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Dr Kathy DeGaris Dr Rosie Colahan

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Planned Voyage Crew Considerations Boat Equipment Legal Compliance - Drugs Before you leave.....

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Before you leave.....CREW Personal Fitness GP Visit Travel Consult Dental check up Crew Confidential Medical Questionnaire Medications including for seasickness Allergies Action Plans for chronic disease Own Water bottle

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YA Blue Book Special Regulations Section 2 Medical Guides Injury/Illness Chart Apply First Aid Certification Medical Kits Contents, storage Simplified Day Medical Kit Accessing Drugs for Ships Supplies Before you leave.....BOAT EQUIPMENT

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Medical Kits Contents Medication Storage Simplified Day Medical Kit Accessing Drugs for Ships Supplies Before you leave.....BOAT EQUIPMENT

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Drugs for Ships Supplies S4 (antibiotics, pain killers, prescription drugs) S8 (restricted drugs, opiates) Legal requirements DHS Drugs & Poisons (Victoria) Customs Storage Record of Supply & Administration Before you leave.....BOAT EQUIPMENT

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Contact details and coverage for Emergency Medical Assistance Communications HF/VHF Radio, Satphone, Mobile phone Authorities Organising Authority SAR (Search & Rescue) - AMSA Water Police Ambulance - Local 000 or International 112 (GSM) Hospital Before you leave.....BOAT EQUIPMENT

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On the Water Medical Emergencies requiring Advice Before administering prescription drugs Cardiac emergency Eye injury Severe pain Diarrhoea with fever Severe burns

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On the Water Illness / Injury Chart Monitor patient over time Record admin of medication Fluid balance Hand-over to SAR, ambulance, hospital Next of Kin Notify and keep them posted

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Medical Emergencies First Aid Priorities Head Injuries Fractures Dislocations

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First Aid Priorities Danger Response Send for Help Airway Breathing Circulation

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First Aid Priorities REMOVE FROM DANGER EXPOSURE Sunstroke / Sunburn Hypothermia DROWNING MOB DANGER RESPONSE SEND AIRWAY BREATHING CIRCULATIO N

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First Aid Priorities ASSESS CONSCIOUS STATE (Shout and squeeze hand) Unconscious Needs constant supervision Conscious Record obs over time ? MOVE CASUALTY Safe protected area No risk of falling Observer access Observation over time DANGER RESPONSE SEND AIRWAY BREATHING CIRCULATIO N

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OBSERVATION SHEET

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First Aid Priorities SEND FOR HELP On the boat Emergency Authorities DANGER RESPONSE SEND AIRWAY BREATHING CIRCULATIO N

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First Aid Priorities AIRWAY Clear Airway of obstructions (loose teeth, tongue, vomit) Lie Casualty on their side ? Oral airway DANGER RESPONSE SEND AIRWAY BREATHING CIRCULATIO N

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First Aid Priorities BREATHING Disposable face shields or CPR mask +/- hand operated breathing bag Ventolin puffer if wheezing DANGER RESPONSE SEND AIRWAY BREATHING CIRCULATIO N

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First Aid Priorities CIRCULATION Pulses Wrist (Radial) Groin (Femoral) Neck (Carotid) Chest (Cardiac) Skin Colour White - blood loss Blue- Hypothermia Green Seasickness Red Sunburn / hyperthermia DANGER RESPONSE SEND AIRWAY BREATHING CIRCULATIO N

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Injuries Head Injuries Open / Closed Fractures Dislocations Fish Hooks Wounds

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Head Injuries Open Closed Observation - Modified Glascow Coma Scale (GCS)

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Fractures

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Fracture Management - Limbs Immobilisation of joint above and joint below the fracture site

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Fracture Management Upper limbs Air splints Slings Lower limbs Air splints Tying legs together Fingers Taping Splinting Ribs Supportive clothing/ brace Hugging a cushion

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Dislocations - Fingers 1.Face the patient, both in standing positions. 2.Firmly grasp the end of the dislocated finger. 3.Request the patient to lean backwards while maintaining the finger in a fixed position. 4.As the patient leans back sudden painless reduction should occur.

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Dislocated shoulder 1.Hang affected arm over back of seat. 2.Grasp the patients wrist with one hand and exert a steady downward pressure. 3.Place the other hand in the armpit exerting a direct outward pressure against the upper part of the upper arm. 4.When appropriate muscle relaxation is achieved, the head of the upper arm slips back into the shoulder joint.

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Removal of Fish Hooks

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Wounds 1. Assessment 2. Dressings 3. Suturing 4. Splinting /slings

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Wound Assessment Site Size and depth ? Under tension ? Skin loss Complicating factors

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Wound Assessment Not under Tension Under TensionOther Superficial DressingSteristrips Micropore tape Glue ? Bandaging Deep ? Steristrips ? Glue ? Suture Deep & skin sutures Bandaging and splinting Complex Sutures Skin flaps ?Antibiotics ? Analgesia

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Suturing - Instruments NEEDLE HOLDERS SCISSORS TISSUE FORCEPS TOOTHED FORCEPS

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Wounds Get the patient comfortable ? Analgesia Get yourself comfortable Non skid mats Tray for instruments Elbows braced on the tab le

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Sharps Disposal Do not re-use syringes, needles or suture material. Dispose of needles into impervious screw top container

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Burns TypeAppearanceCauses First degree RednessSunburn, scalds, chemicals Second degree Redness, blisteringHot liquids Third degree Full thicknessFire

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Burns Cold water immersion for > 20mins Cool compresses Analgesia Rehydration Severe burns Antibiotics Medical evacuation

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Burns TypeManagement First degree Solosite gel applied repeatedly Second degree Solosite or Flamazine (silver) under padded dressing Third degree Flamazine & padded dressing Rehydration. Analgesia. Antibiotics

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More information www.orcv.org.au