Floating Bob

In my last post I talked about how myself and two buddies ended up in a tight situation when one of us, Bob, passed out at depth.  We were 138' down, with no anchor line, in a current with a deco obligation, no reel and no float. We're now trying to get Bob back.  The  other guy in the "we" is Bob's regular buddy, Dave (both are pseudonyms).  I think that just about sums it up.


As we started to rise in the current, keeping all three of us together was a bit of a challenge.  Both Dave and I were managing Bob's buoyancy but, because we were hunting, we had all packed on some extra lead to keep us glued to the sandy bottom.  This meant we needed to choose between adding lots of air to our BCs to lift him or adding some air to all of us and carefully managing his buoyancy.  Dave pumped a bit of air into Bob's BC as we left the bottom but he was still quite negative as we ascended.

At 50' Bob suddenly showed signs of life.  Then he got combative - very agitated.  He was scared, confused and clearly didn't like the fact that Dave and I were each holding onto his webbing with one hand and one arm with the other.  He was really hard to handle. Faced with him knocking one of our regs out we each released him.  Bob responded by dropping away, making no effort to stabilize his buoyancy.  I dumped air and went after him catching him about 10' down.  This time we made it clear to him that he was out of the running-his-own-ascent business. Privately I made the decision that, if Bob started fighting us again, I was going to try to make him positive and send him up but positive or not, I would have to let him go..  We were too low on air to mess around and I was definitely going to make it home.  Later, Steve told me that he made the same decision.  Neither of us was going to let this spiral into the loss of three divers.

 The good news was that we'd cleared our 50' ceiling while messing around with Bob and were now cleared to 30' for our next stop.  All the while, we are drifting further from the boat.  After clearing 30' without incident we FINALLY began our safety stop.  After a couple of minutes, I couldn't take the continued drifting and decide to pop up and see where we were with respect to the boat and give them a signal.  As I waved my arm to show distress, Dave and Bob surfaced next to me.  Anchored and with divers in the water, our dive boat could not come and get us.  We were going to have to swim into the current, dragging Bob.  Meanwhile, the crew of the dive boat let out all of their safety line and more (other nylon lines were thankfully on board).  Though working hard, we were making little headway but at least the drifting safety line was getting closer and closer.

Finally catching the line, we told John he was going to have to haul his own ass home.   As all of us pulled had over hand toward the boat, Dave and I were spent.  By the time we reached the boat, I was a tangled mess of safety line.  Apparently the float had caught on my tank and I'd dragged most of the line back with me.

On board, Bob was a lot more lucid.  He told us that he hadn't been feeling well that morning but wanted to dive the whole weekend.  He explained that, while on the line, he'd experience an episode of vertigo at 45'.  But it cleared after a minute or so and he continued the dive.  I told him that was f*#@ing awful decision that very nearly cost him his life.  He should have scrubbed the dive - no question.

They say that any dive you come back from is a good dive.  I beg to differ - that sucked!! Looking back, I'm amazed we succeeded.  We did so many things wrong that we really didn't deserve to.  

1. Bob should have scrubbed the dive.
2. We should have checked with Bob about his problem when we hit bottom.  We had a slate.
3. We should have put a strobe on the anchor line.  The viz was pretty fair - we definitely would have seen it (actually, its probably a good idea for many of us to carry one to hook onto  the line if the dive boat doesn't - I'll try to review some in a follow-up post).
4. Apparently putting the reg back and purging it isn't the recommended approach (you can over-pressure the guys lungs, I think).  The recommended procedure is to send the guy up buoyant so the folks at the surface can begin to treat him - but I'd love to hear different opinions here.
5. We should have turned back sooner.  This wasn't a planned deco dive and we pushed it to the limit.  When things went bad we had no margin of error.
6. We didn't have reels or bags to tie off to control our drift.  This would have been a huge psychological plus as well.  In my opinion, everyone who diving in a current from a fixed boat (i.e. not a planned drift dive should carry at least a finger reel and large size safety sausage.  I now carry a small, ventable bag and a wreck reel with a ton of line on every dive over 70'.  It's a variable drag reel so, instead of blowing a bag, I can just let line out as I ascend.
7. We should have had more air.  Right after this I switched to steel 120s and I make sure I have more than enough air to handle a rescue and get myself back.  I also carry a pony for deeper dives.  That is really a redundancy thing but it came in useful on another rescue (see Big Guy Out Of Gas).
8. We didn't dump Bob's weights - I have no excuse.  In fact, we all could have dropped our extra poundage (beyond what we needed to be neutral) and the task loading on the ascent would have been WAY less.
9. We didn't dump the damn lobsters!!!  In the confusion, we forgot all about them but those goodie bags were a major source of drag on the swim back to the boat.
10. Oh yeah, and Bob should have scrubbed the dive nullifying items 3 to 9.

I'm sure there are many more lessons here - feel free to add to the list.  We also did some things right that might have tipped the balance in our favor.

1. For two guys who didn't usually dive together, Dave and I worked really well together.  He's a great diver and either I was a great asset to him or the other way around.  Either way, it was good to have a team mate.
2. We didn't panic - well, ok, I'll admit to panicking when the reg was out but, after the initial burst of adrenaline, I calmed down and we worked the problem the best we could.
3. We were both very fit.  That was actually a huge part of the rescue and not just on the swim back.  

On the way home I totalled up the costs for the hunt: $150 for hotel, $330 for boat, $ 60 for fills plus food and tip- that's one expensive way to get some lobster ... so we saved it for a special occasion:)

Dive safely,

Phil

Read more >>

DAN on IPE

Hi. Just a quick note on Immersion Pulmonary Edema. DAN has a good summary on IPE.

http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=82

I think the symptoms are accurate and all divers need to be aware. I would add that hyperventilation was also present in my case as I failed to rid my body of CO2. However, I don't agree with the suggestion that divers return to diving. I know of at least one fatality due to IPE in a diver who suffered a prior incident. In my opinion, returning to diving when the recurrence rate is finite but unknown is irresponsible as it may place a buddy at risk.

Dive safe,

Phil



- Posted using BlogPress from my iPhone

Read more >>

Diver Unconscious - No Reg

To get NC lobsters you need to dive to 130+ feet so it's right on the edge of recreational.  On the other hand, NC lobsters are HUGE!  With no active fishery, these suckers grow to as much as 15 lbs (probably more) and run around the bottom like a pack of dogs.  It's quite an experience!  If you want to go, I suggest calling Bobby Cox, captain of the Diver Down, and ask him to take you to the Live Bottom site.  We weren't on his boat this particular morning nor at that site but there's a ton of "bugs" out there and the current is way easier than some other sites.

We splashed for our second dive around 10:30 am.  There were three of us, let's call the other guys Dave and Bob.  Heading down the line the order was Bob in the lead, then me, then Dave.  At about 45' Bob stopped descending.  Dave and I held our positions above him, our bodies horizontal in a stiffer than usual current.  After about a minute, Bob started to descend again and we were back in business.  A quick, buddy check at the bottom, check depth (136') and air; the hunt was on!

For starters, we were really BAD!  This was my first trip and while I'd figured out how to catch the spiny beasts by this point in the weekend, I was clueless about  how to stuff a ten-pound, writhing mass of spines and spikes into a mesh bag.  I caught four in all. The three big ones beat the crap out of me and took off, having shredded my dive gloves. Somehow I managed to get the last, admittedly smaller, one into my bag.  Looking to my right, I saw that Dave had also managed a success (though with a substantially more hefty lobster, grrr).  Checking my computer, I saw we were out of bottom time and turned to Bob and gave him a thumbs up.  He flashed me an OK and I turned and had the same exchange with Dave who was lovingly inspecting his catch.  It took just a minute or so to get his attention.

The anchor line was to our left but when I turned to head that way I was stunned by what I saw.  Bob was unconscious (or barely conscious - the lights were on but there was definitely nobody home).  His eyes stared, unblinking.  Worse still, he wasn't breathing!  His reg was out!  Acting on impulse, I purged his reg and shoved it in his mouth (perhaps not the best thing to do but there seemed little downside).  Thankfully, amazingly, he started breathing and coughing.  I held the reg in to make sure he didn't spit it out again.

I looked at Dave.  There really should be a sign for WTF???  He had no idea what to do either.  So I tried to bring Bob back to us by shaking, pinching and otherwise abusing him. Nothing worked. All the while precious minutes were ticking by. We were starting build a small but significant deco obligation.

We decided to head up with Bob.  I asked which way to the anchor line and got a shrug in response.  It was like the adrenaline-fueled action with Bob had wiped clean my short term memory.  Everything, in every direction, looked the same.  Neither of us had any idea where the anchor line was.  We were at 138' with an unconscious diver, a deco obligation and a fair current.  No bag, no wreck reel, no way to tie off.  We were screwed!!

next time - Floating Bob

Read more >>

No Substitute for Practice

Three years ago, while diving in Lake Rawlings quarry in Southern Virginia, my dive buddy and I encountered a frantic and exhausted diver at the surface.  Between thrashes we got the idea that his buddy was missing somewhere in the area.  Looking down, I could barely see twenty feet.  I hoped he was somewhere close.  My buddy stayed with the guy on the surface, inflating his BC and rolling him onto his back to rest.  As I descended, the guy started freaking out again - we had our hands full!

At 40 ffw I reached the bottom.  The midsummer sun had warmed the quarry considerably and algae was in full bloom.  The viz was 10 feet at best.  I began a grid search, arbitrarily picking my right side to work first.  10 kicks, turn, 10 kicks, turn ...  On the third pass, I spotted the victim motionless and face down among the algae.  Bass and bluegills clustered around him in the murk, scattering as I approached.

He was a big guy, maybe 6'6", fit looking.  Turning him over, his eyes stared unblinkingly into mine.  I hauled him to a vertical position and began our ascent.  Arriving at the surface, I spotted my buddy churning away toward the dock with the now pacified surface swimmer in tow.  I inflated both of our BCs and pulled the reg for my victim's mouth.  At least there was a chance he hadn't drowned.   Kicking with both legs, I rose out slightly and began rescue breaths.  After several breaths and no response, I began kicking toward others who were heading out to meet me.  In a macabre parody of my earlier search, we fell into a rhythm.  10 kicks, breath, 10 kicks, breath.  For a quarter of a mile!

After what seemed like an endless swim, he suddenly coughed into my face and came to, thrashing his way back to life.  I positioned myself behind his tank, knees on either side and held him steady until he calmed down.  By that time the other divers had arrived and, together, we towed him to shore.  As we entered the shallows, he broke character and slapped me on the back.  "Well done! Really good job!"

Image by Earl - What I Saw 2.0 via FlickrThe 'rescue' was the finale of our rescue diver courser led by Zane Frye of Richmond Dive & Travel.  A former military man, Zane had put us through an exhausting two days of drills, skills and thrills.  Along with several nights of classroom work we had learned what to do and had developed many of the skills to do it.  It was one of the best times I have ever had diving.

Though I had several rescues under my belt, these had been ad hoc efforts.  Through the course I had the opportunity to learn and fail without someone's life being at risk.  A year later, I used many of these skills in rescuing a diver out of gas at 100'. A year after that, I used the skills to plan my own rescue as I fought a medical problem on a dive.

Rescue courses are offered by PADI, NAUI and most of the major certification providers worldwide.  
Here's a partial list:

PADI - Rescue Diver Primary & Secondary Care Course

TDI/SDI Rescue Diver

NAUI Rescue Diver


If you have a weekend free, I highly recommend taking one, perhaps with your regular buddy if you have one.  You will have a ball, you'll be a better diver and it may well save your life.

Dive safely.

Related articles

• Local divers rescued after 17 hours in Gulf (uwtreasures.wordpress.com)
• HK diver and US instructor killed in Subic Bay outing (uwtreasures.wordpress.com)
• Rescue Diver (learntodivetoday.wordpress.com)

Read more >>

Best Diving Advice EVER! (and some stuff about the psychology of survival)

Spoiler Alert - if you haven't seen the movie 127 Hours, and have no idea what happened to Aaron Ralston, and didn't read his bestseller "Between A Rock And A Hard Place", and still somehow care about seeing the flick for the shocking ending, go watch it now before proceeding.  


A few months ago, my family and I watched the movie 127 Hours.  It is the story of Aron Ralston's fight to survive after getting trapped in a slot canyon, alone and beyond help.  In the end, he cuts off his arm below the elbow to get free and then hikes out.  At the edge of his endurance, dehydrated and weak, he spots, on the trail ahead of him, hikers who may be his salvation.  He tries to yell to get their attention.  All that comes out is a croak.  At this point I, very uncharacteristically, went to pieces.


I had been getting more and more tense as I saw him move in slow motion (relative to a dive accident) through the phases of survival.  However it was the croaking and its link to my own IPE accident in June 2010 that really struck home.  Wracked by sobs, I was overwhelmed by the dread I felt in the face of death by drowning, the guilt I felt about passing my son to a friend when I could no longer be his buddy, and the relief that I was alive.  Later, I was able to talk to my wife for the first time about the experience.  Not the events (this happened, then this happened, and so on) but the battle that raged between my ears as I fought for survival.  I'll do my best to describe that process here.


Image via WikipediaBut let me start with something practical.  The very best advice I have ever received from any diver, I got from famed explorer Richie Kohler.  He was discussing the dangers of deep wreck diving and shared this thought which I have passed along to folks as "Kohler's Rule": When facing an incident underwater, be it entrapment, a bad reg, zero viz or whatever, Richie advises to stave off panic by checking two things. 1. Am I still breathing? (if not, you are in seriously deep shit), 2. Can I grab my ass? (If not you may be mired in deep shit).  It's brilliantly simple.  What Ritchie was trying to point out is that most if not all problems are solvable if you have time and mobility.  Free flowing reg? Still breathable? Still have mobility?  Great!  Then work the problem! 


Kohler's Rule is both funny and profound but, most importantly, it is very memorable!  Please pass it along, with attribution to the divers you know.  It saved my life (thanks Richie).


Ok, so back to the accident. 


In June of 2010, I experienced Immersion Pulmonary Edema during a dive off the North Carolina coast.  Coughing started at 50' and became wore and worse culminating in near-respiratory arrest after reaching the boat.  While rare, IPE is a terrifying condition because one leaks fluid from their blood stream into the lungs without aspirating any seawater.  You drown from within.  


When I had the first cough at 50 fsw, I thought nothing of it.  I didn't commonly cough underwater but, apart from the odd, metallic taste, it didn't raise any concern.  (Stage 1: DENIAL)


But the second cough sure as Heck did!  Followed quickly by a third! (Stage 2: RECOGNITION)


At 30 fsw I was coughing continuously.  Already my diaphram was struggling to pull breaths in between the spasms.


Stage 3: ASSESSMENT: My mind moved into a sort of triage:

• OK on Kohler's Rule? Check! But check back in a few minutes.
• Depth? Now 30'.
• Noah (my son) OK? Ascending normally. Check!
• Lots of air? Check!
• Cause of cough? No idea (tingling of panic).
• Apply Kohler's Rule.  Check!

Stage 4: PLANNING: Though wracked with coughs, my training was kicking in.  I knew I was in trouble and I knew I needed a plan for the next few minutes.  Here's what I came up with:

• Goal: Get Noah and I safely out of the water.
• Ascend normally to the hang line.
• Complete 3 minute stop
• If unable to complete stop, hand Noah off to Tim (who was on the line already)
• If symptoms unresolved, surface immediately behind the boat, inflate BC and declare an emergency.

I probably could have taken Noah straight to Tim and surfaced.  I could have surfaced immediately, etc.  But the important thing for me was that I had a plan, any plan.  By working the plan, I was able to balance things a little:  on the negative side, your symptoms are getting worse and you're over-breathing your reg, but on the plus side, you're on the hang line and 1 minute into your safety stop - almost home! Yay!

By the timeI was on the hang line, I was still trying to sort through the possible causes as I started to hyperventilate.  I was really over-breathing my reg but I could not stop.  It was reflexive.  Everything I tried to slow my breathing failed.  What was weird was how my brain interpreted this.  Part of my brain sent a very clear message:  IT'S THE REG!!! SPIT THE REG OUT!!  It was insane!  I have never before had the feeling of two brains in one head but the argument that raged was intense and fighting the urge to do something fatally stupid was a tremendous strain. (Apply Kohler's Rule: Breathing? Ass? Ok, then, work the plan.)

Stage 5: ACCEPTANCE: About 2 minutes into the stop, it became clear that I was going into respiratory arrest. If I stayed, I would die and likely take Noah with me.  I put Noah's hand in Tim's and signaled them to buddy up.  Hoping beyond hope that they understood (neither was aware of what was happening for me), I ascended.

Stage 6: NEAR-PANIC:  Surfacing was very strange.  Thus far, I had kept panic at bay, moving calmly through my normal routine and plan.  As I approached the surface, I revised the plan to include a big arm wave to get attention.  But when I reached the surface, panic hit me like a freight train.  Every fiber of my being wanted to be on that boat.  The only thing I can compare it to is the feeling I had after first jumping out of a plane into free fall.  That momentary sensation that each of my cells are trying to get back into the plane (which, since it is not trailing flames and smoke, seems a much safer place to be) threatening to break loose if necessary.

I clawed at the swim step and croaked, "Can't Breathe! Can't Breathe!!"  Turning to Dave on the ladder, I croaked, "Get the F*@K off!!" and was hauled bodily from the water by the Diver Down's excellent crew.  Now on board, I expected to feel relief as I coughed up whatever was causing the issue.  Instead, I collapsed and felt a wave of horror at the realization that whatever was wrong was probably going to kill me.

I was physically and mentally exhausted, in respiratory arrest (or near to) and hypoxic.  Lacking oxygen, my brain began to shut down.I became calm, accepting death as a less horrible alternative than my current reality.  What kept me going was the support and encouragement of my buddies.  Noah at my head, Roy wrapped around my body saying, "It's Ok. We got you buddy! Stay with us." Sharky in my face imploring me to breathe in the offered oxygen.  Even a little bit.  There was for me a point where my will failed. I survived on the will of the people around me.  Noah gave me an immediate, tangible reason to live.  Roy pushed the pain and panic back.  Sharky, eyes unblinking inches from my face, had a line directly into my brain.  He said "breathe", I breathed.  He said "come on, give me another, brother", I strained for another breath, and so on.  For two hours as we raced back to shore.

Thankfully, I survived.  It is so hard to capture the emotions of the day and very hard to imagine that most of it happened in just a few minutes stretched to an eternity by suffering.  I hope some of this makes sense, that Kohler's Rule sticks with you as it has with me, and that the telling in some small way prepares you to be a better buddy or, if you are so unfortunate, to be a more successful victim.  If there's a final lesson, I feel it would be this: In an accident, your presence of mind and careful action, be it underwater or on the surface, be you victim or rescuer, could be the difference between life and death.  

Safe Diving,

Phil

Related articles

• Watch: 127 Hours (softseatingarea.wordpress.com)
• A Radical Amputation! (iampastorswife.com)
• Pinned Colorado Logger Amputates Own Toes (abcnews.go.com)

Read more >>

First Responders Day

Image via Wikipedia

A few hours ago, a friend from St. Louis texted me a reminder to think of the firefighters and police who lost their lives on 9/11.  I assume it was from Dave or Sharkey. my long-time dive buddies who h
elped me survive last year's IPE accident - coaxing breaths into me on the rocking deck of the Diver Down.  Both experienced first responders, they were there when I needed them - skilled, trained, ready, willing and able.  As Sharky once said after a night of beer and war stories, "The thing is, Phil, no-one is every sorry to see us!!"  Very true.

It is easy to forget that our lives, our way of life and our loved ones rest in the safe comfort of the protection  our first responders provide.  Be they police, firefighters, coast guard, emergency room staff, or EMTs, they train constantly to be able to put their bodies and themselves in harm's way to protect us when we are no longer able to protect ourselves.

While in past years the focus on the news and on television has been on the acts of 9/11, this year was significant in its focus on the victims and the heroes of the day.  I propose that we declare September 11th to be First Responders Day, on which we remember the tens of thousands of men and women who dedicate their lives to protecting ours.

If you agree, please up-tweet this with the hash tag #firstrespondersday.

Be safe and, to all the first responders out there, thank you for life.

Phil

Read more >>

FREE Dive Medicine E-Book

Dr. Carl Edmunds (see my last post) is co-author of the excellent, Diving Medicine for Scuba Divers,  on dive medicine.  They have also released the book as a free e-book that you can load onto your ipad, computer or smart-phone.  Its a great read.


To load the book onto your ipad or iphone, save it to your computer, then open iTunes and choose "Add To Library" under the "File" menu.  Next time you synch, it will be added to your iOS bookshelf.


Dive Safely

Read more >>