[abstract] MOUTH TO LARYNGEAL MASK AIRWAY RESCUE BREATHING DURING TOW OF THE UNCONSCIOUS NON-BREATHING DIVER

Abstract

BACKGROUND: Simultanious towing and rescue-ventilation of the unconscious non-breathing diver applying standard basic life support (LS) techniques is impossible. To overcome this preclusion, the laryngeal mask airway, connected to an extension hose via a non-rebreathing volume might be useful, as this device has been shown to be a possible alternative LS adjunct for divers. METHODS: 15 combat divers on closed circuit oxygen rebreathers familiar with standard basic life support techniques were included in a buddy to buddy rescue training. A diver with standard combat dive equipment including an inflated buoyancy collar had to be towed a 50m distance by jaw grip technique in the training pool. Alternating, the rescue diver had to breathe with his underwater oxygen rebreather and to ventilate a submersed 2.3 liter anesthesia reservoir bag, mounted on the back of the victim diver, serving as lung simulator. Ventilation and collection of expiratory gas were achieved by two hoses connected to the bag via a non-rebreathing valve. The proximal edge of the ventilation hose was locked by an inflator valve that could be activated by the rescue diver during ventilation. The distal edge of the collection hose was connected to a volumeter mounted on a swimming board. CONCLUSION: The method as described above in connection to a laryngeal mask airway, sealing a victim's larygeal aperture, might serve as LS adjunct in such situations. Diver would have to be trained to avoid airway pressures exceeding 20 mbar by applying tidal volumes not exceeding 700ml, however.