Basic Boating First AidBasic Boating First Aid

Joshua Hawley

Captain Tri-Community Fire Department

Vice President Bridgeton EMS EMT-Basic USMC Active Duty 10 years

Training TopicsTraining Topics First aid kit contents Handling Basic Emergency Medical

Situations

Please write down any questions and hold until end of presentation.

Basic First Aid KitBasic First Aid Kit

Buy or Build your own? Make sure it’s well marked and easily

found on vessel First Aid Book

Basic First Aid KitBasic First Aid KitAdhesive bandage compressAdhesive tape 1 in.Bandage compress 2 in.Bandage compress 4 in.Triangular bandageAbsorbent gauze compressesGauze roller bandage 4 in.Aluminum splintTourniquetEye dressing packet (pads andstrips)Eye wash solutionAntiseptic swabs

Oral airwayAntibiotic ointmentPlastic strips (various sizes)Latex gloves (Nitrile if allergic

to latex)Bandage scissorsNon-adherent pads 2in. X 3 in.TweezersSunscreen (SPF 30 or higher)Burn Treatment Compound Baby Aspirin, 81 mg.BenadrylFirst Aid book*

First AidFirst Aid

Doing what must be done to: Stabilize (before medically trained

personnel arrive) Transport (to an appropriate medical

facility)

First AidFirst Aid

Initial examinationDetermine Primary Problem

ResponsivenessAirwayBreathingCirculation

Determine Seriousness (Priority)Look for any additional problems

CommunicationCommunication Activate appropriate emergency

servicesCall 911Channel 16 USGC

Provide pertinent information Receive advice for care

Information to provideInformation 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

Neck or Spinal InjuriesNeck or Spinal InjuriesCausesCauses

Boating Collisions Falls Blunt trauma Penetrating trauma to head, neck, or

torso Springboard or platform diving

accidents

Neck or Spinal InjuriesNeck or Spinal InjuriesSigns and SymptomsSigns 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

Neck or Spinal InjuriesNeck or Spinal InjuriesProtect SpineProtect Spine

Manual Stabilization Hold patient’s head still Maintain head in position found

Do not turn to either sideDo not tilt forward or backward

Neck or Spinal InjuriesNeck or Spinal InjuriesProtect SpineProtect Spine

Manual Stabilization Kneel behind the patient Spread your fingers and thumbs around

the sides of the head Hold the head steady

ShockShock(Compensation)(Compensation)

Multiple CausesTrauma (bleeding, blunt, burns)Allergic reactionsDrugsHypothermiaToxinsEmotionalNear drowning

ShockShockOnset and Onset and SymptomsSymptoms

Restless Faint Thirsty Nauseated

Frightened Weak Anxious Dizzy

Rapid or delayed (hours) after apparent cause

ShockShockSignsSigns

State of consciousness: alert (may be deceiving) to unconscious

Breathing: shallow, rapid, irregular Pulse: weak and rapid Skin: cold, clammy (sweating) Pupils: dilated

ShockShockTreatmentTreatment

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

AnaphylaxisAnaphylaxisDefinitionDefinition

An immediate, life threatening systemic

allergic reaction

AnaphylaxisAnaphylaxisTriggers (examples)Triggers (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

AnaphylaxisAnaphylaxisSymptomsSymptoms

Onset Can be only seconds or up to 2 hours

after incident Reaction may recur up to 24 hours

after first reaction

AnaphylaxisAnaphylaxisSymptoms (General)Symptoms (General)

Hives Bronchoconstriction (closing of

airway) Headache Loss of consciousness

AnaphylaxisAnaphylaxis

Do NOT minimize an allergic reaction DEATH can occur within minutes

AnaphylaxisAnaphylaxisTreatmentTreatment

Obtain medical attention regardless of response

Epinephrine (EpiPen®, AnaKit®) Ice pack locally if applicable Antihistamines (Benadryl) Tourniquet (last resort) Treat for shock

EpiPenEpiPen®®1. Familiarize yourself with the unit

2. Grasp unit with black tip pointed downward3. Form a fist around auto-injector, black tip

downward4. With your other hand, pull off the gray activation

cap

5. Hold black tip near outer thigh6. Swing and jab firmly at 90° angle into outer thigh7. Hold firmly in thigh for 10 seconds

EpiPenEpiPen® ® (cont.)(cont.)

8. Remove unit and massage injection area for several seconds

9. Check black tip: If needle is exposed you received the dose If not, repeat steps #5-8

10. Bend the needle back against a hard surface

11. Carefully put the unit (needle first) back into the carrying tube (without the gray activation cap)

12. Recap the carrying tube

EpiPenEpiPen® ® (cont.)(cont.)

13. 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

BurnsBurns 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

BurnsBurnsNormal SkinNormal Skin

Dermis

Fat

Muscle

BurnsBurnsFirst DegreeFirst Degree

Only outer layer of skin

Mild pain Redness Warmth Tenderness

Skin Reddened

BurnsBurnsSecond DegreeSecond Degree

Inner layer of skin

Red Warm Tender Blister Severe pain

BurnsBurnsThird DegreeThird Degree

Tissue is destroyed

Charred (white to black)

May lack feeling

BurnsBurnsTreatmentTreatment

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

Burns Burns TreatmentTreatment (cont.)(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

BurnsBurnsSeriousSerious

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

BurnsBurnsSpecial SituationsSpecial Situations

EyesFlush with water for 5 minutesCover both eyes

BurnsBurnsSpecial SituationsSpecial Situations

Respiratory tractAlways a medical emergencySingeing of nasal hairsCoughHoarsenessDifficulty breathing

Near DrowningNear DrowningAny Apparent DrowningAny Apparent Drowning

Evaluate for: State of consciousnessAirwayBreathingCirculation Identify other injuries

Near DrowningNear DrowningTreatmentTreatment

Request medical assistance Inform emergency services of status CPR – check for responsiveness,

A – B – C - D Treat for shock

Near DrowningNear DrowningTreatment Treatment (cont.)(cont.)

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

Near Drowning Near Drowning DocumentationDocumentation

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

HypothermiaHypothermia

Heat loss to water 32 times faster than to air

May simulate or accompany shock

HypothermiaHypothermiaSignsSigns

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

HypothermiaHypothermiaLife Expectancy Without Survival SuitLife Expectancy Without Survival Suit

0

1

2

3

4

5

30 40 50 60 70

SafeMarginalLethal

Hours InWater

Water Temperature Degrees Fahrenheit

Safe: Most persons survive Marginal: 50% expectancy of unconsciousness; will probably result in death Lethal: 100% expectancy of death

HypothermiaHypothermiaCommand Responsibility and Waiver Command Responsibility and Waiver

AuthorizationAuthorization

Water Temperature - Degrees Fahrenheit32 41 50 59 68

Estimated Time - Hours to Loss of

Useful Consciousness

14

12

10

8

6

4

2

0

Dry SuitAntiexposure CoverallWork Uniform

HypothermiaHypothermiaTreatmentTreatment

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

Heat and DehydrationHeat 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

Heat and DehydrationHeat 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

BleedingBleeding External

Apply direct pressureElevate woundUse pressure pointsApply tourniquet (last resort)

InternalMay not be apparentAbdominalExtremities

BleedingBleedingDirect PressureDirect 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

BleedingBleeding Pressure Points Pressure Points

Apply pressure where artery lies near skin over bone.

BleedingBleeding Pressure Points 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

BleedingBleeding Tourniquet 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

BleedingBleeding Tourniquet Tourniquet

FracturesFracturesSigns and SymptomsSigns and Symptoms

Pain Swelling Bruise Deformity False Motion Crepitus

Tenderness Exposed

fragment Locked joint Guarding Unable to support

weight

FractureFractureSimpleSimple

Two distinct bone fragments

FractureFractureCompoundCompound

Bone penetrates through skin

FracturesFracturesTreatmentTreatment

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 fractureReduces painPrevents additional damagePad all rigid splints

FracturesFracturesTreatmentTreatment (cont.)(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

FracturesFracturesSplinting and Immobilizing Splinting and Immobilizing

SlingSling 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

FracturesFracturesSplinting and ImmobilizingSplinting and Immobilizing

(cont.)(cont.)

Splints Magazine

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