One dead, one missing (since found), 300 foot dive - Lake Michigan

[John C. Ratliff]

What caught my eye was the comment about trying to stabilize glucose levels in the hospital before calling deceased. I don't know squat about what happens to the body during this stuff but that is the first time I have ever heard of stabilizing glucose outside of diabetics. Is this something that normally happens in CPR situations? I have zero emergency room experience and no medical training anywhere near this. So I am asking as an idiot about this stuff. This thread has been down enough tangents, I don't see why not ask about this one.

I talked to my wife, who is a hospital pharmacist, and she noted that people with low glucose levels can be in coma from that, and that the docs try raising the glucose levels to see whether that has caused the coma, or something else.

SeaRat

 

[rongoodman]

I talked to my wife, who is a hospital pharmacist, and she noted that people with low glucose levels can be in coma from that, and that the docs try raising the glucose levels to see whether that has caused the coma, or something else.

SeaRat

A finger stick is quicker, more accurate, and less harmful than just blasting every unconscious person with glucose. That went out of style years ago.

 

[Brad_Horn]

So what's your point Brad?

No specific point. Just an observation that the WOB of both CCR and OC is an opportunity cost selected well before any dive.
You appeared to be indicating that the WOB would vary during the dive based on equipment. While the WOB of diving equipment can and does vary tremendously, it is a fixed constant once in use. All other variables (gas/depth/workload) remaining equal.

That the REVO manual states that horizontal vs vertical position doesn't have a significant impact on WOB?

Per the manual there is a quite significant change in WOB from 2.45J/L to 2.75J/L give or take in going from horizontal to vertical on a mixed gas dive. Having read that, I’m now interested in learning how buddy rescue, especially at mixed-gas depths, is taught on this rebreather?

I'm only trying to say that the WOB on a ccr at that depth and temperature range is higher than diving OC and could possibly (hypothesis) be a cause or in any case contributing factor to the accident that happened.

The WOB on ‘a’ CCR doesn’t need to be higher than OC. Granted on some CCRs it is. Dependent on the specific pitch, depth, gas and workload and test criteria 'a' CCRs WOB can be lower, see http://www.deeplife.co.uk/or_files/DV_OR_WOB_Respiratory_C1_101111.pdf
Unlike scrubber duration, WOB is also independent of temperature. Though for CE purposes its testing is done at 4’C or roughly the water temp of this dive.

I agree with your sentiment that WOB may and quite likely in this specific case did have a contributing factor noting how high it is. It’s just not the case for all CCR!
Hence the opportunity cost comment. And before someone get twisted up that this is a commercial post, if one wanted a current 'COTS recreational eCCR' better suited for this dive, I'd suggest looking at the VMS Sentinel. When you’re diving right on the edge of the unmanned testing envelope, a little more known safety buffer, could mean a lot!

See also Work of Breathing Limits for Heliox Breathing

PS: on the BOV... this is exactly why I'm diving my set without BOV, and use a necklace backup reg to bail out too... almost as fast as BOV (in any case significant faster than deploying a reg from a sidemounted bailout tank), without the increased WOB that a BOV gives.

A BOV doesn’t ‘have to’ raise a rebreathers WOB when substituted for a DSV. Based on us all now knowing that the total dive lasted less than 60min, at least for one of the divers, hypercapnia seems to have been ruled out and oxygen flow may have been more an issue by design. But closing a DSV (so your ccr doesn’t flood and you sink), pushing it below your neck, untangling your necklaced reg and then purging it all still takes time and multiple hands. Been there, had to do it. Time you or your buddy may just not get, be it due to your RMV having gone through the roof due to CO2 from hypercapnia or going hypoxic. Especially compared to one finger triggering bailout on a BOV or your buddy being able to do this for you and the airway then not being needed to be exposed to water and the risk of drowning.

I understand that the ALVBOV significantly lowers the rEvo WOB when substituted for the stock DSV and has the same right to left gas flow as default. And a gag strap. While I know one wasn’t being used in this case, the option to fit ALVBOVs to rEvos and therein lower their WOB, has been an option that the manufacturer has known about for a considerable period.
http://www.deeplife.co.uk/or_files/DV_DL_ALVBOV_Breathing_Params_A3_100318.pdf
https://www.opensafety.eu/datasheets/ALVBOV_40m_75lpm_air_081014.pdf
Open Safety Equipment Ltd
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While the Mares BOV that rEvo is now heavily promoting was seemingly not an option for this couple, it will be interesting seeing its WOB in OC and CC benchmarked against the ALVBOV. And learning why it took so long for a BOV, despite being a critical safety feature, to be offered as default on the rEvo?

 

[Rollin Bonz]

A finger stick is quicker, more accurate, and less harmful than just blasting every unconscious person with glucose. That went out of style years ago.

I read SeaRat's post as in a person who has low blood glucose (likely confirmed via finger stick or labs) and is in a coma, that the low glucose could be the culprit, therefore the patient would receive glucose to rule out low blood glucose as the cause of the coma.
As opposed to, as you seem to be describing, just blasting anyone in a coma with glucose to see if they come around.

 

[a878bob]

Report details Lake Michigan diving accident in which Illinois couple died

These stories are full of holes, I wouldn’t put any credence into most of it.

 

[Chidiver1]

I read SeaRat's post as in a person who has low blood glucose (likely confirmed via finger stick or labs) and is in a coma, that the low glucose could be the culprit, therefore the patient would receive glucose to rule out low blood glucose as the cause of the coma.
As opposed to, as you seem to be describing, just blasting anyone in a coma with glucose to see if they come around.

Which is what I had said previously, my bet is they determined her levels were low enough to warrant it(it's vital to brain function), or they found out she has a pre-existing condition warranting the infusion, as they probably thought that is what caused her to be unconscious as I said earlier.

 

[Chidiver1]

A finger stick is quicker, more accurate, and less harmful than just blasting every unconscious person with glucose. That went out of style years ago.

Yes, and I addressed why it went out of style and a couple of scenarios as to why they would have administered it to her.

And as searat described it, he basically repeated some of what I said, outlining a situation that would cause glucose to be given during an incident of unconsciousness. I don't think he was saying they give it to just anyone in all situations.

 

[flyingron]

EMS rarely worries about exact glucose levels. If the patient is low, we whack them up with 50cc of D50. Hypoglycemia is life threating. Hyperglycemia is a slower evolution problem.

In fact, the O2-D50-NARCAN combo is generally a sign that we don't have a clue what's wrong with the person.

 

[victorzamora]

@tbone1004 and @victorzamora have, I believe, even had this discussion with each other's SO as they are a pretty constant team.

@tbone1004's wife doesn't dive, but mine does. TBone and I are also friends IRL, outside of diving (we watched each other's dogs often, we had a Mario Kart Trophy that we passed around between winners, etc). I've had conversations with my wife and we've both talked to each other and each other's.

The problem is that, especially in life-threatening situations, you just don't know how you'll react. I've been, frustratingly, in a position where my life was being directly and immediately threatened on several occasions....and I can promise that all of the plans go away upon being confronted with your mortality.

I can't imagine how awful it must be to be in that situation underwater with a stranger, much less a friend or loved one. I don't want to ever have to. My wife and I do everything we can to never be in that situation: extra gas, extra bottles, turning early, thumbing dives over relatively minor issues, etc. Even fairly minor "issues" between us on dives stresses me out notably more when it's her compared to when it's TBone or one of my other dive buddies. I can absolutely see myself dying trying to save her if things went seriously bad whereas I could likely break away from the rescue with others. The whole "don't make two victims" is hard to face even when it's not a wife or child.

 

[tbone1004]

echoing what @victorzamora and I know my SO is quite ok with it and has threatened to learn to cave dive just to bring me back and kill me herself for being an idiot.
I haven't had to go through what VZ has with his wife, but I do dive with her without him and I tend to take extra precautions with her vs. diving with him. We are still pansies when diving with each other but go out of the way when diving with her.
The discussions we have had are basically that we are solo diving in close proximity to each other and if it's not a problem to help the other one, we will, but otherwise you're on your own. What would actually happen in a scenario like that? I don't know and I would like to think that the planning we do and precautions we take when diving together would make the odds of it happening minuscule, and so far, we haven't had anything past a couple butt puckers that were more annoying at best.

We do need to restart the mariokart tournament, though work has moved us annoyingly far apart distance wise.