U.S.Sailing Association Safety at Sea Medical Issues. April 14 & 15, 2012

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2 U.S.Sailing Association Safety at Sea Medical Issues April 14 & 15, 2012

3 Donald Michael Bush Lieutenant, Operations Division, Emergency Preparedness Disaster Services Oak Park Fire Department

4 Medical Issues w What types of medical issues at sea may be encountered w When should we prepare for medical problems on our boat w What can we do to resolve medical issues when cruising or racing

5 Medical Issues w Environmental Situations w Wound care & Bandaging w Splinting & Pain Management w CPR and AED Operations w Calling for Assistance w Medical Supplies

6 Environmental Situations Sea sickness or motion sickness w While not life threatening, can be debilitating to the point that other medical problems can arise w Prevention is the most effective treatment w A variety of over the counter medications are available

7 Environmental Situations Sea sickness or motion sickness is a conflict between your senses w The natural fluid in your inner ear tells your brain you are in motion while your eyes tells your brain that you are not in motion. w This conflict can upset the natural balance of the body with unpleasant results.

8 Environmental Situations Sea sickness or motion sickness prevention w Hydrate w Plenty of rest w Avoid acidic, heavy food w Ginger is a natural preventative w Wrist bands w Dramamine, Marizine, Bonine or Scopolamine

9 Physiology w Skin Epidermis Dermis Subcutaneous Fat Deep Fascia Defend against infection Support structures Insulation Bone and muscle

10 Physiology

11 Sun Burn w Signs and symptoms of sunburn include w Chills, Fever, Nausea, Vomiting, Headache, Electrolyte Imbalance, Dehydration w Fluid replacement w Pain management

12 Sun Burn w Apply sun protection lotion of SPF w Reapply through out the day w Cover up w Get out of the sun w Watch for blistering

13 Insect Bites w Deet w Reapply through out the day w Cover up w Watch for signs of anaphylaxis w Consider Benadryl, 50 ml

14 Hypothermia w The reduction of the body s core temperature significantly below normal w Heat loss in the body is 26 times more in water, than in air w Immersion in water 70 degrees or less w Caused by overexertion, insufficient water intake or lack of food energy w Consider the rule

15 Hypothermia If the water temperature is Exhaustion or unconsciousness Expected time of survival 32.5 Under 15 Minutes Under Minutes Minutes Minutes Minutes 1-3 Hours Hours 1-6 Hours Hours 2-40 Hours Hours 3 Hours-Indefinitely 80.0 and Above Indefinitely Indefinitely

16 Hypothermia Signs and Symptoms Shivering Slurred speech Abnormally slow breathing Cold, pale skin Confusion or memory loss Loss of coordination

17 Hypothermia Treatment Remove the victim from the water Place the patient below deck Remove wet clothing and dry patient Sleeping bag and watch cap

18 Hypothermia Treatment Avoid alcohol or hot liquids Provide warm fluids only A gradual warming is best Do not rub to re-warm Check body temperature

19 Wound Care & Bandaging w Abrasions w Lacerations w Puncture Wounds w Avulsions w Amputations

20 Wounds & Bandaging w Steady direct pressure against the wound site is the best treatment to control the bleeding w Elevation of the wound site above the heart can substantially aid in bleeding control w Tourniquet is utilized only as a last resort and must be monitored

21 Splinting & Pain Management Assess the area to be splinted Dress any wounds before splinting Splint the extremity in the position where it is Do not reduce dislocations

22 Splinting & Pain Management

23 Splinting & Pain Management Colles Bent Fork Back Door

24 Splinting options Splinting & Pain Sam splint, winch handle, compartment door Support the effected limb Management Assess pulses before and after splinting

25 Splinting & Pain Management Naproxen Sodium Aleve Naprosyn Anaprox Aspirin Ibuprofen Advil Motrin Nuprin Tylenol

26 CPR & AED Operations w The ABC s Airway Breathing Circulation

27 Cardio Pulmonary Resuscitation w American Heart Association recommends a compressionventilation ratio (30:2)." w After one minute of C.P.R. assess pulse" w Automated External Defibrillator (AED)

28 AED "Philips,Physio Control, Medtronic, Welch-Allen, ZOLL" "" "Pads,Batteries,Case" $ to $ "

29 Calling for assistance w Contact USCG on VHF 16, or SSB 2182 khz w CYC Fleet Surgeon will not be available on the Mackinaw w Cell Phone coverage questionable, consider signal booster for cell phone

30 Calling for assistance Affix a note to the patient detailing w Medical Problem w When problem occurred w Treatments preformed and results w Medications: Dose and Time w Other pertinent information

31 Additional medical considerations w Any incident that causes unconsciousness, especially head wounds, the patient needs to be closely monitored and evacuation must be considered. w Special medical needs of the crew need to be considered ahead of the event.

32 Additional medical considerations w Consider a general medical form for the crew w Pertinent medical issues listed w Sealed in an envelope, kept in the navigation station w Returned at the completion of the voyage

33 Choose a first aid kit that is designed for boats carrying up to 10 people, where professional care or evacuation is 24 to 48 hours away that contains plenty of basic supplies. Medical Supplies

34 Medical Supplies Check medical supplies annually for completeness and restock missing items Check expiration dates, especially analgesics Discard damaged or open supplies

35 Medical Supplies Cost $40.00 to $ Weigh 3.5 lbs to 70 lbs Hard or soft case Based upon the amount of time until medical intervention

36 Medical Issues w Plan for medical situations before they happen w Take a first aid and a CPR class w Check medical supplies when preparing boat in the spring and before event w Know when and how to reach out for help

37 Safety at Sea References Caroline, N. L. (1991). Emergency care in the streets. Maloney, E. S. (1999). Chapman piloting seamanship and boat handling. Rousmaniere, J. (1989). The Annapolis book of seamanship

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