Write Up of Near Death in Monterey

[TSandM]

Yes, it is quite possible to gurgle with even just a small amount of water or secretions in the airway. Although salt water in the larynx CAN create laryngospasm (the situation where the vocal cords close and the person can't open them to breathe) it doesn't always happen at all. The type of sounds described by the author of the article definitely indicate fluid in the airway, but may not indicate at all how much. I've seen patients who SOUND terrible, but whose lungs are actually clear, because all the fluid is in the upper airway. But the fact that they intubated the patient indicates that she aspirated a LOT of water -- which is actually a rather rare occurrence in a conscious patient, because most people simply won't do it -- they stop inhaling when they feel the water in their trachea. (Thus the phenomenon of "dry drowning".)

awap, under normal diving conditions, I don't think anybody should argue with a thumb. But with instruction, sometimes the student is overreacting and just needs to be calmed down. I actually asked Peter about this last night, about how you tell when to agree with a request to surface, and when you try to encourage the student to stay down and work through the problem, and all he could say is that it's a judgment call. Clearly the instructor in this case made the wrong call, and I don't argue with that at all.

 

[JohnN]

. But with instruction, sometimes the student is overreacting and just needs to be calmed down. I actually asked Peter about this last night, about how you tell when to agree with a request to surface, and when you try to encourage the student to stay down and work through the problem, and all he could say is that it's a judgment call. Clearly the instructor in this case made the wrong call, and I don't argue with that at all.

Isn't there a parallel to medicine here? You as a practitioner certainly have free will and do not need to follow protocols, and can treat a patient any way you choose. . .

BUT, if you do, and poo hits the fan, it's your ass on the line. And depending on how much poo is distributed, it may be your last case.

I think it's exactly the same thing here. These instructors need a new line of work

 

[Anna G]

If somebody has inhaled so much water that they’re gurgling, how can they possibly get air through their larynx at all, let alone manage to form intelligible sounds? I wouldn’t think this is possible, but perhaps you know better.

Saltwater aspiration causes transudate fluid to fill the lungs (noncardiogenic lung edema) - that's in addition to the water she'd have swallowed. The gurgling was likely due to the lung edema, and yes, people can make (not all that effective) sounds even when in pretty severe edema.
But the buckets of fluid he describes is most likely due to the transudate, not just the swallowed seawater.

The "enough fluid to kill her twice over" is either for dramatic purposes, or one of those layman-explanation things docs sometimes do. There is no set amount of fluid needed to kill you "once over", so you can hardly calculate twice. Maybe the doc just wanted to get across the idea of "a lot, and clearly life-threatening."

 

[Peter Guy]

Fascinating story here and the basis of, perhaps, many a lawsuit.

From the POV of this poor instructor, I can't even begin to identify the number of instructional mistakes -- beginning with allowing the boy friend anywhere near his girlfriend once they hit the beach and ending with the "high fives" alleged at the end of the class.

There is so much in the story that just doesn't make sense to me -- not saying it didn't happen as written, just that things are so far out of the norm as to be unimaginable.

 

[mdb]

This scenario, unfortunately, is not at all unimaginable to me.

I've watched instruction in Monterey, La Jolla Shores, etc., hundreds of times as part of my work.

I've seen instructors standing on the beach "instructing" students and DM's in the water.

Fully geared up students being lectured for 30 minutes, overheated and uncomfortable.

Instructors comfortably in their drysuits keeping shivering scared students in the water
in their ill fitting rental wetsuits sluicing water like a wet carpet.

Watching stressed and over weighted students come through the surf line crying.

Not pretty sometimes.

Of course, there are many fine SCUBA instructors who teach fine courses and help
create good safe divers who have a lifetime of enjoyment ahead of them. I have been
very fortunate to have had a number of such instructors; so here I am, 40+ years later
still diving due to the quality instruction I received early on.

There is much to be learned in this thread. I hope a lot of active instructors will chime in.

 

[SeaHorse81]

There is so much in the story that just doesn't make sense to me -- not saying it didn't happen as written, just that things are so far out of the norm as to be unimaginable.

I'm glad I wasn't the only one to think that. Full apologies to the author and his girlfriend for my doubts if it all happened as described. It's just hard to imagine things going that repetitively and dramatically wrong. Lawsuits, indeed.

 

[razorbackdiver]

I've only been diving for 2 years but unless they are doing some sort of drill shouldn't it be assumed that if someone is switching to their backup reg there is something wrong?

 

[raftingtigger]

Very interesting thing just happened. I'm following this story both here and on the california diver magazine site. For a brief period today there were 2 posts from an individual that posted "100% true, I was there..." and then went on to name the shop and city in both posts. A few minutes later when I refreshed my browser the posts were gone.

I don't recall the poster's moniker, but do remember the name and city of the shop. I don't feel comfortable sharing that, as I have nothing to substantiate the accuracy and to do so in error would damage an innocent shop. I will say that any shop I have seen named on this thread IS NOT the one mentioned in the disappearing posts. Nor was it a shop from either Monterey, San Jose, or San Francisco.

 

[oldschoolto]

It has been my experience that Crappy Instructors get every upset and threatened by people that know a lot more then them.... Or just have many more years of doing it... Good instructors tend to enjoy the person being there and uses it as a tool... I am sure that Scott Cassel could have had trained her and got the C card signed off if he wanted too... He didn't do that.... I think , He sent her off to a dive shop to be trained because he wanted a outside trainer for her own good... (as in her passing on her own) Now was the story written with a LOT of color... YES... But the bottom line is .. This girl came very close to being a DEAD STUDENT DIVER.... That's all the color I need to see....

Jim...

 

[Bopper]

There is so much in the story that just doesn't make sense to me -- not saying it didn't happen as written, just that things are so far out of the norm as to be unimaginable.

+1

Yesterday when I was originally reading the story, I - like I imagine most people - started getting myself in a lather over how the instructors behaved. And then I realized, I'm just getting half the story here. Why am I taking this person's word verbatim? Imagine for a moment that the two instructors were completely competent, experienced, and professional. We don't know they weren't. What if it was the author that had acted out of line and has a completely distorted opinion of the events? For instance, how the heck did he deduce that sand had gotten into her reg when she slipped/sat down and that it was the cause of the malfunction? From what I could tell that sand could have ended up in the reg after she was dragged to the beach. Why was the boyfriend so careful to point out how the reg became defective when it had to be based on speculation? The author passes off this detail (reg was filled w. sand pre-dive) as though it was fact, and that's a little disconcerting.

I'm not at all saying that what happened didn't happen exactly as the author had stated, but it is such a surgical re-telling of the story with the instructors looking so incompetent that it does make you wonder if it was written with a reasonable sense of balance.