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 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 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