We’ve put together a short film with a demonstration of Basic Life Support. It runs through the most likely causes of Cardiac Arrest onboard, how to recognise it and what to do. We can’t stress enough how important it is to start CPR as soon as possible.
Survival rates reduce by 10% for every minute that nothing is done.
CPR doubles the chance of survival.
Using an AED triples the chance of survival.
First things first…
Make sure everyone onboard knows where your AED is.
Check that it’s serviced regularly and whoever is responsible is checking it on a regular basis. The last thing you need in an emergency is a flat battery or bits missing.
Think about the last time you organised a drill. Does everyone know who should be doing which tasks in the event of a cardiac arrest?
This link will take you to our video tutorial which talks you through how to check your AED, safety and maintenance, and a demonstration of how to use it. Feel free to share the link and show it to your crew too. It is only 15 minutes long so an ideal tool box talk.
There are lots of things to consider with regard to airway management, but for the purpose of this video tutorial, we’re sticking to the equipment and techniques that are regulated for STCW, and that are M1905 compliant. This means you should have the equipment onboard, and have already been trained in these techniques, making this a really handy refresher!
During the short film, we’ll run through the techniques to carry out a head tilt, chin lift, a jaw thrust, manual suction and sizing and fitting an oropharyngeal airway (OPA).
Airway management is at the start of the ABCs because it’s the most important. Quite simply, if you don’t have an open, (or patent) airway, anything else you do is pretty pointless. Knowing how to manage an airway really is the difference between life and death.
The Primary Survey helps you to prioritise what happens next in terms of what help or equipment you need, and the appropriate treatment, and extrication of the patient if required.
We work to a tried and tested algorithm, DRSCABCDE, which you should all be familiar with. It’s also important to note that all of the information relates to equipment and techniques detailed in MSN 1905 - Ships Medical Stores.
There’s a lot of information to review, so part one is taking you from Danger to Breathing. Next time we will cover C to E and handing over.. We’ve also added in some relevant examples of what to do, and sometimes what not to do!
In Part 1 we looked at D to B in our tried and tested algorithm, DRSABCDE, which you should all be familiar with. In Part 2 we run through C to E. It’s also important to note that all of the information relates to equipment and techniques detailed in M1905. We’ve also added in some relevant examples of what to do, and sometimes what not to do!
We’re taking a closer look at strokes, and the video tutorial below will give you a basic overview of what a stroke is, what the risk factors are, the signs and symptoms and what to do if you think someone might be having a stroke.
This little gem contains all the documentation that you will need to fill in when assessing someone who is ill onboard ship.
Just pick up your Flag State Medical Guide and grab this little beauty and you are good to go!
Here we’re taking a first look at wound management. But as we’ve got so much to tell you about this topic (can you tell that we love what we do?), the second part will be covered seperately.
You’ll find links to three video presentations below, covering the basics of Wound Management, Wound Cleaning and the first part of closing and protecting a wound, Steri strips.
You’ll find links to three video presentations below, covering the basics of Wound Stapling, Skin Sutures and Paraffin Gauze. It should be a useful reminder of the what, how and when in case it’s not something you’ve had to do since your last course or refresher.
WARNING: There are a few quite graphic images of wounds, so if you’re a bit squeamish, you have been warned!
The tutorial takes you through a step by step protocol to help manage finger injuries.
The advice on dressing a simple cut shows how to use the medical kit that you have onboard - at last, you get to find out what to do with that odd looking piece of plastic! We often get asked what it is (it’s called a finger stall or finger stock) and how to use it on our courses.
Once you’ve dealt with the injury, and assuming that the casualty remains onboard, you’ll need to monitor for any infection. If infection, even from a small wound, is left untreated, it can develop into Sepsis which can be life threatening. So, you’ll need to watch out for redness, swelling, heat and increased pain in and around the wound. Pus is a waste product that signifies infection and if your casualty appears unwell and/or has a temperature, you would want to check the wound.
Treatment for an infection could be as simple as removing the dressing, cleaning the wound and redressing it. But it could involve a call to your telemedicine provider and a course of antibiotics being administered.
In November 2018, before the world changed due to Covid, S/Y Banyu Aman set off from the Canaries with a family onboard, to sail around the world.
Before they departed, Christina and Jeremy (and their two children) took part in a medical drill with us. The idea being to find out what they would do and how they would manage as a family if one of them became injured in the middle of an ocean. We’d like to reassure you that no children were harmed in the making of this case study - in fact you can hear them in the background jumping around on the pontoon!
Together with our Telemedicine partner, Dr Ross of Praxes, we set up a scenario involving Christina and Jeremy’s daughter. The story was that she had fallen on the foredeck and had a head injury.
The first consideration the couple noticed was the difference in running an onboard scenario compared to a classroom. Speed, motion and safety all became very real! The initial step they carried out was to slow the boat and secure all crew members, whether going forward to help or remaining in the cockpit.
The ‘casualty’ was found to be conscious but a little dizzy. As she was able to move, the decision was made to relocate to the cockpit for safety.
Once everyone was in the cockpit, Christina and Jeremy noted that although they’d recently attended a medical course, they did get a little confused by their limited knowledge. They realised how much they’d forgotten in just a few weeks.
They got to a point in the exercise where they felt confident that they had done everything they could. But they didn’t know what to do next or how to establish just how bad the injury was. So they appreciated having the option of phoning a telemedicine service to talk through the incident, what they needed to check and monitor, how to manage the casualty and when to become concerned.
You can see the follow up interview with Dr Ross (Praxes) Christina and Jeremy below.
S/Y Banyu Aman Case Study video
Some of the key learning points that the family took away from the exercise were the small but practical precautions they could put in place to make life easier in an emergency. Little things like having the pulse oximeter in a more handy location rather than buried in the grab bag, having a satellite phone that isn’t fixed down below and pre-programming important numbers (like telemedicine) into the phone.
As a result, they decided to set up a new grab bag with all the items that they might need to access quickly in an emergency. They found the exercise to be extremely useful as part of their preparations and went to sea for their incredible family adventure feeling a little more prepared!
We all know that certain drills are mandatory and dare we say it they become a tick box exercise in many cases.
Let us ask you a question: When you do a fire drill, do you rescue the manikin out to the safe area and put it on Oxygen for 5 minutes and then declare the “person” fit to return to duty? OR, do you work through the realities of assessing a casualty that has been rescued from a smoke filled compartment who has potentially taken in a few breaths of toxic fumes and is actually really pale and coughing loads?
Many people just want to get through a drill and fill in the matrix, but the reality is that when you rescue someone from a smoke filled compartment they may seem ok initially but what may happen if you don’t conduct a proper assessment and access definitive care? What are the complications?
We strongly recommend that every time you do a fire drill you also throw in some patient assessment skills and this month we have put together a scenario that allows you to slot in your casualty to an already planned Fire Drill.
That way you can tick 2 boxes: Fire drill - done. Patient assessment - done.
Yes, this ticks off 2 important drills!
The mandatory Enclosed SPace rescue drill and then some super useful first aid and medical care refreshing on top of that.
A total win win!
For this drill, we are using the scenario of a guest who has dived into water - either a shallow onboard pool and hit the front of their head, or dived into the water and hit their head on a hard water toy resulting in the same injury. They are unconscious in the water.
This could be combined with your routine Man Overboard drill to bring in an added layer of complexity.
With terminology changing and life at sea always carrying the risk of a person falling in, this video is a useful resource for refreshing crews knowledge and keeping those risk factors at the forefront of our mind when onboard.
View the VIDEO here
Copyright @ Red Square Medical Limited. Company Registration number: 5129622
Registered offices: Breamore House, The Butts, Warnford Road, Corhampton, SO32 3ND