Question PADI Rescue Diver Chest compressions

[tursiops]

You're giving voice to what happens when recommendations from medical and diving experts that are based on best available evidence are turned into education that is designed for divers of a variety of experience and prior training, possibly without putting those recommendations into context.

To your question about weight/gear removal and timing of breathing, IMHO there's no single answer but the biggest deciding factors are how close you are to help and a dry platform on which to better assess and resuscitate the diver, and whether the gear is keeping the diver afloat (e.g. in high seas) or impeding rescue.

Best regards,
DDM

This is exactly what is taught in the PADI Rescue class and written in the training materials. It may not be learned or remembered. it seems.
The class provides various skills....most of which probably will never get used....like the emergency skills in most classes, or the S-drill in tech/cave diving. the most glaring example of an emergency skill that is always taught and almost never remembered is removing the LPI hose if the BCD starts self-inflating due to a faulty inflator.

 

[Outbound]

I think you are correct. The Rescue class should be a week long and include all possible exercises plus multiple relevant scenarios. And preferably taught by an instructor with at least EMT credentials.

Do you think anybody would take (and pay for) the class, and any shop would offer it?

I don't know if the course would need to be a week long, or if people would take it if it was. Given, however, that the people who take Rescue Diver classes tend to be on the more serious side in terms of their diving and training, I think people would sign up even if the course was longer and the training more robust.

But what is the downside of spending a little more time practicing and demonstrating important in-water skills in a course? Exercise 7 is clearly considered important enough by PADI to be included in both the DM training requirements as well as in the IE for instructors. If it is that important, and if the flowchart information provided in the learning materials is that critical, then it seems to me that it should be discussed, practiced, and demonstrated more in at least the three variations outlined in the materials.

Moreover - and following on what DDM posted above - I also think there needs to be a better discussion of the implications of strictly adhering to a rote procedure (Exercise 7) when it comes to making real-world decisions. In the Rescue Diver course, students are presented with scenarios to which they have to respond. They have to make various decisions such as whether to use a throw bag to help a distressed and panicking diver, or to grab a float and use that, etc. Great! They are making on-the-fly decisions. Then they are presented with a submerged and unresponsive diver who they have to find, surface, and then rescue. And there is no choice in what they decide to do - they have to go through the exact, choreographed steps outlined in Exercise 7, regardless of whether or not those exact steps make any sense in the context.

Then the student decides to become a DM, and they have to demonstrate Exercise 7 again. Then they do an IDC and get tested at the IE on it again. It reinforces that for every other real-world situation there is a range of responses, except for an unconscious diver. In that case, despite what the training materials told you, your practice says you must go through the dance of counting to 3, clearing your dripping hand on 4, giving a proper breath on 5, and then unbuckling BCDs in between while also trying to support the victim's head, not drip water in their airway, juggling hands to support the head while being able to pinch the nose for breaths and then have the correct hand available to unclip buckles in between, etc. I might fully be wrong here, but that seems to me to be just about the least efficient way of trying to save a person's life that I can imagine. The situation is already pretty dire, and the odds are slim, and now you are faffing about because you've been taught that you can take as long as you like to get the person to shore so long as you remove their BCD and give breaths every 5 seconds on the dot.

 

[Duke Dive Medicine]

This is exactly what is taught in the PADI Rescue class and written in the training materials. It may not be learned or remembered. it seems.
The class provides various skills....most of which probably will never get used....like the emergency skills in most classes, or the S-drill in tech/cave diving. the most glaring example of an emergency skill that is always taught and almost never remembered is removing the LPI hose if the BCD starts self-inflating due to a faulty inflator.

That speaks to any type of skill. Learning it in the moment is one thing, integrating it it well enough to employ it under extreme stress is another.

Best regards,
DDM

 

[tursiops]

That speaks to any type of skill. Learning it in the moment is one thing, integrating it it well enough to employ it under extreme stress is another.

Best regards,
DDM

And as the previous post (#72) shows, even understanding when it is just an exercise to demonstrate you have a skill (parts or none of which you might actually need to use), versus demanding a certain response in all situations, seems to be hard to understand. One reason for the Rescue class is exactly to try and reduce the stress in the moment, and to provide a toolkit from which you must choose. You do not always use every tool in the toolbox.

 

[Duke Dive Medicine]

And as the previous post (#72) shows, even understanding when it is just an exercise to demonstrate you have a skill (parts or none of which you might actually need to use), versus demanding a certain response in all situations, seems to be hard to understand. One reason for the Rescue class is exactly to try and reduce the stress in the moment, and to provide a toolkit from which you must choose. You do not always use every tool in the toolbox.

We're all at varying levels of skill and knowledge here and hopefully we can use this as a forum to lift one another up.

Your point is a good one. The knowledge and skills from rescue diver (or any advanced diving class) don't exist in a silo, they need to be integrated in an existing skill set and then it's up to the individual to think critically and apply those integrated skills as dictated by the situation, sometimes under extreme stress. At the risk of being trite, this can be hard. I'm reminded of Benner's novice-to-expert continuum. The linked article is about nursing but the theory behind it is universal.

Best regards,
DDM

 

[tursiops]

We're all at varying levels of skill and knowledge here and hopefully we can use this as a forum to lift one another up.

Your point is a good one. The knowledge and skills from rescue diver (or any advanced diving class) don't exist in a silo, they need to be integrated in an existing skill set and then it's up to the individual to think critically and apply those integrated skills as dictated by the situation, sometimes under extreme stress. At the risk of being trite, this can be hard. I'm reminded of Benner's novice-to-expert continuum. The linked article is about nursing but the theory behind it is universal.

Best regards,
DDM

Interesting linked article! The application to a Rescue class is awkward. I guess the person who takes the class is a novice, i.e., no experience upon which to rely for making good judgements. If there is a rule, follow it. What is the situation for multiple possible rules, no experience, and no one mentoring/leading?

 

[Duke Dive Medicine]

Interesting linked article! The application to a Rescue class is awkward. I guess the person who takes the class is a novice, i.e., no experience upon which to rely for making good judgements. If there is a rule, follow it.

Maybe? Would a novice diver who takes a rescue diver class incorporate the information into his/her skill set the same way an expert diver would?

What is the situation for multiple possible rules, no experience, and no one mentoring/leading?

Kind of a broad question but I would think it would depend on the individual.

Best regards,
DDM

 

[justinthedeeps]

Ok so protect the airway from chop or submersion, but also give breaths to an open airway (head back chin up).

Isn't the BC actually a good thing, keeping the head out of the water? Except for that big tank strapped to it.

Anyone ever try dropping the tank from a BC? Possible on some configs, but you'd have to disconnect all LPI(s), clips, shock cords etc first.

 

[Outbound]

And as the previous post (#72) shows, even understanding when it is just an exercise to demonstrate you have a skill (parts or none of which you might actually need to use), versus demanding a certain response in all situations, seems to be hard to understand. One reason for the Rescue class is exactly to try and reduce the stress in the moment, and to provide a toolkit from which you must choose. You do not always use every tool in the toolbox.

First of all, just because we disagree does not mean you need to be disagreeable.

I understand perfectly well that it is just an exercise. I question the effectiveness of it as it is presented, that's all. And clearly I'm not alone, judging by the responses in this thread.

@justinthedeeps, the way I was taught was that you unclip all the buckles of the victim's BCD and get the octo loop out of the way while towing, but you keep the inflated BCD underneath them. That helps with the flotation and also helps keep their airway open because their head extends past the BCD bladder and falls back a bit. Then, when just about close enough to shore to stand up (or near the boat), you push/kick the BCD out from underneath them for the final tow to hard ground.

 

[Endler's]

Exactly! I mean, it's not like any other training agency offers those stupid "rescue diver" courses! It's just a PADI money grab thing.

Oh, wait:

So how do the other associations teach this skill?