&EPA
United States
Environmental Protection
Agency
Gulf Breeze, Florida
May 1991
Diver Training Curriculum
Prepared by
JAMES M. PATRICK, Director, EPA Diver Training
DON LAWHORN, Chairman, EPA Diving Safety Board
DICK RUTKOWSKI, Hyperbarics International
NOAA Diving Office
EPA, Safety, Health, and Environmental
Management Division
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1 I /
LIBRARY COPY
DIVER TRAINING CURRICULUM
by
JAMES M. PATRICK, JR.
Director, EPA Diver Training
U.S. EPA Environmental Research Laboratory
Gulf Breeze, FL 32561
DONALD LAWHORN
Chairman, EPA Diving Safety Board
College Station Road
Athens, GA 30613-7799
DICK RUTKOWSKI
President, Hyperbarics International, Inc.
490 Caribbean Drive
Key Largo, FL 33037
NOAA Diving Office
Rockville, Maryland and
Seattle, Washington
EPA, Division of Safety, Health,
and Environmental Management
Washineton, D.C.
Environmental Research Laboratory
Office of Research and Development
U.S. Environmental Protection Agency
Gulf Breeze, FL 32561
PROPERTY OF
ENVIRONMENTAL PROTECTION AGENCY
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DISCLAIMER
The information described in this manual has not been
subjected to Agency review and is intended to be used as
an instructor/student guide during the EPA Diver Training
Course. Mention of trade names or commercial products
does not constitute endorsement or recommendation
for use.
James M. Patrick
Director, EPA Diver Training
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EPA DIVING
TRAINING CURRICULUM
VARIABLE-VOLUME DRY SUIT
DIVING ACCIDENT MANAGEMENT
DIVER RESCUE
OPERATIONAL/WORKING DIVER
CONTAMINATED WATER DIVING
DIVEMASTER
NOAA NITROX I AND II
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CONTRIBUTORS
Bruce Reynolds
U.S. EPA
Environmental Research
Laboratory
27 Tarzwell Drive
Narragansett, RI 02882
Duane W. Kama
U.S. EPA, Region 10
1200 6th Avenue
Seattle, WA 98101
Jonathan Amson
OMED, WH-556F
U.S. EPA
401 M Street, S.W.
Washington, D.C. 20460
David W. Charters
EPA/ERT(MS101)
2890 Woodbridge Avenue
Edison, NJ OS832
Walter Nied
EPA Region 5
230 S. Dearborn
Chicago, IL 60604
Ed McLean
U.S. EPA
OMEP/MOD WH-556F
Washington, D.C. 20460
David Scott Smith
Acting Deputy Director
U.S. EPA
Safety, Health, and Environ-
mental Management Division
401 M Street, S.W.
Washington, D.C. 20460
IV
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ACKNOWLEDGEMENT
The material contained in this manual was compiled with
assistance of many valuable suggestions from the NOAA
Diving Office staff.
Julius C. Jimeno, Director and Patricia Cox of the EPA
Safety, Health and Environmental Management Division
provided funds for the Diving Accident Management/
Operational Diver Training Program.
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CURRICULUM
OUTLINE FOR
EPA DIVING PROGRAM
Program Purpose:
The purpose of this curriculum is to instruct the Environmental
Protection Agency (EPA) and other visiting divers in the use of vari-
able-volume dry suit, diving accident management, contaminated
water awareness, operational/working diver, divemaster, and NOAA
NITROX I and II. These instructional techniques apply to Under-
water Breathing Apparatus (UBA) to be used with Self-Contained
Underwater Breathing Apparatus (SCUBA) and surface supplied air
equipment in accordance with EPA Directives.
Program Objective:
The objective is to ensure that each diver can safely use the UBA in ac-
cordance with the EPA Diving Directives, return to his/her unit and per-
form working dives. Divers must have a good working knowledge of the
equipment used in the course and Limitations in accomplishing working
dives. The program will aid in establishing guidelines used in con-
taminated water diving and diving accident management.
Any candidate who does not meet requirements of this outline will be
dropped from the EPA Diving Program or be reverted to a trainee diver.
In trainee diver status, divers are not allowed to perform working dives.
Program Equipment:
All participants should bring all diving equipment from their unit, as
listed in this Program Outline. Participants who cannot bring the
proper diver's dress should notify the Course Director and other
arrangements will be made.
Equipment which should be brought by the participant from their unit
includes: regulator, underwater pressure gauge, knife, watch, mask,
wet suit, fins, snorkel, compass, depth gauge, gear bag, 30 Ibs. of
weight, weight belt, and back pack. SCUBA tanks are normally
furnished by the Diving Program.
Medical Examinations/
Qualifications:
All participants must show proof of meeting the qualifications as out-
lined in the EPA Diving Directives. All participants, through their
Unit Diving Officer must submit their medical records and diving
qualification to the EPA Diving Officer before the course begins.
Any participant whose records are not in order will not be allowed in
the water without the approval of the EPA Diving Officer and or the
EPA Divine Medical Review Board.
VI
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VARIABLE-VOLUME
DRY SUIT
Page 1
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VARIABLE-VOLUME
DRY SUIT DIVER
TRAINING PROGRAM
(Course Outline Only)
Note: This is a course outline for instructors and team leaders, divemasters
and divers.
Purpose: The purpose of this program is to teach all participants the principles,
applications and use of the variable-volume dry suit.
Objective: The objective of this program is to ensure that the participants are
qualified in the use of variable-volume dry suits in accordance with
the NOAA/EPA Diving Directives.
Qualifications: Participants must be qualified for scuba diving in accordance with
the EPA Diving Directives and be recommended by their unit diving
officer, through the EPA Diving Safety Board.
Pace 2
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OPERATIONAL
CONTAMINATED WATER
DIVER TRAINING
COURSE OUTLINE
FIRST DAY:
0800-0830
Classroom
INTRODUCTION
1. Program
2. Facilities
3. Instructors/team leaders
4. Registration
5. Review of diving qualifications, medicals, etc.
6. Team selection
7. Transportation, hotels, etc.
8. Inventory of student diving equipment
0830-1000
Classroom
HYPOTHERMIA/HYPERTHERMIA
1. Body core temperature changes and their physiological effects
2. Heat transfer
a. Conduction
b. Convection
c. Radiation
3. Prevention of heat loss in cold water
4. Prevention of over-heating
5. Restoring body heat in hypothermia
6. Lowering body temperature in hyperthermia
7. Decompression tables and cold-water diving
8. Missed decompression procedures
9. Blowup decompression procedures
10. Polluted water divine
Pace 3
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THE VARIABLE-VOLUME DRY SUIT
1. Purpose of the dry suit
2. Pros/cons of Viking vs. other variable-volume dry suits
3. Preparing the dry suit for diving:
a. Inspection procedures for holes, etc.
b. Inspection and care of the zipper
c. Check on inlet/outlet valves
d. Care of the neck seal and cuffs
e. Operation, care and inspection of inflation hose
f. Repairing the suit
g. Proper fit and its importance
h. Lubrication of neck seal and cuffs before entry
i. Mobility in the dry suits
j. Cleaning of the suit after normal use
k. Disinfecting washdown of polluted water dive
DANGERS OF USING DRY SUITS
1. Blowups — how they can occur and contribute to embolism:
a. Air in the legs when inverted
b. Dropping of the weight belt
c. Using the dry suit as a lift bag
d. Stuck inlet, inflator hose/valve
e. BC fully inflated preventing access to purge valve
f. Nonfunctioning purge valve
2. Holes in upper portion of dry suit and loss of buoyancy
3. Diver in inverted position due to air in legs
4. Out of air and difficulty in maintaining buoyancy
5. Suit too large and loss of fins due to air in feet
6. Suit too tight
Pace 4
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BLOW UP PREVENTION AND RECOVERY METHODS
1. Don't use the variable-volume suit as a lift bag
2. Ensure adequate training in use of the dry suit
3. Know emergency venting procedures:
a. Neck seal
b. Wrist
c. Purge valve
d. Flare-outs to slow ascent
4. Don't use BC over purge and inlet valves
5. Use shoulder harness or other means of holding weight belt in
place, especially with weak buckJes
WEIGHT BELTS
1. Use of a heavily weighted scuba weight belt and problems
(buckles not holding)
2. The pros and cons of using harnesses on weight belts or
using commercial-type belts with harnesses
3. The use of weights: types, sizes, and how to place them
for best position in the water
4. Dangers of dropping weight belts (blowups)
5. Weighing for the dive and check buoyancy
ANKLE WEIGHTS
1. Keep feet down helping to prevent inverted blowup
2. Allow for more air in legs, keeping lower half of the diver warmer
3. Some weight retained if weight belt is lost
4. Help to keep feet in boots of dry suit if diver gets inverted
5. Make swimming harder, especially long distances
FIN STRAPS
Help to keep fins on when jumping into water or when diver gets into
inverted position and air gets into legs.
Pace 5
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NECK SEAL
1. Proper fit for good seal around the neck
2. How to wear the seal
3. Lubrication and ease of donning
4. Venting suit through neck seal
5. Leaks caused by long hair
6. Advantages of neck seals in surface-supplied diving
HOODS
1. Possible external squeeze
2. Problems associated with air in hood on ascent
3. Elimination of air in hood with a hole
4. Care of hood and seal
5. Long hair and problems associated with leaks
6. Problems of leaks due to overlapping of hood and mask
7. Venting from hood and neck seal
AIR INLET VALVE
1. Proper use for buoyancy control (ascent/descent)
2. Cleaning and inspecting before dive
3. Dangers involved with stuck inlet valve
4. Quick-connect to air hose and its function
5. Problems if quick-connect becomes loose under water
AIR OUTLET VALVE (PURGE)
1. Proper use (ascent/descent)
2. Cleaning, inspecting and lubricating
3. Stuck purge valve
4. Leakv valve
oe 6
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AIR HOSE
1. Proper type and fit
2. Purpose
3. Quick-connect
4. Adapting hose to the first stage:
a. U.S. models must use an adaptor with Teflon
set to change from metric thread
b. A "T" swivel might be needed if only one
low-pressure port on first stage
c. A new modification-type hose is used to
prevent fitting from coming off at depth
d. Quick-connect is cleaned and lubricated for
proper operation
AIR IN SUIT
1. Insulation for warmth
2. Buoyancy control
3. Changes in buoyancy due to depth
4. Blowups (inverted/upright)
UNDERWEAR
1. Types, purposes and insulation qualities
2. Additional weight with additional underwear
CUFFS
1. Importance of proper fit
2. Venting from cuffs
3. Lubrication
4. Repair
5. Type of material
Pace?
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ZIPPER
1. Care and lubrication of zipper
FINS
1. Types of dry suits
2. Proper fit
3. Shoe and suit interface problems
4. Fin straps and their importance
5. Dangers of losing fins:
a. When jumping into water
b. When diver is in inverted position
1000-1030
Classroom FILM, 20 MIN., TV, VIDEO, B&W
(This film demonstrates the normal and emergency
functions of the Unisuit)
1. Ascending/descending, using air inlet valve and
purge valve with controlled conditions
2. Descending without letting air into the dry suit
(this demonstrates suit squeeze in all portions of the body)
3. Inverted diver with air in legs attempting to right himself
4. Venting from the wrists
5. Swimming without weight belt
6. Venting from the neck seal
7. Barrel roll showing movement of air in suit
8. Adding air, becoming positive, and venting
from wrist, neck, and/or purge
9. Inverted diver drops weight belt, corrects position,
and controls buoyancy to the surface
10. Dropping weight belt and
controlled breathing ascent to surface
11. Descending without weight belt
12. Shoulder-harness-type weight demonstration
(with buckles and velcro) — the pros and cons
of shoulder harness use
Pace 8
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1030-1130
Classroom SUIT SELECTION (CHECK FOR FIT) INVENTORY
1. Each student is fitted with a suit for the duration of the program
2. Suits are checked by students for leaks
3. Suits repaired as needed
4. Each student is issued an air inlet hose
5. Students attach air inlet hose to first stage to ensure
proper threads from U.S. to metric
6. Each student is issued fin straps
ACCESSORIES
1. Weighted shoes for stability
2. Rubbers or galoshes for protection
3. Gloves: types, insulation values, and duration of use
in cold water for each type
4. Under-gloves for added insulation
5. Full-face mask for added warmth/communications
6. Hats, pots and/or helmets and how they can be mated
to the dry suit
a. Neck seal, hat, pot, and/or helmet not attached
b. Neck ring, hat, pot, and/or helmet attached
7. Mixed gas diving and different heating values
8. Coveralls: types, reasons for wearing, etc.
9. Cleaning, storing and/or hanging the dry suit
1130-1300 LUNCH
Pace 9
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1300-1355
Pool (Shallow End) DRY SUIT CHECKOUTS
1. Program instructor demonstrates getting into
and out of dry suit
2. All students prepare their suits for diving
a. Set up dive stations with team leader/buddy
b. Set up scuba tank and regulator
c. Lubricate dry suit, cuffs, neck seal,
and zipper as needed
3. Students dress in dry suit
4. Students checked by instructor for:
a. Proper fit
b. Proper equipment
c. Proper connections of air hose to regulator and suit
d. Proper type, fit and weight on weight belt
e. Proper fins and fit with fin straps
5. Students enter shallow end of pool for self-checkout of:
a. Suit buoyancy with and without weights
b. Use of air inlet valve and purge valve
c. Ascent and descent with use of air inlet and
purge valves, and proper position for use
d. Getting into inverted position, air in legs
e. Swimming with and without ankle weights
f. Mobility in suit
g. Venting from wrists and neck seal
h. Swimming with and without weight belt
i. Barrel rolls
j Removal of face mask and work with hood seal
Pace 10
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Pool
(Deep End) DRY SUIT CHECKOUTS
1. Students enter deep end of pool for self-checkout of dry suit:
a. Perform exercises in item 5 above
b Check suit squeeze
c. Controlled ascents and non-controlled ascents
1630-1700 SECURE FROM POOL ACTIVITIES
1. Undress and secure diving dress and equipment
2. Report to team leader for debriefing
3. Report defective equipment and repairs needed
SECOND DAY
0800-0845 1. Homework review (physics/physiology)
2. Question and answer period
3. Debriefing of previous day's water work by team leaders
4. Briefing and schedules for day's program
0845-1000 1. Diving Accident Management
a. Pressure
i) ATA, FSW and PS1
b. Physics
i) Dalton'sLaw(P = Pi + P2 + P3... etc.)
ii) Partial pressure of gases
c. Boyle's Law
i) Pressure vs. Volume
ii) Pressure vs. Diameter
d. Boyle's Law as related to the skin diver (breath holding)
e. Boyle's Law as related to scuba diving and
breathing under pressure
Pace 11
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1000-1015 BREAK
1015-1100 1. Extra Alveolar Air
a. Physics
b. Physiology
c. Pathophysiology of:
i. Arterial Gas Embolism
ii. Pneumothorax
iii. Pneumopericardium
iv. Pneumomediastinum
1100-1145 TEAM BRIEFING FOR AFTERNOON WATER WORK
1145-1300 LUNCH
1300-1600 TEAM LEADERS ORGANIZE TEAMS AND
Open Water DIVE STATIONS/SITES
1. Teams report to the dive site
2. Leaders brief teams on their respective dive projects
3. Teams set up dive stations, check all gear, and work with
buddy to ensure he has all gear and understands the dive plan
4. Dive teams dress in dry suits
5. Buddies check each other, review dive plan and tables
6. Team leaders check each dive team
7. Divemaster and/or safety diver check each diver
8. Divemaster/team leader ensure diving accident management
emergency plan is in effect
9. Teams check out with divemaster and enter water
Pace 12
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Purpose (Dive Plan) The purpose of this dive is to let students become familiar with their
diving dress (dry suits) for the first time in open-water conditions.
Diver will work with team leader and/or divemaster and demonstrate
performance of all normal and emergency procedures as practiced in
the pool the previous day. The rate of advancement through these ex-
ercises will be determined by the instructor. Students who do not
show proficiency will remain one-on-one with the team leader until
proficiency is demonstrated. This will allow students to move to the
next part of the training program (working with another student). The
rate of advancement through these exercises is determined by the in-
structor/team leader.
The team leader/instructor will ensure that dive area is cleared for
diving in accordance with the EPA Diving Directives. The diving ac-
cident management emergency plan must be in effect and understood
by all involved, in accordance with the EPA Diving Directives and
the EPA Diving Accident Management manual.
The students will use all dry suit techniques as employed in the pre-
vious days' pool session. The afternoon session will use ascend-
ing/descending lines to contro'l rates, but will make excursions using
buddy lines and diver-to-surface lines. While making these excursion
in limited visibility, divers will use a compass. The tending diver on
the surface will signal divers below with the line-pull signals when
he/she wants them to come up for any reason
A diving safety boat must be in the water in case of diving emergen-
cy, and equipped to handle emergencies in accordance with EPA
Diving Directives. All appropriate clearances must be maintained for
diving, and appropriate flags must be flown in accordance with the
EPA Diving Directives.
SECURE FROM DIVING OPERATIONS
1. Secure diving projects
2. Secure diving accident management network
3. Inform all appropriate authorities that diving operations are
secured, remove diving flags
4. Secure diving equipment, undress, and clean all gear
5. Debriefing by team leader
1600-1630 BREAK
Page 13
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1630-1800 CONTINUE DIVING ACCIDENT
MANAGEMENT/RESCUE FOR E.A.A.
1. Prevention of diving accidents (E.A.A.)
a. Medical Causes
b. Operational
c. Environmental
2. Early recognition of signs/symptoms of E.A.A.
3. First aid of diving accident
a. Use of oxygen and its importance, medical
implications and pathophysiology
b. Protection of airway and vital signs
c. Oxygen safety
d. Oxygen delivery systems
THIRD DAY
0800-0845 HOMEWORK REVIEW (Physics/Physiology III)
0845-0900 TEAM LEADER REVIEW SESSION
0845-1000 MAN AND HIS NEW ENVIRONMENT
Acclimation to mean sea level
Ascending to lesser pressure (hypobaric conditions)
Descending to higher pressures (hyperbaric conditions)
Ascending/descending in unpressurized conditions
Controlling physiological parameters within the body, under varying
pressures
Barotrauma (direct effects of pressure) and the semi-rigid spaces in
the body and how they are affected
Indirect effects of pressure
(decompression sickness and density of gases)
a) Inward/outward gradient of inert gases from the body
and importance of keeping it in balance
Pace 14
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Note: Divers attending this program should fully understand the physics,
physiology and medical aspects of decompression sickness. The lec-
ture above is a quick review, especially for non-divers, of the basic
physics/physiology of diving.
MEDICAL ASPECTS (Signs/Symptoms)
1. Decompression sickness
a. How it occurs
b. Onset times
c. Post dive early recognition of mild/severe signs
and symptoms
d. Immediate first aid
2. Examination by physician at chamber
3. Transfer into chamber and related problems
4. Flashback to accident site, showing victim coming to surface
confused, being helped into boat and first aid being
administered. Full narration of procedures as performed
for a conscious and unconscious victim
5. Coast Guard alarm office and their procedures for alerting
flight crews
6. Complete visual display of "bubble trouble", signs/symptoms
7. Complete animated outline of the pathology of
decompression sickness and extra alveolar air
REVIEW OF:
a. Importance of oxygen and its pharmacology
b. The Trendelenburg Position/Left Lateral Down
c. Liquids and aspirin and the pharmacology
100-1015 BREAK
Paee 15
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1015-1100 DIVING ACCIDENT MANAGEMENT
(Manual is used for this lecture as a guideline and
for future reference)
History of first aid procedures
Case history of victim with management in the field and outcome at
the chamber
Case history of victim with proper first aid and evacuation
Review of the diving accident flow chart first aid procedure
a. Mild symptoms
b. Severe symptoms
Step by step explanation of the flow chart, why and when to give
oxygen, and other first aid measures
The importance of first aid for early mild symptoms
a. Fatigue
b. Weakness
c. Indifference/personality changes
d. Skin rash
1100-1200 INTRODUCTION TO ADVANCED DIVE EQUIPMENT
1. AGA (Use and Service)
2. Wireless Communication
3. Finger Locator
4. Hand pull signals
1200-1300 LUNCH
1300-1630 WATER WORK
1. Purpose of day's dive plan: The purpose of this day is for
team leaders to designate divemasters and allow them to su-
pervise a diving operation/project of less qualified divers on
any of the projects designated by the Diving Supervisor. This
might be any project outlined in days one and two of this pro-
gram. Students with lesser qualifications should use these
projects to improve their diving ability and skills.
Page 16
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2. Objectives:
a. The objective of the above dive plan is to ensure that
each divemaster can supervise diving operations with
less qualified divers, in accordance with the EPA
Diving Directives and this Course Outline. He should
be confident in all emergency situations, make
decisions to avoid accidents, and in the event of an ac-
cident, be able to stabilize the victim and evacuate
him to the hyperbaric trauma system, if needed.
b. Student divers should be able to perform all working
skills of an EPA working diver, in accordance with
the EPA Diving Directives and this Course Outline.
c. Previously qualified EPA divers who are in this
course to requalify must demonstrate their skills.
3. Team leaders, diving supervisors, instructors, and
divemasters must observe all subordinates and report their
abilities, particularly if there are any students with abilities
less than the standards outlined in this Course Outline and the
EPA Diving Directives.
4. Any diver whose performance/ability/skill/knowledge upon
completion of this course does not equal that of an EPA work-
ing diver or higher will, upon recommendation of the Course
Director through the EPA Safety Board Chairman, be
dropped from the EPA Diving Program or reverted to an
EPA Trainee Diver.
1300-1630 WATER WORK
TEAM BRIEFING BY DIVEMASTER TRAINEE,
SUPERVISED BY INSTRUCTOR
1. Team leader/instructor/divemaster selection
2. Team selection and other surface support personnel
3. Hyperbaric accident trauma network requirements:
a. Emergency phone numbers
b. Money for emergency phone calls
c. Call or visit to chamber complex
d. Verification that local paramedics know dive site,
where chamber is located, and diving accident/first
aid procedures
Page 17
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e. Communication channels/frequencies
f. Mechanical resuscitative equipment at site
g. Oxygen supply at dive site (enough to transport
patient to chamber complex)
4. Small boats as needed
5. Plan to remove injured diver out of water
6. Surface support personnel (standby/safety diver)
7. Secure dive site for diving operations:
a. Notification of proper authorities: harbor, Coast
Guard, etc., to ensure safe diving operations
8. Diving flags on shore/floats, as needed
9. Safe ship dive check-off sheet, if working under boats or
docks in immediate area, to ensure that they have no
electronic equipment operating that could be harmful to
divers (pingers, sonar, etc.), even though diving operations
might not be under ships '
10. Dive projects as directed by Diving Instructor,
Dry Suits
Surface Supply Diving
U/W Communications (Wireless, Hard Wire, Hand Signals,
Diver Recall Systems)
Search and Recovery Procedures
Underwater Tools (Flange)
Underwater Metal Detectors
Active/Passive Pinger Locators
Underwater Cutting (Mapp Gas)
Nitrox I and II
Teams will be assigned projects as directed by EPA Diving Instructors.
1630-1700 Debriefing by Diving Instructors
Fill in dive log
Pane 18
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1700-1800 The importance of first aid, stabilization and evacuation for severe
signs/symptoms
a. Joint pains
b. Dizziness/visual disturbances
c. Paralysis of face, limbs or extremities
d. Feeling of blow on chest/chest pain
e. Shortness of breath
f. Severe hacking cough/bloody, frothy mouth
g. Staggering/difficulty telling direction
h. Convulsions
i. Collapse or unconsciousness
j Cessation of breathing and/or pulse
Importance of knowing location of nearest hyperbaric trauma center
and how to evacuate victim
a. Availability of hyperbaric physician
b. Availability and location of multi-place, multi-lock
recompression chamber
c. Methods of evacuation (air/land)
d. Communication (phone/radio)
Importance of qualification in first aid procedures and CPR
Importance of emergency medical equipment at site
a. Oxygen, type, supply and delivery system
b. Neurological base line equipment
c. Complete first aid kit for diver/marine use
d. Fluids (oral/I.V.), I.V by qualified persons only
e. Aspirin, Afrin, etc.
Emergency evacuation procedures for paramedics, physicians and
flight crews. The importance of their knowing these procedures
before beginning evacuation.
a. Maintain breathing and heart functions, ensure
airway is open and remains open
b. Supply oxygen to patient in transport, pros/cons of
the Trendelenburg Position/Left Lateral Down
c. Ensure paramedics/physicians understand why diving
accident victims must be taken directly to recompression
chamber facility instead of to a hospital
Pace 19
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d.
Ensure they understand why patient must be kept on
oxygen (unless convulsions occur). Without oxygen,
bubbles will reload with nitrogen and worsen condition.
e. Keep patient out of hot sun and monitor for shock
f. Do not give pain killing drugs. I.V.'s can be started to
prevent vascular collapse or dehydration (plain lac-
tated ringers is I.V. of choice: otherwise, D5LR or
DI/2NS). Two aspirins may be given.
g. Instruct flight crews to fly or pressurize aircraft below
1000 feet (if no hazard to aircraft). Pressure as near to
mean sea level is desired
h. Prepare a complete history of events leading up to,
and including accident should be forwarded. All first
aid measures taken and any previous medical history
of patient should be forwarded with patient
i. In the event of a fatality, all diving equipment should
be forwarded to the proper authority
In-water recompression (pros/cons)
1. In-water recompression should not be attempted:
a. It loads the bubbles more
b. Exposure time is too great
c. Environmental factors subject to change
d. Pros/cons of in-water treatment with oxygen
e. If serious symptoms exist, it is not possible to put
into water. If mild symptoms, time exists to evacuate
f. Missed decompression procedures (asymptomatic)
Recompression chamber requirements (35 mm slide presentation of
types/sizes/purposes)
1. Multi-place, multi-lock, 6 ata
2. Multi-place, single-lock, 6 ata
3. Mono-place (single-place), 2 ata
4. Single-place, 6 ata
5. Portable, inflatable (PIRC)
NOTE: The pros and cons of each type of recompression chamber is dis-
cussed to ensure that diving accident victims requiring hands-on care
and six atmospheres of pressure are sent to the proper facility, in ac-
cordance with the OSHA Regulations.
Pace 20
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Pressure must be sufficient to reduce bubble size (gas embolism
requires 6 atmospheres and even this only reduces the diameter
of the bubble by 52%).
Physicians have no way of getting hands on patient
a. To maintain vital signs and monitor patient
b. Keep airway clear
c. Perform neurological examinations necessary to
determine proper treatment/reoccurrence of symptoms
d. Perform operations such as intubation as needed
Pulmonary overdistention cases may have air leakage causing
a tension pneumothorax which requires hands-on care and
continuous monitoring. Physicians must have the option of
changing from oxygen to air and/or going deeper than 2
atmospheres when necessary. Mono-type chambers do not
have this capability.
Oxygen convulsions may cause respiratory arrest, close off
patient's glottis, causing embolism while dropping pressure
to relieve convulsions
It is often better to transport victims without putting them into
a one-lock chamber for the above reasons. Transportation
using oxygen and Trendelenburg while monitoring vitals is
often the best way.
COMMUNICATIONS
Ensure participants understand the importance of
communications to:
a. Talk with physician on the beach
b. Alert the Coast Guard, if at sea
c. Know all important frequencies and numbers
necessary to make a medical evacuation in U.S.
and foreign territories
i. Know all frequencies and telephone numbers for
contacting shore-based paramedics
ii. Know all numbers for recompression chamber
facilities and/or physicians attached to them
iii. Have copies of international/domestic chamber
facilities, USN, Worldwide Hyperbaric Chamber,
Shore Based, NAV SHIPS 0994-4011
Pace 21
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HELICOPTER EVACUATION PROCEDURES
1. Try to establish communications with the helicopter.
If your boat is unable to, work through another boat if possible
2. Maintain speed of 10 to 15 knots
3. Maintain course into the wind, about 20 degrees on port bow
4. Put all antennas down if possible, while continuing
to maintain communications
5. Secure all loose objects on/around decks
6. Always let the lifting device (stretcher) touch the boat
before handling, to prevent electric shock
7. Place life jacket on patient
8. Tie patient in basket (stretcher) face up
9. If patient cannot communicate, place as much information
about him as possible on note paper and pin to clothes
(age, name, address, medications given, etc.)
10. If patient is a diving accident victim, ensure that flight crew
has a copy of or is instructed in procedures for diving
accidents and will take patient to hyperbaric trauma complex
(chamber)
11. If patient dies, inform flight crew
12. Instruct flight crews to fly as low as possible to prevent
pressure changes and explain why
FOURTH DAY
0800-0845 Review Homework (Physics/Physiology III)
Review previous day's diving project
0845-1000 OPERATIONAL DIVING
1. Dive planning
a. Gas physiology (narcosis, DCS and CNS balance)
2. Gas supply requirements
3. Cylinder duration
4. Gas analyzation
5. Compressor safety (lubricants, filters and the lungs)
6. Decompression procedures
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7. Dive safety
8. Contaminated water (diving and equipment)
a. Type of dress
b. Decontamination
c. On-site coordinator
d. On-site awareness of contaminants
e. Use of ROV's and other related equipment
1000-1015 BREAK
1015-1100 Nitrox diving (NNI and NNII)
Physics of nitrox diving
Oxygen life support ranges
CNS oxygen toxicity
Equivalent air depth concept
Nitrox decompression tables
Oxygen safety
1115-1200 Advanced equipment briefing
Wireless communication systems
MAPP Gas cutting
Nitrox diving
1200-1300 LUNCH
1300-1630 WATER WORK
1. Purpose of day's dive plan: The purpose of this day is for
instructors to designate divemasters and allow them to super-
vise a diving operation/project of less qualified divers on any
of the projects designated by Diving Instructors. This might
be any project outlined in days one and two of this program.
Students with lesser qualifications should use these projects
to improve their diving ability and skills.
2. Objectives:
Pace 23
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a. The objective of the above dive plan is to ensure that
each divemaster can supervise diving operations with
less qualified divers, in accordance with the EPA
Diving Directives and this Course Outline. He should
be confident in all emergency situations, make
decisions to avoid accidents, and in the event of an ac-
cident, be able to stabilize the victim and evacuate
him to the hyperbaric trauma system, if needed.
b. Student divers should be able to perform all working
skills of an EPA working diver, in accordance with
the EPA Diving Directives and this Course Outline.
c. Previously qualified EPA divers who are in this
course to requalify must demonstrate their skills.
3. Team leaders, diving supervisors, instructors, and
divemasters must observe all subordinates and report their
abilities, particularly if there are any students with abilities
less than the standards outlined in this Course Outline and the
EPA Diving Directives. .
4. Any diver whose performance/ability/skill/knowiedge upon
completion of this course does not equal that of an EPA work-
ing diver or higher will, upon recommendation of the Course
Director through the EPA Safety Board Chairman, be
dropped from the EPA Diving Program or reverted to an
EPA Trainee Diver.
1300-1630 WATER WORK
TEAM BRIEFING BY DIVEMASTER TRAINEE, SUPERVISED
BY INSTRUCTOR
1. Team leader/instructor/divemaster selection
2. Team selection and other surface support personnel
3. Establish hyperbaric accident trauma network requirements:
a. Emergency phone numbers
b. Money for emergency phone calls
c. Call or visit to chamber complex
d. Verification that local paramedics know dive site,
and know where chamber is located, and
diving accident/first aid procedures
e. Communication channels/frequencies
Pace 24
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f. Mechanical resuscitative equipment at site
g. Oxygen supply at dive site (enough to transport
patient to chamber complex)
4. Small boats as needed
5. Plan to remove injured diver out of water
6. Surface support personnel (standby/safety diver)
7. Secure dive site for diving operations:
a. Notification of proper authorities: harbor, Coast
Guard, etc., to ensure safe diving operations
8. Diving flags on shore/floats, as needed
9. Safe ship dive check-off sheet if working under boats or
docks in immediate area, to ensure that they have no
electronic equipment operating that could be harmful to divers
(pingers, sonar, etc.), even though diving operations might
not be under the ships
10. Dive projects directed by diving instructors:
Dry Suits
Surface Supply Diving
U/W Communications (Wireless, Hard Wire, Hand Signals,
Diver Recall Systems)
Search and Recovery Procedures
Underwater Tools (Flange)
Underwater Metal Detectors
Active/Passive Pinger Locators
Underwater Cutting (Mapp Gas)
Practical Use of NOAA Nitrox 1 and II
Teams will be assigned projects as directed by the EPA Diving Instructors.
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Pace 26
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COURSE MATERIALS
(Manuals/Handouts)
(FILMS/SLIDES)
a. Hypothermia
b. Hyperthermia
c. Drysuit Emergency Training Techniques
d. Overview of Diving Accidents
e. Microbial Hazards of Diving
f. Demonstration of NOAA/EPA Contaminated
Diving Protection
g. Contaminated Water EPA Diving Operations
h. Use of ROV's in Contaminated Water by EPA
Emergency Response Team
MATERIALS/HANDOUTS
a. Diving Accident Management Manual
b. Instructor/Student Guide to NITROX Use
c. Equipment Innovations Cut Risk for Divers
d. Interim Protocol for Diving Operations in
Contaminated Waters
e. Microbial Hazards of Diving in Polluted Water
f. Compressor, Lubricants, Filters and the Lungs
g. Program Curriculum
h. Dry Suit Diving/Equipment Guidelines
i. Factors That Contribute to the Bends
j. Homework Assignments
k. Nitrox Training Manual
1. USN Divers Handbook
Paee 27
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