Doing rescue

[Dyno Bill]

Don't mind my question but why would you remove an exposure suit prior to having the victim out of the water

 

[Bubbletrubble]

New research is also showing that starting non rescue breathing cpr may be more valuable in keeping oxygen flowing to the brain. I still do what the standards require but also give them the new info and practice it both ways.

@Jim Lapenta: Currently the AHA has posted very specific recommendations regarding when to do Conventional CPR (compressions + rescue breaths) instead of Hands-Only CPR (compressions only). Here's a quote from the FAQ page on the Hands-Only CPR website:

Hands-Only™ CPR vs. Conventional CPR with breaths

Are there times when I should use conventional CPR with breaths?

Yes. There are many medical emergencies that cause a person to be unresponsive and to stop breathing normally. In those emergencies, CPR that includes mouth-to-mouth breathing may provide more benefit than Hands-Only™ CPR. The American Heart Association (AHA) recommends conventional CPR (CPR with a combination of breaths and compressions) for:

• All infants (up to age 1)
• Children (up to age 8)
• Adult victims who are found already unconscious and not breathing normally
• Any victims of drowning, drug overdose or collapse due to breathing problems.

Please consider sharing this information with your students. Based on these recommendations, it's clear that rescuers in scuba-related incidents should be striving to provide conventional CPR rather than Hands-Only CPR.

Of course, a major consideration during the rescue should be getting the victim to a boat, dry land, or into a situation in which compressions can be performed (if necessary) or more skilled EMS pros can assist. Obviously, it can be very challenging to provide BLS care to a victim floating in the water.

There's no doubt that Hands-Only CPR can be a life-saving intervention. It's easily taught, does a surprising amount of good, and is much better than bystanders doing nothing at all. It has its place...just probably not in the context of a scuba-related accident.

All the best...

 

[RU4SKUBA]

"...a major consideration during the rescue should be getting the victim to a boat, dry land, or into a situation in which compressions can be performed."

This is where I think PADIs rescue scenario has an issue in their protocol for an unresponsive victim with a long surface swim.

If I were a real victim I wouldn't want the rescuer to waste precious time on a breath every five seconds that isn't being circulated anyway. I'd rather they focused their energy on getting me to a location where proper compressions can be performed and where an AED can be utilized and doing it without delay.

 

[JanK]

In PADI the protocol includes the estimate on how long it will take you to swim to the shore (boat) with the victim, assuming he's in respiratory arrest. If it's more than five minutes, you don't bother with providing breaths, if it's less, you do.

The reasoning behind this is: The victim is in respiratory arrest, othewise you would not even consider giving breaths. But respiratory arrest does not imply cardiac arrest. You cannot determine a pulse in water, so a victim may or may not be in cardiac arrest. If he is in cardiac arrest, then yes, breaths will not do anything. But if he isn't, then a respiratory arrest will cause cardiac arrest and lower the chances of survival.

So you make a cutoff of 5 minutes (at which point the likelyhood of brain damage starts getting very high). Less swim time than that: you provide breaths to oxygenate (whilst hoping he's not in cardiac arrest) and to prevent one from occurring. More swim time: the possibility that he already is in cardiac arrest prevails and you just get him out as quickly as possible.

 

[drbill]

Important course to have under your weight belt. Of course back in the "old days" they taught rescue (and AOW) as part of OW, at least through Los Angeles County.

 

[Dyno Bill]

Important course to have under your weight belt. Of course back in the "old days" they taught rescue (and AOW) as part of OW, at least through Los Angeles County.

so should those whom have been trained in much earlier situational responses retrain as the science of rescue has in fact been modified. It seem from reading posts here that some things have been changed but I'm not sure about how much

 

[Hatul]

@Jim Lapenta: Currently the AHA has posted very specific recommendations regarding when to do Conventional CPR (compressions + rescue breaths) instead of Hands-Only CPR (compressions only). Here's a quote from the FAQ page on the Hands-Only CPR website:

Please consider sharing this information with your students. Based on these recommendations, it's clear that rescuers in scuba-related incidents should be striving to provide conventional CPR rather than Hands-Only CPR.

Of course, a major consideration during the rescue should be getting the victim to a boat, dry land, or into a situation in which compressions can be performed (if necessary) or more skilled EMS pros can assist. Obviously, it can be very challenging to provide BLS care to a victim floating in the water.

There's no doubt that Hands-Only CPR can be a life-saving intervention. It's easily taught, does a surprising amount of good, and is much better than bystanders doing nothing at all. It has its place...just probably not in the context of a scuba-related accident.

All the best...

That makes sense, because in drowning cardiac arrest is usually because of hypoxia, and pumping hypoxic blood with CPR and no breaths will not help.

 

[kanonfodr]

In PADI the protocol includes the estimate on how long it will take you to swim to the shore (boat) with the victim, assuming he's in respiratory arrest. If it's more than five minutes, you don't bother with providing breaths, if it's less, you do.

The reasoning behind this is: The victim is in respiratory arrest, othewise you would not even consider giving breaths. But respiratory arrest does not imply cardiac arrest. You cannot determine a pulse in water, so a victim may or may not be in cardiac arrest. If he is in cardiac arrest, then yes, breaths will not do anything. But if he isn't, then a respiratory arrest will cause cardiac arrest and lower the chances of survival.

So you make a cutoff of 5 minutes (at which point the likelyhood of brain damage starts getting very high). Less swim time than that: you provide breaths to oxygenate (whilst hoping he's not in cardiac arrest) and to prevent one from occurring. More swim time: the possibility that he already is in cardiac arrest prevails and you just get him out as quickly as possible.

So lemme get this straight: if shore/boat is closer than 5 minutes away then I keep the victim in the water and give him (inefficient) rescue breaths and can't fully treat the victim. If shore or boat is farther than 5 minutes away, I say "screw it" and haul tail to where I can fully treat him, even if that means not trying to have him breathe for, oh...5-10+ mins (brain-death zone).

Peace,
Greg

 

[on_two_wheels]

So lemme get this straight: if shore/boat is closer than 5 minutes away then I keep the victim in the water and give him (inefficient) rescue breaths and can't fully treat the victim. If shore or boat is farther than 5 minutes away, I say "screw it" and haul tail to where I can fully treat him, even if that means not trying to have him breathe for, oh...5-10+ mins (brain-death zone).

Peace,
Greg

Sort of....if less than 5 min you give breaths WHILE towing to boat or shore. You don't just stay put giving breaths. If more than 5 min you simply use all your energy to get them to boat or shore in less time.

 

[theduckguru]

One thing I really fail to understand and don;t agree with is all the focus on one person rescues. If you and your buddy are properly trained what is more likely is coming upon someone whose initial training left something to be desired. I just did day one of a rescue class and I put much more emphasis on doing it as buddy team. I'm also of the school that while it's ok psychologically for the rescuer to try rescue breathing unless you are really good at it and don't end up climbing onto the vic or turning the head, which may close the airway anyhow, it;s better to haul ass for the boat or shore where you can get some stability and stand to deliver the breaths. As a DM and instructor I have been dunked more times than I care to admit by rescue students who had dropped my weights, inflated my bc, dropped theirs, and were nearly hovering out of the water and still in their eagerness to get the breaths in ended up driving me under or turning the head so that my throat was closed. New research is also showing that starting non rescue breathing cpr may be more valuable in keeping oxygen flowing to the brain. I still do what the standards require but also give them the new info and practice it both ways. Stripping gear alone is IMO BS. Ok to unclip so that by the time they get to shore or boat the bc is in effect a raft and you just slide them out of it.

I completed the SSI rescue course this summer. The emphasis was on two person resue teams with the victim not being your buddy as you suggest. One person rescues were strongly discouraged.