DIVE DIVING MEDICAL (MED) Checklist

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Imogene Parker
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1 DIVE DIVING MEDICAL (MED) Checklist UPDATED August 2017

2 SAFETY REVIEW ITEMS - DIVING MEDICAL EMERGENCY EQUIPMENT 1. (MED08) 2. (MED09) 3. (MED10) 4. (MED11) 5. (MED12) DOES THE COMMAND HAVE THE MINIMUM REQUIRED EMERGENCY EQUIPMENT TO CONDUCT DIVING OPERATIONS (PORTABLE OXYGEN KIT, LITTER OR BACKBOARD, AMBU BAG AND AED)? REF: U.S. Navy Dive Manual IS ALL APPLICABLE EMERGENCY EQUIPMENT COVERED UNDER (O2 CYLINDERS, LITTER/BACKBOARD, NON-DISPOSABLE AMBU BAGS AND AEDS)? REF: Applicable IS THE FIRST AID KIT COMPLETELY STOCKED AND TAILORED TO THE COMMAND S MISSION? ARE ALL APPLICABLE CONSUMABLE AND/OR DRUGS IN THE FIRST AID KIT IN SATISFACTORY CONDITION AND WITHIN EXPIRATION DATE? IF OVER-THE-COUNTER (OTC) MEDICATIONS ARE STOCKED IN THE FIRST AID KIT, ARE THEY PROPERLY LABELED (DRUG AND STRENGTH, DOSING INFORMATION, LOT NUMBER AND EXPIRATION DATE) AND ARE MEASURES IN PLACE TO PREVENT UNAUTHORIZED ACCESS TO OTC MEDICATIONS?

3 6. (MED13) 7. (MED14) 8. (MED15) 9. (MED16) PHYSICAL REQUIREMENTS IS THE PORTABLE O2 KIT COMPLETE (ADEQUATELY CHARGED O2 CYLINDER, NON-REBREATHER MASKS, ORAL AND NASAL AIRWAYS AND AMBU BAG), AND ARE ALL ITEMS IN SATISFACTORY CONDITION? REF: Applicable U.S. NAVY DIVE MANUAL ARE MEDICAL O2 CYLINDERS IN USE BEING GAUGED QUARTERLY AND DOES CYLINDER CONTROL TAG INCLUDE DATE OF RECEIPT, PSI UPON RECEIPT AND WHEN FIRST OPENED, AND MOST RECENT PSI READING. REF: Applicable U.S. NAVY DIVE MANUAL IF APPLICABLE, ARE THE AED BATTERY AND PADS WITHIN THEIR EXPIRATION DATE AND DOES THE BATTERY INDICATOR ON THE AED INDICATE THAT THERE IS A SUFFICIENT CHARGE? IS BIOMED CHECK/REPIAR PERFORMED? REF: Applicable IS LITTER AND/OR BACKBOARD CLEAN AND IN SATISFACTORY CONDITION AND ARE ALL STRAPS AND BUCKLES FREE FROM DAMAGE AND FUNCTION AS DESIGNED? REF: Applicable 10. (MED17) ARE ALL DIVING PHYSICALS CURRENT (EVERY 5 YEARS UNTIL AGE 50, THEN EVERY 2 YEARS) AND SIGNED BY A DMO/UMO?

4 11. (MED18) 12. (MED19) 13. (MED20) RECOMPRESSION CHAMBER MEDICAL KITS IF A WAIVER OF PHYSICAL STANDARDS IS RECOMMENDED ON THE DIVING PHYSICAL, DOES THE PROPER WAIVER PAPERWORK (INTERIM OR APPROVED WAIVER) ACCOMPANY THE PHYSICAL? ARE ALL MILITARY AND RESERVE DIVER S ANNUAL PERIODIC HEALTH ASSESSMENTS (PHA) CURRENT, INCLUDE A SKIN CANCER SCREENING, DOCUMENTED ON THE DD 2766 AND NAVMED 6120/4 AND SIGNED BY AN APPROVED HEALTH CARE PROVIDER? PHA NOT REQUIRED FOR CIVILIANS. IS A CURRENT LIST OF PERSONNEL IN "NPQ" STATUS AVAILABLE TO ALL DIVING SUPERVISORS? REF: U.S. Navy Dive Manual MANMED (NAVMED P-117) 14. (MED01) 15. (MED02) DO THE PRIMARY AND SECONDARY MEDICAL KITS HAVE THE MINIMUM REQUIRED EQUIPMENT? ARE ALL DRUGS AND CONSUMABLES IN THE PRIMARY AND SECONDARY MEDICAL KITS IN SATISFACTORY CONDITION AND WITHIN EXPIRATION DATE?

5 16. (MED03) 17. (MED04) 18. (MED05) 19. (MED06) 20. (MED07) ARE INVENTORIES BEING PERFORMED ON THE PRIMARY AND SECONDARY MEDICAL KITS QUARTERLY AND AFTER EACH USE AND DOCUMENTED IN SKED? REF: Applicable DOES EACH CHAMBER HAVE ITS OWN PRIMARY AND SECONDARY MEDICAL KIT AND ARE THEY EASILY ACCESIBLE? IS A PORTABLE OXYGEN SUPPLY WITH A CYLINDER AND A REGULATOR CAPABLE OF DELIVERING 12 LPM BY MASK OR 2 LPM VIA NASAL CANNULA AVAILABLE IN THE EVENT A PATIENT NEEDS TO BE TRANSPORTED TO ANOTHER FACILITY? IF MEDICAL EQUIPMENT IN ADDITION TO THE MINIMUM REQUIRED EQUIPMENT IS USED, IS IT ON THE AUTHORIZED FOR NAVY USE (ANU) LIST? IF NOT ON THE ANU LIST, HAS THE SENIOR MEDICAL OFFICER AT NAVY EXPERIMENTAL DIVING UNIT BEEN CONSULTED PRIOR TO USE IN THE CHAMBER? NAVSEA/OOC AUTHORIZED FOR NAVY USE (ANU) IF THE COMMAND PARTICIPATES IN THE AREA BENDS WATCH, DO THEY MAINTAIN SUFFICIENT ADVANCED CARDIAC LIFE SUPPORT (ACLS) MEDICATIONS IN ACCORDANCE WITH THE AMERICAN HEART ASSOCIATION GUIDELINES TO SUPPORT A CARDIAC EVENT? IN ADDITION, ARE ENOUGH MEDICATIONS FOR THE TREATMENT OF ANAPHYLAXIS AVAILABLE TO TREAT ONE DIVER IN THE EVENT OF A MARINE LIFE ENVENOMATION (EPINEPHRINE 1:1000, DIPENHYDRAMINE IM OR PO, AND HYDROCORTISONE SODIUM SUCCINATE IV)? CURRENT ACLS PROTOCOL

6 DIVING MEDICAL COMMAND NAME: LOCATION: UIC: DATE: SURVEYOR(S): NO. COMPLETE: NO. REQ ACTION: NOT APPLICABLE: Q # Question Result Sig Rep 1 MEDMED08 C R N U Sig Sig Sig 2 MEDMED09 C R N U Sig Sig Sig 3 MEDMED10 C R N U Sig Sig Sig 4 MEDMED11 C R N U Sig Sig Sig 5 MEDMED12 C R N U Sig Sig Sig 6 MEDMED13 C R N U Sig Sig Sig 7 MEDMED14 C R N U Sig Sig Sig 8 MEDMED15 C R N U Sig Sig Sig 9 MEDMED16 C R N U Sig Sig Sig 10 MEDMED17 C R N U Sig Sig Sig 11 MEDMED18 C R N U Sig Sig Sig 12 MEDMED19 C R N U Sig Sig Sig 13 MEDMED20 C R N U Sig Sig Sig 14 MEDMED01 C R N U Sig Sig Sig 15 MEDMED02 C R N U Sig Sig Sig 16 MEDMED03 C R N U Sig Sig Sig 17 MEDMED04 C R N U Sig Sig Sig 18 MEDMED05 C R N U Sig Sig Sig 19 MEDMED06 C R N U Sig Sig Sig 20 MEDMED07 C R N U Sig Sig Sig

DIVE SCUBA (5SC) Checklist

DIVE SCUBA (5SC) Checklist UPDATED May 2017 SAFETY REVIEW ITEMS - SCUBA ADMINSTRATION 1. (A1M0) 2. (A1N0) 3. (A1O0) 4. (A2P0) 5. (A2VO) IS ALL SCUBA EQUIPMENT COVERED BY TO INCLUDE PRESSURE POT AND CALIBRATED