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Advanced Maritime EMS?

Discussion in 'Advanced Scuba Discussions' started by George Price, Sep 29, 2016.

  1. Kevrumbo

    Kevrumbo Banned

    # of Dives: 1,000 - 2,499
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    Imagine doing that "inside a Scuba tank during a fast fill". . .

    The worst case scenario that we trained as Volunteer Crew for inside the Catalina Recompression Chamber was performing CPR on a full cardio-respiratory arrest casualty with AGE, in the 90 to 100 degF heat of compression to 6 ATA (165'). You have to continue working it as a team alongside LA County Baywatch Paramedic/Lifeguards until the victim regains vital signs (not likely), or the Emergency/Hyperbaric Physician arriving by helicopter from the mainland some 30min later examines & declares the patient dead.
     
    Last edited: Oct 1, 2016
  2. DaleC

    DaleC Solo Diver

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    If you are 12+ hours from evac (such as a remote charter) you had better not be the primary care giver available as a guest/customer.

    I'm not trying to be argumentative but there is nothing in a "marine environment" medical course that is more "helpful" than a good land based course gives you, from a first responder perspective. A dive oriented F/A course will not give you more/better info than say, a wilderness F/A course, which is specifically designed to deal with delayed transit concerns. Knowing what to expect from a chamber facility is interesting but no one is going to let an outsider operate a chamber or take the ride with a patient. Jelly fish stings are unique, as are shark bites, but they both follow the basic principles of anaphylixis and avulsion treatment. Yes the marine environment is different than land but so is treating someone stuck in a tree, down a well or under a bus.

    It is far better to be proficient in delivering the core interventions comprehensive mainstream courses teach you: CPR/AED, O2 therapy, shock mitigation and the ABCD's of primary care. I would rather someone take a good F/A - CPR course 5 times and get it right than taking 5 different courses. If you have those skills down you simply flex them for whatever environment you are in, but the interventions are still the same. There is no unique "marine" injury that lies outside that.

    Kev's scenario paints an exotic picture but at its core it is just someone performing CPR until relieved. The more proficient, the better. AGE has no bearing on what is delivered neither does the temp nor does the ATA.
     
    Last edited: Oct 1, 2016
  3. Kevrumbo

    Kevrumbo Banned

    # of Dives: 1,000 - 2,499
    Location: South Santa Monica Bay/Los Angeles California, USA
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    For that draconian scenario of a remote location without a nearby Recompression Chamber, with a prolonged or delayed long distance medevac route for transport: In-Water-Recompression Course such as offered by IANTD, can be a useful albeit controversial skill set to have for the First Responder.
     
  4. Bubblesong

    Bubblesong Marine Scientist

    # of Dives: 50 - 99
    Location: Massachusetts
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    True about repeating training, but varying scenarios keeps it interesting. Low expense EMT options are available through local Firefighters Dept. And on the high expense side is this example: the two week class in Anthony's Key resort is $1,000.00 and not available during summer month schedule: Diver Medic Home - Diver Medic for that info.
     
  5. Kevrumbo

    Kevrumbo Banned

    # of Dives: 1,000 - 2,499
    Location: South Santa Monica Bay/Los Angeles California, USA
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    DaleC, any Underwater Breathing Apparatus diving casualty that surfaces and presents to the Catalina Recompression Chamber as unconcious full arrest is Rule/Out Arterial Gas Embolism, and treated with basic & advanced Life Support while undergoing recompression treatment to 6 ATA for AGE. The point is as non-professional EMS personnel, we as Volunteer Chamber Crew choose to be in there in the heat of compression trying to save the Diver's Life at this particular emergent point in time. We're already certified recreational Rescue Divers, but also further interested in learning higher levels of life support and serving active stand-by duty in the emergency chain of care for dive accidents.

    In other words, the relevancy of Recompression Chamber Operations & Advanced Life Support obviously doesn't apply to a First Responder whose primary task is to rescue, recover and stabilize the victim while awaiting for medevac transport to higher levels of care -so your point is moot as well as ignorant DaleC. . .
     
  6. Bubblesong

    Bubblesong Marine Scientist

    # of Dives: 50 - 99
    Location: Massachusetts
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    So can you post where to look for training opportunities? I live in Boston area, and I am searching on line, but if you know some of the possibilities to Internet search for, I could use some direction.
     
  7. Wookie

    Wookie Orange Man Bad Staff Member ScubaBoard Business Sponsor

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  8. DaleC

    DaleC Solo Diver

    # of Dives: 500 - 999
    Location: Leftcoast of Canada
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    Well... I think you what you are saying amid the excess verbage is that chamber crews take people into chambers... in there they provide basic and advanced life support... the relevancy of Recompression Chamber Op's etal doesn't apply to first responders... whose primary task is to rescue, recover and stabilize while awaiting medivac... So yeah... exactly what I said. If it sounds moot or ignorant it's probably just because you said it too and you have that effect on things.

    As a first responder on a boat you may have to recover a diver from the water and provide basic care. You will not package for the USCG to transport, you will not accompany the USCG to acute care, you will not go in the chamber to continue care. Everything you need to do is covered in a comprehensive F/A course.

    My point is that competency is not gained by jumping from boutique course to boutique course but rather from practicing core skills repeatedly until they become ingrained so that, if the time to act comes, you will get most of the things right, most of the time.

    Good god, those GUE guys have infected me...
     
    Last edited: Oct 1, 2016
    Wookie likes this.
  9. Kevrumbo

    Kevrumbo Banned

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    No DaleC.

    Competency and skill is gained by constant practice and drill by applying it and being involved in an active EMS program that requires you to be ready to do it right for real, the first time -all the time.

    The Recompression Chamber at Catalina Island and its comprehensive volunteer program is a satellite extension of the mainland Los Angeles County/USC Medical Center Emergency Dept and has never been a one & done suite of "boutique certification courses" (as you so imply DaleC): Essentially we're recreational Rescue Divers trained as volunteer Chamber Operators standing-by alongside professional LA County Lifeguard/Paramedics, ER/Hyperbaric Medicine Physicians and USCG personnel to take in & treat actual diving casualties. And while we're standing-by, we are all prepping, going over & practicing basic First Aid/CPR core skills along with chamber operation training run scenarios & contingencies.

    (Btw, with the opening of SoCal Lobster Season last night, this weekend is the annual potential "DEFCON One" triage condition for LA County EMS Lifeguard/Paramedics, Catalina Chamber Ops, USCG and California State Fish & Game Officers)
     
    Last edited: Oct 2, 2016
  10. Bubblesong

    Bubblesong Marine Scientist

    # of Dives: 50 - 99
    Location: Massachusetts
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    Wookie, thanks for Mass Maritme, that is an option because my sister lives close by and can put us up for some training days, but at college credit prices, I am still looking.

    Kevrumbo, the volunteer program you describe would be exactly what my daughter and I would be interested in, but in Mass area. Plus both my kids are engineering majors, and developing new types of safety and rescue products would be an interesting goal, so learning these skills and equipment for Diver Medic Training would be a step in that direction. Thank you!

    So far this link shows a number of places that train Diver Med Tech with re compression chambers that are far from me but could be useful to others following this thread: http://www.nbdhmt.org/forms/DMT_Approved_Training_Courses.pdf
     
    Last edited: Oct 1, 2016

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