Wednesday, December 25, 2013

Birthday Celebration!

You are cordially invited to a Birthday Celebration!!!
Guest of Honor: Jesus Christ
Date: Every day. Traditionally, December 25 but He's always around, so the date is flexible...
Time: Whenever you're ready. (Please don't be late, though, or you'll miss out on all the fun!)
Place: In your heart.... He'll meet you there. (You'll hear Him knock.)
Attire: Come as you are... grubbies are okay. He'll be washing our clothes anyway. He said something about new white robes and crowns for everyone who stays till the last.
Tickets: Admission is free. He's already paid for everyone... (He says you wouldn't have been able to afford it anyway... it cost Him everything He had. But you do need to accept the ticket!!
Refreshments: New wine, bread, and a far-out drink He calls "Living Water," followed by a supper that promises to be out of this world!
Gift Suggestions: ; Your life. He's one of those people who already has everything else. (He's very generous in return though. Just wait until you see what He has for you!)
Entertainment: Joy, Peace, Truth, Light, Life, Love, Real Happiness, Communion with God, Forgiveness, Miracles, Healing, Power, Eternity in Paradise, Contentment, and much more! (All "G" rated, so bring your family and friends.)
R.S.V.P. Very Important!
He must know ahead so He can reserve a spot for you at the table. Also, He's keeping a list of His friends for future reference. He calls it the "Lamb's Book of Life."
Party being given by His Kids (that's us!!)!
Hope to see you there! For those of you whom I will see at the party, share this with someone today!

Thursday, September 26, 2013

The Most Contaminated Dive: Recovering Human Remains

Posted on: September 25, 2013
 
contaminated dive
Photo Credit: Riverside Dive Team

It’s a late Thursday evening, the shift operator at the local sewage plant notices something floating in the first settling pond. Upon closer investigation he discovers that it is a hand… A human hand that still has a ring on its finger. He immediately calls the authorities, when the authorities arrive the investigating process proceeds.

Often as public safety divers we face circumstances that may be dangerous and life threatening; either during the dive, or later when we are at home with our families. The first priority as a public safety diver is our safety and well being. After all there is NEVER a time that two dead bodies are better than one. We should always consider our scope of practice and whether it is within our ability to perform the operation we are considering.

Simple questions to ask ourselves: Is this operation beyond my scope of practice and have I been properly trained for this mission?  Do I have the proper hazmat equipment to do the job safely? Should this be a commercial dive operation?

Every public safety diver should have a solid foundation in the basics of Boyles Gas Law. It is imperative to have a good understanding of how Boyles Gas Law relates to decomposition of human tissues at depth. Let’s take a look at how these gas laws can affect our recovery efforts. When it comes to recovering human remains from a liquid environment there are several factors to consider. It has been said that a body that is at a depth of greater than 100ft will not surface on its own accord. Simply put, gases will be at four times the pressure at this depth as they would be at the surface.  The total volume of gas at 100ft  is 1/4 of the volume it would be at the surface. The likelihood of gas building at this depth is very unlikely. Depths less than 100ft our recovery efforts become a more complex.

Decomposition is able to take place at shallower depths as gas production takes effect in the body. With direct relationship to Boyles Gas Law, the body will begin to lift and make its way to the surface due to the decomposition process within the tissues and  increased gas production.

Besides the contamination hazards that exist we will also need to be concerned with the buoyancy characteristics  of tissues after the process of decomposition has occurred. The expansion of the body mass due to gas production is now of greater concern and becomes a buoyancy issue that may have direct consequences with our recovery efforts. We must be able to control our accent to the surface, when recovering a body at depth.

As public safety divers we expose ourselves to environments that are contaminated to varying degrees, whether it be biological, chemical, pesticides, insecticides or other harmful bacterium, the bottom line is this; any body of water must be considered contaminated. We must understand how important it is to protect ourselves against exposure to elements that may be life threatening. The use of the proper protective equipment will significantly lessen the potential risk of exposure. With this in mind, we must protect our mucus membranes as well as our extremities, in order to best accomplish this we should be diving with a full face mask and a dry suit.

I would like to think that most PSD (should we spell out Public Safety Divers here?)dive units are properly trained and understand the importance of using full face masks, with the knowledge and understanding that  90% of our mucus membranes are located on our face. While there are many FFM available on the market today they will all offer some form of contamination protection, some considerations that should be made are as follows. What is the air volume of the mask, and the positive pressures that will allow a greater possibility for water to enter the mask?  Both instances may create buoyancy issues and must certainly be considered. Remember that 1 pint of air is equal to 1 pound of buoyancy,  given the fact that the head of most adults will weigh between 4 and 6 pounds (dry weight) this doesn’t seem to have much of an effect as you are still negatively buoyant. However, this may become an issue within your attached hood. Air that escaped from the mask may become trapped underneath your hood which may cause you to become positively buoyant. A recommendation to consider is the use of hood vents to manage the escaped air from the mask. These hood vents can be installed easily, but the placement of the hood vents is crucial. Observe the FFM you are diving, you will notice where the spider straps position themselves when tightened. Placing a vent on each side near the back, directly on top of the hood, this placement is the best position to manage the air that may get trapped underneath the hood.
It is the belief of at, Public Safety Dive Services, that you should consider any and every body of water a contaminated body of water, especially if you are in search of a victim. If you are diving a dry suit, you should be trained by a professional ERDI dry suit instructor that completely understands and is familiar with the diving environment and the proper equipment required for every situation.

You will have several factors to consider when diving a dry suit, which depend on the style, the material, the thermals you wear, and the fit of your dry suit. One major factor is buoyancy, air trapped within your dry suit is directly related to buoyancy and may create potential hazards. We should be trained to manage the air within our dry suit to prevent emergency situations. Here are a few considerations: Use a properly fitted dry suit. Use the appropriate thermals that will offer optimal thermal protection for the water temperature you are diving. Know and practice proper donning techniques. Know and use proper burping procedures. Be properly weighted, consider using a weight harness system that allows air to move within the suit. Understand and use proper inlet and exhaust air management skills, this will allow useful and important air management that will help with buoyancy. Practice emergency skills that help protect you from injury.

In short, every public safety diver should have a solid foundation in the basics of Boyles Gas Law. We need to know how to manage our personal air supply at depth. It is imperative to know how Boyles Gas Law relates to decomposition of human tissue at depth, and how it affects our recovery efforts.     

Public Safety Dive Services offers training that keeps public safety divers as safe as possible.

Public Safety Dive Services
Bo Tibbetts
ERDI Instructor Trainer – 16061
Contact SDI TDI and ERDI

Public Safety Buoyancy

Posted on: September 25, 2013
 
public_safety_buoyancy
 
Photo Credit Keith Cormican
 
Public Safety divers spend a lot of time practicing search patterns, signals, evidence collection and team safety.  Each one of these skills and techniques are very important part of a safe and successful mission. Have you ever thought about what each of these things have in common?  What is required to perform these skill successfully? Buoyancy.  A search pattern cannot be successful if divers are floating away.   Signals cannot be transferred if they are not felt.   Evidence is impossible to collect if it cannot be found due to silting.  The team is not safe if they cannot control ascents and descents in the marine environment.  When is the last time your team practiced buoyancy skills?
 
The search patterns, such as the Sweeping Arc, Jack Stay or Expanding Circle, all require refined buoyancy to make them effective.  Consider a new public safety diver being deployed in any of those patterns and not taking a few seconds to establish proper buoyancy.  During these patterns they are trying to use their hand to feel for an object in near zero visibility.  Because of the lack of buoyancy their face is planting into the ground, their hand is being used to push off the bottom or they are floating away, out of reach of any potential object.  Each time their body disturbs the sediment it makes it that much harder to locate the target.
 
Recreational divers are trained to stay off the bottom with visual references.  They swim along looking for the fish and staying off the delicate plant life or structures.  If they get too far off or start to float away, they check their computers and have ample time to adjust their equipment or techniques.  Public Safety divers do not have those options.  They know their target object is on the bottom, but they cannot see the target, let alone the bottom.  They don’t know how far they are from the bottom unless they touch something.  If they float above the bottom, they are lucky if they can clearly see their computer in time to realize their actual depth.  The one thing they do not have is ample time to adjust for misjudgments. Their line is being pulled, the current is moving them or they are struggling their way through some aquatic obstruction.
 
The diver feels rushed to get into the water and complete their task.  They have a lot of things on their mind and they may have some hesitation going into an unknown environment.  If the diver is not trained to stop and obtain good buoyancy the mission could become more difficult or fail.  Proper buoyancy requires controlled breathing, an understanding of their equipment and the ability to make adjustments using their senses since they may not have a visual reference.
 
The Public Safety diver never has a choice of where they want to dive.  As much as the diver would like the mission to be in warm, clear, flat contour environments, we all know that is never the case. Buoyancy is a very important factor when the search pattern involves changing bottom topography.  If the team decides on a circle search pattern and the pattern runs on a slope, the diver will continually change their depth and buoyancy characteristics.  Just imagine a slight slope where the diver is at 10 feet during part of their pattern and 35 feet at the opposite end.  If the diver does not have good buoyancy control there is an increased hazard for runaway ascents or dragging the bottom and possibly destroying evidence.  Proper buoyancy will allow a diver to maintain neutrality no matter what depth during the pattern.
 
A buoyancy training technique you can try during your next drill involves a team of two divers. Have one primary diver place an obstruction in their mask which will limit their vision.  Have the second diver act as the safety and lead diver.  As the lead diver moves along in the training environment the primary diver follows by a slight touch to the lead diver as well as staying as close to the bottom as possible.  The lead diver can intentionally rise above the bottom to the point the primary diver cannot touch.  The primary diver will then need to adjust so they are touching the bottom again using only their fingertips. The lead diver can then re-establish contact and continue with the pattern.  The lead diver intentionally moves up and down, away from the bottom, making the primary diver feel and adjust using their senses. The primary diver will need to know where the adjustment points are located on their equipment.  They need to remain calm if they lose contact with the lead diver and maintain control of their breathing.  The exercise will give the primary diver confidence in their buoyancy while being trained in a controlled environment.
 
A second training suggestion involves team members and extra weights, for an underwater game of hot potato.  The divers all descend and establish neutral buoyancy with controlled breathing.  The team brings down a bag of varied weights, from a few ounces to multiple pounds.  When a diver gains good buoyancy, someone hands him a weight.  The diver must re-establish their buoyancy with breathing techniques, BC adjustments or drysuit adjustments.  Once they are neutral they hand the weight off to a nearby team member.  As they hand over the weight, their buoyancy changes and they must re-adjust, only to be given a different weight.  The exercise continues with the goal being the diver can quickly and properly adjust to changes in weight without overcompensating, or handing a weight off and not floating to the surface.
 
Dive teams need to become proficient with basic diver skills, such as buoyancy.  All too often the team training focuses on the exciting parts of the mission and high end equipment and ignores refreshing on the basic skills.  If the team works harder to become proficient at buoyancy, it will translate in to more efficient missions, safer divers and a greater likelihood of a successful mission.

About the author
donkinney

Don Kinney – ERDI Instructor Trainer
Don Kinney has been a Public Safety Diver since 1991.  He continues to lead his public safety team as well specialize in training other dive teams around the world.  He has extensive experience in lakes, rivers, ponds, oceans and water holding tanks.  He prides himself on developing training around the needs of each team and their unique environments.  For further information please go to www.etds.org.

Because Miracles Happen

Posted on: September 25, 2013    
By Mark Phillips

Intova Digital Camera
 
Photo Credit: Mark Phillips
 
Are you ready for a challenge? This is not a challenge to train or accomplish a specific task. You don’t get a coin if you finish. This challenge issued to you is much more than that.

The questions have no right answer. No action you take will be the right one. Nothing you do, including nothing at all, will prevent someone from dying.

But, doing nothing could save a life.

Perhaps challenge is too specific. Perhaps dilemma is more appropriate.
How do we protect ourselves from harm or death while doing everything possible to prevent someone else from being harmed or dying?

Consider this: A 911 call comes in and you and your team are dispatched to a car in the water. The location is 3 minutes away. You arrive and the crew that is with you are members of your water response team. You grab a mask, snorkel and fins and jump into the water heading for the vehicle that is underwater hoping for a quick rescue or situational assessment while your crew begins setting up the limited dive gear on board.

You take a quick breath and dive down to the 12 foot deep car and find you are on the driver’s side. Visibility is minimal at best. A quick feel around tells you that all the driver’s side windows are down. You reach in and feel the driver. It is a woman and she is not moving. You quickly cut her seatbelt and have to make a quick ascent for another gulp of air. A quick breath and down you go to extract the woman. Once on the surface you swim her to shore and your crew drags her out of the water  diverting their efforts to CPR.

Breathing heavily with adrenaline pumping through your veins, you take a moment to see that your team has the situation under control. Another breath and you dive back down to the car.

As you reach the car  you realize  you did not get a good breath and have to make a quick ascent. You take a moment to regroup, get your breathing under some control, take a gulp of air and go back down.

This time you  reach inside the rear window and feel a child seat,  it’s  occupied. Before you can react, something brushes against your hand and you realize it is the hair of someone else.

Do you take time to save the baby? Do you take time to search the other side of the car to see if there are even more passengers? Your time frame for a realistic and viable rescue is slipping away. Who do you save? Taking time to search potentially takes  life from the infant but could give you valuable information  you can share on the surface where you could  get a teammate  in the water to assist,  possibly rescuing  someone else.

Either decision, either action is likely to result in a fatality. But if you take the time and everything works out perfectly you may save a family.

You choose to take the chance and search.  Back to the surface for another breath and a quick shout to the team letting them know there are two more victims.

Deep breath and back down.

The adrenaline rushing through your body is demanding that you breathe; the exertion of the swim is having a dramatic effect on your ability to hold your breath for even a short time. How long can you hold your breath? In the moment, will you be able to control your breathing? Will you be able to be effective? Maybe, but probably not.

Each ascent without a victim is another nail in their coffin.

You make it to the passenger side of the car and determine that both windows are down and discover a child in the front passenger seat and another in the back seat. Now you have three victims. Who can you save?

Who do you try to save?

Save one and two die? Save none and rush to the surface to report and scream for help? Maybe all of them die because of the delay. Maybe the additional help is there and together you save one of the three… or two… or all of them.

Which is the better choice? How can you possibly know? How do you make that decision?

As a water response team we strive for rescue. We want more than just a victim out of the water and breathing on their own, we want them to fully recover and resume their normal lives.

One of the sad realities is that we cannot save everyone and by the time the divers arrive, the chances of rescue have diminished to close to zero. We know this. We understand this. But even knowing and understanding that there is virtually no chance of a rescue, we still try.

We like to say we have a “Golden Hour” which allows us to work in rescue mode for an hour before transitioning to recovery mode. We even fudge this 60 minute time frame past the intent. The “Golden Hour” was originally(?) an hour of rescue  efforts from the  time of submersion but we’ve skewed that to be an hour from the time  we start. Some teams have even extended the time frame to 90 minutes.

Our GOAL, our training, planning and purpose is to save lives. So we sometimes fudge a number that we already consider to be overly generous. Miracles do happen and we should help one along when we can.

However, we also train, plan and prepare for the risk we assume and the known hazards we will face in and under the water: depth, current, zero visibility, debris, sharp metal and broken glass, rising gasoline columns and more. We do this because our other goal is to ensure our own people live through the incident. We typically use and refer to an analysis done on site called “Risk / Benefit.”

Is the RISK to our people worth the BENEFIT of saving someone else’s life?  We want to be heroes and say yes, absolutely, you bet! But the reality is that we are not going to purposefully place one of our own in a situation that we know has a high possibility  of killing them for the chance we might save someone else.

In the previous scenario, the car was in a shallow body of water. Now use that same scenario and make the depth just 30 feet. How much more risk does that create? How does that affect the survival possibility of the victims? Can you  perform a breath hold dive to 30 feet and still have time to do any searching or work?  Is there even a marginal possibility that the attempt could  be made? What is your limit?  If you do not know your limits or those of your team, who has to die during the onsite / on scene discovery of those limits? You? One of your team members? One or more victims?
We live in a lawsuit happy society. There are public expectations of us regarding our skills, talents and abilities as Emergency First Responders. When we show up to a scene, regardless of what it is, we are expected to overcome the obstacles and save lives.

We are EXPECTED to put our lives at risk. That may not be a realistic expectation. We train and equip ourselves very purposefully to reduce our risk. WE know what we do but the public watching does not know all we had to do to prepare ourselves or our teams to do the jobs we do.

Most of the time we do our job well and without injury or major incident. If it is not a contract year, they call us heroes and praise our hard work and dedication. Unless we do something wrong and someone gets hurt or killed. Then the gloves come off and everyone waits  to see whose heads will roll.
What if someone was hurt, or died, and we did nothing wrong? The public expectation of us is so high that when someone gets hurt or dies, it MUST be our fault. And again, everyone waits  to see whose head will roll.
Is it fair? Of course not but it is how we are perceived and if we do not recognize this we are deceiving ourselves.

You respond to a Not Breathing call from a frantic elderly woman who found her husband sleeping on the couch  when she woke up this morning. When you arrive you immediately recognize lividity and a quick touch confirms rigor mortis. Before you can speak, the wife tells you that she saw him breathing just a few minutes before she called 911. In a heart-wrenching sobbing voice she can barely whisper, “please save him.”
We know the outcome already. There is nothing we can do that will bring him back to life.

Nothing.

Why won’t you help him?”

“PLEASE, PLEASE HELP HIM!”

Do you say, “Sorry for your loss” and pack your gear and leave? Do you wait for EMS or a Justice of the Peace(?) to show up before you leave? While you are waiting are you talking and joking around? Does your crew step outside to have a smoke? Do you get on your cell phone and have an unrelated and public conversation?

Hopefully your response to all the above  is NO.

If you have been on the job for even a little while you have seen death. You have seen the grief of the survivors. You have seen the mechanism of fatality on more than one occasion.

You already know if there is family or friends present. Your patient is dead. Don’t you have a responsibility to the survivors? If it is nothing more than showing a little human compassion and respect, we should do it. On some occasions, we take time to discuss what our procedures are and what can be expected to occur over the next hour or two. We give them information that includes the truth. Information shared with family members who are on your scene, regardless if it is above or below water, should be truthful, accurate and respectful.

But what do we do when our victim is still alive  and under the influence of drugs or alcohol and has decided to commit suicide?

What do we do if our victim is perfectly sober and is trying to commit suicide? What if they are successful and we are present when it occurs?
A gunshot through the head is usually pretty final. A drug overdose, while daunting, can sometimes be mitigated. A bridge jumper, depending on the height of the bridge and/or the depth of the water could survive the impact and might be saved.

What do we do if someone is determined to commit suicide by drowning? What if they are successful and you witness the event?

If they are in the water and are trying to kill themselves, your ability to assess risk is limited to what you can see and what you can determine from witnesses. What you cannot see is the possible weapon in their hand or pocket, their mental state of mind (other than the obvious) or their capacity for violence if approached or interfered with. Do you train for this? Do you have an Operational Guideline for this kind of emergency?

What if they are successful? What is the public perception of your team or department now?

There are no right answers. There are no right procedures to follow. It is a dilemma that will result in one of three outcomes:
  • The victim is prevented from being successful.
  • The victim is successful and you perform a possible rescue or a body recovery.
  • The victim is or is not successful and injures or kills one or more of the potential rescuers.
If you are part of an active water rescue and / or work as an Emergency First Responder in any form, there will be numerous incidents in your career where you will be placed in possible jeopardy. The ability to breath normally, to walk or run, to see what is coming at you ends when you submerge.

Our risk goes up. The ability to be fatally injured goes up. Why are we doing it? Why would we take on and accept that level of risk? There is no right answer for that question either. We just do. Or primary goal is to save lives. It is who we are and how we are wired.

We CAN mitigate and lessen the risks through training, equipment maintenance and awareness of our own physical and mental conditioning. When we are expected to put our lives in jeopardy, we should know when the expectation exceeds reality. But our reality is usually much more than that seen by the public. We accept the risk and take on the challenges but we do so having trained and equipped ourselves properly. Our goal is to save lives  without losing ours or one of our own. In extreme incidents, we do sometimes have to rely on a miracle.

Nothing says we can’t help it along.

About the author
Mark Philips is a 33 year career firefighter who just recently retired and has been an active diver since 1979. Mark holds instructor credentials from 5 scuba agencies and specializes in Underwater Crime Scene Investigation. He has taught from Hawaii to North Carolina and been a consultant for numerous organizations, institutions and manufacturers in the field of Public Safety Diving. He is the author of PSDiver – A Textbook for Public Safety Diving and the Editor / Publisher of the free E-Zine, PSDiver Monthly. He is also a member of International Training, Training Advisory Panel.

Friday, April 26, 2013