Do not ever say you are a rescue diver

[johndiver999]

Untrue. She is a natural while I am a cerebral. When we got started in diving, I was struggling with buoyancy control at shallow depth. I am ashamed to say that I destroyed some reef twice hitting some curved walls with my head not realizing I was ascending. She had no such issue. And she was always there for me, rushing and pulling me down. Fortunately, I got better after almost 200 dives in two years. However, I read all literature I can. About diving accidents, the way to prevent them,… I have read all DAN and BSAC incident reports of the last ten years. She did not. Past her AOW, she is just enjoying herself. It is not because I am a control freak that I will blame her.


She really enjoys it, loves sport waters and she would do scuba without me but you have a point. I have dived with other people while she has only dived with me. But she does not always trust me. Once, we faced a very strong current. I told her to follow me deep and close to the reef but she preferred following a dive guide who was behind us, having fun with the current. She followed him and ended up in trouble. Another time, her, me and a guide had to surface because we lost our way. I took a bearing, checked my wife SPG (100 bars) and told her that we should descend shallow instead of swimming at the surface. She refused until the maybe 21 years old guide said it was the good course of action. She later told me that she was not comfortable with me making “ life and death “ decisions. I told her that she should have other buddies but she wants to stick with me. Couple dynamics are probably beyond SB’s scope.

She has probably seen, and almost for sure heard, about all your screw ups underwater and probably a lot above water. Not so, for some unknown DM, who she may find it psychologically beneficial and comforting to blindly ASSUME is extremely competent and flawless.

If she does not trust you, when diving, you have a serious challenge. It is essential that a buddy team have trust in each other for it to have good value. If that is not there, it is hard to imagine things going well when a big problem develops and for the run of the mill, normal dive; it must reduce her enjoyment of the outing.

I personally, would much rather dive alone, rather than with a buddy who I have little or no confidence in. Perhaps the two of you can take turns leading dives, but somehow still defer to the more experienced and stronger team member if something critical happens?

It really sounds like an issue that will benefit both parties, when it is finally remedied.

 

[Dody]

She has probably seen, and almost for sure heard, about all your screw ups underwater and probably a lot above water. Not so, for some unknown DM, who she may find it psychologically beneficial and comforting to blindly ASSUME is extremely competent and flawless.

If she does not trust you, when diving, you have a serious challenge. It is essential that a buddy team have trust in each other for it to have good value. If that is not there, it is hard to imagine things going well when a big problem develops and for the run of the mill, normal dive; it must reduce her enjoyment of the outing.

I personally, would much rather dive alone, rather than with a buddy who I have little or no confidence in. Perhaps the two of you can take turns leading dives, but somehow still defer to the more experienced and stronger team member if something critical happens?

It really sounds like an issue that will benefit both parties, when it is finally remedied.

Useful comment. Even though, honestly, I very rarely screw up out of water except in my relationship with people. I am what people call, a bear or autistic. And I am very bad at human relationship out of my work. Complicated issue. I think it would be worth a dedicated thread about spouse relationship in diving. She would dive only with me but she does not trust me saving her life under water. Oprah! Please help!

 

[kinoons]

Yeah, I wasn’t disagreeing with you or them. I was responding in general because there were other posts talking about how getting the victim to the boat was more important than anything else.

I wanted to stress a simple message that is far more likely to be recalled in an emergency than a complex training pathway. Open the airway and give a breath or two. The few seconds that takes away from water egress are definitely worth the trade off. So that’s my clear, simple recommendation. Complex emergency procedures are rarely remembered correctly, even by professionals with frequent recertification. That’s the reason why checklists are important (not applicable here).

Having watched many people desaturate in the OR during bronchoscopy, I can tell you that people with full lungs can hold a reasonable Sat for a minute or so once ventilation stops. But if ventilation stops from a point where oxygenation is marginal, the saturation drops like a rock.

DoctorMike for the win.

I will echo very much the same experience regarding oxygen saturation and apnea. When performing endotracheal intubation on a patient a sedative and paralytic are given. A well oxygenated patient will maintain a “normal” oxygen level for quite some time (minute or two) before I need to breathe for them.

If I’m starting behind the 8 ball with someone who is very sick to begin with the oxygen level may be low to start and drops like a rock when I suppress their own natural breathing.

And finally following a resuscitation algorithm is key in an emergency to not forget a step. Yes professionals who work in the emergency department still have the steps listed on hand, but rarely do more than glance at them because we do that sort of thing frequently. If you’re not well practiced having someone specifically follow the sheet directing others is critical.

It’s been two decades since my lifeguard training, and I’m only a OWD. Trying to get a diver to the surface, inflate their BCD, drop their weights, get unnecessary gear off and out of the way, check a pulse, open their airway and assess if they are breathing, perform rescue breaths, and tow them to shore/boat is a big ask. As an emergency professional I’d like to think I could get the medical part done correctly, but in the water with all the other things stacked against you I can absolutely see that scenario not going well.

 

[tursiops]

Yeah, I wasn’t disagreeing with you or them. I was responding in general because there were other posts talking about how getting the victim to the boat was more important than anything else.

I wanted to stress a simple message that is far more likely to be recalled in an emergency than a complex training pathway. Open the airway and give a breath or two. The few seconds that takes away from water egress are definitely worth the trade off. So that’s my clear, simple recommendation. Complex emergency procedures are rarely remembered correctly, even by professionals with frequent recertification. That’s the reason why checklists are important (not applicable here).

Having watched many people desaturate in the OR during bronchoscopy, I can tell you that people with full lungs can hold a reasonable Sat for a minute or so once ventilation stops. But if ventilation stops from a point where oxygenation is marginal, the saturation drops like a rock.

So, your advice might be...how about this?

"Use two rescue breaths to get some air into them, and then get them as fast as possible to a hard surface where chest compressions can be initiated and an AED might be available. If you are more than 5 mins away, add two more rescue breaths every minute."​

I made that up, but is it what you are saying?

 

[johndiver999]

Useful comment. Even though, honestly, I very rarely screw up out of water except...

yeah but she knows about all of them, I assume, that is the point rather than the number itself. LOL

But seriously, perhaps if she builds confidence and competence by leading some dives, she will trust herself more and you as well?

 

[doctormike]

Here’s an observation about all of this.

The transcribed rescue cue card text that posted was actually TLDR. I responded generally, but I didn’t read that whole post. I guess I shouldn’t have done it as a quote reply because that implied that I was arguing (sorry, @tursiops ).

So if that protocol was too long and boring for me to bother reading in an online forum post, I probably wouldn’t remember the details when I need it 10 years after I get my rescue card!

 

[Dody]

She has probably seen, and almost for sure heard, about all your screw ups underwater and probably a lot above water. Not so, for some unknown DM, who she may find it psychologically beneficial and comforting to blindly ASSUME is extremely competent and flawless.

If she does not trust you, when diving, you have a serious challenge. It is essential that a buddy team have trust in each other for it to have good value. If that is not there, it is hard to imagine things going well when a big problem develops and for the run of the mill, normal dive; it must reduce her enjoyment of the outing.

I personally, would much rather dive alone, rather than with a buddy who I have little or no confidence in. Perhaps the two of you can take turns leading dives, but somehow still defer to the more experienced and stronger team member if something critical happens?

It really sounds like an issue that will benefit both parties, when it is finally remedied.

DoctorMike for the win.

I will echo very much the same experience regarding oxygen saturation and apnea. When performing endotracheal intubation on a patient a sedative and paralytic are given. A well oxygenated patient will maintain a “normal” oxygen level for quite some time (minute or two) before I need to breathe for them.

If I’m starting behind the 8 ball with someone who is very sick to begin with the oxygen level may be low to start and drops like a rock when I suppress their own natural breathing.

And finally following a resuscitation algorithm is key in an emergency to not forget a step. Yes professionals who work in the emergency department still have the steps listed on hand, but rarely do more than glance at them because we do that sort of thing frequently. If you’re not well practiced having someone specifically follow the sheet directing others is critical.

It’s been two decades since my lifeguard training, and I’m only a OWD. Trying to get a diver to the surface, inflate their BCD, drop their weights, get unnecessary gear off and out of the way, check a pulse, open their airway and assess if they are breathing, perform rescue breaths, and tow them to shore/boat is a big ask. As an emergency professional I’d like to think I could get the medical part done correctly, but in the water with all the other things stacked against you I can absolutely see that scenario not going well.

But would you say that rec Rescue training is useless?

 

[doctormike]

So, your advice might be...how about this?

"Use two rescue breaths to get some air into them, and then get them as fast as possible to a hard surface where chest compressions can be initiated and an AED might be available. If you are more than 5 mins away, add two more rescue breaths every minute."​

I made that up, but is it what you are saying?

I like that, but I would forget about the 5 minute thing. Maybe just two breaths every minute or so while you are getting them out.

Remember, the compressions and AED are likely low yield. Also, you are ventilating with EAN 16, so the Sat is going to drop faster during the apneic intervals…

 

[johndiver999]

DoctorMike for the win.

I will echo very much the same experience regarding oxygen saturation and apnea. When performing endotracheal intubation on a patient a sedative and paralytic are given. A well oxygenated patient will maintain a “normal” oxygen level for quite some time (minute or two) before I need to breathe for them.

If I’m starting behind the 8 ball with someone who is very sick to begin with the oxygen level may be low to start and drops like a rock when I suppress their own natural breathing.

And finally following a resuscitation algorithm is key in an emergency to not forget a step. Yes professionals who work in the emergency department still have the steps listed on hand, but rarely do more than glance at them because we do that sort of thing frequently. If you’re not well practiced having someone specifically follow the sheet directing others is critical.

It’s been two decades since my lifeguard training, and I’m only a OWD. Trying to get a diver to the surface, inflate their BCD, drop their weights, get unnecessary gear off and out of the way, check a pulse, open their airway and assess if they are breathing, perform rescue breaths, and tow them to shore/boat is a big ask. As an emergency professional I’d like to think I could get the medical part done correctly, but in the water with all the other things stacked against you I can absolutely see that scenario not going well.

I seriously doubt you are checking pulse in the water, and since you have no immediate and effective response (should you be able to reliably discern if there is, or is not a pulse), all you can do is provide some rescue breaths, protect airway and try to get to a safe place ASAP. If a rescuer is in good shape, they can swim and provide rescue breaths without slowly down too much, but it is strenuous and challenging. Hope I never have to do it.

 

[doctormike]

But would you say that rec Rescue training is useless?

I would not say that…