Rescuing unconscious diver question

[Cacia]

laughing...

Actually, there's nothing more effective than an unqualified faulty answer to bring out the experts with loads of great information.

yea, ...bait 'em I say! Certain posters are good for the common good for just that reason!

I thought Lynne made sense. I have a hard time imagining the expanding air forcing the nasopharynx open, especially when the neck and mandible are not on the right position. I would think the stimulation of water in the face would initiate some gag reflex not helpful, but I have no idea. She intubates, so her guess would be pretty accurate, in my book.

I am very interested in the whole laryngo-spasm thing. Once you reach a certain level of hypoxia, I understand your cords open. I have visualized cords spasmed shut and I thought that was a protective mechanism that is in play.... Once they become oxygen deficient enough, the cords open, I thought. Maybe some medical hot shot could clear this up?

 

[SparticleBrane]

I was trying to make a point that it seems that the path of least resistance would probably be out through the mask instead of into the nostrils, as there will probably be air coming out of the nose while the diver is ascending.

 

[aboalreem]

It is an easy answer...IT DEPENDS.
If you rescuing from 100 feet, you are better to control both your and the victims BCD. It is better to deflate your BCD and since the Victim (more likely dead), use their BCD to go up if they are heavy, but if it is a 5 feet, or 100 lbs person, you better deflate their BCD and deflate yours going up, so control yours...the answer it depends

 

[SparticleBrane]

Another "it depends" answer.
What if I find someone on the bottom in double 130s and I'm wearing my 30lbs Eclipse? In that situation I'd definitely have to use their BC first to get them off the bottom, and I'd probably use a combination of both afterwards.
So really, I would say that it depends on the situation.

 

[Cacia]

I was trying to make a point that it seems that the path of least resistance would probably be out through the mask instead of into the nostrils, as there will probably be air coming out of the nose while the diver is ascending.
__________________

well, I think that is the crux of the question. Would it be the path of least resitance? (VS blowing an aveoli, AE) The pressure has to rise high enough to open the airway...would this happen? has anyone ever observed this? I am pretty sure it would in a person who has been dead a bit. Not sure if it would in a victim not yet hypoxic, with reflexes intact. Which is the only type of person that it would matter on.
where are the docs around here when you need 'em?

 

[ReefHound]

Another "it depends" answer.
What if I find someone on the bottom in double 130s and I'm wearing my 30lbs Eclipse? In that situation I'd definitely have to use their BC first to get them off the bottom, and I'd probably use a combination of both afterwards.
So really, I would say that it depends on the situation.

The simple answer is "whatever it takes". Focus more on getting it done, less on how you get it done. Chances are any "real" rescue situation is not going to fit neatly within the scope of your training exercises, you have to be able to improvise and adapt.

 

[SparticleBrane]

^^ I agree--whatever it takes to bring them up.

 

[MB]

A tight mask seal will make it difficult for water to escape the mask on ascent. Also, some people teach rescuers to hold the reg & mask in place (you usually need 5-6 hands to follow all their directions!) which effectively prevents water from burping out. And, since most divers with any rescue acumen will try to bring the diver up head first -- in a sort of chin up manner, in hopes of maintaining an open airway -- the ascent will make it very easy for water to enter the nose. Since the person is unconscious, it takes precious little pressure to force that water into the diver instead of out thru the mask seal. It takes only miniscule positive pressure to get water into the diver, and the resulting laryngospasm will prevent rescue ventilations from entering the lungs when the diver does get to the surface.

One question involved whether the mask should only be removed if its fully, rather than partially flooded. Nope. The problem with that is that a fully flooded mask may not appear to be flooded at all. A mask full of water often appears to be air-clear.

Another question invloved whether the lungs would already have water since the person is unconscious. Likely not. Frequently people ingest only tiny amounts of water into the lungs. The same laryngospasm that blocks rescue breaths block water -- unless its forced (such as happens when water in the mask expands...). Unconscious UW frequently does not mean the person drowned (not in the first couple of minutes.)

A person being brought to the surface, with an open airway, is very unlikely to inhale water. Once again, Boyle's law helps air (and any water) exit the airway. As long as the rescuer maintains a steady ascent of 1'/second or better, physics is a partner in the rescue.

Now to really stir the pot, here's something else you'll seldom see in Agency X Rescue Guidelines: How about stripping the diver of his/her gear on the ascent so that by the time the rescuer hits the surface, the diver is out of most of his gear? (Rescuer too.)Advantage? Way less drag, much improved manuverability at the surface, more efficient ventilation access, less work for the resuer. If the diver has neoprene, the buoyancy of the suit is a big aid at the surface. Disadvantage? Poor rescue technique / high stress situation will require rescuer to depend on the BC for bouyancy, but its no longer there... (OK, the other disadvantage is that you'll loose some cool gear.)

Good questions here! For a real eye opener, Google Butch Hendricks' rescue guides to see difference between Generic Agency Guidelines vs the tools that the pros use to effect rescues.

 

[Cacia]

How about stripping the diver of his/her gear on the ascent so that by the time the rescuer hits the surface, the diver is out of most of his gear?

great post,... but

are you kidding about this? I do not think I could do all that underwater.

I am pretty sure the cords open once you reach a critical level of hypoxia. I was taught way back, if the cords were in spasm to visualize them and just wait to pass the ET tube. A victim still viable, being brought up would most likely still be in laryngospasm, yes? ...

the whole thing about taking the gear off in tow of the unconscious diver, I thought was ridiculous. They are basically suggesting removing the flotation from an unconscious person far from the boat WHILE doing rescue breaths....seems counterintuitive to me. You get hit by a wave, your hand slips. They are gone. I had some real doubts about the rescue algorythms but managed to keep my mouth shut.

 

[gcbryan]

But that's exactly what NetDoc is saying! The water will be forced out of the mask cavity by expanding air. The question is where will it go? Is the path of least resistance through the mask skirt or up his nostrils?

If it's expanding air coming out of the nostrils I don't see how it would go up the nostrils.

I thought Kidspot's point about wanting more info was regarding medical authorities confirming the mask removal procedure being discussed here as fact.