Rescue Diver Course Knowledge Review Answer Keys
Rexcue Diver Course Knowledge Review Answer Keys © PADI 2009 Published by PROFESSIONAL ASSOCIATION OF DIVING INSTRUCTORS 30151 Tomas Rancho Santa Margarita, CA 92688 USA Printed in U.S.A.
PADI Rescue Diver Course Knowledge Review Chapter One – ANSWER KEY 1. What is the most common cause of diver emergencies? Poor judgment. 2. List three things to consider before attempting an inwater rescue. 1. Do you need to enter the water at all? 2. Do you have the equipment and training necessary for your safety and the victim’s safety? 3. Can you reasonably expect to accomplish the rescue without getting into trouble yourself? 3. What is diver stress? Explain what effects stress can produce in a diver and how perceptual narrowing relates to these effects. Stress is defined as a physical or mental tension that results in physical, chemical and/or emotional (psychological) changes in the body. A degree of stress causes biological changes that temporarily make you stronger, think faster and more pain tolerant. Extreme stress can cause you to flee when confronted by something frightening or overwhelm you emotionally so that you can not handle the situation rationally. As stress increases, a diver may experience perceptual narrowing – a decrease in broad awareness. Perceptual narrowing may reduce the ability to look for the real problem or alternate solutions, or to perceive other problems arising. 4.
What are four advantages of a pocket mask? 1. It simplifies getting an effective seal and head positioning. 2. It reduces worries about disease transmission. 3. It is one of the most effective ways to provide inwater rescue breathing for a nonbreathing diver. 4. You can connect a pocket mask to emergency oxygen to provide oxygenated air with your rescue breaths.
5. What are two types of emergency oxygen systems recommended for PADI Rescue Divers? How do these systems differ? Nonresuscitator demand valve units and continuous flow units. Nonresuscitator demand valve unit. Oxygen flows only when the diver inhales Minimizes oxygen waste Can deliver nearly 100% oxygen Used with a breathing diver 6.
Continuous flow unit. Releases oxygen continuously More wasteful of oxygen Can deliver more than 90% oxygen Used with a diver who has difficulty breathing
What are six basic steps for emergency management? 1. Assess the situation 4. Attend to injuries 2. Act on your plan 5. Control the scene 3. Delegate 6. Arrange evacuation to medical care
7. What five skills increase your self rescue abilities? What should you do when you encounter a problem while diving? 1. Good buoyancy control 4. Handling air depletion 2. Proper airway control 5. Responding to vertigo 3. Cramp removal Stop. Breathe. Think. Act.
8. What are the signs and behaviors that indicate a diver may have a problem at the surface? Compare and contrast the characteristics of tired divers versus panicked divers. Distress signals Rejecting equipment Struggling on or just below the surface Clinging or clambering High treading or excessive kicking Not moving
Tired Diver Adequately manages stress Asks for help and respond to directions Doesn’t reject their equipment Usually assists with your efforts Often recovers quickly
Panicked Diver Overwhelmed by stress and fear Abandons rational responses Reacts through instinct and fear Tends to reject their equipment Fails to establish buoyancy and swims vigorously until exhausted Eyes tend to be wide and unseeing due to perceptual narrowing Does not respond to commands or questions Can do little to help themselves
9. Why does the rescuer’s safety take priority over the distressed diver’s safety? With that in mind, what four types of rescues should you consider before an inwater rescue? You can’t help a victim if you’re in trouble. If you become a victim, it divides the remaining rescue resources between you and the original victim.
1. Reaching assists 2. Extension assists
3. Throwing assists 4. Wadding assists
10. Describe the steps for inwater rescues of responsive divers at the surface. Explain how to make contact with a panicked diver at the surface. Responsive Diver Approach – keep your eyes on the victim and pace your swim. Evaluate – stop out of reach and assess whether the diver is rational or panicked. Note BCD inflator location and ask the diver to inflate the BCD or drop weights. Make Contact – establish ample buoyancy, approach from the front and assist the diver in establishing buoyancy. Reassure the Diver – make eye contact, talk directly to the victim and help the diver to relax. Assist and Transport – assist the diver to the boat or shore and allow them to self assist as much as possible. Panicked Diver Approach – keep your eyes on the victim and pace your swim. Evaluate – stop out of reach and assess whether the diver is rational or panicked. Note BCD inflator location and ask the diver to inflate the BCD or drop weights. Make Contact – make a surface or underwater approach. Gain control of the situation and assist the diver in establishing buoyancy by inflating the BCD or dropping weights. Reassure and Transport – reassure the diver while assisting them back to the boat or shore. Student Diver statement: I’ve reviewed the questions and answers, and any I answered incorrectly or incompletely, I now understand what I missed. Signature _____________________________________________ Date ______________
PADI Rescue Diver Course Knowledge Review Chapter Two – ANSWER KEY 1. Explain two steps to apply to recognize stress in a diver and what you should do when you recognize it. • Direct Observation – look for behavioral changes. • Ask the diver about what you’ve observed. Do not pressure the diver - ask about your concerns privately in an open, caring and nonjudgmental manner. Break the cycle that leads to anxiety and potentially, panic or other problems. Encourage solution thinking. 2. What three points does the dive community generally agree upon regarding alternate air sources? 1. The second stage the out-of-air diver should use should be clearly identified. 2. It should not be allowed to dangle. 3. It should be secured in the triangle formed by your chin and the corners of your rib cage. 3. What are six general causes of equipment-related problems? 1. Using unfamiliar equipment. 2. Using equipment that doesn’t fit properly. 3. Using makeshift or obsolete equipment. 4. Not using equipment essential for the dive environment. 5. Using modified equipment. 6. Using equipment that is not properly maintained or inspected. 4. What are the six types of releases commonly found in scuba systems? What is at least one problem each may have? 1. Release Quick release buckle. Problem The buckle not holding. 2. Release Quick disconnect fastener. Problem They may become less reliable with wear or pull free under strain. 3. Release Touch fastener. Problem They may wear out. They can become clogged with sand and lint, making them less reliable. 4. Release Tank band release. Problem The release is not threaded or adjusted properly. 5. Release Inflator quick disconnect. Problem Failure to connect it or not connecting it properly. 6. Release Integrated weight releases. Problem Unfamiliarity with their use. 5.
What are three forms of aquatic life injuries? 1. Bites 2. Cuts, abrasions or punctures 3. Stings
6. What is the common treatment for aquatic life injuries? Begin with primary assessment. Remove spines or stingers with forceps or other tools, or by irrigating the wound. Soak the affected area with hot water for 30 to 90 minutes.
If injury occurred to a limb, keep the limb below heart level. Treat the patient for shock. Maintain the ABCD’S and get the patient to emergency medical care as soon as possible. 7. What is the basic first aid for jellyfish stings? Remove tentacles or stingers with forceps or other tools, or by irrigating the wound with seawater and 5% solution of acetic acid. If possible, shave the affected area. Resoak the area with acetic acid or ammonia solution. Clean the wound with soap and apply an antihistamine or mild corticosteroid ointment. Ice packs may also help to reduce pain. Follow local protocol and get emergency care, if appropriate, as soon as possible 8. Describe the techniques and considerations for responding to a responsive diver at the surface from a distance, including the use of emergency flotation. The equipment you take will depend on the circumstances. In most cases, you’ll need your mask, fins, snorkel and some form of flotation. Enter the water as close to the distressed diver as possible. Don’t lose sight of the victim. Swim with your head up and eyes on the victim. Pace yourself to conserve energy to handle the rescue. Stop out of reach to evaluate the victim’s mental state. Note BCD inflator location and ask the diver to inflate the BCD or drop weights. Establish ample personal buoyancy but be ready for a quick reverse, if necessary. Use emergency flotation devices to provide immediate buoyancy and to avoid contact with a potentially panicked diver. Put it between you and the victim as you approach. It may be easier to tow the diver to safety using a flotation device than by towing the diver directly. 9. What are the general criteria for tows used for transporting a distressed diver in the water? The diver’s face is kept out of the water. Drag is minimized, letting you and the tired diver move through the water horizontally. You must be able to maintain control. Your swimming should not be restricted. The tow allows you to communicate with the tired diver. 10. What three concerns do you need to handle with a responsive diver once you get on the boat or shore? 1. Assess the diver for injuries or illnesses 2. If you find a serious medical condition contact EMS 3. Be sensitive to the diver’s feelings Student Diver statement: I’ve reviewed the questions and answers, and any I answered incorrectly or incompletely, I now understand what I missed. Signature _____________________________________________ Date ______________
PADI Rescue Diver Course Knowledge Review Chapter Three – ANSWER KEY 1. What is an emergency action plan? What five areas of information should it include? An emergency action plan is the information you will need in the event of a dive accident at a particular dive site.
1. The sequence of steps to follow that may be affected by the local environment. 2. A list of local emergency phone numbers. 3. A script for what to say when calling emergency services. 4. The procedures for responding to, moving and transporting an injured diver out of the area to within reach of emergency medical care. 5. Procedures for completing any required accident and incident reports.
2. What is meant by “Basic Life Support”? What types of dive accidents can require BLS? BLS includes monitoring and enacting emergency procedures for patient respiratory and /or cardiovascular system failure. Dive accidents involving drowning, decompression sickness and lung overexpansion injuries can cause respiratory and/or cardiac arrest. Heavy exposure suits in hot weather can cause heat stroke and heat exhaustion. Prolonged exposure to cold can cause hypothermia. Exertion beyond physical limits can cause heart attack or stroke. 3. Explain how time affects BLS? Without oxygen, brain damage can occur in four to six minutes. After six minutes brain damage is likely and after 10 minutes it is almost certain. 4. What are the steps, in order of priority, for conducting a primary assessment? How can diving circumstances affect each step? 1. Assess the situation – water can conceal potential dangers 2. Establish responsiveness – turn the diver face up in the water 3. Upon discovering unresponsiveness or other serious medical emergency, call for help as soon as possible – when diving, you may not be able to contact help easily. 4. Establish an airway if the diver is unresponsive – protect the victim’s airway from water. 5. Check for breathing – use techniques for doing so in the water. 6. Check for circulation – it’s difficult or impossible to detect a heartbeat in the water, so don’t waste time trying to do so. 7. Check for bleeding – it may be difficult or impossible to use pressure points through an exposure suit. 8. Manage shock – get the diver out of the water 5. What is the procedure for treating shock, and how may dive accident circumstances affect it? Once out of the water, begin with primary assessment and monitor the patient’s ABCD’S until a medical professional takes over. Maintain the patient’s body temperature. This may mean removing a wet exposure suit – cutting it away if necessary with a weak patient. It can also mean protecting the patient from heat, by providing shade and removing a hot exposure suit.
6. What are the differences between heat exhaustion and heat stroke, and how should you handle each? Heat Exhaustion Heat Stroke Body’s ability to cool becomes taxed.
More serious condition. Rising temperatures exceed the body’s cooling mechanisms.
Signs and symptoms include profuse sweating, nausea, dizziness weakness and faintness.
Core temperature rises and may result in tissue damage and permanent disability.
Body temperature will be near normal with cool clammy skin.
Symptoms include hot, dry flushed skin. Patient is hot to the touch and does not perspire.
Treatment – begin with primary assessment and move patient to a cool, shaded area. Remove wetsuit and have the patient drink water.
Treatment – begin with primary assessment. Get the patient into a cool area, remove exposure suit and immerse the patient in cool water or apply cool wet towels.
7.
What are the seven signs and symptoms of hypothermia? 1. Shivering 4. Loss of coordination 2. Numbness 5. Weakness and confusion 3. Blueness in the fingers, lips 6. Body systems fail and toes 7. Loss of consciousness
8. Explain what to do to help a diver with the following underwater problems: Overexertion – have the diver stop and rest. Encourage the diver to relax and resume breathing normally. Uncontrolled descent – you can often stop an uncontrolled descent by signaling to the diver to add air to the BCD and level off. If this doesn’t work, make contact with the diver to arrest the descent. If the diver has extreme negative buoyancy, you may need to drop the diver’s weights. Excessive buoyancy – escort an underweighted diver to the surface and get the right amount of weight. If you are close to someone as a runaway ascent begins, you need to make contact and correct the problem quickly. Use the quick dump on the diver’s BCD, and reduce your own buoyancy by dumping your BCD. Cramps – before helping the diver stretch and massage a cramp, point to the muscle you suspect has a cramp and confirm with the “cramp” signal. After relieving, encourage a slower pace and stay close, just in case the diver needs a tow back to the boat or shore. Entanglement – your first priority when dealing with entanglement is to have the victim hold still. Signal “stop,” and get the victim to hold still while you disentangle him. Entrapment – your first concern will be ensuring adequate air supply while working to free the diver. If you believe you won’t be able to free the victim before you run out of air, it may be best to ascend and get more while you still have ample time. If you decide to do this, mark the site in anyway you can so you can return easily with additional tanks. You may also consider leaving your scuba unit with the victim and making an assisted or emergency ascent. Passive panic – approach the diver from the front and signal, “Okay?” If you get no response, go behind the diver and, holding the regulator in place, take the diver to the surface. Once you reach the surface, establish buoyancy for the victim and yourself, and help the victim out of the water. Active panic – you probably can’t stop a panicked diver from ascending, but you don’t need to. You need to prevent a rapid breath-held ascent. If the victim has the regulator in the mouth, simply hanging on and flaring out will usually suffice to control the ascent
rate. If the victim is breath holding, delay is your best bet at getting the diver to resume breathing before ascending too far. If the diver has dropped the regulator, slow the ascent as much as possible while providing your alternate air source. 9. List the steps you should take if you discover a diver is missing. 1. Have someone call for emergency help while you find out where the missing diver was last seen. 2. Assign spotters to look in that area for bubbles and to direct rescuers to that area. 3. Try to determine if the missing diver may have left without telling anyone. 4. Immediately assign qualified divers to don scuba equipment and head to the area where the diver was last seen to begin an underwater search. 5. If immediately available, send two or more skin divers to mark the search area with buoys. 10. What considerations should you take into account when implementing a search for a missing diver? 1. Have a way to recall searchers when someone finds the victim. 2. Permit searches in buddy teams only. 3. Begin searches where someone last saw the diver. 4. If you don’t have qualified divers present for the searches, you may need to choose a buddy and begin the search yourself. 5. Search for 30 minutes, until you find the victim, until you reach the safe limit of air supply, no decompression time or exposure for searchers, or until relieved by professionals. 6. If unsuccessful, turn the search over to professionals. Student Diver statement: I’ve reviewed the questions and answers, and any I answered incorrectly or incompletely, I now understand what I missed. Signature _____________________________________________ Date ______________
PADI Rescue Diver Course Knowledge Review Chapter Four – ANSWER KEY 1. Explain what critical incident stress is, its signs and symptoms, and what you should do to reduce it. The acute stress caused by an emergency involving a serious injury or death. Signs & symptoms include: confusion, lowered attention span; restlessness, denial, guilt or depression, anger, anxiety, unusual behavior, changes in interactions with others, increased or decreased eating, uncharacteristic excessive humor or silence, sleeplessness or nightmares. Requires professional help to prevent post-traumatic stress disorder. 2. Explain what decompression illness is. Term which combines both lung overexpansion injuries and decompression sickness. 3. What’s the most common cause of lung overexpansion injuries? How do you prevent it? Running out of air, panic and rushing to the surface without exhaling. Check your air often remember your training if you do run out of air and never hold your breath. 4. Explain the differences between air embolism, pneumothorax, subcutaneous emphysema and mediastinal emphysema. Air embolism: expanding air is forced into blood vessels in the lungs and enters the blood stream where they collect and block blood flow. Pneumothorax: total or partial collapsed lung. Subcutaneous emphysema: expanding air from torn lung accumulates under the skin around the neck and collar bone. Mediastinal emphysema: expanding air from torn lung lodges in the chest cavity between the lungs. 5. Describe the first aid steps to take for a diver with suspect decompression illness. Begin with primary assessment, if patient is unresponsive maintain the ABCD’S, provide rescue breathing and CPR if necessary. Encourage responsive patient to lie down and relax. Ask the patient or their buddy (if unconscious) questions about the incident and make notes on the PADI Diving Accident Management Work Slate. Give breathing patient 100% oxygen and maintain the patient’s lifeline. Protect the patient from excess heat or cold and arrange for emergency evacuation and medical care. Keep the patient comfortable, lying down and breathing oxygen or enriched air with the highest O2 content available until medical help arrives or patient gets to a medical facility. 6. What is the primary first aid for a serious near drowning accident? Immediate rescue breathing, with CPR if the patient has no heartbeat. Be alert for vomiting. Be prepared to turn the patient and keep the airway clear. Give breathing patient emergency oxygen, keep lying down and treat for shock. Contact local EMS. Patient should always go to hospital as soon as possible. 7. Imagine you’re rescuing an unresponsive diver at the surface. You find the diver isn’t breathing. What would you do if you’re more than an estimated five minute swim from safety? What would you do if you’re less than an estimated five minute swim from safety? More than 5 minutes: give rescue breaths for one more minute while checking for signs of movement or other responses to ventilations. If signs of response are present continue providing rescue breaths while towing to safety. No signs of response, discontinue rescue breaths, tow victim to safety as quickly as possible, exit water and perform CPR and rescue breathing as appropriate. Less the 5 minutes: tow the diver to safety while continuing rescue breaths. Begin CPR if necessary and continue with the ABCD’S.
8. Why do you give rescue breaths to an unresponsive diver with no apparent heartbeat? Describe how you would give rescue breaths using mouth-to-pocket mask. Even if you cannot detect a heartbeat one may be present. If you correct respiratory arrest quickly with rescue breaths, cardiac arrest may not occur. The survival rate for respiratory arrest is much higher than survival for full cardiac arrest. Mouth-to-Pocket Mask: approach victim, retrieve pocket mask and prepare for use. Move above the victim and place the mask on his face, thumbs on the mask and fingers on the bony part of the jaw. Secure the mask strap and administer the two initial breaths. Leave the mask on while you look, listen and feel for breathing. If the victim doesn’t breathe, give rescue breaths every five seconds as you tow the diver to safety. 9. Describe what to do when bringing an unresponsive diver to the surface from underwater. 1. Upon finding the victim, quickly note diver’s position, if regulator is in the mouth, mask on and any other clues about the accident. 2. If regulator is in victim’s mouth, hold in place. If not, don’t waste time putting it back in. 3. Hold the victim from behind, keep the regulator in the mouth and hold the head in a normal position. 4. Use your BCD to ascend with the victim. Begin your ascent and vent air from your BCD to maintain a safe ascent rate. You may need to vent the victim’s BCD to maintain control and flare out if needed to keep the ascent under control. If you cannot control the ascent, allow the victim to ascend separately, ascend at a safe rate and regain contact at the surface. 5. During ascent keep the victim’s head in a normal position so expanding air will vent by itself. 6. As you ascend, think about the steps you’ll take when you reach the surface. 7. If victim’s weights are still in place drop them just below the surface to assure the victim’s positive buoyancy. 10. Explain the priority equipment removal takes in rescuing an unresponsive diver at the surface. What considerations affect whether to remove gear, what gear to remove and when? Equipment removal takes a very low priority. Remove gear if doing so more than offsets the time required. For a long tow this could help reduce the equipment’s drag and speed up the swim. For a short tow it makes little sense to remove the gear. Think “What’s the fastest way out of the water?” rather than “I need to take this gear off.”
1. Think buoyancy- don’t dump anything you need to maintain buoyancy. 2. Do things in a logical order, always using one hand to ensure an open airway. 3. Keep a rhythm. When giving rescue breaths, remove gear between breaths. Breaths have priority. 4. Keep moving! Swim and tow while ditching the gear.
Student Diver statement: I’ve reviewed the questions and answers, and any I answered incorrectly or incompletely, I now understand what I missed. Signature _____________________________________________ Date ______________
PADI Rescue Diver Course Knowledge Review Chapter Five – ANSWER KEY 1. When should you write up a report after a dive accident? What should you avoid doing on a report or when answering questions? Following an accident that requires first aid and summoning emergency medical care or other emergency personnel. Do not guess or speculate or offer opinions. 2. Explain why administering oxygen to a diver suspected of decompression illness is crucial. Emergency oxygen provides significant benefit in many (but not all) cases of DCS. 3.
List six procedures to follow when handling oxygen. 1. Keep unit clean and protected in its box until needed. 2. Never attempt to lubricate oxygen equipment or use standard scuba parts in it. 3. Always open valves on oxygen equipment slowly. 4. Keep your unit assembled to minimize the possibility of contaminates getting into it and to save time in an emergency. 5. Never attempt to clean or service the equipment yourself. Have it serviced regularly as required by the manufacturer. 6. Always extinguish any source of flame before deploying oxygen.
4. Describe the procedure for administering oxygen to a breathing diver. Open the oxygen kit. The kit should be set up in advance. If not, set it up. Slowly open the valve and test the unit by inhaling from the mask. Do not exhale into the mask. Secure the tank and protect it from being knocked over or rolling loose. Say to the injured diver, “This is oxygen. It will help you. May I give it to you?” Assuming agreement, place the mask on the diver’s face and instruct the person to breath normally. If the diver is unresponsive and breathing, you may assume that the diver would want oxygen, and supply it. Monitor the oxygen pressure gauge and do not let it run empty with the mask still on the diver. 5. Describe the procedure for administering oxygen to a weakly breathing diver. Open the kit and attach the tube from the nonrebreather mask to the continuous flow outlet on the regulator. Slowly open the valve a set the continuous flow rate to 15 liters per minute. Using a nonrebreather mask, hold your thumb over the inlet inside the mask and allow the reservoir bag to inflate. Say to the injured diver, “This is oxygen. It will help you. May I give it to you?” Assuming agreement, place the mask on the diver’s face and instruct the person to breath normally. Use the head strap and be sure the mask fits snugly. You may assume consent with an unresponsive diver. If the reservoir bag collapses completely when the diver inhales, increase the flow rate to 25 litres per minute. Monitor the oxygen pressure gauge and do not let it run empty with the mask still on the diver. 6. Describe the procedure for administering oxygen to a nonbreathing diver. Have someone open the kit while you continue rescue breaths and attach the oxygen tube from the continuous flow outlet. Slowly open the valve a set the continuous flow rate to 15 liters per minute. Give rescue breaths through the pocket mask. If the diver begins to breath, switch to the demand or nonrebreather masks. 7. Describe what to do for a diver after beginning primary care, secondary care, oxygen and other first aid while waiting for emergency medical care to arrive. The priority is to continue to monitor the patient’s lifeline and the ABCD’S. Protect the patient from excess heat or cold (shock management), and control bystanders to keep the area open for arriving emergency medical personnel. Maintain contact with the local diver
emergency service. Keep a responsive patient comfortable, but lying down. Try to collect information regarding the accident and write it down to send with the injured diver. 8. What information should you collect to send with the injured diver upon the arrival of emergency medical services? Diver’s name and contact information. Significant medical history. First aid procedures initiated. Dive profile information. Comments relative to emergency care received. Contact information for local diver emergency system and name of doctor or personnel you’ve spoken with. 9. Describe how to perform the lifeguard exit. The rescuer places the injured diver’s hands on the deck. The rescuer pushes out of the water keeping one hand on the victim’s hands so the victim doesn’t slide back in. Holding the diver by the wrists and standing, the rescuer lifts the victim’s waist to dock level, then lowers the diver face down on the deck. From there the rescuer rolls the victim over, and may drag the person the rest of the way from the water. 0. Explain how circumstances may affect exiting with an unresponsive diver. 1 Environmental conditions and other circumstances will affect what you have to do when you exit the water, including the technique that you use. Shore exits: give two breaths then carry or drag the victim ashore. Exit through surf: protect the victim’s airway. Over rocks let the water carry you and the victim up the rocks in stages. A longer swim to an easier exit may be the fastest way. Swim steps, low docks and small boats: may be easiest using the lifeguard exit. Tall dock, boat or pier: you might be able to use the roll up technique. Student Diver statement: I’ve reviewed the questions and answers, and any I answered incorrectly or incompletely, I now understand what I missed. Signature _____________________________________________ Date ______________
