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Diver First Responder (DFR) Module C: Diving Emergencies 2 Non-DCI. DFR Course. In Module C: we will Cover. Non-Pressure Related Emergencies Dive Site Accident Management Gas toxicity Near drowning Minor barotrauma Good diving practise. Common Terminology. Dive Site Accident Management.

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in module c we will cover
In Module C: we will Cover
  • Non-Pressure Related Emergencies
    • Dive Site Accident Management
    • Gas toxicity
    • Near drowning
    • Minor barotrauma
    • Good diving practise
dive site accident management1
Dive Site Accident Management
  • Be aware of all symptoms
  • An unwell diver should exit the water
  • Presume illness is dive-related
  • Have 02 and emergency kit to hand
  • Alert Emergency Medical Services (EMS)
    • Dial 999 or 112 or VHF Channel 16
treatment of the injured or ill diver
Treatment of the Injured or Ill Diver
  • Get diver back on boat or ashore
  • If altered consciousness on surfacing, ensure jacket inflated & weights removed
  • Loosen tight clothing
  • History / examination – Symptoms / signs
  • What is the key problem /condition …?
  • Monitor A-B-C / Administer 100% oxygen
  • Alert EMS
role of cox n in an emergency
Role of Cox’n in an Emergency
  • Ensure VHF radio is working and listen in
  • Ensure EMS is alerted
  • Know your exact position
  • Follow instructions of EMS
  • Ensure a record is kept
gas toxicity

Gas Toxicity

Oxygen (02)

Nitrogen (N2)

Carbon Dioxide (C02)

Carbon Monoxide (CO)

oxygen 0 2 toxicity hyperoxia
Oxygen (02) Toxicity (hyperoxia)
  • Oxygen at partial pressure >1.6 bar is toxic
  • Poisonous to various body tissues - especially the brain and nervous tissues
  • First Aid O2 delivered at 1 bar is safe
oxygen 0 2 toxicity hyperoxia1
Oxygen (02) Toxicity (hyperoxia)
  • Symptoms (CONVENTID)

CON Convulsions

V Visual disturbances/Tunnel vision

E Ears ringing (Tinnitus)

N Nausea

T Tingling or twitching (facial)

I Irritability

D Dizziness or vertigo

  • Signs (two phases)
    • Tonic phase: the muscles “tone” or stiffen
    • Clonic phase: the muscles start to jerk
oxygen 0 2 toxicity hyperoxia2
Oxygen (02) Toxicity (hyperoxia)
  • Treatment Underwater
    • If trained/familiar with the procedure, provide breathing gas with correct ppO2
    • Bring to the surface
    • Attempt lift after ‘Tonic’ phase has passed
  • Treatment on Surface
    • Monitor ABC / Administer 100% oxygen
    • Alert Emergency Medical Services (EMS)
nitrogen n 2 narcosis
Nitrogen (N2) Narcosis
  • Increased ppN2 causes a form of ‘narcosis’ or intoxication
  • Symptoms
    • Elation / false sense of well-being / sight and sound altered
    • Feeling of unease, panic/fear
  • Signs
    • Unusual behaviour / Loss of judgement and dexterity
    • Panic / stupor and/or unconsciousness
    • Diver’s subsequent actions may lead to injury or drowning
  • Treatment
    • Ascend to a shallower depth – or to the surface if necessary
carbon monoxide co toxicity
Carbon Monoxide (CO) Toxicity
  • C0 is produced when carbon is incompletely burned; fuels such as wood, petrol or diesel
  • Enters through lungs; delivered to blood
  • Red blood cells pick up CO instead of oxygen
  • Haemoglobin attracts CO 250 times more than oxygen
  • CO inhibits blood oxygenation and distribution to organs
carbon monoxide co toxicity1
Carbon Monoxide (CO) Toxicity
  • Symptoms
    • Breathlessness on exertion/ fatigue, nausea headaches
    • Vertigo / noises in the ears
    • ‘Pins and needles’ / confusion and disorientation
  • Signs
    • Loss of consciousness without warning / red lips
    • Respiratory arrest
carbon monoxide co toxicity2
Carbon Monoxide (CO) Toxicity
  • Treatment
    • Monitor ABC’s / 100% Oxygen / Contact EMS if necessary
    • Monitor all divers who used same air source
    • Retain cylinder for inspection
    • Medical assessment and hyperbaric oxygen
carbon dioxide poisoning hypercapnia re inhalation of c0 2
Carbon Dioxide Poisoning (Hypercapnia) re-inhalation of C02
    • CO2 is a natural by-product of metabolism
    • High concentrations of CO2 can displace oxygen in the air
    • Hypoxia may be combined with CO2 toxicity
    • Hypercapnia may exacerbate conditions: narcosis, Hypothermia, DCI
  • Symptoms
    • Headache / confusion / disorientation / lethargy
  • Signs
    • Panic / hyperventilation / convulsions / unconsciousness
  • Treatment
    • Remove from source, i.e. surface / abort dive
    • Monitor ABC’s / Administer 100% oxygen / alert EMS
near drowning1
Near Drowning

Near drowning ......

..... the survival of a drowning event involving unconsciousness or water inhalation ......

..... can lead to serious secondary complications, including death, after the event ......

There may be deterioration later – important to closely monitor patient closely following event

near drowning2
Near Drowning
  • Symptoms
    • Respiratory distress: cough, wheeze, shortness of breath
  • Signs
    • Altered consciousness / Cyanosis: grey/blue skin
    • Froth around lips and nose
    • Respiratory arrest
    • Nothing initially…
  • Treatment
    • Remove from water, discontinue activity, check for other injuries, keep warm
    • Monitor ABC’s / 100% oxygen / Alert EMS
    • Hospitalise for observation - ‘secondary drowning’
slide22

This slide for info only:

  • PHECC Clinical Practice Guidelines
  • [CPG]
  • SUBMERSION INCIDENT
  • For use by trained:
  • EMT
  • PARAMEDIC
  • ADVANCED PARAMEDIC
other pressure related illness
Other Pressure Related Illness
  • DENTAL BAROTRAUMA
    • Loose fillings, badly fitting crown – pain on ascent / descent
    • Regular dental visits / check-ups
  • EAR PROBLEMS
    • Caused by mucus build-up, cold, perforation in ear drum
    • Don’t dive if you have a cold/infection
    • Visit GP if problems persist
prevention good diving practise
Prevention - Good Diving Practise
  • DOD: dive planning
  • Location/profile planned
  • Maintain dive log
  • Fly ‘A’ Diving Flag during dive
  • Brief all re emergency procedures
  • Monitor location of divers throughout dive
safety at sea
Safety at Sea
  • Plan your dive – dive your plan
  • Tides / charts / weather
  • Contingency and emergency plans
  • First aid and oxygen kits
  • SMB’s / hi-visibility clothing / flares / lights
  • Whistles / sound generators
  • In an Emergency: Channel 16: Tel 999 or 112
module c diving emergencies 2
Module C: Diving Emergencies 2
  • We have covered
    • Dive accident site management
    • Gas toxicity
    • Near drowning
    • Minor barotrauma
    • Prevention - good diving practise
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