Accident Management

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Diving Emergencies
Main Topic Areas
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Problem recognition
Unsafe Diver behavior
Stress
Panic
Accident Management
Problem Recognition
Learning Objectives
• Identify the best time to begin evaluating
yourself and your dive team for potential
problems.
• Best place and time to evaluate the team:
Pre-dive during briefing and gear up.
• Pre-dive warning signs:
– Fixation with minor gear problems,
– Idea fixation (sharks, depth, kelp, current,
waves.)
– Data collection fixation
• In-water warning signs:
– Mask off on surface
– Jerky movements
– Loose weight belt
– BC inflated to the max
– Treading high out of the water
– Struggling to stay at the surface
Early warning signs of diver stress or
difficulty may be as subtle as an altered
breathing pattern such as panting.
Unsafe Diver Behavior
Learning Objectives
• Provide examples of unsafe behavior and
discuss causes, recognition and
prevention of each.
Unsafe Diver Behavior
• Poor diving techniques
– Failure to check water prior to entry.
– Diving with equipment problems.
– Diving when unhealthy
• Permanent contraindication
• Temporary contraindication
– Diving when physically unfit to dive
• Temporary condition
• Long term condition
• Drugs and diving.
– Street drugs.
– Prescription drugs.
– Over the counter drugs.
– Decongestants
Drowsiness
– Pain killers
Can't feel squeeze
– Seasick
Dehydration & drowsiness
Stress and the Diver
• Compare the two types of stress.
• Describe the 3 primary factors which
determine an individual's reaction to a
stress situation.
• Give examples of causes of stress and
possible responses.
• List and describe 7 steps in stress
management.
Physiological Stress
• Undesirable interaction between the diver and
the environment resulting from physical stimulus.
stimulus
rough conditions
cold
fatigue
equipment
response
fatigue, motion sickness
hypothermia, fatigue
cramps, air starvation
overexertion, hypothermia
Unrecognized physiological stress can
lead to psychological stress.
Psychological Stress:
• Undesirable emotional reaction to physical
stress or to one's own beliefs and
attitudes.
• The stimulus can be real or imaginary.
Either way, the end result is stress.
• The severity of the reaction depends on
the strength of the beliefs.
Contributing Factors
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peer pressure
ego
travel
inexperience (activity or site)
long layoff
gear discomfort (emotional, unfamiliar with gear)
Environmental issues
weak water skills
Signs of Psychological Stress:
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change in personality
idea fixation
pale or withdrawn
nervous laughter
irritable
fixation with minor gear problems
refuses to acknowledge any of the above
Stress Management
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Advance Visualization Anticipate and be prepared.
Prevention:
Observe and interact.
ID and Solve Problems Give solutions not problems.
Avoid negative words.
Assist in Decision
No undue encouragement or
pressure.
• Stop, Think, Act
Have a plan ready to put into
action!
• Control Breathing
Deep/Slow abdominal breathing
has a calming effect on the
diver as well as the rescuer.
Panic
• Studies show that panic has killed many
divers even in cases where the stimulus
was relatively minor.
Panic
Learning Objectives
• Identify the causes and signs of panic .
• Track the physiological development of panic.
• Compare the two types of panic.
• List and describe the three steps in panic
prevention
• Discuss techniques for controlling a panic
situation.
• Compare the responses of a stressed vs. a
panicked diver.
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Causes of panic can be:
environmental
Physiological psychological
one extremely stressful situation
series of small stimuli may snowball.
The onset of panic may be sudden or very
gradual.
Signs:
The initial signs of may subtle such as
altered breathing.
• big eyes
• jerky/thrashing movements
• idea fixation
• inappropriate responses
– Active
– passive
• high treading
• pale face
Physiology of Panic:
• adrenaline rush
• panting
• feeling increasing need to breathe
• loss of buoyancy
• fatigue leading to exhaustion
• perceptual narrowing/tunnel vision
• PANIC either active or passive
Types of Panic
Passive:
The diver withdraws to the point of
becoming catatonic and is unable to
provide self-rescue.
Active
The diver goes crazy and may become
physically uncontrollable.
Prevention
• Advance Visualization
• control breathing
• relaxation
• dive within limits of training and experience
Panic vs. Stress
Panicked Diver: May be either completely
unresponsive or likely to grab anyone or
anything for support.
Stressed Diver: May be capable of rational
behavior and respond to simple
commands, or may be unresponsive, or
may grab anyone or anything.
Control Techniques:
• stop activity
• control breathing
• solve the problem
• establish appropriate buoyancy
• rest
Accident Management
• LEARNING OBJECTIVES:
• Outline 7 steps in accident management.
• Describe the primary concern when directing
other rescue personnel.
• List three areas of concern when contacting the
local rescue agency.
• Name at least one national agency which can
give advice on diving accidents, and describe
the proper procedure for contacting this agency.
• List 5 precautions which should be taken in the
event of a helicopter evacuation.
Anticipate:
• prevention:
– assess divers &conditions, ID potential problems
• preparation:
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med. history form
emergency contact info
evacuation plan
equip. (be familiar with location and operation)
• readiness
– be ready to enter the water now!!!!!
Assess:
Stop,Think, Evaluate and form a plan.
Act
Implement the plan within the scope of
training.
Assign Tasks
Do not endanger inexperienced divers!
• establish a chain of command
• phone callers
• spotters
• team of scuba divers follow the surface
diver
• I.D. victim and find buddy and personal
effects
• secure victims gear, rinse it, and hold for
the authorities.
Attend to Injuries
• 1st Aid
• CPR
• 02
• treat for shock
• Med. attention
• No further harm!
Administrate
• Keep a record of what goes on.
• Just the facts.
Arrange Evacuation:
• Opening statement establish scuba accident.
• ID exact location.
• Stay on the phone/radio until told to hang up.
• Advise those involved that help is on the way.
• Meet EMSS or mark area/boat so it is easily
found.
Don't assume that the local agency is
familiar with dive injuries.
It may be necessary to:
• Advise of the need for 02 due to possible
bends or embolism.
• Where appropriate, advise of precautions
regarding altitude.
Helicopter evacuation:
• Secure all loose objects.
• Keep people clear of landing zone.
• Maintain eye contact with pilot.
– Never approach from the rear.
• Allow basket or cable to ground itself to
avoid shock from static electricity.
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