new divers and rescue skills

[gcarter]

I was skiing tonight. I was not required to get a cert, certainly not required to do any first aid or CPR. I was not even required to wear my helmet. I would be shocked if more people don't get hurt skiing each year than diving.

When I cycle during the summer, I am not required to be certified, to have first aid or CPR. I am not even required to wear my helmet. I would be shocked if more people don't get hurt cycling each year than diving.

I could go on.

Some resuce skills are good to have, particularly in a buddy situation. Suggesting that first responder training should be required of an entry level cert is, IMO, stupid. Nice yes, required no.

 

[FPDocMatt]

..He looked at me incredulously and asked, "What? You didn't learn to navigate in your o/w? You didn't learn buoyancy? You didn't learn to dive deep or at night? How can you be certified and not know buoyancy or navigation?"...Six weeks after that, I ... told him that I was taking the Rescue course, he again had not realized that I had only done a little bit of rescue techniques in my o/w and thought that was still a requirement in o/w.

I find it interesting that the same Scuba Board members who find it horrifying that new divers are not taught extensive rescue techniques in the basic Open Water class are the ones who are dismayed that extensive experience is not a requirement of the Rescue Diver class.

 

[DiveNeptune]

Relative to odds with no intervention, but CPR in the situation of cardiac arrest outside a hospital setting is probably going to fail.



So, using CPR & First Aid as examples, what number of serious injuries/fatalities in diving is 'okay,' and what number is 'too many?' Do we have any hard evidence that the current serious injury/fatality rates in recreational diving are in the 'too many' category, and that CPR & First Aid requirements for all divers would push them into the 'okay' section?

What rational basis is there to stop at First Aid & CPR? People talk about experience; perhaps OW candidates should be required to go on some 'runs' with a local EMT service and witness real emergencies so they'll be more psychologically ready to handle the stress if one comes up on a dive. If everyone had to complete GUE Fundamentals before getting an OW cert., they'd be better buddies and safer divers, too, right? Ridiculous, I know, but my point is, what rational basis is there to draw the line in one place vs. another?

Richard.

Not true, Sudden Cardiac Arrest is a survivable condition but it relies on quick implementation of CPR and defibrilation.

Chance of survival with no care after collaps-0%

No CPR and defib delayed by 10min-0-2%

CPR from a non-medical person (such as a bystander or family member) begun within 2 minutes, but delayed defibrillation-2-8%

CPR and defibrillation within 8 minutes-20%

CPR and defibrillation within 4 minutes; paramedic help within 8 minutes-43%

Since more than 70% of SCA cases occur at home, and another 10% to 15% occur at work ^{[SIZE=-2] 2[/SIZE]} , trained EMS personnel are unlikely to be at the scene at onset. Therefore, trained lay responders with quick access to defibrillation units can be a vital asset when SCA strikes. In certain environments, where the Chain is strong and when defibrillation occurs within the first few minutes of cardiac arrest, survival rates can approach 80% to 100%. ^{[SIZE=-2] 3[/SIZE]}
People who survive sudden cardiac arrest have an excellent prognosis: 83% survive for at least one year, and 57% survive for five years or longer. In fact, when analyzed by age group, survival rates for SCA survivors are comparable to survival rates of people who have never had an event. Clearly, early intervention can offer years of productivity and fulfillment to victims of SCA.

1. American Heart Association, http://www.americanheart.org, accessed January 2, 2002.
2. National Center for Early Defibrillation, http://www.early-defib.org, accessed January 2, 2002.
3. Comparison of Naïve Sixth-Grade Children With Trained Professionals in the Use of an Automated External Defibrillator; John W. Gundry, MD; Keith A. Comess, MD; Frances A. DeRook, MD; Dawn Jorgenson, PhD; Gust H. Baardy, MD - Their sources: Hossack KF, Harwig R. Cardiac arrest associated with supervised cardiac rehabilitation. J Cardiac Rehab. 1982;2:402-408. Valenzula TD, Bjerke HS, Clark LL, Hardman R, Spait DW, Nichol G. Rapid defibrillation by nontraditional responders: the casino project. Soc Acad Emerg Med. 1998;127:414. Abstract.
4. USA Today, "Emergency CPR Guidelines Simplified," by Robert Davis, August 15, 2000.
5. The Paramedics, by James O. Page, jems.com, EMS, Emergency Medical Services - JEMS - Training, Paramedic and EMT News, Products, Resources, EMS Jobs @ JEMS.com, accessed January 2, 2002.
6. American Red Cross, American Red Cross, accessed January 2, 2002.

This is why a simple 1 hour CPR course is important. We are talking literally about the difference in life and death

I would argue that 1 is the number of serious injuries/fatalities is too much...quality training with smart divers should eliminate this. Gear does not fail often or these companies wouldnt be in buisness. Most accidents are operator error and could be avoided. Calculated risk evaluation and smart dive planning and execution are key.

I dont think anything you suggested is ridiculous

And CPR for DMs and Instructors should be absolutely mandatory!

 

[Thalassamania]

All divers I train have CPR (1 and 2 person), first aid, and oxygen administration ... that's what AAUS standards call for. Would the world not be a better place if all the training agencies did the same?

 

[gcarter]

Not true, Sudden Cardiac Arrest is a survivable condition but it relies on quick implementation of CPR and defibrilation.

Chance of survival with no care after collaps-0%

No CPR and defib delayed by 10min-0-2%

CPR from a non-medical person (such as a bystander or family member) begun within 2 minutes, but delayed defibrillation-0-2%

CPR from a non-medical person (such as a bystander or family member) begun within 2 minutes, but delayed defibrillation-20%

CPR and defibrillation within 4 minutes; paramedic help within 8 minutes-43%

Since more than 70% of SCA cases occur at home, and another 10% to 15% occur at work ^{[SIZE=-2] 2[/SIZE]} , trained EMS personnel are unlikely to be at the scene at onset. Therefore, trained lay responders with quick access to defibrillation units can be a vital asset when SCA strikes. In certain environments, where the Chain is strong and when defibrillation occurs within the first few minutes of cardiac arrest, survival rates can approach 80% to 100%. ^{[SIZE=-2] 3[/SIZE]}
People who survive sudden cardiac arrest have an excellent prognosis: 83% survive for at least one year, and 57% survive for five years or longer. In fact, when analyzed by age group, survival rates for SCA survivors are comparable to survival rates of people who have never had an event. Clearly, early intervention can offer years of productivity and fulfillment to victims of SCA.

1. American Heart Association, http://www.americanheart.org, accessed January 2, 2002.
2. National Center for Early Defibrillation, http://www.early-defib.org, accessed January 2, 2002.
3. Comparison of Naïve Sixth-Grade Children With Trained Professionals in the Use of an Automated External Defibrillator; John W. Gundry, MD; Keith A. Comess, MD; Frances A. DeRook, MD; Dawn Jorgenson, PhD; Gust H. Baardy, MD - Their sources: Hossack KF, Harwig R. Cardiac arrest associated with supervised cardiac rehabilitation. J Cardiac Rehab. 1982;2:402-408. Valenzula TD, Bjerke HS, Clark LL, Hardman R, Spait DW, Nichol G. Rapid defibrillation by nontraditional responders: the casino project. Soc Acad Emerg Med. 1998;127:414. Abstract.
4. USA Today, "Emergency CPR Guidelines Simplified," by Robert Davis, August 15, 2000.
5. The Paramedics, by James O. Page, jems.com, EMS, Emergency Medical Services - JEMS - Training, Paramedic and EMT News, Products, Resources, EMS Jobs @ JEMS.com, accessed January 2, 2002.
6. American Red Cross, American Red Cross, accessed January 2, 2002.

This is why a simple 1 hour CPR course is important. We are talking literally about the difference in life and death

I would argue that 1 is the number of serious injuries/fatalities is too much...quality training with smart divers should eliminate this. Gear does not fail often or these companies wouldnt be in buisness. Most accidents are operator error and could be avoided. Calculated risk evaluation and smart dive planning and execution are key.

I dont think anything you suggested is ridiculous

And CPR for DMs and Instructors should be absolutely mandatory!

If I am diving with a buddy and there is no DM around, it certainly won't be on a boat, it will be a shore dive.

By the time I get them to shore, CPR is, based on the above, extremely unlikely to be of any help.

Unless there is some form of CPR that can me adminstered while in the water with no support, I fail to see why CPR should be connected in any way to an OW cert.

Just because it would be nice if everyone had CPR training does not mean there is a logical connection that dictates requiring it of an OW cert - especially when I can easily dive without a cert of any kind.

The duty of care required of a DM or above, sure, it makes sense. But there is no logical tie between CPR and OW.

 

[gcarter]

All divers I train have CPR (1 and 2 person), first aid, and oxygen administration ... that's what AAUS standards call for. Would the world not be a better place if all the training agencies did the same?

Is the fact that it might make the world a better place sufficient reason to REQUIRE it?

The world would be a better place if people were REQUIRED to be pleasant with each other. Good luck with that one.

 

[freewillie]

Jim, I totally respect you as a diver and an instructor. From reading your posts I can say that you truly care about your students and their skills. Instead of mass producing diver's in a mill you actually take the time to individually teach and train your students. I believe your students are better qualified than many PADI AOW students, especially those whe did AOW training with only few previous dives.

But, remembering my first dive as a certified diver without the safety net of my instructor I was just a little freaked out. Part of that was I was with a complete set of strangers in new dive club. Part of that was the conditions. It was so foggy that morning I couldn't see the shore at about 150 ft from the beach. I was almost about to ditch my weights and swim back by myself and just call the dive. But I took couple deep breaths, said I'm a certified diver and I can do this and continued wit the dive. My training kicked in and I realized I could actually do this sport.

At that time I was still trying to get my buoyancy and weighting down. I was still having to think about where is my inflator, am I sinking or floating. Where is my buddy. So many things I was trying to do all at once. I was still in the task load overload stage as a newbie.

I was fully trained in CPR at the time, and had advanced critical care training as well. As a previous lifeguard in my high school days I am also comfortable with emergency situations and would be able to deal with panicked diver at surface. But even with all my previous experience and training I have to admit I would be little overwhelmed those first few dives if an emergency happened.

As a doctor used to emergencies and "code blues" and a former life guard I would say I have more experience and training than an average lay person. Even so I think I would have been overwhelmed trying to bring an unconscious diver up from depth by myself.

We can appease our own sense of responsibility by teaching and requiring a certain exposure during class, but I think that expecting someone to be able to handle emergencies as if they were a pro is a little naive or over ambitious until they have had a few more dives and more experience.

BTW all those stats about CPR and sudden death are fine, but if you took a boat and even short 20 min ride to dive site, your odds of survival are just about zero. If a patient is lucky enough to survive a sudden death cardiac arrest in the field then they are the lucky 2%. And that is on dry land with paramedics and a quickntrip to the hospital. Personally. If you are performing CPR on a victim for 20-30 min and you have not brought them back it's time to call the code. By the time you got back to port the victim is probably beyond medical help anyways.

 

[Thalassamania]

Is the fact that it might make the world a better place sufficient reason to REQUIRE it?

The world would be a better place if people were REQUIRED to be pleasant with each other. Good luck with that one.

Ah ... there is a major difference, all it would take is for the agencies to have the strength of will to decide to do it, nothing more, meet the spec to be certified, end of story. But there is no way to force pleasantness.

 

[Steve50]

All divers I train have CPR (1 and 2 person), first aid, and oxygen administration ... that's what AAUS standards call for. Would the world not be a better place if all the training agencies did the same?

depends on which folks are saved

 

[endurodog]

Ah ... there is a major difference, all it would take is for the agencies to have the strength of will to decide to do it, nothing more, meet the spec to be certified, end of story. But there is no way to force pleasantness.

This gets back to the argument. If you require this it will increase the length of your course and cost of the course. If one agency does this and the others don't, where will most consumers go to learn? Cheaper and shorter or longer and more expenisive? If all the stars were to align correctly and all the agencies were to do this at once and all the courses were longer and more expensive would as many people take up scuba as a hobby? My belief is that less people would become involved in the activity. With less people involved how would that effect the over all industry ot include resorts, charters, shops, instructors, manufactures, our clout as a political group for scuba and ocean causes? How many lives would really be saved?