Safety Freedivers bringing up the BO victims

[alex_russu]

I’ve seen quite a few different techniques for safety freedivers to bring up the black-out victims. All of them were focusing on bringing the athlete to the surface as fast as possible, but not everybody was also concerned to keep the victim’s airways blocked (to prevent water getting into the lungs)

Kirk Krak (PFI) was explaining during a safety seminar that salty water is extremely dangerous for the lungs creating long term damages on the cells. He was also saying that it’s easier to reanimate a BO victim who spent a few more seconds in the water that one who had been taken up fast but inhaled water on the way.
So the conclusion was that is better to block the victim’s airways on the way up even if this position may not allow the fastest ascent and you can loose a few seconds.

During an AIDA seminar that I recently joined the instructor was teaching us to bring the victim to the surface without blocking his/her airways on the way up.

With the above introduction, I would like to have your comments on the pros & cons of blocking the airways of the BO victims during the ascent.

PS: I’m doing safety in competitions so if you’re an athlete I’m sure you don’t want me to hesitate.

[samdive]

On the AIDA courses I teach, I teach to hold the mouth closed and mask on if at all possible - it depends a bit on relative size of victim and rescuer

[deep thinker]

Interesting facts you state, it does make sense to close someones airways as to not have them take in any water, but isnt a BO victims airways constricted to the point of closure anyway, hence the having to blow on face or gently tap to reinstate normal breathing and having the victim wake up. I have heard that it is almost impossible to start cpr immediately on a BO victim because of this.

[alex_russu]

I don’t know if the airways are always constricted during the black-out (if somebody can clarify I would appreciate it)
On the other hand isn’t it possible that the victim wakes-up while still under water and want to breathe?

[samdive]

there was a belief that most BO victims would also have laryngospasm, closing the mouth automatically, however a recent paper from DAN from the breath hold diving conference last year now throws this into question.

We are not talking about closing the internal airway on ascent, the airway should be open, as in the head tipped back slightly so air can travel up the trachea - but about protecting the airway from water entry - so it should be closed to the outside -by holding the mask on and mouth closed.

[deep thinker]

Yes thats the word I was looking for lol. Another question wont removing the mask while still underwater and then closing the nose and mouth with your hand allow a victim to be rescussetated easier and faster when on the surface as the hit of water on the face can reduse the efect of BO?

[samdive]

removing the mask underwater opens up the nose to water however quick you do it and its very hard to hold the mouth and nose shut on the way up - much easier to hold the mask on - plus removing the mask delays the ascent time. I wouldn't do it. It's quick enough to do it once you reach the surface.

[deep thinker]

True, perhaps it would be better if the diver did so himself before BO as dicussed in the thread by seb on redusing BO onset and risk...
But then again it could happen anytime anywhere...

[glennv]

We from Apnea Academy also teach to focus on closing the airways underwater in favor of ascend speed.
I like Sebs ideas about the mask but have serious concerns about safety issues with underwater blackouts without the mask on (an extra possible passage for water into the lungs and as stated before and well know fact that this seriously complicates a successful recoverie). So comparing the pros and cons I would never suggest removing the mask underwater in case of difficult ascends . Rather dive without mask and use a noseclip instead. (or liquid goggles etc.) This way at least the open nose passage is closed off.

[TheDude]

Originally Posted by deep thinker

Another question wont removing the mask while still underwater and then closing the nose and mouth with your hand allow a victim to be rescussetated easier and faster when on the surface as the hit of water on the face can reduse the efect of BO?

The hit of water on the face would in no way reduce the effect of BO. It can boost the diving reflex, so that the BO can possibly be delayed. But once in BO it will have no positive effect.

The laryngospasm is triggered by presence of water in the airways and it protects the lungs by shuting the vocal cords. It will typically hold for 30 to 60 seconds. It can complicate the recovery, because the laryngospasm has to release first before you can breathe in. So water in the airways -> big trouble. If the victim is still in water after the laryngospasm has released and the airways are not protected -> water gets into the lungs -> very big trouble.

So keeping the airways closed should be the highest priority...

[DeepThought]

http://forums.deeperblue.net/safety/...tml#post578370

[naiad]

Maybe they are both very important. It would be no good to get someone to the surface very slowly, reducing their chances of recovery, or to get them to the surface very fast but with their lungs full of water.

[alex_russu]

Thanks DeepThought for the link. After reading everybody's posts on your thread it's clear now that whatever your rescue technique is, you need to prevent the water to enter the airways of the "blackoutee"

[cebaztian]

Now I have seen it one too many times so I must say this:

Rescue-breath is the wrong way to revive a black-out victim at surface. It can actually prolong the time of Black out.

Blow tap talk with increasing intensity is the right way the first 20-30 seconds (maybe more).

One must understand the mind of a blacked out freediver.
The black out comes from lack of oxygen in the brain.
But the reason why a BO victim does not breath at the surface is not due to lack of oxygen in the brain.

The reflex to stay alive includes holding ones breath at surface, since the BO victim does not know that there is air available.

The safetydiver must "talk" to the subconcious of the BO victim (they can still hear and feel). It is about contacting the subconcious with the message that "you are safe".

This is done by touching, holding and specially tapping the cheek and talking to the victim, saing their name.

But the most important thing is the blowing in the face, this is many times better than a rescuebreath. Air on the face causes a reaction to breath.

While a rescue breath might even feel like an "attack". It is scientificly proven that one can not get a laryngospasm to go away by breathing against the epiglottis.

The rescue breath is a anti-rescue breath. If done at a later state - it should be done on a plattform. If water gets down the throat that migth seal a laryngospasm even more.

Some might say: I have revived many freedivers with rescuebreath. Yes that is because rescue breath is better than nothing. If you fidle around with a BO victim long enough they will either realize they are at the surface or the laryngospasm will release itself due to lack of oxygen in the muscle. BTT will be faster.

Stop this rescue-breath nonsense. Or give me arguments why its better than initial and throrugh BTT.

Sebastian

[immerlustig]

interesting post, sebastian.

could you maybe refer to some links regarding the release of laryngospasm? i'd much appreciate it.

take care,

roland