Disabled Divers International Rehab.diver Specialty Course Instructor Guide v/1.0 English
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronically or mechanically, including photocopy, recording, or any information and retrieval system, without permission in writing from the DDI DDI 2012 Rehab.diver Specialty Course Instructor Guide - 1 -
Introduction The DDI Rehab.diver Specialty Course is a special course especially for you as a DDI Instructor In all other courses you teach you probably are the expert of not only the diving part, but also the theory part. Teaching this course puts you in the interesting position of probably being less knowledgeable than your students on the theory part. And that is not only OK - it s how it should be! The students are health professionals with years of studying anatomy, physiology, pathology etc. and probably years of experience with patients in a rehab phase. The course manual takes care of the extra theoretical framework needed for the therapists to get an eye-opener of the possibilities rehab.diving can have for their patients. Your job during the course is to be a dive expert when it comes to buoyancy trim and equipment configuration and a DDI pro that is not only the master of the course, but also make it possible for real patients (non-divers) to be included during the practical part. As stated in the manual: The purpose of this Specialty Course for therapists is to stimulate creativity and supply some basic tools and understanding for diving health professionals to open up a new branch of medicine, by applying established physical rehabilitation modalities in a realm where the effect of gravity can be adjusted at will. You as a DDI Instructor are a vital part of opening up that frontier! Rehab.diver Specialty Course Instructor Guide - 2 -
Acknowledgements The DDI wish to extend its thanks and gratitude to the following organizations, institutes and persons, whose help and information has contributed towards the contents of this Specialty Course. Skogli Helse- og Rehabiliteringssenter AS, Norway Totenbadet AS, Norway Anders Orpana, Norway Cressi diving equipment, Italy In addition to the above we would also like to thank all the other individuals not named whose support, information or materials we have drawn upon, in developing our training programs. Pictures: Katarina Orpana Contents Course Standards.... 4 Important notice. 6 Overview of training. 7 Rehab.diver Specialty Course Instructor Guide - 3 -
Rehab.diver Specialty Diver The DDI Rehab.diver Specialty course provides candidates with the necessary knowledge and skills required to safely and effectively administer exercise therapy in a confined water environment. Candidates are required to self study all sections of the manual and actively participate in the confined water training. Rehab.diver Specialty Course overview: The DDI Rehab.diver Specialty course is an experience program and an ad-on to the DDI Assistant Diver course, designed to make it possible for diving therapists to not only go diving with disabled licensed level-2 divers, but to open their eyes for the rehab-possibilities of taking exercise-therapy under water. The course is experience based; participants are required to self study all sections of the manual and actively participate in the confined water training Certification requirements Upon satisfactory completion of the program participants qualify for the DDI Rehab.diver certification. The certifying instructor can apply for the C-card online at www.ddivers.org. All paperwork is to be retained by the Instructor for a minimum of seven years, or according to the legal system in the country of residence. Prerequisites To participate in the DDI Rehab.diver Specialty course the candidate must: Be a licensed DDI Assistance Diver (or license pending), or equivalent and submit a copy of proof. Be a licensed therapist of minimum B.Sc degree (or equivalent that is minimum three year full time college/university program)) and submit a copy of proof. Submit a copy of a medical examination stating that the individual is fit for diving. The examination must be conducted within the past twelve months. Sign and submit a Safe Diving Practice Agreement and, where applicable, a liability waiver. Ratios 8 candidates to 1 DDI Instructor (8:1) If real patients without diving licenses participate - the normal 2:1 ratio for Try Scuba Dive participants apply in addition. So a maximum of 8 candidates can be in water with maximum 2 Try Scuba participants per one DDI Instructor. Instructor rating DDI Instructors and higher may conduct this program while in active teaching status. Number of Dives Two Rehab.diver Specialty Course Instructor Guide - 4 -
Depth and limits Confined water: Max 6 meters from surface For confined water at a depth of more than 2 meters, any participating non-dive licensed patients must show mastery of the following skills, before going deeper than 2 meters: Breathing under water Successfully equalize BCD inflation and deflation at the surface Mask clear Regulator clear Regulator recovery Vertical access to the surface Every dive should be made in water that allows direct vertical access to the surface. Dive profiles should be planned which do not require in-water decompression. Knowledge Development The candidates self-study all sections of the Rehab.diver manual and watches the DVD - before any inwater activity. Use of breathing gases other than air: Where a breathing gas other than air is used during the training course, the student shall be made aware of any depth limits, oxygen exposure management issues and equipment considerations relevant to the dives planned. Examination: There is no examination Equipment: For training in the confined water all participants must be equipped and familiar with the following equipment (respective of the disability but not compromising the safety of the diver). Mask. Compressed-air cylinder. Buoyancy control device (BCD) with low-pressure inflator. Regulator, alternate air source and submersible pressure gauge (SPG). Weight system. Depth gauge and timing device. Adequate exposure protection, appropriate for the local diving condition. Rehab.diver Specialty Course Instructor Guide - 5 -
Confined Water A pool is the most natural arena, but if a confined open water dive site is available that have non-silting flat sand/pebble bottom and good visibility that is also a possibility. Important notice about exercise therapy sessions after the course! As stated in the manual: General and local rules for scuba diving AND general and local rules for therapy apply: Non-licensed divers need to be in an established try-dive program to be allowed under water in scuba gear including the necessary paperwork and direct supervision by a teaching-status dive-professional minimum a DDI DM. Unless a holder of an autonomous dive-license, divers need to follow possible limitations on their type of license regarding type and number of accompanying divers, depth, type of dive-conditions (pool/cw/ow) etc. You as a therapist need to be licensed and insured to treat patients even if you do volunteer work outside established health-care networks. Apart from you being a licensed therapist (of B.Sc degree (or equivalent) or higher), the minimum requirements of you being a licensed (and liability insured) DDI Assistant Diver is just that a minimum requirement for having the diving skills of a Rescue Diver (or equivalent) and understanding of planning, skills and techniques for diving with disabled people. To be able to take your patients underwater without the task of involving a supervising dive- professional DDI recommend you to consider becoming a dive-professional yourself! Many of your patients will probably want to get licensed divers too 1. Since non-licensed divers need a dive instructor (or at least a DM with DSD leader credentials (or equivalent) in direct supervision during all dive related activity, it creates a new kind of job opportunity for you and your fellow dive-pro s. Talk to your candidates about future cooperation! 2. Many Rehab.divers would probably consider becoming a dive-pro themselves in an effort to be more independent this increases the demand for DM and IDC courses (and DDI Pro-courses). As Assistant Divers they are already carrying liability insurance, making the extra step into the dive-pro community less of a cost barrier. Talk to your candidates about becoming dive-pro colleagues! 3. Doing gymnastics underwater is of course possible and free for everyone that is allowed to dive the same way anyone can try to stand on his head in the park, or challenge anyone else to try. Unless that is done in a patient-therapist relationship then a system of government approved health work licenses and liability insurance demands come into play (to insure quality treatment and safety for the patient). That is why a DDI Rehab.diver needs to be officially licensed and insured - to treat patients. As long as a patient is allowed under water in a Try Dive setting with Instructor/DSD Leader or as a licensed diver, pool therapy can be done underwater. The DDI Rehab.diver Specialty course is merely an eye-opener for therapists, not an official license to take patients underwater. At least not yet Rehab.diver Specialty Course Instructor Guide - 6 -
Overview of Training Dive 1 Play time! Objective: Familiarization of how it feels to walk and jump and stand on the head and do all the circus/gymnastic tricks one have dreamt of managing. The role of the instructor: Be a buoyancy trim guide including a guide for asymmetric trim to give the candidates a direct feel for how many disabilities causes extra trim struggle - and also get the opportunity to figure out how/if that extra struggle can in fact be very specific exercise therapy Option: If available let the candidates try different configurations (small tanks, side-mount etc). After the dive Initiate a debrief were the candidates discuss how it felt and of what options might be useful for their kinds of patients. Optional Try Scuba dive session If non dive-licensed patients (or healthy volunteers) do participate, you take them through an official Try Dive session and deem if he/she/they are dive-competent enough to participate in the work shop (Remember the 2:1 ratio), while the candidates prepare for the workshop Dive 2 Work shop! Objective: Practical workshop of an underwater exercise therapy session(s). The role of the instructor: Be in direct supervision of any non licensed divers. Or be in indirect supervision of the candidates. Or do the role as a patient if alone with one candidate. After the dive Initiate a debrief were the candidates and patient discuss how it worked out and what to do the next time. Rehab.diver Specialty Course Instructor Guide - 7 -