Question PADI Rescue Diver Chest compressions

[JohnN]

Apologies in advance, Ive not taken the PADI Rescue Diver course, but reading an "incident" in the SCUBA diving mag about a free diver who had a shallow water blackout, the "experts" recommend in water chest compressions

My understanding from medical professionals is that to be effective on anyone other than an infant, you need to depress the sternum 1.5-2 inches

Clearly this is impossible while in the water (those arms extended chest compressions you see on TV are complete BS)

So what am I missing?

 

[justinthedeeps]

I'm not sure I would consider medical advice from someone who makes it their life goal to walk the line of in-water hypoxia as far as it will take them. But indeed the "rescue freediver" thing seems to have really taken off. Is it endorsed by any reputable agency, EMS, or clinician that isn't themselves married to the sport?

The unconscious diver in-water rescue routine in PADI seems totally ineffective, and I guess that is why it is so strongly emphasized that you must perform it 'perfectly' to be a PADI divemaster or instructor. If the patient is actually totally helpless until reaching shore, then you better at least pretend you did everything you can before that.

That said, rescue breaths may in fact bring someone around if their heart has not actually arrested yet?

 

[JohnN]

I'm not sure I would consider medical advice from someone who makes it their life goal to walk the line of in-water hypoxia as far as it will take them. But indeed the "rescue freediver" thing seems to have really taken off. Is it endorsed by any reputable agency, EMS, or clinician that isn't themselves married to the sport?

I think you missed my point. Effective in water chest compressions seem impossible

Again, what am I missing?

 

[justinthedeeps]

I think you missed my point. Effective in water chest compressions seem impossible

Again, what am I missing?

No, I am totally agreeing with you. And more!

 

[JohnN]

Chest compressions, properly done

 

[Endler's]

'Favorite CPR Video:
and yes, they do teach chest compressions to the rhythm of Stayin' Alive, and Ken Jeong is a real M.D.

 

[kinoons]

I have not looked at any of the PADI rescue diver info, but as a 20+ year emergency medicine professional (EMT, Paramedic, ER RN, ENP) I cannot think of any situation where in water CPR will be effective.

I began my medical career as a teenager as a lifeguard. We trained to get the person out of the water before initiating CPR.

In theory rescue breaths may help someone who is unresponsive, not breathing, but happens to still have a pulse. That is likely to be a very specific situation.

 

[Wants2divemore]

Apologies in advance, Ive not taken the PADI Rescue Diver course, but reading an "incident" in the SCUBA diving mag about a free diver who had a shallow water blackout, the "experts" recommend in water chest compressions

The PADI Rescue Diver curriculum doesn't recommend giving chest compressions while in water. Per the e-learning: "If you are more than five minutes from surface support give rescue breaths for one to two minutes while watching the victim for signs of movement or other response to the ventilations. If there is a response, but continued absence of spontaneous breathing by the victim, continue providing rescue breaths while towing the diver to the surface support. If there is no response to this period of rescue breathing then cardiac arrest is likely. Rescue breaths don’t benefit someone in cardiac arrest without chest compressions, so it’s necessary to get the victim out of the water as quickly as possible to start CPR. Discontinue rescue breaths in favor of speed. Tow the victim to safety as quickly as possible, exit the water, perform a circulation check and begin CPR and rescue breathing as appropriate according to your Emergency First Response training."

Can you post the specific recommendation listed in the SCUBA diving mag you're referring to, as well as who the "experts" are?

 

[happy-diver]

So what am I missing?

The Heimlich mate

Chest compressions, properly done

and always remember to dive with a table

 

[Duke Dive Medicine]

Apologies in advance, Ive not taken the PADI Rescue Diver course, but reading an "incident" in the SCUBA diving mag about a free diver who had a shallow water blackout, the "experts" recommend in water chest compressions

My understanding from medical professionals is that to be effective on anyone other than an infant, you need to depress the sternum 1.5-2 inches

Clearly this is impossible while in the water (those arms extended chest compressions you see on TV are complete BS)

So what am I missing?

You're not missing anything. Sometimes experts offer recommendations like this with the idea that it's better than doing nothing. That said, chest compressions on the surface are best about 20% as efficient as a normally functioning heart. In the water they would likely be of no benefit and IMHO could waste valuable rescue time. To @happy-diver's point, abdominal thrusts could be effective in a drowning scenario where the diver is suffering from laryngospasm or has water intrusion into the lungs, but that would be hard to discern in the water and would take a well-trained rescuer with a cool head.

Best regards,
DDM