Medic FA being replaced

[The Iceni]

Ronmedic once bubbled...
The local Paramedics are well trained in the performance of needle Thoracostomy in the cases of tension pneumothorax that is hemodynamically unstable.

Someone knows what is important!

If Type 1 DCS is involved in a significant manner the circulation throughout the body becomes restricted by the expansion of nitrogen bubbles in the bloodstream and the heart. I have seen many cases during recompression therapy that literally the heart will develop something similar to vapor lock in the ventricles from expansion and accumulation of nitrogen bubbles, effectively making recompression nearly impossible in a local chamber.

Ronmedic,former US Navy Corpsman:doctor:

If only! I know all US paramedics have much more stringent training than their British equivalents - six weeks of paramedic school and then on-the-job training - so it does not surprise me that this can be included in your courses. My past includes being the medical officer of a parachute regiment battalion. As a former military man , you clearly appreciate the importance of early resuscitation and the inevitable delays whenever a diver (or soldier) is injured. There will of course be occassions when even instant treatment is unhelpful and the cases you quote are examples of that, but even the most highly qualified attendant must assess the casualty's condition with the information at hand and PB is not always associated with arterial gas embolism - at least in the early stages - which is when needle thoracostomy will be very effective, much like intravenous glucose in hypoglycaemic coma. Surely it is worth trying? :boom:

By the way Ron, do you not mean the more serious type II DCI?

 

[Ronmedic]

If only! I know all US paramedics have much more stringent training than their British equivalents - six weeks of paramedic school and then on-the-job training - so it does not surprise me that this can be included in your courses. My past includes being the medical officer of a parachute regiment battalion. As a former military man , you clearly appreciate the importance of early resuscitation and the inevitable delays whenever a diver (or soldier) is injured.






In The US Paramedics are put through 13 months of intensive didactic and clinical training, prior to that they must have at least 2 years experience working in the field as basic level EMT's whose course is 12 weeks long.

 

[The Iceni]

Ronmedic once bubbled...
In The US Paramedics are put through 13 months of intensive didactic and clinical training, prior to that they must have at least 2 years experience working in the field as basic level EMT's whose course is 12 weeks long.

Sadly, it would seem that in the US human life is valued much more highly than it is over here. But our paramedics wear a really snazzy uniform, some even have motorbikes!

No wonder your ancestors fought a revolutionary war!

:boxing:

 

[Butch103]

cmay once bubbled...
Guys,

I respect your views, and I understand where you are coming from but I think we are getting a little ahead of ourselves. Let's remember the purpose of the MFA (or whatever) course is to teach basic first aid. I feel that it is extreme to teach such advanced techniques such as thoractostomy to recreational divers. Quite frankly, it scares me to think about it.


Chris

I am in the middle of completing my Rescue Diver training....I have completed my first aid thru St John ambulance and CPR thru Heart and Stroke..........I don't expect to bring anyone back from the dead. If it is at all possible I leave it up to the highly trained.......I want to dive, dive safe and if need be lend a hand in an emergengy situation if required.....no more , no less......If one is to believe that we in fact need diving EMTs or something similar ( I do believe there is such a course now), than best PADI, NAUI, SSI and the rest of the organizations come up with the course in conjuction with some local college/university/educational institute.

 

[The Iceni]

Butch103 once bubbled...
I don't expect to bring anyone back from the dead. If it is at all possible I leave it up to the highly trained.

I fully accept your position, Butch103, and agree that this is perhaps a step too far and I am not criticising you at all.

Can I explain my possibly unique philosophy?

Once upon a time no one would have dreamed that bystanders could attempt, let alone succeed, at that every thing. AED allows those, such as yourself, to effectively bring the victims of cardiac arrest "back from the dead". Defibrillation is time critical, but so is the treatment of tension pneumothorax.

While I fully accept that many diver casualties will be beyond help there are likely to be a number who appear to be so but who could be fully resuscitated as with VF in acute MI. In particular, there are the victims of apparent drowning who are hypothermic (particularly chidren).

As a graduate of the courses you mention am I right in believing these are variations of "public first aid" with the emphasis on BLS and that they do not touch greatly on the causes and treatment of pulmonary barotrauma or electromechanical dissociation?

Army medics are taught the treatment of a "sucking chest wound", which they are very unlikely to see before they are required to treat one for real on the battlefield, with no supervision by any "professional" but, as I am sure Ron will confirm, they have saved many lives in Vietnam and elsewhere.

Do not deprecate your own abilities. The point I believe I have made, and obviously overstated, is that with a modicum of training diver rescuers could recognise the features of pulmonary barotrauma (such as in the example I gave before) and provide definitive treatment, preventing an inevitable arterial gas embolism and everything that that means.

At one time we would not have expected ordinary divers to administer 100% oxygen to the victims of DCI as this was considered beyond their capabilities and so should more properly be left to the "professionals" but the benefits of early oxygen administration are now beyond doubt.

In addition I undertsood the purpose of first aid was to attempt resuscitation in all cases because without it death is often almost certain?