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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