What should be done with unconcious diver at depth?

[Blackwood]

I've done the PADI rescue course some years ago, but am puzzled by the UTube video referenced earlier in this thread. It shows what appears to be a continuous slow purging of the victim's reg by the rescurer as they ascend. I understand that the "victim" in the video was breathing during the ascent, but the bubbles appear to be continuous, not incremental. As I recall, this was not taught in PADI Rescue and was not mentioned in the extract from the PADI Rescue manual earlier in the thread.

In fact I believe that we were taught not to purge, because that may force water into the victim's lungs.

Can someone clarify the proper procedure.

TIA

Andrew (who put together that training video) believes in lightly purging the regulator to create positive pressure, reducing water entry. A full-forced purge is probably not a good idea.

 

[Blackwood]

The video shows the rescuer giving the victim his regulator. This is highly unusual in rescue instruction. It is not usually taught that way in recreational rescue classes, and it was not taught that way when I learned a toxing diver rescue in my technical training.

I was taught that IF the victim spits out the reg during convulsions, I should do my darndest to get a regulator in his mouth, as he'll inhale immediately following the siezure.

Donating my own regulator in this scenario is preferable. I know it works, and I know it's the right gas.

When I played the victim in a recent practice, a rescuer did not do that and just used buoyancy adjustment for the ascent. He had a very hard time keeping me vertical--my feet kept rising in front of me, forcing me to turn over on my back.

I had the same problem resucing a doubles 'victim.' It can be a PITA. It may be easier to bring someone up horizontal, but a vertical position can promote an open airway, so I believe that's preferred.

The text that was cited said to use your own BCD to maintain buoyancy control. The video and several subsequent posters said to dump your air and use the victim's. I have seen raging debates on this on the Internet and in person. I personally agree with the video (use the victim's).

I do too. If I let go, he's going up (where he has at least a chance at survival), not down (where's he'll more than likely die).

 

[boulderjohn]

I've done the PADI rescue course some years ago, but am puzzled by the UTube video referenced earlier in this thread. It shows what appears to be a continuous slow purging of the victim's reg by the rescurer as they ascend. I understand that the "victim" in the video was breathing during the ascent, but the bubbles appear to be continuous, not incremental.

EDIT: I posted this without seeing Blackwood's responses, which he posted while I was writing.

I am a bit puzzled by this as well. I was waiting for someone who knows more about this particular film clip to respond, but absent that I will offer some opnions. Let me first admit that I am not considered a serious expert on this, although I teach regular rescue classes in which raising an unconscious diver is taught, and I have been trained to raise a toxing diver as well.

I examined the film as closely as I could. Early on it appears as if we are looking at normal breathing on the part of the "victim," but it does get to be more of a continuous stream as we progress nearer to the surface.

Remember that this is a video of a toxing diver, which is a little different from a normal unconscious diver situation. The proper procedure for a toxing diver is very controversial. The toxing diver goes through the stages of a tonic seizure, and for part of that time will almost certainly be holding his or her breath. Making any ascent at that point dangerous. (But so is staying down!) This is usually followed by a more typical unconscious state. I have heard people argue for an occasional pushing of the purge valve for a long ascent, but I have never heard of any argument for a continuous pushing of the purge valve.

I tend to think we are looking at the victim's intentional breathing in this film. The reason I believe that is because using a continuous purge technique would indeed be controversial, and I think they would therefore have pointed it out in the second part of the film, when they spell out each of the steps being taken. I also note that it is definitely not a continuous purge early on.

Just taking a wild guess, the more continuous exhalation at the end could be part of the person playing the victim not acting totally inert but instead reflexively helping control the rate of ascent through a slow exhale. Maybe.

 

[boulderjohn]

Andrew (who put together that training video) believes in lightly purging the regulator to create positive pressure, reducing water entry. A full-forced purge is probably not a good idea.

I wish you had posted that just a little earlier!

 

[boulderjohn]

I was taught that IF the victim spits out the reg during convulsions, I should do my darndest to get a regulator in his mouth, as he'll inhale immediately following the siezure.

Donating my own regulator in this scenario is preferable. I know it works, and I know it's the right gas.

I see the logic there. Once again, this is a toxing diver scenario rather than a simple unconscious diver.

The advantage in this approach, though, depends upon the rescuer having a long hose. Most divers will not have that advantage and may heve trouble with this.

 

[Blackwood]

I wish you had posted that just a little earlier!

lol, my bad. What are the chances that two days later we both come back to this thread and pick the same post to respond to?

I am a bit puzzled by this as well. I was waiting for someone who knows more about this particular film clip to respond, but absent that I will offer some opnions. Let me first admit that I am not considered a serious expert on this, although I teach regular rescue classes in which raising an unconscious diver is taught, and I have been trained to raise a toxing diver as well.

I doubt there are many legitimate experts. There are a lot of people think they know what they're doing, but very few who have ever had to implement their knowledge.

Having successfully rescued a toxing diver from something like 130', I'll defer to Andrew on this issue.

I see the logic there. Once again, this is a toxing diver scenario rather than a simple unconscious diver.

Yah, for the purposes of this thread, it may have been best to suggest ignoring the first minute or so of the video and just concentrating on him bringing the diver up.

The advantage in this approach, though, depends upon the rescuer having a long hose. Most divers will not have that advantage and may heve trouble with this.

Yah, a long backgas hose (or, perhaps more likely in the 'tox' scenario, a 40' deco-bottle hose) could certainly simplify the situation.

 

[MMM]

Well, the victim sure won't be improving while you deploy an SMB, ascend to the surface and wait for help. Realistically, we are talking about recovery in this situation, not rescue.

I don't pretend t have the answers. What if the diver is family? What if they're not even part of your buddy team? In my view there is a difference in the level of personal risk I will take performing the rescue for family.

Yes, I'm aware they aren't going to get much better, but realistically, what are the stats around divers fpond unconscious at depth recovering once brought to the surface? Low, I expect. I came at answering this question from the OP's perspective. S/he did not have rescue training. I think my answer would work just from its common sense and relative risk perspective for someone who was untrained. I certainly agree with you about willingness to assume greater risk for family. But I think my biggest take-away from my rescue class was "don't become another victim while trying to rescue another". I'm not that large or physically strong and so another of my learnings was how to adapt rescues (and yes, maybe recoveries) accordingly.

 

[NudeDiver]

I'm having that made into a sign that I'm going to hand you when you are breathing water at 100' and no one is around but me. Make sure your relatives know to put that on your tombstone.

If someone finds me unconscious in 100 feet of water, I hope to god they have the good sense to leave me there and forget the ever saw me.

 

[boulderjohn]

Having successfully rescued a toxing diver from something like 130', I'll defer to Andrew on this issue.

I'm assuming you meant to say that Andrew successfully rescued the toxing diver. (Fine grammar point--the way you worded it means you did the rescue.)

I would be interested in hearing the details.

For those of you who are reading and are interested in these things, one of the differences between a toxing diver and an unconscious diver is that the toxing diver may come to after the seizure ends. If so, there can be a happy ending even while they are still under water.

As I said earlier, there is a lot of controversy about how to do it best. I have read the various arguments and can say with firm conviction that I don't know what to believe. I suspect that what will work best in situation A might not be best in situation B, and I'm not sure there is any way to know for sure which situation is which.

 

[Blackwood]

I'm assuming you meant to say that Andrew successfully rescued the toxing diver. (Fine grammar point--the way you worded it means you did the rescue.)
...
I would be interested in hearing the details.

My bad. Your assumption is correct.

On this list, in our GUE classes, and within our projects we have consistently reiterated that divers must carefully identify the true risk of a given dive. With gas diving, oxygen toxicity remains the most consistent and yet often under appreciated risk. Irresponsible mixing, convoluted marking/procedures, and careless divers are almost exclusively the culprit in these cases. The following actual account depicts an all too common over confidence that nearly cost one diver their life. I encourage everyone to read this report and to appreciate the risk to which divers expose themselves and their team.



While conducting a Tech 1 in Croatia this last week we were faced with the following incident, one that should prove educational to all. It is for this reason that we wanted to bring it public attention. The course was conducted in Croatia, on an Island called Pag. The initial part of the training, DIR fundamentals and critical skills went well, with students undergoing training with myself and Richard Lundgren. After two days of fundamentals and 4 days of critical skills training, we were ready to move forward to the experience portion of the class. During this portion, the students plan and execute two dives to a max depth of 36 m, on a 30/30 triox mix and decompress on Nitrox 50.



The logistics of the course were coordinated by the local dive facility. The owner of the facility was involved with the class. Upon returning from the sixth day of training, Diver X who also is the facility owner, began the nightly filling process for the next day of diving. Oddly enough in Croatia, the same valve fitting (threads) is used for all gases, facilitating confusion for those that are not properly vigilant. In fact, diver X confused the supply bottles, accidentally filling oxygen instead of Helium into his own back tanks. Failing to heed the directions of his instructors to properly analyze his gasses, diver X marked all his cylinders as analyzed while, in fact, his back tanks were never analyzed. Clearly such a mistake placed the diver and his team at tremendous risk; in this instance it almost cost him his life. Individuals must bear in mind that these actions do not occur in a vacuum, and that rescuers and other team members are compromised when they must take extreme actions to safeguard the safety of other members.



Following the execution of all pre-dive drills (conducted in seven minutes) both groups proceeded with their dive. Nineteen minutes into the dive, Diver X gently flashed me with his light to get my attention. He pulled his regulator out of his mouth (as if he was giving me an OOA) but instead began to convulse at 36m. I immediately donated my regulator, grabbed his harness (with my left hand) and tried to put a regulator in his mouth. His convulsions were very strong and I could not initially get the regulator in his mouth. I proceeded to swim him closer to the wall to avoid being swept away by the current. Diver X convulsed for a solid two minutes. We then started up, my right arm under his right arm, holding him firmly while keeping the regulator in his mouth. During this process I tried to remain conscious of maintaining an open airway.



We then proceed up, with the help of my assistant, controlling all buoyancy with my left hand. It took about one minute to reach 17m; there Diver X began to convulse again. Following this convulsion I slowly led him to the surface. Upon surfacing, I called for the surface support boat, which initiated an emergency response. I removed my mask and his and prepared to start mouth-to-mouth breathing. Fortunately he was breathing, making this unnecessary. We then removed his gear and put him on the Zodiac. Upon establishing that all divers were safely at the surface with no need for additional decompression, we decided to start back to the dock, where we could meet the ambulance. During the ride to shore, Diver X began to come around, his color improved and his breathing became more rhythmic. We administered oxygen during the return trip to the dock and by the time we had arrived, he was feeling and looking much better. Upon reaching the dock the ambulance took over, taking him to the hospital for further testing.



Further testing proved that there was no lung damage or bends and only as a precaution did they treat him for near drowning.



Subsequent analysis proved that Diver X's cylinders had been improperly marked. At this point we re-analyzed all diving cylinders, demonstrating that the only improper marking had been on Diver X's cylinders. It turns out that although his tanks were marked for 30/30 he was, in fact, breathing 50.1%.



Although this event ended well it was clearly filled with dangerous potential. All divers should use this as yet another example of the importance in following careful procedures for gas analyzation and tank marking. This must be the case whether they fill themselves or whether others fill the tanks for them. In this particular case Diver X allowed his personal filling of the tanks and the accuracy of the other mixes to induce a false sense of confidence. The diver later told me that he is keenly aware of his error, embarrassed by his arrogance and grateful to be alive.



It is my hope that this account will help others realize that short cuts often fail and seemingly impossible things can and do occur. Ignoring the proper procedures can cause an accident very quickly.



Andrew Georgitsis

GUE Training Director