An elderly diver appears confused

REPORTED STORY


I was a guest on a dive trip and was paired with the buddy who invited me. The captain gave a review of the boat and safety equipment available, as well as what he would do if someone would be needing oxygen after a dive. Other than this discussion, there was no site briefing given and divers were told to get in the water once we arrived at the site. I assumed that many of these divers had dove together before and he did not think it necessary to do a more thorough briefing. I did talk to my buddy about emergency procedures, and we reviewed each other's dive gear so that we were aware of how to use the other person's gear in case of an in-water emergency.

We initially were told that the dive site was around 45 feet (14 meters) depth. The dive and current, however, led us into 80 feet (24 meters) of water. To my dismay, I saw the majority of divers making direct contact with the reef with their hands, bodies and fins. One elderly man, perhaps in his 70s appeared to be the worst offender. I signaled to him to come up off the reef but he was not responsive. I then gently tugged on his fins, so that he would take them off the reef, but within minutes, he was laying on the reef again with both hands fastened to coral heads. I noticed he was largely unaware of the divers around him and I could not ascertain who his buddy was.

Just short of 40 minutes, the majority of divers had started to surface. My buddy, the dive guide, the elderly man and I were the last four to ascent at exactly 40 minutes when the dive guide and I signaled that it was time to go up. We managed a slow ascent with a deep stop at around 35 feet (10 meters), but noticed that the elderly man had barely lifted off the bottom. After a minute or two at 35 feet (10 meters), the three of us began another slow ascent to the safety stop. The elderly man remained below us and did not make eye contact with us during the ascent. We watched him in bewilderment as he came up to approximately 35 feet (10 meters), he seemed to be trying to equalize using the Valsalva maneuver, but then he began to descend again. He may have come up to 35 feet (10 meters) maybe one more time before we watched him sink again. He was barely moving and I could not see his face from where we were. I banged my tank to get his attention but he did not respond. All I could see was that he was sinking and drifting farther away from us. We were also nearing 50 minutes bottom time which was well over the time we were supposed to surface. My buddy was also low on air and ready to surface. I looked at the dive guide/instructor who was carrying the float and wondered if she would go and get him. She signaled to me that she would wait for him to join her but, after 7 minutes at the safety stop, it did not appear that that was going to happen. I decided then that I was going to get him. He wasn't swimming, he was sinking, he was alone and he was not communicating with the rest of the group. I wondered if he was going to have enough air to make a safe ascent from the depth he was at.

I swam down and signaled that it was time to go up. He had a blank look on his face and was breathing, but not doing too much of anything else when I made contact with him. He moved very slowly and just could not reciprocate any type of communication. I gave him the "up" signal, got behind him to grab his tank valve and slowly ascended with him. He did not move or try to swim at all. At 20 feet (6m), I asked him again if he was ok but he did not signal back. I signaled to him to inflate his BCD so that he wouldn't sink and that I wouldn't have to hold him in place at the safety stop, but he did not respond. His arms were just floating. So I held him from behind and inflated his BCD for him. I had to maintain contact because he was not swimming nor could he keep from sinking. I did this as gently as I could, he didn't fight, just kind of floated there in "happy-land" – so strange . . .

Under the circumstances I felt it was safer to have him complete a safety stop than go straight to the surface. Once at the surface he seemed to be fine and was able to get to the boat and up the ladder without incident. He was apologetic but offered no explanation for why he continued to sink or why he would not re-attempt an ascent. He also acknowledged that he did not know or did not think to signal anyone about any trouble he might have been having during his dive. He denied any other problems after questions by several other divers on the boat but, by the decision of the dive leader, he did stay at the surface during the second dive.

COMMENT

This case is mysterious and we will likely never know why the elderly diver appeared unresponsive at depth. With the diving population gradually aging, we are hearing more reports of cardiac complications while diving; some of which may be transient and/or may result in momentary memory loss. Regardless of the cause, in this case another diver noticed something odd, assessed the circumstances (time at depth, remaining gas, overdue at the surface, etc.) and decided to act by assisting. As this diver discovered, being aware of other divers in the water need not be limited to just our buddies. Also, having the rescue skills to assist an unresponsive diver certainly helped this Good Samaritan retrieve the elderly diver and then to maintain their depth during the safety stop. Skills such as these are taught in dive rescue courses for such emergencies.

~ Peter Buzzacott, MPH, PhD