Transcript LECTURE First Aid - World-Wide-Sail

FIRST AID ABOARD THE NAV 44 MK II
Allan Lohaus, MD
THIS PRESENTATION: An Overview
An Ounce of Prevention is Worth a Pound of Cure…Ben Franklin
First Aid as a Damage Control Effort
Being Prepared
Skills Session
Assessment of Illnesses, Injuries, and Emergencies
Events Aboard NAV 44 EXPERIENCE
Debrief
First Aid as a Damage Control Effort: Prevent, Contain, Repair
Review all Warnings in BIB: these operating procedures,
practices or conditions may result in Injury or Death to
Personnel, if not carefully observed or followed.
Operate Engine with 20 degrees of heel or less
Overhead Clearance and Water depth
Audible Alarms require Key in “on” position
Sulfur Odor in Cabin
The Gybe and Preventers
Expansion Tank contains Steam and Hot Water
Keep cockpit microphone in scan position
Being Prepared
• Know crew members’ medical histories, medications and allergies
• Don’t Assume crew members are physically fit: ask about limitations.
• Take Responsibility for Administering First Aid
• Chain of command: CO/XO >OTC>DNAS
• Communication links: Use 2013 OFFSHORE OPORDER
• Have a plan for record keeping of First Aid Events
• Keep a minor First Aid Kit in Galley
Skills Session
Measure Pulse: Palpate pulse in radial artery in the wrist under the thumb.
Count for 10 seconds, multiply by 6 = beats per minute.
Pulse is normally regular, if irregular report it as such.
Measure Respirations: Observe chest excursion
Count for 15 seconds, multiply by 4 = respirations /min
Assess Pupil Status: Observe the size of right pupil, shine light from temple
into eye and observe response. Repeat on left eye. Normally, pupils are equally
dilated, and constrict with light application. Report if pupils unequal, or
unreactive; fixed either as dilated or constricted.
Assessment of Illnesses
• Sea Sickness
• Infections
• Dehydration
• Allergic Reactions and Asthma
• Pain as a Presenting Symptom
SEA SICKNESS
• A general feeling of being unwell (malaise)
• Headache
• Nausea or vomiting, or both
• Cold sweating, which means you sweat even though you're not overheated
• A pale appearance
PREVENTION:
SEA BANDS (ACUPRESSURE WRIST BANDS)
MECLIZINE 25 MG every 12 hrs STARTING PRE-SAIL
Neck collar
MANAGEMENT: Saltines, gingersnaps, sips of non-carbonated caffeine
free fluids, fresh air, take the helm, heave to leeward, Tylenol for headache.
Infections
Invasion of body tissues by disease causing bacteria, viruses or parasites
Skin: Boils
Cellulitis
Infections
Mouth
Respiratory, Gastrointestinal, Genitourinary and Eye
DEHYDRATION
The loss of more fluids than are replaced
Allergic Reactions
An over reaction of the body’s natural defense system
Rashes caused by foods, medicines and latex:
Asthma: a lung disease that inflames and narrows the airways
causing wheezing .
Anaphylaxis; A rapidly progressing life threatening
reaction affecting many body systems.
allergic
Pain as a Presenting Symptom of Illness
Scale 1-10 used to quantify event. 10= worst pain in the world
• Headache
• Chest Pain
• Abdominal
• Flank
• Back
• Limbs
Assessment and Management of Injuries
• Lacerations and Contaminated Wounds
• Burns
• Eye Injuries
• Contusions, Abrasions and Crush Injuries
• Neck Injuries
Lacerations and Contaminated Wounds
Contusions, Abrasions and Crush Injuries
BURNS
THERMAL
2nd Degree
3rd Degree
ROPE
EYE INJURIES AND INFECTIONS
Assessment and Management of Emergencies
• Fractures
• Arterial Bleeding
• Body Temperature Crises
• Loss of Consciousness
• Head Trauma
• Heart Attack
THESE REQUIRE 911 TYPE ASSISTANCE
First Aid Kit Aboard NAV 44
Yellow or Red Tool Box
EVENTS ABOARD NAV 44 EXPERIENCE
Events Aboard NAV 44 EXPERIENCE
•All hands are on deck immediately following a daytime Crew Overboard recovery from 62
degree waters off Point-No-Point in the Bay. The CO takes charge.
•Underway in heavy weather a member of the off watch crew rushes into the cockpit and
vomits over the rail. The Watch Captain responds.
•Underway at night, a member of the oncoming watch is in the galley heating soup when the
boat heels sharply to port scalding his unclothed left lower leg; causing a 2nd degree burn.
The CO is on deck.
•At the Santee Basin dock during preparation for a day sail, a crew member opens the aft
port hole. It springs out lacerating his right eyelid. The CO, XO and Sr. Watch Captain are at
the morning briefing at RCC. You take charge.
•Sixty miles northeast of Cape May NJ, the Skipper begins to perspire, grasps his chest and
collapses to the deck. The Watch captain takes charge.
•A thirsty MIDN opens the aft reefer (refrigerator), fails to latch it, and the door slams shut
crushing the base of his left thumb.
DEBRIEF
DEBRIEF
Did you……
• Stay calm.
• Splint and immobilize the neck of anyone complaining of neck pain before
you moved them.
• Move the patient to a secure bunk.
• Start first Aid for bleeding, take pulse and respirations.
• Find out exactly what happened.
• Call your medical resource: Report the situation clearly and calmly.
• Use a form.
• Clarify all advice you received.
• Prepare and carry out a plan.