Cave Diving Stretcher Rescue....

[argyris]

What is the rectangular box between the divers doubles? Anyone know?

Rebreather SCR

[Webmaster]

We used to run accident drills in the Navy for injured/passed out persons in a smoke fill compartment on the submarine. It was always a big mess with dozens of people with masks covered so they can't see running everywhere plugging into air hose connections and daisy chaining connections from one person to the next.

The poor victims playing injured someone had to find them in the dark and put a mask on them.

In addition to putting out the simulated fire and generally taking care of general emergency proceedures. All too often someone would have to move and a several people were plugged into them and no one can hear/see much of anything so they'd unplug and suddenly there are a number of people with no air scrambling to find the nearest empty plug connection (which are few and far between located in the memorized locations).

And of course when a "victim" gets unplugged they aren't supposed to be able to do anything and no one can really see what is going on. It always looked bad in drill review when someone unplugs an injured victim and they "die" suffocating in thier air mask.


Bad vis evacuating a injured diver on a stretcher would probably be a lot like that. Good thing to be thinking about and practising but bad vis etc is probably a whole other level. Something to do once they've got the basics down solid under ideal conditions. It is underwater so they could actually kill someone just practising.

Except that you don't actually have an incapacitated patient in that case. I think you would still want them to have their own backup, be able to access it themselves etc... Also the progression would probably be to go though the whole process on the surface first. And then you would progress to just a loaded litter underwater with no patient to practice handling and rigging before putting anyone in it in the water. And like you said, you probably wouldn't want to start out with the worst spot you could find.

Also there is always at least one person assigned to a patient that is constantly monitoring them. Harder to do in low vis, but you would want to do things like keep touch contact, keep your hand over their face to prevent scraping it on the ceiling, feeling bubbles to make sure they're still breathing.

Marbry

[Cindy]

While I agree with reduncancy I know how injured people act or react. And you will have most of these people c-spined. Injuries to both limbs etc. Most of the cave rescues that actually worked the person was sedated. They can't be expected to act in a rational manor. It is the responsibility of the person watching the patient to monitor them and prevent them from pulling off their oxygen supply or further injury to themselves by thrashing around etc. . Full face mask, sedation, C spine. The patient tender would give gas as needed. This is why we should do this under actual conditions to trial some of this stuff in a reality based situation. Please see the PM I just sent you and Forrest. Cindy

[cliffhanger]

I must agree with Cindy on this. Unless the people being rescued are already avid divers, then there will be big issues with pts being anxious, uncooperative. Seeing as one of the bigger uses could be in the realm of rescuing pts trapped in flooded caves, and even then it would be pts that cannot wait for the water to recede due to some life threatening situation, sedation would be a must. Also, unless you did have the good fortune to have a diver that was able to maintain their composure and not flail around on you, you cannot leave their hands free. To do that, even with sedation, would just be adding many more risks. One thing that I could see looking at adding to a sked stretcher, or whatever device you decide to use would be a wire/mesh cage covering the pt face. This is something that doesn't have to be tight down on the face, in fact it needs to give enough room so the rescuer can get to the pt face/throat if need be, but that will help when in a close in space to keep from raking their facemask against the ceiling and possibly dislodging it. Also, one needs to look at what you are going to use for spinal immobilization. You cannot use a standard backboard to secure a pt to before putting them in the sked stretcher, since it is extremely positively buoyant. I don't know if they make a long spine board that is neutral buoyant or not, but it would be idea for this type of scenario.
Just some of my thoughts on the matter, but I think that this is definitely something realistic and needed.

[Webmaster]

There is also the possibility of extraction for non-medical reasons. But yes I agree that you need to account for at least the possibility of an unconcious patient. That's why I had wondered if a band mask type helmet would be more secure than a FFM.

A Sked is usually used in conjunction with an OSS and a collar for spinal immobilization. It's actually very uncomfortable to be dragged through a cave in a Sked without the OSS.

To protect the face a halved helmet with a flip down face guard is a popular choice. But even that sticks up quite a bit in tight areas and is no substitute for knowing you're not scraping their face off.

Marbry

[Cindy]

A full face mask doesn't stick up any more than a regular mask. Your getting confused with those gas masks you see on TV.
Cindy

[SLIM]

Before it is ever done with a live person, even if it is for practice, a Rescue Randy should be used and one person is dedicated to watching RR to observe him.

I think that if you were to do a mock rescue with a person, it would be asking for trouble. Now if you are testing a small distace to figure out a way is differant. Then you have to think about what is the training of all envolved. Are they just CD or do they have a rescue background and knowledge. I know that NFPA does ont cover any of this but what does NSS cover? I know that it would be a new way to look at performing a rescue.

We might need to just network and all sit down in person and throw out some ideas and look at the pro's and con's.

SLIM

[Cindy]

Slim, not to put a damper on things but Nothing will get done throwing a few things around and talking. Forrest has been talking this up for four years now that I know of. As the man on TV said "just getter done"! You get the NSS rescue people involved then you will really find out what politics are. We are talking a marraige between dry cave rescue and spring cave rescue. Neither group in my opinion is ready to do this. Sometimes you need to just gather up the gear, find a good place and put a plan into action. Bring a dummy, different gear and go practice. See what works.

No matter what you practice in reality we are looking at a critically injured person. Someone with a broken arm, even a leg can be splinted and taken out through a sump. We are talking broken backs, severe head injury, multipal trauma. You have to have some trauma training or mindset. The diver who is having these type of rescues will die if you don't get them out. It's going to happen soon the way sump diving keeps getting promoted as an alternative diving choice. Either the people involved in the issue figure out NOW how to handle it or you Will lose someone. You need to figure out what works then join with the local dry caving rescue people with the back ground to help and include the equipment and divers with the right gear for the problem and have it available where it will be most needed. I saw a quote that is right for this situation. Wisdom is knowing the right path to take, integrity is taking it. Cindy

[SLIM]

I agree with you Cindy. Let me put it differant. We need to sit dwon one morning and tlak about it and then go and do it that afternoon. Yes when in a Multi System Trauma, the impovisaion is best most of the time. At that point, anything can be done. For if it is not tried then there is a greater chance of it being a recovery.

I know that getting all of us togather and comming up with all the gear is a hurdle that first has to be crossed. I think that once we have had time to try a few ideas then when the rescue is needed and a local rescue team arives they dhould have most of what we would need s for as SKED, Full SMR equipment, and any med gear to take in. We would just have to provide the transportaion to the victum and the removal of the victum.

SLIM

[Webmaster]

A full face mask doesn't stick up any more than a regular mask. Your getting confused with those gas masks you see on TV.
Cindy

You'll see I was referring to a face shield something like this http://www.abbeypro.co.uk/eyewear-sa...m-LFN0066.aspx often used to protect the patient while in the litter. A FFM or even any other type of mask would still stick up and provide a good target to be dislodged.

I like to keep my hand between their face and the rock when moving through very tight spots. It may not have been that tight going in, but you add the litter, packaging, and being locked into one position and the same passage can be difficult to maneuver them through delicately.

Marbry