Rescue and resuscitation factors in scuba diving and snorkeling fatalities in Australia, 2001-2013.

Aim: The aim of this study was to examine first aid measures applied in a large series of Australian dive-related fatalities to better determine where improvements can be made.
Methods: The National Coronial Information System was searched to identify scuba diving and snorkeling-related cases reported to various Australian Coroners for the years 2001-2013 inclusive. Coronial documents examined included witness statements, police reports and ambulance and medical reports where available. Information relating to the recovery, rescue and/or resuscitation of the victims was extracted, compiled and analyzed.
Results: 126 scuba diving and 175 snorkeling-related fatalities were identified during the study period, with airway management complications reported in one-third. Cardiopulmonary resuscitation was performed in three-quarters of the incidents. An automated external defibrillator was attached to 40 victims as a first aid measure, and shocks were indicated and delivered in five cases. Although three-quarters of the reports included no information about whether supplemental oxygen was provided, it was confirmed in 19% of both the scuba diving and snorkeling incidents.
Conclusion: There were often considerable delays in the recognition, rescue and/or recovery of an unconscious snorkeler or diver and, consequently, the time to commencement of basic life support. Such delays can affect chances of survival and need to be minimized. Delivery of supplemental oxygen during resuscitation appears to be relatively infrequent and sometimes suboptimal; improvement appears necessary. Some measures that would have improved availability and/or better use in these cases include the selection of appropriate equipment compatible with likely circumstances and operator skills; improved training and ongoing skills practice; and regular checking and maintenance of equipment. Improved data collection and recording by official on-site investigators, preferably with knowledge of diving, would better inform potential or necessary improvements. Copyright© Undersea and Hyperbaric Medical Society.