RESCUE DIVER COURSE LESSON GUIDES

1. RESCUE DIVER COURSELESSON GUIDES Knowledge DevelopmentPresentation Five

2. Knowledge Development Five Overview • The Psychology of Rescue • Postaccident Reports • Being Prepared for a Diver Emergency • Use of Emergency Oxygen • Accident Management • Managing the Scene Until Help Arrives • Responding to Diver Emergencies • Exiting with the Unresponsive Diver Rescue - Knowledge Development Five

3. The Psychology of Rescue • Postaccident Reports • Postaccident Report • Making a Report • The Statement • What to Avoid in aPostaccident Report Rescue - Knowledge Development Five

4. Postaccident Report • When should you write up a report? • Following an accident that requires first aid and the summoning of emergency medical care. • When authorities ask for a report. • For litigation and investigation purposes. Rescue - Knowledge Development Five

5. Making a Report • What are eleven questions to answer, if you can, when completing a report? • How did you become aware of the problem? • Where was the victim (depth, location, etc.)? • Was any of the victim’s equipment out of place or unusual (regulator out of mouth, etc.)? • How soon were you able to respond to the emergency? • What did you do when you responded to the emergency situation? • Were you able to identify the person you helped? Rescue - Knowledge Development Five

6. Making a Report • What are eleven questions to answer, if you can, when completing a report?continued… • What did you personally see happen? • What first aid was administered? • Was emergency oxygen necessary? Was the individual responsive or unresponsive? Was the person breathing or not breathing? • Was EMS called? At what time? When did they respond? What action did you see EMS take? • Was the victim’s gear recovered? If so, and you personally checked it, how much air was in the cylinder and was the air delivery system functioning properly? Rescue - Knowledge Development Five

7. The Statement • What statement can you make regarding the incident that will allow you to avoid questions from the media? • Refer media questions to the proper authorities. • Say something like: “Accident investigation is underway and I’m not in a position to answer questions. Please get a statement from the authorities when they have completed their investigation.” Rescue - Knowledge Development Five

8. What to Avoid in aPostaccident Report • What should you avoid doing on a report or when answering questions? • Avoid speculation and guesses. • Stick to the facts – what youpersonally witnessed. Rescue - Knowledge Development Five

9. Being Prepared for a Diver Emergency • Use of Emergency Oxygen • Administering Emergency Oxygen • Oxygen Handling Procedures • Administering Oxygen to a Breathing and Nonbreathing Diver Rescue - Knowledge Development Five

10. Administering Emergency Oxygen • Why is administering emergency oxygen to a diver with suspected decompression illness crucial? • Administering oxygen for suspected decompression illness is the dive community standard of care. • Oxygen provides significant benefit in cases of decompression illness. • Medical case histories show that prompt oxygen first aid can improve the effectiveness of recompression treatment. • Improves the overall probability of complete recovery. Rescue - Knowledge Development Five

11. Oxygen Handling Procedures • What are six procedures to follow when handling oxygen? • Keep your unit clean and protected in its box until needed. • Never attempt to lubricate or use scuba parts with your oxygen system. • Open valves on oxygen systems slowly; pressurize the system slowly. • Keep your system assembled. • Never attempt to clean or service the equipment yourself. • Always extinguish any source of flame before deploying oxygen. Rescue - Knowledge Development Five

12. Administering Oxygen • How do you administer oxygen to a breathing injured diver? • Give a breathing injured diver 100 percent oxygen supplied by a nonresuscitator demand valve unit. • Open the oxygen kit – it should already be set up. • Slowly open the valve and test unit by inhaling from the mask. • Secure the tank; the best place for it is cradled in its box. • Say to the injured diver, “This is oxygen. It will help you. May I give it to you?” Rescue - Knowledge Development Five

13. Administering Oxygen • How do you administer oxygen to a breathing injured diver?continued… • Assuming agreement, place the mask on thediver’s face and instruct the personto breath normally. • If the diver is unresponsive and breathing,assume that the diver would want oxygen,and supply it. • Monitor the oxygen pressure gauge. • Don’t let the oxygen run empty withthe mask still on the diver. Rescue - Knowledge Development Five

14. Administering Oxygen • How do you administer oxygen to a breathing injured diver?continued… • If the diver is breathing very weakly, use the continuous flow outlet and setting with a nonrebreather mask. • Open the kit and attach the tube from the nonrebreather mask to the continuous flow outlet on the regulator. • Slowly open the valve and set the continuous flow rate to15 litres per minute. • Using a nonrebreather mask, hold your thumb over the inlet inside the mask and allow the reservoir bag to inflate. Rescue - Knowledge Development Five

15. How do you administer oxygen to a breathing injured diver?continued… Say to the diver, “This is oxygen. It will helpyou. May I give it to you?” Assuming agreement, place the mask onthe diver’s face and instruct the personto breath normally. Assume impliedconsent with an unresponsive diver. If reservoir bag collapses completelywhen the diver inhales, increase theflow rate to 25 litres per minute. Monitor the oxygen pressure gauge. Administering Oxygen Rescue - Knowledge Development Five

16. Administering Oxygen • How do you administer oxygen to a nonbreathing injured diver? • If you have an unresponsive nonbreathing diver, you’ll use a pocket mask with oxygen inlet valveand continuous flow oxygen. • Attach the oxygen tube from the continuous flowoutlet to the pocket mask. • Slowly turn open the valve and set the flowrate at 15 litres per minute. • Give rescue breaths through the pocket mask as usual. • If the diver begins to breathe, switch to the demand ornonrebreather masks. Rescue - Knowledge Development Five

17. Accident Management • Managing the Scene Until Help Arrives • Waiting for Emergency Care • Collecting Information for Emergency Medical Services Rescue - Knowledge Development Five

18. Waiting for Emergency Care • After beginning primary care, secondary care, oxygen and other first aid as needed for a patient, what do you do for the patient while waiting for emergency care to arrive? • Maintain a vigilant watch over the primary ABCD’S. • An injured diver’s condition can change from breathing to nonbreathing and from responsive to unresponsive quickly. • Protect the diver from excess heat or cold. • Control bystanders to keep area free for emergencymedical personnel. Rescue - Knowledge Development Five

19. Waiting for Emergency Care • After beginning primary care, secondary care, oxygen and other first aid as needed for a patient, what do you do for the diver while waiting for emergency care to arrive? continued… • Maintain contact with your local diver emergency service. • Keep the diver as comfortable as possible, butlying down. • Provide oxygen until you get the diver toemergency care. • Do not attempt to recompress someone in the water. Rescue - Knowledge Development Five

20. Collecting Information forEmergency Medical Services • What information should you collect to send with the injured diver upon the arrival of emergency medical services? • Diver’s name and contact information. • Significant medical history. • First aid procedures initiated. • Dive profile information. • Comments relative to emergency care received. • Contact information for local diver emergency system and name of doctor or personnel you’ve spoken with. Rescue - Knowledge Development Five

21. Responding to Diver Emergencies • Exiting with the Unresponsive Diver • Six Techniques for Exiting the Water • Circumstances Affecting Your Exit Rescue - Knowledge Development Five

22. Six Techniques for Exiting the Water • What are six techniques for exiting the water with an unresponsive diver? • Saddleback carry: • The injured diver is stretchedacross the rescuer’s back. • Normally used as a shore exit. • Fireman's carry: • The injured diver is swungacross the rescuer’s shoulders. • Normally used as a shore exit. Rescue - Knowledge Development Five

23. Six Techniques for Exiting the Water • What are six techniques for exiting the water with an unresponsive diver?continued… • Packstrap carry: • The injured diver is draped over the rescuer’s backand arms are pulled over the rescuer’s shoulders. • Roll Up technique: • Blanket, net or tarp can be loweredform a pier or boat deck to roll upan injured diver. Rescue - Knowledge Development Five

24. Six Techniques for Exiting the Water • What are six techniques for exiting the water with an unresponsive diver?continued… • Lifeguard exit: • Place the injured diver’s hands on the deck. • Lift yourself from the water with one hand onthe victim’s hands so the victim doesn’t slideback into the water. • Hold the diver by the wrists and stand, bringvictim's waist to dock level. • Lower the diver face down on the deck, thenroll the victim over. Rescue - Knowledge Development Five

25. Six Techniques for Exiting the Water • What are six techniques for exiting the water with an unresponsive diver?continued… • Ladder exit: • The injured diver is straddled over therescuer’s high thigh and shoulder cradlesbetween the rescuer’s arms as therescuer climbs the ladder. • Rescuer steps up one rung with highthigh (with victim), then brings other footto same rung and continues up ladder. Rescue - Knowledge Development Five

26. Circumstances Affecting Your Exit • How can circumstances affect your exit with an unresponsive diver? • For shore exits without help: • Give two slow breaths and then carry the diver ashore using the saddleback, fireman’s carry or the packstrap carry. • If the diver is too heavy to carry, simply drag the victim ashore by the wrists. • When exiting through surf: • Protect the victim’s airway – use a pocket mask. • If you have trouble standing, crawl out with the diver ratherthan walk. Rescue - Knowledge Development Five

27. Circumstances Affecting Your Exit • How can circumstances affect your exit with an unresponsive diver? continued… • Exits over rock (avoid if at all possible): • Proceed cautiously and allow the water to carry you and the injured diver up the rocks in stages. • Brace yourself for the next wave. • A longer swim to an easier exit may prove the fastest way to get the victim out of the water. • Expecting help: • Consider staying in the water, maintaining the airway and/or giving rescue breaths until help arrives. Rescue - Knowledge Development Five

28. Circumstances Affecting Your Exit • How can circumstances affect your exit with an unresponsive diver?continued… • Exits onto swim steps: • Swim steps, low docks and small, stable boats may be easiest using the lifeguard exit. • For a tall dock, boat or pier, you might be able to use the roll up technique with a tarp, net, rope or even several lengths of fire hose. • A second rescuer available: • One rescuer can continue rescue breathing while the other goes ahead and prepares exit equipment. Rescue - Knowledge Development Five

29. Circumstances Affecting Your Exit • How can circumstances affect your exit with an unresponsive diver?continued… • Interrupting rescue breaths: • The priorities are maintaining rescue breathing and contacting emergency medical care. • It may be impossible to exit the water without interrupting rescue breaths more than 30 seconds. • Do the best you can and resumerescue breathing/start CPR assoon as possible. • The victim has a better chance outof the water than in it. Rescue - Knowledge Development Five

30. Final Exam • To be certified as a PADI Rescue Diver, you must show mastery of the material by demonstrating acceptable performance on the PADI Rescue Diver final examination. • There are 50 multiple choice questions covering the material you have been studying. • You need to score 75 percent or higher and demonstrate mastery of all exam items. • A score less than 75 percent requires a retest. Rescue - Knowledge Development Five

31. Knowledge Development Five Review • The Psychology of Rescue • Being Prepared for a Diver Emergency • Accident Management • Responding to Diver Emergencies Rescue - Knowledge Development Five