Scuba student loses consciousness during Seattle dive

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ljjames
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Re: Scuba student loses consciousness during Seattle dive

Postby ljjames » Wed Nov 26, 2014 8:25 pm

I think it's important to discuss details and learn from experiences, which seems to be less frowned upon in incidents that don't involve a fatality.

Thanks the strong work of the associated divers and the plankton gods, maybe when she is ready, she will be able to weigh in at some point and give us the story from her perspective so that we might connect a few more dots. This is SO KEY to understanding if possible, and quite unusual.

I've recounted my personal CO2 experience numerous times, and I know it helped a few people understand their own experiences better, and in some cases helped folks recognize what was going on and learn how to better manage their diving and head off potential CO2 adventures for the most pleasant diving experience possible.

It may also help buddies understand and recognize what might be going on when their dive buddy is seeming 'off' underwater, and perchance help head off future situations. "hmm, my buddy's dive light pattern seems twitchy, and they are not responding in the normal fashion, maybe they are just distracted and checking their gas, sorting out buoyancy, or maybe I've been swimming a bit fast because i'm excited to go video something, and we could slow down and even ascend up the slope a bit". In this case someone noticed something and was there to help. ALL HAIL THE BUDDY SYSTEM :)

Dusty2 wrote:What ever happened I'm just glad that it turned out well and she went home breathing! Thanks to all who helped us have this happy ending!
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Re: Scuba student loses consciousness during Seattle dive

Postby fmerkel » Wed Nov 26, 2014 5:44 pm

The article was long but detailed. Easier to follow the slide show. Devastating thing to go through.
Sure dampened my enthusiasm for deep CCR cave diving. :eek:
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Re: Scuba student loses consciousness during Seattle dive

Postby CaptnJack » Wed Nov 26, 2014 11:07 am

Its not all that uncommon for panicky divers (or working too hard at depth) to pass out.

Here's another example from Norway. Much deeper but they were on mix for sure.
newspaper:
http://www.helsinkitimes.fi/lifestyle/11212-deep.html

diagram/slide show:
http://translate.google.nl/translate?sl ... edit-text=

The CCRs were found not at fault, the current thought is that they basically panicked, their breathing obvious went up a lot and that put them into a CO2 runaway situation and then they rapidly passed out and drowned. The first got stuck, the later fatalities were just panic due to seeing their buddy drown.
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Re: Scuba student loses consciousness during Seattle dive

Postby fmerkel » Wed Nov 26, 2014 10:41 am

Not trying to beat up on the forum or the diver involved. I'm absolutely glad everything turned out fine. But I am curious what kind of physiological process could create an event like what happened.

Thank you Laura and Lynn for your input. It gives me something to 'chew on'. I've got a lot of experience on ventilation above water, but there is little actual data on what goes on below water. Mostly what is available is speculation. I'm trying to get a personal/professional handle on the apparent discrepancies. The environment and the processes involved make it about impossible to actually get any kind of physiological parameters while diving.

Thank you Laura for your offer to try to personally create the experience. I'll have to think about that. The idea scares the hell out of me.
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Re: Scuba student loses consciousness during Seattle dive

Postby Dusty2 » Wed Nov 26, 2014 3:36 am

What ever happened I'm just glad that it turned out well and she went home breathing! Thanks to all who helped us have this happy ending!

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Re: Scuba student loses consciousness during Seattle dive

Postby ljjames » Tue Nov 25, 2014 7:43 pm

<apologies for the thread drift>

There is so much we don't even know on the surface about these things, it's no wonder that they seem a bit daunting to tease apart when mixed with all the other variables of being underwater.

LCF wrote:It's true that, in general, the body detests excess CO2, and people are very uncomfortable if their CO2 levels go up acutely. However, it has been documented that some divers appear to have a significantly increased tolerance for CO2 while diving, which suggests that the CO2 trigger is somehow blunted while someone is underwater.

In the case of our student, it was his first trip to that depth. He was able to go back on another day and complete the specialty, and he is still diving. That goes to the fact that narcosis is individual AND variable on a day-to-day basis.
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Re: Scuba student loses consciousness during Seattle dive

Postby LCF » Tue Nov 25, 2014 6:51 pm

It's true that, in general, the body detests excess CO2, and people are very uncomfortable if their CO2 levels go up acutely. However, it has been documented that some divers appear to have a significantly increased tolerance for CO2 while diving, which suggests that the CO2 trigger is somehow blunted while someone is underwater.

In the case of our student, it was his first trip to that depth. He was able to go back on another day and complete the specialty, and he is still diving. That goes to the fact that narcosis is individual AND variable on a day-to-day basis.
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Re: Scuba student loses consciousness during Seattle dive

Postby ljjames » Tue Nov 25, 2014 4:29 pm

Not gonna quibble about the usage of the hyper/hypo, other than to say that it is often used differently in diving lingo vs hospital lingo.

BUT, i am gonna beat on the retained CO2 dead horse a bit, since y'all know its one of my favorite topics, and it hasn't been beaten much as of late ;) Image

What I will point out is that a lot of people confuse what is actually a host of issues (layperson terms here again) "retained" CO2 in blood (CO2 produced is more than CO2 being expired for whatever reason) vs. dead space CO2 (ineffective ventilation, full face mask, CCR design whatever) vs. CO2 scrubber breakthrough (in CCR's).

Generally what I feel impacts divers most often (again, layperson talking here) is nitrogen narcosis + CO2 build up in the body due to either rapid shallow breathing or skip breathing or most likely overwork for the rate CO2 exchange by lungs due either due to skip breathing, holding breath, or increased breathing resistance of equipment. I would argue that there is a tipping point, and I agree that people don't like CO2 build up in our system and even less so at depth. Once it gets to a certain point, (usually caused by trying to swim a bit harder or slow shallow breathing to not move when shooting a photo) coupled with some nitrogen narcosis, then it can hit what feels suddenly like a ton of bricks, I say 'feels' sudden, but if you are paying attention, you can actually feel the niggle coming on. Most people on a regular recreational dive (where the are not chasing to keep up with an instructor or mentor) handle this subconsciously at times by easing off on the swimming pace, stopping to look at something (and showing it to their buddy) hanging out shallower/above their buddy by 10' or gently swimming up slope without even realizing they've essentially 'turned' the dive.

Fritz, I'm happy to go out swimming with you and I'm quite sure we can demonstrate it with pretty much any high performance regulator you want to bring. (of course I'll be on trimix, because it's amazing what a wee bit of helium can do for breathing resistance and narcosis and one of us will want to be clear headed) we can do it swimming the boundary line in Cove 2 or trying to dig some heavy object out of the sediment and drag it around without a lift bag in the 50' zone :)

Most often, in class, it happens when a diver (student or otherwise) starts chasing their buddy, or trying to keep up. Because of what presents like narcosis, they forget to signal the team to slow down, and just swim harder, which builds up CO2 and they don't efficiently exchange it, and the cycle spirals until they either realize what is going on and stop it, just muddle through and report (or not report) being "really narc'd" on the dive, have a panic attack and bolt, or in a few cases it seems go unresponsive.

As a retired instructor, I believe this happens more often in a class or mentor situation where there is disparity between the buddies and one buddy is trying to keep up to be deemed worthy or pass the class/test, etc.

These experiences are often unreported, underreported, reported as a 'dark narc', not remembered, or 'i don't know what happened, just suddenly had to get out of there'. Even to this day, being narc'd and admitting it is kind of like admitting being a lesser diver. Maybe people won't want to dive with you, maybe they won't want to dive to 100' with you, etc... I think if we drilled down, many of the incidents that occur in that 'deep recreational zone' (the 80-130) on air can be attributed to CO2 compounding narcosis issues.

I did not pay much attention to all this until I started diving CCR, and in learning more about CO2 and its compounding effect with nitrogen narcosis it became clear to me that it is something we should all at least be a bit aware of OC or CCR.

OF COURSE there are also a ton of variables, people who are in shape, people who dive more efficiently, people who put a bit of helium in their mix, high performance regs, vs. rental gear, vs. CCR's... People who tolerate more or less uncomfortable feelings. People who only dive with divers who swim at similar pace so they are never chasing. People who simply don't dive deeper than 80' and don't really know why. Some folks have higher tolerance and have never experienced any of this... So to the readers, don't take my diatribe as gospel or blanket statement, they are just my observations and experience, which may differ dramatically from other peoples.

<we now return you to regularly scheduled programming>
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Re: Scuba student loses consciousness during Seattle dive

Postby lamont » Tue Nov 25, 2014 4:16 pm

fmerkel wrote: People simply HATE CO2 buildup....


*Most* people hate CO2 buildup and would panic before blacking out. There's probably a bell curve and may be outliers due to genetic variation, and probably fitness. You've also got elevated enough N2 at that point to have measurable effects on short term memory, so now you're dealing with a drug-drug interaction on top of that (which are mostly poorly understood and I doubt there's any useful studies of how CO2 and N2 affect the 'average' human much less what kind of outliers you can get when you start mixing them).

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Re: Scuba student loses consciousness during Seattle dive

Postby fmerkel » Tue Nov 25, 2014 3:14 pm

Wow, that would be scary!
I've had friends that got very anxious below 75-90' but nothing like that. Once person I know of exhibited what you describe much below 60' and had to be all but hand carried shallower. Got to wonder why folks THAT N2 sensitive even dive, let alone the buddy hassles.
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Re: Scuba student loses consciousness during Seattle dive

Postby LCF » Tue Nov 25, 2014 2:21 pm

We have had a "Deep" specialty student become all but unresponsive at about 90 feet -- eyes open, still breathing, but not responding to us at all. In his case, it appears to have been narcosis (possibly augmented by CO2) because we turned him around and started upslope, and at about 70 feet or so he started kicking and by 60 he seemed normal. He did not remember what had happened, when we got him to the surface.
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Re: Scuba student loses consciousness during Seattle dive

Postby fmerkel » Tue Nov 25, 2014 12:57 pm

By medical definition..... :) You are quibbling with a Respiratory Therapist. :angelblue: :stir:

What you are describing is 'ineffective/dead-space ventilation', and in the case you describe appears to be hyperventilation, but in reality would have been hypoventilation, again, by medical definition.

I'd say that conjecture is certainly possible. But with a functioning reg, the CO2 buildup should have been somewhat gradual. People simply HATE CO2 buildup and will do most anything to make it go away. In a diver case they probably would bolt for the surface. A healthy person can tolerate a fair amount of CO2 buildup before they actually pass out. Way before then they become crazy anxious for air. Anyone that tries holding their breath for more than a minute can attest to that. (Free divers excepted)

I know this is speculation, and as usual we probably won't ever find out unless the woman joins the group and provides us with some personal insight. It's got to be an incredibly traumatic event to deal with at many levels.
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Re: Scuba student loses consciousness during Seattle dive

Postby CaptnJack » Tue Nov 25, 2014 12:38 pm

fmerkel wrote:Hyperventilation by definition is blowing off CO2. :smt064


Rapid shallow panicky anxious breathing does not. And if the gas is dense enough and the breathing shallow enough the work of breathing (and hence CO2 production) can far exceed the rate at which CO2 is actually removed. She also could have fainted, volumically or for some other reason.

My money is on a diver/health issue not the gear or the gas quality.
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Re: Scuba student loses consciousness during Seattle dive

Postby fmerkel » Tue Nov 25, 2014 12:19 pm

Hyperventilation by definition is blowing off CO2. :smt064

Mostly hyperventilation just makes you feels really weird and anxious. (You can do it yourself safely in the comfort of your own living room.) It's not uncommon in newer divers that get in an anxiety producing situation, hyperventilate, then are sure they got a CO2 hit from hypO-ventilating. I'd say it's possibly more common than true CO2 hits.....but you just can't trust the reporters. Hypoventilation creates the same general kind of anxiety but 'feels' different, but in the middle of the situation people simply are not doing a calm review of the finer points. If they were, they probably wouldn't be having the problem.

Anyone check the kit, see if there was air and a functional reg?
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Re: Scuba student loses consciousness during Seattle dive

Postby CaptnJack » Tue Nov 25, 2014 10:54 am

fmerkel wrote:It's wonderful that everything turned out all right.
But....does anyone know this person? I'm incredibly curious what would make a 19 year old go unconscious on a dive. Didn't seem deep enough for Ox-Tox.


Hyperventilating w CO2 accumulation?
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Re: Scuba student loses consciousness during Seattle dive

Postby fmerkel » Tue Nov 25, 2014 10:44 am

It's wonderful that everything turned out all right.
But....does anyone know this person? I'm incredibly curious what would make a 19 year old go unconscious on a dive. Didn't seem deep enough for Ox-Tox.
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Re: Scuba student loses consciousness during Seattle dive

Postby archisgore » Mon Nov 24, 2014 11:32 pm

Incredible news! What a nice way to end a Monday.

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Re: Scuba student loses consciousness during Seattle dive

Postby Iver » Mon Nov 24, 2014 7:15 pm

Great job. This is what we train for, the chance to help. Excellent recovery.

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Re: Scuba student loses consciousness during Seattle dive

Postby Jeremy » Sun Nov 23, 2014 8:10 pm

Great job Fritz and team!!!

Fritz, did you use the standard unconscious diver protocol? Or did you use some other method?

Curious about how the rescue went and if there are any lessons to be learned.

Again, well done!!!!

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Re: Scuba student loses consciousness during Seattle dive

Postby lamont » Sun Nov 23, 2014 6:09 pm

lost consciousness at 95 and headed back home the next day is not the typical outcome... good job whoever brought her up...

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Re: Scuba student loses consciousness during Seattle dive

Postby Linedog » Sun Nov 23, 2014 2:28 pm

Outstanding!
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Re: Scuba student loses consciousness during Seattle dive

Postby Joshua Smith » Sun Nov 23, 2014 1:24 pm

That's a relief. These incidents usually don't have happy endings.
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Re: Scuba student loses consciousness during Seattle dive

Postby Penopolypants » Sun Nov 23, 2014 11:57 am

Excellent news! Thank you for your rescue efforts.
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Re: Scuba student loses consciousness during Seattle dive

Postby DeepBloo » Sun Nov 23, 2014 11:53 am

I just got word this morning that the diver is well and out of the hospital. She's headed back home to Salem and did not require any chamber time. It's great news for all involved.
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Re: Scuba student loses consciousness during Seattle dive

Postby DeepBloo » Sun Nov 23, 2014 10:10 am

I was one of the divers in the in water rescue. Wishing and praying for her in hopes that we did enough to give her a fighting chance. Thanks to all that helped.

http://westseattleblog.com/2014/11/dive ... -hospital/
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