IDC Rescue Skills & Emergency Response 2 — Questions and Answers
Question 1: What is the primary symptom that distinguishes Type II DCS (serious) from Type I DCS (mild) in the field?
- Joint pain is present in Type II but not Type I
- Type II involves neurological symptoms such as numbness, weakness, or paralysis (Correct answer)
- Type II symptoms appear within 10 minutes of surfacing
- Type II requires deeper dives to trigger
Correct answer: Type II involves neurological symptoms such as numbness, weakness, or paralysis
Type II DCS involves neurological symptoms such as numbness, tingling, weakness, paralysis, or respiratory/cardiac involvement, distinguishing it from Type I which mainly involves pain and skin symptoms.
DCS is classified as Type I (mild: joint/limb pain, skin rash, fatigue) and Type II (serious: neurological symptoms). Type II indicators include numbness or tingling, muscle weakness, paralysis, loss of bladder/bowel control, respiratory difficulty (chokes), cardiac involvement, and cognitive changes. Type II is a medical emergency requiring immediate hyperbaric oxygen treatment. In the field, any neurological symptom following a dive must be treated as Type II DCS until proven otherwise, and 100% oxygen and emergency evacuation to a hyperbaric facility should begin immediately.
Question 2: After providing first aid to a suspected DCS victim on the boat, what is the PADI-recommended position for transport to medical care?
- Prone (face down) position
- Left lateral (recovery) position if unconscious (Correct answer)
- Seated upright position
- Supine (face up) with legs elevated
Correct answer: Left lateral (recovery) position if unconscious
An unconscious DCS victim should be placed in the left lateral (recovery) position, which protects the airway and reduces aspiration risk.
For an unconscious or unresponsive DCS victim, the left lateral (recovery) position is recommended. This position keeps the airway open, allows fluids to drain from the mouth, prevents aspiration if vomiting occurs, and maintains circulation. Oxygen should be administered continuously during transport. The previously recommended Trendelenburg position (head down) is no longer advocated as it may worsen cerebral edema. Conscious DCS patients should be positioned comfortably—usually lying down—while breathing 100% oxygen. Rehydration with water or sports drinks is recommended for conscious patients.
Question 3: According to PADI's Emergency Action Plan, what information should be included in a site's emergency contact list?
- DAN emergency number and local hospital only
- Local EMS, DAN, nearest hyperbaric chamber, coast guard, and dive site contact (Correct answer)
- Dive operator insurance and legal contacts
- All of the above plus weather service
Correct answer: Local EMS, DAN, nearest hyperbaric chamber, coast guard, and dive site contact
A complete emergency contact list includes local EMS, DAN emergency number, nearest hyperbaric chamber, coast guard (for boat operations), and local dive site emergency contacts.
PADI emergency action plans require comprehensive contact information. The essential contacts are: local emergency services (EMS/911), DAN emergency line (+1-919-684-9111 for emergency advice), nearest recompression/hyperbaric chamber (with address and transport route), coast guard (for open water/boat operations), and site-specific contacts (harbor master, resort management). Contact lists should be posted in accessible locations, tested periodically, and updated when information changes. Each dive professional should know these contacts by memory for the most critical numbers.
Question 4: During a training dive, a student performs an uncontrolled rapid ascent. After surfacing, the student says they feel fine. What should the PADI instructor do?
- Accept the student's report and continue training after a brief surface interval
- Monitor the student closely for 30-60 minutes for DCS/AGE symptoms before continuing (Correct answer)
- Immediately evacuate the student to a hospital
- Have the student breathe oxygen for 15 minutes and resume diving
Correct answer: Monitor the student closely for 30-60 minutes for DCS/AGE symptoms before continuing
After a rapid ascent, the student should be closely monitored for 30-60 minutes for signs of DCS or AGE, even if they report feeling fine initially.
A rapid ascent creates significant risk of arterial gas embolism (AGE) and DCS. Even when a student reports feeling fine, symptoms can develop minutes to hours later. The instructor should: stop all diving activities for that student, have them breathe oxygen if available, monitor closely for neurological symptoms (confusion, vision changes, paralysis—AGE) and DCS symptoms (joint pain, numbness, rashes), be prepared to activate EMS if symptoms develop, and contact DAN for guidance. Resuming diving after a rapid ascent the same day is not recommended.
Question 5: What is the correct treatment priority order for an unresponsive, non-breathing diver rescued from the water?
- Remove equipment → CPR → oxygen → call EMS
- Call EMS → oxygen → CPR → remove equipment
- Establish buoyancy → rescue breathing → remove from water → CPR/AED → oxygen (Correct answer)
- Oxygen → CPR → establish buoyancy → call EMS
Correct answer: Establish buoyancy → rescue breathing → remove from water → CPR/AED → oxygen
The correct sequence is: establish buoyancy in water, begin rescue breathing while towing to exit, remove from water, start CPR/AED if no pulse, administer oxygen as soon as possible.
PADI rescue procedures begin in the water: establish positive buoyancy for rescuer and victim, assess breathing, begin rescue breathing while towing to exit point (one breath every 5 seconds). On land/boat: check for pulse—if absent, begin CPR and use AED if available. Oxygen is administered as soon as possible throughout. EMS is called as early as possible—ideally by a bystander while rescue is ongoing. Equipment is removed as needed to access airway and chest, not as the first priority. The chain of survival (early access, early CPR, early defibrillation, early advanced care) applies to dive emergencies.
Question 6: What does the acronym DAN stand for, and why is it important for PADI instructors?
- Diving Association Network — the certifying body for rescue divers
- Divers Alert Network — 24/7 emergency advice for diving accidents and medical referrals (Correct answer)
- Deep Air Normoxic — the oxygen protocol for emergency response
- Diver Assistance Network — provides insurance for dive accidents only
Correct answer: Divers Alert Network — 24/7 emergency advice for diving accidents and medical referrals
DAN (Divers Alert Network) provides 24/7 emergency medical advice for diving accidents and can direct to the nearest hyperbaric facility — an essential resource for dive professionals.
DAN (Divers Alert Network) is a non-profit organization providing emergency medical advice specific to diving accidents 24/7 at +1-919-684-9111. DAN can help diagnose suspected DCS/AGE over the phone, identify the nearest hyperbaric chamber, coordinate medical evacuation, and advise on oxygen administration. PADI instructors are strongly encouraged to have DAN's number memorized and posted at dive sites. DAN also offers dive accident insurance, dive safety research, and professional training. Every dive professional should have an active DAN membership.
IDC Rescue Skills & Emergency Response 2
What is the primary symptom that distinguishes Type II DCS (serious) from Type I DCS (mild) in the field?