Rescuing unconscious diver question

[Dive-aholic]

Okay MB, but what if, as Lynne suggests, the diver regains consciousness on the ascent. The initial impulse may be to take in a deep breath. The natural way to do this will be through both the mouth and the nose. This will cause much more water to enter the lungs than if the mask were left in place, even with a mask fully flooded.

 

[Dive-aholic]

You can try over at www.ScubaBoard.com for some great info. Let's face it, we are far, far more dynamic than any agency's rescue manual. You will find lot's of info here that is missing in the manuals.

I agree. We have a great resource here. I've learned a lot in the couple of years I've been posting here. It's not a substitute for training, but it can, at the very least, generate some thought about things not covered in training manuals.

 

[MB]

Okay MB, but what if, as Lynne suggests, the diver regains consciousness on the ascent. The initial impulse may be to take in a deep breath. The natural way to do this will be through both the mouth and the nose. This will cause much more water to enter the lungs than if the mask were left in place, even with a mask fully flooded.

When we train, we lay out a lot of "what ifs." but think about this one. A diver is not breathing, and is unconscious at depth. S/he does not arouse when when shaken, stirred, or stripped of a weightbelt. What is it about bringing the diver to the surface that will make him or her "wake up"? Maybe once the face hits the surface, or a couple of rescue breaths are provided, but its not likely that ascending-only will result in consciousness... And if so, and the mask is full of water, and its already entered the nose, the mask provides no better outcome than no mask at all.

 

[The Chairman]

Great point MB, either way you will have water byt the nose. At least without the mask, the disoriented diver has less of a chance of choking due to water being pushed back through the nasal passages onto the pharynx. That is a HORRENDOUS feeling. I know, because I partially flooded my mask during a rescue class and forgot to maintain that positive pressure when the candidate forgot to remove it! It almost turned into a REAL rescue.

 

[KrisB]

When we train, we lay out a lot of "what ifs." but think about this one. A diver is not breathing, and is unconscious at depth. S/he does not arouse when when shaken, stirred, or stripped of a weightbelt. What is it about bringing the diver to the surface that will make him or her "wake up"? Maybe once the face hits the surface, or a couple of rescue breaths are provided, but its not likely that ascending-only will result in consciousness... And if so, and the mask is full of water, and its already entered the nose, the mask provides no better outcome than no mask at all.

Of course, it depends on what has caused this non-responsiveness. Is narcosis not a potential cause? If so, even going up 5' could be enough to help the diver regain consciousness...

 

[The Chairman]

Of course, it depends on what has caused this non-responsiveness. Is narcosis not a potential cause? If so, even going up 5' could be enough to help the diver regain consciousness...

Deep water blackout does not interfere with the diver's breathing, unless they have lost their reg. I have seen it and the diver in question was still breathing while tumbling down the deck of a wreck. Some mouthpieces are superior in this respect.

Either way, the chance of his "awakening" is far, far less than the chance of him getting water down his pharynx.

But in reality...

If a diver is unconscious at depth, for all intents and purposes THEY ARE DEAD ALREADY. It's incredibly hard to hurt a dead person any further. Their only hope is to make it to the surface ASAP where you can try to resurrect them.

I would suggest that if you find yourself in this scenario, that doing ANYTHING is better than doing nothing. Do all that you can do, while keeping yourself safe, and realise that you have little control over the ultimate outcome. It's either their time to go or it's not. Do your best and be comfortable with your decisions: BUT DO SOMETHING!

 

[TSandM]

If a diver is unconscious at depth, for all intents and purposes THEY ARE DEAD ALREADY. It's incredibly hard to hurt a dead person any further. Their only hope is to make it to the surface ASAP where you can try to resurrect them.

I totally agree. A completely unresponsive person who is not spontaneously breathing and is at depth is probably dead, and certainly will be unless brought to the surface and adequately resuscitated. As I have said before, the drive to breathe is a primary and primitive one, and when someone is no longer attempting to do this, the central nervous system is in deep trouble. It is highly likely that circulation has ceased or is ineffective, or that oxygen deprivation has been severe enough, long enough, to do major damage. Little you can do in the water will help this person very much, but getting them to the surface, and getting them out of the water where CPR can be administered, are the two effective moves you can make.

I wouldn't delay getting these things done to remove a partially flooded mask, or to get the diver out of his gear (unless required to get him out of the water). Just my personal opinion, after taking Rescue and thinking about this a great deal.

 

[MB]

I wouldn't delay getting these things done to remove a partially flooded mask, or to get the diver out of his gear (unless required to get him out of the water).

That is wise - you should NOT delay the ascent to do these things! The mask check is done immediately on finding the person, and is a 2 second action. Stripping gear (if done at all) is done during the ascent. Time spent doing stuff while not ascending is wasted.

 

[Walter]

Remove or not?

Mask - well in what position are you going to have the victim for the ascent? If it's supine, if there's any water in the mask at all, take off the mask - purge or not. We need to remember Boyle, but in doing so we shouldn't forget Newton. Gravity also plays its part. Water will not exit the purge valve unless the purge valve is at the lowest point. As you ascend and the air expands, water will be forced into nasal passages, if and only if, water is covering the nostrils. If you bring the victim up in a vertical position (my usual method) you need to check how much water is in the mask. If it reaches the nostrils, remove the mask. If not, the water will be forced out of the mask along the bottom seal and not into the nasal passages.

I never remove the BC until the victim is on the boat. It is much easier to maintain positive buoyance with the BC in place and it gives you additional places to hold onto the victim assuring a more secure grip. Having the BC in place also (assuming there's a swim platform) changes the very difficult and time consuming process of getting an unconscious victim on board into one of ease that takes less than a second to complete. To demonstrate this technique Joanne and I (the two smallest folks present) zipped Pete (the largest) right out of MB's pool like he was a feather. It's even easier on a boat with a rail to hold.

 

[victor]

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.

I think I would want the person I am rescuing to be positively buoyant, I don't want to expend all my energy trying to drag them up to the surface. Yes necessary to try and avoid a runaway ascent, but that is better than dropping them and having a runaway ascent myself.

There must be at least 2 scenarios here, not breathing and breathing.

Assuming they are not breathing surely time is the essence at this point. The quicker they are at the surface the better chance of survival they have.
Maybe the best scenario would be to drop their weight belt and send them to the surface as quickly as possible, following as fast as a safe ascent allows you to do. If you are off a boat, hopefully the crew will spot them and assist, starting CPR before you reach the surface. Yes they might be bent, but that’s a whole lot better than being dead.

If they are breathing but unconscious then it’s different. A controlled ascent would be called for. You have time to check things before starting the ascent. Have they got enough air, etc. You have time to mess with buoyancy, control of 2 BC’s to insure you don’t get into an uncontrolled ascent. I would still prefer to have them more buoyant than I am, then if anything goes wrong they will still end up on the surface.