Chapter 19
Water Emergencies
Lesson Objectives
• Assess and manage submersion incidents.
• Assess and manage scuba diving injuries,
including breathing-gas problems and
decompression illnesses.
• Assess and manage marine animal stings,
including those from Portuguese man-of-war,
jellyfish, and sea anemone, as well as other
marine organisms.
Submersion Incidents (1 of 3)
• Drowning is defined as “the process of
experiencing respiratory impairment from
submersion/immersion in liquid.”
• Most submersion incidents are preventable.
Submersion Incidents (2 of 3)
• What to look for:
– Victim struggling in the water.
– Victim floating motionless.
– Victim lying at the bottom of a body of water.
• What to do:
– Assess your own resources and abilities.
– Rescue the victim. Remember to reach, throw,
row, and go.
Submersion Incidents (3 of 3)
• What to do (continued):
– Open victim’s airway and provide rescue
breathing, as needed.
– Perform resuscitation, as needed.
– Evacuate all victims who have been resuscitated.
– Observe victims closely who do not require
resuscitation.
Scuba Diving Injuries (1 of 7)
• Scuba: self-contained underwater breathing
apparatus
• Divers should be familiar with medical problems
from their certified training course.
• Non-divers should know the basic problems that
divers might face and how to provide appropriate
treatment.
Scuba Diving Injuries (2 of 7)
• Breathing-gas problems
– As depth and pressure increase, more gases
are able to dissolve in the blood.
– Excessive oxygen in the blood can cause
visual changes, confusion, and seizures.
– Increased nitrogen can cause nitrogen
narcosis.
– Hypoxia occurs when breathing air is used up.
Scuba Diving Injuries (3 of 7)
• Decompression
illnesses (dysbarism)
– Decompression
sickness (“the bends”)
– Arterial gas embolism
(AGE)
© louise murray/Alamy Images
Scuba Diving Injuries (4 of 7)
• Decompression illnesses (dysbarism)
– What to look for: AGE
• Unconsciousness
• Paralysis or weakness
• Convulsions
• Cardiac/respiratory arrest
• Dizziness or visual problems
Scuba Diving Injuries (5 of 7)
• Decompression illnesses (dysbarism)
– What to look for: Decompression sickness
• Joint or limb pain
• Paralysis
• Fatigue and weakness
• Breathing difficulty
• Numbness or tingling
• Rash
Scuba Diving Injuries (6 of 7)
• Decompression illnesses (dysbarism)
– What to do:
• Evaluate breathing and resuscitate as needed.
• Give 100% oxygen.
• Place victim in recovery position.
• Give victim sips of water if conscious and alert.
• Protect from excessive cold and heat.
• Protect from injury if seizure occurs.
Scuba Diving Injuries (7 of 7)
• Decompression illnesses (dysbarism)
– What to do (continued):
• Evaluate for other injuries.
• Do a neurologic exam.
• Contact local EMS and DAN
(Divers Alert Network)
• Get the victim with decompression
sickness to recompression therapy
in a hyperbaric chamber.
Courtesy of NOAA
Marine Animal Stings (1 of 6)
• Portuguese man-of-war
• Jellyfish
• Sea anemone
Marine Animal Stings (2 of 6)
• What to look for:
– Pain, varying in severity
– Whiplike streaks on the skin
– Blisters, welts, scattered red blotches
within 24 hours
– In severe cases: headache, dizziness,
paralysis, and anaphylaxis
– Possible coelenterate poisoning
Marine Animal Stings (3 of 6)
• What to do:
– Rinse with sea water.
– Do not touch tentacles with your bare hands.
– Apply vinegar, rubbing alcohol, or household
ammonia for 30 minutes.
– Apply shaving cream or baking soda paste and
shave the area to remove nematocysts.
Marine Animal Stings (4 of 6)
• What to do:
– Reapply vinegar or alcohol and soak for
another 15 minutes.
– Apply hydrocortisone cream, antihistamine
cream, or anesthetic ointment twice a day.
Marine Animal Stings (5 of 6)
• Other marine life
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–
–
–
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Stingrays
Sea urchins
Catfish
Stonefish
Scorpion fish
Marine Animal Stings (6 of 6)
• Other marine life
– What to do:
• Irrigate with water.
• Soak in hot water for 30 to 90 minutes.
• Remove obvious pieces of barb.
• Treat as a puncture wound.
• Seek medical attention promptly.
• Consider a tetanus booster.