Unit 6

Stress and Distress

• Recognizing Excessive Stress• Stress Related Behaviors• Helping Out a “Stressed-Out” Buddy• Personal Stress Management• Distress• Signs of Distress• Self-Rescue• Observable Surface Problems• Rescue• Effecting a Rescue

Recognizing Excessive Stress• Determining if you are under

excessive stress:• Feelings generated by excessive

stress:

Stress Related Behaviors• Gear-fumbling:• Blabbering:• Behavioral extremes:• Obsessive behavior:

Helping Out a “Stressed-Out” Buddy• If your buddy shows signs of stress:• Learn to listen.

Personal Stress Management• The best way to remove negative

stress:• If stress does start to build before

a dive:

Distress

• When stress becomes distress:

Signs of Distress

• Distress is obvious and observable.• Passive distress:

Self-Rescue

• You are your own best buddy.• At the first hint of a problem:

Observable Surface Problems• A person in distress at the surface

is in obvious, easily recognizable trouble.

• The first task of the rescuer:

Underwater Signs of Distress/Impending Problems• Bubbles:• Buoyancy problems:• Erratic, jerky movement:• Trim problems:• Gear rejection:

Rescue

• Is it safe to intervene?

Effecting a Rescue

• Scenario for an unconscious victim:

Stress and Distress End of Unit 6• Recognizing Excessive Stress• Stress Related Behaviors• Helping Out a “Stressed-Out” Buddy• Personal Stress Management• Distress• Signs of Distress• Self-Rescue• Observable Surface Problems• Rescue• Effecting a Rescue

Unit 7

Dealing with Out of Air Situations• Prevention is everything• Self-rescue for an out-of-air emergency• Emergency swimming ascent• Emergency buoyant ascent• Extra air in an emergency• Shared air ascents• Mutual emergency planning• Alternate second stage air sharing• Redundant scuba ascent• Buddy breathing• Buddy breathing method• Problems with sharing air

Prevention is Everything• Monitoring your air:• Air consumption rate:

Self-Rescue for an Out of Air Emergency• Loss of buddy contact:

Emergency Swimming Ascent• NAUI Worldwide recommends:

Emergency Buoyant Ascent• From depths beyond 10-15 meters

(30-45 feet):

Extra Air in an Emergency• Redundant scuba systems:

– Spare air– Pony bottles

Shared Air Ascents

• The concept of buddy pairs:

Mutual Emergency Planning• All effective buddy briefings must

include:• Most emergency plans include:• Type of equipment chosen:

Alternate Second Stage Air Sharing• There is no “one correct method”.• Octopus:• BC-mounted integrated second

stage:

Redundant Scuba Ascent• When a needy diver signals that air

is needed:

Buddy Breathing

• Once the standard for out of air emergencies.

Buddy Breathing Method• When a needy diver signals that air

is needed:

Problems with Sharing Air• Physiological changes:• Use the eyes as the mirrors of the

problem:

Dealing with Out of Air Situations End of Unit 7• Prevention is everything• Self-rescue for an out-of-air emergency• Emergency swimming ascent• Emergency buoyant ascent• Extra air in an emergency• Shared air ascents• Mutual emergency planning• Alternate second stage air sharing• Redundant scuba ascent• Buddy breathing• Buddy breathing method• Problems with sharing air

Unit 8

Underwater Rescue• Responsibility vs. Duty• Risk Assessment• A Responsive Victim• An Unresponsive Victim• Underwater Panic• Warning Signs of

Impending Panic• Is it Safe to Intervene?• Monitoring a Panicked Diver• Underwater Attack• A Final Note

Responsibility vs. Duty

• As an SRD or ASRD, absent some pre-arranged, documented assumed burden of duty with another diver or divers, such as when acting in a well-defined position as a diving leader, you have no responsibility to risk yourself for another diver.

Risk Assessment

• All rescues begin with a difficult question:

• The next question is where is the buddy?

A Responsive Victim

• Approach any diver in distress with extreme caution.

• Once you decide to intervene:

An Unresponsive Victim

• An unresponsive diver will drown without immediate assistance.

• Steps to take:

Underwater Panic

• Panic can strike any diver:

Warning Signs of Impending Panic

• Seeing any diver struggling with equipment:

Is it Safe to Intervene?

• If a diver is bolting to the surface:

Monitoring a Panicked Diver• Once you see the diver is out of

control:

Underwater Attack

• You should do whatever you must in order to break free:

A Final Note

• There is little if anything you can do to prevent a panicked diver from getting to the surface quickly under most circumstances.

Underwater Rescue End of Unit 8

• Responsibility vs. Duty• Risk Assessment• A Responsive Victim• An Unresponsive Victim• Underwater Panic• Warning Signs of

Impending Panic• Is it Safe to Intervene?• Monitoring a Panicked Diver• Underwater Attack• A Final Note

Unit 9

Diving Maladies

• Pulmonary Barotrauma• Signs vs. Symptoms• Types of Lung Over-expansion Injuries• Understanding Decompression Sickness• Types of Decompression Sickness• Signs and Symptoms of

Diving Maladies• Basic Principles of

Neurological Assessment• Performing the Exam

Pulmonary Barotrauma

• The reason divers are so vigorously taught to “never hold your breath”:

• If breathing is interrupted during ascent:

Signs vs. Symptoms

• Signs are observable.• Symptoms are felt.

Types of Lung Over-expansion Injuries• Subcutaneous Emphysema:• Mediastinal Emphysema:• Pneumothorax:• Arterial gas embolism (AGE):

Understanding Decompression Sickness• Decompression results from:• The damage caused:• Dive planning to reduce the risk of

DCS:

Types of Decompression Sickness• “Skin bends”:• “Limb bends”:• “Neurological bends”:• “Inner ear bends”:• “Chokes”:

Signs and Symptoms of Diving Maladies• React immediately to the signs:• The trouble with symptoms:• Dealing with denial:• Neurological assessment:

Basic Principles of Neurological Assessment• What to do:

Performing the Exam

• Following a check list:

Diving Maladies End of Unit 9• Pulmonary Barotrauma• Signs vs. Symptoms• Types of Lung Over-expansion Injuries• Types of Decompression Sickness• Understanding Decompression Sickness• Signs and Symptoms of

Diving Maladies• Basic Principles of

Neurological Assessment• Performing the Exam

Unit 10

Treatment of Diving Maladies• Why Oxygen?• Handling Oxygen• Types of O2 Delivery Systems• Recompression Therapy:The Necessary

Second Step

Why Oxygen?

• The nature of the injury:• The process simplified:

Handling Oxygen

• Oxygen must be handled with care.• Simple precautions:

Types of O2 Delivery Systems• Constant flow:• Demand:

Recompression Therapy:The Necessary Second Step• Oxygen is merely the beginning

first step.• A “typical” multi-lock, multi-place

recompression chamber:

Treatment of Diving Maladies End of Unit 10• Why Oxygen?• Handling Oxygen• Types of O2 Delivery Systems• Recompression Therapy: The Necessary

Second Step