A chilling question, if you came across someone not breathing, would you know what to do to save a life? How would you feel if no one was able to help and it was a friend or relative? As divers, we are possibly more exposed to life-threatening situations than non-divers. Do not get me wrong, I am not saying that scuba diving is high risk. It just we are around the water more, increasing the exposure to possible drownings. Another factor is in many locations the average age of the divers on-board a dive vessel is much higher than the average population. Cardiac issues is the leading cause of death in scuba diving because as a group we are older.

This article is editorial in nature and the question can apply to both diving situations and normal everyday events. My inspiration for this article is an online posting I read about a Girl Scout summer camp. The writer was a scuba instructor who, as a part of the summer camp, was conducting discovery dives. Some of the observations they made included that the girls had a basic understanding of what they would be doing, were CPR/first aid qualified and were comfortable working with a checklist. My mind drifted to the question, why are scuba divers not required to be CPR qualified?

Unsung Heroes

Recently, a dive instructor I know and another diver happened across a situation that ended with the pair saying a young lady’s life. The dive instructor has downplayed his heroic role and just said he reacted according to his prior military and current diving training, so we will just call him Andy. The two divers had just finished a day of diving and were on their way to have a cold beer. As they near the beach they noticed a commotion and saw a man carrying a young lady from the water. They saw the girl placed on the beach but everyone was just standing around watching. The two hurry over and Andy started CPR as the other diver moved the crowd back and made sure that an ambulance was called. They then alternated who was doing CPR until the ambulance arrived about 15 minutes later. The young lady survived and fully recovered. If these two had not jumped into action, the women would have died.

When the heart has stopped, The odds of survival go down 10 percent every minute. There is a window of between five and seven minutes after cardiac arrest where there is a chance of resuscitation with advanced drugs or other medical procedures. After 10 minutes if resuscitation does happen, there is a high risk of permanent brain injury.

CPR alone is not likely to restart a heart. The benefit of CPR is that it keeps blood circulating in the body bringing oxygen to the brain and other body organs. This extends the window for recovery and reduces the risk of brain damage.

CPR and AED Training

Different studies have shown that on average only 20% of victims of cardiac arrest outside of a hospital will be given CPR by a bystander without prompting. In some cities around the world, emergency services dispatchers are encouraging bystanders to perform CPR giving them instructions on the phone. Victims given CPR at or shortly after the arrest are 8 times more likely to survive. As mentioned, CPR will not generally restart a heart. However, an Automated External Defibrillator (AED) is a device that will restart a heart that has stopped by a cardiac arrest.

AED Photo By GO (MedPlus Medizintechnik GmbH) CC BY 4.0
We have all seen the television programs where someone heart stops in a hospital, and they attached this huge device to the person and shock their heart to work. That device is a defibrillator. The manner it is shown on television is not really accurate, however, the end result of allowing the heart to restart is. An Automated External Defibrillator has the same function but in a smaller portable package that is simpler to use. The AED does most of the work, the user only needs to understand a few simple procedures, how to turn it on and then follow instructions. When you turn on an AED, it does a fast self-check and verbally reminds you to connect the pads to the victim’s chest. Once the AED senses the pads are in place, it will diagnose if the victim’s heart has stopped and if a shock is necessary. If it is necessary, the device will tell you to stand clear and press the shock button. After the shock, the device will determine if the heart has started. If not the device will either tell you to shock again or to continue CPR.

Statics show that there is a 90% chance of recovery if an AED is used within one minute of the cardiac arrest. Even if there is a delay in using the AED if CPR is started in the first few minutes the survival rate can still be as high as 70%.

The majority of cardiac arrest events occur in the home and it has a much lower survival rate than in a public place. Public rates are higher because the potential for a CPR qualified bystander is higher and AED may be on hand. At home, if your loved one is to survive it is highly depended on how fast you find them and if you are CPR trained. The cost of an AED normally places them out of reach for homes.

Just a clarifying comment. A heart attack and cardiac arrest are different. A heart attack happens when there is a blockage to the heart. The heart is still pumping but not enough blood is being pumped to the body. A cardiac arrest happens when the heart stops pumping.

Speakers’ Corner or Soap Box Time

I learned mouth-to-mouth resuscitation as a teenager (Boy Scouts) and when CPR was developed in the early 1970s, learned that as well. Procedures have changed and I have kept updated including being trained to use an AED. My siblings and most of my second-degree relatives are similarly trained.

The scuba diving industry does not seem to support the need for CPR and AED training. In my viewpoint, many of the certification agencies seem more afraid of scaring away potential clients, then to introduce CPR and AED training for the average diver. In their view, the need for this type of training does not surface until you reach the rescue diver course. Why not include it in the Advanced Open Water Diver course?

In the same light, it seems to me that the training agencies are motivated by profit for these courses. I checked 4 dive shops within 100 kilometers of my home. The average cost was $130. I did an AHA course that cost $50, which was waived because I was a local resident. I randomly picked a few locations and compared the dive agencies program cost against the standard cost for a similar health agency-sponsored program. The majority of comparisons I did, show the dive agency programs were 2 to 3 times higher than the standard health agency program. Hats off, however, to Jack’s Diving Locker in Hawaii for their Emergency First Response (EFR) course. https://www.jacksdivinglocker.com/scuba-diving-lessons/advanced-courses-2/emergency-first-response-cpr-first-aid-aed/ While their calendar is out of date, The price of their course is similar to a health agency-sponsored program in their area and even less than some. If they can do it, why can others not?

Put aside the dive agencies viewpoint. If you are not CPR and AED qualified, seek out a course near you and get it done. There may be a time that your training will help save a loved one.