Diver Died In West Palm Beach, Fl.

[seaducer]

Hey all, I don't mean to hijack your hijack, but getting back to the original incident for a moment...

I was diving the Deep Obsession that day. We set out for our afternoon dive a little early, and were geared up after our 10-minute warning for a negative-buoyancy drop over Governor's Walk (I think that's the name... series of drug-runner boats).
...Why are these details worth recounting? Because I was impressed by how much these supposed competing operations quickly pulled together to assist when needed. There was a lot of instantaneous coordination between all parties involved, and that meant no Narcosis diver had to float on the surface wondering where their boat was. The operators all behaved professionally, and that's worth noting.

I was on Deep O. a few weeks back. One of the other boats was assisting an injured turtle, and we picked up a few of their divers as well. All these boats look out for each other all the time. You are not really diving with one crew, but all of them. It is a good feeling. I am a fairly experienced diver used to doing my own thing but I felt well taken care of.

RE the demand valve conversation: I did a bunch of courses back in February, DAN O2 and such. There is a new demand valve out that releases under pressure, before lung overexpansion. We were able to test it out and it worked. I hear it is quite pricey though.

 

[dashark]

I believe Jim Fixx, world class runner died of a heart condition. Some pre existing conditions are never known until its too late. Not saying that is the case here. Just saying.

good point.

 

[deep.dude]

I went diving with a friend that had been out of the water for about a year. We were in a lake, wearing dry suits. As soon as we got in the water and descended a few feet, she had us go up, saying, "I can't breathe" I noticed quite a bit of anxiety and tried to calm her but she would not calm down. I decided to abort the dive.

From the little bit in the referenced articles, it sounds similar. Can you be scared to death?

Is it just me, or does that statement that she deflated her BC sound fishy? I understand spitting out the reg, as that appears to be a common thing. But, in the midst of this issue, take the time to deflate the BC? Hmmmmm. I wasn't there, but it just seems odd.

It would not be odd if she mistook the lower dump valve on the back of her BC for a release mechanism for dumping her weights. I would suspect that the lower dump valve probably would not have released enough air in the upright position to be a problem unless she was over weighted, which appears to be a common problem amongst new divers.

 

[medical1]

RE the demand valve conversation: I did a bunch of courses back in February, DAN O2 and such. There is a new demand valve out that releases under pressure, before lung overexpansion. We were able to test it out and it worked. I hear it is quite pricey though.

The DAN Advanced O2 administration course is now taught with a MTV-100 flow-restricted Manually Triggered Ventilator which releases under pressure. They START at about $575.00 just for the ventilator unit :11: There were occasionally problems with the older units from what I hear.

 

[deep.dude]

First, I wish to express my condolences to the friends and family of the dear departed. I also would like to offer my support to the crew of the Narcosis. I have been diving for many years and have dove from many boats. It is my opinion that the crew and captain are top notch and I believe that they did everything possible to try to save the woman.

I have read all the post concerning this incident and am appalled by the line of posts. I was going to keep my nose out of it but I have since decided that it would be better if I attempted to aid the diving community by offering my suggestions on how to promote dive safety and perhaps prevent further situations form occurring by attempting to educate, if not the public in general, at least the divers who have viewed this post.

First is the matter of speculation and how doing so can take away from the real issues. Most of these posts seem to be focused on what was or should have been done in an attempt to revive the victim. There seesm to be a lot of discussion on the use or failure to use O2. The only legitimate statement I have heard about the incident was the Captain’s statement that rescue breathing and CPR was done by the crew until emergency personnel took over at the dock. That was a generic statement to the press under conditions of obvious stress. That statement did not indicate whether O2 was used or not. I know for a fact that the Narcosis has an O2 setup that I would be willing to bet is superior to that carried by most local dive boats. I was on board a few years ago when O2 was supplied to a person who appeared to have nothing more that a panic attack. This person was taken to the hospital and ultimately checked out clean.

My second issue is regarding the use of an AED. If any of you have dove from the Narcosis within the last year as I have, you would know that the Narcosis does have an AED on board and the local of the first aids kits, the O2 kit and the AED are pointed out during the captains pre trip lecture which I know by observation the people tend not to listen to because they are too busy talking to friends or setting up their gear. Whether or not an attempt was made to use the device was never mentioned on any of the news that I have heard or read. But I do know that an AED can not be used to start a heart that is in full cardiac arrest.

So far I have not heard why she came to the surface so early in the dive. Since she supposedly never got below 15 feet or so maybe she was having trouble clearing her ears. May be she was nervous about making her first dive without an instructor and panicked. Maybe she had a medical condition that contributed to the problem. What seems to be known is that she only made it to 10 feet or so of depth. When she made it back to the surface she would not keep her regulator in her mouth. She was apparently struggling on the surface and that she was trying to dump the air from her BC even though one of the divers with her was trying to put air into her BC and they were trying to hold her up. This paragraph opens up a number of questions. First of all her instructor was on board the boat that day but he was working with new students. The victim was there to dive for fun. Since she was already certified, it was not the instructor’s responsibility to watch her in the water. If he/she was watching their students as they were supposed to be doing there is the high probability that they never knew there was a problem.

As for the fact that she wouldn’t keep the regulator in her mouth it is a common symptom of diver panic. The want the regulator out of their mouth and the mask off their face. The also want to be out of the water so bad that the struggle to stay up even if it is unnecessary. They literally try to climb out of the water even if there is nothing to climb on. The last thing they would do is to dump the air out of there BC. This brings us to another major point. One of the divers that surfaced with her claimed she was trying to dump the air out of her BC instead of trying to add air. When they made the statement they mimicked her doing so. This showed that she was dumping air from the dump valve located on the lowed part of her BC. This is not a dump valve that is normally used by a new diver or student. Since it is on the bottom of the BC, it will not release much air unless the person is swimming in thew head down position. Upright and on the surface it won’t do much more than act as an over pressure relief valve. If she was pulling that valve while upright on the surface It really shouldn’t have much of an effect. So why was she pulling it. I would bet that she was mistaking it as a cord to dump her weight rather than a cord to dump her air.

This leads me to a major training issue. I was taught that a diver should only were enough weight to make themselves neutral (not floating upward or sinking while on the surface with no air in their BC. This means in an upright position you should be about eye level with the water. If you are weighted properly it should take very little effort to kick high enough to keep your moth above water. This is with no air in the BC. If there is any air in the BC at all, keeping your mouth above the water line should require no effort. One of the divers came to the surface with her filled her BC. Since she was pulling the lower dump valve and not the one that all of her training taught her to use she should have been high enough to keep her mouth out of the water with no effort. I heard that not only was she struggling to stay up the divers with her were trying to hold her up. The only way that this makes any sense at all would be if she was definitely over weighted. With all the diving I have done over the years I have found over weighting amongst new divers is probably the single most common problem out there. If a diver is struggling on the surface the first thing you want is for them to keep the regulator in their mouth and if they don’t or that is not enough the second thing you do is drop their weights. With all the people I have heard from, no one has indicated that her weight were dropped. Most people range from being neutrally buoyant to definitely positively buoyant. Add a highly buoyant wet suit to the mix and lead weight becomes a necessity to dive. Remove this lead and you will definitely float.

My favorite quote is “Learn from your mistakes or your doomed to repeat them. Better yet, learn from others mistake and never make them yourself”

 

[dashark]

You make some good points, deep dude. however, don't be too critical of the previous posts. They aren't speculating any more than you are. Sounds like you do have some good info to add, though.
However,your comment about the AED "not being used to start a heart that is in full cardiac arrest" is wrong. That is exactly what it is designed for. If a person is not in full arrest, you don't use any type of defibrillator on them. If you do, you could send them into full arrest.
Not sure what experience you have with using or being trained on an AED. I have used them several times on people in full arrest. If your patient isn't in full arrest, the unit won't even advise a shock. They are almost dummy proof. No need to be able to read an EKG for a shockable rythm like a standard field monitor (which I also use on a regular basis).
As far as the rest of these posts, people are just asking questions and trying to learn from an unfortunate accident. That is the beauty of this site.

 

[deep.dude]

I am sorry if I sounded too critical dashark. The only thing I was trying to be critical of was what appeared to me to be assumptions that the crew failed to use O2 or an AED. I have made at least 30 trips on that boat and I know they have the equipment on board. And as of yet I have not heard anything from a reliable sourece that they failed to use the equipment available to them.

As for the AED I am not sure where you are getting your information but here is some text taken directly from the red cross web site.

How does an AED work?
An AED is easy to operate. It uses voice prompts to instruct the rescuer. Once the machine is turned on, the rescuer will be prompted to apply two electrodes provided with the AED to the victim's chest. Once applied, the AED will begin to monitor the victim's heart rhythm. If a "shockable" rhythm is detected, the machine will charge itself and instruct the rescuer to stand clear of the victim and to press the shock button.

As it states "there must be a shockable rhythem"

From wikipedia
AEDs, as with all defibrillators, are not designed to shock asystole ('flat line' patterns) as this will not have a positive clinical outcome.

I'm sure I can dig up a lot of other sources that indicate the must be sometype of heart rhythem before an AED will introduce a shock. This is the whole reason that having quick access to an AED is so critical. The Objective is to stabalize the rhythem before the heart flat lines. After does the only options available to the layman is good old fashion CPR.

 

[dashark]

I get my info from the fact that I was trained as a paramedic 12 years ago and have practiced as such in very busy areas the entire time. i have personally run more full arrests than i can remember. Both with an AED and a full ekg monitor.
Your above reference is correct, of course. It does have to be a shockable rythm.
I was referring to your comment : "an AED cannot be used to start a heart that is in full cardiac arrest". Not sure if you meant to say something else, or, if you are misunderstanding your info. Just because the heart is in a shockable rythm ( v-fib or pulseless v-tach) doesn't mean that the patient is not in full arrest. Electrical activity in a heart does not mean that it is still pumping. That is why we check for pulses.
The whole purpose of AED's and is to "re-start" a heart that is in full arrest. The shockable rythm is just the electrical activity that is left in the heart when it goes into arrest.
Full cardiac arrest is a patient that is pulsless and not breathing. Sometimes they are in a shockable rythm, and, if you can get to them in time or provide cpr until a shock, an AED can re-start a heart that is in full arrest. It is exactly what AED's are designed for.
As far as the crew of the boat goes, if you read some of my previous posts, I make mention to the fact that any rescuer involved does the best they can with the training and conditions available with any given rescue.
The point of this thread is not to second guess, i feel, but to pose questions for all of us to learn from. Although we sometime stray from that. I think we probably could both agree on that......

 

[Reef]

RIP...

Condolences go out to family and friends.

 

[deep.dude]

I apologize to everyone for my misunderstanding. I thought that full arrest meant the same as flat lined which apparently inaccurate. I will try to be more careful with my wording in the future. My thanks to Dashark for setting me straight on this matter.