Diver dies at Molokai on Maui dive boat

[wgw04024]

"Really, really good CPR can keep people alive for a remarkably long period."

How long?

 

[scubadada]

Sorry, did this event actually occur?

 

[doctormike]

Without a pulse (no evidence available either way but common in a drowning), an AED will do nothing

I only dig out earwax for a living, but this is not correct. A defibrillator (automatic, or otherwise) is used to convert a pulseless arrhythmia into a normal sinus rhythm. Specifically, they treat ventricular fibrillation or sustained ventricular tachycardia. In VF there is no detectable pulse, and sometimes in VT there is no detectable pulse either. This is because the contraction of the heart muscles are disorganized or too fast, and doesn't effectively pump blood.

If you come across a pulseless victim, unless you have an EKG there would be no way of knowing if the patient had VF/VT or asystole (a complete cessation of cardiac electrical activity). So the one person that an AED could save would be someone with one of those shockable rhythms without a pulse. The AED reads the electrical rhythm and is designed to deliver a shock if one of those shockable rhythms is present, but they are typically used on pulseless victims.

Also, I don't think that it's reasonable to expect any diver to blow off 34 minutes of deco, no matter what kind of recall system you have. Those are hard choices, but it has nothing to do with mixing OC and CCR, or rec and tech. Lots of sad stories involving emergencies on a boat and divers who can't surface immediately.

 

[KevinNM]

"Really, really good CPR can keep people alive for a remarkably long period."

How long?

A Case of Survival after Cardiac Arrest and 3½ Hours of Resuscitation

Full Recovery Case After 82 Minutes Out-of-Hospital Cardiac Arrest: Importance of Chain of Survival and Predicting Outcome

The basic problem is that survival after extended submersion isn't at all good.
An Analytical Look at Survivable Submersion Times
"Despite this frequency, a 2011 review of medical and news reports with documented submersion time and age found only 43 cases of survival with near-normal functionality following prolonged submersion (> 4 minutes).(4) Two-thirds were children less than 12 years old, and the remaining adolescents and adults were noted to be small in size. Only 4 survived prolonged submersion in water greater than 6° C (42.8° F), and all were submerged less than 30 minutes."

But it happens
Scuba accident survivor: I'm here because "hero" husband did not stop CPR

However, the odds of successful CPR are generally not very good. But it offers the only chance of survival.

 

[Frontpointer1000]

Red notations are my response

"Really, really good CPR can keep people alive for a remarkably long period."

How long?

Rephrase: Good CPR can oxygenate the brain and other vital organs for a long time. How long? as long as you are doing CPR (and providing oxygen -even in the form of normal air). HOWEVER, that does not equal "alive"

Personally (and professionally), after one hour of good CPR and other typical interventions for a "code", I typically stop CPR. This time can change based on how long the patient has been down and unresponsive, comorbidities, age, etc

I only dig out earwax for a living, but this is not correct. A defibrillator (automatic, or otherwise) is used to convert a pulseless arrhythmia into a normal sinus rhythm. Specifically, they treat ventricular fibrillation or sustained ventricular tachycardia. In VF there is no detectable pulse, and sometimes in VT there is no detectable pulse either. This is because the contraction of the heart muscles are disorganized or too fast, and doesn't effectively pump blood.

Be careful about your definitions here. Pulseless electrical activity is NEVER supposed to get a shock. VF/VT certainly should be shocked into rhythm. Modern AEDs can determine the difference.

If you come across a pulseless victim, unless you have an EKG there would be no way of knowing if the patient had VF/VT or asystole (a complete cessation of cardiac electrical activity).

Asystole is NEVER shocked, an AED is useless in this case.

So the one person that an AED could save would be someone with one of those shockable rhythms without a pulse. The AED reads the electrical rhythm and is designed to deliver a shock if one of those shockable rhythms is present, but they are typically used on pulseless victims.

Pulseless patients can have VF/VT or asystole/PEA. The latter two should not be shocked/defibrillated. They should, however, continue the regular BLS PEA algorithm: CPR, oxygen, epinephrine (if available), atropine (if available).

NOTE: applying O2 is part of BLS if available.

Also, I don't think that it's reasonable to expect any diver to blow off 34 minutes of deco, no matter what kind of recall system you have. Those are hard choices, but it has nothing to do with mixing OC and CCR, or rec and tech. Lots of sad stories involving emergencies on a boat and divers who can't surface immediately.

I agree.

Im reading this post again and I think we are saying the same thing: only shock VF and VT (in the case of a pulseless victim)

 

[pasley]

Any one find any credible news media or government report on the alleged incident?

In several searches on the internet the only reports of this alleged incident are on Trip Advisor and here on this forum. That strikes me as odd. Could the OP provide any links to any newspaper or government reporting of this alleged incident.

 

[eelnoraa]

When I dove with Lahina Divers they were very thorough on the safety briefing. They showed everyone where the O2 kit was kept. I was impressed with how professional the crew was. This was 8 years ago.

I also dove with Lahina Divers before, maybe about 2 years ago. I can support this observation for my trip

 

[Kevrumbo]

No mention of US Coast Guard aid or medevac involved in the account of this incident . . .

Nothing in the News Releases:

14th District Hawaii & the Pacific

 

[Scubagolf]

"Sorry, did this event actually occur?"

Call me jaded-- but if this or something close to it did NOT happen, I think we would have seen some form of denial from the operator.

 

[Unhappy]

Hello. I'm the one who posted the Trip Advisor review. Please feel free to ask me questions and I will respond here.