The Dive Locker, episode 11. In this episode you’ll learn why airway control is such an important life saving skill for scuba divers.
Welcome to The Dive Locker podcast, the podcast for dive professionals where we bring you the latest and diving industry resources that make you excellent at teaching techniques, risk management and dive business. I’m your host Tec Clark. You know the term airway control has been thrown around a lot and there’s lots of angst and discord out there about masks on foreheads and snorkels versus no snorkels. So what’s the big deal? Well, I’m going to share a case I worked as a forensic diving accident investigator where a loss of airway control actually cost a diver his life. We’ll get into that in a moment.
This episode is sponsored by the Scuba Exam App. I have partnered with the award winning Swedish app development team by Boboshi for this enhanced diving knowledge tool that helps students pass their scuba exams. This app was first released in 2010 since then, it has helped thousands of people on their way to getting their dive certification. The Scuba Exam App is loaded with features. You can customize your quizzes by selecting whether you want it timed or not, unanswered questions only or repeating questions. Questions you have flagged for follow up, incorrectly answered questions, and how many questions you would like to be quizzed on are all part of these settings.
You can also select to be quizzed on general questions or dive tables or both together, and you can choose which agency’s dive table questions you want to be tested on; PADI, NAUI or SSI. You can also select whether you would like your dive table questions to be in meters or feet. And every question comes with an explanation detailing the reason for the correct answer. There’s even a 17 chapter dive theory guide with tons of extra content. The Scuba Exam App contains over 200 scuba theory questions and 50 dive table questions and you will find that these questions can help any level of diver. The Scuba Exam App is only $4.99 and it’s available for iOS and Android. And, there is the Scuba Exam Lite. That’s a free version with less content and less features. So use it and turn your students onto it. It’s available in the Apple App Store or Google Play Apps.
All right, pros, let’s dive in.
Airway Management 101
So let’s get real here. What is it that makes the aquatic environment hazardous to humans? Bends? Marine life? Equipment failure? Look, those are issues that have led to fatalities, but there’s tens of thousands more fatalities taking place from drowning. So fundamentally, we breathe air and when our respiratory tracks are blocked by water, humans have a very fragile and limited window to breathe again. So we hear about this term airway management. Most training agencies reference this and some have it explicitly built into their training standards and educational materials. But countless dive professionals claim that this is an area that is completely overlooked in our industry and they’re right. Airway control or airway management is basically the ability to have respiratory tracts covered and with the ability to breathe with little to no water intrusion. This is accomplished by wearing a mask and breathing through the regulator or snorkel.
Well, duh. How else would you dive? You’re right, but this includes the surface too and that is precisely where we are seeing a major breakdown. Divers of all levels on the surface of a scuba dive have exposed respiratory tracks when they perch their mask on their forehead or around their neck and remove their regulator or snorkel. This is an issue when dive site conditions have even the slightest wave action on the surface. Now hang on. Before you go deleting this episode and saying Tec is an overly conservative worrywart. Here’s why this is such an issue.
The Case
Years ago as a forensic diving accident investigator, I worked a case. This case involved a diver that came up at the end of the dive. It was at wreck dive. The boat was moored to the wreck, the diver surfaces at the bow and there was a strong current. And there was moderate wave action about two to three foot seas.
Now the diver came up and immediately put the mask on his forehead, took the regulator out of his mouth and started talking to the people on the boat, telling them how great the dive was, how awesome it was, what he saw on and on and on. Everything was perfectly fine. No fast ascent, no running out of air, no distress, a perfectly fine dive. The diver is drifting towards the back of the boat. As he’s approaching the stern, he’s still talking to everybody up on the boat and now the divemasters see him and say, “Hey, will you please put your mask on and put your regulator in your mouth?” He doesn’t do that. He’s still talking. Well now he’s coming closer to the stern and the divemaster says, “Hey, grab onto the tagline, grab onto the tagline.” So behind the boat was a tagline for the people to hang on to so that they could wait their turn to get on the ladder.
So the individual swims over to the tagline still with regulator out of the mouth, snorkel out, mask, perched on the forehead, and talking to the people. He swims over to the line and he grabs hold of the line. Now imagine this, once he grabs the line, the current now is fighting him because he grabbed on, the current has kicked in and now the waves are hitting him in the face. So he’s got this death grip going onto the line because he was told to grab onto the line. He grabs onto the line. Well soon as that happens he takes a few hits to the face with a couple waves. Well with that the crew is saying and yelling at him, “put your mask on, put your regulator in your mouth.” Well what does he do? He lets go of the line to try to grab his mask and do something with it and he can’t and he realizes he’s now drifting.
So he grabs back onto the line. A couple more waves hit him, he lets go. He does this a couple more times. He can’t get his mask. By this time his mask has popped off his head and his regulator is dangling behind him. He can’t, can’t even reach it because of the current. Folks, that individual drowned right there at the surface. Right there he went unresponsive and drifted off the line. They had to go and get him and attempts to revive him were unsuccessful. So when people tell me that airway control isn’t an issue, that putting your mask on your forehead isn’t an issue, that not having airway control by either having a regulator in your mouth or a snorkel in your mouth is not an issue. It’s absolutely wrong. I have seen the dark side of what happens when that’s not followed.
It Starts With Instructors
You see, there’s a bunch of you out there that are teaching in lakes and quarries and you are not vigilant about this because there’s no current and the conditions are as flat as a pancake, right? So you’re thinking there’s no reason to have these protected airways right now. We can put our mask on our forehead and we can have a nice discussion floating up the surface here. But the deal is this, are your students becoming divers to only dive in your quarry all their life? No, they’re going to go to the ocean someday and they need to train for that from day one in the pool, in the lake, in the quarry. It doesn’t matter, but from day one, airway control has to be put into place.
So here’s what we see. You’re at the surface as a dive professional. You come to the surface and you put your mask on your forehead to talk to your students. Once you do that, your students do the exact same thing. They mimic you. You do this over and over again. Every time you pop down, you do a skill. Then you come back up, you put your mask on your forehead. Had you talked to your students over and over and over again in multiple pool sessions over and over again at the lake, the quarry, the open water dives, whatever. This is, guess what? This is motor memory. You are actually creating a pattern of behavior of motor memory for your students because now they realize when they come to the surface and they inflate their BC and they give a surface okay, the next thing they’re going to do is put a mask on their forehead, take their regulator out of their mouth to talk. Wait a minute. We can’t do that because what happens is this, when they go to the ocean and surface from a dive, boom, the mask goes on the forehead and now we’ve got problems.
Now, if you don’t believe me, all you gotta do is spend time on dive boats, especially down here in South Florida or the Caribbean or wherever we’ve got some good wave action and currents. You’re going to see every dive trip divemasters and captains are saying, “diver, put your mask on. Put your regulator in your mouth,” “diver please put your mask on. Put your regulator in your mouth.” It’s happening all the time and it’s because of the way the divers were trained. They don’t know any better because they were trained by people that are doing it themselves.
Now consider this. Competitive swimmers can control their airways, right? I mean, here’s water and humans and they don’t need masks. They don’t need a regulator to control their airways, right? In fact, we’re talking hundreds of thousands of breaths are taken in, on top and underwater by collegiate swimmers during one season of practice. Think about that. Now take that to the open water like in a triathlon. There’s a reason why they will cancel the open water swim of a triathlon if the water’s too rough and you know what it revolves around? Airway control. You see the conditions are harder, which can lead to more fatigue and exhaustion. Combine that with a wave action that impedes airway and you have a hazardous situation, so they cancel the open water swim.
Now think about that for diving exhaustion. Now we’ve got someone who is breathing heavily at the surface with no airway protection and there are waves. Because they are breathing so heavily, they take out their regulator and remove their mask to get more air, but waves keep washing over their face. Another scenario, someone runs out of air. Now the regulator is not an option at the surface and there are waves and they have no snorkel to switch to. Why? Because people are really poo-pooing snorkel wearing right? Now you’ve got an issue. How about this scenario? Someone has a BC malfunction and the dump valve comes off underwater and it can’t hold air. Now the person is struggling to keep afloat at the surface and their airway keeps going under.
Friends, these are all genuine incidents that are currently happening in our industry and the outcomes are drownings. Look, some of us have spent hours in the ocean. For me growing up one mile from the beach here in Fort Lauderdale, I’m truly at home in the ocean. But just two weekends ago I took out college students that had never been in the ocean. They look like toddlers learning how to walk. It’s so foreign to them. It’s so unnatural. They awkwardly resist the waves and the surge. This elevates stress, a stress that is naturally there because they’re looking all around already thinking of sharks going to eat them.
And it doesn’t matter how well I train them in the pool or gave a great briefing that no shark’s gonna eat you, but these are new experiences that the body and mind must process for the first time when they’re in the ocean. But here’s the thing, because I teach that the mask and snorkel and regulators state in when ever we’re in the water, none of them got into anything problematic. There were no breathing issues and this was a beach dive, so there was lots of surface swimming. No matter how comfortable we are in the water as dive professionals, we must put ourselves in the shoes of every one of our students and divers and train them for the environment they’ll be in.
Please friends, be vigilant about airway control by keeping masks on for the entirety of pool sessions and dives. Do this yourselves so that you aren’t exemplifying poor behaviors so that you are not exemplifying lack of airway control. Teach this to your students. Get them comfortable with a mask on their face. Dear goodness, we want that to be built in that, yeah, we’re going to keep a mask on and not be constantly putting it up and on our foreheads or around our next, come on. So the same thing goes with the regulator and the snorkel. Look, I mean, when I break the surface, I’m going to show them the regulator to snorkel exchange before I pull that out of my mouth and start saying, “Hey, good job everyone.” Right? Show them at first so that that way they do it and keep it in for them. Look, if they need to talk to you or something like that, then obviously we do that. Don’t be militaristic about it, like you can’t ever do this. No, we’re just talking sensibility here.
And also show them what it’s like to have airway issues. I do that for my students as well. I show the reason why we don’t put a mask on the forehead. I’ll splash myself in the pool or I’ll go under or things like that and explain to my students that what it’s like when that saltwater wave hits your face and starts to get in your tear ducts or your nose or your mouth. It’s slightly uncomfortable, we all know that. But did you also know that it creates mucus production? Just that bit of salt being in the tear ducts, the nose, what not. Now we are aggravating our sinuses and that leads to mucus discharge, which leads to inability to equalize.
So there’s a whole bunch of reasons and I think a bunch of you that I know and folks I’ve trained with and everything throughout the years, you all know the thing about putting the mask on the forehead and talking about that it’s a sign of distress in some cases; not a signal of distress as distress signal, but a sign of distress when uncomfortable or panic divers come to the surface and they immediately put their mask up and get it off their face. That is actually a sign of distress.
Okay, so that’s one of them. And then how many of you also are teaching that, Hey, if we perched our mask on our forehead, then if a wave comes along and knocks it off, that’s another reason. So use these reasons that don’t make that a smart thing. But look, folks, I’m telling you, there are cases out there where airway control at the surface has led to problems; to fatalities. We’re not talking about a lost mask. We’re talking about a lost life. So I take this very seriously. I’m very passionate about it. I hope you agree with me. And, and now I know because I’ve been in this industry for 30 years, that there are those of you that absolutely do not agree with me and absolutely don’t believe it, don’t get it, and you’re not going to change.
I’m begging you to consider this. I’m begging you to point to the educational materials in your agency, the standards in your agency that say, here’s what airway control looks like. Here’s what a regulator to snorkel exchange looks like. Because while we’re on that topic, we’re teaching to do a regulator, snorkel exchange, right? It’s in most agency standards. Now are we also teaching how to do the regulator snorkel exchange when your snorkel is coiled up in your BC pocket? Well, you see what happens is some people are sitting here going, “I don’t like snorkels. So I don’t wear a snorkel, so I’m not gonna show that for my student. And the standard says I need to carry a snorkel, so I’m just going to carry it on me. But when it comes to the snorkel regulator exchange, you know, here, I’ll show it one time, but then eventually the students are not going to want to do this.”
“They leave the class, they don’t do it, and I sell them a pocket snorkel just like I have a flexible folding snorkel just like I have.” Well folks, did you actually train that flexible pocket snorkel to do the snorkel regulator exchange? You don’t. Most people aren’t. And I’m saying this because this is what we’re seeing. So please think very, very carefully at what you do, how you do it, and the lasting affects that your training has on your students. Remember this, I always say your fingerprints are all over your students. The level that you teach at is what your students reflect. Your craft, the quality of your craft is reflected in your students. And yes, this is going to sound judgmental, but it’s the truth. And many of you are going to agree with me. We can come onto boats and trips and training locations and we can see divers and look at them and go, “Whoa, where did you get trained?”
And when they say, we can go, “yep, that makes sense. That makes sense. Because that professional doesn’t teach this, that professional doesn’t teach this.” And now here these poor people are on the dive boat getting yelled at by captains and divemasters because whatever the issue. And this is one of the biggest issues we see every weekend on all of these dive trips. So there you go. Airway control. That’s what it’s about. That’s what this episode is. And I just want to implore all of you to really, really think about this and make this a priority in your training.
Hey, if this episode ruffled your feathers or if this episode made you fist pump and go “right on brother!”, whichever way, hey, let me know. Go to the scubaguru.com notes page for this episode and click on the microphone and let me know what you think because we really do need to share. We really do need to discuss issues that are issues in our industry, and this creates a bit of a forum. So let me know. Contact me through the show notes page, click the microphone, send me a message.
Thanks For Listening!
That’s it for today, my friends. Once again, this episode is sponsored by the Scuba Exam App. Thank you so much for listening. Remember to subscribe to this podcast on iTunes, Google Play or Stitcher. That way you’ll be notified of new episodes as soon as they go live and please leave a show rating. Items talked about in this episode can be found on the show notes page at scubaguru.com and there you can also click that microphone and leave us a comment. Thanks again. We’ll see you in the next episode. Safe diving and take good care of my friends.
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