Basic Boating First Aid

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Basic Boating First Aid

• Joshua Hawley

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• Captain Tri-Community Fire Department
• Vice President Bridgeton EMS
• EMT-Basic
• USMC Active Duty 10 years

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Training Topics

• First aid kit contents
• Handling Basic Emergency Medical Situations

Please write down any questions and hold until
end of presentation.
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Basic First Aid Kit

• Buy or Build your own?
• Make sure its well marked and easily found on
  vessel
• First Aid Book

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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

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First Aid

• Doing what must be done to
• Stabilize (before medically trained personnel
  arrive)
• Transport (to an appropriate medical facility)

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First Aid

• Initial examination
• Determine Primary Problem
• Responsiveness
• Airway
• Breathing
• Circulation
• Determine Seriousness (Priority)
• Look for any additional problems

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Communication

• Activate appropriate emergency services
• Call 911
• Channel 16 USGC
• Provide pertinent information
• Receive advice for care

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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

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Neck or Spinal InjuriesCauses

• Boating Collisions
• Falls
• Blunt trauma
• Penetrating trauma to head, neck, or torso
• Springboard or platform diving accidents

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Neck or Spinal InjuriesSigns 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

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Neck or Spinal InjuriesProtect Spine

• Manual Stabilization
• Hold patients head still
• Maintain head in position found
• Do not turn to either side
• Do not tilt forward or backward

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Neck or Spinal InjuriesProtect Spine

• Manual Stabilization
• Kneel behind the patient
• Spread your fingers and thumbs around the sides
  of the head
• Hold the head steady

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Shock(Compensation)

• Multiple Causes
• Trauma (bleeding, blunt, burns)
• Allergic reactions
• Drugs
• Hypothermia
• Toxins
• Emotional
• Near drowning

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ShockOnset and Symptoms

• Rapid or delayed (hours) after apparent cause

• Restless
• Faint
• Thirsty
• Nauseated

• Frightened
• Weak
• Anxious
• Dizzy

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ShockSigns

• State of consciousness alert (may be deceiving)
  to unconscious
• Breathing shallow, rapid, irregular
• Pulse weak and rapid
• Skin cold, clammy (sweating)
• Pupils dilated

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ShockTreatment

• 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

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AnaphylaxisDefinition

• An immediate, life threatening systemic
• allergic reaction

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AnaphylaxisTriggers (examples)

• Foods peanuts, tree nuts, shellfish, fish,
  milk, eggs, food additives
• Medications antibiotics, muscle relaxants,
  seizure medications, beta-blockers
• Insect stings bees, wasps, hornets, yellow
  jackets, fire ants
• Exercise and cold

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AnaphylaxisSymptoms

• Onset
• Can be only seconds or up to 2 hours after
  incident
• Reaction may recur up to 24 hours after first
  reaction

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AnaphylaxisSymptoms (General)

• Hives
• Bronchoconstriction (closing of airway)
• Headache
• Loss of consciousness

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Anaphylaxis

• Do NOT minimize an allergic reaction
• DEATH can occur within minutes

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AnaphylaxisTreatment

• Obtain medical attention regardless of response
• Epinephrine (EpiPen, AnaKit)
• Ice pack locally if applicable
• Antihistamines (Benadryl)
• Tourniquet (last resort)
• Treat for shock

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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

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EpiPen (cont.)

• Remove unit and massage injection area for
  several seconds
• Check black tip
• If needle is exposed you received the dose
• If not, repeat steps 5-8
• Bend the needle back against a hard surface
• Carefully put the unit (needle first) back into
  the carrying tube (without the gray activation
  cap)
• Recap the carrying tube

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EpiPen (cont.)

• 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

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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

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BurnsNormal Skin
Dermis
Fat
Muscle
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BurnsFirst Degree

• Only outer layer of skin
• Mild pain
• Redness
• Warmth
• Tenderness

Skin Reddened
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BurnsSecond Degree

• Inner layer of skin
• Red
• Warm
• Tender
• Blister
• Severe pain

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BurnsThird Degree

• Tissue is destroyed
• Charred (white to black)
• May lack feeling

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BurnsTreatment

• 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

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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

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BurnsSerious

• Monitor airway
• Reassess vital signs every 5 minutes
• Do not give fluids by mouth
• Do not place ice on any burn

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BurnsSpecial Situations

• Eyes
• Flush with water for 5 minutes
• Cover both eyes

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BurnsSpecial Situations

• Respiratory tract
• Always a medical emergency
• Singeing of nasal hairs
• Cough
• Hoarseness
• Difficulty breathing

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Near DrowningAny Apparent Drowning

• Evaluate for
• State of consciousness
• Airway
• Breathing
• Circulation
• Identify other injuries

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Near DrowningTreatment

• Request medical assistance
• Inform emergency services of status
• CPR check for responsiveness, A B C
  - D
• Treat for shock

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Near DrowningTreatment (cont.)

• Remove wet clothing
• Treat for hypothermia
• Constantly monitor airway
• Reassess vital signs every 5 minutes

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Near Drowning Documentation

• Length of submersion
• Temperature of water
• Fresh or salt water
• Use of drugs or alcohol
• Treatment rendered

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Hypothermia

• Heat loss to water 32 times faster than to air
• May simulate or accompany shock

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HypothermiaSigns

• Clouded mental capacity
• Breathing slow and labored
• Pulse weak, slow, irregular or absent
• Skin cold
• Shivering
• Muscular rigidity
• Pupils dilated
• Speech slurred (as intoxicated)

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HypothermiaLife Expectancy Without Survival Suit
Hours In Water
Water Temperature Degrees Fahrenheit
Safe Most persons survive Marginal
50 expectancy of unconsciousness will
probably result in death Lethal 100
expectancy of death
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HypothermiaCommand Responsibility and Waiver
Authorization
14 12 10 8 6 4 2 0

• Estimated Time -
• Hours to Loss of Useful Consciousness

Dry Suit Antiexposure Coverall Work Uniform
32 41 50 59 68
Water Temperature - Degrees Fahrenheit
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HypothermiaTreatment

• 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

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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

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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

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Bleeding

• External
• Apply direct pressure
• Elevate wound
• Use pressure points
• Apply tourniquet (last resort)
• Internal
• May not be apparent
• Abdominal
• Extremities

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BleedingDirect 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

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Bleeding Pressure Points
Apply pressure where artery lies near skin over
bone.
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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

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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

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Bleeding Tourniquet
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FracturesSigns and Symptoms

• Pain
• Swelling
• Bruise
• Deformity
• False Motion
• Crepitus

• Tenderness
• Exposed fragment
• Locked joint
• Guarding
• Unable to support weight

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FractureSimple

• Two distinct bone fragments

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FractureCompound

• Bone penetrates through skin

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FracturesTreatment

• 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

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FracturesTreatment (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

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FracturesSplinting 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

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FracturesSplinting and Immobilizing(cont.)
Splints
Magazine
Shirt Flap
Shirttail
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Formula for Safe Boating

• BE TRAINED
• BE PREPARED
• BOAT SAFELY
• BOAT SMART