CAVE RESCUE TECHNIQUES – to swim, to drag, or to stay put?
Ask any diver how he would wish to be extracted through a sump and he will tell you that he would rather dive himself out, thank you very much. A conscious lucid diver who is not feeling very well and who is trussed up to a rigid stretcher or a drag sheet, dubiously weighted, wired up for air and then propelled through a cold, tight or long sump in zero visibility by two “friends” he may not know and whom he cannot see, will never forget the experience.
Depending on the injury and circumstances of the situation, the injured diver is very strongly advised to pull himself together, clear his mind, get well patched up, gird himself with resolve and determination, strap on plenty of gas and head on out with the assistance of the rescue team or buddies.
The last resort scenario arises when the condition of the victim is such that self-extraction is out of the question. This may be due to a spinal injury, multiple arm and leg injuries, major torso trauma, severe blood loss, or a serious head injury. What to do then? Dive out anyway and take the risk, or stay within and see what can be done? It is unwise to dive a victim out under the following circumstances:
- With the victim unconscious or having been unconscious, or with a significant head injury – depth may worsen brain trauma, cause fitting, or vomiting.
- With a significant chest injury – if a pneumothorax ascending back to the surface could be fatal.
- With a significant abdominal injury – air entrapment and injury.
- Where decompression will/may be required.
- Where there has been significant blood loss.
- Where there is a possibility of unconsciousness.
So, it can be seen that there are not that many instances when it is possible, wise or safe to stretcher, drag or tow a diver out. However, as has been seen, there is often little alternative – Hobson’s choice, the worst of two evils.
Where it is possible or necessary to escort a victim out, physical assistance is required. It is now generally accepted that the use of a stretcher or drag sheet must be as a last resort. Depending on the injury and circumstances e.g. sump size, it is now accepted that it is far better to splint the victim where necessary, load him up with the usual diving gear with an overkill of gas, fit a full face mask, attach good and ample well-controllable buoyancy and tow the victim.
If for some reason this is not possible then a rigid stretcher in a spacious sump, or a drag sheet in a more tortuous, adjacent underwater passage, will have to be used. Practice rescues have been carried out over the years using stretcher-like equipment, with mixed success. As an example, a few years ago the Somerset Section of the CDG carried out a practice rescue out from Chamber 19 in Wookey Hole. A dummy was strapped to a rigid stretcher and dragged out by two unfortunate volunteers. Despite some organisation, an agreed system of audible signals (tapping on metal objects with a stone) and buoyancy aids, one diver suffered a crashed ear, visibility was obliterated within a very short distance, the puller and pusher pulled and pushed too hard or too softly at the wrong times, and the buoyancy was incorrect. Although the task was completed, had the dummy been a living colleague he would not have survived the experience. From this exercise, and other sump rescue practices that have been carried out, several points arose which are the basis of a procedural technique.