FIRST AID 8 Transportation

2009

Transportation

• The high speed of fast rescue craft makes them a good choice for transporting patients when time is the prime consideration.

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Transportation

• However it should be borne in mind that most fast rescue craft have: 1. little or no shelter from the elements 2. limited space for first aid equipment 3. limited deck space for stretcher/ spine board and for first aiders to work.

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Transportation

• Violent acceleration/deceleration forces that may aggravate injuries, accelerate onset of shock and make some medical procedures (e.g. CPR) difficult or impossible to perform.

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Methods of Immobilisation • Once again, the high speed and violent motion of an FRC should be a consideration when choosing methods of immobilisation of injuries.

• It would be extremely uncomfortable for a patient to be strapped to a scoop stretcher for even a short time on a fast rescue craft in rough sea conditions.

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Methods of Immobilisation • A padded basket stretcher might be a better alternative.

Scoop stretcher Basket Stretcher CANADIAN COAST GUARD AUXILIARY - PACIFIC

Methods of Immobilisation • Even minor fractures need to be secured thoroughly during transport in a fast rescue craft.

• Lower limb fractures need to be tightly splinted (blanket splint would not be adequate on its own), as movement may cause severe shock due to blood loss.

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Methods of Immobilisation • However keep in mind that an urgent transportation may take precedence over securing minor fractures.

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Methods of Immobilisation • Full spinal immobilisation should be particularly well-padded, possibly including greater padding between the spine board and the basket stretcher to act as a shock absorber.

• Great care should be taken in securing the stretcher into the FRC to prevent unchecked movement with the craft.

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Methods of Immobilisation • Patients who are immobilised for transport will be very susceptible to cold, which could worsen shock.

• Even in warm weather, high wind speed and the patient’s inability to move could cause lowering of body temperatures. • Every effort should be made to provide shelter.

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Methods of Immobilisation • Space blankets and heat packs will help reduce heat loss.

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Artificial Respiration and CPR in Fast Rescue Craft • The limited space and small crew size in a FRC may preclude two people performing CPR.

• Although not recommended, it may be necessary for only one rescuer to perform CPR.

• This is something that should be practiced regularly so that rescuers are familiar with the limitations within their vessel.

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Artificial Respiration and CPR in Fast Rescue Craft • If artificial respiration is required, especially on a hypothermic patient, the preferred method is mouth to mask (with supplemental oxygen if available).

• This provides warmth and moisture to the patient and is frankly much easier to perform than the Bag/Valve/Mask method, which is difficult to perform correctly, even under the most controlled conditions.

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Artificial Respiration and CPR in Fast Rescue Craft • Limited space beside the patient may make giving CPR compressions difficult.

• Rescuers may need to straddle the patient’s hips and give compressions from that position.

• Care will be needed to landmark correctly.

• Regular CPR exercises should be practiced in your FRC to help develop a strategy for overcoming the limitations of the craft.

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From the CCG SAR Seamanship Reference Manual CANADIAN COAST GUARD AUXILIARY - PACIFIC