Two lessons learnt....

ForTheFight · 28th September 2007, 17:58

I wanted to share an incident that happened to me two weeks ago because I think there is a valuable message related to rescuing CCR divers. I was acting as a victim in a Rescue class, the class was on on OC (clearly), I was diving CCR. For those not familiar with the Rescue classes offered by a number of agencies, it is common to have a scenario towards the end of the class in which the students must find and recover an unconscious diver from depth, the challenge is both the search and the recovery. I played the "unconscious" diver, with the lack of bubbles we considered that it would be more of a challenge for the students. The students did find me, at 40 feet, where I had been for nearly half an hour, just floating - waiting. The next step in the "recovery" was to manage my ascent to the surface as though they had found me unconscious. Students often have trouble with this, for most, this is their third of fourth dive class and they are still learning buoyancy for themselves, managing another diver is very challengeing. In the process of the rescue I was sent extremely rapidly to the surface, the students were unable to manage the expansion of gas in my BC, dry suit and counter lungs at the same time.

Fortunately, because I was not truly unconscious I was able to manage the counter lung volume and dry suit volume as soon as I realized that they were not completely in control of the ascent.
Unfortunately, both because of the earlier (relatively shallow) dives during the day and because of the speed of the ascent, I ended up in a hyper-baric chamber with DCS. While in the chamber I experienced a nasty bout of Pulmonary Oxygen Toxicity.

The hospital staff, both doctors and chamber operators, came to the conclusion that the DCS was more a result of the ascent than anything else (max depth that day was 60ft - and not for long), the Pulmonary tox was most likely due to the long exposure to elevated PO2 during the day (I dove a 1-1.2 most of the day).

LESSON 1: a rebreather diver rescued from depth is harder to control than an OC diver because of the additional gas. It would behoove all of us to make OC buddies aware of this issue before we get in the water. Properly informed, experienced divers should be able to manage it.

LESSON 2: ALWAYS tell chamber operators you were diving a rebreather and have had exposure to high PO2's during the day.

In the end, after US Navy Table 5 and 6 treatments, I am fine and ready to get back into the water, it was an important lesson to learn, I wish I didnt have to learn it this way, but I hope others can benefit from it.

A big thanks to DAN, not only for their excellent insurance, but also for their invaluable information, advice and genuine concern for my well being.

deanc · 28th September 2007, 18:34

Quote: (Originally Posted by ForTheFight)

In the end, after US Navy Table 5 and 6 treatments, I am fine and ready to get back into the water, it was an important lesson to learn, I wish I didnt have to learn it this way, but I hope others can benefit from it.

Glad you came out OK, hope you have none/few residual injuries. You never mentioned where was your pain? or what was the symptom from that sort of ascent? And your PO2 at the surface? Could be more information to be gleaned from your misfortune, it could happen to any one of us.

Quote: (Originally Posted by ForTheFight)

Students often have trouble with this, for most, this is their third of fourth dive class and they are still learning buoyancy for themselves, managing another diver is very challengeing.

Did you not see this coming? I wouldn't have volunteered.

ForTheFight · 28th September 2007, 18:45

Quote: (Originally Posted by deanc)

Did you not see this coming? I wouldn't have volunteered.

Agree - Its hard to see this kind of thing coming, and I had a lot of confidence in that group of students, but you are correct, it was not a good idea. I play have played victim all the time on OC. Thats a lesson too....

cramerdn · 28th September 2007, 18:51

Quote: (Originally Posted by ForTheFight)

I was acting as a victim in a Rescue class,...

In the end, after US Navy Table 5 and 6 treatments, I am fine and ready to get back into the water,

No Good deed goes unpunished

ForTheFight · 28th September 2007, 18:53

Quote: (Originally Posted by deanc)

Glad you came out OK, hope you have none/few residual injuries. You never mentioned where was your pain? or what was the symptom from that sort of ascent? And your PO2 at the surface? Could be more information to be gleaned from your misfortune, it could happen to any one of us.

The pain was mostly shoulders and left arm at first, by the time I made it to the chamber there was pain in every joint, felt like sandpaper between my bones...not fun. I also had a terrible headache. The pain in my shoulders and the headache came quickly, I wrote it off at first as muscle pain from lifting tanks and such at first...

PO2 on the surface was .21, during the ascent, right at the end, I bailed out to the BOV after emptying the loop.

**sfldiver** · 28th September 2007, 19:30

I'm glad to hear that you are recovered and ready to dive again!

I am curious of a few things, and please bear in mind that I am no expert on the subject, but I have toured a chamber or two throughout the years. Didn't the chamber physician and/or the paramedic profile you about the degree of diving you had done that day, prior to administering the treatment, to ensure they were administering the correct Navy Table Treatments, unless you were unconscious of course? I know that they generally administer a standard Navy Table Treatment, because it tends to cure 99.9% of the patients they receive, but it seems that a proper round of profiling questions is still in required and might of eluded them to the fact that you were in a position to be sensative to exceeding your allowable O2 and potentially experience an O2 hit.

Furthermore, how large or sophisticated a chamber were you in? I ask, because the main chamber at Mercy hospital in South Florida is very large and allows for medics to be inside with you, primarily because of its size and because it administers the gas to the patient via masks, which can be removed at the onset of convolsions. If you were in a small chamber, I can only imagine how unpleasant it must have been, if you did actually convulse and have to wait until they dropped the PO2 in the entire chamber before you became stable.

Additionally, you indicate that the students at the rescue level are still getting comfortable with their own buoyancy control. Even though I am a PADI Open Water Instructor, I have not taught a class or rescue class for that fact in over 20 years; however, at the rescue diver level, shouldn't students already have a high degree of buoyancy control in order to be accepted to that class and to take on the role of being responsible for the well being of others? I do not recall the specific requirements, but at the very least, the instructor should evaluate their skill level and make a judgement call, but then again, I am aware of the financial responsibilities end of the business and how there does exist pressures to accept or move students along to levels that they are perhaps not completely prepared for.

Either way, I'm glad your ok! I'm also happy you shared this information with us, becuase I was not aware of that particular precaution. Up until now, when I dove with an OC diver, I simply informed them there was nothing they could do in the event of something going wrong, other then to bring me to the surface. It might be prudent for me in the future to give my oc buddies a VERY BRIEF heads up to the fact that the expansion of my bc and my loop may be a consideration. However, in the event of a real emergency where I became unconscious underwater, I'd rather be bent and/or embolized, rather than drowned at the bottom.

Thanks for sharing!

***ScubaDadMiami*** · 28th September 2007, 19:57

Again, as I mentioned in another thread, everyone please be sure to watch your OTUs out there. Glad you are okay.

**Freef** · 28th September 2007, 20:51

I'm surprised that you had pulmonary and not CNS tox, had you done a lot of high pO2 diving in the days before?

**Dsix36** · 28th September 2007, 21:06

Thanks for posting this! It has given me a couple of things to think about and implement into my diving.

mempilot · 28th September 2007, 22:32

First, glad to hear you are now OK, and second, thanks for posting about the experience.

I've always wondered about bringing an unconscience diver from depth. During an O2 tox convulsion, the glottis can freeze shut, partially shut, or open depending on where in the cycle the breathing is at the time of the convulsion. Managing the gas in the loop, wing, drysuit is the difficult part for the rescuer, but if the glottis is frozen shut, overexpansion of the lungs on ascent becomes the most probable killer. Getting bent can in many cases be mended. Schredding the lungs can't.

It seems that slowly bringing the toxed diver up just a small percentage of depth initially might allow for the convulsion to stop, the glottis to unfreeze and allow for the gas in the lungs to expand and excape. I'm no expert, so I'm just hypothesising.

In the event of an OC diver rescuing a CCR diver, I think I would tell them to open all OPRV fully and bring them up horizontally if possible since the majority of the OPRV's are on the front and centrally located on the body. (lower counter lung, lower front of wing, arm of drysuit) Just thoughts, as I've never tried this and may not be reasonable.

I guess if it's not your time to die, then hopefully your rescuer doesn't kill you.

28th September 2007, 17:58	#1 (permalink)
ForTheFight Eliot Danner Current Rebreather/s: Classic Kiss Optima rEvo Other CCR Dolphin Other Rebreather/s: Sport Kiss Optima rEvo Other CCR Dolphin Join Date: Jul 2006 Location: Virginia Posts: 225	Two lessons learnt.... I wanted to share an incident that happened to me two weeks ago because I think there is a valuable message related to rescuing CCR divers. I was acting as a victim in a Rescue class, the class was on on OC (clearly), I was diving CCR. For those not familiar with the Rescue classes offered by a number of agencies, it is common to have a scenario towards the end of the class in which the students must find and recover an unconscious diver from depth, the challenge is both the search and the recovery. I played the "unconscious" diver, with the lack of bubbles we considered that it would be more of a challenge for the students. The students did find me, at 40 feet, where I had been for nearly half an hour, just floating - waiting. The next step in the "recovery" was to manage my ascent to the surface as though they had found me unconscious. Students often have trouble with this, for most, this is their third of fourth dive class and they are still learning buoyancy for themselves, managing another diver is very challengeing. In the process of the rescue I was sent extremely rapidly to the surface, the students were unable to manage the expansion of gas in my BC, dry suit and counter lungs at the same time. Fortunately, because I was not truly unconscious I was able to manage the counter lung volume and dry suit volume as soon as I realized that they were not completely in control of the ascent. Unfortunately, both because of the earlier (relatively shallow) dives during the day and because of the speed of the ascent, I ended up in a hyper-baric chamber with DCS. While in the chamber I experienced a nasty bout of Pulmonary Oxygen Toxicity. The hospital staff, both doctors and chamber operators, came to the conclusion that the DCS was more a result of the ascent than anything else (max depth that day was 60ft - and not for long), the Pulmonary tox was most likely due to the long exposure to elevated PO2 during the day (I dove a 1-1.2 most of the day). LESSON 1: a rebreather diver rescued from depth is harder to control than an OC diver because of the additional gas. It would behoove all of us to make OC buddies aware of this issue before we get in the water. Properly informed, experienced divers should be able to manage it. LESSON 2: ALWAYS tell chamber operators you were diving a rebreather and have had exposure to high PO2's during the day. In the end, after US Navy Table 5 and 6 treatments, I am fine and ready to get back into the water, it was an important lesson to learn, I wish I didnt have to learn it this way, but I hope others can benefit from it. A big thanks to DAN, not only for their excellent insurance, but also for their invaluable information, advice and genuine concern for my well being. __________________ This post may be up to 80% accurate...the remaining 20% is speculation.
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28th September 2007, 18:34	#2 (permalink)
deanc New Member Current Rebreather/s: Megalodon Other Rebreather/s: Join Date: Dec 2006 Location: Perth, WA Posts: 52	Re: Two lessons learnt.... Quote: (Originally Posted by ForTheFight) In the end, after US Navy Table 5 and 6 treatments, I am fine and ready to get back into the water, it was an important lesson to learn, I wish I didnt have to learn it this way, but I hope others can benefit from it. Glad you came out OK, hope you have none/few residual injuries. You never mentioned where was your pain? or what was the symptom from that sort of ascent? And your PO2 at the surface? Could be more information to be gleaned from your misfortune, it could happen to any one of us. Quote: (Originally Posted by ForTheFight) Students often have trouble with this, for most, this is their third of fourth dive class and they are still learning buoyancy for themselves, managing another diver is very challengeing. Did you not see this coming? I wouldn't have volunteered. __________________ You dont know what you dont know.
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28th September 2007, 18:45	#3 (permalink)
ForTheFight Eliot Danner Current Rebreather/s: Classic Kiss Optima rEvo Other CCR Dolphin Other Rebreather/s: Sport Kiss Optima rEvo Other CCR Dolphin Join Date: Jul 2006 Location: Virginia Posts: 225	Re: Two lessons learnt.... Quote: (Originally Posted by deanc) Did you not see this coming? I wouldn't have volunteered. Agree - Its hard to see this kind of thing coming, and I had a lot of confidence in that group of students, but you are correct, it was not a good idea. I play have played victim all the time on OC. Thats a lesson too.... __________________ This post may be up to 80% accurate...the remaining 20% is speculation. Last edited by ForTheFight : 28th September 2007 at 18:46. Reason: correction
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28th September 2007, 18:51	#4 (permalink)
cramerdn Obey my dog! Current Rebreather/s: Evolution Dolphin Other Rebreather/s: Dolphin Join Date: Dec 2006 Location: Townsville QLD Posts: 619	Re: Two lessons learnt.... Quote: (Originally Posted by ForTheFight) I was acting as a victim in a Rescue class,... In the end, after US Navy Table 5 and 6 treatments, I am fine and ready to get back into the water, No Good deed goes unpunished __________________ "Its better to live one day as a tiger than an entire life as a worm." "But who's ever heard of a worm skin rug?"
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28th September 2007, 18:53	#5 (permalink)
ForTheFight Eliot Danner Current Rebreather/s: Classic Kiss Optima rEvo Other CCR Dolphin Other Rebreather/s: Sport Kiss Optima rEvo Other CCR Dolphin Join Date: Jul 2006 Location: Virginia Posts: 225	Re: Two lessons learnt.... Quote: (Originally Posted by deanc) Glad you came out OK, hope you have none/few residual injuries. You never mentioned where was your pain? or what was the symptom from that sort of ascent? And your PO2 at the surface? Could be more information to be gleaned from your misfortune, it could happen to any one of us. The pain was mostly shoulders and left arm at first, by the time I made it to the chamber there was pain in every joint, felt like sandpaper between my bones...not fun. I also had a terrible headache. The pain in my shoulders and the headache came quickly, I wrote it off at first as muscle pain from lifting tanks and such at first... PO2 on the surface was .21, during the ascent, right at the end, I bailed out to the BOV after emptying the loop. __________________ This post may be up to 80% accurate...the remaining 20% is speculation.
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28th September 2007, 19:30	#6 (permalink)
sfldiver S.C.R.U.B.'S Photographer Current Rebreather/s: Optima Other Rebreather/s: Join Date: Jul 2007 Location: Pompano Beach, FL Posts: 785	Re: Two lessons learnt.... I'm glad to hear that you are recovered and ready to dive again! I am curious of a few things, and please bear in mind that I am no expert on the subject, but I have toured a chamber or two throughout the years. Didn't the chamber physician and/or the paramedic profile you about the degree of diving you had done that day, prior to administering the treatment, to ensure they were administering the correct Navy Table Treatments, unless you were unconscious of course? I know that they generally administer a standard Navy Table Treatment, because it tends to cure 99.9% of the patients they receive, but it seems that a proper round of profiling questions is still in required and might of eluded them to the fact that you were in a position to be sensative to exceeding your allowable O2 and potentially experience an O2 hit. Furthermore, how large or sophisticated a chamber were you in? I ask, because the main chamber at Mercy hospital in South Florida is very large and allows for medics to be inside with you, primarily because of its size and because it administers the gas to the patient via masks, which can be removed at the onset of convolsions. If you were in a small chamber, I can only imagine how unpleasant it must have been, if you did actually convulse and have to wait until they dropped the PO2 in the entire chamber before you became stable. Additionally, you indicate that the students at the rescue level are still getting comfortable with their own buoyancy control. Even though I am a PADI Open Water Instructor, I have not taught a class or rescue class for that fact in over 20 years; however, at the rescue diver level, shouldn't students already have a high degree of buoyancy control in order to be accepted to that class and to take on the role of being responsible for the well being of others? I do not recall the specific requirements, but at the very least, the instructor should evaluate their skill level and make a judgement call, but then again, I am aware of the financial responsibilities end of the business and how there does exist pressures to accept or move students along to levels that they are perhaps not completely prepared for. Either way, I'm glad your ok! I'm also happy you shared this information with us, becuase I was not aware of that particular precaution. Up until now, when I dove with an OC diver, I simply informed them there was nothing they could do in the event of something going wrong, other then to bring me to the surface. It might be prudent for me in the future to give my oc buddies a VERY BRIEF heads up to the fact that the expansion of my bc and my loop may be a consideration. However, in the event of a real emergency where I became unconscious underwater, I'd rather be bent and/or embolized, rather than drowned at the bottom. Thanks for sharing! __________________ *Currently piloting & shooting...* Dive Rite O2ptima FX Rigged w/ a Dsix Custom Aluminum Frame, Nomad Wing, Transpac Harness and VR3 Computer w/ VPM-B/E & a 4th Cell Sensor Link.* Canon PowerShot G9 Digital Camera *Rigged in a Patima-PDCH 2008 G9 Aluminum Housing w/ an Inon UWL-100 Achromat Wide Conversion Lens, 2 Inon UCL-165M67 Close-Up Lenses and 2 Inon Z-240 Strobes.
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28th September 2007, 19:57	#7 (permalink)
*ScubaDadMiami* Moderator Current Rebreather/s: Optima Other Rebreather/s: Join Date: Sep 2005 Location: Florida, USA Posts: 2,141	Re: Two lessons learnt.... Again, as I mentioned in another thread, everyone please be sure to watch your OTUs out there. Glad you are okay. __________________ Howard Packer IANTD CCR Instructor Miami Beach, Florida CCRDiveTraining.com
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28th September 2007, 20:51	#8 (permalink)
Freef Custom Title Disallowed! Current Rebreather/s: Dolphin Other Rebreather/s: Dolphin Join Date: Jan 2006 Location: Land of the Freef, UK. Posts: 1,356	Re: Two lessons learnt.... I'm surprised that you had pulmonary and not CNS tox, had you done a lot of high pO2 diving in the days before? __________________ David. Currently owner of two differently sized ankles.
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28th September 2007, 21:06	#9 (permalink)
Dsix36 Going Down? Current Rebreather/s: Optima Other Rebreather/s: Join Date: Aug 2007 Location: Deerfield Beach, Florida Posts: 1,054	Re: Two lessons learnt.... Thanks for posting this! It has given me a couple of things to think about and implement into my diving. __________________ THE MORE THAT I LEARN, THE MORE THAT I STILL NEED TO LEARN!!!!!!
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28th September 2007, 22:32	#10 (permalink)
mempilot Eric Stadtmueller Current Rebreather/s: Megalodon Other Rebreather/s: Megalodon Join Date: Aug 2006 Location: Ft. Lauderdale Posts: 1,458	Re: Two lessons learnt.... First, glad to hear you are now OK, and second, thanks for posting about the experience. I've always wondered about bringing an unconscience diver from depth. During an O2 tox convulsion, the glottis can freeze shut, partially shut, or open depending on where in the cycle the breathing is at the time of the convulsion. Managing the gas in the loop, wing, drysuit is the difficult part for the rescuer, but if the glottis is frozen shut, overexpansion of the lungs on ascent becomes the most probable killer. Getting bent can in many cases be mended. Schredding the lungs can't. It seems that slowly bringing the toxed diver up just a small percentage of depth initially might allow for the convulsion to stop, the glottis to unfreeze and allow for the gas in the lungs to expand and excape. I'm no expert, so I'm just hypothesising. In the event of an OC diver rescuing a CCR diver, I think I would tell them to open all OPRV fully and bring them up horizontally if possible since the majority of the OPRV's are on the front and centrally located on the body. (lower counter lung, lower front of wing, arm of drysuit) Just thoughts, as I've never tried this and may not be reasonable. I guess if it's not your time to die, then hopefully your rescuer doesn't kill you. __________________ Eric Stadtmueller, otherwise known as, MEM "Da Pilot"
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