BOAT CREW TRAINING First Aid

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BOAT CREW TRAININGFirst Aid

• Guenther H. Hennig
• FL 86, D7 USCGAUX

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FIRST AIDThe Road Map

• The Topics will be presented in the same sequence
  as you see it in your
• RECORD OF COMPLETED TASKS

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FIRST AID

• Section A
• Crew Efficiency
• Sun Heat Related Considerations

• Section B
• Physical Fitness
• Crew First Aid Responsibility
• Symptoms Treatment of Shock
• Symptoms Treatment of Anaphylactic Shock
• next slide

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FIRST AID

• Section B
• Control of Bleeding
• Direct Pressure
• Pressure Points
• Tourniquets
• S S of Burns
• Hypothermia

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FIRST AID
Section c Occasions may arise where you will be
confronted with medical/health problems for which
you have received no training HOW TO treat the
conditions. However, you will most likely have
sufficient knowledge to be aware that a
medical/health problem exists. What to do?
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CREW FATIGUEBCM-01-01 AUX

• Feeling well contributes greatly to successful
  completion of mission
• Everyone has physiological and psychological
  limits of endurance
• Fatigue reduces powers of observation,
  concentration
• Causes of extreme fatigue?

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CREW FATIGUEBCM-01-01 AUX

• CONTRIBUTORY FACTORS
• Extreme hot or cold weather
• Eye strain
• Maintaining balance
• Exposure to noise, sun
• Physical Fitness
• Lack of sleep
• Boredom
• Stress associated with all of the above

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CREW FATIGUEBCM-01-01 AUX

• SYMPTOMS OF FATIGUE
• INABILITY TO FOCUS, CONCENTRATE, DECREASED
  ATTENTION SPAN
• JUDGEMENT ERROR CONFUSION
• MOTOR SKILLS AND SENSORY ABILITY DECREASED
• EASY TO ANGER
• DECREASED PERFORMANCE
• DECREASED CONCERNS FOR SAFETY

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CREW FATIGUEBCM-01-01 AUX

• PREVENTIVE MEASURES
• Adequate Crew Rest
• Appropriate Clothing for Weather conditions
• Rotation of Crew Duties
• Appropriate Food and Refreshments
• Observe other Crewmembers for signs of fatigue

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CREW FATIGUEBCM-01-01 AUX

• CONTRIBUTING ENVIRONMENTAL FACTORS
• Motion Sickness
• Glare from Sun
• Rough Sea Conditions, Wind
• Rain and/or Snow
• Vibrations
• Noise

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Sun and Heat Related ConcernsBCM-01-02 AUX

• Too much exposure to Sun and/or Heat is VERY
  DANGEROUS
• Heat causes FATIGUE
• Decreases PERFORMANCE

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Sun and Heat Related ConcernsBCM-01-02 AUX

• Commonly Used ,VERY Important Terms
• HYPERTHERMIA
• Too Much Heat, gt 105F and above Body Core
  Temperature
• HYPOTHERMIA
• Not Enough Heatlt95F and below Body Core
• Temperature

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Sun and Heat Related ConcernsBCM-01-02 AUX

• Extended Exposure to Sun and Heat will contribute
  to decreased Performance.
• Extended Exposure to Sun and Heat may lead to
  serious Medical problems

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Sun and Heat Related ConcernsBCM-01-02 AUX

• SUN HEAT related PROBLEMS
• Sun burns
• Dehydration
• Heat Rash
• Heat Cramps
• Heat Exhaustion
• Heat Stroke
• Contributing Factors

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Sun and Heat Related ConcernsBCM-01-02 AUXSUN
BURNS

• Identified by
• Redness, Swelling, Blistering
• Related Findings
• Fever
• GI Problems
• Skin Pigment Changes
• Treatment
• Prevention, Sunblockers Avoid Overexposure Cool
  moist towels

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Sun and Heat Related ConcernsBCM-01-02 AUX

• Heat Rash
• A fine rash associated with long exposure to
  sun and/or heat. Failure of Heat Regulatory
  Center, lack of Perspiration. Will disappear when
  heat exposure hazard has been eliminated.
  Associated with severe itching, difficulty
  sleeping

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Sun and Heat Related ConcernsBCM-01-02 AUX

• Heat Cramps
• Painful, involuntary, muscle contractionsCRAMPS
• Especially Lower Extremities,
• Abdominal Musculature
• Treatment
• Cool Place
• Encourage Fluid Intake, Water, Electrolyte
  Solutions Sports Drinks, Gatorade, etc

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Sun and Heat Related ConcernsBCM-01-02 AUX
Dehydration

• Signs and Symptoms
• Dry Mouth
• Dizziness
• Headache
• Difficulty Breathing
• Tingling in Extremities
• Skin color bluish-grey
• Slurred Speech
• Inability to walk
• Cramping, GI and extremities

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Sun and Heat Related ConcernsBCM-01-02 AUX

• Dehydration Loss of Extracellular and
  Intracellular Fluid
• Ordinary Fluid Intake/day 2 3 Liters of
  water/day
• Fluid Loss Routinely Urination, Sweating,
  Breathing
• Fluid Loss preferably replenished by WATER not
  by coffee, tea, soda, alcohol and or Electrolyte
  Solutions

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Sun and Heat Related ConcernsBCM-01-02 AUX

• Avoid excessive Fluid Loss by
• Drinking plenty of water
• Observe color of Urine
• Dark yellow, gold or brown colored urine
  indicates fluid replacement is necessary
• Drastically reduced urinary output, fluid
  replacement is a must
• Do not use Coffee, Tea, Sodas, Alcohol

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Sun and Heat Related ConcernsBCM-01-02 AUX

• REMEMBER
• Never force fluids by mouth when the patient is
  either semiconscious or unconscious

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Sun and Heat Related ConcernsBCM-01-02 AUX HEAT
EXHAUSTION

• Heat Exhaustion is a worsening stage of Heat
  Related Problems.
• First Stage Heat Rash, Heat Cramps Extremities,
  GI
• Second Stage Heat Exhaustion
• Third Stage Heat Stroke
• Associated with EXCESSIVE WATER LOSS

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Sun and Heat Related ConcernsBCM-01-02 AUX HEAT
EXHAUSTION

• Symptoms
• Profuse Perspiration
• Nausea
• Pounding Heartbeat
• Pale Skin
• Headaches
• Restlessness

• Treatment
• Place patient in a cool environment
• Supine Position
• Cool patient fanning
• Call for Medical Help

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Sun and Heat Related ConcernsBCM-01-02 AUXHeat
Stroke

• HEAT STROKE IS A VERY SERIOUS MEDICAL EMERGENCY
• Few Patients Survive
• Temps gt105F and higher
• Skin is dry
• Skin feels hot

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Sun and Heat Related ConcernsBCM-01-02 AUXHeat
Stroke

• Patient is confused, lacks coordination,
  delirious
• Patient may be unconscious
• Brain damage will occur unless rapid medical
  treatment is provided Air Evac
• Immediate threat to life
• Heat Regulatory Center no longer functioning

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Sun and Heat Related ConcernsBCM-01-02 AUX

• Contributing Factors
• Impermeable Clothing
• Excessive Body Weight
• Febrile Illnesses
• Alcohol Consumption
• Fatigue
• Insufficient FluidWater Intake

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Physical FitnessBCM-02-01-AUX

• As a member of the USCGAUX it is the members
  responsibility to advise the Coxswain of the
  AUXFAC of any physical disabilities or weaknesses
  which might make it impossible for the member to
  complete an assigned task, thus jeopardizing the
  safety of the vessel and crew.

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Crew First Aid ResponsibilityBCM-02-02-AUX

• First Aid may be rendered by Crew members
  consistent with their training.
• Notify Controlling Station of Medical Emergencies
  encountered
• If believed necessary, request medical
  assistance

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Crew First Aid ResponsibilityBCM-02-02-AUX

• When Arriving on Scene
• Status of Training
• Evaluate
• Self Protection
• Remain Calm
• Act Quickly
• Call Controlling Station, advise and/or request

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Crew First Aid ResponsibilityBCM-02-02-AUX

• Evaluate
• Number of victims
• General Condition
• Type of injury
• Level of consciousness

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Crew First Aid ResponsibilityBCM-02-02-AUX

• Self Protection
• Use protective devices Goggles, Gloves, Masks,
  Protective Clothing
• Avoid Contact with Blood and/or other body fluids
  or excrements
• Dispose of protective devices/clothing in a
  proper manner contact Medical Facility for
  where, when and how to dispose of material

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Crew First Aid ResponsibilityBCM-02-02-AUX

• Self Protection
• If inadvertent contact with blood and other body
  fluids has occurred, contact USCG MEDICAL
  FACILITIES immediately for professional advice

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SHOCKBCM-02-03-AUX

• SHOCK IS A DEPRESSED PHYSIOLOGICAL AND/OR MENTAL
  STATE
• THERE ARE MANY TYPES OF SHOCK.
• Most common types
• Hypovolemic Loss of blood, inter and
  intracellular fluid
• Anaphylactic very severe, sudden, allergic
  reaction can lead to sudden death

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SHOCKBCM-02-03-AUX

• ONSET, SUDDEN OR DELAYED depending what caused
  shock
• Trauma
• Allergic Reaction
• Hypothermia
• Hyperthermia
• Drugs

• 6. Toxins
• Heart Attack
• Illness I.e. diabetes
• Emotional
• High Fever

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SHOCKBCM-02-03-AUX
SIGNS AND SYPTOMS
SIGNS AND SYPTOMS SIGN Objective Evidence of
patients changing condition SYMPTOM Subjective
Evidence of patients changing condition
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SIGNS AND SYMPTOMS SHOCK BCM-02-03-AUX

• SYMPTOMS
• Restlessness
• Anxiousness, Fright
• Faint, Dizziness
• Weakness
• Thirst
• Nausea

• SIGNS
• Pulse weak, rapid
• Breathing rapid, shallow, irregular
• Skin cold, clammy,
• Pupils dilated
• Consciousness ?

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TREATMENT OF SHOCK BCM-02-03-AUX

• Place Patient In Supine Position, elevate legs
• Establish Vital Signs P, R, BP
• Control Hemorrhage
• Patient unconscious or semiconscious, ask for
  medical assistance
• Keep patient warm or cool, depending on cause of
  shock
• Obtain medical and medication Hx if possible

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TREATMENT OF SHOCK BCM-02-03-AUX

• Handle gently
• Moisten lips, how?
• CPR if the care provider is trained, qualified
  and certified

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ANAPHYLACTIC SHOCK BCM-02-04-AUX

• Anaphylactic Shock is a very serious Allergic
  Reaction with Sudden Onset.
• It can be caused by medications penicillin,
  food shellfish, stings, bees, wasps, aerosols
  pollen.
• Death can be almost instantaneous

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TREATMENT OF ANAPHYLKACTIC SHOCK BCM-02-04-AUX

• Signs
• Wheals, hives, rash, swelling lips, eyelids,
  tongue, throat, ears, bronchi wheezing,
  shortness of breath, coughing
• Loss of consciousness
• Vomiting ?

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TREATMENT OF SHOCK BCM-02-04-AUX

• Symptoms
• Itching of Skin
• Headaches
• Nausea
• Feeling Of Impending Doom
• Dizziness

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TREATMENT OF ANAPHYLACTIC SHOCK BCM-02-04-AUX

• TREATMENT WHAT TO DO
• If patient carries an anaphylactic shock kit
  Epinephrine Kit, assistance may be rendered to
  administer the drug
• Keep Controlling Station apprised
• Record, record, record
• Do not hesitate to ask for medical assistance
• Death May Occur in Minutes

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TREATMENT OF ANAPHYLACTIC SHOCK BCM-02-04-AUX

• REALIZE
• Hyperanxiety will produce some of the symptoms
  associated with anaphylaxis
• Diabetes will produce some of symptoms associated
  with anaphylaxis
• Hyperventilation will produce some of symptoms
  associated with anaphylaxis

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CONTROLL OF HEMORRHAGEBCM-02-05-AUX

• TYPES OF BLEEDING
• Arterial Bright red, pulsating, synchronous with
  pulse
• Venous Darker red, not pulsating, steady
• Capillary Continuous oozing

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CONTROLL OF HEMORRHAGEBCM-02-05-AUX

• Treatment Modalities Methods
• Direct Pressure
• Digital Finger pressure to specific anatomical
  areas, PRESSURE POINTS

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUX
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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUX Temporal Pressure Point

• Location Scalp or Head
• Procedure Use this pressure point for no
  longer than 30 seconds as it may cut off blood to
  the brain

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUX Facial Pressure Point

• Location located in the ridge along the
  lower edge of the bony structure of the jaw
• Use only for a minute or two to help slow blood
  flow from a cut on the face

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUXCarotid Artery Pressure Point

• Location Begin at the trachea at the midline
  of the neck
• Procedure - Slide your fingers to the site of
  the bleeding and feel for the pulsations of the
  carotid artery. Place fingers over the artery
  with thumb behind the neck. Apply pressure by
  squeezing fingers toward the thumb. Never apply
  pressure to both sides of the neck at the same
  time. Apply pressure for only a few seconds
  because this cuts off blood circulation to the
  brain.

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUXSubclavian Pressure Point

• Location deep behind the collar bone in the
  sink of the shoulder
• Procedure Push thumb through the thick layer
  of muscle at the top of the shoulder and press
  the artery against the collarbone

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUXAxillary Pressure Point

• Location Under the upper arm
• Procedure Press the artery just under the
  upper arm against the bone from underneath

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUXBrachial Pressure Point

• Location Groove on the inside of the arm and
  elbow two locations near the elbow joint
• Procedure Apply pressure to the point, grasp
  the victims arm with the thumb on the outside of
  the arm and fingers on the inside. Press Fingers
  towards the thumb.

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUXRadial and Ulnar Pressure
Points

• Location Radial point located on the forearm
  close to the wrist on the thumb side of the hand.
  Ulnar point is located on the little finger side
  of the hand
• Procedure Apply pressure to both points to
  control bleeding of the hand. Use the radial
  point to control bleeding of the wrist

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUXFemoral Pressure Point

• Location Front center part of the crease in
  the groin area, pelvic basin. 2 locations
• Procedure Used to control severe bleeding on
  the lower extremity and leg amputation. Place
  heel of hand directly on the point and apply a
  small amount of pressure to the artery across the
  pelvic basin.

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUXPopliteal Pressure Point

• Location Back of the knee
• Procedure Apply pressure to the point to
  control bleeding from a leg wound

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUXDorsalis Pedis Pressure Point

• Location Top of the foot
• Apply pressure to control bleeding from the foot
  and toes

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUXPressure Bandage

• A pressure bandage can replace direct hand
  pressure on most parts of the body. Apply the
  pressure bandage by placing the center of the
  bandage or strip of cloth directly over the pad.
  Hold the pad in place by circling the bandage
  ends around the body part and tie it off with a
  knot directly over the pad.

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUXTourniquet

• If severe bleeding cannot be controlled after
  trying all other means and the victim is in
  danger of bleeding to death, use a
  tourniquet-They are extremely dangerous
• Used only on arms and legs
• It is a constricting band placed around an
  extremity then tightened until bleeding from an
  artery has stopped

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUXTourniquet

• Place the tourniquet 2-3 inches above the wound
  (between wound and heart) but not touching the
  wound edges. If the wound is in a joint area or
  just below a joint, place the tourniquet directly
  above the joint
• Wrap the tourniquet band tightly around the limb
  twice and secure it in place

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUXTourniquet

• Attach a note to the victim giving the location
  of the tourniquet and the time that it was
  applied.
• If you cant attach a note, write the letter T
  on the patients forehead and the time it was
  applied
• Always leave the tourniquet exposed to view

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CONTROLL OF HEMORRHAGE, Pressure
PointsBCM-02-05-AUXTourniquet

• The tourniquet should only be tight enough to
  stop the bleeding
• Once applied, do not loosen it unless you can
  initiate primary control of the bleeding by
  direct pressure or packing with pressure,
  followed by the release of the tourniquet.
• Continue to treat for shock and obtain medical
  attention IMMEDIATELY

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CONTROLL OF HEMORRHAGEBCM-02-05-AUX

• Generally, the best and most
  simple method to control
• Significant Bleeding, is the
  application of DIRECT PRESSURE
• to the bleeding area wound

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BURNSBCM02-06-AUX

• Classification of Burns
• First Degree Involves outer layer of skin
  produce redness, warmth, tenderness, minimal pain
• Second Degree Extends through outer layer of
  skin, produces blisters, redness, pain
• Third Degree Penetrates full thickness of skin
  color white to black charred pain may or may
  NOT be severe

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TREATMENT of BURNSBCM02-06-AUX

• 1st deg. Immerse in cool water for 20 minutes
  cover with sterile or clean airtight wrap.
• 2nd deg. Same as above, do not puncture blisters
• 3rd deg. Cover burn with sterile, nonstick,
  material, DO NOT apply any OINTMENT Vaseline
• Immediately request medical assistance

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HYPOTHERMIABCM-02-08-AUX

• Definition A lowering of a persons core
  temperature below 95F 35C
• It is the leading cause of death among survivors
  of shipwrecks and other disasters at sea
• Do not delay treatment
• Struggle to aid their own rescue may kill the
  victims

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HYPOTHERMIABCM-02-08-AUX

• Quiz Question
• What is the name of the condition directly
  opposite to Hypothermia?

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HYPOTHERMIABCM-02-08-AUX

• Person in the Water exerting too much energy, may
  incur Loss of Body Temperature Hypothermia
• Person recovered from water may continue to lose
  body temperature if untreated
• Cold Air may cause Hypothermia due to inadequate
  clothing

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SIGNS AND SYMPTOMS HYPOTHERMIABCM-02-08-AUX

• Signs
• Disorientation, slurry speech,
• Pupillary reflexes are absent
• Cold Skin, Low Body Temp, shivering looks
  Shocky
• Lowered BP, slow, weak pulse,
• Slow, labored breathing
• State of consciousness ?

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SIGNS AND SYMPTOMS HYPOTHERMIABCM-02-08-AUX

• SYMPTOMS
• Feels cold
• Difficulty breathing
• Generalized Weakness
• Disoriented
• Feels not well, lethargic

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TREATMENT of HYPOTHERMIABCM-02-08-AUX

• Remove from cold, get to a warm environment
• Remove wet clothes and get dry clothes or
  blankets on
• Check breathing and pulse frequently
• Avoid rough handling
• Get medical help
• Apply CPR if needed qualified ?

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TREATMENT of HYPOTHERMIABCM-02-08-AUX

• Call for immediate Medical Assistance
• Death may occur rapidly

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BOAT CREW TRAININGFirst Aid

• REMEMBER
• Unless you are
• TRAINED,
• QUALIFIED and/or
• CERTIFIED
• DO NOT RENDER TREATMENT BUT ASK FOR MEDICAL
  ASSISTANCE/ADVICE

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BOAT CREW TRAININGFirst Aid

• The End!
• Thank you for your interest

Guenther H. Hennig