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APNEA AND SURFING SURVIVAL TRAINING

! AND SURFING SURVIVAL TRAINING ! Introduction Have you ever been held underwater for a very long time, driven to the deep, dark depths, and the turbulence and the of the water wouldn't let you come up to breathe? Have you ever free dove to the bottom of the ocean and tried to stay there as long as possible, waiting to shoot a fish or photograph marine life, and your instincts start telling you that you need to breathe? What did you feel in these situations? Were you scared? Did you think you were going to pass out or drown? Any watermen will experience these situations one day, when the urge to breathe overtakes the ability to remain calm. The question is, are you ready for that? This is the purpose of the Apnea and Surfing Survival Training. ! Objective The objective of this training is to provide enough information and practice so that you can train your body and mind to do the most important thing when you reach your survival instinct: to remain calm. ! How to remain calm in those situations is what we emphasize in our training. This course is essential for all surfers, divers, and watermen in general who are always willing to push their limits underwater. The goal of this training is to teach proper techniques and exercises to increase your breath holding ability and to be familiar with all the symptoms and signs that tells us when our bodies are being close to shutting down. ! ! Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

Apnea Apnea is a term for suspension of external or holding breath. During Apnea there is no movement of inhalation, and the volume of the lungs initially remains unchanged. Apnea can be voluntarily achieved, drug-induced by medication, or mechanically induced by strangulation or choking. Also, in people who suffer from sleep apnea, this event will occur 20-30 times per hour. Voluntary apnea can be achieved by closing the vocal cords, simultaneously keeping the mouth closed and blocking the nose, and constantly activating respiratory muscles. In the sport of free diving, voluntary apnea is well practiced and it can be improved through many exercises. Breath holding above water in a safe environment is not dangerous. In fact, even holding breath to the point of losing consciousness does not cause the body any harm. Because ventilation is controlled by the nervous system, normal breathing resumes the moment that consciousness is lost. Brain damage does not occur unless ventilation is somehow prohibited for approximately 4 minutes beyond the loss of consciousness. Breath holding exercise increases the amount of time the body can sustain apnea by improving ventilation, increasing psychological fortitude, and lengthening the maximum duration for which the body can maintain an anaerobic exercise. ! Static apnea is simply a timed breath-hold exercise usually performed while floating on the surface without any movement. Static Apnea is a great training exercise for free divers and surfers. After all, time spent underwater involves holding your breath. The most important rule in apnea training underwater is to NEVER train alone. Apnea training must be accompanied by a training partner. Time signals are commonly used in all apnea training to provide safety and communication between buddies. Usually a tap on the shoulder and an “OK” is the standard signal for communication. ! Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

The 1st tap is usually at the first minute. The following taps come after every 30 seconds until the target time is reached. After the targeted time, a is mandatory every 15 seconds. Once the Static Apnea exercise is completed, six full recovery breaths are mandatory followed by the “OK” signal. Dynamic Apnea is defined as an exercise where breath is held in movement underwater. During dynamic apnea, creates higher C02 level quicker than static apnea, therefore breath holding time is usually less than static. When training dynamic apnea, the buddy/diver must always be 6 feet in front of the person performing the exercise. When the diver surfaces the buddy must emphasize safety by being within arms reach of the diver in case of loss of motor control. After six recovery breathes followed by the “OK” sign, only then can the buddy can relax and stop paying attention to the diver. The most important rule in apnea training underwater is to NEVER train alone. Apnea training must be accompanied by a training partner. ! Improving Ventilation / Breathing Ventilation can be improved by practicing deep breathing (both inhaling and exhaling) regularly. Like any other muscle, the diaphragm can be strengthened with regular exercise. A strong, healthy diaphragm can help to fully expand the lungs and more effectively collapse them, improving the volume of a fresh breath as well as ensuring that used air can be thoroughly purged. Improving ventilation can increase levels in the blood and raise the amount of oxygen rich air that can be stored in the lungs, thus increasing dive time. ! ! !

Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

Exercises to improve ventilation Use the following simple exercises to improve ventilation. These can be done standing with feet shoulder length apart. Broaden your shoulders during inhalation to increases lung volume; shrug them together towards your solar plexus during exhalation to decrease lung volume. Repeat these exercises several times a week on a regular basis. In addition to any muscle strengthening and development achieved, practice will improve , making it easier and more natural to ventilate properly before going underwater. ! Increase strength & capacity: Take a slow, deep breath while broadening the shoulders, then continue attempting the inhalation — flexing the diaphragm — for a four-second hold. Exhale slowly and completely. Repeat in sets of eight. ! Improve total exhalation: Exhale completely to the point of mild discomfort, then continue exhaling by compressing the upper abdominal muscles and collapsing the shoulders towards the solar plexus. When further exhalation becomes impossible, hold for four-seconds and then inhale. Repeat in sets of eight. ! When deprived of proper ventilation, the body responds with an urgent sense of needing to breathe. That feeling, generally characterized by a mounting sense of , is caused not by oxygen deprivation but by carbon dioxide (CO2) buildup in the bloodstream. Oxygen levels are actually normal far beyond the time that the initial urge to breath is experienced. ! Breath holding practice, in time, will develop a tolerance to the urge to breath which is felt by all free divers. The goal of developing this tolerance is to allow a diver to approach actual depletion of oxygen storage and withhold from reacting to the uncomfortable sensation caused by carbon dioxide buildup. While the urge to breathe will always exist, practice can improve your abilities, allowing for longer dives and time spent underwater. !

Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

Many divers experience involuntary diaphragm contractions at some point during their breath hold. These uncomfortable muscle spasms are a symptom of the autonomic nervous system attempting to regain control of . Diaphragm contractions do not signal danger; in fact, some divers report that anywhere from one quarter to even a half of their breath hold remains after contractions begin. The best way to fight contractions is to relax and enjoy it. ! Developing a tolerance to the urge to breathe takes time. Fortunately, breath holding practice requires only a stop watch and can be done just about anywhere. Use the following steps to time a breath hold. Daily practice and an ambition to beat previous records can improve a breath hold dramatically. Often, when several breath holds are performed sequentially, times improve remarkably with each hold. Remember, however, that each hold must be preceded by a generous breathe-up interval. ! 1) Lay somewhere comfortably that allows easy, natural breathing, and allow your body to reach a state of relaxation. 2) Begin slow, deep breathing, filling your lungs to capacity and emptying them completely ten times. 3) After the desired time, completely empty your lungs and then fill them to capacity. Broaden your shoulders and use muscular force to ensure the maximum volume of air is achieved. 4)Start your timer and hold your breath for as long as you can. ! The above exercise describes a generic routine that can be used to test your breath hold. It can, of course, be modified to fit to whatever is most comfortable for each individual. Below are some tips to improve your hold: -Don’t move at all: any movement burns oxygen. In a real diving environment, of course, you'll be swimming. This exercise, however, focuses on tolerating the urge to breathe and learning about your personal carbon dioxide tolerance. !

Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

-Try not to think. Thinking also uses oxygen. Picture a blank white sheet, focus on a sound or listen to soothing music. ! -Get comfortable with your body's responses. Learn when you can expect involuntary diaphragm contractions, how many contractions you can tolerate, and what different stages of the breath- hold feel like. This knowledge can be applied while diving to better gauge your oxygen stores. ! -Expect mild muscular cramps. Whether in your thighs, shoulders or hands, often the increasing acidity of the blood that results from breath holding will cause muscles to stiffen and contract. ! Improve anaerobic exercise capacity When the muscles are employed in the absence of breathing, both carbon dioxide and lactic acid accumulate quickly in the bloodstream. The body converts oxygen stored in the blood and in the lungs into energy, releasing carbon dioxide as a byproduct. Increased levels of carbon dioxide stimulate the rising urge to breathe. Glucose stored in muscle cells is also converted into energy, releasing lactic acid as a byproduct. Lactic acid accumulation causes a stiff, aching sensation in the muscles. This feeling will dramatically relent once ventilation is continued, but will become more and more uncomfortable until regular breathing is restored. Improving the body's capacity for maintaining anaerobic exercise simply takes practice. By combining breath holding with calisthenic exercises, the body's capacity for lactic acid and carbon dioxide tolerance can both be improved. Just about any exercise can be performed during breath holding to help develop the body's anaerobic exercise capacity. It's important to take special precautions when performing exercises that require squatting, bending or otherwise changing the height of the head. These elevation changes can affect blood , which combined with breath holding is likely to cause blackout. Losing consciousness and falling during exercise could result in serious injury. !

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Breath holding in combination with calisthenics, walking, jogging, and swimming can all prove incredibly effective. These exercises should be performed in the form of interval training, wherein breathing is limited but not altogether stopped. For example, while swimming the crawl, take a breath only every fifth stroke; when jogging, breathe only on every fourth step, etc. Remember that the goal is to bring lactic acid and carbon dioxide levels just as high as is barely tolerable, then reduce them (via breathing), then bring them back up again. ! Problems Associated with Apnea Hypoxia means lower than normal oxygen level in the body. Oxygen is crucial to survival and our body uses it all the time. Different levels and types of activities can raise the amount of oxygen that we consume. For example when you run, swim, or paddle, you tend to breathe heavier as you increase speed, this way circulating more air through your lungs. Sometimes our bodies’ demand for oxygen is more than the available supply, especially during heavy exercising. This could happen while paddling to a wave as you are trying to take off after a long paddle out and fighting for position. In the case of a wipeout or getting caught inside and being held underwater with a low level of O2 or Oxygen, your body requirements for O2 exceeds the available supply, and the result is Hypoxia. There are varying degrees of Hypoxia. Examples are running, swimming, and paddling. In most cases, the level of oxygen debt in our bodies is not noticeable, but when you are holding your breath for a long period of time, especially after exercising, you will experience a higher level of Hypoxia which can be unsafe and lead to loss of consciousness. Severe hypoxia can lead to loss of motor control and loss of consciousness. ! Symptoms of Hypoxia Euphoria Dizziness or confusion

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Tingling or numbness Visual disturbance Loss of motor control ! Signs of Hypoxia confusion / poor judgement emotional instability loss of motor control convulsions ! Loss of Motor Control At high levels of Hypoxia, the body still has enough oxygen to stay conscious, but not enough to keep control of motor and muscle skills. This condition is known as a “black out” and can lead to a full black out. A diver experiencing loss of motor control needs continuous supervision and direct assistance until motor control is fully regained. If a diver/surfer suffers a loss of motor control during training, the training must be stopped immediately and must relax for the rest of the day. ! Signs of Loss of Motor Control or Near Black Out Confusion Loss of balance Spasms Loss of postural control Speech problems Cyanosis - blue lips pale face Convulsions !

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Assisting someone with Loss of Motor Control Immediate intervention is necessary to avoid . It is very important that when assisting someone with loss of motor control to always protect the airway by keeping it open. Our bodies have the ability to resolve oxygen debt and normalize body functions naturally. ! Loss of Consciousness / Black Out When Hypoxia levels are extremely high, divers and surfers can experience loss of consciousness, also commonly referred to as a black out. The most serious consequence of blacking out is that the diver/surfer is no longer able to protect his airway. This is extremely dangerous underwater because the diver is no longer able to save himself from inhaling water and potentially drowning. An alert diving partner would be in the best position to rescue such a person. Static apnea blackout occurs at the surface when a motionless diver holds a breath long enough for the circulating oxygen to fall below that required for the brain to maintain consciousness. It involves no pressure changes in the body and is usually performed to enhance breath-hold time. It should never be practiced alone, but under strict safety protocols with a safety beside the diver. ! TREAT BLACK OUT AS A VERY SERIOUS SITUATION Above water Remove the mask, open the airway, and gently tap on the diver/surfer’s face. It is important to calmly talk to the diver/surfer as they regain consciousness. Loss of respiratory control, non responsiveness, convulsion, and short-term amnesia may occur. In all of these cases, contact emergency personnel. Under Water Dive down to bring the diver/surfer to the surface. It is important to close the airways by blocking the nose and mouth with one hand and using the other hand to hold the back of the neck. Position of the arms is important. Once at the surface, follow the above water procedures.

Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

Hyperventilation Fundamentally, hyperventilation is the process of breathing faster or deeper than you need to, beyond what you require to maintain your homeostasis. For example, if you are sitting on a sofa and relaxing, and you start to breathe deeper and perhaps faster than normal, you are hyperventilating. However, if you are running and your breathing rate increases, this is not hyperventilation. This is a natural process of your body when exercising. The main result of hyperventilation is a rapid decrease of C02 in our bloodstream. Co2 is the gas which causes us to want to breathe. By removing this gas from our bloodstream, we start a dive with a very low Co2 content, which then tricks our bodies into thinking that we don’t really need to breathe. However, the hyperventilation hasn’t increased our o2 levels to compensate, and our o2 levels are decreasing just as quickly as normal, but without the safety mechanism of the high Co2 ‘need to breathe’ reflex. So this leaves the diver in a very dangerous position, as they continue their dive but without any strong desire to return to the surface. It’s like driving along with a broken fuel gauge: it may appear that the tank is half-full, but the reality is that it’s a lot lower! ! Never hyperventilate before a dive. ! Co2 & o2 Tables A Co2 table is basically a series of dives which gives you less and less time to recover in between breath-holds. So the Co2 in your blood and tissues slowly creeps up and up throughout the exercise. This slow increase develops your tolerance to that nasty Co2. People who have a really strong or early desire to breathe need to concentrate on Co2 tables. The maximum hold should really be no more than about 50% of your maximum breath hold time. O2 tables work differently and it is designed to increase your maximum breath-hold, by increasing the amount of time that you retain you breath on each attempt. The recovery phase is fixed, unlike the Co2 table, so the Co2 is expelled properly in between dives. These kind of tables are important to get the body working well under the effects of low o2. ! Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

Let’s have a look at 2 basic examples of both. ! CO2 TABLE PREP HOLD 2.00 2.00 1.45 2.00 1.30 2.00 1.15 2.00 1.00 2.00 0.45 2.00 0.30 2.00 0.15 2.00 ! O2 TABLE PREP HOLD 2.00 1.30 2.00 1.45 2.00 2.00 2.00 2.15 2.00 2.30 2.00 2.45 2.00 3.00 2.00 3.15 ! ! Important: It is recommended to perform between 2-4 tables per week - one at a time - Never perform both types of table during the same day. !

Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

Surfing Survival Training ! To survive a massive wipeout, your mental preparedness will be just as important as your physical conditioning. In addition to maintaining a high level of physical fitness and stamina, being able to control your mind, keeping your composure, and entering a relaxed state during a wipeout are all essential to getting through each big wipeout. If you are really trying to test your limits in the big surf, it is imperative for survival. The main idea of staying calm and relaxed underwater is to conserve your energy and oxygen. The more you panic, struggle, and fight underwater, the faster you will deplete both. A huge part of becoming comfortable during a bad wipeout comes from experiencing them first- hand. When you gradually work your way into and progress in larger surf, the wipeouts will naturally come. Make sure to never push yourself beyond your limits and ALWAYS manage your risks well. Become comfortable at each new level, until you know you are ready to progress forward. Try to learn and understand the physical and mental stress your body was put under (which is typically the initial cause for people to panic) as well as the physiological processes that takes place while being held underwater, and depleted of oxygen. Also, strengthening your cardiovascular system by swimming and training APNEA is extremely beneficial for extended periods of breath-hold and to increase your confidence underwater. The idea behind this type of exercise is to teach your body to operate more efficiently with less oxygen and build up its tolerance level of CO2. ! Through Apnea training you will put your body under gradual levels of physical stress in order to feel and understand the physiological process that happens during oxygen depletion. This is the main cause for panicking. There are a lot of situations that you will find yourself in, and each situation will be different. However, there are a few tips that you could use in order to make your wipeout a more endurable experience. !

Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

First and foremost, DON’T PANIC - EVER. Panicking is the first step to drowning. Maintaining calm is by far the most important thing you can do! Maintain control of your mind by putting into practice your apnea and surfing survival training. ! Close your mouth and nose when possible with one hand. With the same arm protect your ribs. The other arm could protect your other side of your ribs or your head, depending on the situation. By holding your nose you will prevent precious air from getting out of lungs, keep the water from going in and you could also equalize your ears if you go too deep. ! Bend your legs towards your stomach as you crawl into a ball in order to protect your core as well as keeping your limbs and ligaments from injuries and dislocations. ! Don’t fight the water’s turbulence, it’s a waste of oxygen supply. Save your energy and air to swim to the surface when the water finally lets you go. ! Use your legs and arms to propel through the white water on an effective and controlled swim and without expending too much energy. Remember, there could be a second wave hold-down. ! If you are about to have a second wave hold-down there is only one thing you can do: REMAIN CALM. Go back to Wipe Out position! This is when you will have to FIGHT CONTRACTIONS and use MIND CONTROL in order for you to wait until the wave finally lets you swim to the surface. ! When you finally break through the surface, take your recovery breaths and tell yourself that you are OK. ! A flotation vest tremendously increases your positive underwater and also helps you to recover from a bad wipe-out without struggling to keep your head above the water. !

Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

Panic ! Panic is a sudden sensation of fear which often dominates or prevents reason and logical thinking, replacing it with overwhelming feelings of anxiety and frantic agitation, consistent with the animalistic fight-or-flight reaction. Panic can cause hysterical or irrational behavior and it is the number one cause of drowning in people. The surest path to overcome panic is to train yourself to respond to panic in accepting and calming ways. ! People who have the ability to prevent and/or control their own and others' panic by disciplined thinking or training have a far better success rate in dealing with stressful situations. ! Signs of panic ! Racing heart Feeling weak, faint, or dizzy Tingling or numbness in the hands and fingers Sense of terror, or impending doom or death Feeling sweaty or having chills Chest pain Breathing difficulties Feeling a loss of control ! ! How to deal with panic ! The first step in dealing with a panic attack is to actually ACKNOWLEDGE that you are panicking. !

Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

The second step is to ACCEPT it and use mind control to keep it from developing into an uncontrolled panic attack. ! In order to avoid uncontrolled panic attack, it is important that you STOP, take a deep BREATH and tell yourself to remain CALM as you work on breathing. ! The breathing pattern is the most important part of the process. By breathing deep and slow through your diaphragm, you will be able to regain control of your thoughts and to achieve a calm state of mind. ! Once you are in control of your mind and able to relax, then you will THINK about possible for the situation you are in. Once you recognize the best , you will ACT. ! Steps: Acknowledge, Accept, Breath, Think, Act ! and Emergency Action Plan ! Risk management is key to survival. It doesn’t provide safety with just a precise course of action and there is not just one way of doing the right thing. Managing risk is about being aware of and calculating all risks and aspects of any situation you are about to put yourself into, good or bad. The most important aspect of risk management is to not accept unnecessary risks that put yourself or someone else in danger. ! The impact of poor decisions can be severe and sometimes deadly. Therefore, making good use of risk management can help you create choices about appropriate courses of action and to take control and make the best of potentially bad situations. !

Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

Risk management needs to be flexible, fluid, and adaptive. Surfers must often make quick decisions in a matter of seconds often based primarily on pre-planning, training, and a good dose of common sense of local ocean and wave knowledge. The more knowledge you have, the more calculated your risks can be. ! Implementing risk management and awareness will not only increase your chances of successfully riding big waves but, most importantly, will minimize the chances of creating unnecessary risks. ! Your biggest assets in big-wave surfing are your own physical and mental preparation. Every time you are about to paddle out, observe what the ocean is doing for a while and ask yourself the following questions: ! How big is it? Is there anyone in the water? What are the ? Where is it dangerous? When is it dangerous? How can I minimize the risks? How can I get out of the water without my surfboard or the assistance of anyone else? How can I be safe? Is it within my limits? What is the worse-case scenario and how can I avoid it? ! Answering these questions will allow you to manage all possible risks and could also determine an emergency action plan. ! !

Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

Rescues As much as we reduce the risks involved in surfing, we must always be prepared for emergency situations. This preparation involves the development and utilization of appropriate rescue skills following an Emergency Action Plan (EAP). ! The most important thing to consider prior to performing any rescue is to be sure you have the appropriate training to complete such a rescue. You must also be certain that you will not become a victim yourself, otherwise there will then be two victims in need of rescue. ! There are 3 steps to consider in order to perform a rescue: ! 1. STOP (Observe for a few seconds what created the accident and look for any possible danger to you. Wait until it is clear.) 2. THINK (Think of an action plan to perform the rescue without jeopardizing your safety.) 3. ACT ( Execute your course of action but be prepared for a sudden change of plan) ! An Emergency Action Plan includes having emergency equipment and supplies available such as cell phone, marine radio, complete kit, 100% oxygen, AED, and the utilization of appropriate emergency medical skills such as primary care (CPR, Rescue Breath) and secondary care (fractures, dislocations, bleeding etc…) ! Cardiopulmonary Resuscitation (CPR) and Rescue Breath CPR can make a lifesaving difference in countless everyday situations. While surfers and those who spend a lot of time in the water may be more likely to find themselves in an emergency situation concerning a breathing emergency, performing CPR to someone unresponsive in the water is almost impossible without the use of hard surface, therefore if you think it will take longer than 3 minutes to get an unresponsive person to a boat or shore, you

Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

should start rescue breath immediately. Brain damage can occur within 3 to 6 minutes after breathing stops. After 6 minutes without oxygen, irreversible brain damage is almost certain due to long term oxygen deprivation. Rescue breathing can provide enough oxygen to support a non- breathing victim until CPR can be started. ! When performing in water rescue breath/swim to someone be sure to always protect the airway, preventing water from going inside the victim’s lungs. You can do this by keeping the head above the water as you rescue swim or provide rescue breath, and also by shaking your hands before you block the victim’s nose in order to breath in. ! The role of CPR is to provide a patient with oxygenated blood flowing to the heart, brain, and other vital organs until a defibrillator becomes available or emergency services are able to make it to the scene. When the heart stops, the lack of oxygenated blood can cause brain damage in only a few minutes. A person may die within eight to 10 minutes, so the earlier assistance can be given to someone in need, the greater the chances of survival. ! Before starting CPR, the general rules are: ! • Is the person conscious or unconscious? • If the person appears unconscious, tap or shake his or her shoulder and ask loudly, "Are you OK?" • If the person doesn't respond, is not breathing and has no pulse, direct someone to call 911 or the local emergency number while you begin CPR. If you are alone and have immediate access to a telephone, call 911 before beginning CPR — unless you think the person has become unresponsive because of suffocation (such as from drowning). In this case, begin CPR for one minute and then call 911 or the local emergency number and resume CPR immediately. ! ! ! Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

Remember to spell C-A-B ! The American Heart Association uses the acronym of CAB — compressions, airway, breathing — to help people remember the order to perform the steps of CPR. ! Compressions: Restore blood circulation ! • Put the person on his or her back on a firm surface. • Kneel next to the person's neck and shoulders. • Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands. • Use your upper body (not just your arms) as you push straight down on (compress) the chest at least 2 inches (approximately 5 centimeters). Push hard at a rate of about 100 compressions/minute. ! Airway: Clear the airway ! After you have performed 30 chest compressions, open the person's airway using the head tilt, chin-lift maneuver. Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway. Check for normal breathing, taking no more than five or 10 seconds. Look for chest motion, listen for normal breath sounds, and feel for the person's breath on your cheek and ear. Gasping is not considered to be normal breathing. If the person isn't breathing normally, provide two rescue breaths and continue to provide CPR. You should continue CPR until the person resumes breathing or until EMR arrives. If you get tired, ask someone to take over for you. !

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Breathing: Breathe for the person ! Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened. With the airway open (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for mouth-to- mouth breathing and cover the person's mouth with yours, making a seal. Prepare to give two rescue breaths. Give the first rescue breath — lasting one second — and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver and then give the second breath. Thirty chest compressions followed by two rescue breaths is considered one cycle. Resume chest compressions to restore circulation. If the person has not begun moving after five cycles (about two minutes) and an automated external defibrillator (AED) is available, apply it and follow the prompts. Administer one shock, then resume CPR — starting with chest compressions — for two more minutes before administering a second shock. If you're not trained to use an AED, a 911 or other emergency medical operator may be able to guide you in its use. If an AED isn't available, continue CPR until there are signs of movement or emergency medical personnel take over. ! Watch this video for Cardiopulmonary Resuscitation (CPR) Guidelines https://www.youtube.com/watch?v=ZjszBXF0l8A ! We highly recommend taking a full EFR course from Red Cross or any other medical or training agency that provides Primary and Secondary care training. ! Weather and forecasting In order to minimize the risks involved in surfing, especially big wave surfing, you should first totally understand the weather system and swell forecasting for your local area or the location you are willing to surf. Understanding and tracking a swell will not only give you precise information Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

about the waves you are about to surf, but it will also warn you about potential hazards that come along with that swell or storm. ! Swell forecasting is an essential tool that every surfer needs to know how to use. Understanding swell height, energy and period, wind directions, refraction, and will let you know where to be at the right place and at the right time. It will also let you know when you should get out of the water before conditions get too dangerous for your level of surfing, especially at certain locations around the world where the swells arrive and grow very fast. For instance, Hawaii is definitely a place to know the conditions 3-4 hours in advance from the time you start surfing. Many people have been surprised by a fast rising swell and suddenly couldn’t get out of the water without the assistance of lifeguards.

One of the worst case scenarios is when surfers want to stay in the water until dark not knowing that there is a big swell on the way. Even experienced surfers have been caught by unexpected, rapidly rising swells at places like Sunset Beach, one of the worse zones for this to happen. An even worse situation is found by surfers that decide to enter the water at Waimea Bay at an inviting, clean, and perfect mid-size day, only to be confronted with 20-25 feet closing out sets 3-4 hours later. ! Every wave/surf spot is different and it is important to increase local awareness by studying and understanding all potential risks in regards to currents, swell size, wind, refraction, water movement, bottom composition, marine life, rocks, cliffs and any other hazards that could put your life in danger. Remember; in doubt don’t go out! ! Impact and flotation vests for big wave surfing There is no doubt impact or flotation vests are here to stay. It has revolutionized the sport of big wave surfing, first with tow-in and now with paddling. This simple and very effective flotation vest has been saving the lives of the best surfers in the world since the tow-in surf riding era started.

Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

Now with the revolution of paddle surfing, new companies have developed produced vests, leading to more availability in the market for the average surfer. There are lots of vests on the market, look for one with enough flotation for your body weight and type. The only downside of a floatation vest is that it keeps a surfer from going down when he/she actually needs to. It’s recommended that you train going under water as much as possible with your vest on so you can do it when a critical time presents itself. ! Spare Air for Surfing The ability to take extra breaths while underwater during long hold-downs lessens fatigue and restores oxygen depletion. It can be a great tool to use in big wave surfing but many risks will also come with it.

The first problem is actually using it when you need it most. As with any other SCUBA devices, the spare air is a compressed air canister with pressurized air and a regulator connected to it. Since you have a mouth piece attached to the regulator, there will always be between your mouth and the canister. In that dead space there will be water, because during a wipe-out you are underwater. In order for you to take a breath, first you have to clear the regulator in order to expel the water out. Expelling your air when you need it the most can be a crucial decision and you can only hope that device will work. ! The second problem is that by inhaling compressed air under water, you will be equalizing your lungs to the pressure you are at. At 33 feet of water or two ATM (), you will need two times more air to fill up your lungs. Air expands during ascent and ascending to the surface with a full breath from 2 ATM without letting the expanding air out could result in lung over expansion, a very serious injury in . ! References Surfline, Deep Water, Instructors international, Wikipedia, American Heart Association and Freediving UK Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

Knowledge Review ! 1 - What is the definition of Apnea? ! 2 - What is the difference between static and dynamic apnea? ! 3 - What is the most important rule in apnea training underwater? ! 4 - How can you improve ventilation? ! 5 - When a person is deprived of ventilation and is experiencing an urgent sense to breathe, what is happening in the blood stream? ! 6 - How can you develop a higher tolerance to the urge to breathe and why should you do it? ! 7 - What are contractions and when do you start feeling it? ! 8 - What is the best way to fight contractions during apnea training? ! 9 - What is the definition of Hypoxia? ! 10 - Name all symptoms of Hypoxia. ! 11 - Name all signs of Hypoxia. ! 12 - Define loss of motor control. ! 13 - Name all signs of loss of motor control or near black out?

Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected] APNEA AND SURFING SURVIVAL TRAINING

! 14 - What are the main keys to survive a massive wipe out? ! 15 - What is the definition of panic? ! 16 - What are the necessary steps in dealing with panic. ! 17 - Describe the main aspects of Risk Management. ! 17 - What is the main purpose of CPR? ! 18 - What are the general rules before starting CPR? ! 19 - Why should you provide rescue breath to someone when CPR is not possible? ! 20 - Describe C.A.B. ! !

Hawaii Eco Divers www.hawaiiecodivers.com 1 808 499 9177 – [email protected]