REScuE DivER MANuAl

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NASE Rescue Diver Manual

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Published by:

NASE Worldwide

808 Moody Lane

Flagler Beach, FL 32136 www.ScubaNASE.com

Concept and Development:

Patrick Abercrombie, NASE

Regional Training Manager

Editor:

Harry Averill, NASE Training Director

Reviewed by:

Scott Evans, NASE Executive Director

Version 140616

Copyright Notice

This work is Copyright (©) 2014 by the National Academy of Scuba Educators and its principal author.

All rights reserved under USA and international copyright law.

If you are an NASE Instructor in Active status, you may provide this document in electronic form to students enrolled in the NASE Rescue Diver course, so long as you make them aware of this copyright notice. Otherwise you may not:

• Post this document on any website, bulletin board or other Internet-connected portal.

• Transfer this document to any non-authorized individual via email, CD-ROM, DVD, flash drive or other electronic media.

• Transfer this document to another individual in printed form.

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Contents

Introduction .........................................................................1

Rescue Diver Characteristics .......................................................2

Rescue Training Foundations ..........................................6

Basic Abilities and Skills ................................................................. 7

Problem Solving Using What You Know ..................................14

Stress, Overexertion, Panic .......................................... 20

Stress ..................................................................................................21

Overexertion and Panic ...............................................................24

General Problem Prevention ........................................ 29

Team Separation ........................................................................... 30

Being Without Air ...........................................................................34

Heat- and Cold-Related Problems ............................................37

Seasickness ......................................................................................41

Entrapment and Entanglement ..................................................44

Currents ............................................................................................46

Marine Life .......................................................................................48

Equipment .........................................................................................51

Breathing Gas Mixtures at Depth ..............................................53

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Distressed Divers at Surface ......................................... 61

Surface Assists ...............................................................................62

Assisting Divers Under Water ...................................... 69

Stressed/Panicky Divers Under Water ....................................70

Unresponsive or Non-Breathing Divers ..................................73

Surfacing with Unresponsive Divers ........................................84

Being Prepared ............................................................... 92

Emergency Action Plans (EAPs) ................................................93

Emergency Equipment ................................................................ 95

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Introduction

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Before we get into the nuts and bolts of rescue diver training, we are going to answer a fundamental question and talk about some of the characteristics rescue divers should have in common.

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Rescue Diver Characteristics

In this section, we discuss two things: n

What is a rescue diver?

n

The four abilities of a rescue diver

Study Questions

As you go through this material, look for the answers to the following: n

What is a rescue diver?

n

Which four abilities are NASE Rescue Divers required to master and demonstrate?

n 6 n

What is a Rescue Diver?

We have all, at one point or another, witnessed or been involved in some type of accident. It may have been a minor accident like falling down and skinning your knee as a kid.

The accident might have been more serious. Just think of any car accident you might have seen.

Regardless of the type and severity of the incident, and whether you were directly involved or just a bystander,

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this thought probably went through your head: Could this accident or incident have been prevented?

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How does this apply to diving? Divers experience mishaps and accidents, too. Some are minor and some can be life threatening. But divers can prevent most accidents by paying attention to their surroundings, observing a potential problem and preventing an accident from happening. In cases where an accident or mishap occurs, some divers are trained to assist other divers.

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Divers who are trained to observe and prevent problems from occurring, and assist others or themselves if something does go wrong, are rescue divers.

By completing the NASE Rescue Diver course, you will learn how to spot potential problems before they occur and develop the skills and confidence to assist others if they experience some sort of diving mishap.

The Four Abilities of a Rescue Diver

During your NASE Rescue Diver course, you will learn how to recognize and prevent problems, perform self-rescue and assist or rescue other divers.

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Managing risk begins with preventing problems or accidents before they happen. Prepare for every dive by making sure you are physically ready to dive, checking your equipment to confirm each piece of gear is in good shape, planning your dive thoroughly, and never diving in conditions beyond your abilities. As a trained rescue diver, you can observe, recognize and prevent potential problems from occurring.

Even if you are well prepared, you can’t prevent all emergency situations from occurring. You need to develop and refine skills to keep yourself safe, but you must also be able to assist others.

Key Points

n

A rescue diver is a person who has received specific training in a diver rescue course and maintains this skill level through periodic skills practice.

n

Rescue divers must be able to do the following, both on the surface and under water:

Recognize and prevent problems

Perform self-rescue

Assist or rescue others

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Rescue Training Foundations

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In this part, we discuss two general areas: n

Basic abilities and skills n

Problem solving using what you already know

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Basic Abilities and Skills

In this section, we discuss two things: n

Becoming comfortable, confident and competent n

Foundational rescue skills

n 11 n

Study Questions

As you go through this material, look for the answers to the following: n

What can you do to become competent, comfortable and confident and help prevent possible problems or emergencies while diving?

n

Which six skills learned during the NASE Open Water

Diver course lay the foundation for developing selfrescue and rescue skills?

n

Which diving emergencies can you learn to prevent or mitigate?

Becoming Comfortable, Confident and Competent

During your Open Water Diver course, you should have learned basic key mask skills, regulator skills including air

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sharing, and the ability to swim, stop, and change depth and direction while maintaining control of your buoyancy. You should competently be able to demonstrate these skills and abilities.

As you continue to dive and consequently gain experience, you will refine your skills and become more comfortable in the water. As you increase your skill competency and comfort in the water, your confidence as a diver will grow.

You have to be competent, comfortable and confident to become an effective rescue diver. Why? As a rescue diver, although you still consider your own safety a priority, your

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perspective will start to shift. Instead of just worrying about yourself, now you will take into consideration the wellbeing of others. You can only make this shift or change in perspective if you are competent, comfortable and confident in the water.

As you adopt this mindset, your attention will shift to observing other divers, and you will begin to perceive possible problems and emergencies and prevent them before they happen.

Foundational Rescue Skills

Believe it or not, you have already started training as a rescue diver. During your open water course, you should have mastered self-rescue skills and skills for assisting other divers in trouble: n

Gas sharing while stationary, traveling and ascending n

BC oral inflation n

Weight system removal and replacement n

Scuba unit removal and replacement n

Cramp release n

Tired diver tow

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Here are two important points to remember about each of these skills or any new skills you learn in this course: n

Preventing an incident or accident is preferable; if you have to perform an assist or rescue using one of these skills, at some point the question must be asked, What could have been done to prevent this from occurring?

n

Using one of these skills as a self-rescue technique or to assist another diver might prevent the onset of panic.

When you learn about the Panic Cycle later in this course, you will understand that preventing panic might mean the difference between assisting another diver and rescuing another diver.

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Using the Skills You Already Know

In the last section, you reviewed six skills you mastered in your open water course that lay the foundation for learning self-rescue and rescue skills.

Now let’s focus on actual emergencies that you can prevent or mitigate using those skills and other abilities you have learned.

You can prevent muscle cramps by drinking plenty of fluids before diving, staying hydrated between dives and stretching before diving like you should prior to any physical activity.

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n

You can prevent loss of breathing gas by making sure your regulator system, including your power inflator mechanism, is functioning properly, agreeing upon a gas management plan with your buddy, and monitoring your SPG during the dive.

n

You can prevent losing your buddy by agreeing upon and sticking to a dive plan and by continually checking on one another during the dive.

n

You can prevent entrapment by avoiding overhead environments and by paying attention to any hazards, such as fishing line on a wreck.

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Yearly servicing and pre-dive inspections of your own gear, and your buddy’s gear, will help you to avoid equipment problems.

Key Points

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By refining key skills you learned during entry-level training, you can become more confident, more comfortable and help prevent problems and emergencies.

n

These six skills lay the foundation for both self-rescue and assisting or rescuing others:

Gas sharing while stationary, traveling and ascending

BC oral inflation

Weight system/scuba unit removal and replacement

Cramp release and tired diver tow n

In the Rescue Course, you will learn to prevent or mitigate the following diving emergencies:

Muscle cramps

Loss of breathing gas

Loss of buddy

Entrapment and equipment problems

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Problem Solving Using What You Know

In this section, we’ll look at three things: n

Solving problems at the surface n

Establishing buoyancy at the surface n

Preventing and mitigating problems under water

n 18 n

Study Questions

As you go through this material, look for the answers to the following: n

What common problems should you be able to solve at the surface?

n

Why is establishing positive buoyancy important for handling emergencies at the surface?

n

What three things can you and your dive buddy do under water to prevent or mitigate problems under water?

Solving Problems at the Surface

Believe it or not, statistically, most dive accidents or incidents occur at the surface. Common problems encountered by

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divers at the surface include overexertion, cramping, choking and lack of buoyancy.

Typically, most problems start with stress. You should look for signs of stress before entering the water. Among the signs that a diver is stressed include: n

Sudden changes in the tone of the voice n

Excessive talking or suddenly becoming quiet n

Exhibiting strange or inappropriate humor n

Prolonging dive preparations n

Difficulty with equipment n

Sudden mood swings

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At the surface, you may observe the following signs: n

Instability in the water n

Struggling to stay afloat even with the BC completely inflated n

Continuously adjusting equipment, especially masks n

Continually checking gouges n

Nervous behavior

As we will see, establishing positive buoyancy helps prevent minor issues from becoming emergencies.

Establishing Buoyancy at the Surface

Establishing positive buoyancy allows you to safely remedy any problem you have at the surface or to assist other divers who need assistance. By establishing positive buoyancy at the surface, you can relax, solve problems and mitigate stress.

You can relax on the surface if you are positively buoyant.

Trying to solve a problem while treading water is a recipe for disaster. Inflate your BC, either using the power inflator or orally, and drop your weights if necessary. Helping others establish buoyancy allows them to relax and calm down. They can help themselves or you can provide further

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assistance. A panicked diver won’t be able to help himself and might put his rescuer in danger as well.

Effective problem solving requires a calm and relaxed state of mind. While buoyant, you can focus and direct all of your energy to solve whatever problem you are having instead of expending all of your energy to stay afloat.

If you are relaxed and solving your problem, you can reduce or avoid the onset of stress. By avoiding stress, you may prevent problems from starting.

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Preventing and Mitigating Problems Under Water

For the buddy system to work, you and your buddy have to make it work. You have to adhere to the precepts and practices associated with diving with a buddy. Adhering to three key buddy diving procedures also helps prevent or mitigate potential problems and emergencies under water: n

Swimming side by side n

Making periodic eye contact n

Remaining in a position to communicate or assist one another

n 22 n

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Although we list these three steps separately, swimming next to your buddy provides the foundation for preventing and mitigating problems. Swimming side by side enables you and your buddy to make periodic eye contact so each of you can confirm that the other is okay. Remaining close to your buddy allows you both to communicate and assist one another almost immediately.

Key Points

n

At the surface, you should be able to solve these common problems including, overexertion, cramping, chokingand lack of buoyancy n

By establishing positive buoyancy at the surface, you can relax, solve problems and mitigate stress.

n

You and your dive buddy can prevent or mitigate problems under water by:

Swimming side by side

Making periodic eye contact

Remaining in a position to communicate or assist one another

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Stress, Overexertion, Panic

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In this part, we’ll cover two general areas: n

Stress n

Overexertion and Panic

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Stress

In this section, we’ll examine what stress is and steps you can take to prevent or mitigate it.

Study Questions

As you go through this material, look for the answers to the following: n

Why do you need to know how to prevent and mitigate stress while diving?

n

Why is overcoming overexertion and restoring normal breathing while under water important to you as a diver?

n

Why is reaching a state of panic dangerous for you as a diver?

n

What phenomenon might prevent you from solving problems under water?

Why Prevent and Mitigate Stress

Stress is the response of our bodies due to external stimuli, pressure, or demands. Stress, especially that created by

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an uncontrolled series of events, can lead to panic — the motivating factor in most underwater accidents.

You can control stress only if you are aware of what causes it. Psychological factors such as fear, lack of confidence and anxiety cause stress. Environmental factors such as poor visibility, water temperatures, and sea conditions can also increase stress levels.

Stress leads to overexertion, increased breathing rate, increased heart rate, breathlessness, fatigue and, finally, the early stages of panic.

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Once panic sets in, you might compromise your ability to solve problems and act in an emergency.

Preventing and mitigating stress allows you to more clearly evaluate an emergency situation and solve any problems you face.

Key Points

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You must prevent and mitigate stress because uncontrolled stress might lead to the inability to evaluate and solve problems.

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Overexertion and Panic

In this section, we’ll cover three things: n

Overcoming overexertion and restoring breathing n

Why panic is dangerous n

The panic cycle

Study Questions

As you go through this material, look for the answers to the following: n

How can you and your buddy reduce the chance of separation while diving?

n

What is the ultimate goal of the lost buddy procedure?

n 28 n

Overcoming Overexertion and Restoring Breathing

You just learned that failing to prevent and mitigate stress might lead to your inability to evaluate any emergency situation and solve problems. Stress leads to panic. Once panic sets in, you might compromise your ability to solve problems and act in an emergency.

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You can interrupt the onset of panic by overcoming overexertion and restoring normal breathing. By stopping and breathing, you can relax and give yourself a chance to analyze the situation and concentrate on solving the problem.

Why Panic is Dangerous to Divers

Stress leads to overexertion, increased breathing rate, increased heart rate, breathlessness, fatigue and, finally, the early stages of panic.

Panic is defined as sudden fear that produces irrational behavior. A neglected, stressful situation can often grow into a situation of panic. Panic leads to decreasing confidence in

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yourself, obsession on a fixed thought and improperly coping with the problem. Statistics indicate that the principal cause in diving accidents is panic.

If you reach a state of uncontrolled panic while under water, you lose the ability to evaluate and solve problems in a reasonable manner. You can interrupt the onset of panic by stopping, overcoming overexertion, relaxing and restoring normal breathing.

While this is easier said than done, a complete understanding of the Panic Cycle will help you confront it.

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The Panic Cycle

As you just learned, when you are in a state of uncontrolled panic while under water, you lose the ability to evaluate and solve problems on your own which increases the chance of injury or death.

While many factors incite panic, an overall understanding of the Panic Cycle will help you prevent or mitigate the effects of panic.

You encounter a problem under water. You begin to feel stressed. You experience overexertion, increased breathing rate, increased heart rate, breathlessness and fatigue.

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At this point, you might recognize the stress and its cause.

You slow down, relax, control your breathing and deal with the situation. Through self-rescue, you mitigate the problem.

On the other hand, you may fail to recognize or acknowledge the situation that is causing the stress. As the stress progresses and your panic level heightens, you lose the ability to help yourself and must rely on assistance from your buddy or another diver.

As your panic grows, you lose the ability to help yourself and you experience perceptual narrowing where focusing on and solving the problem becomes impossible. If you don’t receive external assistance at this point, then you are in real trouble.

Key Points

n

While under water, you can interrupt the panic cycle by overcoming overexertion and restoring normal breathing.

n

If you reach a state of uncontrolled panic while under water, you lose the ability to evaluate and solve problems on your own which increases the chance of injury or death. n

If you panic, you may experience perceptual narrowing which prohibits you from focusing on solving problems.

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General Problem Prevention

n 33 n

In this part, we’ll look at several potential problems and their prevention, including: n

Team separation n

Being without air n

Heat- and cold-related problems n

Seasickness n

Entrapment and entanglement n

Currents and marine life n

Equipment n

Breathing gas mixtures at depth

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Team Separation

In this section, we discuss two things: n

Preventing team separation n

The lost buddy procedure

Study Questions

As you go through this material, look for the answers to the following: n

How can you and your buddy reduce the chance of separation while diving?

n

What is the ultimate goal of the lost buddy procedure?

n 34 n

Preventing Team Separation

For the buddy system to work, you and your buddy have to make it work. You have to adhere to the precepts and practices associated with diving with a buddy. Adhering to three key buddy diving procedures also helps prevent or mitigate potential problems and emergencies under water.

These are:

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n

Swimming side by side n

Making periodic eye contact n

Remaining in a position to communicate or assist one another.

Although we list these three steps separately, swimming next to your buddy provides the foundation for preventing and mitigating problems. Swimming side by side enables you and your buddy to make periodic eye contact so each of you can confirm that the other is okay. Remaining close to your buddy allows you both to communicate and assist one another almost immediately.

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The Lost Buddy Procedure

Despite you and your team mates’ best intentions, separation does happen. When it does, you will want to reunite with your team member as soon as possible.

The standard procedure for buddy separation is to look for no more than one minute, then meet on the surface. Use the minute to look in all directions, rise above any disturbed sediment on the bottom and backtrack in the direction you came from.

If you can’t locate your buddy within one minute, ascend slowly, make a safety stop and then surface. If your buddy

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followed the procedure too, then you should meet on the surface. If your buddy doesn’t surface within a reasonable time, summon assistance. Do not put yourself at risk by searching for your buddy alone.

Key Points

n

You and your dive buddy can reduce the chance of separation by swimming side by side, by making periodic eye contact and by remaining in a position to communicate or assist one another.

n

The ultimate goal of the Lost buddy procedure is to reunite the dive team, on the surface if not under water.

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Being Without Air

In your beginning scuba course, you learned both independent and buddy-dependent methods of dealing with out-of-air emergencies. But, by far, the best way to deal with such situations is to prevent them from happening in the first place. That’s what we cover next.

Study Question

As you go through this material, look for the answer to the following: n

What steps can you and your buddy take to avoid running out of air?

Preventing Out-of-Air Emergencies

The ultimate goal of any dive is for both divers to return to the surface safely. One way to do this is to avoid running out of air by making sure you and your buddy have adequate gas reserves for an emergency, have a plan to manage your overall gas supply and that both of you regularly check your pressure gauge.

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When you took your NASE Advanced Open Water Diver course, you learned about NASE’s Minimum Gas Reserve and

Usable Gas concepts. If you didn’t earn your advanced open water certification through NASE, your instructor will review these concepts with you.

In a nutshell, your Minimum Gas Reserve is the amount of breathing gas you set aside in case you have to share air.

This amount is based on how deep you are and how long it will take you to reach the surface sharing only one gas supply.

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Your Usable Gas is the amount of gas you can use from your own supply for a dive, taking into consideration the Minimum

Gas Reserve you have set aside for your buddy.

Both of these concepts are useless unless you and your buddy regularly check your pressure gauge and monitor your gas supplies.

Key Points

n

You can avoid running out of air by making sure you have adequate gas reserves for an emergency, have a plan to manage your overall gas supply and that you regularly check your pressure gauge.

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Heat- and Cold-Related Problems

In this section, we’ll look at two things: n

Hypothermia n

Heat related illnesses/emergencies

Study Questions

As you go through this material, look for the answers to the following: n

What are the symptoms of hypothermia and why is hypothermia dangerous to you as a diver? n

What two steps should you take to avoid heat related emergencies?

n 41 n

Hypothermia

Hypothermia can occur when the internal temperature of a body goes below 98.6°F (37°C). When a body is exposed to low temperatures, it retains heat in the core to support the vital organs. Body extremities and the skin receive less heat.

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Some of the signs and symptoms include: n

Uncontrollable shivering n

Slow reaction time n

Lack of muscular dexterity n

Numbing n

Difficulty speaking n

Reduced reasoning capacity n

Loss of memory n

Limited willingness to react and eventual loss of consciousness

When the internal organs reach a temperature below 95°F

(35°C), vital processes slow down and brain function can also

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be compromised. A person can feel confused and incapable of motor coordination, and lack mental clarity.

In these conditions, one can easily make bad decisions that can compromise safety. If the interior temperature should decrease further, heart beats would become irregular until the person finally loses consciousness. The major risk in this case is cardiac arrest.

Heat Related Illnesses/Emergencies

Heat related illnesses, such as heat stroke, in contrast to hypothermia, are caused by an increase in the body’s internal

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temperature. Typically the body is unable to respond and cool itself by sweating.

Signs and symptoms associated with heat related illnesses include: n

Reddening of the face n

Disorientation n

Hot and reddened skin n

Weak pulse

To avoid heat-related emergencies, you should drink water or other non-alcoholic, room-temperature beverages and avoid wearing wet suits for long periods of time in direct sunlight.

Key Points

n

You might be hypothermic if you feel confused, lack mental clarity and suffer from poor motor coordination, all of which can lead you to make bad decisions that can compromise safety.

n

To avoid heat related emergencies, you should drink water or other non-alcoholic, room-temperature beverages and avoid wearing wet suits for long periods of time in direct sunlight.

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Seasickness

Few things can ruin a day of diving more than seasickness.

What is particularly sad, however, is that seasickness is largely preventable.

n 45 n

Study Question

As you go through this material, look for the answer to the following: n

When should you take seasickness medication for optimum effect?

Preventing Seasickness

As a diver, sooner or later, you will experience the effects of seasickness or motion sickness. In the case of diving, the rocking motion of a dive boat sends conflicting signals to the brain. While your eyes show a world that is still, your body, and in particular the equilibrium sensors located in your ears, send signals of a moving environment.

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The signs and symptoms of seasickness usually include: n

Nausea n

Vomiting n

Dizziness n

Intense sweating n

Pallor n

General feeling of unease

To avoid seasickness, snack on something like crackers before leaving the dock. Also avoid drinking beverages such as milk or alcoholic beverages, and do not eat spicy food or food that is very fatty before and during the trip.

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For the prevention and treatment of seasickness, you can use a number of over-the-counter medications. You can use bracelets that apply light pressure on the wrist, which can help control nausea.

Regardless of what you use, you will find seasickness medicine more effective if you take it before symptoms present themselves. It is best to take whatever you choose before setting foot on the boat.

Key Points

n

Seasickness medicine is generally more effective if you take it before symptoms present themselves.

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Entrapment and Entanglement

Being entangled or trapped in fishing line, kelp or wreckage has long been a staple in movies and television. Ironically, it’s a situation that, for the most part, is easily prevented.

Study Question

As you go through this material, look for the answer to the following: n

What two steps should you take to avoid an entanglement and entrapment problem?

Preventing Entrapment and Entanglement

It is not difficult for a diver to get caught in lines or nets used for fishing, or to get trapped while diving in a wreck. Well, let’s just say it is not hard to get entangled or entrapped.

The inverse of the statement above goes like this: It is difficult for a diver to become entangled or entrapped if he avoids overhead environments and pays attention to any hazards, such as fishing line on a wreck.

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There are some problems in diving you will never experience or have to worry about if you use common sense. Watch where you are going and stay out of wrecks. Enough said.

Key Points

n

You can avoid entanglement problems by paying attention to your surroundings and by streamlining your gear.

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Currents

Current-related problems are as easily avoided as most other others in diving.

Study Question

As you go through this material, look for the answer to the following: n

What should you and your buddy do to avoid or mitigate problems associated with diving in currents?

Dealing with Currents

A current is water moving in one direction. Currents are often localized to a certain area. You can exhaust yourself and your air supply swimming against even a gentle current.

If you encounter a current under water, start the dive against the current. When you reach your turn pressure or time, let the current return you to the boat or the shore. If you and your buddy must swim against a current, get as close as you can to the bottom where the current is usually weaker.

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If a current pushes you and your buddy beyond your planned exit point, swim perpendicular to the direction in which the water is moving. Then you both should be able to swim easily to your planned exit point. If you or your buddy exhaust yourselves, establish positive buoyancy, if possible signal someone on the boat or on the shore, and wait for assistance.

Key Points

n

Evaluate surface conditions prior to diving to avoid or properly handle currents and other water movement.

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Marine Life

The notion that one may be stung, poisoned, bitten or completely devoured is among the most primal of human fears. How many people do you know who are convinced they will be eaten by a shark the minute they set foot in the ocean? Ironically, for those who understand and respect aquatic animals, such concerns are likely at the bottom of the list.

Study Question

As you go through this material, look for the answer to the following: n

What can you do under water to avoid problems with dangerous marine animals?

Avoiding Problems with Marine Life

Most aquatic animals are timid and harmless. Some are as fascinated with you as you are with them. Most aquatic life injuries are simple cuts, scrapes and punctures, resulting from divers not paying attention to their surroundings. Other injuries result from defensive behavior – not from animals

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that are naturally aggressive or who have any desire to eat humans.

Making yourself familiar with the aquatic life present at your dive site will help you avoid injuries. Watch what you touch.

You can protect yourself from accidental contact by wearing an exposure suit and gloves.

Some animals can be dangerous when provoked. However, diver injuries caused by aquatic animals are extremely rare.

If you see a large animal acting in a seemingly aggressive manner, remain calm, descend to the bottom if possible and exit the water when you can.

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The bottom line is that you should avoid interactions and contact with dangerous marine animals or any marine animal you’re not familiar with.

Key Points

n

You should avoid interactions and contact with dangerous marine animals or any marine animal you’re not familiar with.

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Equipment

Diving is an equipment-intensive activity. Your dive equipment should provide you with solutions, not problems.

And, should you practice a little common sense, it will.

Study Question

As you go through this material, look for the answer to the following: n

What can you do to mitigate equipment problems?

Preventing Equipment Problems

Equipment problems statistically cause very few accidents; however, equipment problems can increase stress levels, which can lead to panic. Common problems include: n

Dive mask with a broken strap or that leaks water n

Poorly fitting fins that cause cramps or losing a fin n

Snorkels that leak or are difficult to clear n

Weight loss, overweighting or quick release failure n

Regulators that free flow n

BCs that leak and lose air

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Diving with equipment that is well maintained, the right size, appropriate for the location and type of dive, and inspecting it before entering the water, reduces the probability of having an equipment related accident.

Key Points

n

You can avoid equipment problems by having your equipment serviced annually and completing thorough inspections and tests prior to entering the water.

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Breathing Gas Mixtures at Depth

In this section, we’ll cover four things: n

The danger of nitrogen narcosis n

The danger of underwater convulsions n

Avoiding lung overexpansion injuries n

Decompression sickness

n 57 n

Study Questions

As you go through this material, look for the answers to the following: n

Why is Nitrogen Narcosis a potential danger?

n

Why is a convulsion from a high oxygen breathing mix dangerous?

n

How can you avoid lung overexpansion injuries?

n

How can you reduce the possibility of decompression sickness?

The Dangers of Nitrogen Narcosis

As you learned in your entry-level scuba course, under pressure, nitrogen in the air we are breathing can impair

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judgment and coordination. We call this nitrogen narcosis even though recent studies suggest that oxygen may be at least as narcotic as nitrogen. Symptoms include loss of coordination or motor skills, disorientation, bad judgment and euphoria. Specifically, narcosis reduces your ability to react and makes simple manual or mental operations, such as monitoring air supply or dive time, more difficult.

You can avoid the symptoms of narcosis by simply avoiding deeper dives. Stay above the recommended recreational depth limit of 30 m/100 ft. However, simply staying above 30 m/100 ft. will not make you immune to narcosis.

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You and your buddy must remain vigilant and take appropriate action if you suspect its symptoms. Immediately ascending to a shallower depth to reduce the ambient pressure should ease the symptoms.

The Dangers of Underwater Convulsions

Exposure to high partial pressure of oxygen from breathing

Nitrox can trigger a response in the central nervous system that can cause divers to convulse.

While these convulsions are not necessarily fatal on the surface, under water a CNS “hit” could incapacitate you, resulting in your not being able to keep your regulator in your

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mouth or recover your regulator if it comes out. You would lose airway control and drown.

Fortunately, as long as recreational divers remain within No-

Decompression Limits and the Maximum Operating Depth of the gas they are breathing, the risk of a convulsion from breathing a gas with too high of a partial pressure of oxygen is low.

Avoiding Lung Overexpansion Injuries

As you learned in your entry-level scuba course, during ascent, you vent expanding gas in your lungs through normal respiration. You could suffer serious injuries if you hold your breath during ascent.

Collectively, these injuries as known lung expansion injuries.

There four recognized types: n

Arterial Gas Embolism (AGE): A blockage in the flow of blood caused by gas bubbles that have entered into the lung’s arteries, blocking the supply of oxygen n

Mediastinal Emphysema: Air between the lungs n

Pneumothorax: The collapse of a lung caused by air between the lungs and chest wall

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n

Subcutaneous Emphysema: Air under the skin

You can avoid lung overexpansion injuries by breathing continuously and not holding your breath. If your regulator comes out of your mouth or you run out of air, inhaling might be difficult. However, breathing is a two-part process: inhaling and exhaling. If you can’t inhale, then make a long, slow exhale. Also, if you lose your regulator or you run out of air, air-sharing with your buddy is the best way to avoid putting yourself in a situation where a lung expansion injury is possible.

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Decompression Sickness

Even if you follow your planned dive profile precisely and use your computer or dive tables conservatively, you and your buddy still can’t eliminate the possibility of decompression sickness. Some of the causes of decompression sickness include: n

Not adhering to depth and time limits imposed by dive tables or by a dive computer n

Approaching or exceeding no-decompression time limits n

Ascending too quickly and not making safety stops n

Poor physical condition n

Dehydration

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Even if you can avoid the causes listed above, your physiological conditioning varies from day to day. One day you might be well rested and hydrated. The next day you may be tired and dehydrated. Also, certain physical predispositions such as obesity can lead to a decompression hit.

However, you can reduce the possibility of decompression sickness by: n

Adhering to depth and time limits imposed by dive tables or by a dive computer n

Avoiding no-decompression limits n

Making slow ascents and safety stops n

Maintaining good fitness n

By staying hydrated before and after the dive

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Key Points

n

Nitrogen Narcosis reduces your ability to react and makes simple manual or mental operations, such as monitoring air supply or dive time, more difficult.

n

If you experience a convulsion from breathing a gas with too high of a partial pressure of oxygen, you might become incapacitated and not be able to keep your regulator in your mouth or recover your regulator if it comes out.

n

You can avoid lung overexpansion injuries by breathing continuously and not holding your breath.

n

You can reduce the possibility of decompression sickness by:

Adhering to depth and time limits imposed by dive tables or by a dive computer

Avoiding no-decompression limits

Making slow ascents and safety stops

Maintaining good fitness

By staying hydrated before and after the dive

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Distressed Divers at Surface

n 65 n

Ironically, most dive accidents begin on the surface.

Unfortunately, this may also be where potential rescuers are at greatest risk.

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Surface Assists

In this section, we discuss three things: n

Protecting yourself n

Surface rescue approach n

Assisting a distressed diver at the surface

Study Questions

As you go through this material, look for the answers to the following: n

What should you do to protect yourself prior to assisting another diver?

n

At what distance should you stop and evaluate another diver before proceeding with an assist or rescue?

n

What two steps should you take to assist a distressed diver at the surface?

n 66 n

Protecting Yourself

You do not want to become a victim while trying to rescue another diver. Both the environmental conditions and the

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diver you are trying to rescue present potential dangers that you must assess in order to determine whether you can effect a safe rescue. In this case, a safe rescue is one in which you don’t knowingly place yourself in harm’s way.

Environmental conditions that could affect your ability to carry out a successful rescue include: n

Air and water temperature n

Wave and tide motion n

The presence of currents n

Geographical features such as submerged rock or coral n

Boat traffic

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The diver’s mental condition may dictate the rescue techniques you employ. Specifically, you need to determine if the diver is panicking.

n

Divers in a state of active panic may thrash wildly, struggling to stay afloat. They often discards their masks and may not have a regulator in place. They may be incapable of following directions and be beyond the point of helping themselves.

n

Divers in a state of passive panic may appear calm and collected. However, like divers in the state of active panic, they are incapable of following directions. When you get close to them, they suddenly “come alive” and will often see you as a means of flotation and try to grab and climb on top of you.

When affecting a surface rescue, treat any diver that can’t follow directions as a panicked diver even if he appears calm.

Surface Rescue Approach

As noted in the last section, you must assess the mental state of a diver on the surface before affecting a rescue in order to keep yourself safe from a panicked diver and from potentially becoming the second victim.

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When swimming toward the victim, you should always maintain constant visual contact. If possible, place external observers at your back who can direct you toward the victim in the presence of high waves, where you could easily lose sight of the victim.

Once you reach the victim, approach slowly. Stop at arm’s length and out of reach of the diver, especially if he is panicking, to avoid being attacked. Safely evaluate the situation before proceeding with an assist or rescue. Speak directly to the diver, assure him that you are there to help and try to get him to help himself by either directing him to drop his weights, inflate his BC or both.

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Assisting a Distressed Diver at the Surface

If you instruct a distressed diver to drop his weights or inflate his BC and he doesn’t respond or is already in a active panicked state, you will need to take direct action to establish positive buoyancy and probably tow the diver to shore or to the closet boat or platform.

Remember that divers in a state of passive panic will appear calm and collected. However, when you get close to them, they may suddenly “come alive” and will often see you as a means of flotation and try to grab and climb on top of you.

Treat all distressed divers as though they are panicked.

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In order to stay out of a panicked diver’s grasp, you should approach from behind. As you approach, be prepared to back away quickly if the diver turns and attempts to grab you.

When you are close enough, grab the diver’s tank between your knees firmly. This will make it more difficult for the diver to turn and grab you. Reach over the diver’s shoulder, grab his power inflator and inflate his BC. If necessary, reach down and release his weights as well.

As you approach, if the diver rotates and pivots in the water to face you and you are not able to approach him from behind, you can descend and swim up behind him under water. Grab his legs pull yourself up his body. Release his weights as you work your way up. As you surface, grab the diver’s tank between your knees firmly and reach over the diver’s shoulder, grab his power inflator and inflate his BC.

After establishing buoyancy, if the diver is still in an active panic, simply push away but remain just outside of arm’s reach in case you need to render additional assistance. Try to speak to and calm the diver again.

If the diver calms down, explain that you are going to tow him to safety. If the diver remains panicked, then repeat the under water approach described above, make contact and grab his

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tank with your knees. Then grab his tank where it meets the valve and start towing.

Key Points

n

Before you can safely assist another diver, you must evaluate environmental conditions and, if possible, quickly evaluate the diver’s mental state so that you do not place yourself in danger.

n

You should stop at arm’s length and out of reach of a distressed diver to avoid being attacked by the distressed diver and to safely evaluate the situation before proceeding with an assist or rescue.

n

When assisting a distressed diver at the surface, first help the diver establish positive buoyancy and, second, tow him to shore or to the closest boat or platform.

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Assisting Divers Under Water

n 73 n

In this part, we’ll cover three things: n

Dealing with stressed/panicky divers under water n

Dealing with unresponsive or non-breathing divers n

At the surface with an unresponsive diver

We also cover what to do should you encounter an unresponsive or non-breathing diver at the surface.

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Stressed/Panicky Divers Under Water

In this section, we discuss two things: n

Calming a diver under water n

Bolting to the surface

n 74 n

Study Questions

As you go through this material, look for the answers to the following: n

Why is calming a diver under water important?

n

After witnessing a panicked diver bolt to the surface, what should you consider before attempting to render assistance?

Calming a Diver Under Water

As you learned earlier, stress is our body’s response to external stimuli, pressure or demands. Stress leads to overexertion, increased breathing rate, increased heart rate, breathlessness, fatigue and, finally, the early stages of panic.

Panic is the underlying factor in most underwater accidents.

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Once panic sets in, you might compromise your ability to solve problems and act in an emergency. Calming a distressed diver under water is the first step in breaking the panic cycle.

Interrupt the onset of panic by directing the diver to stop, relax and breathe. By stopping and breathing, the diver gets a chance to relax and you get a chance to analyze the situation and concentrate on solving the problem.

Bolting to the Surface

Regardless of the situation and the cause, if you witness a panicked diver bolt to the surface, you should not try to

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stop him or follow him in order to arrest his ascent. You must always consider your own safety and not put yourself in the position of becoming the second victim.

n

First, if you try to hold the diver down, you would heighten his sense of panic and possibly cause him to drown.

n

Second, by attempting to follow him and slow him down, you would expose yourself to the risk of lung expansion injuries.

Watch the diver carefully and, if possible, begin your own controlled ascent. Try to reunite with the stricken diver on the surface and render assistance.

Key Points

n

Calming a distressed diver under water is the first step in breaking the panic cycle.

n

If you witness a panicked diver bolt to the surface, you should consider your own safety before attempting to render assistance.

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Unresponsive or Non-Breathing Divers

In this section, we’ll look at seven things: n

Rescuing an unresponsive diver under water n

Getting an unconscious diver to the surface n

Responsive or not responsive?

n

Regulator out of the mouth n

Convulsing diver n

Position of rescuer while surfacing an unresponsive diver n

Ascent rate during rescue of an unresponsive diver

Study Questions

As you go through this material, look for the answers to the following: n

What are the three phases of rescuing an unresponsive diver under water?

n

What is the overarching priority when you find an unresponsive or unconscious diver under water?

n

What is the first step you should take before assisting an apparently unresponsive or unconscious diver?

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n

What action should you take if you find that an unresponsive or unconscious diver’s regulator has fallen out?

n

What factor determines when you attempt to bring a convulsing diver to the surface?

n

When bringing an unresponsive diver to the surface, where should you position yourself relative to the unresponsive diver?

n 78 n

Rescuing an Unresponsive Diver Under Water

The three phases of rescuing an unresponsive diver under water are: n

Preparing to ascend with the diver n

The ascent n

What to do at the surface

One key component of each phase of the rescue is the visualization of and preparation for the next phase. For instance, at the end of a normal and uneventful dive, as you ascend, you should take the time to think about the transition from being under water to being on the surface. This becomes even more important during a rescue. You need to

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think and visualize what will happen and what actions you need to take when you break the surface.

n

Do you need to drop the victim’s weights and your weights?

n

How will you maintain the victim’s buoyancy?

n

How far is the shore or the closet boat?

n 79 n

The following sections will address in details the important points of rescuing an unresponsive diver under water.

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Why Surfacing is a Priority

Any diver who cannot respond to hand signals or other communication needs to be brought to the surface as quickly as you safely can. It does not matter whether the diver is conscious or not, nor does it matter whether or not the diver is breathing.

Divers who can respond to your attempts to communicate will most likely be able to help themselves with minimal assistance. Divers who cannot are at risk of drowning if not taken to the surface (they may, in fact, already be in respiratory arrest).

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Approach an apparently unresponsive or unconscious diver cautiously and try to determine if they are responsive.

Determining Responsiveness

Determining whether a diver under water is responsive is easy; you attempt to get his attention (tapping him gently on the shoulder) and he either responds or he doesn’t. If he does, attempt to ascertain if there is a problem and respond accordingly. If he doesn’t respond, get him to the surface as quickly as you can without jeopardizing your own safety.

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Regulator Out of the Mouth

If an unresponsive or unconscious diver’s regulator is in his mouth, leave it and try to hold it in place if possible during the ascent.

If the regulator has fallen out, do not try to replace it. First, trying to replace a dislodged regulator wastes time. Second, to replace the regulator means you have to open the diver’s mouth; this allows water to enter and there is no discernible advantage. A closed mouth will protect the airway as much as a regulator.

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Convulsing Diver

A convulsing diver experiences two phases of the convulsion: n

The clonic or active phase of the convulsion n

The tonic or relaxed phase of the convulsion.

One long-standing belief has held that a diver in the clonic phase should be held under water at depth until the convulsion ends. This belief is based on the notion that during a convulsion, a diver’s glottis will close and trap expanding air in the lungs during ascent.

While there are studies that support this approach, additional studies provide enough evidence to question it. First, other studies have indicated that individuals suffering a convulsion can ventilate their lungs and can be ventilated with a bag and mask. This suggests that glottal obstruction is partial rather than total. Second, a victim could resume deep breathing after the clonic phase. If the victim is under water and his airway is not protected, he would almost certainly drown.

Given the uncertainty of what actually occurs during a convulsion, the following is recommended: If a convulsing diver’s regulator has fallen out of his mouth, bring him to the

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surface as soon as possible. If the regulator is still in, wait until the convulsions subside.

Positioning While Surfacing an Unresponsive Diver

After placing the diver in a heads-up position, get behind the diver and place your left arm under his left armpit and grab his power inflator with your left hand. This gives you a lifting point and the ability to vent air from his BC during the ascent.

You can place your power inflator over his shoulder as well so that you can control your ascent.

You can use your right hand to either hold the regulator in place or grab the victim’s tank just beneath the valve for

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extra stability and a different lift point. You can also use the right hand to drop the victim’s weights as you ascend if necessary.

Ascent Rate During Rescues of Unresponsive Divers

As stated earlier in the course, you do not want to become a victim while attempting to assist or to rescue another diver.

You must keep this mantra in mind especially when rescuing an unresponsive or unconscious diver.

Particularly, you must adhere to a safe ascent rate while bringing the diver to the surface. While you should bring an

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unresponsive or unconscious diver to the surface as soon as possibly you can’t risk your own safety.

You might be tempted to swim the diver up as fast as you can. You must ignore this temptation and ascend at the recommended 10 m/30 ft per minute. Why?

n

First, you place both yourself and the victim in danger of a lung expansion injury. Even if you can ventilate yourself through normal breathing, the victim’s ability to exhale might be compromised. You might make his condition worse.

n

Second, at the end of a normal and uneventful dive, a slow ascent rate gives you time to think about the transition from being under water to being on the surface. This becomes even more important during a rescue.

Key Points

n

The three phases of rescuing an unresponsive diver under water are:

Preparing to ascend with the diver

The ascent

What to do at the surface

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n

Upon finding an unresponsive or unconscious diver under water, you should bring the diver to the surface and begin resuscitating, if necessary, as quickly as possible without putting your safety at risk.

n

Approach an apparently unresponsive or unconscious diver cautiously and try to determine if he is responsive by tapping the diver on his shoulder or shaking the diver gently.

n

If you find an unconscious diver under water, do not attempt to replace a dislodged regulator. If the regulator is in the diver’s mouth, attempt to hold it in place.

n

If a convulsing diver’s regulator has fallen out of his mouth, bring him to the surface as soon as possible. If the regulator is still in, wait until the convulsions subside.

n

You should position yourself behind an unresponsive diver to make it easier to grasp the diver’s scuba unit before attempting to bring him to the surface and to maintain control during ascent.

n

You should bring an unconscious diver to the surface as soon as possible without risking your own safety.

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Surfacing with Unresponsive Divers

In this section, we discuss five things: n

The first steps n

Why two rescue breaths?

n

Signaling on the surface n

Less than five minutes away n

More than five minutes away

n 88 n

Study Questions

As you go through this material, look for the answers to the following: n

What is a safe ascent rate for bringing an unconscious diver to the surface?

n

What procedure should you follow when you surface a non-breathing, unconscious diver regardless of the location of a boat or the shore?

n

Why is it important to administer at least two initial rescue breaths to a non-breathing, unconscious diver on the surface?

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n

How can you signal a dive boat or someone on land for assistance?

n

What procedure should you follow for a non-breathing, unconscious diver on the surface if a boat or shore is less than five minutes away?

n

What procedure should you follow for a non-breathing diver on the surface if a boat or shore is more than five minutes away?

The First Steps

At the surface, establish positive buoyancy for the victim by dropping his weights and inflating his BC. Get the diver on his back. Discard his mask and remove his regulator from his mouth but be prepared to protect the victim’s airway. Next, open the victim’s airway and deliver two rescue breaths.

Even if you surface next to a boat or near the shore, you should position the victim on the back, establish positive buoyancy, open the airway and deliver the two rescue breaths.

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Why Two Rescue Breaths?

Recently, studies indicate that “compression only resuscitation” provides clear advantages over traditional CPR.

However, these studies have little or no relevance to diving where respiratory arrest is more likely due to asphyxia. In these cases, there may be a significant amount of elapsed time before a cardiac event.

Consequently, the administering of rescue breaths might prevent a diver who has stopped breathing from progressing to cardiac arrest.

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Signaling on the Surface

The excitement and stress of finding and surfacing an unresponsive or unconscious diver can be exhausting. Once at the surface, you may have to signal for assistance if you are incapacitated and too exhausted to attempt a surface swim.

If you need assistance on the surface, you can signal a dive boat or someone on land for assistance by: n

Blowing a whistle n

Using a signaling mirror n

Inflating and waving a surface marker buoy

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n

Removing and waving a fin back and forth

If you can’t get the attention of someone, you will have to swim and tow the victim to safety. Depending on how exhausted you are and how far away from land or a boat you are will determine the towing procedure used.

Less than Five Minutes Away

When rescuing a non-breathing, unconscious diver on the surface and a boat or shore is less than a five minute swim, you should administer two rescue breaths, tow the victim to the boat or shore while administering intermittent rescue breaths and get the victim out of the water so that you can

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administer proper rescue breathing, and if necessary, chest compressions.

Administering rescue breaths can be difficult, exhausting and cause delay in getting the victim to safety. If the boat or shore is less than a five minute swim, you should continue to administer rescue breaths at a rate of one breath every five seconds following the two initial rescue breaths.

If you find the delivery of rescue breaths exhausting or causing delay, either reduce the amount of breaths or discontinue them.

More than Five Minutes Away

When rescuing a non-breathing diver on the surface and a boat or shore is more than a five minute swim, you remain where you are administering rescue breaths for one minute.

If there is no response, tow the victim to the boat or shore without rescue breaths and get the victim out of the water so that you can administer proper rescue breathing, and if necessary, chest compressions.

Remember, the administering of rescue breaths might prevent a diver who has stopped breathing from progressing to cardiac arrest. When facing a surface swim/tow of more

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than five minutes, administering rescue breaths for one minute prior, might reduce the chances of the victim suffering a cardiac event during the time it takes you to tow him to safety. You should administer the breaths at a rate of one breath every five seconds following the two initial rescue breaths.

Key Points

n

Even when surfacing with a non-breathing, unconscious diver next to a boat or near the shore, you should position the victim on the back, establish positive buoyancy, open the airway and deliver two rescue breaths.

n

Rescue breaths should be administered on the surface since they may prevent progression to cardiac arrest.

n

If you need assistance on the surface, you can signal a dive boat or someone on land for assistance by:

Blowing a whistle

Using a signaling mirror

Inflating and waving a surface marker buoy

Removing and placing your fins on your hands and waving them back and forth

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n

When rescuing a non-breathing, unconscious diver on the surface and a boat or shore is less than a five minute swim, you should administer two rescue breaths, tow the victim to the boat or shore while administering intermittent rescue breaths and get the victim out of the water so that you can administer proper rescue breathing, and if necessary, chest compressions.

n

When rescuing a non-breathing diver on the surface and a boat or shore is more than a five minute swim, you remain where you are administering rescue breaths for one minute. If there is no response, tow the victim to the boat or shore without rescue breaths and get the victim out of the water so that you can administer proper rescue breathing, and if necessary, chest compressions.

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Being Prepared

n 96 n

In this part, we’ll cover two things: n

Emergency action plans n

Emergency equipment

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Emergency Action Plans (EAPs)

It’s said that failing to plan is planning to fail. Nowhere is this more true than in the area of diver rescue.

Study Question

As you go through this material, look for the answer to the following: n

Why does an Emergency Action Plan make an emergency less stressful?

Emergency Action Plan

Remember that the excitement and stress of a rescue can be exhausting. It can also create an environment where you find it difficult to make decisions about the next step that you need to take. If you have an Emergency Action Plan, that defines key roles, procedures and operations, you can effectively manage the stress associated with a rescue.

For instance, imagine you are leading a group dive at a dive site where the entry and exit point is far from the road or parking lot. Prior to the dive you assign an individual and

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a back-up the job of going and meeting the emergency response team if an emergency occurs. With this detail resolved, you have one less thing to worry about and can concentrate on providing aid to the victim.

n 98 n

You should write the plan out on a slate or on a laminated sheet of paper and review it with everyone prior to the dive.

Key Points

n

An Emergency Action Plan, which predefines roles, procedures and operations, can make an emergency less stressful.

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Emergency Equipment

In this section, we’ll look at six things: n

Signaling devices n

Oral/nasal mask n

First aid kit n

Oxygen n

Cell phone n

Additional equipment

Study Questions

As you go through this material, look for the answers to the following: n

Why should you carry a signaling device while diving?

n

Why is an oral/nasal mask a critical tool when attempting rescue breaths in water?

n

Why should a first aid kit be checked prior to a dive?

n

What four things must you ensure regarding emergency oxygen as part of your overall emergency preparedness procedures?

n

Where should you store a cell phone while diving?

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What additional emergency items may you want to have on hand?

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Signaling Devices

As we have already discussed, a rescue can be exhausting and stressful. While on the surface, you may have to signal for assistance if you are incapacitated and too exhausted to attempt a surface swim or continue to assist the victim.

Consequently, you need to carry both audible and visual signaling devices.

Some devices are small and can be inexpensive to purchase.

These include items like a whistle or signaling mirror. Other items typically have other primary uses but in a pinch can be

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excellent signaling devices. These include surface marker buoys and the fins on your feet.

Oral/Nasal Mask

\Even though the latest recommendations concerning attempts at in-water resuscitation have downplayed the frequency which you would attempt rescue breaths in water, the ability to do so remains important.

The problem is that, without additional tools, administering rescue breaths in water is difficult to do effectively and can be physically exhausting. Experience shows that the only truly effective way to administer rescue breaths in the water

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is through use of an oral/nasal mask, such as the Laerdal

Pocket Mask.

When such a mask is available, the rescuer no longer has to get up and over the victim, nor exert energy rocking the victim toward him. The rescuer can maintain a position above the victim’s head, put the mask in place, and hyperextend the victim’s jaw to open the airway.

This has the added benefit of putting the rescuer in the best possible position for towing while, at the same time, helping to keep water out of the victim’s nose and mouth.

First Aid Kit

A key part of the Emergency Action Plan should include making sure everyone knows the location, contents and use of the contents of a first aid kit.

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Informing everyone of the location of the first aid kit is pretty straight forward and typically, most dive leaders handle this well. However, being informed about the contents and the use of the contents is where the ball gets dropped.

First, check to make sure that the contents are not expired.

Most first aid kits contained prepackaged items such as aspirin, creams, lotions, etc. Most of these have expiration dates. Frequently check the expiration dates on these items and replace the ones that have expired.

Also, make sure you identify the divers who know what each item can be used for and how it is to be used. These individuals should be listed on the Emergency Action Plan.

Oxygen

The availability of emergency oxygen is critical to the proper treatment of many diving maladies, including lungoverpressure injuries, decompression sickness and drowning.

The proper use of emergency oxygen is beyond the scope of this course; however, training in oxygen administration is as important to rescue divers as training in first aid and CPR.

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As part of your emergency preparedness procedures, you need to ensure that emergency oxygen is present, that the oxygen cylinder is fully charged, that the oxygen kit has been adequately maintained, and that no critical components are missing.

Cell Phone

Another key part of the Emergency Action Plan should include the availability of a cell phone to call and activate emergency medical services.

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This is pretty straight forward but here are a couple of things to keep in mind: n

Identify the location of more than one phone n

Make sure the cell phone battery is charged n

Keep at least one phone with the first aid kit n

Make sure that none of the available phones are password protected n

Verify that all the phones have a signal — especially if diving in a remote area

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Additional Equipment

While a fully stocked first aid kit and emergency oxygen represent the minimum equipment you need to have on hand, there are many other items which, depending on circumstances, may be helpful.

n 106 n

These can include: n

Throw rings and line n

Backboards and/or litters n

Bullhorns or loudspeakers

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n

Diver emergency recall systems

At commercially operated dive sites and dive boats, these items are generally provided by the operator. Make sure you know where they are and how to access them.

Key Points

n

Carry a signaling device such as a mirror or whistle in order to attract attention in case of an emergency.

n

Experience shows that the only truly effective way to administer rescue breaths in the water is through use of an oral/nasal mask, such as the Laerdal Pocket Mask.

n

A first aid kit should be checked, prior to each dive, to ensure that all of the supplies are in order, that everyone knows where the kit is stored and that each diver is familiar with its contents and use.

n

As part of your emergency preparedness procedures, you need to ensure that emergency oxygen is present, that the oxygen cylinder is fully charged, that the oxygen kit has been adequately maintained, and that no critical components are missing.

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n

Keep a cell phone with the first aid kit so that EMS can be activated in case of emergency.

n

Additional emergency items that may be helpful include

Throw rings and line

Backboards and/or litters

Bullhorns or loudspeakers

Diver emergency recall systems

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