From the June, 2008 issue of Scuba Diving Magazine. When there's trouble on the water, will you be part of the lifesaving solution--or part of the problem?

It could happen to you: As you wait your turn on the back of the boat, the diver on the platform struggles to get comfortable in his gear before awkwardly stepping into the water. As you move to the edge of the swim step, he starts screaming for help a few yards off the stern. He throws away his mask and dips beneath the surface. Popping up, he sputters saltwater, screaming again, and bobs under once more.

In a dive emergency like this, everyone on the dive boat falls into one of two categories: part of the lifesaving solution or part of the problem. Which one are you?

To help you find out, we've outlined four common emergency scenarios and the proper responses to them. But before we continue, let's be clear: While many of the techniques and procedures covered here are taught in a rescue diver course, no magazine article is a substitute for proper training (see "Rescue Certified," p. 81). Our goal here is to show you the importance of rescue certification, help you understand how dive accidents happen, provide practical advice on how you can avoid being a victim, but most of all, to stress the importance of a calm, rational response in a crisis. When dive accidents turn fatal, the root cause is almost always panic--that highly charged state where rational thought is replaced by adrenaline-fueled instincts. Panic can overwhelm victims and bystanders, which is why the common reaction among untrained divers to an emergency is to stand there shocked as the crew pushes them out of the way. Even if you aren't directly involved in an emergency, flailing about in the water ineffectively or standing on the deck of the boat like a deer in the headlights certainly doesn't help, and in fact, may even hinder a rescue.

Scenario I: Panic on the Surface

Let's start with the unfortunate diver above, who stepped off the boat before turning his air on. He's sucking saltwater, and he can't get his BC to inflate. He's obviously in a full-blown panic. What do you do?

Rescue Plan: A rescuer's best course of action with a panicked diver at the surface is to help the victim without getting into the water. All dive vessels should have safety floats of some type, usually a life ring or float ball, and most have long-handled boat hooks, all of which can be thrown or held out to a diver in the water. If for some reason those objects are not immediately available, or the victim is too freaked out to grab them, enter the water and grab the diver without becoming a victim yourself. Always go in the water with some sort of flotation device. If you're already wearing your scuba gear, your BC will work--inflate before approaching the victim.

Approaching a panicked diver from the front puts you within his tunnel vision, the same tunnel vision that may cause him to scramble onto anything or anyone in an attempt to keep his head above water. Always approach a panic victim from the side or from behind so you can keep control of the situation. Once you reach the diver, grab his tank valve and hold on securely. That way, if he attempts to twist around, you stay behind him and he can't grab you and force you under. If necessary, you can even grip the sides of the tank with your knees. When you do this, fully inflate his BC--the reason for his panic may be that the tank isn't turned on, so crack the tank valve to inflate his BC if this is the case. Next, lean back so your body is partially beneath him and his face is out of the water. Speak to the diver firmly, in reassuring terms like "Relax," or "I'm here to help you." Don't yell or show your own level of excitement because this will add to his anxiety. Once you are firmly in control, swim him back to the boat and help him get on board.

Prevention Tips: Victims in this type of situation often ask, "How did I get here?" The answer to that question is usually a lack of preparation. For example, scrambling to get in the water and jumping in without your fins or, more frequently, without your air turned on. Rushing through your gear setup or your pre-dive checks, or waiting until the last minute to find a missing mask or fix a rotted fin strap can cause you to overlook important aspects of your preparation. Before your next giant stride, be sure to:

• Inspect all of your equipment before you pack it for your dive trip.


• Have any equipment problems repaired before you go diving.


• Arrive at the boat on time so you can assemble your primary equipment before you even leave the dock.


• Once you're suited up, safety check your own equipment as well as your buddy's.


• Enter the water completely geared up: BC inflated, fins on your feet, mask on your face and regulator in your mouth.


• Most important: Don't panic. If you make a mistake and step off the boat unprepared, swim immediately back to the boat and grab the ladder. Air not turned on? Reach back and crack the tank, or have another diver do it. Even in the most drastic situations, you can always drop your weights, inflate your BC (normally or orally) and alert someone on the boat. Clear-cut, simple actions like these are the difference between minor embarrassments and tragic accidents.

Scenario II: A Panicked, Out-of-Air Buddy

You're swimming along a wreck when, suddenly, the regulator is ripped from your mouth and your mask is flooded or knocked from your face as your frantic buddy makes a mad grab for your air supply. When an out-of-air diver panics, it's not uncommon for him to do whatever seems necessary to preserve his own life, even if that means putting someone else's at risk.

Rescue Plan: Many divers make the mistake of trying to take their regulator back--a virtually impossible task when the out-of-air diver has reached this stage of anxiety. Your first priority here is self-rescue, and that means getting something to breathe. Fortunately, your octopus works as well for you as it does the other diver. Retrieve it, clear it and breathe. Then, clear your mask and assess the situation. Generally speaking, at this point it's best to make a slow and controlled ascent to the surface holding on to the out-of-air diver. Once you reach the surface, remember that the diver's BC cannot be inflated from the empty tank so assist him by either orally inflating his BC or dumping his weights. Safety stops are a judgment call in this scenario. With a limited air supply and a diver in a full-blown panic, skipping the stop is probably the safer of the two options.

Prevention Tips: Monitor your air supply--and your buddy's. Make it a habit to check your gauges every 10 breaths or so on deeper dives. Many advanced divers will also crosscheck their buddy's air supply every five to 10 minutes, depending on the depth of the dive and the diver's usual air consumption rate. Start heading back to your ascent point when you've used up one-third of your air supply and try to be on or near the ascent line with at least a third of your tank remaining for the ascent and safety stop. As a backup plan, you should routinely practice controlled air-sharing exercises with your buddy so an out-of-air situation can be effectively handled.

Scenario III: The Bolting Diver

So, your dive is over. Your BC is inflated and you're waiting patiently for your turn to board the dive boat when, suddenly, a panicked diver surfaces in Polaris missile mode just 10 feet to your left. Choking and coughing, he rips off his mask and attempts to scream for help, but a choking gurgle is all that comes out before he becomes passive in the water and drops face-down. It's clear the diver has bolted to the surface--an all too common scenario often precipitated by running out of air, inhaling water from a flooded mask or extreme overexertion.

Rescue Plan: If the diver is conscious and continues panicking, your response should be the same as Scenario I. A runaway ascent can also lead to other problems, however, like an air embolism or severe decompression sickness, which can rapidly result in unconsciousness and even death. If the diver is unconscious, your first order of business is protecting the airway. Approach the diver and roll him face-up. Ditch his weight belt and inflate his BC. Grab the diver by the head, keeping his face above water, and check that he is breathing. If not, there are two schools of thought: One is immediately getting the diver breathing again through in-water rescue breathing--one of the important skills taught in a rescue diving class. The other is to swim the diver to the boat as quickly as possible so traditional CPR can be performed on the deck. Both plans have merit, and which one you use will usually depend on the circumstances. Within a few yards of the boat, ditch the diver's BC and get him aboard as quickly as possible. If it's a long swim to the boat or shore, in-water resuscitation makes more sense.

If you experience this scenario underwater, proceed with caution. Trying to grab a bolting diver has two potentially hazardous results: 1) You hold the diver on the bottom (if you can hold a diver in full panic), potentially drowning him if he is out of air or has malfunctioning equipment. 2) He drags you to the surface, risking the bends or an embolism yourself. Divemasters and instructors receive special training in dealing with these problems underwater, but even for them, this scenario can be deadly, and they'll often let a diver go if he's out of control. Following the diver to the surface using a controlled ascent is usually the best plan. If the diver is having a runaway ascent, you may try to dump the air from his BC. But watch that the panicked diver doesn't grab you (or your hoses) and drag you to the surface if he continues upward.

There's a self-rescue scenario to consider here, too. If you find yourself in an uncontrolled ascent that results from excess buoyancy, stay calm and slow your ascent any way you can until you regain control. Dump air from your BC using as many valves as possible. If your inflator is stuck open, disconnect it or hold the dump valve up and open so the air will vent with no effect on your buoyancy. You can also slow your ascent by laying face-down in the water and flaring your arms and legs to increase resistance. Try kicking back toward the bottom, and if you are close enough to an ascent line, grab it until you can regain control. Exhale forcefully all the way up to avoid injury.

Prevention Tips: The most important step in preventing panic is being aware of those things that may push you beyond the limit and being prepared to avoid or deal with them. Fatigue from excessive physical activity or a lack of sleep and dehydration cause physiological stress and this stress can mentally take you off your game. Any diver who enters the water physically or mentally stressed is predisposed to panic, sometimes in response to what would otherwise be a minor problem. The best methods of prevention are to avoid circumstances you--and your buddy--are not comfortable in, maintaining your gear and checking it carefully before every dive and monitoring your air supply carefully throughout the dive.

Scenario IV: The Suddenly Unconscious Diver

You and your buddy are swimming along and everything seems fine--until he suddenly becomes nonresponsive and sinks to the bottom, motionless. Divers experiencing heart attacks or other major medical problems underwater can be rendered incapacitated or unconscious in this manner.

The Rescue Plan: Approach the diver and ensure that he is actually in peril by waving a hand in front of his face and checking for air bubbles coming out of his regulator. If the diver is incapacitated or unconscious, you must get him to the surface quickly without causing an embolism, causing him to drown or injuring yourself. Hold the regulator in the diver's mouth, and tilt the head back so that the airway is open and the diver's lungs can vent. It is quite simple to accomplish both tasks by holding the diver under the chin with one hand and using your forefinger to secure the second stage in place. You can only control one BC effectively so dump either yours or the victim's of all its air. Use the other BC to control your ascent. Make a direct ascent to the surface, slowly and in control, and ensure that the victim's airway remains open all the way to the surface. Once you are on the surface, drop the victim's weights, inflate his BC, signal for help and start towing the diver to the exit point while making sure his airway is open and protected from splashing water. Begin in-water resuscitation if necessary.

Prevention Tips: Regular personal health maintenance can make all the difference. Get an annual physical, maintain a healthy weight, do regular cardiovascular exercise and always dive well rested and adequately hydrated. You should also keep your water skills current and never dive if you feel ill. If you do have a medical emergency underwater, the most important thing you can do is to be honest with yourself about your medical status and any symptoms you experience. Signal your buddy early on and abort the dive safely before you become a casualty.

Rescue certified

For a complete understanding
of the rescue techniques covered here, there is simply no substitute for a stress and rescue class. When an accident occurs, you don't want to be afraid to take action, whether that means carrying out the rescue, providing backup support or simply getting out of the way. Rescue certification is also an incredible confidence booster that will make you a more relaxed, self-assured diver. Every major training agency offers a course in self- and buddy rescue. For more information, see your local dive center.