Is Scuba First Aid Really Good Enough?

Words by Steve Lewis

What a strange year 1994 was; not as famous as 1984 perhaps, and certainly not even close to the strangeness of 2020, but memorable in its own sweet way. 

The movie Forrest Gump was released in 1994 and—at the other end of the interest spectrum—it was the year I decided to supplement my dive agency first-aid class with something more general in scope and a little more…how to be diplomatic about this?…“thorough”.

Now, as a current member of a scuba agency’s staff, I should establish immediately that there was absolutely nothing wrong with the first-aid classes being delivered by scuba agencies back then. I think my cert that year was from NAUI or PADI; I forget, and the card and wall certificate are long gone.

But in any event, the specifics and which flavour of plastic it was, are irrelevant. The course was fine. Fine then and—if anything—scuba agency first-aid courses are even more fine now. The quality of instruction is possibly better, and the scope of courses now is broader, more comprehensive, and easier to find. They certainly cover more first-aid stuff now than they used to. (For instance, no AED in 1994!)

However, 1994 was the year I found out first-hand that diving-centric first-aid training had left me with a great big hole in my knowledge. 

Revelation

It was autumn and a couple of friends and I were mountain biking in Algonquin Park. For those of you unfamiliar with Ontario’s Provincial Park system, Algonquin Park is epic and remote. It’s about a three-hour car journey north of Toronto, covers more than 2700 square miles (7000km²), and is nothing but trees, rocks, lakes, hiking trails; and, near the East Gate, a pretty amazing bike trail. There are also moose, white-tailed deer, wolves, coyotes, wolf/coyote hybrids, black bears, foxes, fishers, martins, mink, porcupines, skunks, raccoons, a liberal seasoning of smaller mammals, insects…lots of insects…reptiles, amphibians, birds, fish, and, most important of all, in the autumn there are not many people. 

We rode our bikes there regularly, or as often as possible, and on this occasion we were almost at the end of the trail—perhaps ten minutes from the spot where our cars were parked off Highway 60—when we came across a rider who was in serious trouble. She’d fallen, broken her arm or wrist, and smashed her nose on the way down. She had also cut her leg deeply. She was in pain, and a sorry sight. There was mud, blood, and some mayhem. Her companion was frantically trying to pull himself together to do something useful, but instead he was making things worse, and looked very close to throwing up and crying. 

Now, according to the training I’d had, this is where I was supposed to walk up to the scene, assess the situation and declare: “Hello, I’m Steve. I know first-aid, can I help you?” Instead of that, I was standing there, thinking to myself: “If she’d surfaced too fast or had a jellyfish sting, I might know what to do.” 

In the circumstances, both of those scenarios seemed unlikely. 

But by the time I’d pulled myself together, got off my bike, and approached, one of my riding buddies had sent our other buddy to get a first-aid kit from his car, told him EXACTLY what to tell the emergency medical services (EMS)—whom he was directed to call—and was throwing me a notebook and pencil, as he ordered me to take notes. At the same time, he was telling the poor woman’s partner to get him random articles of clothing, bottles of water, unfold a space blanket that appeared from nowhere, and get it wrapped around his friend. He was also treating the victim. 

In what seemed like about 30 seconds, he had the nosebleed and cut leg under control, had made a splint from a rain jacket, had found out the woman was allergic to bee stings, had no other medical history, and had a cat called Basil at home in Pickering. 

By the time the first-aid kit had arrived with buddy number three, buddy number one had his patient reasonably comfortable—actually smiling gamely—and warm. 

By the time the EMS arrived, we had a little shelter up, the woman’s arm was in a proper splint, the nasty gash on her leg was dressed, her nose looked normal…well, normal-ish…and our friend was able to hand the medics a minute-by-minute record of everything we’d done including what seemed very close to a full medical history of the ‘patient’.

Buddy number three was as surprised and impressed as I was as we watched our riding companion in action. Certainly, as we stood by watching the paramedics do their thing, we were both very, very quiet, and looking at each other sheepishly.

As they left, the EMS thanked our buddy, and within a couple of minutes, Wendy and Eric (the victim and her boyfriend) were on their way to the hospital in Huntsville. Pretty soon after, a couple of park rangers came by to pick up the couple’s bikes. They asked buddy number three and I if we were OK before they left. Two of us must have looked stunned. 

Our buddy, Ian, didn’t get a medal, was not awarded the Order of Canada, never heard from the couple again, and I don’t remember if he ever got his rain jacket back. 

But he’d won our admiration.

Back in our motel room, later that night after what seemed like a long ride back to our cars and all the paraphernalia of getting three bikes hooked up to the bike rack, it felt like the right time to ask: “Where the hell did you learn how to handle an accident like that?”

“A wilderness first-aid course,” was all he had to say for himself. He didn’t seem ready to elaborate.

Certification

That day in 1994 I realized I knew bugger all about first-aid outside of very specific scuba mishaps. A nosebleed, a busted arm, a boyfriend about to break into tears, all happening a couple of kilometres into the Ontario bush, NOPE. NADA.

Before the end of the year, I’d enrolled in a wilderness first aid (WFA) course run by a local outdoor adventure organization. I figured it wasn’t only biking that got me to some pretty remote areas; diving had its moments, too. And knowing how to administer oxygen and conduct a five-minute neurological exam have their place, but there is so much more that could happen. I wanted to be more useful than I’d been in the park.

And that’s why, every three years since 1994, I reup my WFA certification. The last time was this past August, and I feel very comfortable that, if something hits the fan at a dive site or on the way to or from a dive site, I can help. Really help and not stand around checking for lung-overexpansions with an otherwise blank look on my face.

Of course, agency standards for anyone wanting to instruct for an agency affiliated with WRSTC is expected to have a current scuba first-aid certification, but I feel pretty strongly that any of us in a leadership role in diving—that’s to say, a Dive Master, an Instructor, even someone organizing a dive trip to anything approaching the great outdoors—should think seriously about an additional and higher level of first-aid training. In my opinion, your XYZ agency first-aid certification doesn’t fully qualify you to be the primary first aid provider on any dive trip. But that’s just me. 

Sure, the diving aspects are probably well covered in a scuba class, and so perhaps is keeping someone stable for 30-45 minutes until the Coast Guard arrives, or until the boat captain gets the charter boat back to the dock. 

But how confident that you’re doing the right thing would you be looking after an injured buddy overnight or longer? 

If you’re a diver who does their thing more than half-an-hour from EMS, and you are thinking to yourself that this sounds like a good idea, you should know that the basic level of Red Cross Wilderness First-Aid certification involves about four or five hours of online study, around 20 hours of practical work including some realistic scenario role-play, and a final exam. A typical curriculum includes: 

•  Trip planning
•  Protecting your health  
•  Scene assessment  
•  Airway emergencies  
•  Breathing & circulation emergencies  
•  Cardiac and respiratory arrest (includes CPR and AED)  
•  Wound care  
•  Head and spine injuries  
•  Bone, muscle, and joint injuries  
•  Sudden medical emergencies  
•  Environmental emergencies  
•  Poisons  
•  Extended care  
•  Evacuation: transporting the ill or injured person

Luckily, I’ve never had to apply any of the skills learned in a WFA course, but I’m very, very glad to have the training and confidence that comes as part of that particular package.

I think you might, too.