1. RESCUE DIVER COURSE LESSON GUIDES
PADI Rescue Diver Course
RESCUE DIVER COURSE LESSON GUIDES
Knowledge Development Presentation Two
III. Knowledge Development Presentation Two
By now student divers have a firm understanding regarding the basics of diver stress. This section furthers their ability to recognize stress and the procedures that mitigate stress in other divers. Being prepared for a diver emergency requires specific knowledge of first aid rescue equipment covered in Knowledge Development Presentation One. In addition, this section covers an understanding of the operation of and the common problems associated with typical dive equipment. Accident management ranges from managing several people available at a dive accident scene to tending to common marine first aid injuries. Although primary care first aid and CPR are prerequisites to this presentation, first aid and CPR courses don’t typically cover common marine injuries. This section builds upon those skills and introduces students to different aquatic life injuries, the associated signs and symptoms of distress, as well as the basic treatment for such injuries. Refer students interested in further training to advanced diver emergency courses. Students are now competent with the basics of rescuing a responsive diver at the surface. This section builds upon this knowledge with the foundation concepts that apply to responding to a diver who may be some distance from shore.

2. Knowledge Development Two Overview
PADI Rescue Diver Course
Knowledge Development Two Overview
The Psychology of Rescue
Recognizing Stress in Divers
Being Prepared for a Diver Emergency
Equipment Function and Function Related Problems
Common Equipment Problems
Release Function and Problems
Accident Management
First Aid for Common Aquatic Life Injuries
Rescue - Knowledge Development Two
Overview and Learning Objectives
By the end of this section, the student should be able to answer the questions in italics:
A. The Psychology of Rescue
Recognizing Stress in Divers
• What two steps do you apply to recognize stress in a diver?
• What should you do when you recognize diver stress?
B. Being Prepared for a Diver Emergency
Equipment Function and Function Related Problems
• How does a regulator function?
• What are the two basic types of alternate air sources?
• What three points does the dive community generally
agree upon regarding alternate air sources?
• What functional problems can occur with cylinders, valves, regulators, SPGs and BCDs?
Common Equipment Problems
• What are six general causes of equipment-related problems?
• What are the causes, effects and prevention of problems with masks, snorkels, fins, exposure suits, BCDs, weight systems and scuba units?
Release Function and Problems
• What are six types of releases commonly found in scuba systems and what problems may they have?
C. Accident Management
First Aid for Common Aquatic Life Injuries
• What are the three forms of aquatic life injuries?
• What five signs and symptoms indicate venomous aquatic life injuries?
• What is the common treatment for aquatic life injuries?
• What is the basic first aid for jellyfish stings?

3. Knowledge Development Two Overview
PADI Rescue Diver Course
Knowledge Development Two Overview
Responding to Diver Emergencies
More on Responding to Responsive Divers at the Surface
Exits with a Responsive Diver
Postattendance
Rescue - Knowledge Development Two
D. Responding to Diver Emergencies
• More on Responding to Responsive Divers at the Surface
• What are the techniques and considerations for responding to a responsive diver at the surface from a distance?
• What is a quick reverse, and how do you do it?
• What is the advantage of using emergency flotation when assisting a responsive diver at the surface?
• What are the procedures for approaching, evaluating and helping more than one responsive diver in the water?
Exits with a Responsive Diver
• What factors should you consider when removing equipment from a distressed diver?
• What are the general criteria for tows used to transport a distressed diver in the water?
• What should you consider when helping a distressed diver exit the water?
Postattendance
• What three concerns do you need to handle with a responsive diver once you get on the boat or shore?

4. The Psychology of Rescue
PADI Rescue Diver Course
The Psychology of Rescue
Recognizing Stress in Divers
Two Steps to Apply
Recognizing Diver Stress
Rescue - Knowledge Development Two
A. The Psychology of Rescue
Recognizing Stress in Divers
• What two steps do you apply to recognize stress in a diver?
• What should you do when you recognize diver stress?

5. PADI Rescue Diver Course
Two Steps to Apply
What two steps do you apply to recognize stress in a diver?
Recognize stress by direct observation.
Be alert for behavioral changes.
Look for uncharacteristic talkativeness, silence, irritability or hesitation.
Ask the diver about what you’ve observed.
Be careful not to pressure the diver or make the diver feel uncomfortable.
Ask about your concerns in an open, caring and nonjudgmental manner.
Rescue - Knowledge Development Two
A. Presentation Two – Speaker Notes:
The Psychology of Rescue
1. Recognizing Stress in Divers
What two steps do you apply to recognize stress in a diver?
a. As a PADI Rescue Diver, you should learn to recognize stress in other divers and yourself.
b. The first way to recognize stress is direct observation. Signs of stress may be subtle or they may be overt. Be alert for behavioral changes, especially when a diver’s actions appear inappropriate or abnormal, such as uncharacteristic talkativeness, silence, irritability or hesitation.
c. Because you may not always know the other divers (for example on a dive boat) or because changes in behavior may not be due to diving-related stress, you want to verify the meaning of behaviors you observe. The second way to recognize stress is to ask the diver about what you’ve observed.
1. Be careful not to pressure the diver or make the individual feel uncomfortable. This may cause or add stress, and the diver may not feel able to answer honestly.
2. The best approach is to ask about your concerns privately in an open, caring and nonjudgmental manner. A genuine, “Are you up for this dive?” may be all you need to ask.

6. Recognizing Diver Stress
PADI Rescue Diver Course
Recognizing Diver Stress
What should you do when you recognize diver stress?
Encourage the diver to apply solution thinking. This includes four steps:
Problem recognized.
Plan of action formulated.
Plan successfully implemented.
Problem minimized or eliminated.
Rescue - Knowledge Development Two
What should you do when you recognize diver stress?
d. When stress causes anxiety in a diver, it’s important to break the stress response cycle before it leads to more severe problems.
e. Do this by encouraging the diver to apply solution thinking. This includes four steps:
1. Problem recognized – through observation and questions you can help the diver recognize the cause of stress.
2. Plan of action formulated – by discussing the problem, encourage the diver to think analytically and form a plan.
3. Plan successfully implemented – allow the diver to act on the plan and offer assistance if necessary.
4. Problem minimized or eliminated – effective action leads to a solution and prevention of a more serious problem.
f. It’s critical that you, the Rescue Diver, avoid sounding judgmental or applying peer pressure.
1. Empathy goes a long way – statements like, “I feel (or, have felt) the same way,” help others recognize that there’s nothing wrong with their concerns.
2. If it appears other divers aren’t forthcoming about their concerns, the best course may be to take it on yourself by saying, “You know,
I’ve got some concerns about this dive. Maybe we should “

7. Being Prepared for a Diver Emergency
PADI Rescue Diver Course
Being Prepared for a Diver Emergency
Equipment Function & Function Related Problems
Common Equipment Problems
Release Function and Problems
Rescue - Knowledge Development Two
B. Being Prepared for a Diver Emergency
Equipment Function and Function Related Problems
• How does a regulator function?
• What are the two basic types of alternate air sources?
• What three points does the dive community generally
agree upon regarding alternate air sources?
• What functional problems can occur with cylinders, valves, regulators, SPGs and BCDs?
Common Equipment Problems
• What are six general causes of equipment-related problems?
• What are the causes, effects and prevention of problems with masks, snorkels, fins, exposure suits, BCDs, weight systems and scuba units?
Release Function and Problems
• What are six types of releases commonly found in scuba systems and what problems may they have?

8. Equipment Function and Function Related Problems
PADI Rescue Diver Course
Equipment Function and Function Related Problems
Being familiar with how dive equipment works:
Helps you to more easily recognize an equipment malfunction or a decline in function.
This knowledge may allow you to act quickly should a minor problem occur and to prevent a more serious problem altogether.
For more information enroll in a PADI Equipment Specialty course, read the PADI Encyclopedia of Recreational Diving, and/or seek advice from a PADI Dive Center, Resort or Professional.
Rescue - Knowledge Development Two
B. Being Prepared for a Diver Emergency
1. Equipment Function and Function Related Problems
a. Being familiar with how various pieces of dive equipment work helps you to more easily recognize a malfunction or decline in function. This may allow you to act quickly should a minor equipment problem occur and to prevent a more serious problem altogether. We’ll look specifically at basic equipment function and potential operational problems.
b. For more information about dive equipment, consider enrolling in a PADI Equipment Specialist course, reviewing the dive equipment section of the PADI Encyclopedia of Recreational Diving Multimedia or book, looking at dive equipment manufacturer catalogs, and seeking advice from dive professionals at PADI Dive Centers and Resorts.

9. PADI Rescue Diver Course
Regulator Function
How does a regulator function?
The regulator first stage attaches to the tank valve and reduces tank pressure.
This low pressure air flows through hoses to the second stage, alternate air source, and low pressure inflator.
As you inhale from the second stage mouthpiece, a diaphragm moves inward, pushing open a downstream valve that allows air to flow from the hose.
Rescue - Knowledge Development Two
How does a regulator function?
c. As you know, a scuba unit consists of a cylinder with valve, regulator and BCD. Let’s concentrate on the regulator first stage and second stage to start.
1. A regulator first stage attaches to the tank valve and reduces tank pressure to a “low” (intermediate) pressure. This low pressure air flows through the hoses to the second stage, low pressure inflator and alternate air source. The first stage also allows high pressure air (direct from the cylinder) to flow to the submersible pressure gauge (SPG).
2. As you inhale from the second stage mouthpiece, a diaphragm moves inward, pushing open a downstream valve that allows air to flow from the hose.

10. PADI Rescue Diver Course
Regulator Function
How does a regulator function? continued…
When you exhale, the diaphragm moves outward, the valve closes and your breath exits via the one-way exhaust valve into the water.
First stage also allows high pressure air to flow to the submersible pressure gauge.
Rescue - Knowledge Development Two
Regulator terms that apply to design and function:
Balanced regulator design.
Fail-safe function.
Downstream valve design.
When you exhale, the diaphragm moves outward, the valve closes and your breath exits via the one-way exhaust valve into the water. [Use a diagram to explain second stage function.]
d. The following terms apply to regulator design and function:
1. Balanced refers to a regulator design in which breathing resistance is unaffected by tank pressure.
2. Fail-safe means that a malfunctioning regulator has the tendency to free flow, rather than terminating air delivery.
3. Downstream refers to a valve design in which the valve opens in the direction of the air flow. This goes along with the fail-safe feature because a failed downstream valve will usually open.

11. Types of Alternate Air Sources
PADI Rescue Diver Course
Types of Alternate Air Sources
What are the two basic types of alternate air sources?
Alternate air sources connected to a redundant air tank that allows a diver to self-rescue.
Pony bottle.
Self-contained ascent bottle.
Rescue - Knowledge Development Two
What are the two basic types of alternate air sources?
e. Alternate air sources are standard equipment, but there’s a variety available, so the features and configurations are not standardized.
The two basic types include:
1. Alternate air sources connected to a redundant air tank that allow a diver to self-rescue.
• A small, compact tank with regulator (pony bottle). These secure to the main cylinder.
• Self-contained ascent bottles are miniature cylinders with built-in regulators. They have just enough air to reach the surface within the limits of recreational no stop diving.

12. Types of Alternate Air Sources
PADI Rescue Diver Course
Types of Alternate Air Sources
What are the two basic types of alternate air sources? continued…
Alternate air sources that connect to the primary air tank.
Extra second stages (octopus regulators) for use by the out-of-air diver.
Second stages built into low-pressure BCD inflators (alternate inflator regulator), require the donor to switch to the alternate and provide a buddy with the primary second stage.
Rescue - Knowledge Development Two
2. Alternate air sources that connect to the primary air tank are the most common type used by divers.
• Extra second stages (a.k.a. octopus regulators) for use by the out-of-air diver. These have extra long hoses to make ascents easier by providing the divers with maneuvering room.
• Second stages built into low-pressure BCD inflators (alternate inflator regulators), which require the donor to switch to the alternate and provide a buddy with the primary second stage.

13. PADI Rescue Diver Course
Community Agreement
What three points does the dive community generally agree upon regarding alternate air sources?
The second stage to be used by the out-of-air diver should be clearly identified.
The additional second stage should not be allowed to dangle when not in use.
Secured with a quick release in plain view in the triangular area between the mouth and the lower corners of the rib cage.
Rescue - Knowledge Development Two
What three points does the dive community generally agree upon regarding alternate air sources?
f. Although alternate air source types and techniques used for sharing air differ, there is general agreement on these three points:
1. The second stage intended for use by the out-of-air diver should be clearly identified.
2. The additional second stage should not be allowed to dangle when not in use.
3. The alternate air source should be secured with a quick release in plain view in the triangular area between the mouth and the lower corners of the rib cage. [Ask divers what types of alternate air sources they use. Discuss placement variations and techniques for use.]

14. Problems Specific to Cylinders
PADI Rescue Diver Course
Problems Specific to Cylinders
What functional problems can occur with cylinders?
Corrosion
Avoid by regular visual inspections and proper maintenance.
Contamination
Obtain air only from a reputable dive operation.
Improper tank positioning
Secure cylinders properly during transportation and don’t leave tanks standing unsecured.
Check tank height in BCD during predive check.
Rescue - Knowledge Development Two
What functional problems can occur with cylinders, valves, regulators, SPGs and BCDs?
g. You already know that scuba cylinders are either made of aluminum or steel, and they hold compressed gas. You also probably remember that there are two basic types of valves – K and J – and that regulators attach to the tank with a yoke screw or DIN fitting. The most common problems with tanks include:
1. Corrosion due to water or moisture entering the tank. Corrosion may cause structural weakness. Corrosion can flake off the interior walls and clog valves and regulators. Corrosion is avoided by regular visual inspections and proper maintenance.
2. Contamination occurs when poorly filtered or unfiltered gas is pumped into a scuba tank. Although rare, contaminated air can be hazardous. As you’ve learned, be alert for air with taste or odor. Avoid contaminated air by obtaining air only from reputable dive operations.
3. Improper tank positioning may cause problems both in and out of the water. Cylinders that are not firmly secured to a BCD may slip and those that are positioned too high may hit the diver in the head. Avoid this problem by securing the cylinder properly and checking its height during predive check.

15. Problems Specific to Cylinder Valves
PADI Rescue Diver Course
Problems Specific to Cylinder Valves
What functional problems can occur with cylinder valves?
Not opening the valve.
Diver opens valve to check air supply, then closes the valve or leaves it barely open.
Avoid by proper predive check.
O-ring leaks
Worn, dirty, or dislodged o-rings may cause air to escape from the tank valve.
Avoid by proper predive inspection and regular valve maintenance.
Rescue - Knowledge Development Two
h. Problems specific to cylinder valves:
1. Not opening the valve – Diver opens the valve to check air supply, then closes the valve or leaves it just barely open. Diver begins the dive and immediately “runs out of air” after breathing the one or two breaths remaining in the regulator.
3. O-ring leaks – Worn, dirty, or dislodged o-rings may cause air to escape from the tank valve. A minor leak is an inconvenience, but a major leak can reduce air flow to the regulator or cause rapid loss of tank air. Careful predive inspection and regular valve maintenance helps avoid O-ring problems. [Ask divers what other tank or tank valve problems they’ve seen. Discuss these as appropriate.]

16. Problems Specific to Cylinder Valves
PADI Rescue Diver Course
Problems Specific to Cylinder Valves
What functional problems can occur with cylinder valves? continued…
Reserve valves.
J-valve is accidentally moved to the down position, leaving diver without expected reserve.
No way to trip the J-valve lever down for reserve.
Avoid by monitoring submersible pressure gauge.
Rescue - Knowledge Development Two
2. Reserve valves – A J-valve must be positioned “up” to work as a reserve valve and the diver must be able to pull it down to access the reserve.
• If the valve is not positioned correctly or is accidentally moved to the down position during a dive, the diver will not have the expected reserve.
• If the valve is in the up position, but there’s no way to trip the lever, the diver may not be able to access the reserve (turn the lever) without assistance.
• Proper use, as well as monitoring a submersible pressure gauge, helps avoid J-valve problems.
• Reserve valves appear to be fading away from the dive community in most areas.

17. Problems Specific to Regulators
PADI Rescue Diver Course
Problems Specific to Regulators
What functional problems can occur with regulators?
Hose rupture.
Ruptured low pressure hoses can flail wildly at the surface.
Ruptured high pressure hoses may be quite loud.
Avoid by replacing hoses at first sign of aging.
Hose configurations.
Dangling hoses have entanglement problems.
Dragging alternate air sources can fill with mud or sand.
Twisted or sharply bent hoses can cause discomfort and premature aging.
Rescue - Knowledge Development Two
i. Problems with regulators.
1. Although uncommon, hoses can rupture if damaged or allowed to wear thin. All regulator hoses need to be inspected often for wear, particularly at the point of attachment. It’s best to replace hoses at the first sign of aging.
• A low-pressure hose rupture at the surface will usually flail about wildly. This is unlikely underwater, but extreme bubbling indicates a potential rupture.
• Because of the restricted orifice at the regulator first stage, a ruptured high-pressure hose does not flail. However, it may be quite loud.
2. When observing other divers, watch for hose configurations that may cause difficulties. Dangling hoses have entanglement potential; dragging alternate air sources fill with mud/sand and become unusable. Regulator configurations that twist or sharply bend hoses may cause diver discomfort and contribute to premature hose failure.

18. Problems Specific to Regulators
PADI Rescue Diver Course
Problems Specific to Regulators
What functional problems can occur with regulators? continued…
Problems with regulator second stages include:
Free flowing caused by sand or debris preventing valves from sealing properly.
The exhaust valve sticking due to deposits or clogging with debris.
Water leaking in through a torn mouthpiece or diaphragm.
Free flow due to improper valve seal caused by poor maintenance.
Malfunctions due to freezing in cold water caused by lack of, or inadequate, environmental seals.
Avoid problems by rinsing your regulator thoroughly with fresh water and have it serviced as recommended by manufacturer.
Rescue - Knowledge Development Two
3. Problems associated with scuba regulators are most often the result of poor maintenance and care. Salt and mineral deposits will reduce regulator efficiency or even prevent it from working properly. Always rinse your regulator thoroughly in fresh water and have it professionally serviced as recommended by the manufacturer.
Problems with regulator second stages may include:
• Free flowing caused by sand or debris preventing valves from sealing properly.
• The exhaust valve sticking due to deposits or clogging with debris.
• Water leaking in through a torn mouthpiece or diaphragm.
• Free flowing due to improper valve seal caused by poor maintenance.
• Malfunctions due to freezing in cold water caused by lack of, or inadequate, environmental seals.
[Ask divers what other regulator problems they’ve seen. Discuss these as appropriate.]

19. Problems Specific to SPGs
PADI Rescue Diver Course
Problems Specific to SPGs
What functional problems can occur with SPGs?
Wear at the first stage connection or other spots along the hose.
Leaking o-rings at either end of connection.
Computer or battery failure in integrated electronic and hoseless gauges.
Failure of the metal tube in mechanical gauges can flood the gauge with high pressure air.
The most common problem is failure to monitor gauges.
Avoid problems by regular service and by watching the SPG while diving.
Rescue - Knowledge Development Two
j. Problems with SPGs
1. Divers have several types of submersible pressure gauges to choose from, including:
• Mechanical gauges measure pressure by routing air through a flexible, coiled metal tube connected to the gauge needle. The tube flexes (tends to straighten) under pressure and the needle registers the pressure.
• Electronic gauges are usually integrated into a dive computer. They use a transducer that measures electronic resistance as the air pressure changes.
• Hoseless pressure gauges use a pressure transducer on the first stage to transmit air pressure to a dive computer on the diver’s wrist, eliminating the need for a hose.
2. Wear at the first stage connection or other spots along the hose.
3. Leaking o-rings at either the first stage connection or where the hose connects to the gauge.
4. With integrated electronic and hoseless gauges, computer or battery failure will cause you to lose all your dive data, including your air supply information.
5. Failure of the metal tube in mechanical gauges can flood the gauge with high pressure air. A blow-out plug on gauge back releases the air so the gauge doesn’t burst.
6. The most common problem is simply failure to monitor the gauge.
7. To avoid problems, have your SPG serviced regularly and inspect it carefully before a dive. However, it takes a proper attitude and following safe diving practices to avoid the common problem of not watching the SPG.
[Ask divers what other SPG problems they’ve seen. Discuss these as appropriate.]

20. Problems Specific to BCDs
PADI Rescue Diver Course
Problems Specific to BCDs
What functional problems can occur with BCDs?
Over inflation is possible if the low pressure inflator sticks in the open position.
Caused by poor maintenance or freezing in cold water.
Practice disconnecting a low pressure inflator hose while in the water to handle this problem.
Rescue - Knowledge Development Two
k. Problems with BCDs
1. Because they are less mechanically complex than other scuba equipment, BCDs present relatively few problems.
2. Over inflation may be caused by the low pressure inflator sticking in the open position. At the surface, a rapidly filling BCD is an inconvenience, but underwater it could cause an uncontrolled ascent.
• May be caused by poor maintenance, or freezing in cold water.
• It’s a good idea to practice disconnecting a low pressure inflator hose while in the water to quickly handle this problem should it occur.

21. Problems Specific to BCDs
PADI Rescue Diver Course
Problems Specific to BCDs
What functional problems can occur with BCDs? continued…
Under inflation due to difficulty locating inflator mechanism.
Quick dumping mechanism and/or overpressure valve may leak.
Internal cable on hose-activated quick dump valves can fail.
Improper fit can cause problems.
Avoid these problems by proper maintenance.
Rescue - Knowledge Development Two
3. Inability to inflate the BCD may be caused by difficulty locating the inflator mechanism, or it may be caused by failing to secure the inflator.
4. BCD’s quick dumping mechanism and/or overpressure valve may leak and release air that the diver needs to stay positively buoyant. This is caused by poor maintenance, tension loss in valve spring or wear on valve seat. Such a leak is generally slow, but the valve can fail fully open. If this happens the diver may need to drop weights.
5. Deflation problems may be caused by the inability to locate the deflation mechanism or by an improper body position that traps air. The internal cable on hose-activated quick dump valves can fail, so that the diver then has to use the regular deflator.
6. It’s also important that a BCD fit the diver properly and provide enough lift. Improper fit can make it difficult for the diver to maintain a comfortable position on the surface.
[Ask divers what other BCD problems they’ve seen. Discuss these as appropriate.]

22. Common Equipment Problems
PADI Rescue Diver Course
Common Equipment Problems
What are six common causes of equipment-related problems?
The use of unfamiliar equipment or specialized equipment without proper instruction and controlled practice.
Use of ill-fitting equipment or wrong equipment for the environment or type of dive.
Substitution of standard items with makeshift or homemade equipment.
Diving without one or more essential pieces of equipment.
Modifying equipment to the point that it no longer functions as designed.
Failure to inspect, adjust and maintain equipment.
Rescue - Knowledge Development Two
2. Common Equipment Problems
What are six general causes of equipment-related problems?
a. Many equipment problems do not result from the equipment’s mechanical function. Diver-caused problems usually result from one of the following:
[Provide local examples as appropriate.]
1. The diver uses unfamiliar equipment or specialized equipment without proper instruction and controlled practice.
2. The diver uses equipment that doesn’t fit properly, without adjusting it to fit, or that is the wrong equipment for the environment or type of dive.
3. The diver substitutes standard items with makeshift or homemade equipment.
4. The diver dives without one or more essential pieces of equipment.
5. The diver modifies equipment to the point that it no longer functions as designed.
6. The diver fails to properly inspect, adjust and maintain the equipment.

23. Common Equipment Problems
PADI Rescue Diver Course
Common Equipment Problems
What are the causes, effects and prevention of problems with masks, snorkels, fins, exposure suits, BCDs, weight systems and scuba units?
Let’s look at the “Common Equipment Problems” listed in your PADI Rescue Diver Manual.
Rescue - Knowledge Development Two
What are the causes, effects and prevention of problems with masks, snorkels, fins, exposure suits, BCDs, weight systems and scuba units?
b. There are many small issues with equipment that can cause or contribute to incidents, ranging from annoyances to major accidents. [Refer student divers to the Common Problems List in the PADI Rescue Diver Manual. Supplement list with local examples and show equipment, as appropriate. Encourage divers to provide additional examples from their own experience or observations as you discuss each of the following.]
1. Mask
2. Snorkel
3. Fins
4. Exposure suits
5. BCD
6. Weight system
7. Scuba unit

24. Six Types of Releases and Problems
PADI Rescue Diver Course
Six Types of Releases and Problems
What are six types of releases commonly found in scuba systems and what problems may they have?
Quick release buckles.
Improper webbing alignment or not fully locking the buckle.
Improper placement of crotch strap.
Quick disconnect fasteners.
Too much strain.
Touch fasteners.
Sand, lint and debris.
Rescue - Knowledge Development Two
3. Release Function and Problems
What are six types of releases commonly found in scuba systems and what problems may they have?
a. Quick release buckles are common weight belt fasteners. Improper webbing alignment or not fully locking the buckle may cause a sudden release and uncontrolled ascent. Putting a crotch strap over a weight belt can prevent it from being discarded easily in an emergency.
b. Quick disconnect fasteners are common on BCDs. Putting too much strain on one could cause it to release.
c. Touch fasteners join fabrics together – (Velcro™). Sand, lint and debris may cause these fasteners to be less reliable.

25. Six Types of Releases and Problems
PADI Rescue Diver Course
Six Types of Releases and Problems
What are six types of releases commonly found in scuba systems and what problems may they have? continued…
Tank band releases.
Improper threading.
Nylon stretches when wet.
Low pressure inflator hose connect (LPI and dry suit).
Quick disconnect mechanism malfunctions.
Integrated weight releases.
Hard to find or improperly threaded releases.
Rescue - Knowledge Development Two
d. Tank band releases snug the webbing holding the tank in place. Improper threading can cause the cylinder to slip. Nylon stretches when wet, so that a snug, dry strap becomes loose when wet.
e. Low pressure inflator hoses connect via a quick disconnect mechanism. These connections are also used for dry suit hoses and air powered accessories.
f. Integrated weight releases allow a diver to quickly dump weights that are contained within BCD pouches or weight harnesses. [Ask divers if they have observed any problems with various releases and discuss these as appropriate. Discuss prevention and solutions for each of the above problems and those student divers cite.]

26. PADI Rescue Diver Course
Accident Management
Common Aquatic Life Injury First Aid
Three Forms of Aquatic Life Injuries
Signs and Symptoms of Venomous Aquatic Injuries
Common Local Treatments
Basic First Aid for Jellyfish Stings
Rescue - Knowledge Development Two
C. Accident Management
Common Aquatic Life Injury First Aid
• What are the three forms of aquatic life injuries?
• What five signs and symptoms indicate venomous aquatic life injuries?
• What is the common treatment for aquatic life injuries?
• What is the basic first aid for jellyfish stings?

27. Three Forms of Aquatic Life Injuries
PADI Rescue Diver Course
Three Forms of Aquatic Life Injuries
What are three forms of aquatic life injuries?
Bites.
Abrasions, cuts or punctures.
Stings or venomous wounds.
Do not use unprotected hands to remove tentacle pieces or other stingers.
Use forceps or other tools to gently lift the pieces off and/or irrigate the wound with salt water.
Rescue - Knowledge Development Two
C. Accident Management
1. Common Aquatic Life Injury First Aid
What are the three forms of aquatic life injuries?
a. Aquatic injuries
1. Bites
2. Abrasions, cuts or punctures
3. Stings or venomous wounds
NOTE TO STUDENT DIVERS: Do not use unprotected hands to remove tentacle pieces or other stingers – they can still sting even detached from the animal. Use forceps or other tools to gently lift the pieces off or irrigate the wound with salt water.

28. Signs and Symptoms of Venomous Aquatic Injuries
PADI Rescue Diver Course
Signs and Symptoms of Venomous Aquatic Injuries
What five signs and symptoms indicate venomous aquatic life injuries?
Injury signs and symptoms are specific to the type of creature encountered.
Excruciating pain.
Local swelling, inflammation or welts.
Weakness, nausea, mental confusion and shock.
Spreading numbness, paralysis and convulsions.
Unconsciousness, respiratory or cardiac arrest.
What is the common treatment for aquatic life injuries?
Apply treatment as per local protocol.
Rescue - Knowledge Development Two
What five signs and symptoms indicate venomous aquatic life injuries?
b. Venomous aquatic injuries
1. Venomous aquatic animals can cause a variety of problems for divers, although serious cases are rare.
Injury signs and symptoms are specific to the type of creature encountered, however, in general they include:
• Excruciating pain
• Local swelling, inflammation or welts
• Weakness, nausea, mental confusion and shock
• Spreading numbness, paralysis and convulsions
• Unconsciousness, respiratory or cardiac arrest
• What is the common treatment for aquatic life injuries?
What is the common treatment for aquatic life injuries?
c. Common local treatments for aquatic life injuries. [Review treatments specific to the local area.]
1. Always begin with primary assessment.
2. Remove any foreign objects – spines, tentacles, stingers, etc.
3. Soak afflicted area in hot water (43-49°C/ °F) for at least 30 to 90 minutes; use hot compresses if soaking isn’t possible.
4. If afflicted area is a limb, keep the limb below heart level.
5. Treat for shock.
6. Continue to monitor the injured diver’s lifeline and transport to emergency medical assistance as soon as possible.

29. Basic First Aid for Jellyfish Stings
PADI Rescue Diver Course
Basic First Aid for Jellyfish Stings
What is the basic first aid for jellyfish stings?
First aid varies from applying vinegar (box jellyfish) to applying ice packs (bluenose).
It’s important to consult local practices for basic first aid procedures.
Rescue - Knowledge Development Two
What is the basic first aid for jellyfish stings?
d. Divers who have encountered jellyfish usually complain of a stinging or burning sensation. Do not let the affected diver rub or scratch the sting (this worsens and spreads it). The stung diver may develop hives and have an allergic reaction with laryngeal swelling that may lead to airway blockage, respiratory distress, cardiac irregularities, and loss of consciousness. First aid varies from applying vinegar (box jellyfish) to applying ice packs (bluebottles). Consult local practices for basic first aid procedures.

30. Responding to Diver Emergencies
PADI Rescue Diver Course
Responding to Diver Emergencies
Responsive Diver at the Surface
Exits with a Responsive Diver
Postattendance
Rescue - Knowledge Development Two
D. Responding to Diver Emergencies
• More on Responding to Responsive Divers at the Surface
• What are the techniques and considerations for responding to a responsive diver at the surface from a distance?
• What is a quick reverse, and how do you do it?
• What is the advantage of using emergency flotation when assisting a responsive diver at the surface?
• What are the procedures for approaching, evaluating and helping more than one responsive diver in the water?
Exits with a Responsive Diver
• What factors should you consider when removing equipment from a distressed diver?
• What are the general criteria for tows used to transport a distressed diver in the water?
• What should you consider when helping a distressed diver exit the water?
Post Attendance
• What three concerns do you need to handle with a responsive diver once you get on the boat or shore?

31. Responding to a Responsive Diver on the Surface from a Distance
PADI Rescue Diver Course
Responding to a Responsive Diver on the Surface from a Distance
What are the techniques and considerations for responding to a responsive diver at the surface from a distance?
Entry considerations:
Respond with mask, snorkel, fins and some form of flotation.
When and where to don equipment depends on circumstances.
Enter water at a point nearest to the distressed diver.
Keep the victim in view.
Rescue - Knowledge Development Two
D. Responding to Diver Emergencies
1. More on Responding to Responsive Divers at the Surface
What are the techniques and considerations for responding to a responsive diver at the surface from a distance?
a. In Rescue Training Session One, you learned the basic procedures for rescuing responsive divers at the surface. Let’s review and look at some aspects of the procedures in more detail.
b. Entry Considerations
1. Always respond with at least mask, fins, snorkel and some form of flotation.
2. When and where to don equipment depends on circumstance.
• You want to be close to the water, but also not lose sight of the victim.
• It may be best to don mask and snorkel, enter the water and then don fins.
• If wearing a buoyant exposure suit, you may need weights to go down if the victim sinks. You would drop weights to assure buoyancy after making contact with the victim. [Review considerations appropriate to training location.]
3. To reduce swimming distance, try to enter the water at a point nearest to the distressed diver.
4. Always enter the water in a manner that keeps the victim in view.
• If possible have someone keep an eye on and point to the victim. Instruct the spotter not to look away for any reason.
• If you lose sight of the victim in waves, look back to see where the spotter directs you.
• Easing or wading into the water without a splash is usually best. If you must step into deep water, wear your fins and bring your legs together as you enter so your face doesn’t submerge.

32. Responding to a Responsive Diver on the Surface from a Distance
PADI Rescue Diver Course
Responding to a Responsive Diver on the Surface from a Distance
What are the techniques and considerations for responding to a responsive diver at the surface from a distance? continued…
Reach the victim as quickly as possible, but with adequate reserve of energy.
Set your own pace based on:
Distance to tired diver, and then to safety.
The environmental conditions.
The condition of the tired diver.
Your strength and condition.
Rescue - Knowledge Development Two
c. You learned that you want to reach the victim as quickly as possible, but with an adequate reserve of energy to enable you to perform a safe rescue and tow.
1. You set this pace based on:
• the distance to the tired diver, and then to safety.
• the environmental conditions.
• the condition of the tired diver.
• your strength and condition.
2. The crawl stroke allows a quick approach and leaves your legs more rested. However, use your legs as well, and don’t tire your arms so much that you don’t have enough strength for the assist.

33. PADI Rescue Diver Course
Quick Reverse
What is a quick reverse and how do you do it?
A quick reverse backs you into a position of safety if a potentially panicked diver reaches for you.
Lean backward and angle your legs towards the victim.
This positions you to kick away quickly to stay out of reach.
Rescue - Knowledge Development Two
What is a quick reverse and how do you do it?
3. When you stop and evaluate, be prepared with a quick reverse, which backs you into a position of safety if a potentially panicked diver reaches for you.
• Lean backward and angle your legs towards the victim.
• This positions you to kick away quickly to stay out of reach.
4. As you evaluate the diver, check for ample buoyancy – tell the victim to put air into the BCD and/or release weights. Assure the victim that you’re there to help.

34. PADI Rescue Diver Course
Emergency Flotation
What is the advantage of using emergency flotation when assisting a responsive diver at the surface?
Greatly simplifies the rescue by providing immediate buoyancy.
Allows you to avoid contact with a potentially panicked diver.
May be easier to tow the diver holding the device than the diver directly.
Rescue - Knowledge Development Two
What is the advantage of using emergency flotation when assisting a responsive diver at the surface?
5. You’ve learned the basics for assisting a responsive diver at the surface without emergency flotation. However, having emergency flotation is preferred:
• Greatly simplifies the rescue by providing immediate buoyancy
• Allows you to avoid contact with a potentially panicked diver
• May be easier to tow the diver holding the device than the diver directly
• Anything with adequate buoyancy and portability will work: PFD, a spare BCD, gear bag stuffed with wet suits, boat fender, etc.
6. If you have emergency flotation with you, place it between you and the victim and extend it from a safe distance. Tell the diver to hold onto it for support. (A panicked diver may grab and climb on it before you can say anything, or totally fail to recognize it.)
7. If you don’t have emergency flotation or the victim doesn’t take it, you’ll have to make contact and assist as you’ve already learned, based on whether the diver is a tired diver or a panicked diver.

35. More than One Responsive Diver on the Surface
PADI Rescue Diver Course
More than One Responsive Diver on the Surface
What are the procedures for approaching, evaluating and helping more than one responsive diver in the water?
Determine which diver needs the most help.
Give flotation to first diver, then assist the next.
Approach and evaluate each diver as you’ve already learned.
May need to separate two panicked divers.
If handling more than one panicked diver presents unacceptable risk, stay clear until one/they exhaust themselves.
Rescue - Knowledge Development Two
What are the procedures for approaching, evaluating and helping more than one responsive diver in the water?
d. It’s possible you will encounter situations in which more than one diver needs help at the surface. To rescue multiple divers follow these principles:
1. Remember it is better to reach, throw, wade or take a watercraft before attempting an inwater rescue.
2. Multiple rescuers for multiple victims is the best response.
3. If you have to aid multiple divers by yourself, emergency flotation may be almost essential.
4. Enter the water and determine which diver needs the most help (usually the person who initiated the situation). Ideally, give flotation to the first diver, confirm that solves the immediate problem, then go to assist the next. Approach and evaluate each diver like you’ve already learned.
5. It may be necessary to separate two panicked divers. This is usually most effective from underwater or behind; inflate the divers’ BCDs and/or drop their weights.
6. If handling more than one panicked diver presents unacceptable risk, stay clear until one/they exhaust themselves. This may require an underwater unresponsive diver rescue, but that’s better than getting into trouble yourself. Remember, you cannot rescue others if you become a victim, too.

36. PADI Rescue Diver Course
Factors to Consider
What factors should you consider when removing equipment from a distressed diver?
How far do you have to go?
If a long distance, eliminating the drag may help.
What is the environment like?
You might remove equipment if environment is calm.
What’s the victim’s condition?
If the diver recovers completely, no need to remove any equipment.
Rescue - Knowledge Development Two
2. Exits with a Responsive Diver
What factors should you consider when removing equipment from a distressed diver?
a. In Rescue Training Session One, you practiced rescuing the responsive diver at the surface. Let’s look more at this situation, with attention to exiting the water.
b. To make transporting and exiting easier, you may need to remove equipment from the distressed diver (which you’ve practiced already). You should consider whether to do this or not, or which pieces you can or can’t remove, based on several factors.
1. How far do you have to go? If you have a short swim to safety or help, the additional weight and drag from equipment probably won’t make much difference. If you have a long swim, eliminating the drag may help you both save strength and energy.
2. What is the environment like? You can eliminate equipment if you are in flat, warm water with an exit on a calm shore or aboard a boat. On the other hand, you’ll probably need your mask and snorkel in choppy seas. If you have to exit through heavy surf, both you and the distressed diver may need to keep all your equipment, but through mild surf an exhausted diver might be best off with mask and snorkel, but no heavy scuba unit or weights.
3. What’s the victim’s condition? If the diver recovers completely, there may be no need to remove any equipment. With tired, injured or distressed divers who have trouble recovering and appear weak, it may be best to eliminate equipment to reduce drag and make it easier for them to exit the water.

37. General Criteria for Tows
PADI Rescue Diver Course
General Criteria for Tows
What are the general criteria for tows used to transport a distressed diver in the water?
The ideal tow meets the following criteria:
The tow keeps the diver’s face out of the water.
The tow reduces drag by letting you and the tired diver move through the water horizontally.
The tow gives you control.
The tow doesn't restrict your swimming.
The tow allows you to communicate with the tired diver, preferably with eye-to-eye contact, so you can continue to reassure the diver as you swim.
Rescue - Knowledge Development Two
What are the general criteria for tows used to transport a distressed diver in the water?
c. You practiced tows in Rescue Training Session One. The ideal tow meets the following criteria; you’ll practice different tows because each has advantages and disadvantages with respect to these:
1. The tow keeps the diver’s face out of the water.
2. The tow reduces drag by letting you and the tired diver move through the water horizontally.
3. The tow gives you control.
4. The tow doesn’t restrict your swimming.
5. The tow allows you to communicate with the tired diver, preferably with eye-to-eye contact, so you can continue to reassure the diver as you swim.

38. PADI Rescue Diver Course
Effective Tows
Effective tows include:
Underarm tow.
Modified tired swimmers carry.
Tank valve tow.
Rescue - Knowledge Development Two
d. Effective tows include:
1. Underarm tow – grasp the tired diver under the arm and continue to swim to shore while your face remains close to his.
2. Modified tired swimmers carry – use your shoulders to push the tired diver’s feet.
3. Tank value tow – grasp the tired diver’s tank value and swim to shore or boat. [Ask students if they have tried other types of tows in swim courses.]

39. Considerations for Helping a Distressed Diver Exit the Water
PADI Rescue Diver Course
Considerations for Helping a Distressed Diver Exit the Water
What should you consider when helping a distressed diver exit the water?
Conditions such as:
Terrain.
Proximity to medical assistance.
Your own size and strength.
The assistance available.
The distressed diver’s size and condition.
Rescue - Knowledge Development Two
What should you consider when helping a distressed diver exit the water?
e. Conditions such as terrain, proximity to medical assistance, your own size and strength, the assistance available and the distressed diver’s size and condition influence the type of exit you use.
1. For a shore exit, you may need to assist a weak distressed diver to safety. Stand at the diver’s side with the near arm across your shoulder, secured by grabbing the wrist with your far hand. Support with your free arm around the waist or tank. You should be able to walk the tired diver to safety.
2. You may decide the diver is too weak to walk ashore or climb aboard a boat with equipment on. In this case, and if environmental conditions allow, remove the victim’s equipment before exiting.
3. With a difficult shore exit, or one where it’s best to wear gear due to conditions, you may opt to have the diver crawl out.
4. In many instances, a seemingly difficult exit with a weak, tired diver may be simplified by allowing adequate time for the victim to rest and recover enough to manage the exit with relatively little assistance from you (though you should stay at hand in case needed).

40. PADI Rescue Diver Course
Postattendance
What three concerns do you need to handle with a responsive diver once you get on the boat or shore?
Assess for injury/illness as you learned in your first aid and CPR courses.
Contact emergency medical care if necessary.
Be sensitive. Don’t play hero.
Don’t minimize the situation.
Rescue - Knowledge Development Two
3. Postattendance
What three concerns do you need to handle with a responsive diver once you get on the boat or shore?
a. Once out of the water, you have three concerns to handle with a responsive diver.
1. Assess for injury/illness as you learned in your EFR courses.
2. Contact emergency medical care if necessary.
3. Be sensitive – don’t play hero. Some divers may experience self-esteem loss and residual fear. Don’t minimize the situation, but do reassure by citing the diver’s correct actions.

41. Knowledge Development Two Review
PADI Rescue Diver Course
Knowledge Development Two Review
The Psychology of Rescue
Being Prepared for a Diver Emergency
Responding to Diver Emergencies
Accident Management
Rescue - Knowledge Development Two
Overview and Learning Objectives
By the end of this section, the student should be able to answer the questions in italics:
A. The Psychology of Rescue
Recognizing Stress in Divers
• What two steps do you apply to recognize stress in a diver?
• What should you do when you recognize diver stress?
B. Being Prepared for a Diver Emergency
Equipment Function and Function Related Problems
• How does a regulator function?
• What are the two basic types of alternate air sources?
• What three points does the dive community generally
agree upon regarding alternate air sources?
• What functional problems can occur with cylinders, valves, regulators, SPGs and BCDs?
Common Equipment Problems
• What are six general causes of equipment-related problems?
• What are the causes, effects and prevention of problems with masks, snorkels, fins, exposure suits, BCDs, weight systems and scuba units?
Release Function and Problems
• What are six types of releases commonly found in scuba systems and what problems may they have?
C. Accident Management
Common Marine First Aid Injuries
• What are the three forms of aquatic life injuries?
• What five signs and symptoms indicate venomous aquatic life injuries?
• What is the common treatment for aquatic life injuries?
• What is the basic first aid for jellyfish stings?
D. Responding to Diver Emergencies
• More on Responding to Responsive Divers at the Surface
• What are the techniques and considerations for responding to a responsive diver at the surface from a distance?
• What is a quick reverse, and how do you do it?
• What is the advantage of using emergency flotation when assisting a responsive diver at the surface?
• What are the procedures for approaching, evaluating and helping more than one responsive diver in the water?
Exits with a Responsive Diver
• What factors should you consider when removing equipment from a distressed diver?
• What are the general criteria for tows used to transport a distressed diver in the water?
• What should you consider when helping a distressed diver exit the water?
Post Attendance
• What three concerns do you need to handle with a responsive diver once you get on the boat or shore?