ROPE - I have not heard of this snorkeling problem

[DanBMW]

Hawaii tourist dies on Maui beach, and wife alleges state failed to warn her about snorkeling danger

Patti Johnson believes her husband Ryan Johnson's snorkeling death off the coast of Maui could have been prevented if he had known about Rapid Onset Pulmonary Edema.

news.yahoo.com

A man dies in Hawaii and his widow is claiming that the state should have warned them to wait 3 days before snorkeling.

 

[Billg68bg]

Sad outcome, and I am not trying to be callous, but I’d be interested in the health backgrounds and physical conditions of the victims. Sounds to me like there is likely more to the story than just snorkeling. Now, if they asked of the risks involved and got the,”Oh. It’s perfectly safe.” answer, that would be a different story, IMO.
Either way, we assume a level of risk whenever we do things out of the norm. I’ve seen a few on snorkeling excursions get sick, due to oceanic conditions alone.
I do a lot of snorkeling when on vacation. Think I’ll be researching this.

 

[boulderjohn]

This is the first I have ever heard of ROPE, but the similarity to Immersion Pulmonary Edema is obvious, and that is something I have been looking at with interest for a while. Both ROPE and IPE are connected with older citizens and a greater than normal work of breathing. Another issue seems to be related to hydration. DAN has recently warned that over hydration can increase the risk. (I think of this every time I hear a DM dive briefing telling the divers to drink lots and lots and lots and lots and lots of water to prevent DCS.)

One of the things I wonder about is that just plain pulmonary edema happens a whole lot more than people think, and it definitely hinders your ability to breathe efficiently. Here is the Mayo Clinic's description. As you can see, pulmonary edema is more likely to affect older people because of its association with heart issues, and it can strike anyone and even be life threatening without the presence of water. You can have bouts of mild pulmonary edema come and go without realizing it.

I cannot help but wonder if the people who fall victim of both IPE and ROPE were not to some degree suffering from a minor level of pulmonary edema before they got into the water.

 

[Billg68bg]

So this thread brings up a question for me. I have a dive planned the morning after my arrival to COZ. Flight is JFK-MEX-COZ. I’m in reasonably good health, carrying an extra 25-30 lbs. I wonder if that heightens my risk. Never have issues snorkeling or diving, but things like this make me think(or overthink).

 

[boulderjohn]

So this thread brings up a question for me. I have a dive planned the morning after my arrival to COZ. Flight is JFK-MEX-COZ. I’m in reasonably good health, carrying an extra 25-30 lbs. I wonder if that heightens my risk. Never have issues snorkeling or diving, but things like this make me think(or overthink).

I personally wouldn't worry about it too much. The article spends a bunch of time going over the effect of snorkels and snorkel masks, and I think that may well have been a factor. It sounds to me as if the guy had a problem with a sudden onset of pulmonary edema while he was using a full-face snorkel (not totally sure on that), and he had no choice but to breathe the limited amount of air through the inhalation tube of the snorkel because you can't just spit out the snorkel and take a deep breath.

 

[Outbound]

I've made it a point to discuss the issue of ROPE and its signs and symptoms with snorkel students. I also discuss IPE with divers. While overall risk is probably low for the majority of people, I believe that incidents of ROPE/IPE/SIPE might be more prevalent than we originally thought. At the very least, I think we should include it in our discussions of dive safety and not just focus on DCI.

Hawaii put together a good report, which can be found here: https://www.snorkelsafetystudy.com/...23/06/Snorkel-Study-Final-Reports-Updated.pdf

 

[Gene]

I had an IPE incident while cave diving here in north Florida back in April 2019. You can look it up here on ScubaBoard as I've mentioned it a few times. The only warning I had was a slight gargle type breathing two and three weeks before upon surfacing doing the same dives just for a very short time. And I had noticed being out of breath some while walking up hill on vacation earlier. Turns out a virus had weakened my heart muscle, and my ejection fraction was a third of what it was supposed to be, and I didn't know! It keeps changing but is up to about half of what it's supposed to be now. So, no solo diving for me or any dives too far away from any entrances/exists to the surface....

 

[Soloist]

If this couple had been issued a waiver from the state detailing ALL the risks associated with snorkeling would they have deviated from their original plan? We will never know, but I've signed my life away hundreds of times barely reading the documentation. There are risks involved with physical activity and those risks increase dramatically with obesity, asthma, hypertension, heart disease, diabetes, lung disease, etc. What was his overall health, prescribed medications and daily physical activity? I realize the death is a tragic event for the family, but this is a frivolous lawsuit.

 

[Lorenzoid]

If this couple had been issued a waiver from the state detailing ALL the risks associated with snorkeling would they have deviated from their original plan? We will never know, but I've signed my life away hundreds of times barely reading the documentation. There are risks involved with physical activity and those risks increase dramatically with obesity, asthma, hypertension, heart disease, diabetes, lung disease, etc. What was his overall health, prescribed medications and daily physical activity? I realize the death is a tragic event for the family, but this is a frivolous lawsuit.

If I were writing waivers, I think I'd add over-hydration and dehydration to that laundry list.

I know this thread relates to snorkeling, but I just want to say the thought of an IPE episode in a cave (@Gene) scares the bejeezus out of me.

 

[Billg68bg]

If I were writing waivers, I think I'd add over-hydration and dehydration to that laundry list.

I know this thread relates to snorkeling, but I just want to say the thought of an IPE episode in a cave (@Gene) scares the bejeezus out of me.

Never really thought much about over hydration, but it seems people generally don’t know, or take seriously, the importance of proper hydration.