Coping with a critical incident

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It’s a delicate subject and one that – rather than being openly discussed – is often skirted around, or avoided altogether. But as a physically challenging activity that takes place in an alien environment, diving will always carry with it an element of risk.

That those risks can be reduced to a manageable level through appropriate training and a rigid adherence to proper procedures and protocols doesn’t nullify the fact of their existence. They are real and have their basis in the many variables that divers have to consider. That’s not to suggest that a properly considered and executed dive plan is any more dangerous than, for example, crossing a busy intersection when the traffic lights are in your favour: Although the potential for mishap is always present, it’s reduced when everybody observes the rules.

A diving incident, of course, comes in many forms. It may be something as seemingly trivial as a badly leaking mask that calls for the dive to be aborted. It might be a major equipment malfunction that’s resolved by carrying out an air-sharing ascent back to the boat: Or, and at the more extreme end of the scale, it could be a bad judgement call that results in severe injury or even death.

Perhaps because serious incidents are comparatively rare when balanced against the tens of millions of dives that take place each year, few people ever give thought to how they might manage an emergency: Not only in the flurry of the crisis itself and their immediate ability to respond to the needs of the victim but, and of equal importance, how they will cope once the situation is resolved?

There are three distinct phases in any incident; the events that precede it; the episode itself; and the aftermath. An appreciation of each is important in determining how well people will cope when the unthinkable happens.

Prevention is better than cure

It may sound trite, but the first step in learning to cope with a critical incident is to ensure that all reasonable precautions have been taken to prevent one happening!

Many of the so-called ‘accidents’ that occur in diving are avoidable. Rather than being, ‘events without apparent cause’, they are often the result of a failure to safeguard against what – in retrospect – becomes the obvious.

With the benefit of hindsight, it’s usually easy to determine what went wrong:
• The dive plan was flawed.
• A diver failed to follow the dive plan or adhere to the pre-dive briefing instructions.
• The person giving the pre-dive briefing omitted key facts.
• Nobody thought to check the qualifications of a diver allowed to participate in a dive beyond the level of their experience.
• Pre-dive safety drills and equipment checks were overlooked.
• An appointed dive leader allowed people to dive in less than perfect conditions rather than be criticised for cancelling the dive.
• A qualified person failed to properly check rental equipment before it left the dive store.
• A diver caved in to peer pressure and undertook a dive that they didn’t feel comfortable performing.
• Unsuitable equipment was used.
• A seemingly minor incident or malfunction went un-reported and subsequently escalated into a major one.

The list is endless and highlights the fact that in diving nothing should be taken for granted and that nobody should relinquish personal responsibility for his or her own safety and well being.

However – and regardless of effort – it’s impossible to plan for the totally unexpected. One day, despite all reasonable care, a diver or dive operator may still be confronted with a crisis. It’s then that any precautions they’ve taken to protect themselves or their customers from harm will pay dividends, not least as regards the insidious effects of later self-recrimination and nagging doubt about what they might have done to prevent the incident.

“We have a problem!”

Although they might appear similar, no two diving incidents are ever exactly the same. Both the circumstances and the actions taken will differ.

How each individual responds to an emergency will largely depend on their level of training; their experience; whether they’ve mastered and absorbed the information taught; and how much thought they’ve given to the, “What if …?” questions of diving.

(In this regard the ability to visualise what could happen is a useful technique. Not only for its value in spotting in advance any possible causes of an incident but also in influencing the outcome. In the emotion-charged atmosphere of an emergency most of us lose sight of the fact that an ill-considered and inappropriate response may actually compound a situation and prove worse than no action at all!)

In extreme circumstances, particularly when the victim is beyond immediate help, it may be necessary to call on specialised assistance to affect a rescue or recovery. It’s at times such as these when, frustrated by inactivity and their inability to assist in what they believe to be a positive fashion, those at the scene of an incident are at their most vulnerable.

As a useful tool in ensuring the best outcome to an incident, the value of an emergency contingency plan cannot be over-emphasised. Documenting all of the procedures to be followed – including the assignment of small tasks to keep peoples minds occupied – an Emergency Plan is a reference source that can be used by anyone at the scene. Providing step-by-step instructions on what to do and when, a well-formulated contingency plan can, quite literally, be a life-saver.

Reducing the risk

The first step in reducing risk is to eliminate unnecessary worry about something that may never happen. Imagine the worst that can possibly happen: And then calmly try to improve on procedures so that it doesn’t!

Dive operators
Some positive measures that a dive operator can adopt includes:
• Ensuring that everybody involved in the dive operation is familiar with – and adheres to – the relevant Training Agency standards.
• Having on hand – and familiarising themselves with – all regulations, and Occupational Health & Safety standards relevant to their business. (And then ensuring that they are in compliance with such regulations.)
• Familiarising themselves with any relevant diving industry ‘Codes of Practice’. (They should regard these as being an acceptable ‘minimum’ and look for ways to improve upon them.)
• Maintaining – and keeping filed away for future reference – all customer records relating to their diving activities.
• Making adequate provision for insurance.
• Ensuring that equipment maintenance schedules are adequate.
• Ensuring that all rental equipment is well maintained and that a qualified staff member checks all items in the presence of the customer before releasing them for use.
• Confirming that all members of their staff – whether full- or part-time – know and properly understand their duties and responsibilities.
• When promoting or conducting guided dives for certified divers ensuring that:
a) Waivers and liability releases are properly completed.
b) That paperwork is adequate to gauge the customer’s diving experience.
c) That the planned dive is within the customer’s capabilities.
d) That the available number of dive leaders is relevant to the experience level of the group.
e) That the dive leader is qualified and insured: That they are familiar with the dive site: That they possess the required skills to properly gauge sea and weather conditions – and if necessary abort the dive: That their pre-dive briefing is based on a written document specific to the dive site in question and covers all aspects of the dive plan, including emergency procedures: That they carry with them a written ‘Emergency Plan’.
f) That complete First Aid, O2 Resuscitation and Spare Parts kits are available to the dive leader at the dive site: That they know and understand how to use the items – and that they are suitably qualified in their proper use.

Divers
Everyone who dives must accept responsibility for his or her own well being and safety. Exposure to risk – for themselves and others – can be reduced by ensuring that:
• They regularly practice all of their diving skills.
• Their qualifications and experience are adequate to the dive being undertaken.
• They are fit, well, and have a positive mental attitude towards the dive.
• They have the strength of character to say, ‘No!’, when they’re uncomfortable with any aspect of a proposed dive.
• Their equipment is appropriate for the dive; that it’s well maintained and operational in every respect; and that they are completely familiar with its use.
• They plan every aspect of the dive in meticulous detail; that they are familiar with the plan, adhere to it; and know when to abort the dive if any aspect comes “unglued”.
• They have familiarised themselves with all emergency procedures and the proper use of safety equipment.
• They ask questions about any aspect of a dive briefing that gives them concern.
• Regardless of experience, they abide by all appropriate safety conditions imposed on them by an operator.
• They recognise their limitations and dive within them.
• They keep in mind that today’s dive starts the night before!

The above represents a very small number of all the steps that divers and dive operators can take to ensure that they don’t learn to handle a critical incident the hard way.

———————-

Nobody, of course, plans a diving incident. But preparing in advance for something that may never happen is the first step in learning to cope appropriately should one occur.



Categories: Techniques

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