Rescuing an unconscious diver underwater.

[Garth]

Okay.. I read TSandM's post from earlier and agree that all it takes is air to be releasing slower than it needs to be to create barotrauma. alright

 

[ReefHound]

Garth, I don't think he was suggesting to check for a pulse underwater but once you reach the surface, where the response splits between providing rescue breaths as you tow them to an exit versus just towing as quickly as possible.

Matt, an EMT or you or I might agree that another approach is better but the dilemma is that if we deviate from the standards as we were taught then we open ourselves up to more liability and perhaps invalidate our insurance.

 

[peterbj7]

But remember that someone who's dead or about to be can't get any worse. Drowning is pretty final.

As the insurance angle, you have to be American (no offence intended!). I don't know any Brits who would be concerned with insurance or even with possible legal liability, but just to do their best at the moment.

From my scant knowledge of First Aid (I teach it, but that doesn't mean that I know much about it) I would never try to find a pulse in the water, whether below or on the surface. It's hard to find on land at the best of times, and in the sea pretty well impossible. And supposing you do fail to feel a pulse, what are you going to do about it in the sea? No, continue the rescue breaths on the basis that they may be doing some good, even if that is only staving off the inevitable. Proper rescue breaths can limit tissue death and give the victim some sort of a chance.

 

[mudhole]

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.

Garth, In a round about way, your question is difficult to answer for all circumstances. But if you will accept a simple view. A non breathing diver, if not dead already, can mechanically close off their airway by their head falling forward. . . Above or below water, this constriction of the airway does cause many deaths every year, above water. The airway constriction can be aggravated by some cold water dive hoods and neck seals, with head position.

Will floating someone to the surface, cause death, who can tell. Anyone not breathing can have pressure exceed the strength of the lung tissue. For some people a 3 or 4 lb overpressure will "blow out". If the head is leaning forward, it can provide more closing power than the 3 or 4 lbs strength of the lung tissue.

Even in this discussion there have been people afraid to become involved. If in their minds the person in distress is a stranger, they won't put out effort to help. There are others like me, that have faced someone else's emergency and stepped in to first recognize what the problem is and then choose the best thing I can do to help

The weight of the head closing off the airway can best be shown by an accident that didn't involved diving. Years ago, along a scenic river with canoe rentals. . . A canoe hit a tree floating in the river. The canoe tipped over, a woman in the front hit her head on the tree and was knocked out. Twenty or more people helped pull her out of three feet of water, then stood around, She was "blue" and making "funny" noises, for a few minutes, then turned white. She was a young mother with two young children. . . and no body, would even lift a few ounces to elevate her chin to stop the "funny" noises of her attempted breaths.

Is this knowledge going to save everyone, no. Can saving a life mean only a slight effort by "somebody", it can.

Garth, please don't think this is an attack, it's not. I would hope just one person will realize how easy it is to save a life, and how bad you feel if someone might be saved by such a slight effort.

 

[Garth]

I'm been thinking about this today and agree with you "Mudhole" (by the way that name rocks). When I think about doing CPR on land I think ABC's. Airway first this is very important. I guess I didn't understand what the positive pressures inside the lungs would do to a rapid increase which may unobstruct the airway. To put this is short... i don't want to find out.
Thank you all for responding to my question.

I don't like to be put in situations like you mentioned about the lady turning blue but it situations like this happen to those I love I would like me to be there. I may not know what to do in underwater rescue. I think my main goal would be to get the person out of the water. From there I know what to do.
This is why I am going to be taking rescue classes soon. You can bet whoever gets into trouble, If i am there I will be performing high quality CPR. And this I'm passionate about. I don't stand around and I don't give up. Until EMS arrives to take over you will find me doing what I do best.

 

[hudson]

Before you take your rescue class, inquire about how "exhaustive" the in-water portion will be. The bare minimum of exercises will be diver location, surface rescue, tows, carries and underwater rescue, but you definitely want more than that, and those could be limited to one scenario per student or more in-depth. Check out some of the previous threads on this. It's also nice if the instructor is involved in rescue in professional capacity, he will have a lot of practical advice for you.

 

[peterbj7]

A non breathing diver, if not dead already, can mechanically close off their airway by their head falling forward. . . Above or below water, this constriction of the airway does cause many deaths every year, above water. The airway constriction can be aggravated by some cold water dive hoods and neck seals, with head position

I agree with the general point you're making, but as a point of detail remember that the weight of the head underwater is greatly less than above. I should think (I have no first hand knowledge) that the chance of the airway being held closed in that manner underwater is pretty slim. But as I've said before, what option do you have?

 

[Rainer]

Slim?

With the head tilted down, it's pretty much assured the airway will be blocked. All my classes that covered unconscious diver rescues made a huge point about keeping the victim's head back to clear the airway on ascent.

I agree with the general point you're making, but as a point of detail remember that the weight of the head underwater is greatly less than above. I should think (I have no first hand knowledge) that the chance of the airway being held closed in that manner underwater is pretty slim. But as I've said before, what option do you have?

 

[Hickdive]

Unconscious or dead people don't hold their breath. Undertakers don't have to deflate their "client's" lungs.

Don't confuse an obstructed airway preventing inhalation with the ability to hold your breath.

In first aid rescue breathing you extend the airway to:

(1) Allow the casualty to breath for themselves or
(2) Allow you to apply rescue breaths.

You will never encounter a situation where, when you open a non-breathing casualty's airway, they exhale.

Extending the airway underwater simply wastes time, overrides the victim's gag-reflex, allowing water to enter the lungs, possibly worsening their condition if they are succesfully resuscitated and gives you something else to worry about during a rescue when you've already got your hands full.

 

[muddiver]

You will never encounter a situation where, when you open a non-breathing casualty's airway, they exhale.

No, they just puke all over you.