Probably the biggest source of confusion during a rescue diver course is the creation of an emergency assistance plan. Students aren’t sure how much or how little to include. They aren’t sure they did it right when it doesn’t take a long time. This article is meant to clear up these problems.

First of all, I’m going to say that creating an assistance action plan should not be a terribly difficult exercise, especially in the internet age. There are a few key components that should be included along with a few optional items. Finding this information these days should be a breeze. Before we get into what exactly to include, let’s discuss the purpose of an emergency assistance plan. This should illuminate exactly what is required to construct a complete plan.

Purpose

The purpose of an assistance plan is simple: in the case of an emergency, an emergency assistance plan should assist an uninformed bystander in contacting emergency services and getting them to the location of the accident. Right away this should clue you in on what’s required. In fact, putting too much information will only slow things down during an emergency situation.

In general, there doesn’t have to be too much detail in an emergency plan. However, courses usually require plans for a specific dive site. This is probably an additional source of uncertainty. If in doubt, just ask your instructor how specific everything should be. Additionally, consult your textbook for any insights it may offer.¹ Though it never hurts to put in too much information, at least for the sake of fulfilling a course requirement.

What’s in it?

Now we know what the overall purpose of the plan is, but what exactly do we put in it? This is what everyone wants to know. After considering the purpose, we can ask some questions to discover what should be in this elusive little document.

If a diving emergency was taking place around you, what information would you need to be of some assistance? Clearly, we need some sort of contact information for the local emergency services. In particular, we want scuba-related contacts. If your diving locale has an emergency hotline dedicated to scuba emergencies, include that as well as general emergency numbers.² Look up the local Divers Alert Network (DAN) for their contact information.

This information (local EMS plus any scuba-related EMS) is the core of your emergency assistance plan. You can’t get away with less. There is, however, plenty more you could include for absolute completeness. What other information could be useful during an emergency?

Sometimes it may be faster to transport the injured yourself. For this reason, I like to include the location of the nearest hospital, possibly with a map or directions. A contact number for the emergency room is also good, to alert staff that you are on your way with an injured diver.

The location of nearby emergency equipment is also pertinent. This includes things like emergency oxygen and first aid kits. Often, EMS may take a while to arrive, costing your victim precious minutes. Being able to help in the meantime by administering oxygen or basic life support could be the difference between life and death. You may know where the oxygen tank is, but if you’re busy giving rescue breaths, you want someone else to be able to retrieve it.

Depending on where you are diving, the location of the nearest telephone may be useful. Imagine if a foreigner was responsible for contacting emergency services after an accident. They have your emergency assistance plan, but no local mobile phone. It could be when you handed them your plan you told them to use your phone, but if diving remotely this may not always be a possibility. It’s location-specific, and definitely something to think about, but not required.

My rescue instructor was fairly stringent and required that I include a script for someone to read when calling emergency services. The key parts of this script are your location (not just the dive site name, but where it actually is), and that this is a scuba diving related emergency. This bit of information could change the reaction of emergency services on the other end. For instance, they may realize that a decompression chamber is needed and avoid hospitals that aren’t equipped to handle decompression sickness, saving valuable time.

Another optional item is a map of your diving location that identifies all the important landmarks nearby, such as the emergency equipment, telephones, and even the hospital. This diagram of the dive site could be useful in an emergency, but is usually not required. If your instructor doesn’t request it, you can still include it for brownie points.

Templates

To save you some time, I created a free emergency assistance plan template. Fill out as much or as little as you (and your instructor) think is necessary, replacing the text inside the <brackets>. Delete the rest. Click the following links for the format of your choice:

iWork Pages
Word 2007 & 2008 (.docx extension)
Word 97 – 2004 (.doc extension)
Adobe PDF
Rich Text Format

My hope is that this article (and the templates) take some of the mystique out of creating an emergency assistance plan. This is something you’ll probably only have to do twice during all your training (for rescue diver and for divemaster), but it is good to know the thinking behind it’s construction and the overall purpose it serves.

Time to help me out. Is there anything critical I left out that should be in an emergency assistance plan? Let me know in the comments.

1. I can’t say for other agencies, but the PADI rescue diver manual is nearly useless for information about creating an emergency assistance plan.
2. Funny story. I did my rescue diver course in New Zealand. For my assistance plan, I wanted to include the telephone number for a local hospital. I found the hospital, looked the number up online, and put it in my plan. During the course, everyone except me noticed something wrong with the hospital’s number, +44 xxx-xxxx. Turns out the hospital was part of a UK conglomerate, and the number I found was for their main London hospital. Being a dumb American, I put the phone number with the UK country code for my New Zealand dive plan. Go me.

The time has come. I’ve been toying with the idea for a while, but I’ve finally taken the plunge and signed up or scuba diving insurance.

Why insurance?

I dive more than three times a year, and plan to dive frequently in the future. It’s said that the only way to prevent decompression illness (DCI) is to not dive, so it makes sense that the more you dive, the more risk you incur. You can follow every table or computer to the letter and still get sick.

I know I sound like an insurance salesman, but when you purchase insurance, you are purchasing peace of mind. DCI is expensive, especially if they have to helicopter you off a boat. To make matters worse, most insurance policies don’t cover scuba diving accidents, so you can easily accrue tens of thousands of dollars in debt from a single incident!

Check your policy. Find out if you’re covered. You’ll probably find that you’re not as protected as you thought. For me, the small cost per year is well worth the peace of mind.

How?

I’m sure many companies will be happy to underwrite you for additional coverage. For most people, however, the easiest way to get coverage is through the Divers Alert Network (DAN). DAN is a non-profit medical and research organization that supplies resources for recreational divers.

I signed up for insurance through DAN and it was easy. There are only two steps:

1. Become a DAN member

   Only DAN members are eligible for insurance. This comes with some perks like a subscription to their magazine, but nothing I was terribly interested in. Individuals pay $35 a year for membership or you can subscribe your household (people with the same mailing address) for $55 a year (these prices are current as of 2010 and in US dollars).

2. Sign up for DAN insurance

   Once you have membership, you can immediately sign up for insurance. DAN offers three insurance programs: the standard plan, the master plan, and the preferred plan.

   The standard plan is rather skimpy, which is reflected in the $25 a year cost. There is a $45,000 lifetime maximum payout for the plan.

   The master plan is a little better, offering a $125,000 lifetime maximum payout. It includes a few additional items, such as payment for lost diving equipment, dismemberment (yikes!), and disability. For these additional benefits the price goes up to $35 a year.

   The preferred plan offers $250,000 coverage per incident. It includes slightly higher payouts for each item compared to the master plan, but the cost doubles to $70 a year.

I went with the Goldilocks plan, right in the middle. It balanced decent payout with a cheap yearly cost. For individual membership in the master plan, you’re facing $35 + $35 = $70 a year: a perfectly reasonable cost for active divers.

The entire process took less than 15 minutes, including signing up for DAN membership. DAN will want to know who your primary insurance provider is since some parts of a diving incident may be covered by your primary plan, so you may want to have that information at hand.

DAN is a US organization, so this only applies to American divers. I’m curious about divers from other countries, particularly those with public health care: does your healthcare cover diving accidents, along with hyperbaric treatment, or do you take out private insurance?

Skip-breathing is briefly holding your breath between inhales / exhales. Theoretically, it could cause hypercapnia, or excess carbon dioxide in your blood. Serious complications from skip-breathing seem unlikely, nevertheless it is a bad habit that should be avoided. Why would someone do it?

• Unconscious activity

  Sometimes we do things without even thinking about it. Any habit formed during basic certification could easily persist without any conscious effort. Force yourself to become conscious and it won’t take long to break the habit.

• Trying to save air

  The less you actively breath the less air you use, right? Wrong. Holding your breath, even momentarily, raises the amount of carbon dioxide in your body, which requires more oxygen to flush. The net effect is that any savings in air usage are cancelled, or become negligible.

• Trying to control buoyancy

  I’m guilty of this one, especially during fin pivot exercises. Fine tuning your buoyancy through breath control is natural, and expected. However, breath control does not equal breath holding. Rather than holding your breath, practice achieving the same effect through shallower breathing.

Slow, controlled breathing is best, while any form of breath holding, even skip-breathing, is not recommended. Try to keep your breathing non-stop throughout, and watch how quickly good habits are formed.

Basic certification in most organizations permits diving to depths of 20m / 60ft. Secondary, advanced certification extends this depth to 40m / 130ft–the recreational diving limit. Past this and you enter the realm of technical diving. Where did this limit come from? There are two factors that led to this number:

• No-stop limits

  40 meters is about as deep as one can dive on air while still having somewhat of a bottom time (albeit less than 10 minutes, with a safety stop strongly recommended) before decompression stops are required. Even brief moments at depths beyond this without stops during ascent will almost certainly yield some form of decompression sickness.

• Nitrogen narcosis

  Technically nitrogen narcosis can take effect anywhere below 60 feet, but below 130 feet it reaches the point of being unmanageable without specialized training. The effects can still be strong even at 130ft, hence PADI generally recommends planning deep dives around 100 feet.

These are the two basic reasons behind the now-standard recreational dive limit.

Previous posts have discussed the importance of proper buoyancy. Here I describe how to do a simple weight check in the water.

1. Initial weight

   If you don’t know where to begin, take about 10% of your body weight. If diving in tropical waters with a thin wetsuit, subtract 4-6 pounds; if diving in cold water with lots of exposure protection, add 4-6. This will give you a starting weight to tweak.

2. Enter the water

   Begin at the water surface with full diving equipment and an inflated BCD.

3. Hold a normal breath and deflate your BCD

   At this point you should find out if you are properly weighted. If you sink, you are overweighted, if you bob out of the water, you are underweighted. An ideal weight will keep you approximately eye-level.

4. Repeat

   Based on feedback from the previous step, adjust your weight accordingly and repeat until you float at eye-level.

5. Compensate for your cylinder

   If you are doing this check with a full cylinder, you should add about 4 pounds to compensate for the end-of-dive when the cylinder will be more buoyant. Trust me, it won’t be fun kicking to stay underwater during the safety stop.

That’s it! Once you have a proper weight, note it in your dive log to save time in similar diving environments with the same exposure protection.

PADI training dictates it is acceptable to share your primary second stage or your octopus with a buddy in need of air.

It is a good idea to work this out with your buddy ahead of time. Should the need arise, it could lead to an awkward underwater shuffle if a buddy needs air and doesn’t know which to take. This frustration may lead to panic–a bad situation for everyone.

So take a quick second and decide which second stage is for sharing.

Communication underwater can be a problem, and is usually restricted to a small set of hand signals. It can be even more challenging to get the attention of your dive buddy, however. It happens to me all the time, I see something really cool, but my dive buddy is looking in the completely opposite direction. Unless I’m within reach, I have no way to get their attention. This articles addresses presents our options for making noise underwater.

Commercial options

Many stores would be glad to sell you a remedy. Here are a few common choices:

• Shaker / Rattle

  

  Probably the most well-known option, many dive instructors carry one of these clipped to their BCD. Most are pretty solid and make a clear sound that can be heard from a moderate distance. Expect to spend about $15 USD.

• Horn

  

  These devices usually connect between your low pressure hose and your BCD, using the air from your cylinder to make noise. I imagine you can hear these from pretty far, even on the surface. They are not cheap, however, and run around $60 USD.

• Tank banger

  

  A pretty rudimentary device, the tank banger is some sort of hard material on an elastic band. You wrap it around your cylinder, and snap the hard plastic / metal against your tank to make noise. I find these a good solution, especially since they are the cheapest of the commercial alternatives, running around $5-10 USD. I’ve heard complaints that they can break easily, and are sometimes hard to use when the band is still new and stiff.

Homemade options

The commercial options technically resolve the issue, but can be expensive when you consider the likelihood of leaving it on your rental BCD or cylinder. Here are some options you can whip together at home, and that are cheap enough where losing it doesn’t matter.

• Shaker / Rattle

  

  At its core, this is identical to the commercial shaker, comprised of some hard metal inside an airtight canister. Old camera film canisters are a popular choice, but are becoming harder to find. A medicine bottle is another option. For the metal, anything from BB’s to a simple nut will suffice. Not all canisters will have a way to easily connect it with a BCD, so you may have to improvise, or keep the shaker in your pocket.

• Ring

  

  This is a great solution, since it doesn’t require clipping anything to equipment. A metal band is a great noisemaker underwater when banged against your tank. You don’t have to get married to use this one, since any metallic band will do. The noise is softer than the other options, which I like because it only catches the attention of those within your vicinity.

• Tank banger

  

  Here’s something we put together the night before a dive in Mexico. It’s a hairband with a keychain clipped on it. Buy a pack of hairbands and a pack of keychains to keep with your dive gear and you have the makings for a number of noisemakers, without worrying about losing one. Like the ring, these make a softer noise that I prefer.

Whatever solution you go with, be courteous to other dives. Use it sparingly so you don’t annoy everything else diving, including your dive buddy. Check with the divemaster in case she also has one, and that she doesn’t have a problem with yours. And lastly, when in the water, do a quick test so that your buddy learns your “call”, especially if there are multiple noisemakers in the water.

Recently in Mexico, a woman gave me an account of a recent dive in Honduras. In this dive, the dive leader brought a bucket of chum (various fish parts). He would pull the fish parts out of the bucket and feed them to a swarm of sharks directly in front of the dive group. This gave the divers an up-close view of these amazing animals.

A similar story is told in a recent New York Times article. This time, the story takes place in Fiji. The author casually talks about the dive leader, who goes so far as to call himself “Papa”, feeding sharks as if they were his pets. The sharks know the ritual, gently taking “turns approaching the feeder in an orderly single file.”

What is wrong with this picture? Let me share several issues I have with this practice:

• It’s unnatural. This is the most common argument. Sharks are not pets. Feeding sharks on regular tourist schedules alters their natural feeding habits permanently. Even after chumming was prohibited in the Bahamas, sharks still regularly gather in those chum spots.

• It’s dangerous. The chum handler usually wears chain mail to protect her arm. What about everyone else on the dive? Divers are told to keep their arms close to their bodies, otherwise the sharks, who associate human arms with food, will go in for a quick bite. What about divers who happen to encounter one of these “domesticated” animals? What about those in the Bahamas who find one of these formerly fed sharks, a primitive animal that is expecting a free meal–from you!

• It’s not real. Encountering sharks under chumming conditions is basically a petting zoo. I think seeing one lone shark in its natural environment inspires more awe than 20 sharks waiting in line like its McDonald’s.

I’ve been debating in my mind whether I would ever participate in such a dive. For something like a great white cage dive the answer is easily, “no.” But what about something like a bull shark dive? After some thought, I feel the downsides of such an activity outweigh any desire I have to see a large gathering of sharks. I encourage readers to think through their positions and find where they stand.

How do you feel about chumming? Would you participate in such a dive? Do you have counter-arguments for why the practice is harmless, or even beneficial?