Diver drowns, 6 feet water, OW training, Scotland

[tonka97]

Female diver in Scotland drowns during OW training 8/18/2010
Female diver died after having panic attack in just 6ft of water - The Daily Record

http://deadlinescotland.wordpress.c...off-the-coast-of-fife-while-learning-to-dive/

Truly sad, and the investigation continues.

In reading this news report one statement caught my attention.

"In the panic, she swallowed a large amount of water."

From my perspective, this oft repeated concept of 'swallowing water' obfuscates a more serious, potentially fatal event, laryngospasm. http://www.youtube.com/watch?v=nPtdkqOLLP4

Simply swallowing water is NOT a problem causing laryngospasm. Pulmonary aspiration of even small amounts of water (or even spray) CAN result in laryngospasm or even 'dry drowning' http://archive.rubicon-foundation.org/5913

The expression "it went down the wrong pipe!" used when we cough or nearly choke addresses the differences. All is ok if we swallow a mouthful of liquid down our esophagus during a meal, BUT if the liquid penetrates our 'windpipe', the larynx, we reflexively cough to clear the AIR passage.

In the following illustration, the two completely distinct passage ways are apparent:

1. The esophagus leading to the stomach, for food and liquid
2. The larynx leading into the lungs via bronchi for breathing
Click on the attachment for a larger view.

Many OW instructors continue to dismiss a student diver's choking with merely 'swallowing water'. This is a dangerous and ignorant instructional error.

The consequence may be a diver death.

 

[TSandM]

It's a good point about laryngospasm, but this is another one of the cases where I wonder about immersion pulmonary edema. If you translate, "thought there was something wrong with her breathing equipment" into "felt like she couldn't breathe," this could easily be the description of a case of IPE. Without the experience and training that denisegg had when she had her event, I could easily understand a diver panicking. And the autopsy will show lungs full of fluid . . . aka drowning.

 

[tonka97]

Thanks Doctor, your posts are always informative and contributive.

Here is a link for immersion pulmonary edema (IPE) from the DAN site:

DAN Divers Alert Network : Immersion Pulmonary Edema

 

[Cave Diver]

And the autopsy will show lungs full of fluid . . . aka drowning.

Lynne, do you know if there is any easily discernible way to determine if fluid filled lungs are from drowning or IPE? If so, is this something that we as divers should press for whenever an autopsy is done?

 

[iztok]

Lynne, do you know if there is any easily discernible way to determine if fluid filled lungs are from drowning or IPE? If so, is this something that we as divers should press for whenever an autopsy is done?

I am assuming (perhaps wrongly) that type of fluid in the lungs would determine that. However if person doing the autopsy didn't capture sample all might be lost.

 

[Ayisha]

But how did they know that she thought something was wrong with her equipment?

 

[TSandM]

The fluid in the lungs from IPE should be isotonic with plasma -- in other words, it should have a salt content similar to that of blood. Therefore, if someone "drowns" in fresh water, it might be possible to sample the edema fluid and determine if the sodium content is appropriate. It will be confounded by any aspiration of water that might occur in the process of drowning, though, and I'm not sure how successful they'd be in getting alveolar samples. I'm not a forensic pathologist.

 

[sabbath999]

The news report is, as usual, poorly written from an accident anaylisys point of view, but it makes me wonder what was going on with the instructor...

Correct me if I am wrong, but shouldn't:

A) the instructor recognize the signs of a diver struggling at the surface... whether it was the traditional drowning symptoms or the far less common "going nuts" panic.

B) inflated the student's BCD and dropped her weights

I don't know if that was done, it may well have been... and indeed my wife the pathophysiolgist finds the thoughts about laryngospasm and immersion pulmonary edema interesting.

We will probably never know, since the news media doesn't report well or follow up. We don't know how deep she had been, what her dive profile was like, what her ascent rate was, etc.

Was she training in shallow water? That might lead us more to think laryngospam. Was she on the tail end of a deeper dive? That might lean more towards immersion pulmonary edema (or so says the pathophysiologist in the house), who says IPE can happen shallow but it is not as common.

 

[cloudflint]

The area she was diving at is very shallow, we always say that if you hit 10 meters at that site you should head in immediately because your probably a mile out at least.

Our club is kinda shocked over this, the Dundee club is just down the road from ours and it was one of our members who originally founded their club. The site they where on is literally a couple of hundred yards from a coastguard station and its a very shallow and flat dive that gets good visibility so we have always considered it to be a perfect training site.

Our DO contacted the coastguard and from what we heard the casualty was brought to land and they began doing CPR while another diver ran up to the coastguard station to summon help. One of the coastguard came down to assist with the CPR and she was evacuated out.