Does your diving need a lift
Practising rescue skills is something too many of us are sloppy about. Unless youre actively training in such skills, or teaching them, the exercise of lifting an unconscious diver lies half-forgotten at the back of our brains. John Liddiard provides a refresher on the art of the Controlled Buoyant Lift

I have been floating just above the sand, holding my breath while waiting for a fish to get into position for a photograph, when a worried diver has come along and started to rescue me.
Its happened more than once, and its worse when using a rebreather. So the first thing to check when you come across a diver who isnt moving or, apparently breathing, is that he or she really needs rescuing - ideally without ruining any photograph in the process.
Having come to the conclusion that a rescue may be in order, the rescuer should gently turn the victim to face him. Grabbing the victims right shoulder-strap in the rescuers left hand will save time having to swap hands later. Look at the victims eyes, give a gentle shake and see if he responds, but not so hard as to shake the regulator out of his mouth.

Starting the lift
The technique for bringing the victim to the surface is a Controlled Buoyant Lift (CBL). There are many variations, but the one I prefer is to face the victim, holding his right shoulder strap with my left hand, then use my right hand to do everything else. This means that my left hand stays in place throughout the lift.
Be careful not to accidentally release a buckle in the victims harness. DIR divers and others with one-piece harnesses are allowed to feel smug at this point.
In line with our pictures, shot with the help of Vicky and Tonin of Island Watersports, Lanzarote, I will be referring to the rescuer as her and the victim as him.
To get the CBL moving, the rescuer takes the victims BC crinkly hose in her right hand, holds it up so that there are no kinks in the hose and turns it so that she can see the controls. A kink can prevent air entering the BC or stop it being vented.
Being able to see the controls allows the rescuer to see what she is doing and, more importantly, if anything is going wrong. I have seen both beginners and experienced divers wearing thick gloves push a lump of plastic moulding instead of the fill button, spending ages wondering why nothing is happening.
How the controls work should have been covered in a buddy check, but in the heat of the moment such details are easily forgotten, and this may not even be your buddy. Being able to see the buttons nips such problems in the bud.
If the rescuer or victim are wearing drysuits, shoulder auto-dumps need to be set to an appropriate position for the ascent before it begins. A rescuer should know how to rotate her own shoulder dump in order to safely ascend. On the victim, if in doubt, open it until a dribble of air emerges, then turn it back a little.
By using a drysuited victims BC to control the lift, there is minimal change of technique from that of rescuing a wetsuited diver. It also avoids any complications of over-inflated drysuits suddenly splurging air and losing buoyancy, and cuts the risk of the victim becoming inverted during the ascent.
In any case, the lift can then be started by giving a good hard squirt of air into the victims BC and the rescuer kicking and swimming off the bottom.
If the regulator has fallen from the victims mouth, the rescuer shouldnt waste time trying to replace it. Its more important to get him to the surface.

The ascent
While a controlled buoyant lift is an emergency ascent, there is no need to compound problems by coming up so fast as to give either the rescuer or the victim decompression sickness or any other pressure-related injury, especially when it may just be a training exercise.
The old trick of following the smallest bubbles is the best guide here.
When the rescuer feels the ascent accelerating to overtake his bubbles, thats the time to dump some buoyancy and keep speed under control. The rescuers right hand will already be holding the controls of the victims BC to vent air, but from anything deeper than the shallowest training dive, she will also have to vent air from her own BC.
Here the rescuer can keep her left hand firmly gripping the victims shoulder-strap, then with her right hand release the victims BC controls to vent her own BC. As soon as the rescuers own buoyancy is reduced, she can move her hand back to the victims BC controls, ready to vent air again as the ascent continues.
With drysuits, air in the suit will also be expanding and need to be vented. If the rescuer has a cuff-dump, she can raise or lower her arms to vent or retain air while keeping hold of the victim. With an auto-dump correctly set, the rescuers drysuit can be left pretty much to take care of itself, perhaps with the occasional shrug of the shoulder to encourage a little extra air out.
Similarly on the victim, by setting an auto-dump before the ascent begins, the victims drysuit should take care of itself. If not, the rescuer can use her right hand to push the shoulder dump or adjust it.
If the victim has a cuff dump, the easiest solution is to just let his arms flap about. Air in the sleeve should lift the arm and vent it automatically.
But the rescuer needs to keep an eye on this, because an arm that is initially hanging down may stay that way and allow air to build up in the shoulders of the victims suit.
So the rescuer may need to encourage the victims arm with the cuff-dump to flap upward and release trapped air.
Temporarily releasing the victims BC controls, the rescuer can use her right hand to push his left arm and cuff-dump upwards, then loop her own right arm beneath the victims left arm before taking hold of the BC controls again, so holding the arm and cuff-dump above the rescuers shoulder.
The fine point of control through all this is to achieve a constant and controlled rate of ascent, not letting it get too fast, dumping excess buoyancy in small and controlled amounts, and not dumping so much buoyancy that everything stops or, worse, starts sinking again. With air running low, sinking could be even more dangerous than a fast ascent, as both rescuer and victim could end up on the seabed with no air.
In BSAC training exercises, the rescuers fine control is further tested by pausing for a safety stop at 6m. After a minute or two, the rescuer and victim then ascend slowly, before resuming the actual controlled buoyant lift just below the surface. Of course, in a real rescue its straight to the surface.
Rescuers can always use their fins to help control the ascent, kicking briefly if things look like slowing down too much and flaring them out sideways to act as temporary brakes when evening out small difficulties in buoyancy control. But this is a controlled buoyant lift, so let buoyancy do most of the work.

Alternative holds
Controlling a rescue can benefit from having both hands free, and one way to achieve this is for the rescuer to wrap her legs around the victims waist.
The disadvantage is that the rescuer is now totally dependent on buoyancy. She cannot kick off the bottom or swim to get things started. During the ascent, she cannot swim to guide the ascent or flare her fins to brake. If the rescuer is small or the victim has a big waist and the rescuers legs wont fit, she needs to know another technique anyway.
Another variation is for the rescuer to hold the victim from behind, by grabbing his pillar valve and possibly even cupping his chin to hold his regulator in place.
Holding the regulator in is a nice touch, but isnt necessarily as important as it may at first appear. If a victim is not breathing, all that will happen on the ascent is that air will come out. If the victim is conscious, he will be keeping the regulator in for himself.
Even on an unconscious and breathing victim, the regulator wont necessarily just fall out, and if it does, he is on their way to the surface while expanding air comes out of his mouth.
Then, consider that while the rescuer is holding onto the victim with one hand, on anything other than the shallowest ascent her other hand will have to move about, dumping excess buoyancy from the victim and herself. It wont be spending much time holding the victims regulator in.
Working from behind gets harder or even impossible when the rescuer is small, the victim is big, or the victim is wearing big kit such as twin 15s.
Worse still, if the victim is still conscious or partially conscious, being dragged up from behind could result in panic. Staying face to face with the victim provides eye contact, reassurance and trust.
Fortunately, I have never had to rescue an unconscious diver. But I have had to perform controlled buoyant lifts on divers who for various reasons needed to be brought to the surface. As they were conscious, these lifts didnt have such a degree of urgency and I could even pause everything for a small safety stop, just as in the training exercise.
There may be better techniques in certain circumstances, but working from in front is at least a good second best in all circumstances. The only time I would advocate working from behind is when victims are already panicking - it keeps rescuers out of their reach.
One of the reasons a non-breathing victim may need rescuing is because he is already out of air. The rescuer tries to inflate the victims BC using the direct feed and it doesnt work. The easiest alternative arises if his BC has an *emergency inflate cylinder, but these are becoming increasingly rare.
If the victim has only a small weightbelt, ditching it is the next easiest option, but for the average UK diver, ditching a 10kg weightbelt is sufficiently dangerous to be relegated to last resort. Orally inflating the victims BC can be slow and may put the rescuer at unnecessary risk.
Which leaves us with the rescuer taking a good firm hold as before, but using her own buoyancy and a good strong kick for the surface to get things moving. The victim may gain buoyancy as the ascent proceeds, diminishing the dependence on the rescuers buoyancy, but this cannot be relied on.
Im afraid I have to make an exception here to my one-technique-fits-all philosophy. The big drawback of using the rescuers buoyancy is that if the rescuer loses contact, the victim goes down while the rescuer goes up.
In UK conditions, that means that the victim will almost certainly be lost. When using the victims buoyancy, at least he will end up on the surface if the rescuer loses contact.

On the surface
Once reached, the critical thing at the surface is to make sure that the victim will stay there. The rescuer needs to fully inflate the victims BC, ditch his weights and, if he is wearing a drysuit, may also close any auto-dump and put some air into his suit.
If the victim is wearing a rebreather, the rescuer first has to close its mouthpiece. One of the early rebreather fatalities involved the rescuer bringing the victim successfully to the surface, only for the victim to sink again as the counterlungs collapsed and the victim lost buoyancy.
Ditching weights is not as straightforward as simply undoing the buckle. The rescuer needs to pull the weightbelt or pouch clear of the victim to make sure it doesnt catch on any of the victims equipment.
If the victims harness has a crotch strap, the rescuer may need to release that strap before the weightbelt can be cleared.
Divers with all their weight permanently attached to a backplate are allowed to feel vulnerable at this point!
With the victim buoyant, the rescuer can then get herself buoyant, give a distress signal, administer AV and, if necessary, tow the victim to the boat or shore. Well save AV and towing for another time, so that just leaves the distress signal.
This signal is arm extended with a clenched fist, waving from side to side. Most diving training is about looking cool and in control when doing it. With a distress signal, you are encouraged to look frantic and scream for help.

Look after the rescuer
The lift has been successful, the victim is back on the boat breathing oxygen, and a helicopter is on the way.
In a real emergency, the urgency of the ascent may have brought both victim and rescuer to the surface a little faster than is safe. Decompression stops may have been missed.
So now is not the time to forget about the rescuer; perhaps the rescuer should also be on oxygen.
If all this moves you to practise your skills before the 2005 season gets underway, all well and good.
But remember that any sort of emergency ascent should be practised at the start of a dive, when you have no nitrogen loading. Its also a good idea to practise beside a fixed line that can be used as a brake - just in case anything gets out of control.

Making sure that BC controls are clearly visible. A good hard squirt of air into the victims BC gets the ascent started.
The rescuer dumps air from the victims BC.
The rescuer dumps air from her own BC.
As the victim reaches the surface, the rescuer is immediately filling the victims BC
Removing the victims mask and regulator.
Pulling the rescuers weightbelt clear before ditching
The distress signal, an extended arm with clenched fist waved from side to side.
Helicopter collecting casualty

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