United States
Environmental Protection Agency
                          Gulf Breeze, Florida
                                   May 1994
      EPA
Diver Training
Curriculum
                           Prepared by
                           JAMES M. PATRICK, Director, EPA Diver Training
                           DON LAWHORN, Chairman, EPA Diving Safety Board
                           DICK RUTKOWSKI, Hyperbarics International, Inc.
                           NOAA Diving Office
                           EPA, Safety, Health, and Environmental Management
                           Division

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                                             X I '
                                                 LIBRARY COPY
            DIVER TRAINING CURRICULUM

                                  by

'-U
                       JAMES M. PATRICK, JR.
                       Director, EPA Diver Training
                       U.S. EPA Environmental Research Laboratory
                       Gulf Breeze, FL 32561
                       904-934-9242
                       DONALD LAWHORN
                       Chairman, EPA Diving Safety Board
                       College Station Road
                       Athens, GA 30613-7799
                       706-546-2297
                       DICK RUTKOWSKI
                       President, Hyperbarics International, Inc.
                       490 Caribbean Drive
                       Key Largo, FL 33037
                       305-451-2551
                                              PROPERTY OF
                                      ENVIRONMENTAL PROTECTION AGENCY

                       NOAA Diving Office
                       Rockville, Maryland and
                       Seattle, Washington
                       EPA, Division of Safety, Health,
                       and Environmental Management
                       Washington, D.C.

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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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DIVING SAFETY BOARD
        Bruce Reynolds
        U.S. EPA
        Environmental Research Laboratory
        27 Tarzwell Drive
        Narragansett, RI 02882
        David W. Charters
        EPA/ERT(MS101)
        2890 Woodbridge Avenue
        Edison, NJ 08832
        Don Lawhorn
        U.S. EPA
        College Station Road
        Athens, GA 30613
        James Patrick
        U.S. EPA
        Sabine Island
        Gulf Breeze, FL 32561
        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
        Safety, Health, and
        Environmental Management Division
        401 M Street, S.W.
        Washington, D.C. 20460
                 IV

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        ACKNOWLEDGMENTS
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 instructthe Environmental Protection Agency (EPA)
 and other visiting divers in the use of variable-volume dry suit, diving accident
 management, contaminated water awareness, operational/working diver, divemaster,
 and NOAA NITROX I and II. These instructional techniques apply to Underwater
 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 obj ective is to ensure that each diver can safely use the UBA in accordance with the
 EPA Diving Directives, return to his/her unit and perform 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
 contaminated 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.

 Diver Certification:
 Several different levels of certification can be issued after the successful completion of
 this training course. Levels of certification are explained in EPA's Diving Safety Policy.
 Diving Accident Management will be included in the Scientific Diver and Divemaster
 Training. Training in the use of the Superlite-27 diving helmet, with surface supplied gas,
 will be provided for those qualified.

 Supervisors are encouraged to upgrade training for their divers.  Divers currently
 possessing the certification asTRAINEE maybe advanced to WORKING DIVER by
 successfully completing the Diving Accident Management course and meeting other
 requirements. WORKING DIVERS may be certified as ADVANCED WORKING
 DIVERS after records of 100 logged working dives have been reviewed, and the
 candidate has successfully completed an  approved DIVEMASTER TRAINING
 COURSE, upon approval of the EPA Diving Safety Board.
No person attending this training will be allowed to miss any class or water work without the
permission of the Training Director. Classes are held during the day and evenings.  If a student
cannot be relieved of duty to attend the program full-time, he/she should not attend.
Attendance at this training does not constitute successful course completion.
                                   VI

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              CURRICULUM OUTLINE
           FOR EPA DIVING PROGRAM
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 outlined 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 Diving Medical Review
Board.

Basic Training:
All prospective EPA divers must have successfully completed a basic diver training
course offered by one of the nationally recognized agencies (e.g., NAUI, PADI, YMCA,
NASDS, or approved colleges and universities) and provide theEPADIVERTRATNING
CENTER (DTC) with a photocopy of the certification.

Training Request:
The individual's supervisor must submit a letter of request to the DTC for EPA diver
training and/or certification stating the need for the diver candidate to enter the program.

First Aid and CPR
All divers must  have received appropriate First Aid, and CPR training before EPA
certification and provide the DTC GB with a photocopy.
                                 Vll

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                CURRICULUM OUTLINE
             FOR  EPA DIVING PROGRAM
Medical Requirements
Prior to acceptance for initial diver training or certification and annually thereafter, a
diving physical examination is required and the results must be checked for complete-
ness by a certifying official.  In order to ensure that the examination received is
appropriate for diving, the following medical forms will be provided:
     a.   NOAA Diving Medical Evaluation Criteria;
     b.   SF-88, Report of Medical Examination;
     c.   SF-93, Report of Medical History or PHS Medical History

Check-Out Dive
In the open water checkout dive and swim, the diving candidate shall demonstrate
confidence and swimming ability during the course by completing the following:
     a.    Swim a distance of one quarter mile on the surface in full SCUBA gear,
     b.    Swim a horizontal distance of 50 feet underwater, in full SCUBA gear
          with the air turned off,
     c.    and stay afloat for 30 minutes.
     d.    Transport another person 75 feet on the surface of the water without
          the use of swim aids.

     e.    Surface dive to a depth of 10 feet using a mask, fins and snorkel, and
          recover a 4 pound weight and clear the snorkel after returning to the
          surface.

    f.     Enter the water in full SCUBA gear and demonstrate mask clearing, buddy
          breathing, understanding u/w signals, remove and replace equipment and
          exit water using a boat ladder and stow equipment
                               Vlll

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             CURRICULUM OUTLINE
          FOR EPA DIVING PROGRAM
Working Diver
For certification at the EPA WORKING DIVER level, the diver must present a diving
resume or "dive log" indicating the completion of at least 25 working dives, results of
the dive physical marked "approved for diving", the results of the successful completion
of the NOAA standard SCUBA diving written examination and a record of completion
of EPA's or NO AA's Diving Accident Management course or comparable diver training,
physical requirements and diver proficiency requirements.

Accident Insurance  Plan
The visiting diver must have written permission from his office, program or agency
indicating on the job diving will be conducted and the diver is covered by an accident
insurance plan.

Terms of Certification
All EPA certifications shall lapse after two months without a logged dive or thirteen
months without a physical.

Recertifications
The EPA Diving Safety Board Chairman or Director of Diver Training or designees,
(UDO) may recertify a diver whose certification has lapsed after the diver has completed
a requalifying program.

Refresher Training
EPA certified divers may be given periodic refresher training.

Advanced Training
EPA certified divers may be given advanced diver training by regularly scheduled
courses onDIVEMASTER, ADVANCED WORKING DIVER, CONTAMINATED
WATER AWARENESS, OXYGEN ENRICHED AIR, SURFACED SUPPLIED
GAS WITH THE SUPERLITE 17 AND SUPERFLOW 27, AND  OTHER
HELMETS AND DRY SUITS, AND CHAMBER OPERATION.

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            CURRICULUM OUTLINE
         FOR EPA DIVING PROGRAM
FIRST DAY:
0800-0830
Classroom
0830-1000
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

HYPOTHERMIA/HYPERTHERMIA
 1.   Body core temperature changes and their
     physiological effects
     Heat transfer
                    2.
                    3.
                    4.
                    5.
                    6.
                    7.
                    8.
                    9.
                   10.
     a. Conduction
     b. Convection
     c. Radiation
     Prevention of heat loss in cold water
     Prevention of over-heating
     Restoring body heat in hypothermia
     Lowering body temperature in hyperthermia
     Decompression tables and cold-water diving
     Missed decompression procedures
     Blowup decompression procedures
     Polluted water diving

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FIRST DAY:        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
                           ofbuoyancy
                     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

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FIRST DAY:        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 buckles
                      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.

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FIRST DAY:        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.    Leaky valve
                                  4

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FIRST DAY:        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

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FIRST DAY:
 ZIPPER
  1.   Care and lubrication of zipper
1000-1030
Classroom
 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

 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 weightdemonstration(with
      buckles and velcro) the pros and cons of shoulder
     harness use

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1030-1130
Classroom
SUIT SELECTION
(CHECK FOR FIT)  INVENTORY
I.    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
I.    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.    CI eaning, storing and/or hanging the dry suit
1130-1300
LUNCH
                                   7

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FIRST DAY:
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
                                   8

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FIRST DAY:
Pool
(Deep End)
1630-1700
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
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

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SECOND DAY:
0800-0845
0845-1000
1000-1015
1015-1100
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

1.    Diving Accident Management
     a. Pressure       i)  ATA, FSW and PSI
     b. Physics       i)  Dalton'sLaw
                        (P = P1+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

BREAK

1.    Extra Alveolar Air
     a.    Physics
     b.    Physiology
     c.    Pathophysiology of:
          i.    Arterial Gas Embolism
          ii.    Pneumothorax
          iii.   Pneumopericardium
          iv.    Pneumomediastinum
                                10

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SECOND DAY:
1100-1145
                    TEAM BRIEFING FOR AFTERNOON
                    WATER WORK
1145-1300
                    LUNCH
1300-1600
Open Water
                    TEAM LEADERS ORGANIZE TEAMS
                    AND 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 under-
                         stands the dive plan
                         Dive teams dress in dry suits
                    4.
                    5.

                    6.
                    7.
                    8.

                    9.
                         Buddies check each other, review dive plan and
                         tables
                         Team leaders check each dive team
                         Divemaster and/or safety diver check each diver
                         Divemaster/team leader ensure diving accident
                         management emergency plan is in effect
                         Teams check out with divemaster and enter water
                              11

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SECOND DAY:     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 previ-
                       ous day. The rate of advancement through these exercises
                       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 instructor/
                       team leader.
                       The team leader/instructor will ensure that dive area is
                       cleared for diving in accordance with the EPA Diving
                       Directives. The diving accident 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 previous days' pool session. The afternoon session
                       will use ascending/descending lines to control 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 emergency, 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.
                                   12

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SECOND DAY:    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
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
                               13

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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
       thebody and importance of keeping it in balance
  Note: Divers attending this program should fully
       understand the physics, physiology and medical
       aspects of decompression sickness. The lecture
       above is a quick review, especially for non-
       divers, of the basic physics/physiology of diving.
                                14

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THIRD DAY:       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
1000-1015         BREAK
                                  75

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THIRD DAY:
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
                               16

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THIRD DAY:
1300-1630         WATER WORK
                        I.     Purpose of day's dive plan: The purpose of this day is
                              for team leaders to designate divemasters and allow
                              them to supervise 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 program.
                              Students with lesser qualifications should use  these
                              projects to improve their diving ability and skills.
                        2.     Objectives:
                              a.  The objective of the above dive plan is to ensure
                                 that each divemaster can supervise diving opera-
                                 tions 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 accident, be able to stabi-
                                 lize the victim and evacuate him to the hyper-
                                 baric 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 out-
                              lined in this Course Outline and the EPA Diving
                              Directives.
                        4.     Any diver whose performance/ability/skill/knowl-
                              edge upon completion of this course does not equal
                              that of an EPA working 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.
                                     17

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THIRD DAY:
1300-163O
INSTRUCTOR
WATER WORK

TEAM BRIEFING BY DIVEMASTER
TRAINEE, SUPERVISED BY

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 acci-
        dent/first aid procedures
     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
                                 18

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THIRD DAY:
                       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

1700-1800
                       1.    The importance of first aid, stabilization and evacu-
                            ation for severe signs/symptoms
                            a. Joint pains
                            b. Dizziness/visual disturbances
                            c. Paralysis efface, 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
                                   19

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THIRD DAY:
                       2.    Importance of knowing location of nearest hyper-
                            baric 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)


                       3.    Importance of qualification in first aid procedures
                            and CPRand the 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.


                       4.    Emergency evacuation procedures for paramedics,
                            physicians and flight crews. The importance of their
                            knowing these procedures before beginning evacua-
                            tion.
                            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
                            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
                                    20

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THIRD DAY:
                              f.  Do not give pain killing drugs. I.V.'s can be
                                 started to prevent vascular collapse or dehydra-
                                 tion (plain lactated 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


                        5.     In-water recompression (pros/cons)
                              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)
                        6.     Recompression chamber requirements (35 mm slide
                              presentation of types/sizes/purposes)

                              a.  Multi-place, multi-lock, 6 ata
                              b.  Multi-place, single-lock, 6 ata
                              c.  Mono-place (single-place), 2 ata
                              d.  Single-place, 6 ata
                              e.  Portable, inflatable (PIRC)
                                     21

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THIRD DAY:
                       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 should have a multi-place, multi-lock, 6 ATA
                             a. To maintain vital signs and monitor patient
                             b. Keep airway clear
                             c. Perform neurological examinations necessary
                               to determine proper treatment/reoccurrence
                               ofsymptoms
                             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 pres-
                       sure to relieve convulsions
                       It is often better to transport victims without putting them
                       into a one-lock chamber for the above reasons. Transpor-
                       tation using oxygen and Trendelenburg while monitoring
                       vitals is often the best way.
                                   22

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THIRD DAY:       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
                                   23

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THIRD DAY:       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 infor-
                            mation 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
                                   24

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FOURTH DAY:
0800-0845
0845-1000
1000-1015

1015-1100
Review Homework (Physics/Physiology III)
Review previous day's diving project

NITROX DIVING
I.    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
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

BREAK
                     Physics of nitrox diving
                     Oxygen life support ranges
                     CNS oxygen toxicity
                     Equivalent air depth concept
                     Nitrox decompression tables
                     Oxygen safety
                                 25

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FOURTH DAY:
1115-1200
                       Advanced equipment briefing
                       Wireless communication systems
                       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 supervise a diving operation/project of less
                            qualified divers on any of the projects designated by
                            Diving Instructors. This might be any project out-
                            lined 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:
                            a. The objective of the above dive plan is to ensure
                               that each divemaster can supervise diving opera-
                               tions 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 accident, be able to stabi-
                               lize the victim and evacuate him to the hyper-
                               baric trauma system, if needed.
                            b. Student divers should be able to perform all
                               working skills of an EPA working diver, in ac-
                               cordance 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 out-
                            lined in this Course Outline and the EPA Diving
                            Directives.
                                    26

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FOURTH DAY:
1300-1630
INSTRUCTOR
4.    Any diver whose performance/ability/skill/knowl-
     edge upon completion of this course does not equal
     that of an EPA working 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.

WATER WORK

TEAM BRIEFING BY DIVEMASTER
TRAINEE, SUPERVISED BY

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
     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
                                  27

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FOURTH DAY:
                     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 proj ects 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 Finger Locators
                           Underwater Cutting (Mapp Gas)
                           Practical Use of NOAA Nitrox I and II
                           Teams will be assigned projects as directed by the
                           EPA Diving Instructors.


1630-1715        NITROX (continued)
                     1.    Mixing
                     2.    Gas analyzers
                     3.    Nitrox diver equipment
                     4.    Determining correct mixtures vs. depth

1715-1800
                     CONTAMINATED WATER
                     FILMS (NOAA/EPA)
                     END OF DAY FOUR
                                 28

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FIFTH DAY:

0800-O830

0830-1200
HOMEWORK REVIEW
(Gas Supply and
Decompression Tables)

Review EPA Dive Regulations
EPA Dive Examination -
     100 questions plus decompression problems
Review Exam
Check in equipment
Certification
End of course
     NOTE:
 Schedule of events subject to change
                             29

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30

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                 COURSE MATERIALS
                     (Manuals/Handouts)

(FILMS/SLIDES)
                     a.    Hypothermia
                     b.    Hyperthermia
                     c.    Dry suit 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
                     m.    NOAA Diving Manual
                                31

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                COURSE PROJECTS
                        (PRACTICAL)
SURFACE SUPPLIED SYSTEM
(DCS) WITH COMMUNICATIONS
                   The DCS-3 surface supplied air control system from DSI
                   is a lightweight, portable dive control system for use in
                   surface supplied diving operations

VARIABLE VOLUME DRY SUITS (VVDS)
                   Variable volume dry suits from Avon and Viking are used
                   in polluted water diving. These suits are used for protec-
                   tion and buoyance control.

PINGER LOCATOR, PINCERS
                   The pinger locator is a diver handheld underwater acoustic
                   locator system that receives signals of a certain frequency
                   from underwater beacons. This enables the diver to locate
                   a site that is not buoyed.

WIRELESS COMMUNICATION  SYSTEMS (3)
                   The AQUACOM single sideband underwater communication
                   provides diver to diver or diver to surface communication by
                   usingthrough-watertransceivers

SUPERLITE 27 WITH  MATED DRY SUIT
                   The Superlite 27 along with a dry suit and surface supplied
                   air can be used for polluted water diving, for mixed gas
                   diving, when protective head gear is needed, or when
                   communications are needed.

DIAMOND REEF SYSTEM
                   The Diamond Reef System is a unique, artificial reef
                   composed of PVC diamonds suspended at various depths.
                   The diver is required to swim through each diamond with-
                   out touching them.  This training device is excellent for
                   improving buoyancy control.

                              32

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                 COURSE PROJECTS
                         (PRACTICAL)
DRUM OVERPACK AND RECOVERY
                    One 55 gallon drum will be overpacked underwater and
                    ecovered by divers dressed for contaminated water diving.
                    The diver will then me decontaminated with a pressure
                    washer.

LIFT BAGS
                    50 lb., 100 lb., and 200 Ib. lift bags are used to bring
                    heavy equipment or samples safely to the surface for
                    recovery.

FLANGE
                    This project consists of a 36 nut, bolt, and washer flange
                    that will be disassembled and then assembled by divers in
                    order to expose them to working conditions while using a
                    VVDS.

SEARCH AND RECOVERY
                    A team of divers use a jack-stay to conduct a search
                    pattern to recover an object lost underwater.

COMPASS RUNS
                    Compass runs are used to teach students to use compass
                    bearings to navigate underwater.

MK II AGA and EXO-26
FULL FACE MASK
                    These positive pressure full face masks are used in
                    conjunction with dry suits, surface supplied, and
                    communication systems such as the AQUACOM  SSB.
                    These are used for protection from aspiration of water
                    molecules in polluted water diving.
                               33

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34

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