Diving Accident, Self-Responsibility and Balance

[drrich2]

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.

Unless you plan to only dive in pools, public aquariums and flooded gravel quarries, you will be diving in some current. The question is how much, headed which way, is this a drift dive, etc...

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?

5. Do Dive Masters get any training regarding the effects of exhaust fumes on an already distressed diver?

Some observations as a diver; I am not any kind of dive professional. I'll answer in reverse order.

1.) Divers often exit at the rear of the boat. If this was near a motor, perhaps they simply hauled you aboard & tried to start working on your immediately, instead of dragging you further up the deck?

2.) I recall in a PADI Rescue Diver course the manual warning against a knee-jerk impulse to leap into the water & swim toward a victim. Often someone on board is more useful. Taking time to stop, observe, think & then act is a rational way to deal with a situation. Especially when the victim is at the surface.

3.) Whether & to what extent guides are 'custodians' of the customers is debated and tends to elicit strong opinions that don't always seem to match up with real work practices & expectations, so I'll switch to a look the physics involved.

Let's say you, me and 5 other folks are walking in a meadow on a nice, summer day. You can hear us walking in the grass, your hearing localizes us easily, you can turn and glance at any of us since we're basically walking on a 2 dimensional plane, and we're not preoccupied having to keep up with anything else.

Let's change all that. Suddenly our group of 8 are wearing hover vests with jets, and we're in 3-dimensional space; I'm 10 feet below and 5 feet back from you, Bob is 5 feet higher and 10 feet out in front of you, etc... Oh, and these vests require user monitor of gauges and jet thrust to alter & maintain altitude, so we're task loaded. And we're wearing goggles that cut down our peripheral vision.

Underwater is similar, except we can't talk, sound seems to come from everywhere so our hearing is useless for localizing anything, and the 'zoom' magnification effect further reduces our peripheral vision.

So, a 'rear guard' can often keep up with several divers, but it's not impossible to lose one.

Advice:

1.) Get an SMB if you don't already have one. It'll give you peace of mind if you have to surface far from the boat.

2.) If you are still fearful, you could get a Nautilus Lifeline. I'm not endorsing it; just a product you might be interested in, that could help in some parts of the world.

Richard.

 

[doctormike]

First, complaining about the boat and the O2 supply is not useful. The boat had sufficent O2. You just hoovered it down faster than a diver in an emergency would have. Wookie was not "defending" (in your sense) the crew; he was explaining their actions. The crew reacted properly. Your reaction was off, and it does not help to attack him.

Again, I think you're seeking a medical reason to blame this on when none exists. I find it hard to believe that a doctor on an island diagnosed you with this; or that your doctor did over the phone. The diagnostic testing is rather involved. A doctor will never state a certain cause unless they've diagnosed you, due to the risks of malpractice this can open up. As well, your understanding of it as "environmentally caused asthma attack" is not consistant with published medical literature on the subject. I believe you're seeking out another factor that paints you as not to blame.

Has a Medical Doctor examined and tested you, and given you a primary diagnosis of EIB? I think that when you doctor does examine you, they will find something more sinister than EIB- They'll find COPD caused by smoking.

However, prolonged shallow hyperventilation can lower 02 levels and stress induced panic can raise BP that high (especially if aggravated by smoking, and poor physical condition). As well, panic attacks are well known to cause vasioconstriction in the capillaries; which will cause blue extremities and low O2 Sat levels (because the pulse-ox sensor measures the capillaries for O2 saturation.

Like I said; I think you're seeking a medical reason for this instead of accepting that it was a classic panic attack. Take the advice of the board. But if you're going to deny it was a panic attack and seek out a non-existant medical condition to blame it on, you won't be doing much to solve the underlying problem.

It sounds like she had a non-rebreather mask, not a demand regulator, so the O2 in the tank drained at the delivery rate, no matter how fast she was breathing. Other than that, I'm inclined to agree with you.

There is so much drama and subjective reporting of terror in the OPs post, that I'm really not sure what was happening to her during this episode, and she may not recall it all precisely either. Sounds like she did a lot of things right, but I'm still not sold on the EIB thing. Bronchospasm is treated with bronchodilators and sometimes heliox. Yes, O2 can make you feel better with any sort of respiratory problem, but if her symptoms resolved instantly with no other treatment, then it doesn't sound like bronchospasm - she would still have the ventilatory problem from airway constriction even if the O2 they gave her in the clinic pushed her up the dissociation curve to the point of improving her O2 saturation.

Another possibility is immersion pulmonary edema. Given the profile, DCI is less likely, although she could have had pulmonary barotrauma if she corked while holding her breath, even from the shallows. However, I doubt that these things would have improved immediately with a bit of oxygen.

I could be wrong, though. I'm not a pulmonologist.

I also agree that while the OPs self flagellation is admirable to some degree, it seems that there is an attitude of "why do we have dive masters if I can't rely on them to make my diving safer, or to let me do dives that I'm not otherwise qualified for?" This is really bad, and it doesn't look like it has been corrected yet.

Finally, for what it's worth, if you go from surfacing on a dive site to a medical clinic in just 40 minutes, that's a pretty superhuman rescue effort.

 

[CoralSeaMan]

I am not a doctor. I am a diver who has had a panic attack exactly one time - scuba diving. From your description that is what you had. I had an overwhelming sense of confusion and loss for days much has you have described. Why? Because nothing similar to that loss of control has ever happened to me before. I was back in the water in a few days and have not faltered since. But because of the emotional response I had I did reach out for some counseling and I encourage you to do the same if these feelings continue. From your comments I take it you are a litigator. A lack of self confidence could do damage to your work.

I have felt the fear and the doubt start to rise a couple of times since - mostly from exertion. Slow down and slow your breathing. Focus on solving your issue by exercising control. Remember the air on the surface is free so when you get to it relax. Carry a SMB and know how to use it. Plan for the contingency of a problem and they are less likely to happen.

I too question the "swim through." This doesn't sound like a normal one but sounds like a true overhead environment. I mostly avoid "swim throughs" now. They just add complications and add little to enjoyment.

I am glad there was no serious physical harm. Good luck and enjoy future diving.

 

[Mike]

No rapid ascent issue, the dive depth at its deepest was 27 feet. I was near the top of the reef we were crossing, maybe 8 feet below the surface when I became unable to control the ascent.
I think I had an unpredicted medical event. The doctor said I had something similar to an asthma attack, bronchial spasms is what he said. It just felt like forever, the whole awful thing. Reading the replies and thinking it all through. Thanks so much for commenting.

Where do most people have the most trouble when it comes to buoyancy control? - in 20 feet or less water - how many times have we all watched newer divers on a safety stop have trouble staying down, a buddy grabbing their hand pulling them back down... combine lightly weighted, add surge, add a diver not familiar or experienced with those conditions and you get a diver corking to the surface, add some waves, add fatigue, add some panic as to where did everybody go and you've got everything you need for a panicked diver over breathing a regulator they refuse to take out of their mouth at the surface...

... diver who needs somebody else to inflate their BC... that's a real good sign of a panicked diver

sorry to repeat myself, but it just sounds like 'the perfect storm' of circumstances just caught up to someone

 

[gianaameri]

Just a point on tbe diesel fumes.

The engine should be turned OFF when divers enter and exit the water.

It was very unsafe to leave it/turn it ON at that point because anyone (Captain/Helmsman included) can trip and push/knock the controls from neutral to gear, even full forward or full reverse.

Everybody was at risk from this common, but poor practice of having the engine ON and running on idle when passengers are entering or exiting the water or are in the proximity of the boat.

Sent from my GT-I9195 using Tapatalk

 

[Redshift]

The engine should be turned OFF when divers enter and exit the water.

It was very unsafe to leave it/turn it ON at that point because anyone (Captain/Helmsman included) can trip and push/knock the controls from neutral to gear, even full forward or full reverse.

Everybody was at risk from this common, but poor practice of having the engine ON and running on idle when passengers are entering or exiting the water or are in the proximity of the boat.

The captain should be at his place and in control. It may be practical to have the engine off when the boat is anchored but not when drifting. I do plenty of dives when the boat and divers are all drifting, the engine is always on. It would be impractical and drain the batteries to be always switching on and off between divers and could be dangerous when closer to rocks. To add safety, the prop can be turned away from the entry side.

 

[gianaameri]

The captain should be at his place and in control. It may be practical to have the engine off when the boat is anchored but not when drifting. I do plenty of dives when the boat and divers are all drifting, the engine is always on. It would be impractical and drain the batteries to be always switching on and off between divers and could be dangerous when closer to rocks. To add safety, the prop can be turned away from the entry side.

When drifting under some circumstances you may need the engine ON because you may not want to risk the engine not turning ON when you need it.

However, when divers are in the vicinity and boarding the boat or entering the water, under no circumstance is good practice to have the engine ON (i.e. running on idle).

 

[TSandM]

Wow -- what a wild ride.

I agree that there was something physical going on to get your O2 sats down to 85% when out of the water and breathing ambient air. It might be exercise induced bronchospasm, although that's rarely a one-off thing. It might have been saltwater aspiration with bronchospasm; it might have been laryngospasm. It might have been a pneumothorax -- did they x-ray your chest? And it might have been immersion pulmonary edema, although having that suddenly come on coincidentally with being completely panicked on the surface would be a real perfect storm.

Your blood pressure reflects the adrenaline coursing through your body. I have seen pressures that high in people in severe pain or very frightened on many occasions.

I am not surprised that the O2 ran out. If they were using the standard DAN kit, the tank is small, and delivering at 15lpm will drain such a tank quite quickly. I do agree that boats that go significantly offshore ought to have more oxygen on board than that (at least a 40) but the regulator system for a continuous flow mask is different from the one for a demand regulator like a scuba reg, so, since they use the oxygen so rarely, most boats don't invest in a bigger supply.

I think the real question you need to ask yourself is why you were so disabled with fear at finding yourself on the surface, positively buoyant, and able to see the boat. You even indicated that the crew appeared to see you, and quite quickly, you were not even alone.

I had an experience just yesterday where we were caught in current, blown away from the group, and had to surface by ourselves. We had a marker buoy which was deployed and then waved. We had a DiveAlert, which was noted by one of the nearby boats (not ours) which did get word to our boat that they had divers on the surface. In the meantime, my husband and I were actively swimming toward shore, which wasn't far (and it certainly sounds as though you were near shore as well). I was mildly anxious about making sure the boat did see us, as we were drifting fairly quickly, but even if they had not, we were going to be okay for a long time, even if we couldn't make shore. We were warm and buoyant and together.

Diving is one of those things where almost any problem can be solved, if the diver can remain calm and run through the available options. The moment you lose the ability to do that, you are in real trouble. It sounds as though the people with you did just about everything that could or should have been done to assist you, especially given that you were unable to assist yourself. What you learned is that people will do what they can, what they know, what they remember, or what circumstances permit -- but it may not be perfect, and your needs may not override the needs of the entire diving group, unless it's obvious you are dying. I believe that, had you stayed calm and just allowed yourself to be reassured about being on the surface and buoyant, this entire story would not have needed to be told. So what can you do to improve your ability to cope with diving stress? Perhaps a stress and rescue class, if you have not yet taken one; perhaps some mentoring from an instructor who can run you through some scenarios until you start to feel more confident in coping with the unexpected. I do think you have now identified a weak spot in yourself as a diver, so the job now is to patch that up.

 

[clownfishsydney]

I would say that what Thea felt on the surface was solely brought about by panic. When she panicked, she was breathing so fast it caused rapid shallow breathing (hyperventilation). Despite what most think, this does not increase the amount of carbon dioxide in the body, it actually reduces the amount of carbon dioxide in the blood. This causes the blood vessels in the brain to restrict, drawing oxygenated blood away from the brain. This then causes light headedness and fainting. It can also cause extremities (hands, fingers and feet) to go blue and cold. I have seen this happen to my wife when she was in hospital with a severe case of appendicitis and the pain caused her to hyperventilate. The solution is to actually make the patient breathe back some carbon dioxide. The normal way that this is done is to get the person to breathe into a paper bag and breathe back the higher carbon dioxide air. Eventually this will slow your breathing back to normal.

 

[doctormike]

I too question the "swim through." This doesn't sound like a normal one but sounds like a true overhead environment. I mostly avoid "swim throughs" now. They just add complications and add little to enjoyment.

"Swim through" is a Caribbean euphemism for "overhead environment". It sounds less threatening, and it's easier to get untrained people to try it. Sort of like "Oh, it's just a cavern dive, not a cave. There's a short segment where you can't see daylight, but it's really only a cavern."

I think the real question you need to ask yourself is why you were so disabled with fear at finding yourself on the surface, positively buoyant, and able to see the boat. You even indicated that the crew appeared to see you, and quite quickly, you were not even alone.

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