FIRST AID

Barotrauma / DCI

The most serious pressure related injuries (known as Barotrauma) result from incorrect dive profiles as well as rapid ascents resulting in either decompression injuries (DCI) or burst lung(s). First aid action is the same for both.

Symptoms

Treatment

·         Weakness, paralysis, numbness, tingling

·         Vision problems balance problems confusion, convulsions, unconsciousness

·         Large joint pain

·         Skin itchiness or rash

·         Arrange immediate evacuation to recompression facility (tank)

·         Lay casualty flat and administer 100% oxygen

·         If no other injuries or nausea, give isotonic fluids or water

·         DO NOT attempt in water treatment

Shock

In most accidents / incidents casualties will suffer shock

Symptoms

Treatment

·         Weakness, faintness giddiness, anxiousness, restlessness

·         Nausea, vomiting, thirst, cold clammy skin, profuse sweating

·         Shallow rapid breathing, rapid weak pulse

·         Treat prime cause, keep quiet, reassure, keep warm and comfortable

·         Lay down with legs raised (not if DCI suspected) and administer 100% oxygen

·         Monitor condition and evacuate to medical attention

External Bleeding

Symptoms

Treatment

·         Excessive blood loss

·         Open wounds

·         Apply pressure, direct or indirect to pressure points

·         Seek medical assistance

Internal Bleeding

Symptoms

Treatment

·         Signs of shock without blood loss

·         Pain out of proportion to visible damage

·         Pattern bruising coughing / spitting blood, blood in urine / faeces

·         Treat as for shock

·         Urgent evacuation

·         Check and record breathing, pulse and level of response every 10 minutes

·         Put in recovery position if unconscious

 

Fractures

Symptoms

Treatment

·         Sound at initial break, visible bone ends, deformity loss of power

·         Pain, tenderness, swelling / bruising

·         Shock

·         Treat as for shock

·         Keep immobilised where the casualty is lying

·         Keep steadied until splinted or placed in gentle traction

·         Support in most comfortable position

·         Dress open fractures before splinting

·         Don’t miss other less obvious conditions

Burns

Symptoms

Treatment

·         Severe pain at site of injury

·         Numbness if deep burn

·         Sometimes blistered, grey, charred peeling skin

·         Shock

·         Treat as for shock

·         Reassure casualty and cool affected area

·         Remove constrictions and protect affected area

·         DO NOT burst blister or apply lotions or adhesive dressings

Dislocations

Symptoms

Treatment

·         Pain limited or no articulation of joint

·         Deformity or abnormal appearance, swelling / bruising

·         Shock

·         Treat as for shock

·         Support in most comfortable position

·         DO NOT attempt to reset

 

 

Five Minute Neurological Examination – Type II DCI

Date

1. Orientation

Divers Name

Date

Details of Dive

Where are they located

What did they eat last

Notes:

2. Eyes

Hold head still, have patient follow your finger up and down; left and right at a distance of aprox 18 inches from patients face. Note if eyes track equally and if there is are jerky movements. Pupils should be equal size and responsive to light

Notes:

3. Forehead

Have patient close their eyes. Touch the forehead and face lightly. Note any numbness. Have the patient wriggle their eyebrows, they should move equally.

Notes:

4. Face

Have the patient whistle. Watch the ‘pucker’. Note any drooping of the lips. Have the patient smile. Have the patient clench the teeth, feel the jaw for equal tension of muscle.

Notes:

 

 

5. Ears

Have the patient close their eyes, rub your thumb and forefinger together about two feet from patient and move closer until the patient can hear the noise. Note the distance. Note any ringing or auditory disturbances

Notes:

6. Gag reflex

Have the patient swallow and watch the movement of the ‘adams apple’ up and down.

Notes:

7. Tongue

Have the patient stick out their tongue. Note any droop or abnormal movements side to side

Notes:

8. Shoulders

Place your hands on the patients shoulders and have them ‘shrug’. Note any difference in strength. Also check for skin sensation.

Notes:

9. Arms

Have the patient squeeze your fingers with both hands at the same time and compare any difference in strength. Have the patient hold his hands together at chest level and elbow high. Gently push and pull the elbows while the patient resists the movement. Note any difference in strength. Check for skin sensation.

Notes:

 

 

10. Chest

Have the patient close their eyes and check for skin sensation..

Notes:

11. Legs

Have the patient lay flat. Raise and lower the legs while the patient resists. Note difference in strength.

Notes:

12. Heel-to-toe

If possible have the patient walk heel to toe and check balance and coordination. Ensure the patient does not fall.

Notes:

Name of Person Performing the Examination

Time Test Conducted

 

Perform hourly as necessary or if treatment is delayed.