myself.
 
Standard practice in the UK is to put your fins on at the bench and shuffle (not walk) to the gate.

I won't let students do that on he pool deck and especially not on the boat. It's too hard to get all the blood out of the tile grout or diamond-plate decking.

flots
 
The full report of this incident focuses on the perceived need to make it safer for heavily encumbered divers to get to the exit point on the deck. It also recognizes that divers so encumbered cannot easily put their fins on after they have become fully equipped. We also had a person post on this thread about the need for safety divers on technical dives. These solutions all sound good, but they all have problems when you try to put them into effect. I am going to address this issue generically, speaking of those needs in general decompression diving more than about the specifics of this incident.

I have done most of my decompression diving in south Florida. I am open circuit, and I have done dives carrying double steel tanks, two Al 40s, an AL 80, and an argon bottle. (Some people carry more than that, but I haven't been there yet.) With all the rest of the gear, I am carrying well over 200 pounds of equipment. It is really hard just to stand up, let alone walk to the exit point. There is no way I can put my fins on without help if I have to do that last. If I were to fall while dressed like that, I can easily see how I could be seriously injured. As I try to work my way to the exit point on a boat that is pitching and rolling in the waves (as the boat in this incident was), falling is a serious danger. It would be great if each diver had someone assist in both walking and putting on the fins.

The first problem with the idea of having assistance as you walk is the common need to get in the water quickly. I have had a number of dives in which a surface current made it important for everyone to get in the water in very rapid succession. If we are "dive bombing" a wreck, we need to get in the water quickly and drop rapidly, with no time for playing around on the surface. Having a mate walk each diver to the entry point and assist in putting on the fins there would be a real challenge in the amount of time it would take. There are many occasions when you can indeed take that much time, and on those occasions, I agree that it is very valuable. If you have the time for a leisurely entrance With enough time, one crew member is all it takes, but if you have to get people in the water quickly, you need more people. These people need to be paid. Having more paid crew on a dive for the sole purpose of helping people get on and off the boat is a luxury that would greatly increase the cost of the trip.

On a typical one-day tech dive in Florida, it can be hard to get enough divers together to make the trip economically feasible for the dive operator. A skipper and mate/DM is usually all you get, and in many cases, I can't see how the operator is making any money on the trip with the small number of divers paying their way. They could charge more, sure, but it is already hard to get enough people for the trip because of the expense. For those who don't do this kind of diving and don't realize it, helium typically costs about $0.80 per cubic foot, and with everything put together, your gas bill alone for a single dive might be around $150. Divers are paying a considerable chunk of change for a single dive before they shell out for the boat fees and tips. Consequently, you can expect the dive operator to try to control costs by having the smallest crew possible. I have done dives with nothing but the skipper on board.

So that brings us to the idea of safety divers. Sounds great, but, again, not many of us can afford to pay people to be in the water at different depths just in case something bad happens.

In the dives I typically do, before we gear up, the DM asks for our dive profile. When the dive time comes, I struggle to my feet, sometimes getting help standing up. My fins are already on, and I waddle to the back of the boat, trying to keep my balance on the rocking boat. There I join the queue waiting to splash in rapid order. There is usually a DM to help at the entry point. Before we suit up, the DM asks for our dive plan. During our ascent, the DM will occasionally drop down to check on us, timing the descent according to the profile we gave him. He will make sure we don't have gas needs, and he will confirm when we expect to be done. He is our "safety diver," but he isonly in the water near the end of our ascent. When we reach the surface, we have to get back on the boat. That is the hardest part of the dive for me--handing up tanks, pulling off fins, and climbing up that ladder with steel doubles while it is slamming up and down in the waves.

In summary, for me, the hardest and most dangerous parts of a deep decompression dive are getting on and off the boat--no question about it. It could be made much better with the addition of more crew to assist us, but I already have trouble affording the dives, and the additional expense might make make it too expensive. I am willing to struggle to get on and off the boat as I do now, at least until some rich uncle I did not know existed dies and leaves me a fortune.
 
It could be made much better with the addition of more crew to assist us, but I already have trouble affording the dives, and the additional expense might make make it too expensive. I am willing to struggle to get on and off the boat as I do now, at least until some rich uncle I did not know existed dies and leaves me a fortune.
So, I run a trip with 12-15 crew with 12 divers. Yes, the biggest complaint is price. But, we'll carry your stages and clip you in, put your fins on, and practically carry you to the exit. You can take all of the stages and scooters and cameras and junque off before getting on the boat and clip off. We will bring it up, all but your scooter. It costs almost $600 a day.
 
On the issue of safety divers....if you have a dozen, or even a half dozen friends/buddies/aquaintances that tech dive--typically together, it is one person's turn each weekend to play safety diver....this is not charged for--and this is not boat crew, it is extra free crew you make up yourself. With the better boats, they don't charge this diver, as they see it as helping them with the tech dive, even though technically it is just another diver with no liability link back to the boat.

Every boat we used over the last 20 years for tech dives, had at minimum, a captain, one crew member, and one safety diver that we would bring ( our responsibility). The safety diver can snorkel topside over the float during the bottom time portion of the dive, and at the pre-arranged ascent time in to the dive--say at 25 minutes in, or 29 minutes in, can swim down to 50 feet or to such depth that he can make visual contact with the tech divers, and determine all is well. When they actually get face to face, the safety diver can check to see if any more gas of any type is needed, or if any special circumstances exist. The safety diver will also help get the tech team gear back on the boat--stages, etc, as we would endeavor to AVOID any tech diver having to exert power to lift heavy gear up onto the platform--heavy exertion can cause bubbling you don't want....

In the initial handshaking at pre-determined time into the dive....the safety diver is free to make an immediate ascent to the surface for anything of an emergency nature, and this worked flawlessly for us for many hundreds of tech dives between 1994 and 2004 ( when we stopped doing these weekly/monthly..George got too busy running his Dad's business, and the rest of us all got busier with our work....tech diving takes up huge planning and detail time, compared to just doing recreational dives!!!! ).
 

So, I run a trip with 12-15 crew with 12 divers. Yes, the biggest complaint is price. But, we'll carry your stages and clip you in, put your fins on, and practically carry you to the exit. You can take all of the stages and scooters and cameras and junque off before getting on the boat and clip off. We will bring it up, all but your scooter. It costs almost $600 a day.

You are talking about a mult-day liveaboard trip, right? I think that's great, and I would be interested in planning a trip on such a boat. That would be a major vacation for me.

What I was describing in my post was day trips. It is very hard to scare up enough people to go out on a one day local trip. I think the circumstances are different because of that. I have spent many a frustrated length of time without being able to dive because of the difficulty of getting a minimum number of people who will go on a given day.
 
I'm not trying to be snarky, but how long would you say that he should had waited (given that he and his buddies were just then descending on a big dive)..?

No snarkiness perceived.

I don't know that there really is an answer. But the other (admittedly loaded) question is: Which is more important, to make the dive or survive the dive? We preach constantly that no one can be more responsible for your safety in the water than you. I would rather take whatever time is necessary (inlcuding a decision to abort the dive) and if that affects anyone else, I'm sorry, but my safety is more important than your inconvenience. I like to think I'm that way with people I dive with too. Take as long as you like and when you're ready, we'll go. Move to the pace of the slowest diver, not some arbitrary schedule or the pace of the fastest diver.

I just don't think that there is evidence that this diver didn't do that...


My impression was that he didn't but that could just be bad writing, not an accurate reflection of the actuasl time. However, regardless of what this guy did or didn't do, the overall concept is worth reflecting on when people are making choices about diving or not diving following some unplanned event in the dive sequence.

- Ken
 
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