What is an emergency action plan and what five areas of information may it include?
The information you will need, at a particular dive site, in the event of a dive accident.
- the sequence of steps to follow hat may be affected by the local environment
- a list of emergency phone numbers
- a script for what to say when calling emergency services
- the procedures for responding to, moving and transporting an injured diver out of the area to within reach of emergency medical care
- procedures for completing any required accident and incident reports
What are the three benefits of practicing emergency procedures regularly based on your emergency action plan?
- It refines your response skills
- It makes a real emergency less stressful
- After practicing, you can evaluate your performance and refine the plan
What is meant by ‘Basic Life Support’ and what types of dive accidents can require BLS?
BLS includes monitoring and enacting emergency procedures for patient respiratory and/or cardiovascular system failure.
Dive accidents involving drowning, decompression sickness and lung overexpansion injuries may require BLS, as well as heat stroke, hypothermia and overexertion.
How does time affect Basic Life Support?
Respiratory and/or cardiac arrest cuts off oxygen to the body. Without oxygen, brain damage can occur in four to six minutes.
What are the recommended steps, in order of priority, for conducting a primary assessment?
- Assess the situation
- Establish responsiveness
- Upon discovering unresponsiveness or other serious medical emergency, call for help as soon as possible
- Establish an airway if the diver is unresponsive
- Check for breathing
- Check for circulation (heartbeat)
- Check for bleeding
How do diving circumstances affect primary assessment?
- Water can conceal potential dangers when assessing the situation
- You may not be able to contact help as quickly from the water
- Establishing an airway and checking for breathing requires special techniques in the water
- CPR is only possible when the victim is out of the water, and it’s too difficult to determine if the victim has a heartbeat in the water, so the protocol is that you don’t waste time trying
- If the victim is bleeding, it may be difficult to apply pressure through an exposure suit, and the body’s clotting mechanism may be slowed by water
What are the nine signs and symptoms of shock?
- Rapid, weak pulse
- Pale or bluish tissue colour
- Moist, clammy skin, possibly with shivering
- Mental confusion, anxiety, restlessness or irrability
- Altered consciousness
- Nausea and perhaps vomiting
- Thirst
- Lackluster eyes, dazed look
- Shallow but rapid, laboured breathing
How may shock occur in a dive accident?
Anything that causes a serious wound or trauma can cause shock, for example decompression sickness, lung overexpansion injuries, aquatic life injuries, heat stroke or exhaustion, hypothermia and near drowning.
What is the procedure for treating shock, and how may diving circumstances affect it?
- Primary assessment, AB-CABS
- Maintain the patient’s body temperature, removing their exposure suit and protecting them from heat if necessary (stay in the shade)
- Keep the patient lying down
- Generally avoid giving the patient anything to eat or drink, except possibly water in order to maintain hydration
What are the procedures for conducting a secondary assessment of a responsive ill or injured patient?
- Examine the diver as learned in EFR training, checking for sensitive areas, looking for deformities, fluid, swelling or reaction to pain
- Don’t remove an exposure suit if spinal injury is suspected, unless overheating is likely, in which case carefully cut off the exposure suit while keeping the patient immobile
- Begin first aid for any injuries
What is heat exhaustion and how do you treat it?
Heat exhaustion when the body’s ability to cool becomes taxed. Signs and symptoms include:
- Profuse sweating
- Nausea
- Dizziness
- Weakness
- Faintness
Move the patient to a cool, shaded area, remove the exposure suit and have them drink water. If symptoms don’t subside in approximately 30 minutes, contact EMS.
What is heat stroke and how do you treat it?
Heat stroke is a life threatening condition when the body’s cooling mechanisms fail, and the core temperature begins to rise. This can destroy tissue and cause permanent disability. Signs include:
- hot, dry flushed skin
- no perspiration
Begin with primary assessment, move the patient into a cool area, remove the exposure suit, and immerse the patient in cold water or apply cool wet towels. Contact EMS while monitoring the patient’s lifeline.
What are the seven signs and symptoms of hypothermia?
- Shivering (in severe cases, body systems fail and shivering stops)
- Numbness
- Blueness in fingers, lips and toes (may be difficult to see underwater)
- Loss of coordination
- Weakness
- Confusion
- Loss of consciousness
What are the proper procedures for rewarming a patient with hypothermia?
- Begin with primary assessment
- Keep the patient lying down and not exercising
- Take an alert patient with mild hypothermia to warmth, remove the exposure suit and dry the patient, rewarming by covering the head and applying heat to the neck, armpits and groin
- For severe hypothermia, contact EMS and protect the patient from further cooling, but leave rewarming to EMS because doing so is medically complicated
What signs indicate a diver may have a problem underwater?
- Rapid breathing
- Awkward kicking
- Other signs indicating exhuastion and tiring
- Wide eyes
- Rapid breathing
- Maintaining a vertical posture
- Jerky movements
- Using arms to swim
- Sinking while swimming upward
- Rejecting the mask and regulator and bolting for the surface
What do you do to help a diver with overexertion underwater?
- Have the diver stop everything and rest
- Make contact and have them hold on to something stationary, but make sure there’s nothing that could sting or cut the diver on the object
- Encourage the diver to relax and breathe normally by signalling or writing on your slate
- Keep watching them after they recovering to avoid accidental overexertion again
What do you do to help a diver with an uncontrolled descent?
- Signal the diver to add air to the ABD and level off
- Make contact with the diver to arrest the descent
- Use caution and avoid descending below safe depths when swimming after the diver
- Grasp the diver’s BCD or tank valve and add air to the BCD
- If their BCD doesn’t work, use your own but keep in mind that you will be excessively buoyant if you let go
- Drop the weights only if necessary as this may cause excessive buoyancy
- Watch for overexertion
What do you do to help a diver with excessive buoyancy?
- Escort an underweighted diver to the surface and get the right amount of weight
- Get them to carry rocks
- With a diver having a runaway ascent, make contact, use the quick dump on the diver’s BCD if possible and dump your own BCD
- If the diver’s inflator is stuck, disconnect the low pressure hose
- If you can’t stop the ascent, let go and signal the victim to flare arms and legs to create drag
- Ascend at a normal, safe rate and check the victim hasn’t been injured
What do you do to help a diver with cramps underwater?
- Point to the muscle you suspect has cramps and confirm with the ‘cramp’ signal (rapidly clenching your fist)
- Relieve the cramp, encourage a slower pace and stay close just in case
What do you do to help a diver with entanglement?
- Have the victim hold still; signal ‘stop’
- Reassure the diver as you disentangle them
- If you must cut the diver free, use caution
- A smaller, sharp dive knife may be more effective than a large, heavy duty dive knife
What do you do to help a diver with entrapment?
- Ensure adequate air supply while working to free the diver
- If you believe you won’t be able to free the victim before you run out of air, ascend and get more
- Mark the site in any way possible so you can return easily with additional tanks
- You may consider leaving your scuba unit with the victim and making an assisted or emergency ascent
- Seek qualified help and do not attempt to rescue a diver from an overhead environment if you aren’t properly trained or don’t have the right equipment
What do you do to help a diver with passive panic?
- Approach from the front and signal ‘Okay?’
- If you get no response, go behind the diver and, holding the regulator in place, take the diver to the surface
- It is important to help from behind in case they change to active panic
- Once at the surface, establish buoyancy for the victim and yourself, and help them out of the water
What do you do to help a diver with active panic?
- Grab their foot or leg to prevent an uncontrolled ascent
- Hang on and flare out to control the ascent rate
- If the victim is breath holding, delay is your best bet to get them to resume breathing before ascending too far
- If the victim has dropped the regulator, slow the ascent and provide your alternate air source
- You may have to force the mouthpiece into the mouth while depressing the purge button lightly
- Once at the surface, establish positive buoyancy and exercise control
Why is time critical in a missing diver situation?
If the victim isn’t breathing, permanent brain damage is likely after six minutes.
