Casualty management |
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zippyRN ![]() Far too distracted from work ![]() Joined: 14 Sep 06 Online Status: Offline Posts: 437 |
![]() ![]() ![]() ![]() Posted: 17 Jan 12 at 2:11pm |
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that's odd given pool lifeguards with the NPLQ and St John Ambulance 'Advanced First Aiders ( under the 2011/12 skill sets)' are taught casualty handling for the patient with a suspected spinal injury based on mechanism of injury . ditto for none Paramedic ambulance staff including the voluntary sector crews as well as technicans and assistant grades in the NHS, Some of whom will be using the JRCALC selective immobilisation guidelines as well. have we got any RNLI personnel or Mountain rescue types who could let us know what is taught at a basic level and for designated casualty care pers ?
Volunteer does not have to mean incompetent or undertrained , would you be quite so forgiving of volunteer Race Officer who couldn't do a general recall ?
You don't need a Paramedic to be able to provide adequate casualty care ... also a safety boat is a poor platform to perform actual 'Paramedic' ( or other Healthcare professional only ) interventions vs life saving first aid intereventions and safely packaging someone for transfer to shore/ a larger boat / rescue helicopter where you can provide advanced life support care. Edited by zippyRN - 17 Jan 12 at 2:16pm |
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jeffers ![]() Really should get out more ![]() ![]() Joined: 29 Mar 04 Location: United Kingdom Online Status: Offline Posts: 3048 |
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The problem is that unless you have a trained paramedic in each 'safety' boat you are never going to be able to cover all possibilities.
Spine and neck injuries are a possibilites but give that (most) dinghy crashes are low speed and most people crewing safety boats at sailing clubs are volunteers you have to give them an overview of the most likely situations which are drowning and hypothermia.
At the end of the day you and only do what you can do at any given incident. Regretably sometimes this may not be enough (this from a former first aider who had someone die on them from a heart attack). The main priority is to get the casualty out of the water and administer first aid and get them ashore as quickly and safely as possible. At that point the professionals can take over.
No doubt there can be lessons learnt from this incident not least of which is observation is key when sailing on a crowded race course and being aware of potential incidents (and giving additonal requirements to hail may help).
At large events such as this one then it may be practical to have at leat 1 safety boat crewed with a paramedic, at grass roots level this is just not possible.
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Paul
---------------------- D-Zero GBR 74 |
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zippyRN ![]() Far too distracted from work ![]() Joined: 14 Sep 06 Online Status: Offline Posts: 437 |
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For those asking aobut injury prevalence etc - a very quick and dirty literature review throws up a variety of discussion in professional literature as well as general news items and specific information from sailing clubs
part of the problem is drilling down through all the over use vs acute trauma and the fact that 'sailing' as a whole can cover a variety of disciplines - including windsurfing and kiteboarding at times as well as dinghy / keelboat/ yacht
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zippyRN ![]() Far too distracted from work ![]() Joined: 14 Sep 06 Online Status: Offline Posts: 437 |
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Hypothermia is a significant consideration, but cold shock is more likely to kill you
and why might people sailing drown ? because of head and neck injuries from the boom striking them or being struck by another boat ... the " it'll never happen " has happened with the unfortunate incident in Aus , will it take a fatality for attitudes to change ? Edited by zippyRN - 16 Jan 12 at 10:48pm |
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radixon ![]() Really should get out more ![]() ![]() Joined: 27 Oct 06 Location: United Kingdom Online Status: Offline Posts: 2407 |
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The RYA Safety boat course or first aid course do not deal with spinal boards. I dont think it is something that should worry us. Hyperthermia and drowning are more of an issue with sailing than having a back injury.
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jeffers ![]() Really should get out more ![]() ![]() Joined: 29 Mar 04 Location: United Kingdom Online Status: Offline Posts: 3048 |
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The simple answer is make sure you club mandates all boats with a 'safety'role to have 2 able bodied people on board, one of whom is dressed to enter the water.
It is common sense if you ask me but should be written down.
We have the rule at Hunts and we are a small inland club where the shore is never much more than 30 secnds way by powerboat at full throttle.
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Paul
---------------------- D-Zero GBR 74 |
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sargesail ![]() Really should get out more ![]() ![]() Joined: 14 Jan 06 Location: United Kingdom Online Status: Offline Posts: 1459 |
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OK - I'll park my concerns. Had you been an RN waterborne medical specialist I'd maybe have seen it differently, but without any evidence of spinal injuries and with just one case where I don't htink we we even know the mechanism of injury I'm not going to worry about equioment or training.
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zippyRN ![]() Far too distracted from work ![]() Joined: 14 Sep 06 Online Status: Offline Posts: 437 |
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Sarge i found your last reply hard to read
i'm not sure of any SCIs from Sailing but given the fact Tess Lloyd was knocked clean out and needed Neurosurgery and is still anaesthetisted on ICU ... boat to boat collisions is not necessarily the issue ,although someone on the wire thrown forward in a collision or someone struck by a boom with the full force of a crash gybe is getting a lot of energy exchange in a short period of time as for the point about an unconcious crewmember and their partner holding on to them and the boat the unconcious person is either going to be on their back being held / towed in the classical lifeguarding 'chin tow' or semi erect pulled up again their crewmate with one of their crewmates arms under their axilla 'hugging' them to keep their head out of the water ( resting on their crewmates shoulder ) and the other arm treading water or holding on to the boat . wrong guess on the RN ... given the topic is casualty management what else might it mean ? ( to save people from further puzzlement I'm a registered Nurse and my clinical background is in three main areas - prehospital care, Emergency departments and Spinal injuries rehab)
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sargesail ![]() Really should get out more ![]() ![]() Joined: 14 Jan 06 Location: United Kingdom Online Status: Offline Posts: 1459 |
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zippyRN ![]() Far too distracted from work ![]() Joined: 14 Sep 06 Online Status: Offline Posts: 437 |
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unless it was some horrid short chop an inert, 'relaxed' body in the water wouldn't be undergoing a lot of violent movement and is supported fairly evenly along their length by being semi immersed ( assuming they are in BA, wetsuit / drysuit +/- trap harness ) rather than ragging them about and them flopping all over the place as they are dragged from the water over the the side of a rescue boat and dumped in a heap on the floor ...
the gold standard would be to roll them while trying to keep them in line
still fairly high energy - and stuff like BMX (racing rather than the stunt / freestyle stuff)) still has the same sort of marshalling and medic-ing considerations despite lower energies it's a fair old whack to knock someone out
if you look at previous debates on here it's suprising that there isn't consensus on this or that you need to be ready to go in the water as rescue crew to save life or limb
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