Question PADI Rescue Diver Chest compressions

[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.

Yeah you are right about the course protocol, and its rationale.

But I wouldn't want to swim the tank around at all if I don't need to, and I don't want that tank anywhere near me or my victim in anything over ankle-high surf. Just like the weights.

Keeping an unloaded BC on might even help with lifting people onto a beach or boat, depending on its type (consider the crotch strap ones)

In anything but the glassiest conditions (usually our course conditions), I would be thinking to ditch the whole deadly wrecking ball while still in at least waist deep water, metres away from shore, potentially with waves and surge to contend with.

Maybe ditch the tank early on, but keep the BC on to ease extraction? Idk just a thought. One wave puts you into a loaded tumble and your victim's airway is toast.

Quick release tanks? Now that's a recipe for disaster, right?

 

[Outbound]

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So how do the other associations, teach this skill?

Good question, and I don't know the answer. Hopefully someone from SSI or NAUI or one of the other agencies will chime in.

I did find a series of short YouTube videos from SSI demonstrating surfacing an submerged unconscious diver and towing that person, and another on how to deal with an unresponsive diver at the surface (flipping them over and towing). In both cases, weights are ditched, two initial rescue breaths are given and then the rescuer tows fast for shore. Unclipping and removal of the BCDs doesn't happen until close to the shoreline. I don't know if these videos are indicative of the course standards or how it is taught, but I assume so given that it is put out by SSI directly.

 

[lowwall]

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?

Someone with no other relevant training who takes the class and doesn't do any followup, even if it's just reading discussions like this, will stay at novice. Since the rules the novice rescuer will likely remember come from the training scenarios rather than the text of the materials, it does matter that the training scenarios be realistic.

This discussion is bringing me around to the belief that the rescue course should be reorganized in some fashion. The information was all there, but the order of demonstrated skills is at odds with what the course text was trying to teach. I went into my rescue course with the background of lifeguard/WSI training and working as a lifeguard so it was fairly easy for me to understand that the doff and swim while doing rescue breaths scenario was a skills exercise rather than a prescription. But I asked a lot of questions about this before it became clear and I can easily see how someone without relevant background would miss this completely.

I don't think the course needs to be any longer to fix this, just reorganized. IIRC, you already do the doff and the swimming while giving rescue breaths earlier. Maybe that's enough or they could get a shorter scenario where you do the two together. But end with the skill scenarios that are the most likely paths in a real rescue, perhaps one of them combined with the search scenario. 1) Bring the unresponsive diver up from depth (or encounter on the surface) a moderate distance from land or a boat, give initial rescue breaths, decide what makes sense for gear removal and start towing while protecting the airway. 2) Bring them up or encounter next to a boat or dock and immediately get them out of the water without doing any rescue breaths; gear removal as needed to get them out quickly.

Note: I took the PADI rescue course. I don't know how applicable this is to courses designed by the other agencies.

 

[justinthedeeps]

So yeah pretty similar to the PADI routine.

If the reg is in, should you take it out? Maybe you should.

But reasons to leave it in include: 1) might be protecting the airway, 2) might give audible indications of breathing, 3) might be able to carefully deliver gas to an open airway (but contentious/risky)

Why are we even "listening for breaths?" Seems like a waste of time if you already have the reg out with no response.

Look at this diver trying to swim around two sets of gear and tanks. Is there really no way to ditch tanks off the BC? Should there be?

 

[Outbound]

So yeah pretty similar to the PADI routine.

If the reg is in, should you take it out? Maybe you should.

But reasons to leave it in include: 1) might be protecting the airway, 2) might give audible indications of breathing, 3) might be able to carefully deliver gas to an open airway (but contentious/risky)

Why are we even "listening for breaths?" Seems like a waste of time if you already have the reg out with no response.

Look at this diver trying to swim around two sets of gear and tanks. Is there really no way to ditch tanks off the BC? Should there be?

The big difference between PADI and the SSI video is that the video does not show any attempt to unclip the BCD while giving rescue breaths and towing. It's simply two rescue breaths and haul ass to the shoreline. To me, the speed of getting the victim to a hard surface is almost always going to be the most critical component. It might be different if you were a long way from a boat to signal or from shore. In that case, then perhaps giving 5-count rescue breaths would be paramount. But honestly, if you have a non-breathing diver that far from help, then the exact protocol you use is likely irrelevant.

 

[kinoons]

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.

The other thing to consider about unclipping a BCD - many wrap around a divers abdomen and/or chest, especially when inflated. This could restrict chest rise requiring greater pressure to give rescue breaths and increase the likelihood of gastric insufflation. I don’t know of any study that confirms this, but in principal it makes sense and further confirms why a rescuer would chose to unbuckle a BCD.

 

[Learner Diver]

This could restrict chest rise requiring greater pressure to give rescue breaths and increase the likelihood of gastric insufflation

Do you mean that the unconscious diver could possibly puke in your face?

 

[Outbound]

The other thing to consider about unclipping a BCD - many wrap around a divers abdomen and/or chest, especially when inflated. This could restrict chest rise requiring greater pressure to give rescue breaths and increase the likelihood of gastric insufflation. I don’t know of any study that confirms this, but in principal it makes sense and further confirms why a rescuer would chose to unbuckle a BCD.

Interesting. If true, then it would be a reason to unclip all buckles of the victim's BCD right away rather than in small steps in between rescue breaths.

 

[kinoons]

Do you mean that the unconscious diver could possibly puke in your face?

Possibly, yes. An inflated stomach can also make rescue breaths more difficult as the stomach would take up additional space and put pressure on the chest cavity as well.

 

[pauldw]

Do you mean that the unconscious diver could possibly puke in your face?

Once I was doing mouth to mouth on someone as part of CPR, and discovered that he'd been eating steak. It didn't taste very good.

Would it be helpful if before pronouncing on whether this or that technique it good, people actually try it? I don't read about wrapping or taping a sprained ankle, for example, and assume that's all I need to know. I do it on myself, and do it again, until I see what works best. Seems like the same principle would well apply to some degree to in water attempts at resuscitation. Don't rely on theory, see what works. If it doesn't work in a pool, it sure won't work in the ocean.