Rescuing an unconscious diver underwater.

[Garth]

If you find an unconcious diver (found to be not breathing) and for some reason or not shoots up to the surface--- will he be likely or not likely to get barotrauma due to an uncontrolled ascent? What about an embolus?

It would appear to me that the pressure increase when moving to the surface would push air out his/her mouth. right?

 

[peterbj7]

I'm not sure why Peter seemed to object to that

I didn't, or I didn't mean to. Sorry if I gave that impression.

You have to remember that if someone has lost control of their buoyancy and/or their breathing there's a reason for it. I would never deliberately inflate someone's BC and just send them to the surface, not for fear of causing them a lung embolism (as I said above, I consider the chances of that very remote) but because they may have a problem with their BC that might cause air suddenly to vent and send them back to the bottom, out of my sight. Although that hasn't happened to me or to anyone I've been with, a friend of mine died partly because of a problem like that.

 

[boulderjohn]

Because of what I believe to be a blur of information in the last few posts, in which it seems to me that people are combining a couple of different situations, I would like to repeat some points I made earlier.

1. The process of taking a toxing diver to the surface is somewhat different from the procedure for taking an unconscious diver to the surface.
2. The process for taking a diver in a single tank to the surface is different from the process for taking a diver in doubles to the surface.

People who are making suggestions or are disagreeing with others should make it clear which they are talking about.

 

[halocline]

I didn't, or I didn't mean to. Sorry if I gave that impression.

Different Peter!

 

[ReefHound]

One thing that I don't understand is that you don't check for pulse. I know you cannot do chest compressions in the water but to take all the extra time to provide a breath every 5 seconds could be a total waste and could waste valuable time getting them back on the boat or to shore. Breaths don't matter if the blood does not carry the oxygen to the vital organs (brain). It would seem to me that you would check for pulse, if no pulse get them out of the water asap to conduct full CPR and don't waste time and energy getting useless breaths in them that don't go anywhere.

When this issue was raised in my Rescue class, we were told that you assume they have a pulse however faint. It can be very difficult to detect circulation (and sometimes respiration) in the water. If there is any doubt, provide rescue breaths. If you are mistaken in concluding there is no pulse then you may be taking away any chance they had. Cardiac arrest is much less recoverable than respiratory arrest, and will follow respiratory arrest within minutes, so immediate ventilation is important. Rescue breaths done properly should not be slowing you down much. This is when you are within 5 minutes of an exit, if not then just tow if they are not showing response to rescue breaths. You are probably just engaging in a recovery operation at that point anyway.

 

[peterbj7]

The process of taking a toxing diver to the surface is somewhat different from the procedure for taking an unconscious diver to the surface

It's more controversial, but I would follow much the same procedure for both.

The process for taking a diver in a single tank to the surface is different from the process for taking a diver in doubles to the surface

I don't think the procedure is different at all, but some of the practical difficulties may vary, purely because of the bulk of the twinset.

 

[halocline]

I

One thing that I don't understand is that you don't check for pulse. I know you cannot do chest compressions in the water but to take all the extra time to provide a breath every 5 seconds could be a total waste and could waste valuable time getting them back on the boat or to shore. Breaths don't matter if the blood does not carry the oxygen to the vital organs (brain). It would seem to me that you would check for pulse, if no pulse get them out of the water asap to conduct full CPR and don't waste time and energy getting useless breaths in them that don't go anywhere.

This is just an opinion I have and I could be totally wrong on this. I would like to get input on this from a medical professional. Any comments appreciated.

The rational for this, as others have posted, is that it's very difficult to accurately detect a pulse in the water. So you assume there is a pulse and provide rescue breaths. That's the PADI stance.

However, I suspect that most EMT experts would agree that just getting the victim out of the water to do CPR is the highest priority. I would not surprise me to see PADI revise their rescue procedures to reflect this in the future.

 

[laurin]

• The process of taking a toxing diver to the surface is somewhat different from the procedure for taking an unconscious diver to the surface.

Not really. The only difference is that waiting until the tonic phase is gives you a lot better shot at getting the victim up without lung expansion injuries.

• The process for taking a diver in a single tank to the surface is different from the process for taking a diver in doubles to the surface.

Not at all. You'd take a single-tank diver up the same way as you'd take diver in doubles. However, you might get away with a worse technique with a single tank diver, but if you want to be able to manage the victim most efficiently, the best body position and the hold is exactly the same in both cases.

What I haven't yet figured out is how to manage dangerous novelty gimmicks like the Airtrim system that some BCD manufacturers keep spewing out.

//LN

 

[Garth]

WAIT a minute....

First check if the unconcious diver is breathing because you can breath when unconcious. They might not be breathing though so look for bubbles maybe.
Most importantly if someone is breathing their heart will be pumping and if not they will likely not be breathing for long.
I don't see the need to check for a pulse underwater due to the fact that it wouldn't change anything you would do. Whereas if someone is unconcious and breathing you secure the airway and slowly ascend. IF someone is not breathing you secure the airway and ascend. but

if you spend 10 seconds underwater attempting to feel a pulse the victim goes without oxygen for an additional 10 seconds. Not a good Idea from my standpoint.

History: I'm a trauma nurse and have performed CPR near 100 times above water but if this is not correct it may be due to the fact that I haven't had Rescue for Scuba.
I'm interested to see how this is judged.

 

[Garth]

On another note... no one has answered my question. How can someone have a lung expansion injury when unconcious and unable to hold breath? Air will release from the mouth unless obstructed.