Transcript Preparations for Cruising Medical Emergencies

Dr Kathy DeGaris
Dr Rosie Colahan
Before you leave.....
Planned Voyage
Crew Considerations
Boat Equipment
Legal Compliance - Drugs
Before you leave.....CREW
 Personal Fitness
 GP Visit
 Travel Consult
 Dental check up
 Crew Confidential Medical Questionnaire
 Medications including for seasickness
 Allergies
 Action Plans for chronic disease
 Own Water bottle
Before you leave.....BOAT EQUIPMENT
 YA Blue Book Special Regulations Section 2
 Medical Guides
 Injury/Illness Chart
 Apply First Aid Certification
 Medical Kits – Contents, storage
 Simplified ‘Day’ Medical Kit
 Accessing Drugs for Ships Supplies
Before you leave.....BOAT EQUIPMENT
 Medical Kits
 Contents
 Medication
 Storage
 Simplified Day Medical Kit
 Accessing Drugs for Ships Supplies
Before you leave.....BOAT EQUIPMENT
 Drugs for Ships Supplies


S4 (antibiotics, pain killers,
prescription drugs)
S8 (restricted drugs, opiates)
Legal requirements
 DHS Drugs & Poisons (Victoria)
 Customs
 Storage
 Record of Supply & Administration
Before you leave.....BOAT EQUIPMENT
Contact details and coverage for Emergency Medical
Assistance
 Communications
HF/VHF Radio, Satphone, Mobile phone
Authorities
Organising Authority
SAR (Search & Rescue) - AMSA
Water Police
Ambulance - Local 000 or International 112 (GSM)
Hospital
On the Water
Medical Emergencies requiring Advice
 Before administering prescription drugs
 Cardiac emergency
 Eye injury
 Severe pain
 Diarrhoea with fever
 Severe burns
On the Water
Illness / Injury Chart
 Monitor patient over time
 Record admin of medication
 Fluid balance
 Hand-over to SAR, ambulance, hospital
Next of Kin
 Notify and keep them posted
Medical Emergencies
First Aid Priorities
Head Injuries
Fractures
Dislocations
First Aid Priorities
Danger
Response
Send for Help
Airway
Breathing
Circulation
First Aid Priorities
DANGER
RESPONSE
SEND
AIRWAY
BREATHING
CIRCULATIO
N
REMOVE FROM DANGER
 EXPOSURE
Sunstroke / Sunburn
 Hypothermia

 DROWNING

MOB
First Aid Priorities
DANGER
RESPONSE
SEND
AIRWAY
ASSESS CONSCIOUS
STATE
(Shout and squeeze hand)
Unconscious
Needs constant supervision
Conscious
Record obs over time
BREATHING
? MOVE CASUALTY
CIRCULATIO
N
Safe protected area
No risk of falling
Observer access
Observation over time
OBSERVATION SHEET
First Aid Priorities
DANGER
RESPONSE
SEND
AIRWAY
BREATHING
CIRCULATIO
N
SEND FOR HELP
On the boat
Emergency Authorities
First Aid Priorities
DANGER
RESPONSE
SEND
AIRWAY
Clear Airway of obstructions
(loose teeth, tongue, vomit)
AIRWAY
BREATHING
CIRCULATIO
N
Lie Casualty on their side
? Oral airway
First Aid Priorities
DANGER
RESPONSE
SEND
AIRWAY
BREATHING
CIRCULATIO
N
BREATHING
Disposable face shields
or
CPR mask +/- hand operated
breathing bag
Ventolin puffer if wheezing
First Aid Priorities
DANGER
RESPONSE
SEND
AIRWAY
BREATHING
CIRCULATIO
N
CIRCULATION

Pulses
Wrist (Radial)
Groin (Femoral)
Neck (Carotid)
Chest (Cardiac)

Skin Colour
White - blood loss
Blue- Hypothermia
Green – Seasickness
Red – Sunburn / hyperthermia
Injuries
 Head Injuries – Open / Closed
 Fractures
 Dislocations
 Fish Hooks
 Wounds
Head Injuries
 Open
 Closed
Observation - Modified Glascow Coma Scale (GCS)
Fractures
Fracture Management - Limbs
Immobilisation of
joint above
and
joint below
the fracture site
Fracture Management
Upper • Air splints
limbs • Slings
Lower • Air splints
limbs • Tying legs together
Fingers • Taping
• Splinting
Ribs • Supportive clothing/
brace
• Hugging a cushion
Dislocations - Fingers
1.
Face the patient, both in standing
positions.
2.
Firmly grasp the end of the
dislocated finger.
3.
Request the patient to lean
backwards while maintaining the
finger in a fixed position.
4.
As the patient leans back sudden
painless reduction should occur.
Dislocated shoulder
1. Hang affected arm over back of seat.
2. Grasp the patient’s wrist with one hand
and exert a steady downward pressure.
3. Place the other hand in the armpit
exerting a direct outward pressure
against the upper part of the upper arm.
4. When appropriate muscle relaxation is
achieved, the head of the upper arm
slips back into the shoulder joint.
Removal of Fish Hooks
Removal of Fish Hooks
Removal of Fish Hooks
Removal of Fish Hooks
Wounds
1.
Assessment
2.
Dressings
3.
Suturing
4.
Splinting /slings
Wound Assessment
Site
Size and depth
? Under tension
? Skin loss
Complicating factors
Wound Assessment
Not under
Tension
Superficial Dressing
Deep ? Steristrips
? Glue
? Suture
Complex
Under Tension
Other
Steristrips
? Bandaging
Micropore tape
Glue
Deep & skin
sutures
Bandaging
and splinting
Sutures
Skin flaps
?Antibiotics
? Analgesia
Suturing - Instruments
TISSUE
FORCEPS
NEEDLE
HOLDERS
SCISSORS
TOOTHED
FORCEPS
Wounds
• Get the patient comfortable
? Analgesia
• Get yourself comfortable
Non skid mats
Tray for instruments
Elbows braced on the table
Sharps Disposal
 Do not re-use syringes, needles or suture
material.
 Dispose of needles into impervious screw
top container
Burns
Type Appearance
Causes
First Redness
degree
Sunburn, scalds,
chemicals
Second Redness, blistering
degree
Hot liquids
Third Full thickness
degree
Fire
Burns
•
•
•
•
•
Cold water immersion for > 20mins
Cool compresses
Analgesia
Rehydration
Severe burns
• Antibiotics
• Medical evacuation
Burns
Type Management
First Solosite gel applied repeatedly
degree
Second Solosite or Flamazine (silver)
degree under padded dressing
Third Flamazine & padded dressing
degree Rehydration. Analgesia.
Antibiotics
More information
www.orcv.org.au