HGPA

Rescue Diver Manual

Knowledge Review Chapter One

The most common cause of diver emergencies is poor judgment.

Three things to consider before attempting an inwater rescue:

Do you need to enter the water at all?

Do you have the equipment and training necessary for your safety and the victim's safety?
Can you reasonably expect to accomplish the rescue without getting into trouble yourself?

Diver stress is defined as physical or mental tension that results in physical, chemical and/or emotional
(psychological) changes in the body.

Seven causes of physical stress include:

cold and heat

nitrogen narcosis
illness or injury
discomfort or impaired function caused by ill fitted or malfunctioning equipment
seasickness
fatigue
alcohol or drugs

Perceptual narrowing is the decrease in broad awareness through close focus on a perceived threat or the
solution to that threat.

Four advantages of a pocket mask include that it:

simplifies getting an effective seal and head positioning

reduces worries about disease transmission
is an effective way to provide inwater rescue breathing for a non-breathing diver
can connect it to emergency oxygen

The two types of emergency oxygen equipment recommended for PADI Rescue Divers are:

non-resuscitator demand valve units, which operate much like a scuba regulator
continuous flow units, which release oxygen continuously

The six steps for emergency management are:

1. assess the situation

2. act on you plan
3. delegate
4. attend to injuries
5. control the scene
6. arrange evacuation to medical care

Five skills to improve your self-rescue abilities include:

 good buoyancy control
proper airway control
cramp removal
handling air depletion
responding to vertigo

When encountering a problem with diving you should Stop. Breathe. Think. Act.

Signs and behaviors that indicate a diver may have a problem at the surface include:

giving distress signals

struggling on or just below surface
high treading or finning
rejecting equipment
clinging or clambering
not moving, unresponsive

Tired divers have a problem, but are adequately managing stress. Panicked divers have a problem and
have become overwhelmed by stress and fear. They pose the most risk because they can overpower you.

Rescuer safety takes priority over distressed diver's because you can't help the victim if you're in trouble.

Four types of rescue to consider before entering water are:

reaching and extension assists

throwing assists
wading assists
watercraft assists

Steps to rescue a tired diver:

approach
evaluate
make contact
reassure the tired diver
assists and transport
equipment removal

Steps to rescue a panicked diver:

approach and evaluate

make contact (take control)
reassure and transport

Make contact with panicked diver by using underarm lift or knee cradle position. You may need to use a
release or escape to regain control.

Knowledge Review Chapter Four

Critical Incident Stress is an emergency involving a serious injury or death.

Sign and symptoms of critical incident stress include:

confusion
lowered attention span; restlessness
 denial
guilt or depression
anger
anxiety
unusual behavior
changes in interactions with others
increased or decreased eating
uncharacteristic, excessive humor or silence
sleeplessness
nightmares

To prevent PTSD, critical incident stress should be treated professional via critical incident stress
debriefing.

Decompression illness (DCI) encompasses both lung over-expansion injuries and decompression sickness
(DCS).

The most common cause of lung overexpansion injuries is running out of air - divers rush to the surface
without exhaling continuously.

You can reduce lung overexpansion injuries by checking air often and encouraging others to do the same.

Arterial gas embolism (AGE) arises when expanding air forces through the alveoli into pulmonary
capillaries. This forms bubbles that travel in the blood stream.

Mediastinal emphysema occurs when the expanding air becomes lodged in the chest cavity between the
lungs. This constricts the heart and lungs.

Subcutaneous emphysema occurs when expanding air accumulates under the skin around the neck and
collar bone.

Pneumothorax, or collapsed lung, can occur when the air from overexpansion forces its way in the the
space between the lung and chest wall.

First aid steps for decompression illness:

primary assessment
document information about dive
administer oxygen
keep patient lying done
maintain lifeline
call emergency services

First aids steps for near drowning

rescue breathing
CPR if no heartbeat
be alert for vomiting, especially if breathing resumes
keep patient lying down
call emergency services

If rescuing an unresponsive, non-breathing diver at surface less than 5 minutes from safety then tow diver
there while continuing to provide rescue breaths. Get diver out of water and perform CPR. If more than 5
minutes from safety then give rescue breaths for 1-2 minutes while watching the victim for responses to
ventilation. If there is no response then cardiac arrest is likely - get diver out of water and perform CPR.
Give rescue breaths to diver with no apparent heartbeat because one may actually be present. Rescues
breaths can correct respiratory arrest before the onset of cardiac arrest.

If you have a pocket mask then:

move above victim

place mask on face
hold mask with thumbs while fingers on bony part of jaw
administer two initial breaths
secure mask strap
listen/feel for breathing
give rescues breath every 5 seconds until breathing
maintain airway open
concurrently tow diver to safety

If you find an unresponsive diver underwater, getting them to the surface takes priority over everything
except your personal safety.

1. Note the diver's position, state of regulator and mask, and any clues about accident.
2. If regulator is in victim's mouth then hold in place, but don't waste trying to put it back if it is not
3. Hold the victim from behind to hold regulator (if necessary) and hold head in place
4. Use your own BCD to ascend. You may need to release air from victim's BCD.
5. Keep victim's head in normal position
6. As you ascent thing about steps you're take at surface
7. Drop the victim's weights

When rescuing an unresponsive diver, equipment removal is a low priority. Remove gear if doing so more
than offsets the time required to remove it. Removal technique considerations:

1. Think buoyancy
2. Do things in logical order, keeping one hand on airway to ensure it stays open.
3. Keep a rhythm. Do things between rescue breaths.
4. Keep moving. Towing to safety should be continuous.

Knowledge Review Chapter Five

You should write up a report after a dive accident that requires first aid and summoning emergency
medical care or other emergency personnel. You should avoid guessing or speculation when doing a
report or answering questions.

Administrating oxygen to a diver suspect of decompression illness is crucial because they may not
respond to it, but it does no harm.

Six procedures to follow when handling oxygen are:

1. keep unit clean and protected

2. never lubricate equipment
3. always open valves on oxygen equipment slowly
4. keep your unit assembled to minimize the possibility of contaminates getting into it and to save
time in an emergency
5. never attempt to clean or service the equipment yourself
6. always extinguish source of flame

The procedure for administrating oxygen to a breathing diver:

 open kit
slowly turn open valve
secure tank
"this is oxygen"
place mask on face
if unresponsive use non-resuscitator demand valve unit
monitor oxygen pressure gauge

The procedure for administrating oxygen to a weakly breathing diver:

open kit and attach nonrebreather

slowly turn open valve to 15 liters/minute
hold thumb over the inlet inside mask and allow reservoir bag to inflate
"this is oxygen"
place mask on face
if bag collapses increase flow to 25 liters/minute
monitor oxygen pressure gauge

The procedure for administrating oxygen to a nonbreathing diver:

have someone open kit while you administer rescue breaths

slowly turn open valve to 15 liters/minute
give rescue breaths
if starts breathing switch to demand or nonrebreather

After beginning primary care, secondary care, oxygen and other first aid while waiting for emergency
medical care to arrive:

maintain lifeline
Protect victim from shock
control bystanders
keep victim lying down
administer oxygen
collect information about diver and incident

You should collect information to send with injured diver upon arrival of emergency medical services:

name and contact

significant medical history
first aid procedures
dive profile information
comments relative to emergency care received
contact information for local diver emergency system and name

Perform the lifeguard exit

place injured diver's hands on deck

push yourself out of water keeping one hand on victim's hands
stand and hold diver by wrists, lift waist to dock level, then lower face down on deck
roll victim over

Circumstances may affect exiting with an unresponsive diver.

Remember maintaining rescue breaths take priority.

exit through surf: Protect diver's airway from crashing waves
 over rocks: let water carry you and the victim up the rocks in stages
swim steps, low docks and small boats: use lifeguard exit
tall dock or boat pier: use the roll technique

Filename: rescue-diver.md (Edit)

Modified: 2016-11-14 (587a7a05338863166554a115132159ae0bcdb725)
Created: 2016-11-14 (587a7a05338863166554a115132159ae0bcdb725)