I don't normally post here (normally on the deco stop), so I'll do a quick intro:
I'm an ER doc, former full-time technical instructor/cave diver/RB diver/ etc. and currently work as a hyperbaric medicine physician in Durham.
A couple of points:
1)You guys could benefit from one of the formal classes mentioned above, you got cookie-cutter advice from good paramedics on your end, but not dive-related training.
2) be careful with CPAP in diving injuries (could be overexpansion injuries/AGE) it could worsen the situation and usually isn't needed. Totally agree CPAP is great for the things you mentioned...I use it all the time in the ED to stave off intubations.
3)I also ran a wilderness SAR team a long time ago...as far as the medical info: we had docs suggest a common form, laminated that form and sealed all of them in an envelope that the team medic carried.
>> Allergies, past medical history, past surgical history, medications, immunization (tetanus), smoker Y/N, emergency contact info, any other pertinent history.
>>you should have a form that you can fill out that includes: dive depth, duration, gas mix, dive history prior to last dive, time to onset of symptoms, treatment given and when started, neurological exam, any events during dive (unexpected loss of control/buddy history/blowups, onset of symptoms at depth, deco obligation, etc.) and protocols for securing equipment. Send the computer with the diver if possible.
4)send a medic or two to an official course if you can. You can also contact me for several ideas on things to consider. The NOAA manual has almost everything you could want and is a much quicker read than the Navy manual...plus the scientific diver mission more closely approximates your diver needs.
5)the medical control MD for the paramedics can review the c-collar and board requirement for divers
6)you need to be able to give O2 and fluids (normal saline, not D-5 anything)...all else other than airway control is just supplemental for a transport.
7) you CAN fly an injured diver IF you (1) have a 1 ATA pressure capable plane (many medical jets can do this) or (2) the helo can stay below 1500 (some prefer 1000, some say higher is OK I like lower, when safe to do so).
Hope this helps,
Richard
I'm an ER doc, former full-time technical instructor/cave diver/RB diver/ etc. and currently work as a hyperbaric medicine physician in Durham.
A couple of points:
1)You guys could benefit from one of the formal classes mentioned above, you got cookie-cutter advice from good paramedics on your end, but not dive-related training.
2) be careful with CPAP in diving injuries (could be overexpansion injuries/AGE) it could worsen the situation and usually isn't needed. Totally agree CPAP is great for the things you mentioned...I use it all the time in the ED to stave off intubations.
3)I also ran a wilderness SAR team a long time ago...as far as the medical info: we had docs suggest a common form, laminated that form and sealed all of them in an envelope that the team medic carried.
>> Allergies, past medical history, past surgical history, medications, immunization (tetanus), smoker Y/N, emergency contact info, any other pertinent history.
>>you should have a form that you can fill out that includes: dive depth, duration, gas mix, dive history prior to last dive, time to onset of symptoms, treatment given and when started, neurological exam, any events during dive (unexpected loss of control/buddy history/blowups, onset of symptoms at depth, deco obligation, etc.) and protocols for securing equipment. Send the computer with the diver if possible.
4)send a medic or two to an official course if you can. You can also contact me for several ideas on things to consider. The NOAA manual has almost everything you could want and is a much quicker read than the Navy manual...plus the scientific diver mission more closely approximates your diver needs.
5)the medical control MD for the paramedics can review the c-collar and board requirement for divers
6)you need to be able to give O2 and fluids (normal saline, not D-5 anything)...all else other than airway control is just supplemental for a transport.
7) you CAN fly an injured diver IF you (1) have a 1 ATA pressure capable plane (many medical jets can do this) or (2) the helo can stay below 1500 (some prefer 1000, some say higher is OK I like lower, when safe to do so).
Hope this helps,
Richard