| Not speaking as someone who has done any mandatory decompression diving, or rescue any unconscious divers, but speaking as an ER doc:
The first thing I would do is assess the state of the ill diver. If someone is unresponsive but breathing, the differential diagnosis of the CAUSE of the state is quite different from that of someone who is unresponsive and not breathing. The latter implies much worse physiologic derangement and a much poorer prognosis, especially if the change is sudden. The diver who is unresponsive but breathing may be severely narced, may have had a small and unnoticed seizure, may be diabetic and hypoglycemic (and didn't tell you), may be severely hypercarbic, may have taken something before the dive. Global depression of consciousness implies a systemic cause or a really severe central nervous system cause (aneurysm rupture, for example). But if the person is breathing, you have time, but maybe not infinite time.
In that case, getting the person expeditiously but not ballistically to the surface would be a good idea, and shortening deco is probably reasonable, as it is likely the person's problem is treatable and they may recover. How much to shorten the deco would depend on how deep you had been and for how long. Taking the two of you to the surface and arriving there coughing up red foam is not productive. And the diver is breathing, so one hopes progressive central nervous system damage is not being done.
If the unresponsive diver is not breathing, you are both in a world of hurt. As I have said elsewhere, breathing resides deep in the brainstem, and is so basic a reflex that the absence of breathing effort (apnea) was used as evidence of brain death before we had EEGs and brain scans. An unconscious diver who is not breathing, and who does not shortly begin to attempt to breathe (as, after a seizure, you can have a brief period of apnea), is indicating either a severe systemic problem (i.e. cardiac arrest) or very severe and extensive central nervous system injury. If you're at 200 feet with either of those, the likelihood of meaningful survival is extremely low. On the other hand, the likelihood of injury to the rescuing diver from blowing the deco on a 200 foot dive is high.
This is one of those where there is no right answer. My guess is that decisions in these circumstances are made as much on emotion as they ever are on rational grounds.
God deliver me from ever having to make such a decision, especially about someone I know well or care about.
__________________ check out www.divematrix.com
"So, it's a good thing to always do the drills the same way . . . but in real life you need to act the right way, whatever that happens to be." LauNar |