Scuba Drowning Deaths and Those Who Survive

Twenty years ago, even talking about diving alone was heresy. Today, it’s common practice. Liveaboard boats are filled with solo divers, and many land-based dive operations allow divers to venture off on their own. Furthermore, divers in groups frequently get separated from one another, with those who lag behind losing sight of the group.

Buddy diving is less commonplace because many divers believe they can’t depend upon a buddy for rescue. Rather than buddybreathe, they believe they’re better off heading to the surface alone.

Perhaps, but the ultimate cause of death in 80 percent of diving fatalities is drowning. And three Australian researchers have found that divers who are alone are, obviously, much less likely to be rescued than those who have buddies nearby.

This is the second of a twopart article summarizing the work of researchers Drs. Carl Edmonds, Douglas Walker, and Brian Scott, who reviewed 100 drowning deaths and forty-eight accidents of divers who survived.

In the first part, we commented on the role of water conditions, air supply, buoyancy compensators, and weights. In this issue, we look at what happens when a buddy is present — and when no buddy is present. The work of Drs. Edmonds, Walker, and Scott originally appeared in the Journal of the South Pacific Underwater Medicine Society.

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For a diver in trouble and drowning, rescue depends on rapid action by either the victim or the buddy. Once a diver is unable to carry out safety actions by himself, he becomes dependent upon other divers. A solo diver doesn’t have that help.

Fatalities

In eighty of 100 fatal cases, the victim was not with another diver. In twenty-one fatalities, the dive was deliberately solo. In another fifty cases, the victim had separated voluntarily from his buddy or the group. (In thirty-one of these cases, the victim aborted the dive — usually due to air shortage — and attempted to return to the surface alone.) And in another nine, the deceased divers were swimming behind and invisible to others at the time of the incident. This de facto solo diving made early rescue and resuscitation improbable.

In only eight of 100 deaths was there continued contact with the buddy or group during and following the incident.

The victims disregarded the buddy system, and group diving conferred little value because the leader often had insufficient contact with individual divers to be classified as a buddy. The responsibility of other divers was unclear, especially toward the last of the followers.

In 31 percent of the cases, no attempt was made to rescue the victim. In the next 24 percent, an attempt failed, often because no one knew where the victim was. In 17 percent of the cases, rescuers found the victim and attempted a rescue, with some initial response by the victim.

In a quarter of the cases there was no search for the victim until after the planned dive had been completed and it was realized that the victim had not returned.

Resuscitation

In only 20 percent of the cases was the diver rescued within five minutes of the incident. In another 12 percent, the diver was recovered within 5-15 minutes, theoretically giving a slight chance of recovery for these divers had the rescue facilities been ideal and had fortune smiled brightly.

However, in ninety-one of 100 cases, resuscitation was not feasible; the victims were obviously dead or showed no response to the rescuer. There was an initial response to resuscitation in 7 percent and ineffectual resuscitation was applied to 2 percent.

Near-Drowning Incidents

Most people who survived did so because they were rescued by their companion, who was of considerable value when he reached the victim. For surviving divers, the buddy was immediately available in 71 percent of the cases. He assisted in 58 percent, and in 52 percent of the cases controlled the diver’s ascent.

The buddy inflated the survivor’s BC in 25 percent of the cases, ditched the weight belt in 25 percent, supplied an independent air source in 15 percent, and attempted buddybreathing in 4 percent.

On the surface, some form of artificial respiration or CPR was required in 29 percent of the cases. Oxygen was used in 52 percent of cases, which suggests a sophisticated and organized diving activity.

Drowning Prevention

Drowning prevention required prefixed plans and action when an incident occurs.

Before the Dive

Medical and physical fitness decreases the likelihood of physical impairment or loss of consciousness or difficulty in handling unexpected conditions.

Adequate experience in the dive conditions increases the likelihood of a successful dive. Use extreme caution with tidal currents, rough water, poor visibility, enclosed areas, and excessive depths.

To ensure neutral buoyancy, avoiding being overweighted so as not to be too dependent on the buoyancy compensator.

Insufficient air may convert a problematical situation into a dangerous one. It also forces the diver to experience surface situations that are conducive to anxiety, fatigue, and saltwater aspiration.

Use traditional buddy diving practice: two divers swimming together. Solo diving, even for part of the dive, is more likely to result in an unsatisfactory outcome if there are diving problems. Divers who are committed to the traditional buddy-diving practices are likely to survive the more serious of the drowning syndromes.

If a problem develops, become positively buoyant. Drop weights and inflate the BC. Buoyancy compensators cause problems in some emergencies and will sometimes fail to provide the buoyancy required. Failure to remove the weight belt during a diving incident continues to be the major omission and must reflect on training standards.

Inform your buddy before ascent. A good buddy will automatically accompany an injured or vulnerable diver.

Rescue, first aid, and evacuation need to be planned before the dive.

What Does It All Mean?

This study raises several interesting questions about how both land-based and live-aboard dive operations handle the buddy system. A solo diver on a trip may not only question the value of an assigned dive buddy with little dive experience; he may resent the additional responsibility that has been assigned him as well. This in turn raises the issue of mixing novice divers and experienced divers on the same boat as well as how to predetermine a diver’s skill level, all of which are complex issues.

Proponents of solo diving could argue that most drownings occur on the surface, where there may be additional support available, and that the statistical incidents of double drowning (when one diver attempts to help another and neither survives) should have been reflected in this study as well.

While denying or repudiating buddy diving has become fashionable and innovative, implying diving expertise, the data shown here definitely indicate that, in a drowning situation, the value of a buddy is hard to deny. The truth is that most of us are solo divers in the strictest sense of the term, lagging far enough behind or engaging in an activity like photography where we’re in sight of our buddy only intermittently at best. In light of this research, however, we may want to reconsider our solo diving habits in situations of low visibility, high currents, deep dives, or other extreme conditions.

— Ben Davison