Administering oxygen

Mounting evidence in recent years points to administering emergency oxygen as one of the single most important first aid steps for a diver suspected of suffering from decompression sickness, lung overexpansion injury or near drowning. Medical case histories show repeatedly that prompt oxygen first aid can make a dramatic difference in the patient's immediate condition and in the effectiveness of subsequent treatment. Let's look at emergency oxygen equipment suitable for use by Rescue Divers.

Emergency oxygen equipment falls into three primary categories: non resuscitator demand valve units, continuous flow units, and positive pressure Resuscitator units. Rescue Divers may use the first two; the letter requires special paramedic level training because it can injure a patient if used improperly.

Non resuscitator demand valve units and continuous flow units adequately meet the needs of a dive emergency.

Non resuscitator demand valve units operate much like your scuba regulator. Oxygen flows only when the patient inhales, so it minimizes waste, and with a proper mask it can deliver nearly one hundred percent oxygen. In addition, a rescuer can inhale from a non resuscitator demand valve unit and ventilate a non breathing patient with a high oxygen concentration (the body only consumes a small fraction of the oxygen in each breath), Dive accident first aids calls for delivering the highest oxygen concentration possible for as long as possible, making the non resuscitator demand valve the best choice for Rescue Diver.

Continuous flow units release oxygen continuously, so they're more wasteful than non resuscitator demand valve units. Fixed continuous flow units usually deliver six or 10 litres per minute; adjustable usually deliver up to 25 litres per minute. With the proper flow (15litres per minute recommended) and a non re-breather mask with reservoir bag, continuous flow units can deliver more than 90 percent oxygen, but with low flow rates and/or an improper mask, the concentration may remain below 60 percent.

By using a pocket mask, you can ventilate a non breathing patient with partially oxygenated air using a continuous flow unit (more about pocket masks and rescue breathing later). Most non resuscitator demand valve systems have multifunction regulators that can be used continuous flow so you don’t sacrifice this benefit.

Emergency oxygen comes in differing tank sizes, and internationally, you may encounter different valve configurations, so it’s a good idea to check the local standards when travelling. Ideally, carry a big enough supply to keep a patient on pure oxygen until in the hands of emergency medical care. However, some very remote dive destinations may make this impractical or impossible; carry as much oxygen as you reasonably can. Some oxygen is better than none at all. For general purposes, 637 litres of oxygen (22.5 cubic feet; even imperial system countries usually measure medical oxygen in litres), can be expected to last approximately 40 to 50 minutes, depending upon whether used with a non resuscitator demand valve or continuous flow.

Like your first aid kit, your oxygen equipment needs a case that can withstand the rigors of diving, ideally one in which you can store your equipment set up and ready to go. Most commercially available oxygen systems for divers come equipped with a suitable case. Most airlines won't let you bring a pressurized oxygen tank aboard the plane when you travel.

If you frequent distant destinations that may not have oxygen on site (i.e., remote locations that lack dive resorts) you can also get systems that have everything except the oxygen tank. Instead, you rent the oxygen tank at your destination and bring it to the dive site.

New Rescue Divers often ask about whether it is legal to give patients oxygen in an emergency, and whether it might cause medical complications. These are valid concerns, but within the scope of diving, administering oxygen in an emergency isn't really an issue

In most areas, there are no laws prohibiting buying medical oxygen for emergency use, or administer­ing oxygen in an emergency. Some areas stipulate that the individual be trained in oxygen adminis­tration (PADI Rescue Diver and/or other emer­gency oxygen diver certifications qualify within the scope of dive emergencies). As long as the patient consents, in most countries there's nothing illegal about providing oxygen in a dive emergency (if the patient is unconscious content is implied).

Only a few countries prohibit giving oxygen in an emergency.

It has been thought that giving oxygen can make a few medical conditions worse, but there’s some doubt about this now, nonetheless, these conditions include emphysema and other lung diseases that impair individuals significantly. People suffering from these are not candidates for diving. Healthy individuals can suffer lung irritation if they breathe high oxygen concentration too long, but this takes hours - more than likely you’ll have the patient in professional medical care, or run out of ­emergency oxygen first. According to DAN recommendations and current emergency care protocols, you don’t have to worry about making someone worse by administering oxygen in a dive emergency.

A quest fulfilled

Paper Nautilus a.k.a Argonaut is a rare specimen and one that has to be handled very gently.

First encounter in all my years of diving our Greek waters.

Karpathos, 21 May, diving the wreck of the Gernig, Diakoftis Bay.

Larisa

Not the common name for a Russian maiden but a place in land locked Greece.

Rumour has it that the city is named after a nymph with whom Poseidon, the god of the sea, mated. So according to mythology, it's natural for this land locked central part of Greece to feature its own dive centre.

I had previously heard about a fresh water lake surrounded by hills and plains from Merryn and Kosta of Aquacore Divers in Larisa and agreed to dive it during my next visit to this vast agricultural area of central Greece which is almost a four hours drive from Athens.

What's so special about diving in this fresh water lake? Interesting and unusual things like patches of boiling/bubbly sand along the bottom of the lake , unexploded world war 2 ordinance, easy access and most importantly the beauty, solitude and serenity of the place.

Water temperature was a cool 16 degrees Celsius and luckily for me, I managed to fit into one of Aquacore Divers' dry suits (they must be the only outfit in Greece providing dry suits for hire).

Although familiar with diving dry, this was the first time I dove in a crushed neoprene suit, and was also provided with larger fins to accommodate the boots and much needed extra weights (14 Kgs with a 12 litre steel 200 Bar cylinder).

Entrance is a simple walk-in from a muddy shore and good buoyancy is required to avoid stirring the fine silty bottom. It was unusual not sensing the taste of saltwater as well as having to carefully fin your way through occasional sections of reeds.

The shallow and relaxing dive which lasted just under an hour worked up an appetite and it wasn’t long before we were enjoying coffee and snacks at a roadside cafe.

Thanks Merryn and Costa for making it happen.

Mad dogs and Englishmen

George Moyse, a 97-year-old RAF veteran, undertook a freefall parachute jump onto Netheravon airfield last weekend to raise money for the Royal National Lifeboat Institution.

Believed to be a UK record for the oldest man to tandem-jump, George, from Bournemouth, leapt out of a Cessna 208 Caravan (Cargomaster) aircraft from 10,000 feet into the blue skies above Wiltshire accompanied by his 43-year-old grandson, Edward Brewer who was jumping on behalf of the Royal Air Force Association. The jump took place on Saturday, 4 April 2009.

Afterwards, George who served in the RAF's No 1 Armoured Car Company during the Second World War in the Middle East, said of his jump:

"It was lovely, I really enjoyed it; I wasn't frightened at all."

George who turned 98 on Wednesday got the idea for the parachute jump after seeing and advertisement in his local paper:

"I thought that would be a good idea, I'll have a go at that."

His grandson Ed hadn't thought George would be cleared fit by a doctor when he came up with the idea:

"I told him if your doctor is mad enough to sign a certificate to say you can jump then I'll do it with you," he said.
"At the time I thought I was on a safe bet. And then he rang me and said, 'my doctor's just given me permission to jump!' So I've ended up doing it with him."

George's freefall descent to earth was clocked at just over 120mph and there to meet him on the ground were members of his family including his great-grandson who were delighted with his achievement. Also there to greet him was Flight Lieutenant Anthony Hutchinson from No1 Squadron, RAF Regiment who presented George with a large framed print of "The battle of Al Waki market", which was a recent notable combat action in Iraq by No1 Squadron, which during the Second World War was then George's unit, No1 Armoured Car Company.

George Moyse and his grandson, Edward Brewer are raising money for the Royal National Lifeboat Institution (RNLI) and The RAF Association (RAFA).

The first and only dive guide to the Antarctic

Formerly an exclusive realm for scientific and military divers, this icy wilderness has now become the extreme destination for recreational divers wishing to explore beyond the conventional.

BELOW FREEZING is the first and only dive guide to the Antarctic. It is written by Lisa Eareckson Trotter who was the first person to learn to dive in the Antarctic and a long time member of the crew aboard Lindblad Explorers's ENDEAVOUR.

Published by WILDGuides, a non-profit organistaion focused on wildlife conservation, the book describes the pleasures of diving in Antarctica's waters, whilst at the same time detailing the hazards of this bitter harsh enviroment.

The 116 page soft cover book opens with a brief history of Antarctic diving dating back to 1902 and then provides a short overview of the the world's fifth largest continent. Subsequent sections cover 'how to get there', the diving, what marine life and underwater conditions to expect as well as a special note regarding Leopard Seals which is the only animal divers need to be wary about. The final chapter deals with the description of 25 dive sites.

The book is an excellent reference outlying what visitors need to know, how to prepare as well as what they can expect to see when they get there.

It is available for under Euro 28.

'Twitter' and Diving

As some of you are aware, the purpose of Twitter is to post instant updates (under 140 characters at a time) on the web and it's most effective for information that's only relevant for a short period of time.

So how about encouraging your local dive stores or service providers to feature Twitter and provide information regarding weather conditions at their local dive sites.

Lights out

All the lights out

What’s this all about you ask? Well, the folk at WWF are behind this little intiative and their aim is to have everyone in the world switch off their lights at the same time - together, taking a stand against climate change. They have managed to get unbelievable support from all over the world, including major landmarks such as Times Square and the Sydney Opera House, and many others.

All you have to do, is follow suit and switch off your lights at the designated hour for an hour. Check out www.earthhour.org for exact times at your location and other initiatives you can take/follow/get involved in. Oh, and sign up to show your support.

It’s going to be amazing to go out on Saturday night at 830pm and see the stars again. Come on, go for it!!!