Medical Care At Sea

Question 1

Medical Reporting considerations

Answer 1

1. MGN 564 MAIB Accident Reporting and investigation
2. Maritime declaration of health
3. MSN 1850 MLC health and safety reporting
4. MSF 4159 Occupational Disease reporting

Question 2

What are standard vital signs you expect to see?

Answer 2

Adult.
Pulse = 50-100/min
Respiration = 12-20/min
Temperature = 36.0-37.5 degrees C
Blood pressure = 90-140mm Hg Systolic and 60-90mm Hg diastolic
Saturation of oxygen = 94 -100%

Child
Pulse = 70-130/min
Respiration = 20-30/min

Baby
Pulse = 100-160/min
Respiration = 30-50/min

Question 3

Catastrophic haemorrhage checklist?

Answer 3

1. Raise alarm
2. PPE
3. Lie CASUALTY DOWN, elevate legs
4. Pack and pressure (haemostats 3-5mins)
   Or
5. Tourniquet. Time:?
6. Medical assistance confirmed and ETA?
7. Oxygen non rebreather 15 LPM
8. IV / IO Access, fluids,
9. Pain Relief
10. Cover and support wound
11. Stretcher

Question 4

What are your responsibilities when first on scene of incident?

Answer 4

1. Address mechanism of injury (MOI)
2. Primary survey
   Dangers
   Response
   Airway
   Breathing
   Circulation
   Disabilities
   Environment/exposure
3. Secondary survey
   Head to toe
   Vitals
   History of the casualty
   Alert
   Voice
   Pain
   Unrepsonsive

Question 5

What would you fill out on a TMAS (Telemedical Advice Service) report form?

Answer 5

ATMIST

• Age and name
• Time of injury
• mechanism of injury
• injuries found it suspected
• signs (vitals)
• treatment given

AMPLE

• allergies
• medication currently being taken
• previous medical history
• last oral intake
• events leading up to injury

Question 6

Heart Pulse:

1. What can cause your Pulse rate to increase and decrease?
2. What else do we need to check besides the rate of the heart beat?

Answer 6

1. Pulse to increase:
   - Fever
   - Bleeding
   - drugs
   - Anxiety
   - Emotion

Pulse to decrease:
-Drugs

2. We also need to check the Rhythm and the strength of the beat.

Question 7

Define Systolic and Diastolic pressure?

What are the normal Values for both pressures?

Answer 7

Systolic is the pressure inside the artery when the heart contracts. 90-140mm Hg
Diastolic is the pressure inside the artery when the heart is refilling. 50-90mm Hg

Question 8

What can cause the blood pressure to increase and decrease?

Answer 8

Blood pressure increase:
Pain, Anxiety, Emotion and coronary heart disease.

Blood pressure decrease:
Bleeding and damage to the heart muscle.

Question 9

What’s more serious in the in short term, High or low blood pressure?

Answer 9

Low Blood pressure is more serious in the short term.

Question 10

Why is High Blood pressure sometimes knows as the ‘Silent Killer’?

Answer 10

Because it can show no symptoms until it’s too late as High blood pressure can slowly damage the heart and the arteries over years before causing any issues.

Question 11

8 Possible Symptoms of Hypertension:

Answer 11

1. Severe Headaches
2. Nosebleed
3. fatigue/Confusion
4. Vision problems
5. Chest Pain
6. Difficulty Breathing
7. Irregular heart beat
8. Blood in urine

Question 12

What does a pulse oximeter measure and what is the normal Range in an adult?

Answer 12

It measures the level of oxygen in the blood and normal level is between 94-100%.

Question 13

Procedure for an adult choking?

Answer 13

1. Check for dangers
2. Ask casualty if they can breath or cough?
3. Start 5 back slaps with flat hand, check mouth after each slap.
4. If nothing comes out then, start 5 abdominal thrusts, checking airway after each thrust.
5. If airway still not clear, then back to 5 back slaps.
6. If airways till blocked and they collapse and not breathing, commence CPR. 30 chest compressions and 2 breathes, continue until casualty starts breathing or medics arrive.

Question 14

Choking; What are exceptional circumstances, do we provide 5 breathes first before compressions?

Answer 14

1. Drowning situation
2. Children up to 12 years of age
3. Babies up to 1 year of age

Question 15

What is Angina? What are its signs and symptoms? How can we treat Angina?

Answer 15

It is a disorder of the cardiovascular system!

• Usually caused by atherosclerosis(narrow arteries, so reduced blood supply to the heart)
• lack of blood to the heart(therefore lack of oxygen) during exercise or exertion
• it is temporary and normally subsides when resting
• it’s a warning that the heart is not getting enough oxygen
• can be triggered by stress, extreme cold and heavy meals.

Signs and symptoms;

• heavy or constricting tightness in the chest, this pain can radiate down the arms, back, neck and jaw.
• mild shortness of breath
• possibly nausea or dizziness
• normally continuous pain
• occur due to exertion or psychological stress

Treatment

• sit down and rest
• Loosen tight clothing
• give nitrates (glyceryl Trinitrate) or prescriptive medicine
• if pain doesn’t no subside after a few mins call the EMS or TMAS

Question 16

What is the difference between a heart attack and cardiac arrest?

Answer 16

A heart attack is due to a lack of blood flow to the heart, therefore a circulation problem!
Cardiac arrest is due to an irregular heart beat, therefore an electrical problem.

Question 17

What is the Glasgow coma scale for?

Answer 17

It is a neurological scale that aims to give a reliable and objective way of recording the state of a persons intoxication for initial as well as subsequent assessment.