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Al, I thought you were on the WKPP list - this is all spelled out in the archives along with complete proceedures from our parmedics, our doctors, our advisors, our surface managers, and myself. Our advisors by are are oil company , Navy or professional sources. In a nutshell, the best response is instant buddy in all cases. The bends is another story, and we use the usual tricks there, including IWR which I already kind of went over on here. We do run safety divers for everything, and stagger the teams, so at any given time, somebody can either take control or surface a problem. One thing I have instituted lately is that support and safety divers have to use scooters - the speed is a must. It is funny that Spec Warfare comes to our dives and studies our proceedures and helps us with them, but the big shots on here have it all figured out following their PADI Rescue class or a stint playing parmedic in a classroom. ajmarve@ba*.ne* wrote: > > G, BIlly, et al, > > What I would like to know is, how do you manage dives in a DIR fashion? What > are the scenarios you expect to deal with when an emergency occurs and what > drills or responses are considered correct. I have a tiny bit of experience > here, the traditional courses plus NYS EMT, 4 years mating a charter boat and > dealing with small scale problems< like towing tired/OOA, correct gear probs in > water, etc>, and participation in two major rescues< where a non breathing > drowned diver was recovered from the water and revived>. I am going to fill in > what answers i can to my own questions, both to give an idea where my thoughts > go, and as a springboard for others. , > > In reveiwing these events it has occured to me that the biggest emphasis must be > placed on preparing for the problem beforehand. You must have the proper tools > for the job, including rescue floats, lots of line, the necessary medical tools > , and a proper method for patient recovery< a hoist and sling>, some kind of > chase craft < we use a kayak> . What else do you need?? What else do the divers > need to have? > > First you need to know how many heads you have, whos diving what and whos diving > with whom, and what they have planned. Then you need to keep track of who is > where and when. the best tools for this are a clipboard, paper and pen. correct? > > You then need someone to use these tools to keep track of whats going on. This > person should also have the general authority to organize and coordinate any > needed action. On a boat the best person for this is the captain. correct? > > The people go in and dives ensure. Problems then arise. Now how do you recognize > these problems? how do you respond to these problems? > > If the buddies get seperate they are suppose to surface right? or at least > return to the planned exit point? < anchor line?> > > If your out of gas and seperated, you ascend and get more gas, go back down > right? does your buddy wait on the bottom? does he have a planned turn point for > the dive? I realize a core point is that buddies never seperate, but what if > they do? rule #1 for future dives, but how do you get out of that particular > exposure? > > Are you using lift bags to signal to the surface? You signal why? in what > situations? do you use color coded signals? slates attached to the bags? do you > always send a swimmer to check the bag? always tie off the bag to the boat?? is > there a reason to let the bags drift away< i cant think of one> > > Now lets consider a scenario and possible options: > you and buddy are diving, lets say double 80 and double 40's, or double 160's > and 98's, either way it really doesnt matter here, we will just assume you can > manage yourself and buddy and that both float as advertised > > buddy begins to have problem, lets say AGE, where a bubble has inflicted > mechanical damage to buddys pulmonary system, and he is going down fast, lets > say worst case tension pneumothorax leading to cardiac tamponade. buddy goes > unconscious, loses ability to maintain airway. O2 levels in core tissues, like > oh say brain are dropping fast. > > What do you do then? You take buddy to surface, apply o2 via fastest most > effecive method, then what? > > Anchored diving you are right off the bow, can yell to the boat and expect to > have assistance w/in say 2 minutes > > drift diving you are now waiting on the boat, there is no swimming anywhere w/ > buddy b/c you were DRIFT DIVING to begin with so what now. > > You ditch buddy's gear, and yours as necessary, ?? then?? > > You get buddy on deck, by what means? We have a gin pole hoist with a block and > tackle, and a belt harness that we got from a friend in construction. this belt > is the type used for saftey rigging of steel workers 60 stories up and such. The > stokes littler is available for air extraction, but we dont see the usefulness > in risking dropping it over the side. We had to use a rope with a knot for the > first serious guy, that was a serious bitch. The belt worked for the second guy > and has worked for lifting stroke rigs as well. the boat is say 8 feet above the > water, its an oil well crew boat. > > When he is prone on a dry deck, then you do abc, primary assesments and proceed > as indicated by protocols< i have to as an emt>, what would you do different? > > One of the things i have learned from trying dir methods is that they work. I am > just trying to learn some more. I know that one thing often mentioned is that > the basics are the core of system, as in the padi ow1 methods. Whats id like to > know is, is there anything special to applying them. Anything not to do there? > > Im open to other voices and ideas, but dont expect me to french kiss stupidity. > > Al Marvelli > > Karen Nakamura wrote: > > > Bill - > > > > With all due respect, do you even bother to read the arguments of those you > > are refuting? Or are you simply just hopping up and down? > > > > I believe in the scenario we've all been talking about, we're on dry land or > > the boat. If you're truly able to explain how you (one person) floating in > > the water can use your demand regulator's purge valve to inflate your buddy, > > I'd like to hear that. Even two of you floating in the open water are not > > going to be able to effectively purge the reg; cover the exhaust; tilt the > > victim's head, and gauge effective inflations. You're better off heading for > > the boat/shore at double-speed. > > > > You can't really swim at any speed if you're using a reg. You can still swim > > slowly doing EAR on a victim. Retake your rescue course if you forgot how. > > > > My suggestion was that (on the shore/boat) in lieu of better equipment (a > > proper O2 system); doing EAR using donor breaths inhaled from the O2 reg (so > > that the victim is receiving about 96% O2) is much better and much safer > > than the crazy regulator method. > > > > People mentioned that they're worried of tiring using EAR/CPR. This is a > > common phenomena, even a strong person has trouble keeping it up for more > > than 15 minutes. Rather than switching to reg purging (when you're already > > tired and anoxic), take breaths from the deco/nitrox bottle. Ask a passerby > > to switch for you. If you've done CPR for 30 minutes and no one has stopped > > to say 'hello' and called for an ambulance and your patient is still not > > breathing, well..... things don't look good. > > > > I think every rescue diver wishes that they could use their deco bottles and > > demand regs as effective resuscitating devices. The simple fact is that they > > are extremely hazardous. Even a trained paramedic would shy away from this > > setup; and it's not something you would recommend to untrained personnel. > > > > To suggest otherwise is placing lives at risk. > > > > Karen Nakamura > > > > > David, when you paramedics turn up with a bag and mask system, > > > I'll be happy and relieved to stand back and hand over to you > > > guys. Same with Ms Nakamura and her boat with the O2 system and > > > trained operators on board. > > > > > > But here's the problem. What do we do till you (and she) get > > > there? > > > > > > > -- > > Send mail for the `techdiver' mailing list to `techdiver@aquanaut.com'. > > Send subscribe/unsubscribe requests to `techdiver-request@aquanaut.com'. > > -- > Send mail for the `techdiver' mailing list to `techdiver@aquanaut.com'. > Send subscribe/unsubscribe requests to `techdiver-request@aquanaut.com'. -- Send mail for the `techdiver' mailing list to `techdiver@aquanaut.com'. Send subscribe/unsubscribe requests to `techdiver-request@aquanaut.com'.
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