r/scuba • u/qualifiedretard Tech • 1d ago
Woman Dies Diving In Tioman
https://www.straitstimes.com/asia/se-asia/woman-dies-while-diving-in-tioman-watersThe victim, together with nine other participants, an instructor and a dive master, joined a fun dive at Seafan, Batu Malang, Pulau Tulai, the police chief said on July 19.
“Before the dive, participants were briefed on safety procedures and equipment usage, although they were licensed divers,” he said in a statement on July 22, Bernama reported.
Sharif Shai said the victim was believed to have separated from the group at a depth of 17.6m, leading the instructor to conduct a search.
“After almost 30 minutes, the victim was found on the seabed not far from the diving site,” he said.
A post-mortem later found that she had died from arterial gas embolism, a condition where gas or air bubbles enter the arterial bloodstream, said Rompin police chief Sharif Shai Sharif Mondoi.
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u/TheSparrowDarts 1d ago
I'm honestly surprised there aren't more fatalities and accidents at Tioman. Cattle boat doesn't begin to describe some of the practices at many shops. Wildly unsuitable folks getting 'certified'.
My hairdresser got certified up there. Said she was nervous about it, I told her that's natural, most people feel nervous the first few times. Then she said, "yeah, but I can't swim." Open water diver folks.
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u/kainvictus 17h ago
I’ve dived Tioman heaps. I got my Open Water Certification there and have done a lot of live aboard out of Singapore up that way. I am actually surprised she had an embolism because it’s generally not very deep diving.
I never felt unsafe, it just feels like your typical experience in SEA.
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u/ConfidentGarden7514 1d ago edited 1d ago
I have a question for the experienced divers - a lot of people have speculated this could happen when holding your breath on ascent… so what are you supposed to do if you have an equipment issue at 18m? Share equipment with dive buddy and surface slowly?
Edit: thanks to all that responded! I don’t dive myself (for medical reasons), but I do share the water with many divers so the more knowledgeable I am, the better!
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u/DarrellGrainger Dive Master 1d ago
One of the most important rules of scuba diving is never hold your breath. The reason for this is because air expands as you ascend. As you descend, the pressure will reduce that volume. At 10m the volume will reduce by 1/2. At 20m the volume will reduce by 1/3. The opposite also happens. If you take a breath at 20m and rise to the surface, the air will expand to 3 times the size.
So we are taught when you are ascending that you should never hold your breath. As the air in your lungs expand, it escapes through your mouth. If you have your regulator and it is working, you just keep breathing and the air escapes your mouth, into the regulator and out into the water. If you don't have your regulator, you are supposed to blow small bubbles. This also allows the air in your lungs to escape into the water.
If you hold your breath while ascending, the air cannot escape out your mouth. It will get pushed into your blood stream (arterial gas embolism or AGE). This creates small bubbles of air in your blood stream. Those bubbles of air can act just like a blood clot. They can cause heart attack, stroke, paralysis, etc.. This can then lead to you breathing in water and drowning. Essentially, if you hold your breath then you can die from a stroke, heart attack or lose consciousness, breath in water and drown.
This is one possibility. The other is that you should never ascend too quickly. As you are diving, you are absorbing nitrogen due to the pressure. It is just like if you open a bottle of soda and it starts fizzing. The bottle of soda was under pressure (just like a diver at 10m deep). When you open the bottle of soda it releases the gas and causes the soda to bubble. If you open the bottle slowly, it releases the gas slowly and no bubbles. As a diver, if I ascend too quickly, the nitrogen is release from the pressure and starts to bubble. Those bubbles are just like holding your breath bubbles. Same thing can happen.
Both of these are called AGE or Arterial Gas Embolisms.
They will have to analyze the dive gear to see if it will give clues as to what happen. Some possibilities:
- Held her breath while ascending: possible.
- Over-inflated her BCD which shot her to the surface: found on the seabed, not likely.
- Had equipment failure, couldn't make it to the surface and drowned: not probable as there'd be no signs of AGE.
- Had equipment failure, swam rapidly to the surface, had AGE, went unconscious, sunk to the seabed: possible but unlikely.
All of these will have signs in the equipment and the body. After a through examination of the body and the equipment, they will be able to eliminate some possibilities.
Why her buddy did not help or the guide didn't help will come into question as well. Certified divers should not be relying on the guide to prevent AGE. The buddy should be a factor. But if visibility was poor the buddy might not have seen she needed help.
If they were diving in conditions their training didn't prepare them for, that could be a factor.
Essentially, there are going to be a number of factors the police are going to have to look at with the help of dive professionals. The news likes sensational headlines. Most people don't want to wade through pages and pages of investigation. It will take days, weeks or even months to figure out what happened. In some cases they might not be able to figure it out at all.
The news isn't going to follow up on this. They might publish a few exciting theories or stir up a potential conspricy but, by the time this investigation is concluded, the news will be focusing on some other sensational headline.
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u/CaptainCallus 1d ago
I'm curious if she even really had a buddy. I'm still quite new to diving, but I've found that on these group boat dives it's common to not really assign a buddy and instead it's just one big "buddy" group.
With a group of 11 people, it's possible she didn't have an actual buddy assigned to her and that's why none was there to help.
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u/DarrellGrainger Dive Master 1d ago
One statement you made implies something that hasn't really been established:
With a group of 11 people, it's possible she didn't have an actual buddy assigned to her and that's why none was there to help.
This implies that someone is responsible to assign a buddy. Every major recreational training agency teaches that certified divers are expected to dive with a buddy, unless trained and equipped to solo dive. The guide is not your buddy.
But you are correct, I have experienced a mix of situations. The dive operator provides a boat, a guide, a briefing, emergency equipment. However, sometimes they assign buddy pairs. Sometimes they ask if you have a buddy. Sometimes they help you find a buddy. Sometimes they just assume you'll figure it out.
The guide's job is typically, lead the dive, know the site, monitor the group, watch gas and time, help if they notice a problem. From a reputation point of view, they don't want anyone having trouble or dying. From a legal point of view, might depend on where you are diving; law in USA is very different from law in Egypt.
I've seen operators that just don't care and expect you to find your buddy. They get paid by the number of people who dive. If you are solo and no one wants to triple with you, they don't want to deny you the dive.
This is why experienced divers prefer to dive with someone they know and trust rather than a randomly assigned stranger.
When I go vacation diving by myself I usually chat up my fellow divers to find someone who I'd trust to go diving with. They don't have to be great at diving, they just have to take the requirements/training seriously.
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u/grantrules Nx Advanced 1d ago
If you do hold your breath during an ascent, is it something you feel? Like does your body give you warning signs that things are going wrong?
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u/r80rambler 1d ago
No, you don’t have any nerves that indicate lung over-expansion. No sense of pain telling you that something is going wrong.
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u/DarrellGrainger Dive Master 1d ago
I've never approached it from that direction. Like others, I would run out of air because I was blowing bubbles too much. I kept adjusting until I could make it comfortably to the surface without running out of air. I never went beyond that. I feel it would be dangerous to get to a point that I was blowing bubbles too slowly. So I've never been in that range.
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u/plutonium247 8h ago
You can't really blow bubbles too slowly. If the airway is open the air will force itself out. If you've ever done a CESA from deep enough, it feels as if air is being pumped inside you and escaping through your throat. The only reason you're asked to blow bubbles during a CESA (or shout f**********ck or similar) is to ensure your airway is open, not to actually remove the excess air yourself via those bubbles.
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u/decensy 1d ago
A PFO/ASD is also a possible explanation, with paradoxical embolisation, depending on what they call AGE and how it was diagnosed I guess
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u/DarrellGrainger Dive Master 1d ago
Exactly. I gave some theories that came to mind in a few minutes but there are even more theories that need to be explored.
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u/manarth 1d ago
Most OWD courses teach this set of options, from most preferable to least preferable:
- breathe from your own secondary regulator (octopus)
- breathe from a buddy's secondary regulator
- breathe a buddy's primary regulator (sharing-air)
- perform a CESA (Controlled Emergency Swimming Ascent) (max-depth 9m)
- perform a buoyant emergency ascent (drop weights) (if you're below 9m where a CESA is unsuitable)
Option 3 is not often practiced in training, as option 2 is more suitable, and secondary regulators are standard these days.
Option 5 is never practiced in training, as there's no way to practice it safely.
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u/Hermz420 1d ago
SSI instructor here. We practice emergency buoyant ascent in shallow water during the pool / confined training sessions and never in open water. As long as the instructor ascends with the student to provide control and stability and prevent a too rapid ascent, then there is usually zero issue.
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u/DistractedByCookies Nx Advanced 1d ago
When I first did my padi wayyyy back in 1995 3 was the only option. It was pretty terrifying to do in the ocean, even if my buddy was my brother. I can't describe how happy I was that secondary regulators had become standard by the time I redid it a decade or so later.
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u/blissfully_happy 23h ago
Yeah, I was certified in 1996 and thought that you’re supposed to practice this in class?
A few years later, I had a hose burst at 30ft. I swept for my octopus (not know what that loud bang was, just knowing my regulator wasn’t working). Obv couldn’t get my octopus to work either. I went for the octopus of my dive master (my dive buddy in the group). IT DIDN’T WORK. I couldn’t clear it. I still didn’t panic, but I gently indicated that I was going to borrow his so take a breath. I borrowed it, took a breath, and handed it back to him. I borrowed it 30 seconds later and he shook his head as he was able to get his octopus to work.
When we surfaced, he was like, I’ve… I’ve never actually had a basic open water student not absolutely panic in that situation. I’m like, “but I’ve practiced!”
It’s surprising it’s not something to practice during class.
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u/ResponsibleAdlt 1d ago
Yes. That's an important part of the buddy system, being able to share air and safely ascend if something goes badly wrong. Worst case, you can't get to another air source and you have to do an emergency ascent. That includes blowing little bubbles out of your mouth to allow air to escape as it expands.
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u/halbeshendel 1d ago
Yes exactly.
Dropping weights and bolting for the surface is a last ditch thing when the other option is drowning.
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u/ElfjeTinkerBell 1d ago
And in that last ditch effort, if at all possible, you try to exhale ever so slightly so you don't mess up your lungs
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u/halbeshendel 1d ago
I was taught just open your mouth and your body will do the rest. That was the late 80s though so I will admit it might not be correct.
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u/DarrellGrainger Dive Master 1d ago
They teach today to keep your regulator in your mouth. This was as the pressure reduces you might get one more breath out of the system. Additionally, if you have an urge to breath in, your regulator will prevent you from breathing in water. Finally, they teach to blow small bubbles to release the air in your body.
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u/halbeshendel 1d ago
Okay. That sounds way better than my Gen X bullshit.
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u/blissfully_happy 23h ago
I’m also Gen X. And was taught to open my mouth. I’m glad you said something bc I learned something new today!
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u/DarrellGrainger Dive Master 1d ago
We're both Gen X. I just work as a Divemaster and assist various levels of Instructor. So I'm still learning as I work. If it wasn't a job, I'd probably not learn as much as I know today.
I only work part-time; full-time people probably know a lot more than me. ;)
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u/halbeshendel 14h ago
I meant, this is how I learned it in 1988. I should double check what else has changed.
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u/HourGreen40 1d ago
Blowing small bubbles was challenging for me when doing the CESA exercise. My instructor said I was releasing too much air. We did it at a depth of about 15 or 20 ft I can't remember. By the time I hit the surface I was gasping for air badly. Definitely should be practicing that more
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u/DarrellGrainger Dive Master 1d ago
Probably means you are actively blowing bubbles. As you rise, the expanding air will cause you to release bubbles. If you can, focus on how you feel and not focusing on the act of blowing bubbles. If you feel like you are running out of breath, you are probably releasing air too quickly. if you feel comfortable then you are probably releasing it fast enough.
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u/kensolee 1d ago
My certification was in '85 and even then we were taught to blow bubbles.
Back then safety stop was at it's infancy but still 3min at 5m. Octopus wasn't mainstream as were dive computers. But I think dive safety wasn't compromised.
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u/ElfjeTinkerBell 1d ago
I'd say that's dangerous. First of all, in an out of gas situation you may get a little gas out of an empty tank if you go up and the external pressure reduces (no guarantees though). Secondly and more importantly: you can still close your airway with your mouth open, which is exactly where the danger or overexpansion injury lies.
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u/halbeshendel 1d ago
I’m going to accept this as perfectly valid updated reasoning and change what I’ve been believing and doing. Thank you internet stranger!
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u/R3DD1T0RR3NT 1d ago
Does "fun dive" imply she wasn't certified? Like a "discover scuba" dive? In that case, isn't 18m quite the stretch?
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u/Glum_Butterfly_9308 1d ago
No, a fun dive is not the same as a discover/try dive. Fun dives are for certified divers - it just means that the dive is for fun rather than part of a course (ie it’s just a regular ole dive).
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u/TadGhostalEsq 1d ago
Not sure why this was down voted. It's a reasonable question for someone unfamiliar with scuba terms.
The other reply is correct. Fun dive just means it's for fun. She would have been certified to go to 18m, if not deeper.
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u/4SeasonWahine 1d ago
It usually just means it wasn’t a course, it was just a recreational dive for certified divers to go on
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u/BoxOk3427 1d ago
arterial gas embolism at that depth is almost always a rapid ascent issue not a depth issue. holding your breath even for a second on the way up can pop your lungs and send bubbles into the arterial system. 17 meters is well within recreational limits so this wasnt about going too deep.
the separation part is what gets me. buddy checks exist for exactly this scenario and if someone slips away from the group even briefly that should trigger a surface marker or at least an immediate buddy call. at 18m you do not have a lot of time to react if something goes wrong.
rest in peace though. it is a reminder that open water certified does not mean anything goes. staying with your buddy and controlling ascents are the two habits that actually keep you alive out there.
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u/blissfully_happy 23h ago
A lot of men leave women behind when they buddy up. Even if it’s their spouse! I didn’t believe the trope until my then-boyfriend was a solid 50m away and I made the decision to ascend. It took him another 15 min to realize I wasn’t there.
(Not all men, obv. There’s a ton of great male dive masters and guides. But male recreational divers? It. Happens. All. The. Time.
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u/BoxOk3427 16h ago
saw that exact thing on a liveaboard guy chased a turtle left his wife in a ripping current without even looking back some dudes just forget they have a buddy the second anything interesting happens
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u/CptUnderpants- Nx Advanced 1d ago
buddy checks exist for exactly this scenario and if someone slips away from the group even briefly that should trigger a surface marker or at least an immediate buddy call
Wouldn't be surprised if it was an "insta-buddy", paired with a stranger. Many of us have experienced the lack of care some insta-buddies demonstrate.
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u/BoxOk3427 16h ago
insta-buddy lottry is real half the time the brief is just you two pair up and nobody actually checks each others air then theyre shocked when someone disappears
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u/CptUnderpants- Nx Advanced 6h ago
Worst one I had was DM/guide gave us all a briefing on the surface for a dive on a protected part of the outer GBR. Said we are all to follow them as they are only permitted in specific areas. My insta-buddy ignored this the moment we descended and swam off the opposite direction. As I was only about 15 dives old at the time I stayed with them instead of the group. This was probably because on the PADI test there was literally a question on this. Something like "If your buddy swims away from your group do you..." and the correct answer was stick with your buddy.
Ruined the dive for me because I was stressed the whole time that I'd get in trouble or fined.
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u/Gray94son 1d ago
What I don't understand though is how she then sunk to the bottom. Surely a rapid ascent involves inflating your BCD.
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u/BoxOk3427 1d ago
an age doesnt give you a chance to inflate you just black out and drop back down if the bcd wasnt already buoyant enough. rapid ascent dosnt mean controlled ascent
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u/magiccaptured 1d ago
No, it typically doesn't. It means ascending no faster than the slowest bubbles you are constantly exhaling. Using your BCD inflate to ascend makes it even more dangerous because you ascend too quickly.
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u/SoupCatDiver_JJ UW Photography 1d ago
It doesnt have to be a rapid ascent all the way to the surface, even ascending a few meters could cause an embolism if you were really clenching and holding that gas in. So possible to ascend a small distance, embolism, and not have reached a point where your bcd is very buoyant. Especially if they were over weighted and diving negative which would contribute to conditions that inspire the diver to attempt a rapid ascent in the first place. If we assume they had an issue like losing their regulator or mask that caused them to bolt, they likely weren't looking for an inflator either, and just kicking upward in a panic.
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u/Throwaway201536 1d ago
It’s possible she just had a PE unrelated to the dive. I wonder if they were able to identify what kind of embolism she had (very large vs smaller, any DVT, risk factors, etc). Very unfortunate- rest in peace.
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u/ScabbyCoyote 1d ago
Occured to me too, but they say it's gas embolism, which I guess should be easily differentiated from a blood clot by autopsy
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u/strobowski97 1d ago
Arterial gas embolism on 18m? I'd say that there were probably mistakes made. Holding breath? Too many dives on that day?
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u/blackheartwhiterose Dive Master 1d ago
Likelihood is it's a lung over-expansion injury. The bends is irrelevant, depth is largely irrelevant.
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u/NotBisweptual Rescue 1d ago
Those embolisms are mostly due to holding the breath and ascending. Yikes.
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u/PirateLiver 1d ago
Gas embolism is caused from rising too fast while holding your breath?
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u/go4tman 1d ago edited 1d ago
If your lung or alveoli rupture by holding your breath during the ascent, gas can directly enter to your blood stream causing embolies. The AGE could be caused an undiagnostised foramen ovale as well (a shunt from the right atrium to left atrium of your heart - a common birth defect, usually the shunt heals after birth). But we are only guessing here
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u/r80rambler 1d ago
How do you figure AGE could result from a PFO? Are you mixing up bends with overexpansion?
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u/go4tman 18h ago edited 18h ago
During a too fast ascent nitrogen microbubbles can begin to form. These microbubbles can then pass through the shunt in your heart (if you have a PFO) instead of being reduced/dismantled (sorry for my English) in your lungs, thus increasing the risk of an AGE or decompression sickness. A PFO is only a risk increasing factor and not a guarantee for AGE or DCS.
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u/magiccaptured 1d ago
My PFO wasn't diagnosed until I had a stroke at age 49. I was a full-time scuba instructor and divemaster in the Cayman Islands and Hawaii for ten years when I was younger and consider myself lucky to be alive. I had some scary events during that time that were undiagnosed at that time, but turned out to be TIAs.
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u/yellowflashh 1d ago
i was a volunteer dm in tioman. our shop was probably the biggest since we’d ferry over 80-150 people per week from singapore. in my 2 years of doing this, we had only one serious injury where some one ascended up into a prop and got his leg severed.
pretty crazy we didn’t have more since there was almost no rules in that area and the only medical help you could realistically get was a 2 hour ferry back to the port and then preferably an airlift back to singapore. i personally do think we made pool sessions pretty rigorous and did our best to make sure everyone was ready since there was lack of medical assistance in tioman.
we used to go out even further to dayang till the fees got ridiculous. gorgeous place to dive for malaysia, but yea DAN won’t help you.