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Diving Safety, Accidents and Incidents Post here to discuss accidents, incidents, ideas, gear, or anything else to improve spearfishing safety. Memorials and condolences threads should be placed in that separate forum.

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Old 09-22-2003, 08:34 AM   #1
fernandezh
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Cause/definition/prevention of embolisms

Guys, in light of a recent tragedy I think it is important that we emphasize the dangers of diving related Gas embolisms. This is the second such death I know of within a year caused by embolism. The key thing to remember is NEVER HOLD YOUR BREATH. Studies show that even a depth change (going from deep to shallow) of as little as 6 feet could cause enough gas expansion to cause an embolism. Skip breathing could also cause an ebolism. Other than holding your breath, embolisms can be caused in rough seas when your depth can suddenly change with the roll of a wave. For example, if you are at 15 ft. and have a full breath of air and a wave rolls over you and takes you suddenly to 6 ft. before you have a chance to exhale, you could theoretically embolize. Get the word out and hopefully some future lives will be saved.


Hector.

This is what I have found so far on Diving related embolisms. . .

Definition
Gas embolism, also called air embolism, is the presence of gas bubbles in the bloodstream that obstruct circulation.

Description
Gas embolism may occur with decompression from increased pressure; it typically occurs in ascending divers who have been breathing compressed air. If a diver does not fully exhale upon ascent, the air in the lungs expands as the pressure decreases, overinflating the lungs and forcing bubbles of gas (emboli) into the bloodstream. When gas emboli reach the arteries to the brain, the blood blockage causes unconsciousness. Gas embolism is second only to drowning as a cause of death among divers.

Gas embolism may also result from trauma or medical procedures such as catheterization and open heart surgery that allow air into the circulatory system.

Causes and symptoms
Gas embolism occurs independent of diving depth; it may occur in as little as 6 ft of water. It is frequently caused by a diver holding his breath during ascent. It may also result from an airway obstruction or other condition that prevents a diver from fully exhaling.

The primary sign of gas embolism is immediate loss of consciousness; it may or may not be accompanied by convulsions.

Diagnosis
Any unconscious diver should be assumed to be the victim of gas embolism, regardless of whether consciousness was lost during or promptly after ascent. A doctor may also find pockets of air in the chest around the lungs and sometimes a collapsed lung from overinflation and rupture. Coughing up blood or a bloody froth around the mouth are visible signs of lung injury.

Treatment
Prompt recompression treatment in a hyperbaric (high-pressure) chamber is necessary to deflate the gas bubbles in the bloodstream, dissolve the gases into the blood, and restore adequate oxygenated blood flow to the brain and other organs. Recompression by returning the diver to deeper water will not work, and should not be attempted. The patient should be kept lying down and given oxygen while being transported for recompression treatment.

Before the diver receives recompression treatment, other lifesaving efforts may be necessary. If the diver isn't breathing, artificial respiration (also called mouth-to-mouth resuscitation or rescue breathing) should be administered. In the absence of a pulse, cardiopulmonary resuscitation (CPR) must be performed.

Prognosis
The prognosis is dependent upon the promptness of recompression treatment and the extent of the damage caused by oxygen deprivation.

Prevention
All divers should receive adequate training in the use of compressed air and a complete evaluation of fitness for diving. People with a medical history of lung cysts or spontaneous collapsed lung (pneumothorax), and those with active asthma or other lung disease must not dive, for they would be at extreme risk for gas embolism. Patients with conditions such as alcoholism and drug abuse are also discouraged from diving. Individuals with certain other medical conditions such as diabetes may be able to dive safely with careful training and supervision.
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Old 09-22-2003, 09:38 AM   #2
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Dive with a buddy

Furthermore,
Spearfish with a buddy. Until the past year I was a "loner" while spearfishing. Once I got into the water, I went my own way. That has changed with my Spearing partner, Sharpshooter (Jose). Underwater, we look out for eachother in any way possible. During the dive we are always within visual range of each other and safety stops we look out for eachother's backs in case a shark comes in from 6 o'clock. Once during a dive, I accidentially came low on air (stupidity on my part) and Jose was there with his octopus in hand.

Although we are together, both of us are still able to whack the fish as several times I shot grouper that were right behind him that he didn't see. Stay with a buddy and you will have a safer spearing trip.

We need to emphasize safety periodically. If a single life is saved through a post, then it all is worthwhile.
Come on guys, I know there are other safety issues I have not brought up.

Hector
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Last edited by fernandezh; 09-22-2003 at 09:41 AM.
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Old 09-22-2003, 10:58 AM   #3
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Well Said... There's got to be a message from this tragedy. I am a loner when shooting, but am willing to make a change after things like this.

Had a buddy that was going after a Cobia....holding his breath to keep the bubbles from spooking it..... he swears he only went up 3 or 4 feet to get the fish but when he surfaced...WHAM.... BENT..... said it was some of the worse pain he had ever endured.
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Old 09-22-2003, 11:20 AM   #4
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Guys, my .02

I have been taught by my dad and uncles that diving solo is more successful to catching fish. My whole family has made a living at spearfishing and no one has ever been injured. With that said, there are many controversial views on diving solo where you are dependent on someone who may actually be more harmful than helpful.

I was a firm believer that diving solo was the way to go until a few weeks ago my friends started getting on my case for taking off in different directions, the boat not knowing where to look since i always shoot up a bag instead of carrying a flag. Not only that but while struggling to fight a fish alone, I have been hammered by sharks and on one occassion my pressure guage failed and I almost drowned and took a definite risk at getting bent as I had no choice but to come up quickly.

All this has lead me to change my thinking and yes, I still get separated when I am in a ZONE because I normally cover a lot of ground but there is a big difference in diving solo for pleasure and diving solo while spearfishing. The fact that at any moment you can encounter a predator is enough of a reason to buddy up with someone. The fact that you may have taskloading and loose track of guages and other factors is also enough reason to buddy hunt.

I conclude in my thinking that the inherent dangers of spearfishing solo are just too many compared to buddying up and all the pluses it brings along with it.

I think the reality of what has happened to Young gun is a contributing factor to my concerns. I dont know the details of his situation but it does drive the message home about having a buddy close by. From now on, I will make it a point to at least try and have a buddy close to me for all the above reasons. Its a big change for me but its one that I feel is needed. There can be no doubt that if this board saves one person from a catastrophy by the advice or foresight of another, then it is all worthwhile for that reason alone!

just my.02
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Old 09-22-2003, 07:44 PM   #5
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I half to agree with Hector up and till my shark incident I was a confirmed solo shooter. However after that incident and Carson's I think I will try and stay with my buddy a little more. Hell we should mention that if you notice your buddy not breathing i.e. holding their breath skip breathing whack em in the sack that will solve that problem.
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Old 09-22-2003, 08:10 PM   #6
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Is there anything that can be done once an embolism occurs? I mean, even if you were with a buddy and you embolize, will any effort to resuscitate the victim be successful?
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Old 09-22-2003, 08:15 PM   #7
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I am with you all the way JCACTION. If you are shooting fish, especially in deep water, don't dive alone. There are too many things that can happen that you can't handle alone, and with another guy( or gal) in the water with you, your able to handle a lot more. Like Hector said, someone will be there to watch you back, very important.

It is also important to always keep someone in the boat that is capable of running it and picking you up if you get stuck 100 yards of the transom. Just because you leave your girlfreind in the boat sunning herself is not going to cut it. They need to be capable of calling for emergency help when both the divers that were in the water are hurt, and fully capable of operating the vessel.
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Old 09-22-2003, 08:36 PM   #8
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Quote:
Originally posted by inletsurf
Is there anything that can be done once an embolism occurs? I mean, even if you were with a buddy and you embolize, will any effort to resuscitate the victim be successful?
Yes, an air embolism that causes a blockage of blood flow to the brain will cause symptoms similar to a stroke. Not all stroke victims die but many of those who survive may experience some level of degraded brain function after recovery.

A diver who experiences these symptoms needs assistance out of the water since they are most likely to be unconscious. Basically, the sooner you get someone out of the water, the sooner you can begin CPR. With a buddy, you increase the chances that someone will find you if such an accident occurs. Air embolism is about the worst thing you can have happen while diving short of being chomped by a shark or run over by a boat.
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Old 09-22-2003, 09:07 PM   #9
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Oxygen First Aid

Inletsurf,

Embolisms can occur in the water or on the surface, some may not occur until 10-15 minutes after surfacing. Embolisms that happen before surfacing would be very difficult to treat. Unless the diver was immediately removed from the water, there may not be a whole lot that can be done.

Embolisms that occur after a diver surfaces are very treatable if you are prepared. Oxygen works wonders. Personally on my boat, I have a medical O2 bottle with two- way mask if mouth-to-mouth resuscitation is necessary and the standard O2 bottle with a scuba regulator. If you are using the scuba regulator to treat embolism or DCS, be sure the victim is wearing their scuba mask. This prevents the diver from inhaling air through the nose and ensures the diver is breathing 100% oxygen.

Several years ago a friend of mine suffered an air embolism to the brain. Fortunately he was climbing up on the transom when the (stroke like) symptoms occurred. I immediately put the diver on O2. The Coast Guard did not answer on channel 16. I dialed 911 and was forwarded to the FMP. I had other divers in the water without flags (a big no-no) and a slow boat. I felt my best option would be to have them come to me. FMP was on the scene in 17 minutes and a CG Cutter with paramedics on board was right behind. After 17 minutes on O2, the diver was beginning to come around. In the beginning, I thought for sure he was dead, but that O2 works miracles.

This accident happened off Ft. Lauderdale near a CG station. So I understand being way out in the Gulf is a much different situation. I would be interested to hear from some experienced Gulf people how they handle bad situations.
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Old 09-23-2003, 10:32 AM   #10
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Bluephoria and I always hunt in teams and found this to be productive and helpful, you never know when you will need a buddy. Even if it is to laugh hysterically as Bluephorias 57 lb AJ gives her a run for her gun. You also have to concerned with working to hard - fighting current or fighting a fish - I have almost blacked out from breathing to hard while on the chase. Starfields and dimming of light - is usually a sign for me to slow down.
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Old 09-23-2003, 11:59 AM   #11
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i work at Mease Countryside ER as an EMT, i've seen tall people bend over and stand up fast, and get a over-expansion injury. The only cure is to go to an ER and they put a chest tube in, and keep you for a couple days in the hospital.
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Old 09-23-2003, 02:48 PM   #12
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All these posts about being with a buddy being said, maybe something of a mentoring to teach new spear gunners could occur to. I mean, ya'll are your own sort of clique in society and probably have knowlege that would be invaluable to a diver just learning how to hunt underwater.

Personally, I've had a gun since my birthday in January. I talked to Carson numerous times about usage and where to go. He gave me lots of advice, my favorite was "go to an unpopulated beach, swim out to where the fish are and shoot everything that moves... you'll get the hang of it". However, I've been to shy to go it alone (because my wife said she'd cut my achillies to prevent it) and have had a tough time finding a buddy to spear with. Just a thought as a way to teach safety and practice at the same time.
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Old 09-24-2003, 10:52 AM   #13
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cbulla, you need a dive buddy in a big way. As far as shooting off of an unpopulated beach goes, you need to remember that it is illegal in Florida to spearfish within 100 yards of a public beach. You can't even get away with walking across that public beach, with a speargun, and swimming out 101 yards before you begin shooting.
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Old 09-24-2003, 03:15 PM   #14
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I do not believe in the "buddy system" as it is taught. Having a PARTNER is fantastic, if you can fing a like minded individula to always be there diving with you; and I am jealous of those people fortunate enougfh to have true dive PARTNERS.

However, when preparing for and conducting a dive, you must take care of yourself. Never conduct a dive that you are not 100% certain that you will complete, without assistance, in every scenario. Never, ever rely on a buddy for anything other than companionship. Have you ever lost a reg underwater? I did. Once; in more than 600 dives ive made. Happened randomly. No warning. one breath its there, the next time I try to inhale all I got was water. How far can you swim with empty lungs and no preparation? If your buddy is ten feet away and swimming away from you, can you get to him? how about thirty feet away? Thats not uncommon for most buddy teams. What if he swam into a wrecK? would you chase him in there on that last breathe of air you never got?

Thats why you should carry a pony, ponies make great dive buddies. They dont panic, and dont run out of air. And they ALWAYS stay real close, like within arms reach, exactly where you want your "buddy"

Another situation is underwater orientation; in most buddy teams there is a dominant diver who leads, and one follows. If seperated the nondominant buddy often gets lost and surfaces far from the boat ... I always wonder how fast they came up on that free ascent when they are nervous. Every diver should always be oriented; diving solo this is much easier... when your not sure where you are you can just double back and check, not likely with a buddy its easier to blindly follow on faith...

What other situations are buddies helpful in; entanglements? There best avoided. I carry two knives. There was one dive, deep cold water, where I got some line around my yoke. A buddy would have been real nice then, I managed to cut free using a knife and staying calm; not easy wearing mitts.

If you have a pony and a couple of knives than whats the point of a buddy?? Companionship, frienship, commraderie, fun , common interest. And yes, safety. If you have someone you know and trust it is a good idea, and safe to buddy up... but be self reliable above all else.

I dive with lots of people, from highly experienced pros, to totally new divers. My relationship with each PARTNER that I dive with is seperate, and usually determined socially before the dive. I, personally, never expect anything out of another diver. Im fully redundent, and fully comfortable with any dive, an or profile that I plan out. If Im diving with a newby, I got his back. Wont let nothing happen to him. Someone experienced who I dont need to watch, well just go have fun together.

The pressing question is "would a buddy have saved the recently deceased?" A second diver could have rendered assistance on getting him back to the boat. Small embolisms are survivable. Large ones arent, at least not without major longterm problems... If he wasnt able to make it to the boat, it likely was a larger one. The best way to survive an embolism is not to get one.
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Old 09-24-2003, 03:41 PM   #15
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I see what you are saying Doc, It isn't good to depend on anyone but yourself to get you out of a bind, but not every situation can be forseen, so it makes sense to have a person by your side who could step in and lend a helping hand if something unexpected comes up. Sure the best way to prevent an embolism is not to have one but what do you do if it does happend, You can't very well have redundant conciousness unless your pal is by your side to get you up to the surface.
I am guilty of solo diving myself, but after the recent tragedy, I am forced to rethink my approch, no matter how confident and skilled you are, something that is beyond your control can, and will come up eventually. So even though you might not like the buddy system it is the only way to minimize the risk of diving other than the above mentioned precautions that although necessary are no substitute for a dependable dive partner who is vigilant and watches your back.
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