Transcript First Aid for Coast Guard Crew

Basic Boating First Aid
Joshua Hawley
 Captain Tri-Community Fire
Department
 Vice President Bridgeton EMS
 EMT-Basic
 USMC Active Duty 10 years
Training Topics
 First aid kit contents
 Handling Basic Emergency Medical
Situations
Please write down any questions and hold until end of
presentation.
Basic First Aid Kit
 Buy or Build your own?
 Make sure it’s well marked and easily
found on vessel
 First Aid Book
Basic First Aid Kit
Adhesive bandage compress
Adhesive tape 1 in.
Bandage compress 2 in.
Bandage compress 4 in.
Triangular bandage
Absorbent gauze compresses
Gauze roller bandage 4 in.
Aluminum splint
Tourniquet
Eye dressing packet (pads and
strips)
Eye wash solution
Antiseptic swabs
Oral airway
Antibiotic ointment
Plastic strips (various sizes)
Latex gloves (Nitrile if allergic
to latex)
Bandage scissors
Non-adherent pads 2in. X 3 in.
Tweezers
Sunscreen (SPF 30 or higher)
Burn Treatment Compound
Baby Aspirin, 81 mg.
Benadryl
First Aid book*
First Aid
Doing what must be done to:
 Stabilize (before medically trained
personnel arrive)
 Transport (to an appropriate medical
facility)
First Aid
 Initial examination
Determine Primary Problem
 Responsiveness
 Airway
 Breathing
 Circulation
Determine Seriousness (Priority)
Look for any additional problems
Communication
 Activate appropriate emergency
services
Call 911
Channel 16 USGC
 Provide pertinent information
 Receive advice for care
Information to provide
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Name of vessel
Radio call sign
Location
Number of victims
Age
Sex
Description of
injury, illness, or
incident
 State of
consciousness
 Airway
 Breathing
 Signs of shock
 Vital signs
 Medical history
 Treatment given
Neck or Spinal Injuries
Causes
 Boating Collisions
 Falls
 Blunt trauma
 Penetrating trauma to head, neck, or
torso
 Springboard or platform diving
accidents
Neck or Spinal Injuries
Signs and Symptoms
 Tenderness and/or pain at injury site
 Soft tissue injuries with spinal injury
 Numbness, tingling or weakness in
arms or legs
 Difficulty breathing
 Paralysis
Neck or Spinal Injuries
Protect Spine
Manual Stabilization
 Hold patient’s head still
 Maintain head in position found
Do not turn to either side
Do not tilt forward or backward
Neck or Spinal Injuries
Protect Spine
Manual Stabilization
 Kneel behind the patient
 Spread your fingers and thumbs around
the sides of the head
 Hold the head steady
Shock
(Compensation)
 Multiple Causes
Trauma (bleeding, blunt, burns)
Allergic reactions
Drugs
Hypothermia
Toxins
Emotional
Near drowning
Shock
Onset and Symptoms
Rapid or delayed (hours) after
apparent cause
 Restless
 Faint
 Thirsty
 Nauseated
 Frightened
 Weak
 Anxious
 Dizzy
Shock
Signs
 State of consciousness: alert (may be
deceiving) to unconscious
 Breathing: shallow, rapid, irregular
 Pulse: weak and rapid
 Skin: cold, clammy (sweating)
 Pupils: dilated
Shock
Treatment
 Position flat on back, feet raised (if no
head, neck or spine injury suspected)
 Keep comfortable; Cover with blanket
if cold, Place in shade if hot
 Nothing by mouth – you may moisten
lips
 Never give alcohol
Anaphylaxis
Definition
An immediate, life threatening systemic
allergic reaction
Anaphylaxis
Triggers (examples)
 Foods: peanuts, tree nuts, shellfish,
fish, milk, eggs, food additives
 Medications: antibiotics, muscle
relaxants, seizure medications, betablockers
 Insect stings: bees, wasps, hornets,
yellow jackets, fire ants
 Exercise and cold
Anaphylaxis
Symptoms
Onset
 Can be only seconds or up to 2 hours
after incident
 Reaction may recur up to 24 hours
after first reaction
Anaphylaxis
Symptoms (General)
 Hives
 Bronchoconstriction (closing of
airway)
 Headache
 Loss of consciousness
Anaphylaxis
 Do NOT minimize an allergic reaction
 DEATH can occur within minutes
Anaphylaxis
Treatment
 Obtain medical attention regardless of
response
 Epinephrine (EpiPen®, AnaKit®)
 Ice pack locally if applicable
 Antihistamines (Benadryl)
 Tourniquet (last resort)
 Treat for shock
EpiPen®
1. Familiarize yourself with the unit
2. Grasp unit with black tip pointed downward
3. Form a fist around auto-injector, black tip
downward
4. With your other hand, pull off the gray activation
cap
5. Hold black tip near outer thigh
6. Swing and jab firmly at 90° angle into outer thigh
7. Hold firmly in thigh for 10 seconds
EpiPen® (cont.)
8. Remove unit and massage injection area for
several seconds
9. Check black tip:
 If needle is exposed you received the dose
 If not, repeat steps #5-8
10. Bend the needle back against a hard surface
11. Carefully put the unit (needle first) back into the
carrying tube (without the gray activation cap)
12. Recap the carrying tube
EpiPen® (cont.)
13. Immediately after use
 Call 911 and activate emergency medical
services
 If EMS not available, go immediately to the
nearest hospital emergency room
 Tell the physician that you have received an
injection of epinephrine
 Give your used EpiPen® to the physician for
inspection and proper disposal
Burns
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Classified by depth
Size generally more important than degree
First degree (superficial): mildest
Second degree (partial thickness): inner
layer of skin
 Third degree (full thickness): tissue
destroyed
Burns
Normal Skin
Dermis
Fat
Muscle
Burns
First Degree
Skin
Reddened
 Only outer layer
of skin
 Mild pain
 Redness
 Warmth
 Tenderness
Burns
Second Degree
 Inner layer of
skin
 Red
 Warm
 Tender
 Blister
 Severe pain
Burns
Third Degree
 Tissue is
destroyed
 Charred (white to
black)
 May lack feeling
Burns
Treatment
 Do not remove burned clothing unless
it is smoldering
 Cool burn rapidly (immerse burn in
cool water until pain relieved – 10
minutes maximum)
 Always do a complete assessment –
there may be other serious injuries
Burns
Treatment (cont.)
 Electrical: remove patient from source
with nonconductive material
 Chemical: flush with water for 10-20
minutes
 Cover with dry sterile dressing
 Treat for shock
 Always obtain medical care
Burns
Serious
 Monitor airway
 Reassess vital signs every 5 minutes
 Do not give fluids by mouth
 Do not place ice on any burn
Burns
Special Situations
 Eyes
Flush with water for 5 minutes
Cover both eyes
Burns
Special Situations
 Respiratory tract
Always a medical emergency
Singeing of nasal hairs
Cough
Hoarseness
Difficulty breathing
Near Drowning
Any Apparent Drowning
Evaluate for:
 State of consciousness
 Airway
 Breathing
 Circulation
 Identify other injuries
Near Drowning
Treatment
 Request medical assistance
 Inform emergency services of status
 CPR – check for responsiveness,
A
–B–C-D
 Treat for shock
Near Drowning
Treatment (cont.)
 Remove wet clothing
 Treat for hypothermia
 Constantly monitor airway
 Reassess vital signs every 5 minutes
Near Drowning
Documentation
 Length of submersion
 Temperature of water
 Fresh or salt water
 Use of drugs or alcohol
 Treatment rendered
Hypothermia
 Heat loss to water 32 times faster than
to air
 May simulate or accompany shock
Hypothermia
Signs
 Clouded mental capacity
 Breathing: slow and labored
 Pulse: weak, slow, irregular or absent
 Skin: cold
 Shivering
 Muscular rigidity
 Pupils: dilated
 Speech: slurred (as intoxicated)
Hypothermia
Life Expectancy Without Survival Suit
5
4
Hours In
Water
3
Safe
Marginal
Lethal
2
1
0
30
40
50
60
70
Water Temperature Degrees Fahrenheit
Safe: Most persons survive
Marginal: 50% expectancy of unconsciousness;
will probably result in death
Lethal: 100% expectancy of death
Hypothermia
Command Responsibility and Waiver
Authorization
Estimated Time Hours to Loss of
Useful
Consciousness
Dry Suit
Antiexposure
Coverall
Work Uniform
14
12
10
8
6
4
2
0
32 41 50 59 68
Water Temperature - Degrees Fahrenheit
Hypothermia
Treatment
 Remove from cold
 Place in warm, dry place
 Body to body contact in blanket
 Treat for shock
 Nothing by mouth
 Never give alcohol
 Do not rub frozen areas
 Always obtain medical care
Heat and Dehydration
 Dehydration can occur insidiously
 Before you leave drink 2-3 glasses of
fluid
 Maintain hydration 4-8 ounces every
30-60 minutes.
 Do not drink caffeinated beverages
 Do not drink alcoholic beverages
 Use shade and head cover
Heat and Dehydration
 Heat cramps
 Heat Exhaustion - dehydration
 Heat Stroke - hyperthermia
 Not perspiring, feeling hot, person may
not be adapting to the heat.
Cool down
Seek medical care immediately
Bleeding
 External
Apply direct pressure
Elevate wound
Use pressure points
Apply tourniquet (last resort)
 Internal
May not be apparent
Abdominal
Extremities
Bleeding
Direct Pressure
 Use a sterile dressing or clean cloth
 Fold to form pad
 Apply pressure directly over wound
 Fasten with bandage; knot over wound
 If bleeding continues, add second
pressure dressing
Bleeding
Pressure Points
Apply pressure where artery lies near
skin over bone.
Bleeding
Pressure Points
 Use pressure point closest to wound,
between wound and heart
 Superficial arteries: use flat surface of
several fingers
 Femoral artery, use heel of one hand
Bleeding
Tourniquet
 Use only if bleeding uncontrolled
 Use wide device
 Place two inches above wound
 Use enough pressure to stop bleeding
 Do not remove until directed to by
competent medical resources
 Place letter T on forehead and time applied
Bleeding
Tourniquet
Fractures
Signs and Symptoms
 Pain
 Swelling
 Bruise
 Deformity
 False Motion
 Crepitus
 Tenderness
 Exposed
fragment
 Locked joint
 Guarding
 Unable to support
weight
Fracture
Simple
 Two distinct bone
fragments
Fracture
Compound
 Bone penetrates
through skin
Fractures
Treatment
 Remove clothing from area
 Check ability to move and feel below
fracture
 Check circulation below fracture
 Cover open wound
 Splint
Immobilize joints above and below fracture
Reduces pain
Prevents additional damage
Pad all rigid splints
Fractures
Treatment (cont.)
 When in doubt, SPLINT
 Ice – not directly to skin
 Position injured limb slightly above
level of heart if easily possible
 Immobilize all suspected spinal
injuries
 Treat for shock
 Seek medical attention
Fractures
Splinting and Immobilizing
Sling
 Triangle bandage under injured arm; over
uninjured shoulder
 Tie ends of sling at side of neck – pad
under knot
 Secure arm with cravat under good arm
Fractures
Splinting and Immobilizing
(cont.)
Splints
Shirt Flap
Magazine
Shirttail
Formula for Safe Boating
 BE TRAINED
 BE PREPARED
 BOAT SAFELY
 BOAT SMART