My friend just got her OW and she's been diagnosed with DCS

[Cave Diver]

If that were the case, I'd exercise my right to choose another instructor.
I want an instructor who's primary concern is the well-being of his/her students.
Perhaps my expectations are too high.

OW students probably don't know any better. AOW might, but wouldn't count on that either.

 

[Dirty-Dog]

One thing I have not seen in this thread is an ID of the dive shop...
Personally, I'm in favor of posting the name of the shop/instructor, regardless of whether the review is good or bad.

 

[TSandM]

Although my memory of events is not entirely sharp, I seem to recall that we did the nav dive of our AOW without the instructor even in the water with us. We had a marker and a course, and he watched our bubbles. We were, after all, certified divers. If the OP was doing some AOW dive where direct supervision wasn't required -- and IF HE HAD HIS OWN BUDDY -- I'm not sure standards were violated here. However, the instructor didn't have very good control, if he was unaware that the student had corked. Sometimes they DO cork, and no matter how fast you move, you may end up on the surface with them, but you should at least end up on the surface with them.

 

[Bubbletrubble]

If the OP was doing some AOW dive where direct supervision wasn't required -- and IF HE HAD HIS OWN BUDDY -- I'm not sure standards were violated here. However, the instructor didn't have very good control, if he was unaware that the student had corked. Sometimes they DO cork, and no matter how fast you move, you may end up on the surface with them, but you should at least end up on the surface with them.

@TSandM: I think the instructor, OW student, and AOW student were diving as a threesome. In the accounts written by the OP, there's no mention of another buddy in the mix. Perhaps the OP can clarify this point.

Regardless of the standards violation issue, I still think we know enough to say that the instructor is guilty of exercising poor judgment. We know that on Class Dive #3 he allowed the OW student to bring along an UW camera. We know that, on the same dive, he was leading out in front...with the AOW student behind him...and the basic OW student lagging behind. With that configuration, the instructor is not in a position to intervene if the basic OW student experiences a loss of buoyancy control. We know that, after the basic OW student inadvertently ascended from approx. 50 fsw, the instructor watched passively from depth while the student realized what had happened, collected herself for a few minutes, and then re-descended to continue the dive. Based on the info shared by the OP, we don't actually know how fast her ascent was.

On a side note, I'm curious what was discussed during the instructor's post-dive debrief for the dive featuring the unplanned ascent. It would have been a great opportunity to discuss "good" buddy behavior, the importance of establishing formal buddy teams before the dive actually begins, the challenges/benefits of diving as a threesome, disadvantages of single-file lead-follow buddy configuration, buoyancy control tips, situational awareness, task-loading, risks of rapid ascent, the distinction between DCI and DCS, DCI/DCS symptomatology, and emergency procedures for a diver potentially suffering from DCI. Perhaps the OP can share with us what the instructor said.

A great deal can be learned from this incident.

 

[Karibelle]

@Karibelle: What is the "Fish ID dive" during OW training? I think I missed that part of the OW training. Perhaps you are referring to the last OW class dive when the Instructor/AI/DM typically takes the class on a short guided tour of the training site? I recall that dive. I had very little mental bandwidth to attend to things other than maintaining buoyancy control and keeping a comfortable separation distance with my buddy.

The example you offered, which involves an instructor attempting to singlehandedly supervise both an OW and an AOW student, makes me wonder why an instructor would want to short-change both students. I don't get it. Why would a husband want to "distract" the instructor from working with his wife, the OW student? Does he really need to accompany his wife on her OW training dives? His presence could potentially distract his wife from focusing on her training skills. I suppose the argument could be made that the husband might be a calming influence on his wife by providing emotional support. However, if I were an instructor, I would feel like I missed out on an opportunity to teach the wife to be a self-sufficient, independent diver. All of this presumes that this kind of simultaneous instruction is allowed by the instructional agency. DevonDiver's post regarding PADI rules seems to address this.

I'm not a scuba instructor, but I do have a fair amount of teaching experience. I've found that eliminating distractions in the classroom/lecture hall makes for a better learning experience for the students.

Sorry to be unclear. What I was referring to was this: If I had an OW student doing dive #3 (for example) I would not hesitate to also bring an AOW student (in my example, the guy who had 250 dives) to do the Fish ID dive from his AOW course, along with his wife as a buddy. Maybe your experience (or DevonDiver's) differs, but I could certainly supervise both of these activities. If I can supervise multiple OW students, then this should pose no problem.

Note that I don't find DevonDiver's interpretation of the standards to be the same as mine, and have asked for clarification.

 

[Karibelle]

Ah. OK. That makes sense. Fish ID dive is part of the AOW curriculum.
I suppose I'm a little selfish. If I were the AOW student, I'd still want my instructor's undivided attention. How can the instructor be looking for interesting critters and pointing them out to me...while still attending to a newbie student diver? That's really asking too much of the instructor. Bad idea to be placing the instructor in such a situation. Even worse idea for the instructor to agree to it.

During the Fish ID dive from AOW, which was my example, it is not the instructor's job to point out interesting things. It's the student's job. I'm not shortchanging my student; I'm giving them the tools they need to identify fish, and then debriefing them when the dive is finished. Nothing about having another student along would prevent this.

YMMV, of course.

 

[Bubbletrubble]

During the Fish ID dive from AOW, which was my example, it is not the instructor's job to point out interesting things. It's the student's job. I'm not shortchanging my student; I'm giving them the tools they need to identify fish, and then debriefing them when the dive is finished. Nothing about having another student along would prevent this.

@Karibelle: So who's playing buddy to your AOW student as he conducts his Fish ID survey?
And you're OK with the AOW student pointing out aquatic critters to you while you're supposed to be watching over the basic OW student on her first OW class dive?

I just wouldn't feel comfortable multi-tasking like that. Perhaps I don't share your point of view because I don't have as much experience working with novices. From my perspective, it unnecessarily increases the chances of something bad happening during the dive. In my book, the benefits of double-dipping like this just aren't worth the risks.

 

[Karibelle]

@Karibelle: So who's playing buddy to your AOW student as he conducts his Fish ID survey?

As I've said, his wife. In my example, the AOW student and his wife (already AOW) are a buddy pair. Then I said that it's not my job to point out critters to him on his Fish ID dive, it's his job to find fish and identify them, once given the proper tools to do so.

And you're OK with the AOW student pointing out aquatic critters to you while you're supposed to be watching over the basic OW student on her first OW class dive?

Well, in my example, it was OW #3, and by that point, I would have evaluated this hypothetical OW student well enough to know whether or not this would be appropriate. Furthermore, as I've pointed out from MY view of the standards, I don't even need to be in the water with the AOW student, so having them tag along on the dive should not really interfere with my supervision of the OW student, as the AOW needs so little of my attention.

I just wouldn't feel comfortable multi-tasking like that. Perhaps I don't share your point of view because I don't have as much experience working with novices. From my perspective, it unnecessarily increases the chances of something bad happening during the dive. In my book, the benefits of double-dipping like this just aren't worth the risks.

FWIW, I do think this is your lack of experience. I'm not saying I'm super duper experienced or anything, but frankly, as the AOW student in my hypothetical example was REAL, I can easily say that if I had an OW student on dive #3, I'd much rather bring Mr. 250 dives and his AOW wife along to do the Fish ID dive than a second (or 3rd, or 5th, or 8th) OW student on that same dive. You know I can do that, right? Bring EIGHT OW students on a single open water dive? Talk about multi-tasking! Compared to that scenario, throwing in an AOW student who has that much experience and who is doing the activity in my example is peanuts.

My point was that I didn't agree with your original generalization, that it would ALWAYS be poor judgment. I still don't agree with that generalization and just wanted to offer a different perspective that illustrated that for me, it's about GOOD judgment.

As I said, your mileage may vary, and we certainly don't have to do things the same way.

 

[Bubbletrubble]

As I've said, his wife. In my example, the AOW student and his wife (already AOW) are a buddy pair. Then I said that it's not my job to point out critters to him on his Fish ID dive, it's his job to find fish and identify them, once given the proper tools to do so.

Thanks for clarifying that. My mistake. I didn't read your post carefully enough. Don't know how I missed that. AOW pair conducting their own dive. Instructor directly supervising the basic OW student. Sure. I see nothing wrong with that at all...so long as the AOW/specialty class doesn't require direct supervision. In my mind, the key here is that the AOW student is buddied up with a certified diver and that you are not his buddy.

I think we've had a misunderstanding here. My original comments criticizing simultaneous instruction at the OW and AOW levels applied to a scenario (possibly the incident in question) in which only three people were involved: instructor, basic OW student, and AOW student. I apologize if I didn't make that clear. I also want to point out that the OP hasn't yet verified whether that's an accurate representation of the people involved in this particular incident.

FWIW, I'm aware of the minimum instructor:student ratio (8:1 for basic OW) that PADI stipulates. I'd like to point out that there's a distinction between what PADI guidelines establish as minimum requirements, the number of OW students that a particular instructor can comfortably supervise, and the instructor:student ratio most conducive to learning.

 

[Duke Dive Medicine]

She presented symptoms before we flew. In fact, now that I know, she presented symptoms on our dives but she didn't realize it and never called it out. Apparently, she felt like she was being choked and didn't know why. And, from what DAN said, that's a sign of DCS too.

I didn't see her do this, but she shot to the surface on a dive at 48 feet. I saw her once she was already on the surface. Basically, she was behind me and her/our instructor (I was getting my AOW) was in front of me. I saw him look up, then noticed she was up there. It was after that dive that she now has told me that she felt the choking sensation. That was on dive three of six. And, it was her third dive ever. She descended again four minutes after she shot to the surface and continued the dive. Of course, I say "shot" to the surface, but maybe she swam up normally. She was fumbling with a camera and not paying attention. I didn't see it, maybe the instructor did. When I saw him looking up at her, she was already at the top.

She didn't have a dive computer, but I did. Here is the info from it for the dives:

Day one:
#1 - Depth 29, Bottom Time 27 minutes
#2 - Depth 27, Bottom time 35 minutes

Day two:
#3 - Depth 53, Bottom time 29 minutes. She shot to the surface maybe from 48 feet, 10 minutes into the dive. At the surface at least four minutes, then descended and continued on the dive. I have no idea what her ascent rate was. Maybe it was normal.
#4 - Depth 50, Bottom time 36 minutes

Day three:
#5 - Depth 77, Bottom time 24 minutes
#6 - Depth 47, Botton time 31 minutes

Of course, her profile may be slightly different than mine, but I think she followed me relatively close.

tholden1,

This whole case sounds a little puzzling to me. These are pretty conservative dives. I'd be interested to see photos of the skin rash if you have them. I'll PM you my work email in case you don't feel comfortable posting them here.

The "choking" feeling could be anything from panic to a tight wetsuit to subcutaneous or mediastinal emphysema (air under the skin or around the heart and trachea). Subcu/mediastinal emphysema is a result of pulmonary overinflation, which may have happened if she was holding her breath on the way up. If that's what it was, then she's very lucky on a couple of counts: it resolved at depth, and she didn't have a gas embolism on top of it. Pulmonary decompression sickness, on the other hand, is caused by a large amount of venous bubbles obstructing the pulmonary circulation. The relatively low inert gas load from this dive makes pulmonary DCS unlikely.

Also, 24 hours should have been long enough to wash out any residual inert gas from those dives. It's really strange that she would have symptoms after flying, even if she was already symptomatic. DCS symptoms from flying after diving are related to residual inert gas coming out of solution at altitude, and the gas should have been gone. The bubbles from DCS damage blood vessels, so maybe the lower O2 content of the airplane cabin was enough to tip the balance and cause her symptoms - if so, her case might be worth publishing or at least discussing in a case conference here. I'd like to talk to you more about it.

I concur with DAN in that if she did indeed have DCS, hyperbaric oxygen treatment probably won't do her any good at this point. It's very likely that she will recover fully, but it may take a while.

Best regards,
DDM