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IHTM This is not a drill

This Is Not A Drill!

A rescue drill with a trainee became a real-life emergency for BSAC advanced instructor Richard Wordsworth

The diving season was well underway and, as diving officer of Blue Dolphins Sub Aqua Club in Guernsey, I was pleased that the annual batch of ocean diver students was progressing well. 

My student that day was Maya. I had dived with her several times during her training and knew her abilities well. She was a 50-year-old woman and a nervous student – she was not very comfortable in the water and had decided to learn to dive to help conquer her fear of the water. This was her third open-water dive and the main element of this lesson was the alternative air ascent – the student has to breathe from their buddy’s octopus and ascend from 6m in a controlled manner.

The dive site was Havelet Bay in Guernsey – a favourite for training as it is sheltered, has a nice slipway for entry and exit and there is plenty of fish life to look at. The weather looked good and the sea calm enough for the planned dive.

After the briefing and a dry run of the exercises, buddy checks were done and we were ready to go. A giant stride off the slipway went well, so I signalled to Maya ‘okay’ and ‘descend’. Knowing her nervous nature, I allowed her plenty of time to settle on the bottom, and was not surprised that she took a minute or two to calm down. The exercises were to be conducted at 6m so we swam away into deeper water.

The first exercise was mask clearing, and I duly demonstrated this. Maya had done this before in cold water, so I was confident she could do it with little trouble, but she seemed hesitant and unwilling to flood her mask. This seemed odd, but eventually she sorted herself out and performed the drill well.

Next, it was the alternative air source ascent. She was to be the out-of-air diver and I was to play the role of rescuer. The swapping of second stages went well, and after exchanging ‘okay’ and ‘ascend’ signals, we headed for the surface at a controlled rate. 

Once there, I fully inflated my BC and motioned to Maya that I was going to inflate her BC and that she was to continue to breathe from my octopus until she was fully buoyant. At this point, she started coughing and I thought she might have breathed in a little water at some point. To help her regain her composure, I raised her head well out of the water, but she was coughing up blood and not responding to instructions! 

Suddenly, it was no longer an exercise. The adrenaline and training kicked in. My first thoughts were to get her as high out of the water as possible, so away went her weight belt. Frantic waving to the shore cover got little response – after all, it was rescue training! Luckily we were only 20m from the slipway, so I started towing with all my strength. At this point, the shore cover realised there was something wrong, and when we got to shallow water they were able to help me get Maya up the slip.

I was by now exhausted, but Maya was in good hands as the shore cover was Ian, our training officer and Claire, a theatre nurse. All I could think was: ‘What went wrong? Could she have held her breath on ascent and damaged a lung? There was little chance of the bends from that depth.’ I was mystified and concerned.

After a short while the ambulance arrived and took over. Maya was still coughing up pink fluid, had gone a worrying grey colour and was still unable to speak. She was given oxygen and taken to the hospital. We followed, anxious about her well-being.

After a thorough examination, the diving doctor diagnosed immersion pulmonary edema (IPE) – a rare condition in which the lungs spontaneously fill with fluid when the individual is immersed in cold water. It turned out that Maya had not declared a high blood pressure problem, and this is considered to be an aggravating factor – but would it have prevented her from diving? Probably not. Apart from that, she had been in good health, didn’t smoke and only drank moderately.

After a couple of days in hospital, she was released and eventually made a full recovery. The diving doctor said it was unlikely to happen again and that she could probably continue to dive, preferably in warm water. I’d never heard of the condition before that day, and it’s not mentioned in the BSAC instructor manual. 

Even with the benefit of hindsight, I don’t think we would have done anything differently, but what might have happened if we had been in a RIB, miles from shore, or if the dive had been deeper? The outcome may have been fatal. The lessons to be learned from this incident are that shore cover is important, even on relatively easy dive sites, and the self-assessment questions need to be answered truthfully – they are there for a reason.  

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