my shallow water blackout nightmare

[SpearoPimp]

I am posting this so that the experienced ppl on this board can help asses the situation, why it happend, how smooth the rescue was. And provide tips that will help me prevent a future disaster.

This is the blackout in chronological order. It was my 12th or so dive to 70ft over a wreck while spearfishing (I do not believe that I was fully warm and my dive reflex had kicked in yet). There was a current that was not very strong but strong enough that I had to keep lightly finning the entire time to stay over the wreck. On this dive I said to my buddy behind me "spot me on this dive" ( i would make sure there was someone watching me every dive i did). The other dives were 1:15 to 1:30 and my surface intervals where all at least 3 minutes. I dove down and spotted a fish at what seemed like a reachable distance maybe 30 ft away. I swam towards it fired a longshot and missed. This is the last thinkg that I remember. My friend spotting me said after this I started heading for the surface normally and did not seem hurried or like I was panicking. at about 15 ft from the surface he said I stopped and dropped my unloaded gun and stuck my chest out and my arms striaght out. He swam for me immediatley and brought me to the surface, he said from the time i blacked out he had me at the surface 20 seconds later. He said I was stiff as a board and convulsing and not breathing.

THE RESCUE:
Once alerted the ppl on the boat should have ditched the anchor but they were too untrained to realize this. instead my other friend jumped immediatley and swam over to us and helped my other friend bring me to the boat. by this time they had dropped my wieghtbelt. I was still super stiff and not breathing. Niether of them are properly trained to deal with a black out victim so one of them did what he had heard before and slapped me several times....tried to squeeze my torso for some reason but he a said it was rock hard. They said my jaw was clenched and mouth closed face was white lips blue. He said one of the times he slapped me when they almost had me to the boat I squeezed my eyelids and thats when they knew I was still alive. As my dad was trying to lift me onto the boat I became conscious. My vision was spinning a million miles an hour and I start gasping for air hyperventelating and trying to scream for help because i didn't know what was happening. They informed me I had blacked out. Everything continued spinning very badly for about 2 minutes then it began to taper off although I was still a little dizzy up to an hour later. I even though I was breathing again I felt like I was suffocating and not getting any oxygen. The dive itself was over 1:30 I probably blacked out around 1:30 then did not breath again for an estimated 1:30 to 2 minutes. The paramedics met us at the dock 15 minutes later and gave me oxygen to breath which helped the dizziness subside. I was hyperventelating almost the whole boat ride back enough so that my fingers went numb.

MY ASSESMENT:
I think the reasons this happend to me are the following
1. I followed a fish that I should have let go and not chased. I over excerted my self at depth.
2. I was diving my maximum depth (which I realize now is out of my range and I will not attempt again for a long time) in a current, which I had never done before.
3. I was trying these dives before being in my dive reflex.

what should my rescuers done immediatley upon getting me to the surface? The paramedic said that a forced breath and tilting the head back and pinching the nose should have got me breathing again but they said my jaw along with the rest of my body was clenched.

I am now overcome with fear about freediving this is the closest I have ever been to death and although it was almost a week ago I am still traumatized by it. I know I will dive again because it is my passion in life, but I don't know if I will ever do it without fear again. I will never dive again deep or shallow without someone right there with me on the surface. Before this happend I usually didn't like to dive without someone watching me but would do it anyways sometimes. I will never dive again without someone else on the boat who is cpr trained. We are all going to take a cpr course now. I own Pellizzaris manual of freediving and I think we are going to go through the excercises and rehearse rescuing a black out victim.

The thing that scares me about this blackout is that at the last thing I remember (shooting and missing the fish) I did not feel I was in any danger. I did not remember feeling starved for air at this point or like I needed to get the the surface badly. I wish i rememberd how I felt as I was ascending.

Please tell me everything that should have been done. What you think I should have not done etc.

 

[Cliff Etzel]

This is a classic case of what happens with most spearo's - fortunately things turned out for the better. You spotter did the right thing in getting to you and ditching your weight belt. That is the positive aspects of this.

Reality is, all your buddy really needed to do was remove your mask and lightly blow on your face - the receptors in the face being cooled by a breath are enough to begin the process of recovery from a blackout. And the fact that you were able to recount in pretty good detail the conditions by which this occurred says alot for your presence of mind. I think the universe handed you an opportunity to let others know how important it is to dive within one's limits, have a spotter and to have proper first aid/cpr training.

Lastly - if you can, take a proper freediving course so that you can go through the proper procedures of shallow water blackout rescue. I wrote an article specifically on this very topic - the article can be found here

Glad to hear you are ok...

 

[jimqpublic]

I'm glad you're alive. Even though your rescue wasn't perfect, it was good enough to save your life with no damage.

In addition to reading about rescue techniques, proper rescue training with in-water practice is important. Now that you know just how dangerous this sport is, the cost of good training probably seems much more reasonable.

PFI have classes in Miami, but their July 22 class is fully booked. You could contact them to see if they would add a session of their 8 hour "Safety Freediver" class tailored for your group. It doesn't hurt to ask. Better yet sign up for the 4 day intermediate class in September.

I am completely inexperienced in freediving, but after just completing the PFI 4 day intermediate freediver course I believe I can handle an in-water blackout of a dive buddy. Still, I suggest that rescue drills would be a good warm up to each dive until they are 100% automatic. Certainly if you are diving with a new dive partner it makes sense to do rescue drills.

Jim

 

[jimqpublic]

One more thing is proper weighting. According to PFI 90% of blackouts or sambas occur at the surface and 9% occur in the last several meters. Your blackout at 15 feet is pretty classic. If you follow PFI's weighting advice and are neutral at 10 meters (33 feet) then you will float up to the surface in 99% of blackouts. You still need to be rescued since face down on the surface you drown, but at least your buddy doesn't have to chase you down as you sink toward the bottom.

As deep as you were diving being neutral at 33' is no problem. It only becomes an issue if you're diving in shallow water. Most of the students in my PFI class reduced their weight belts by 6 pounds or so to be neutral at 10m.

Regarding the fear- I think that practicing rescues each time you go to dive should help to regain your confidence. That and reasonable caution can turn the fear into useful tools.

 

[deep thinker]

Glad to hear you are ok man. A good idea next time you do a deep dive or to your maximum depth or any depth for that matter is to loosen the quick release on your weightbelt and holding it in place with your free hand as you start your return to the surface. If you do this and you black your slack hands will automatically let go of your loose belt and it will fall off allowing you to continue your float to the surface.
Hope to hear you get back in the water soon and good luck

 

[naiad]

Glad to hear you are ok. Very scary. Another similar story:
[ame="http://forums.deeperblue.net/showthread.php?t=50858"]Lessons learned in the Bahamas - An intimate account of our most dangerous enemy.[/ame]

Lucia

 

[SpearoPimp]

Yes the performance freediving course. I would love to take it, but once again the cost of it for a college student I think is too steep for me right now, maybe later this year after I go back to work. I definitley am trying to find a professional or well trained very experienced free diver in the south florida area that I can take out for a day or maybe pay a smaller sum of money than 500 to have them evaluate everything i do in the water and teach me and correct me. So if anyone knows anyone in south florida they can reccommend that would be highly appreciated. I will mention the freediving course to my parents, but they are very cheap but maybe my blackout experience will cause them to help me out with the fee.

 

[Cliff Etzel]

If you're in the miami area, look up Ricardo Hernandez.... http://divesafer.com/pages/829759/index.htm

 

[fcallagy]

glad to hear it all turned out ok and thanks for the advice

 

[efattah]

My golden rule for freediving is simple:
- The most important and critical part of pre-dive preparation is to be absolutely motionless for at least 2 minutes prior to the dive, and at least 5 minutes if the dive is near one's max depth

Having to fight a current at the surface is a total violation of this rule, and I would say that the working depth is cut in half at least. For example if you can dive 70ft under ideal conditions, and you are fighting a current at the surface, I would say your working depth would be 20-35ft.

You say you don't remember feeling panicked or out of air. That is not necessarily the case. Your blackout was long, and the longer the BO, the greater the memory loss. It appears your memory ends just after you shot the fish. This means that any panicked ascent or big contractions have been forgotten. It doesn't mean that those things didn't happen.

 

[Erik]

You say you don't remember feeling panicked or out of air. That is not necessarily the case. Your blackout was long, and the longer the BO, the greater the memory loss. It appears your memory ends just after you shot the fish. This means that any panicked ascent or big contractions have been forgotten. It doesn't mean that those things didn't happen.

And on that note, in the interest of reducing psychic trauma, consider doing some relaxation/meditation and try to remember that incident in a safe and relaxed state of mind, reminding yourself that you survived and are ok. If not, the incident may start coming back to you whether you like it or not- ie in dreams/nightmares/flashbacks.
Even getting into meditative state and visualizing the whole thing, making up the parts that you don't remember can be very powerful and 'healing' (sorry I'm sick of that word).
Good to hear you are still kicking. The sooner you get back in, the better amigo.
Peace,
Erik Y.

 

[efattah]

My first blackout was also traumatic. Initially I didn't remember anything of the ascent from the moment I passed the 30m marker (i.e. final 100ft of ascent were forgotten). However, as I relaxed into the memory, eventually I recalled events until just before the BO at 1-2m.

 

[anthropisces]

Re: shallow water blackout

To those of you that have had experiences blacking out, including knowledge of blackouts; what are the ages of those who blacked out that you know? I have read that young males are most at risk, but that author also stated that the reason might simply be that young males are more likely than older males to push things and to take risks. Still, I would be interested in knowing the ages of those who blacked.

 

[efattah]

Female blackouts range from young (Yasemin at age 19), to older (Annabel at age 50+). In men blackouts also range from young (as low as 14-15), to old (50+, for example Andy LeSauce or Bill on DB).

 

[tylerz]

Glad you survived! And secondly glad you are trying to assess things and grow from the experience. Part of that growth, is using the fears to motivate the hunt for details that are, and have been, easily taken for granted.

Elaborating slightly on other comments, a very important thing to remember when freediving recreationally is that dives are subject to large variances in characteristics from sessions to session and even dives within the same session; characteristics such as currents, dive path/profile, hydration, exhaustion, metabolism, blood shift, etc. all come into play at being factors that adjust what is a safe amount of time before you need to hit the surface.

Therefore in a recreational environment you can not solely rely on a static idea of how long you can dive for and how deep. One dive you kick for 10 secs before sinking, another dive you kick constantly, and another you kick intermittently, all affecting your dive time considerably. And it would be a misconception that if you have your dive reflex/response kick in, that these differences would not still play a significant role. The response is variable as well and is not a complete shut off valve that allows you to exert your extremities as much as you wish.

Just as importantly, neither can you rely on a feeling of urge to breathe. Often the deeper one goes the less urge to breathe they will feel. Breathe up at the surface has to have significant consistency to guage whether you have dove without reducing CO2 to low levels. Just determining whether you felt extremely low CO2, as sensed by tingling extremities, is not a fine enough assessment. The whole range between extremely low CO2 to lots of CO2 is not something most people can sense easily or accurately.

Also, as soon as I read your accounts, it also occurred to me, seconding Eric's statement, that your BO would have induced memory loss. So, unless there was a strong enough significance to the details, your brain would not have retained whether you were feeling different in your urge to breathe or not. When you surfaced from that dive, there is a strong possibility that you were sensing a need to reach the surface, and, being so focused on that objective, you would not have noticed, or focused, on much else occuring in your body. On most of my deep dives from the past, when I surface, I have not sensed much of anything from my body. Instead, I am solely focused on maintaining the rhythm of my technique and consoling my mind that everything will be fine towards reaching the surface. Only recently have I begun to attempt to sense what is happening on the way up in my body, and I forget about it still most of the time.

In terms of being traumatized with fear, I would offer the recommendation to:

1. Take some time to digest your existence at this moment. To feel how alive you are. Regain a strength and consistency of sensation that nothing is threatening you more or less than it ever was. Don't think about diving when you do this. Do this until you feel grounded in the realization that things are as they always were.

2. Take some time to digest what you would like to introduce as new into your existence. Information has increased as it always does; a product of passing through moments. Try to see the events that occurred without pursuing or dwelling on the emotions surrounding them. With the information of the events , and the information you are gathering as a product of the events, form what you have learned and what you comprehend.

3. When you have a clear picture of the events and what information is new and valuable, then let your feelings envelop that information and digest what they suggest, reassessing the importance of the information.

Remember that it appears you were diving with a considerable lack of information regarding safety techniques of recreational freediving. Therefore, if you put some time and focus into integrating such things into your dives you should be able to relax, albeit maintaining a healthy degree of caution and awareness to your dives.

 

[anthropisces]

A friend of mine and I began working fairly earnestly on a free-dive vest that would potentially save the life of a black-out victim. It timed both the dive and the surface interval, and evaluated pressure profiles indicative of descent at an odd time.
We worked fairly diligently on it but in the end, we abandoned the device since it took excessively large cylinders to bring someone up if they had a problem at 100'. We felt that the design had to be flexible enough to address problems at all depths and that it was becoming cumbersome. Free divers already are shy of excessive gear.
Still, the potential for the device is there, especially if one wanted to inflate the vest from perhaps 30' or less.

 

[tylerz]

We worked fairly diligently on it but in the end, we abandoned the device since it took excessively large cylinders to bring someone up if they had a problem at 100'. We felt that the design had to be flexible enough to address problems at all depths and that it was becoming cumbersome.

Well you may have just expressed the perfect combination of safety gear and requirement for common-sense. It appears part of your philosophy for the vest may be the distraction from a product that really makes sense for freedivers. By the vest not functioning deeper than 10m, the freediver can not relax into a reliance and false security towards the vest as easily as if it worked at all depths. If it does work in the range 0-10m or something similar, then it provides its function in the most critical zone. BO at depth is a rare beast. Not having the safety for the shallows, being 99% of the problem, just because it doesn't work for the other 1%, seems a waste.

My recommendation is keep at it.

How did you guage that it functions at 10m? With what neutral point for the diver? How big was the cyclinder for that depth?

 

[Fondueset]

Awesome thread.

I generally dive quite shallow - 10m would be close to max in the areas I dive most - so I'm generally weighted for neutral at 5-7m. I do sometimes hang out down there for awhile. From the movies I'm probably in the 2 to 2 and 1/2 minute range on most dives. I've got alot to learn about all this but I have noticed relaxing on the surface really helps. I do a sort of 'whole body breathing' - just releasing along all the peripheries and slowing the breath. I also like to exert minimally all during the dive. On the breakwall I like to sit on the rocks now and again and take my mask off - fresh air in the sinuses is really nice.

 

[lungfish]

It sounds like you were in a laryngospasm and a rescue breath to equalize the pressure on both sides of your larnxy would have released your breathing.

We had a blackout at the PFD clinic in Kona last week, a spearo, it was a non-event because the rescue is simple and gentle. Get them on top by holding their head while keeping their chin tucked in and the nostrils pinched to protect their airway, remove the mask while supporting the head, gently pat the face while blowing on the eyes and TALK to the victim.... it is the sound of being slapped, not being slapped, and air on the face that brings them around. If they are locked up and not breathing, like you were, then do a rescue breath, mouth-to-mouth to release the laryngospasm.

A properly prepared safety diver who is watching you can make it all like a bad hair day...

As far as going back, our diver who blacked out was in the water the next day heading towards his PB.

Surface intervals are important, but they need to be focused on preparation, not just letting time pass. You can be distracted watching for targets...Proper outgassing at the end of the previous dive - hook breaths and proper ventilations immediately afterwards. Surface intervals above 80ft should be at least twice the duration of the previous dive, and below 80ft should be 8min between, to cope with Nitrogen buildup, etc.

Then do appropriate long breath ups until you are really ready, purge, peak inhale, pack and dive..... You can fool yourself into thinking you are saturating (1-2sec inhale, 2sec hold, 10sec exhale) when you are really distracted and doing a full short inhale, a hold and a short exhale - which is actually a purge. You can tell if you are hypocapnic by tingling in fingers but if the water is cold, you can again be fooled and not notice that you have pounded down your C02 to the point that when you dive you aren't feeling the need to breath though you have depleted your 02 levels....

Your blackout could have been a result of the vacuum effect, gases returning to the lungs on ascent and pulling 02 away from your brain. In otherwords, it might not have been gas related at all but PRESSURE related. OR it can occur in combination with hypoxic/hypocapnic condition I described above.

If you are having traumatic memories, dreams, etc., it might be best to take a course and tell them why you are there. Your confidence may shore up a little with some physiology and physics. Get retrained. Spearfisherman die in this endeavor far more often than trained freedivers.....it is because they are swimming to hunt, and not focused on swimming itself.

Thanks for sharing your story, glad you are here to tell it. You and your buddies could use a freediving course with some emphasis on safety support. The rescues are quite easy and gentle...

 

[tylerz]

It sounds like you were in a laryngospasm and a rescue breath to equalize the pressure on both sides of your larnxy would have released your breathing.

What do you mean by "a rescue breath to equalize the pressure on both sides"? I have not heard of there being a technique to release a laryngospasm other than assisting the body to recognize the presence of air. Shortly after unconsciousness relaxation of the larynx should occur. Supposedly, 10-15% of the time it does not relax until cardiac arrest. In medical practice to release a laryngospasm often requires intubation.

them around. If they are locked up and not breathing, like you were, then do a rescue breath, mouth-to-mouth to release the laryngospasm.

Is there a reference that mouth-to-mouth assists with laryngospasm?

ventilations immediately afterwards. Surface intervals above 80ft should be at least twice the duration of the previous dive, and below 80ft should be 8min between, to cope with Nitrogen buildup, etc.

This is a very new and unexplored topic and specifying generalized times as short as 8min for anything greater than 80feet is not recommended. Recently Eric did some dives where he demonstrated that 8min intervals were not sufficient. If I recall he was doing 11min intervals and it still was not enough.

Then do appropriate long breath ups until you are really ready, purge, peak inhale, pack and dive...

This sequence is also controversial and not recommended by many. Purging wastes energy, increasing metabolism, and reduces CO2 to low levels. Packing you can find all sorts of threads and posts referring to the dangers involved and how it should not be employed for recreational diving, especially by those without considerable experience and understanding of their body.

You can tell if you are hypocapnic by tingling in fingers...

IF, you have tingling in your fingers, it is a good sign that you are hypocapnic, however if you don't have tingling in your fingers, it does not mean you are not hypocapnic. Too low of CO2 for a specific person, has nothing to do with the point that one has tingling in their fingers. It is just a generalization of an obvious sign that one is too low. They could have been too low half way to that point as well.

Your blackout could have been a result of the vacuum effect, gases returning to the lungs on ascent and pulling 02 away from your brain. In otherwords, it might not have been gas related at all but PRESSURE related. OR it can occur in combination with hypoxic/hypocapnic condition I described above.

Why would you distinguish between pressure related and gas related? Gas exchange only occurs due to pressure and related to pressure of the surrounding environment. When diving you are not static, and as long as you are ascending or descending you are being affected by changes in pressure. Considering we were told that the BO was during the ascent, we know that depleting oxygen and pressure were the cause, correct?

Cheers,

Tyler