jbd:What I noticed, was all the deaths in which autopsy found air embolism to be the cause of death even when the person made it back to the surface and even back onto the boat and suddenly went unconscious.
Setting aside the pre-existing medical conditions that IMHO created an artificial OOA scenario which created the panic that you mention, I think buoyancy control is still the key issue. Here's how I see that coming about as an issue. People without good buoyancy control skills struggle through the water and often have trim problems. They are commonly overweighted. They sink too fast and can't clear their ears, creating pain. They can't stop their descent and they can't stop finning, which is their only means of some semblence of depth control. Their arms are flailing. Their adding and removing air constantly to the BC. In other words they are out of control and nearly exhausted. This scares them to no end and as you noted they panic and bolt for the surface upon which they get an embolism or blow a lung.
Lets look at the diver that was taught excellent buoyancy control during his OW course. First they are properly weighted to dive. They have good trim and are able to move through the water easily. All gear and body parts are streamlined. They can move up or down in the water column in 4 inch increments with the ability to stop at each 4 inch move. Consequently they have the time to clear their ears so they don't have pain. They need only add very small amounts of air to the BC during the descent. They don't even have to fin unless they want to so they are relaxed and not anywhere near being exhausted.
Make really good buoyancy control the central core of the training course and lets look at what you can do with the students. The next outer layer(1st from the core) of training consists of the student doing mask clearing including remove and replace while neutral and trimmed while hovering or swimming, regulator skills the same thing. Dealing with entanglement, which is where I would have them remove and replace their gear mid water simulating that they removed fishing line from the scuba unit. Turning off their air and have them turn it back on(after thorough training and working up to this point) while their buddy is either sharing air with them or is ready to share air if needed. All done neutral either swimming or hovering.
The next (2nd from the core) involves introducing task loading in which problems are introduced by the instructor while the students are on a dive mission. This starts with flooding the mask or removing it fom the student. Remove the regulator from their mouth. Remove a fin. Turn off the air. Entanglement. Initially you start with one at a time and then move to 2 problems at once then 3 then four at a time. The whole time the students are maintaining good buoyancy control(nope not perfect but good). This means they don't break the surface and they don't touch the bottom but the instructor is looking to see how well they stay within a much smaller range than the depth of the pool.
In other words (much fewer words) these divers are in control of their dive. There is no reason for them to be scared or panic and they know it.
As I see it, buoyancy control is the central issue, which is why it was the central core of my course.
Yes. One of the things I see in a huge percentage of the divers I see is poor trim. Some say so what? Well, they're usually in a head up attitude. That means that in order to swim foreward without swimming up they must be neg buoyanct. If they stop moving forward they must kick to maintain depth or they sink like a rock. Give this diver a distracting task to perform and they either end up in the bottom or shoot to the surface without even knowing it. These divers are almost out of control, working way too hard, task loaded by just trying to move through the water and basically close to panic (whether they know it or not) the whole time. A very precarious situation.
I too make swimming neutral (including while performing a task) a major part of the class rather than something we spend only a few minutes on. In addition When divers are practicing things like mask R&R it's the divers buddy who is standing by to assist...as in helping to maintain depth or get the mask back to the diver. Why? Because on their 5th life time dive (the first after the class) they may very well have a buddy who has a minor problem like that and they are the one who will have to be aware of it and know how to help. I won't be there.
Now, on most dives nothing happens, which is why I don't by the argument that training is good enough. If nothing goes wrong all you need to be able to do is breath. I dived for years before ever taking a class and never had a problem. Is my survival evidence of the good training I had? It's not adequate training keeping the death rate down but that fact that just being able to breath gets you by when nothing happens. You don't need any training at al to sit on the bottom and breath.
What we need to look at is not an injury rate based on the number of divers or the number of dives but rather the percentage of incedents that are successfully managed. From what I have seen, especially when it comes to new divers is that if there is a problem they stand very little chance of being able to manage it. IME, nearly all result in an undesireable outcome. That doesn't mean that they'll die. It means that they end up shooting to the surface, getting seperated from a buddy or whatever. When there's no problem they just silt the dive site, kill the coral and have trouble finding their buddy. Those things don't always kill you but they can and sometimes do.