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zippyRN View Drop Down
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Post Options Post Options   Quote zippyRN Quote  Post ReplyReply Direct Link To This Post Topic: Casualty management
    Posted: 26 Jan 12 at 4:55pm
assumption central here again ladies and gents...
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winging it View Drop Down
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Post Options Post Options   Quote winging it Quote  Post ReplyReply Direct Link To This Post Posted: 26 Jan 12 at 9:31am
I do know the techniques available - I'm SI at a sailability centre where recovery of disabled persons is something we have to train ourselves for.  Fortunately it's not something we often have to put into practice.  The truth of the matter is that it's actually an incredibly difficult thing to do unless you can call in a helicopter, and thus risk the person drowning or dying from hypothermia while you wait for it, or you risk serious harm to the safety boat crew.

I think the point of my post was to demonstrate to zippy that while what he was expounding was all good in theory, would be almost impossible to put into practice.  I think he sees that now.
the same, but different...

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Stuart O View Drop Down
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Post Options Post Options   Quote Stuart O Quote  Post ReplyReply Direct Link To This Post Posted: 26 Jan 12 at 8:51am
I think you have the answer right there zippyRN you are trying to apply the same 'code' you use in motorsport to the sailing world, especially as in motorsport you have 'control' of the immediate conditions. In the water it is an ever changing situation. Unlike motorsport where you can lay someone flat and control that persons neck you cannot do this in the sea, even professional lifeguards say this, what works in a pool does not work in the sea.
And in answer to Winging it IMHO the only way to get casualties out of the water using a long board or aquaboard without causing injury to to those in the rib is with a helicopter or using a hoist. You could try to fully deflate 1 side of a rib and float a person on but I would say this isnt practical on most club ribs which arent wide enough. 
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zippyRN View Drop Down
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Post Options Post Options   Quote zippyRN Quote  Post ReplyReply Direct Link To This Post Posted: 26 Jan 12 at 2:50am
Originally posted by winging it

What a disappointing answer.  Given the amount of expertise expounded over the previous pages I had assumed there was some practical expertise behind it that could have been of use.   Instead, just theorising and not on the issue I'd asked about.

from my previous reply 

"In terms of recovery into a rescue boat it would be interesting to look at movement  in an 'inert'  body between the methods winging it  describes and a variety of approaches using an Aquabaord or conventional Long Extrication Board - perhaps our RLSS colleagues may be of use hear  as well as people with a 'health' background ? "

I've not had a huge amount to do with on the water for a few years now and certinaly not since i've been involved in emergency care both in and out of hospital as Health Professiojnal, working trackside at motorsport events in both green and orange and more recently working in specialist rehab 
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Post Options Post Options   Quote winging it Quote  Post ReplyReply Direct Link To This Post Posted: 25 Jan 12 at 5:59pm
What a disappointing answer.  Given the amount of expertise expounded over the previous pages I had assumed there was some practical expertise behind it that could have been of use.   Instead, just theorising and not on the issue I'd asked about.
the same, but different...

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zippyRN View Drop Down
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Post Options Post Options   Quote zippyRN Quote  Post ReplyReply Direct Link To This Post Posted: 25 Jan 12 at 5:07pm
Helmets are a two edged sword 

while they may be of benefit  in reducing  head injuries  they  raise as many problems as they solve - see the constant ongoing  debate and discussion about helmet use in  on-road cycling 

There is also a school of thought that helmets can worsen concussion and contra-coup type injuries by adding mass to the to the 'loosely', in relative terms, held on Head  (  speaking to long established  clinicians in Spinal injury care  they noted an increase in neck injuries following the introduction of mandatory seatbelt wearing  in the UK - which dropped off again when head restraints became a common fitment to cars - and  dealing with neck injuries has been an ongoing aspect of safety  reform in motorsport with neck rolls  and now HANS devices to reduce the effect of the head + helmet  shaking around.  

before jumping one way or the other on the helmet issue  the types of head injury  need to be considered 

this also has the issues of appropriate equipment  for the task, at one time IIRC  sailing schools were required to use the then contemporary  equivalent of a 150N  foam + air lifejacket  rather than buoyancy aids for students  ... ( i'm talking 20 + years ago here)  and there being debate at  the time over  whether it was acceptable to move towards 50N BAs  that were deemed more than adequate for club and 'private' sailing and were being worn by instructors in  these same sailing schools ... 

Last week i was listening to radio 4 / world service in the small hours and they were talking about the 'enforcers' in the NHL and how there was evidence of  of brain changes in these players  similar to the brain changes seen in boxers  from repeated concussions 

In terms of recovery into a rescue boat it would be interesting to look at movement  in an 'inert'  body between the methods winging it  describes and a variety of approaches using an Aquabaord or conventional Long Extrication Board - perhaps our RLSS colleagues may be of use hear  as well as people with a 'health' background ? 
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Post Options Post Options   Quote winging it Quote  Post ReplyReply Direct Link To This Post Posted: 24 Jan 12 at 9:02pm
If the Australian assessment process is anything like what happens here in the uk after a major incident (such as Kielder Water) then there will be a thorough investigation of the circumstances surrounding the accident (a collision between a windsurfer and a sailor) and then the findings of that investigation will be circulated to all clubs and centres, along with recommendations of any actions thought necessary to prevent such an accident happening again.  Should a succession of similar incidents take place then recommendations can become legislation.

Assuming that this poor girl suffered a head injury, I would think the most likely recommendation would not be that safety crews receive better training, but would rather be that sailors wear helmets.  This is already required in organisations such as scout sailing, and in many sailing schools.  This is similar to the way in which the NSSA demand trapeze crews wear quick release hooks following fatalities caused by crews being unable to unhook themselves following inversions.

It has to be said that even for trained crews, recovering a disabled or unconcious person from the water is extremely difficult without causing further injury.  At the moment best practice seems to be using a net or sling into which the person in the water is floated, then rolled up the side of the rib.  Those that I have spoken to who have been recovered in ths way have reported that it is extremely painful (though clearly better than drowning) and possibly would cause further injury to spine or brain due to the clumsy nature of the recovery process. 

Following the recent incident on the Dart concerning the inversion of the Hawke 20, this is something which must continue to be investigated, but the investigations must be done by those who can implement a sound knowledge of what is possible in any safety operation, given the limitations of safety crew ability, sea conditions, and resources.  Unfortunately we cannot prepare for every single eventuality.

Zippy, if your expertise can provide any detailed guidance on the recovery of disabled or unconcious persons from the water I would be glad to read them here.




Edited by winging it - 24 Jan 12 at 9:03pm
the same, but different...

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jeffers View Drop Down
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Post Options Post Options   Quote jeffers Quote  Post ReplyReply Direct Link To This Post Posted: 24 Jan 12 at 2:12pm
Originally posted by Buzz

We took legal advice regarding such disclaimers and were told that they wouldn't protect the club or an individual from their duty of care.
Safety boats, briefings, informing the Coastguard, contingency planning etc. are how we fulfill our duty of care. The level of training crews require will depend on the risk and the probability of that risk occurring. To have all safety boat crews trained to a high medical standard would mean that we would be unable to find volunteers and therefore run events.
 
 
I would suggest your club speak to the RYA in that case. The disclaimer does mean a lot as it is the individuals decision to go on the water in the first place (which is key).
 
If the Safety boat crew were deemed to then be negligent, not suitably qualified (relevant RYA cert or equivalent) or not follow established procedures than that is a different matter. This is why you must ensure you club is fully up to date with the latest guidance from the RYA and your Safety Policies are worded appropriately (and all members are aware of them, ignorance is no excuse). 
 
The RYA have a good and powerful legal team, your club pays a fee to be affiliated, make sure you get value from it. They are likely to know more than your high street solicitor as marine law is a specialist area.
 
As a foot note, there is no requirement to be First Aid Qualified for the RYA Safety Boat course (clicky). This is probably because it is damn near impossible to Administer First Aid on a Rib/Dory even on the calmest of days. Even the first aid you have to do for the DI cert is very basic by comparison.
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Buzz View Drop Down
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Post Options Post Options   Quote Buzz Quote  Post ReplyReply Direct Link To This Post Posted: 24 Jan 12 at 11:38am
Originally posted by jeffers

Please do not feed the troll......
 
And remember pretty much evey SC has a clause which states that you sail at your own risk and the club cannot be held liable for death, loss or injury (this is why we have insurance when we sail with large amounts of 3rd party liability).
We took legal advice regarding such disclaimers and were told that they wouldn't protect the club or an individual from their duty of care.
Safety boats, briefings, informing the Coastguard, contingency planning etc. are how we fulfill our duty of care. The level of training crews require will depend on the risk and the probability of that risk occurring. To have all safety boat crews trained to a high medical standard would mean that we would be unable to find volunteers and therefore run events.
 
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Stuart O View Drop Down
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Post Options Post Options   Quote Stuart O Quote  Post ReplyReply Direct Link To This Post Posted: 22 Jan 12 at 3:33pm
I think Zippy you are also harping on and on about what people went through 20 years ago...Yes the culture has changed and we have entered a blame era...however the RYA keep all clubs up to date on best practise and constantly review situations. 

You also forget about the claims IF equipment isnt used properly. We enter a whole legal minefield.

This is what all have said to you
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