CPR on your Boat? Do you know what to do?

[Mac_Attack]

Just the other week a friend of mine suffered heat stroke at fainted when we were out fishing he was ok i just did the normal thing for heat stroke. And it got me thinking what if you had to perform CPR on your mate when your out fishing would you know how to?
Cheers Nick

[seatime]

G'day Mac_Attack,

Your friend is very lucky, heat stroke is a potentially life threatening condition, much more dangerous than heat exhaustion. The body has such low fluid levels there's no sweat left and the brain and vital organs begin to fail. This person requires urgent medical aid.
He must be extremely grateful you were there - if he was alone ??

I recall a marathon runner at one of the Olympics who collapsed with heat stroke just after entering the stadium. Her muscles and organs were liquefying and she later died.
I teach first-aid and would urge everyone to update their first-aid skills and CPR (there has been some changes recently).

cheers
Steve

[Dr_Dan]

I can't believe how many people out there don't have a first aid certificate. The comment i normally get is "I'd know what to do in an emergency". CRAP! while common sense goes a hell of a long way, there are a number of things that can't jsut be left to common sense. When you think about how far away from medical assistance we all are when fishing offshore, i find it hard to believe how many people don't have basic first aid knowledge. Course doesn't cost much, and it gives you the basics to deal with a lot of trouble that we can get into. It gives you the confidence to give a hand when it's needed.

[disorderly]

I did a rescue diver course years ago as part of divemaster training.
Very worthwhile but I really ought to refresh my memory or redo a first aid certificate.
Good thread this one.

Scott

[wags on the water]

I had learnt it many years ago, but last year I did a confined space course and it opened my eyes as to how the methods had changed. I'd like to think it should be a part getting any type of license.

[MEGA'bite]

get back to work wags

[Flattie Assassin]

Yes i'm all good for it. Hate to have to use it though.

[Steve B]

Steve (glesec) has made a very good point regarding heat exaustion Vs heat stroke. You did well Nick to do the right thing otherwise who knows. steve is also very true in his words about First Aid training. Different things change every year, and are usually quite important. ie compresion ratio for CPR is now 30:2. Keeping up to date is very important.

Dr Dan also made very valid point. The "Ill be right when it happens attitude" is the worst. Over confidence with no training is a recipe for disaster.

I once had a security guard at a shopping center doing chest compressions on a 15 year old who fainted....she was fully consious trying to tell him to stop but couldnt get her breath because of the CPR!!!!!

Nick, if you dont mind telling us, I'm sure we could all learn from you experience, how did you mate get to the situation of heat exaustion/stroke. Age, lack of water, fatigue, big night out before etc...obvoiusly it would have been a hot day too. As a paramedic I am interested in hearing more about you experience for the benefit of others too. Thats if you dont mind sharing.

cheers steve

[Mac_Attack]

Steve (glesec) has made a very good point regarding heat exaustion Vs heat stroke. You did well Nick to do the right thing otherwise who knows. steve is also very true in his words about First Aid training. Different things change every year, and are usually quite important. ie compresion ratio for CPR is now 30:2. Keeping up to date is very important.

Dr Dan also made very valid point. The "Ill be right when it happens attitude" is the worst. Over confidence with no training is a recipe for disaster.

I once had a security guard at a shopping center doing chest compressions on a 15 year old who fainted....she was fully consious trying to tell him to stop but couldnt get her breath because of the CPR!!!!!

Nick, if you dont mind telling us, I'm sure we could all learn from you experience, how did you mate get to the situation of heat exaustion/stroke. Age, lack of water, fatigue, big night out before etc...obvoiusly it would have been a hot day too. As a paramedic I am interested in hearing more about you experience for the benefit of others too. Thats if you dont mind sharing.

cheers steve

No problem Steve i don't mind sharing i think some people could actually learn of this (maybe).
We were out fishing in an open boat so we were both exposed to direct sunlight and as everyone knows you must keep hydrated especially in the open.
I drink alot of water when i go out which also means a lot of trips to check the propeller (if you get what i mean) i kept offering him a drink but he refused so anyway he started looking really pail and i said please man have something to drink so he did. He wasn't feeling the best but he looked alot better so we fished on so we continued fishing and in about 20-30min i glanced over at him and he looked very pail and had a cold sweat and bang out like that.
So here is the treatment i gave him roughly ( for fainting/heatstroke) LISTEN TO THIS VERY IMPORTANT YOU MAY NEED IT.
Fainting:
Lay the patient down with a pillow under their head and make sure their airway is clear usually by this time they have recovered. This is very important because if the patient is upright then they may lose breathing and that may lead to heart failure.
Heat Stroke:
Lay the patien t down with a pillow under the head.
Rest the patient in a cool, shaded area.
Loosen clothing.
Douse the patient with water or cool with fans but don't make them shiver.
give the patient water but to much maye cause vommiting.
You may say you were taught differently or you may say i am wrong but thats how i was trained as a SLS.
I hope that healped some people?
Cheers Nick 8-)

[russ81]

Hows it going guys

I agree that boaties should be familiar with first aid as usually they are a lot further of harder to get to for paramedics you maybe that persons only chance for survival.

[Foxy4]

I could do CPR on board But it sure would not be easy and or too comfortable but if it means saving a life I would do it not matter what.

[RayDeR]

G'day!

Getting water into you is important.

And it does not have to be in the sun in the middle of a hot day.

My wife worked as a carer in a nursing home and collapsed from heat stroke at 7am while showering a patient. She had been showering patients since starting her shift at 6am.

It was the 100% humidity which got to her and the heat in the shower.

Her GP said remember heat stroke is heat stroke not sun stroke.

Ray DE R

[seatime]

Mac_attack,

If your friend had fainted and had a cold sweat he wasn't suffering from heat stroke.
If someone has fainted due to standing for long periods in the sun and not drinking enough water they should have their legs raised when they regain consciousness to return blood flow to the brain. Also check for injuries from the fall.
Fainting is caused by a lack of blood flow to the brain, raising their feet (gravity assist) will help increase the blood supply.
If they don't regain consciousness quickly and they are breathing put them into the recovery position and monitor their breathing. Call ahead for a paramedic to meet you and start for home or call VMR - AVCG for assistance. If they're not breathing commence CPR.

Steve

[seatime]

whoops - double up post

[Mac_Attack]

Mac_attack,

If your friend had fainted and had a cold sweat he wasn't suffering from heat stroke.
If someone has fainted due to standing for long periods in the sun and not drinking enough water they should have their legs raised when they regain consciousness to return blood flow to the brain. Also check for injuries from the fall.
Fainting is caused by a lack of blood flow to the brain, raising their feet (gravity assist) will help increase the blood supply.
If they don't regain consciousness quickly and they are breathing put them into the recovery position and monitor their breathing. Call ahead for a paramedic to meet you and start for home or call VMR - AVCG for assistance. If they're not breathing commence CPR.

Steve
Steve just wondering are u a paramedic sounds like it?
You only raise their legs if they do not regain consciousness after laying them down
Cheers Nick 8-)

[tigermullet]

Lots of good ideas here except for the one calling for a first aid certificate being required for all licences.

From the age of 17 to 30 I just about lost count of the number of courses in first aid that we were put through. After that, for the next 25 years, it was annual fire safety courses. Just about drove me mad. Even the Nuclear, Biological and Chemical warfare courses lost their mystique and became boring after a couple of them. You'd be pissed off too if it meant hunting isotopes with a geiger counter whilst dressed up in a funny suit with a face plate that fogged up in about two seconds in 30 degree heat.

And for what? The worst incident encountered in 47 years required the application of a bandaid.

All that fake wound dressing, splinting of broken bones, making of stretchers, CPR, endless lectures on how to put a fire out, rescuing in smoke filled rooms and coughing our lungs out went for nought.

On top of that the ar**holes running this sort of course liked to see eveything polished to a high shine. The firies even had shiny lug nuts on their fire engine wheels for Chrissakes.

If a first aid certificate becomes necessary to hold a boat licence then it's lawn bowls for me.;D

[seatime]

Nick,

If someone is unconscious and breathing they are put into the recovery position, every time.
Raising the legs for a casualty that has fainted and then quickly regains consciousness helps restore blood supply to the brain, same management as for shock - similar signs & symptoms.

No not a paramedic, I conduct first-aid/CPR courses.

Steve

[tigermullet]

Whoops! Sorry Gelsec. I meant those military type ar**holes.;D

[seatime]

You never know when your first-aid skills will be needed. A First-Aid course also raises your safety awareness for home and work.
90% of the time your skills will help a family member or close friend.

I've been first on the scene of 2 motor vehicle accidents involving serious injuries, a drowning, numerous work related injuries, heart attack, angina attack, epileptic seizures, fainting/collapses, and today pulled a young sailor out of the water at Manly that had been struck as his sabot flipped (arm & head injuries).
Each time my skills and knowledge of first-aid were used.

Steve

[tigermullet]

I agree. Sigh! Those ar**holes might have known what they were talking about.;D

[seatime]

no wuckens tigermullet.

[shappy]

g'day everyone,i have done basic first aid training and think it is well worth it for many situations. i have not read all post so some one may have already asked, how many have a first aid kit on board. i have one with my safty gear!

cheers, shappy

[Mac_Attack]

First Aid is not compulsary but well worth it so my advice would be go pay gelsec for a course lol
Cheers Nick 8-)

[bundylundy]

Do Resus training as part of my job as a lecky, have done it every 6 months for over 30 years. Have never had to use it at work or at home but hopefully will come naturally if ever it is needed. Probably something all people should be trained in.

Jeff.

[Steve B]

Thanks Nick for sharing the story. You did the right thing from what I read. Sound like he had heat exaustion and if you hadnt of done what you did to cool and rehydtrate him, it may well have developed into heat stroke (which is VERY bad, could have been fatal if you were a long way from help). You did well. Severe dehydration causes hypotension (low blood pressure) which inturn causes lack of blood flow to perfuse the brain, hence your mate collapsed. Raising his legs increase the BP and inturn increase blood supply to the brain, Thus they regain consiousness. There are many other metabolic changes that occour during heat related illness, but the basic treatment will save lives.

Only one minor thing. Once they REGAIN consiousness. MAKE THEM DRINK AS MUCH WATER AS THEY CAN, if they vomit, MAKE THEM DRINK MORE!!. They need it and lots of it. Cooling is very important too. If you have ice, wrap in a towel or their shirt and put it under their armpits, groin areas and neck. thats where the major blood vessels are closest to the surface and majority of heat is generated. Cool those areas and the rest of the body cools quicker. Plus moist cool towels etc. you will be able to tell when person is getting better. Contact QAS too. Even if you out at sea. The coastal paras can meet boats at sea via VMR etc. We can give IV fluids which is the recommended for serious rehydration.

Shapy, there has been a thread a couple of months ago regarding first aid kits on boats. quite a good read. it was in this section. well worth the search.

cheers steve

[Mac_Attack]

Thanks Nick for sharing the story. You did the right thing from what I read. Sound like he had heat exaustion and if you hadnt of done what you did to cool and rehydtrate him, it may well have developed into heat stroke (which is VERY bad, could have been fatal if you were a long way from help). You did well. Severe dehydration causes hypotension (low blood pressure) which inturn causes lack of blood flow to perfuse the brain, hence your mate collapsed. Raising his legs increase the BP and inturn increase blood supply to the brain, Thus they regain consiousness. There are many other metabolic changes that occour during heat related illness, but the basic treatment will save lives.

Only one minor thing. Once they REGAIN consiousness. MAKE THEM DRINK AS MUCH WATER AS THEY CAN, if they vomit, MAKE THEM DRINK MORE!!. They need it and lots of it. Cooling is very important too. If you have ice, wrap in a towel or their shirt and put it under their armpits, groin areas and neck. thats where the major blood vessels are closest to the surface and majority of heat is generated. Cool those areas and the rest of the body cools quicker. Plus moist cool towels etc. you will be able to tell when person is getting better. Contact QAS too. Even if you out at sea. The coastal paras can meet boats at sea via VMR etc. We can give IV fluids which is the recommended for serious rehydration.

Shapy, there has been a thread a couple of months ago regarding first aid kits on boats. quite a good read. it was in this section. well worth the search.

cheers steve
Thanks for that Steve i never knew to keep giving them water untill they vomit i even got my manuel out of my cupboard to be shore and it states " Give the patient suitable amounts of fluid, remembering tat too much, too soon, may cause vommitting.
But your the pro so thankyou ;D
Cheers Nick 8-)

[Steve B]

Nick,

I probably could have worded my post a bit better. Sorry.

I'm not suggesting force them to drink until they vomit. your mannual is correct in saying,
"too much too soon MAY cause vomiting". Just get them to drink as much as they can, whenever they can at a rate they are comfortable with, even if they are just sipping. If they do get sick, let them recover, then encourage them to drink some more at a rate they feel comfortable with.

Preferably tepid or coolish water, not really cold water. Absorbs quicker and reduces chances of vomiting.

[FNQCairns]

You never know when your first-aid skills will be needed. A First-Aid course also raises your safety awareness for home and work.
90% of the time your skills will help a family member or close friend.

I've been first on the scene of 2 motor vehicle accidents involving serious injuries, a drowning, numerous work related injuries, heart attack, angina attack, epileptic seizures, fainting/collapses, and today pulled a young sailor out of the water at Manly that had been struck as his sabot flipped (arm & head injuries).
Each time my skills and knowledge of first-aid were used.

Steve

Bugger me! Mate can you do me a favour and throw a PM my way if ever you are venturing this far north! cause I am heading south!

Seen only one in my 40years I was 8yo and another kid on the school playground fell hit his head (I assume)and swallowed his tongue, the teacher at the time got it back forward with his comb and saved his life. Who carries a comb these days!

cheers fnq

[mik01]

I have a senior first aid certificate and a first aid kit on the boat and at home.

funny - not long after (I think a week) my first aid course I actually came across a car accident where I had to put my skills to the test!! never came across any type of accident before so it was weird the way it happened.

you just never know - its a cliche but its damn true.
imagine if you happened across the pwc accident where a kid is unconscious in the water and you could have saved them if only you had the skills (not saying that poor kid could have been saved, but who knows?)

its money well spent.

[oldboot]

With CPR and first aid being a requirement for many ocupational licences... It would not surprise me if at some time it becomes a requirement for boating licences.... certainly for commercial ones.



the biggest issue for CPR in a boat or any situation on water is the availability of a flat surface.


also interesting
the current "official line" you dont stop CPR to check for a pulse????????


cheers

[mik01]

With CPR and first aid being a requirement for many ocupational licences... It would not surprise me if at some time it becomes a requirement for boating licences.... certainly for commercial ones.



the biggest issue for CPR in a boat or any situation on water is the availability of a flat surface.


also interesting
the current "official line" you dont stop CPR to check for a pulse????????


cheers

no mate - you keep going and going until help arrives (trained medical help with a defibrellator).
have heard stories of cpr being done for a couple of hours straight and the person surviving, because they didnt stop.

[seatime]

Bugger me! Mate can you do me a favour and throw a PM my way if ever you are venturing this far north! cause I am heading south!

Seen only one in my 40years I was 8yo and another kid on the school playground fell hit his head (I assume)and swallowed his tongue, the teacher at the time got it back forward with his comb and saved his life. Who carries a comb these days!

cheers fnq

No and Yes,

I'll leave your buggering to someone else thanks :P ;)

Next time I'm up your way I'll be sure to let you know.:)

Having been a first-aid/medical officer at sea, and volunteering my skills when ashore has helped broaden my experiences.

cheers
Steve

[Whitto]

Bugger me! Mate can you do me a favour and throw a PM my way if ever you are venturing this far north! cause I am heading south!

Seen only one in my 40years I was 8yo and another kid on the school playground fell hit his head (I assume)and swallowed his tongue, the teacher at the time got it back forward with his comb and saved his life. Who carries a comb these days!

cheers fnqG'Day FNQCairns, Don't worry about who carries a comb the Old wives tale of swallowing your tongue is just that, it is impossible to swallow your tongue, What occurs is an occluded airway (not from tongue) or partially blocked airway due to a number of factors such as poor head positioning, vomit, foreign object and so on, If you find anyone in this condition u need to place the patient on their back and determine their medical status, if u can't hear air expelling or a rise and fall of the chest or no pulse u need to start CPR, firstly correcting the airway by placing one hand under the neck and the other hand on the patients forehead and gently tilt the head back but not too far this generally will do the trick, If this dose not open the airway roll the patient on their side maintaining their head tilt and with your finger clear away any matter in the patients mouth, Once this is achieved u can commence compressions on the chest IF there is no pulse detected ( 2 Breaths 30 Compressions ), That is broadly what is required if u find someone not breathing, Hope I havn't confused people with that, Cheers Whitto

[FNQCairns]

G'Day FNQCairns, Don't worry about who carries a comb the Old wives tale of swallowing your tongue is just that, it is impossible to swallow your tongue, What occurs is an occluded airway (not from tongue) or partially blocked airway due to a number of factors such as poor head positioning, vomit, foreign object and so on, If you find anyone in this condition u need to place the patient on their back and determine their medical status, if u can't hear air expelling or a rise and fall of the chest or no pulse u need to start CPR, firstly correcting the airway by placing one hand under the neck and the other hand on the patients forehead and gently tilt the head back but not too far this generally will do the trick, If this dose not open the airway roll the patient on their side maintaining their head tilt and with your finger clear away any matter in the patients mouth, Once this is achieved u can commence compressions on the chest IF there is no pulse detected ( 2 Breaths 30 Compressions ), That is broadly what is required if u find someone not breathing, Hope I havn't confused people with that, Cheers Whitto

Thanks Whitto for the info, so this kid didn't swallow his tounge, I remember crowding around as the teacher put the comb down his mouth, must have been trying to clear, god knows how my 8 yo mind made sense of what I was seeing, must have been some other cause then.

cheers fnq

[Fafnir]

I once had a security guard at a shopping center doing chest compressions on a 15 year old who fainted....she was fully consious trying to tell him to stop but couldnt get her breath because of the CPR!!!!!


Sounds like he knew but was just going for the grope. No means NO, even if you don't let them say the words.

Recently did a refresher course just because I thought I should update after 20 something years. Really surprised how much has changed, it seems a lot easier now that what I remembered it being. Every school should run a first aid course for students. That's where I first did mine, many years ago.

[Little grey men]

Every school should run a first aid course for students. That's where I first did mine, many years ago.

Gotta agree with that. You may loose a lot of the information over time, but you may also retain enough to save a life. I remember seeing some poor old bloke pass away in a shopping centre when I was younger, people were trying to perform CPR but just didn't know enough or the correct way ( absolute panic )
After seeing that I've done the St Johns course and I've read that big St Johns first aid manual a few times. After having kid's I thought it imortant to really try to get up to speed on the latest techniques. It can get confusing because they change quite a bit.

[seatime]

St Johns Ambulance conduct Senior First-Aid courses on an almost daily basis at various locations around Brisbane, and on-site for industries if required.
A SFA certificate course is run over 2 days with an option of a combined workbook/ 1 day course. Certificates are valid for 3 yrs.
A SFA refresher is a 1 day course.
CPR courses are 3 hours and valid for 12 months.

My kid's high school does FA in yr 8 or 9 ?

cheers

[Steve B]

Whitto was right, cant swallow tounge.

Although I went out with this girl once......hang on thats a different story;D ;)

[kingtin]

Whitto was right, cant swallow tounge.

Although I went out with this girl once......hang on thats a different story;D ;)

She had a bad sense of direction? ;) ;D

kev

I never worry about the destination when I'm going on holiday. My dad is Iranian and my mum is Irish, so I spend most of the time in customs

[Scott nthQld]

I do know first aid, just not the updated stuff, I did my certificate at school, it was part of the conditions of participating in school sport (surfing) we had to complete a jnr first aid course first ( I went to school in Wollongong in case you're wondering what surf is there in NQ) upgrading to SFA once I turned 18, but since then I let the certificate expire, and haven't renewed it yet. I am confident I can do CPR, but thankfully I've never had to, and I hope I don't. I will have to do the course again, and not only refresh my memory, but learn the new stuff that was not included in the older courses.

[Volvo]

Top post n haveta say congrats for bringining it up !!!and more needed far as general first aid is concerned:) ..Some workplaces even run first Aid courses/CPR etc for their workers partners as welol.. My way of thinking is that it is very wise for both parties to know it..
Especially with todlers at home and in the playgrounds...
Cheers

[pommy]

Greetings all!

Are people aware that it is highly unlikely that you could be successfully sued if you give first aid but don't carry it out correctly ie you make an honest mistake.

BUT If you start first aid you MUST continue with it until help arrives or you cannot physically carry on any longer. You cannot give it up because you think you might be doing a bad job or because you suddenly lose confidence. There are legal issues if you do.

Regards, Rob.
Ballina

[seatime]

pommy is referring to the "Duty of Care" a first-aider takes on when administering first-aid to a casualty.

Consent should be obtained where possible. Consent can be 'implied' (unconscious patient, intervention required to prevent further injury), or 'expressed' (agreement from casualty). With children (under 18), consent should be obtained from a parent or legal guardian, if possible.
An intellectually competent person can refuse first-aid - continuing to apply first-aid could result in an assault charge.

There has never been a successful case of 'negligence' found against a first-aider in Australia.

regards
Steve

[mik01]

in fact, I think its been tried but thrown out of court.
No one in Australia will tolerate that type of rubbish.
Any first aid is better than none...

[Steve B]

Mik01 and Steve (gelsec) are spot on.

Straight out of the First Aid training maunual from QAS

BREACH OF DUTY - A breach of duty occurs when a first aider provider fails to act in a way that is consistant with an obligation to provide assistance or with a standard of care that is safe and in reasonable accord with established first aid principles and proceedure.

STANDARD OF CARE- The standard of care expected of a person giving first aid is that of an ordinary, trained first aid provider to have and excersising fundamental first aid skills.

These expectations may be affected, however, by condition of circumstance in which first aid care is provided.

The QLD first aid cde of practice 2004 explains the initial treatment provided by first aid personnel should be consistant WITH THEIR LEVEL OF TRAINING AND COMPETENCE..

OBLIGATON previously refered to as Duty of care, the legal concept of obligation to amounts to a responsibility to act in order to fulfil a percieved commitment.

HERES A GOOD ONE........ QLD LAW imposes obligation on ANY person invloved in a road traffic crash to:

1. Stop at the scene
2. Render any assistance that is needed to the best of their ability.
3. Call for medical assistance

[stevos]

I once went on a charter out of the Goldie and one of the blokes on board had a heart attack coming back through the seaway. Terrible experience and Im glad I wasnt the skipper. He didnt make it in the end but it was most unexpected. He was complaining of feeling seasick (like half the crew) and then when the deckie checked on him it was all over.