Diving Accident, Self-Responsibility and Balance

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Thea Strassburg

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Location
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I am posting here, frankly, for my own mental health. Since this incident 5 days ago, I am unable to focus, think about it constantly, try and pinpoint exactly where I screwed up, what should I have done differently.
I feel shocky, disoriented, we have been home for two days and still I cannot let this go. I need to talk, de-brief, I feel alone, and stressed and need to talk. And having few other friends who have ever dived, I thought I would ask for your indulgence and allow me to share this incident here.

My husband (non-diver) and I just returned from a 2 week vacation in Eleuthra, Bahamas (2/21/2014). I am a 49 year old attorney from Missouri and essentially a vacation diver, certified, with about 60 dives under my belt. About half of those dives were in Hawaii, the rest off of various islands in the Bahamas. I was certified about 2 years ago.


I have visited this forum hundreds of times over the years for informational purposes. Last night, I joined for emotional reasons. Something really bad happened. I am not sure why. I have always been a strong, capable woman, worked in a trauma center for years, (before going to law school). I took every moment of my PADI training extremely seriously. I have watched and read every account of a scuba accident I could find prior to every dive. Safety is what I specialize in.

But for the last 5 days, I have re-lived this incident a hundred times in my head. I can't sleep, I feel physically weak, I am irritable and angry and shocked and... Just in disbelief that this perfect vacation almost, and I mean seriously almost, ended in my death.

There is no one to blame. I take full responsibility for what happened here. I just cannot figure out the WHY of it. I can't make sense of it, and I am asking for help, here, in doing so. My mental health has taken a big hit, and I have no other experienced divers to de-brief with (I live in Missouri). Any thoughts totally appreciated.

This last Wednesday, February 19, 2014, we went on a one tank wreck dive at Devils Backbone off of Harbor Island, Bahamas. I had already dived a few times during this vacation, and had a blast. It was a 1:00PM dive, there were 3 Dive Masters, and a Master in training on board, all under 30 years old. We had 4 certified divers, including me, and 3-4 discovery divers.

S (head Master) gave us our briefing. He and the Master in training (a pretty girl around 22) would take the certified divers over the reef to the wreck, we would descend and explore, then return through a small swim through (a huge iron pipe about 20 feet across and 15 feet wide). S stated that there would be a little current on the way back, and we should feel free to grab the dead coral to ascend the shallow reef after the swim through if needed.

We swam over the shallow reef and down to the wreck. My videos show the surge tossing us around after we reached the wreck. I had some trouble with my weight belt slipping, and had to fuss with that a bit. I remember being unable to hover to get a decent pic of anything. I had my flash light, and was and was checking out nooks and crannies, but the surge was just... too swift to stabilize long enough to really get a look at anything.

It is likely, looking back, I think I was exerting myself more than I realized. You guys know how cool it is down there, how easy it is to focus on the environment around you and not how you are physically feeling. Between getting that damn weight belt right and fighting the surge, I was likely getting winded.

S turned us around as the dive wound down. I waited my turn to enter the swim through, the only other diver behind me was the Master in training. Still, I was having a blast. I swam though the huge pipe, and began to ascend the reef on the other side. I tried to grab the "dead coral" to pull myself up and over the reef, but couldn't get to it. Every time I reached out, the surge grabbed me and dragged me up and away. Swimming hard, I would go forward two feet, then get pulled back ten feet.

And suddenly, I was tossed to the surface and all hell broke loose. The Master in training was gone, the Dive Master was gone, I was alone. And breathing way harder than I knew I should be. 2-3 foot waves were washing over me, at some point, I topped a wave and saw the boat looking smaller than it should have been. Somehow, right about now, my camera turned on and began recording. Purely incidental, I had no idea it was recording. The first think I hear on the video is myself, shouting "help!"

And I was panting. Remembering my training, I immediately gave the distress signal, waving my arm, and could see that the third diver master, who had stayed on the boat, saw me (I hoped anyway). I forced myself to stop, rest, catch my breath. But I could not catch my breath. My breathing was SO hard and SO shallow, I couldn't get my breath. I dropped my weight belt, trying to calm myself, "never panic, never panic" I chanted to myself. Suddenly, a diver surfaced in front of me. I said "are you a dive master?" he said no, just a diver.

He told me to inflate my BCD, but by this point, I was disoriented, I couldn't find it. I think the other diver inflated it but don't remember. At this point, my breathing was out of control, I was getting no air, I took my reg out, it didn't help. S suddenly appears as well, inflates my BCD, speaks to the other diver. I remember he said "keep your reg in", I told him I can't breath.

I remember, deep in my head, that I knew I was dieing. "Stay calm, don't struggle, deep slow breaths" I repeated deep in my head over and over again. I recall the other diver trying to push against my feet, while S, the dive master, had my BCD, trying to tow me in.

My video shows he was kicking hard, on his stomach, then having to flip over onto his back, kicking even harder. The waves washed over us. I remember looking over my shoulder, thinking we were near the boat. We were not near the boat, the boat was getting SMALLER. Later, my husband and the other non-diver, who had no idea it was me they were towing, confirmed that we were being pulled out and away from the boat.

In the meantime, the dive master who had stayed on the boat, put on his wet suit and stood watching us. My husband has no idea what he was waiting for, he had a yellow bouy in his hand attached to a thick rope, but took no action.

My video shows from the moment I shouted help and signaled, to the moment I saw that yellow buoy, 15 minutes had passed. The video also shows that we were suddenly being pulled hard and fast through the water, the dive masters kicking slowed, and within 5 minutes or so we were at the boat.

My breathing had gotten faster and even more shallow. I pulled myself on the boat, telling them I couldn't breath, help me, I need air, I need air, and collapsed. Unable to move, onto the deck. I have never been sick a day in my life, I was shocked and terrified that I could not even lift my hand, or move a finger. "Air", "Help", I think I gasped. Someone said "get the oxygen!"

Still laying at the back end of the boat, I was also inhaling exhaust fumes from the motor. "Pull me up, exhaust" I said maybe 3 times. Finally they dragged my away from the exhaust.

Later, my husband told me that the dive master who had finally swum out and pulled us in produced and O2 tank from somewhere. But he couldn't figure out how to attached the mask. I could here the tank clanging, knew it was coming, felt some smidge of relief. But it didn't come. It took almost 5 minutes to get the mask on my face. Someone just stuck it on my face and let go. The mask was not on right, the O2 was flowing up my cheek. I grabbed it and tried to get it on right, and finally got a whiff of the golden oxygen.

Then suddenly they took the damn mask AWAY, I could hear more clanking, I am panting SO HARD, and SO FAST and forcing myself not to pass out. "AIR, HELP" I think I said again. Finally, another mask was stuck on my face. My husband later told me they had put the wrong O2 mask on me and had to switch it out for another one.

But no one positioned it. I grabbed it and moved it around until I got the fricking air that I knew somehow I had to have or I was going to die..

We raced back to shore, I am still gasping but getting air. S said, "it's ok, the nurse will be at the dock when we get there", I remember being relieved. As we approached the dock, S said, "ok, they aren't coming, the nurse isn't coming". Then he said "you're out of air but we are almost there" (the emergency O2 tank ran out of air in less than ten minutes.)

We get to the dock, I was able to climb the steps, they sat me in a golf cart (more exhaust, still panting bad, still can't get air.)
They drove me the 3-4 minutes to the clinic. I am in severe respitory distress. We pull up in front of the clinic. Someone shouts "go around back, that door is broken". We drive around back, and a tiny Asian nurse sits me in a wheel chair, but can't get me over the poor stop (she was about 90 pounds, I am about 5'9, 180).

I reached for the door and pulled myself to my feet (I do not know how), and stumbled into the small clinic. But no one was there. NO one was in the hall, I just kept walking, I said "****, help, please, please help". And some lady in a blue jacket saunters up and takes me into a room, I got on the gurney, they put the O2 mask on.

By now, 40 minutes had passed since I signaled for help. It was a 15 minute boat ride to the dive site. My feet were blue, BP 180/140, O2 at 85 (even after the O2 I got on the boat). One of the nurses shouted, "get the doctor!" They start some sort of breathing treatment along with the O2, and within 5 minutes or so, I took a deep breath and smiled. Pure, unadulterated joy, relief, my mind started working, my head stopped exploding with pain, my breathing slowed and BP dropped down to 140/80, all within about 20 minutes.

Later, I learned that S, our dive master, had stopped the Discovery divers from crossing the reef and diving the wreck because the surge was too bad. Later, when the shop owner spoke to us, S told him the current was "much stronger than I thgout it would be". Later, my husband told me about the dive master on the boat, putting on his wet suit yet waiting more than 10 minutes to get in the water and pull us in. Later, the other non-diver said she was confused why he didn't jump in when it was obvious we were drifting AWAY from the boat.

This all happened just 5 days ago. I have no pre-existing health problems. I am about 40 pounds over weight (but a long distance runner up until about 5 years ago). I lead a far too sedentary lifestyle. I was likely dehydrated and had been drinking the night before. I believe that I experienced what is called "exercise induced bronchospasms (EIB)".

Being out of shape, partying on vacation, being a smoker, being dehydrated before diving, all these factors were and are within my sole control. I am fully responsible for pre-disposing myself to physical limitations that can make diving dangerous. I know that. Being aware of these factors, I only go on shallow dives (this one was 27 feet at its deepest), where the water is calm and clear. I don't take risks, I stay with the group, am careful to check my O2 constantly.

This was my fault. I screwed up and could have died from this. I believe it may have damaged other organs as well, I have been having bad headaches and mild chest pain since this happened (going to doctor tomorrow).


There is no doubt I came very near to death because I did not stay on the boat when the Master said "some current". I felt it in my gut and ignored it. My over-estimation of my physical abilities and failure to listen to my gut came very, very close to killing me.

What I do not understand are the following factors I did not have control over, and am aski1. How did I end up out there alone, whng for thoughts on, are the following questions:
en the Master in training was bringing up the rear?;

1. Why was the emergency O2 so difficult to access, then correctly administer (the hole where the air flows from should be under your nose, not askew on your cheek.)?
2. Is emergency O2 supposed to "run out" in 10 minutes?

Again, these are questions. This was an unforeseeable incident for which responsibility lies directly on my shoulders. I just can't figure this out. I am confused and depressed, doubting myself, devastated really. My head still hurts. The dive staff did everything they could to help me. I just don't understand the "why".
Any thoughts appreciated.
 
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Thanks for sharing that with us.

Answering your questions...

1. You mean alone in the surface? The other diver was behind you... and you may have been far due to the currents for her to grab you. Then it's not wise to follow someone doing a rapid ascent. And you did get divers getting to you on the surface. One question here is why did you have an uncontrolled ascent?
2. In this situation I would have thought that the boat should have gone to you. The other diver was probably seeing that you had people with you and were far and wondering if another person would make any difference or just be one more to be taken away by the current.
3. 4. 6. The oxygen should be simple, but depends on the systems and it appears that they were not familiar with it. Also the system they had may not standard. It should last a lot more than 40 min! And from what you ask then the O2 wasn't portable?! How was it?! Maybe it was, but since it was empty there was no point in taking it?
5. Yes, they should have noticed you were in a bad place.
 
I think panic attacks can kill, but I am so glad to find out you are able to write & tell us of this experience. There is no shame in having a bad experience as long as you learn from it......Hope you are ok after you get to the Dr. (sometimes you just need to hear them say you are fine & did no damage). and get your butt back in the water.....
 
As to 4., assuming the O2 bottle was full, if the O2 regulator had a maximum setting flow rate of 25 l/m, and it was set there (in an emergency it would be set at maximum flow), and you were put on a continuous flow mask and not an O2 demand valve, then the small DAN style bottles (M9) would run out in about 12 minutes (with an O2 demand valve it would have lasted the same if the breathing rate was 25 l/m).

The bigger the bottle, the greater the initial charge pressure, the lower the O2 regulator flow rate (or your breathing rate in case a demand valve is used), then the longer the O2 bottle will last.

Hope this helps!
 
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Swimming into a current is difficult and once you are on the surface where more is happening, it can be even worse. From your description, I suspect the boat came to you and then the DM brought the float to you and the boat pulled you in.

As soon as you realize the current is more than you can overcome, it is time to stop fighting it, save energy and look for other options.
 
Speaking as a certified and working instructor and boat captain, it seems to me you've had your "met Jesus while diving" moment. Most of us have had them, mine came a bit after yours (around dive 4500) but we have them and now the choice is yours: Continue diving the way you have been (vacation diver, smoking, drinking, being sedentary) or get in physical conditioning for participating in this sport you love and enjoy, because, you see, most of us are properly conditioned for the usual types of diving, but when the SHTF, we need to dig in like an athlete does and look for the reserves that may or may not be there.

I'm not telling you you need to condition yourself to be like an Olympic skier or gymnast. I certainly am not conditioned that way, but I'm strong as an ox, and I have pretty fair endurance for a sprinter. If that seems odd, it means to me I can go like hell for 440 yards, but don't run me in a miler.

To answer your specific questions;

You didn't end up there alone, you had another diver with you and a DM shortly thereafter. The real question is, where was your buddy? I'm guessing you didn't have one. I'm guessing that you didn't learn to not dive with one in OW class.

If I had to guess, the "non-diving Divemaster" had other things on his mind besides you, like, the rest of the group. If he leaves the boat, only the Captain is there to get the boat underway if necessary, recover divers, and drive the boat. Yes, you were in trouble, but you had one then 2 DM's with you, as well as another diver. That should have been plenty of help unless conditions were so obnoxious that it was obvious that your team wouldn't make it back without the tag line. It takes time to make that call. Sometimes 12 minutes. My guess would be that the "non-diving Divemaster" waited for a signal from the 2 who were with you before he abandoned his responsibilities as deckhand and came to your rescue. Now, no one was watching the rest of the divers. Your one incident has left the entire group of customers without any surface support.

The person who would have been available to get the O2 ready for you (the "Non-diving Divemaster") was in the water bringing you a tag line. They have to get back on the boat and situated too. Everyone on the boat except for the Captain was involved in getting you rescued, and he was involved too, or maybe he was getting the other divers back onboard. In any case, the O2 bottle is never rigged and ready to go. Leaving it rigged leads to corroded regulators and broken hoses. Everything is properly stowed and kept safe so when it needs to be used, it works. I don't know why someone didn't get you the right mask right away, maybe their O2 provider training wasn't up to date. It isn't required by standards, even though most dive companies require it for their dive boat crew.

I have no idea what size cylinder was on the boat. For a normally breathing diver, an E or a Jumbo D should last between 20-30 minutes if the diver is getting 100% O2. I don't understand what kind of mask you had, whether it was a nasal cannula, a non-rebreather mask, or a demand mask. 10 minutes is not outside the range of possibility if you had a small bottle and you huffed it. Or maybe it wasn't full to begin with, but I can't make that determination from the keyboard.

Divemasters would not receive training on the effects of exhaust fumes on distressed divers. Exhaust fumes don't bother me, although admittedly, I have never been a distressed diver subjected to exhaust fumes. I can think of no studies (I can't think of any studies) tryong to determine the effects of exhaust fumes on distressed divers.

The boat had a portable O2 bottle. You used it up. The boat crews responsibility is to get you ashore, and in the hands of higher more competent medical authority. They did this. The boat can't possibly plan for any kind of emergency, so they do the best they can to take care of the most common ones. Had you had your foot bitten off by a shark, they would have been unlikely to have an ATLS kit there and anyone competent to use it anyway. The problem you had, Exercise Induced Bronchospasyms, is not anything I've seen in 20 years of being a dive instructor and boat crew. We can't plan or be equipped for every contingency. They carried enough O2 to get a normally bent or embolised diver back to the dock and into the hands of the nurse.

Your narrative reads like you are looking for someone else to blame (Why didn't the boat crew do thus and such, why did the boat crew do this or that) instead of a look for answers, and you state that you are a lawyer. I give you benefit of the doubt and try to help you find answers to your questions. If I have been harsh, I had no intention of doing so, and I hope very much that you are able to overcome this and continue diving happily. Sometimes the most important part of diving is understanding when to say no and call the dive. Relying on someone else to keep you safe is a loser's game, only you are responsible for your safety. Additionally, conditions do change while you are in the water. I remember specifically one Easter on Stetson Bank when I put divers in in 2 foot seas and recovered them in 11 foot seas. The seas built in less than 40 minutes. It's one of the chances you take when you interact with nature.

Good luck with your diving future.

Respectfully,
 
I'm a bit confused about what type the actual incident was. Was there any physical injury (lung over expansion caused by rapid ascent) or was it something psychological like a panic attack? If the latter, what triggered it? The uncontrolled ascent, the lack of a buddy, the high seas, the distance to the boat, or a combination thereof?
 
There is no doubt I came very near to death because I did not stay on the boat when the Master said "some current". I felt it in my gut and ignored it. My over-estimation of my physical abilities and failure to listen to my gut came very, very close to killing me.

What I do not understand are the following factors I did not have control over, and am asking for thoughts on, are the following questions:
1. How did I end up out there alone, when the Master in training was bringing up the rear?;
2. Why did that non-diving Dive Master wait 12 minutes to swim out to us when it was clear, even to 2 non-swimmers, we were drifting AWAY from the boat?
3. Why was the emergency O2 so difficult to access, then correctly administer (the hole where the air flows from should be under your nose, not askew on your cheek.)?
4. Is emergency O2 supposed to "run out" in 10 minutes?
5. Do Dive Masters get any training regarding the effects of exhaust fumes on an already distressed diver?
6. Why didn't the boat have portable O2 bottles? Like a couple of ponies? I went an extra 8-10 minutes on that golf cart without O2, there are no ambulances on Harbor Island, so anyone having O2 problems has to be transported somewhere. A pony would have helped a bunch on the golf cart ride to the clinic?

Again, these are questions. This was an unforeseeable incident for which responsibility lies directly on my shoulders. I just can't figure this out. I am confused and depressed, doubting myself, devastated really. My head still hurts. The dive staff did everything they could to help me. I just don't understand the "why".
Any thoughts appreciated.

#1 You can't count on anybody but you, ever. Not the DM. Not even an instructor. You may also be able to count on your buddy, depending on his training and level of commitment and how often he practices. When things go badly, you need to be able to safely end the dive with nothing but the equipment you brought and the grey stuff between your ears.

#2 Doesn't matter. Maybe he was a dumbass. Maybe he misjudged the conditions. If someone tells you that something isn't safe, or might not be safe/appropriate, it isn't safe and don't do it. However, just because someone tells you something is safe, doesn't mean it is. You can cancel/abort any dive at any time without having to justify it to anybody.

#3 Most divers (professionals and rec divers) never actually have a need to use O2 on real victims. They were probably not well practised.

#4 Depends on the flow rate. If it's a small tank and a high flow rate, it's entirely possible. How long would it take you to hoover down a SCUBA tank that size if you were panicking underwater?

#5 Not specifically, although I would expect pretty much everybody to know that breathing exhaust is bad.

#6 AFAIK, there's no legal requirement to have O2 at all and certainly no requirement for a bottle to send on a golf cart. If you're concerned, you should ask to see the O2 before going out. Anybody who has taken the trouble to buy and maintain an O2 kit will be happy to show it to you. Also, the boat/DM/Instructor should have a valid emergency plan that covers getting a victim to the hospital.

There is no doubt I came very near to death because I did not stay on the boat when the Master said "some current". I felt it in my gut and ignored it. My over-estimation of my physical abilities and failure to listen to my gut came very, very close to killing me.

Without trying to do too much of "blaming the victim," You were responsible for pretty much all your problems and could have headed them off by doing as you were trained.

Regardless of the conditions or who did what to who, or who "should have" done what, you are an "Open Water Diver". The essential part of this is that you can surface at any time for any reason.

When things started going badly, you could have stopped trying to climb up the coral, and done a normal, free ascent in open water, and attained positive buoyancy on the surface. Once on the surface you can ditch your weights if there's any question of your ability to stay there. You can also ditch your weights underwater if you have any doubt of your ability to safely get to the surface.

There is no purpose in trying to haul yourself over "dead coral." The best that would have happened is that you would have gotten all cut up. The surge moves and the coral doesn't and coral is sharp. This is the same process that Ore-Ida uses to turn potatoes into french fries. You needed to "go up" You can worry about finding the boat once you're safely on the surface and breathing normally.

Once on the surface, you can signal the boat and just float there and wait for pickup. There's no point in you trying to overpower a current that's too strong for you. Just get the boat's attention and wait for pickup.

Whatever dive you go on, you need a plan for safely ending it and getting back to the boat or shore that doesn't rely on anybody else.

I'm happy you survived.
 
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A few thoughts. First, don’t feel bad, blame yourself or think bad of yourself or your skills.

You were in a new situation, and the stress became higher than what you’re used to; when that happens, the primitive reflexes are triggered; one can be panic. The boat appeared far away, you believed you were about to be lost, and your mind felt you had to fight for your life. It happens; it doesn’t make you a bad diver or person.

Boats at sea can seem far when they’re not. It’s because you’re used to seeing them up close, or from the 10 foot elevation of the deck and your height. When you’re literally at sea level, your mind compares the boat size to something it knows- waves. So the boat appears far, and that you’re drifting really fast. That can trigger the panic.

Now, you were not drifting away very fast. It seemed fast, but a strong current in the water only runs about 1-2 knots. That means you won’t be going anywhere fast. And a drifting diver is not an emergency (though it can feel like it). There is only one place you can go; down current. It’s easy for the boat to find you.

The heavy surge, and sudden surfacing means that you were probably near the surface already, and didn’t need to grab the coral (I won’t discuss the silliness of that ‘recommendation’ here). Surface surge can definitely be very rough to dive in. The trick is to either hold something when it runs against you, and swim when it’s going your way, or just roll with it.

  1. Was she really a DM? You said she was in training, she may not have noticed or felt comfortable assisting.
  2. Because they were probably recovering the other divers. They could see that you were conscious, alive, not in danger, and with other divers in the water, their priority was not immediate recovery. A panicked diver on the surface is still a breathing, living diver. In rescue class, one technique is to even stand off and let a panicked diver wear themselves out before you initiate a rescue.
  3. Because your sense of time was distorted. It was probably only a minute or two.
  4. If they just cranked it on, yes, a normal O2 tank can easily run out in a few minutes. Correct flow rate should be 4 L/m. That said, oxygen was not needed in your case, calming the panic would have resulted in normal oxygenation. You were hyperventilating, and not circulating the air in your lungs and throat. That’s why you felt out of breath. Normal, deep breathing would have resolved this.
  5. Yes. But one sniff does not mean you were being poisoned.
  6. The boat did have an O2 kit. But see #4. Oxygen was not needed.

The risk factors you list; physical condition, smoking, dehydration, certainly played into this. But I believe it was a panic attack brought on by being in an unknown situation. Certainly see a doctor if you’re still having physical symptoms. If the incident is still bothering you, I highly recommend finding a trusted person trained in counseling to talk to; a counselor at work, a religious leader, or a psychologist. You’ll need to take care of your mental well-being as well as your physical well being.

Recommendations for the future diving:
Stop smoking. I know, easier said than done, but it’s the single biggest change.
Keep in mind your diving when on vacation. Get plenty of sleep, avoid alcohol, and drink lots of fluids before diving.
Talk to your Local dive shop about taking advanced diving classes, and continue to educate yourself and improve your diving. Many places have current, you don’t want to bow out of every dive because of this. Work your way up to the Rescue Diver courses, and if you can, start exposing your diving to more varied environments.
Invest in some equipment, such as an SMB, and whistle. This can help give you peace of mind when you do find yourself in a unexpected situation.
Have your gear serviced, and understand it better. Did you have the dive/pre-dive switch in the wrong position?
Start working on your physical conditioning program again.
Go diving again, in as similar conditions as the last dive, as soon as possible. Really.
 
The other diver was in front to my left I think, he had looked over his shoulder and seen me. The reef after the swim through ascended from about 12 feet at the bottom, to about 5 feet below the surface. As we came through the swim through, we were supposed to climb the reef with our hands if the current was too strong to swim. Had I been able to grab ahold of the reef with my hands, I would have climbed to the top of the reef then over it into deeper water. But I couldn't get to the reef, the current grabbed me and pulled me to the surface.
The boat couldnt come to me because the reef, Devils Backbone, only had about 5 feet clearance from the top of the reef to the surface.
They said they could not take the boat to me because of that.

I had a total of about 18 minutes of ER O2 before it ran out. The whole ordeal lasted about 40 minutes. I don't know if the O2 was portable, I never saw the actual tank. I just know it ran out in about 15 minutes... Thanks so much for taking a moment to talk to me.
 
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