Marine First Aid Level 4 (VTQ)
Course Content
- Course Introduction
- Human anatomy and physiology for immediate emergency care
- Safety and Calling for Help
- What3Words - location app
- Marine band radios
- Marine VHF Radios
- Common Coastal Water Dangers
- Common Fresh Water Marine Dangers
- Emergency Flares
- LED Flares
- The Coastguard
- The Air Ambulance
- Personal Location Beacons
- Accident Prevention
- Boat Safety
- Calling for help
- Water safety tubes
- Types of Blankets
- Emergency response for hybrid and electric boats
- First Aid and Safety Equipment\
- Initial Assessment and Care
- Basic airway management in emergency care
- CPR
- AED
- Administration of oxygen therapy
- Drowning
- Choking
- Shock
- Bleeding
- Catastrophic Injury
- Injuries
- Hypothermia
- Illness
- FIrst Responder - Management of injuries
- Prioritising first aid
- Pelvic Injuries
- Spinal Injuries
- Rapid Extrication
- SAM Pelvic Sling
- Box Splints
- Spinal Injury
- Stabilising the spine
- Spinal Recovery Position
- Introduction to Spinal Boards
- The spinal board
- Using the Spinal Board
- The Scoop Stretcher
- Using the scoop stretcher
- Cervical collars
- Vertical C-Spine Immobilisation
- Joint examination
- Adult fractures
- Types of fracture
- First Responder - Management of trauma
- Elevated Slings
- Lower limb immobilisation
- Elevation Techniques
- Helmet Removal
- Different Types of Helmets
- The Carry Chair
- Applying Plasters
- Strains and Sprains and the RICE procedure
- Eye Injuries
- Electrical Injuries
- Foreign objects in the eye, ears or nose
- Nose bleeds
- Bites and stings
- Chest Injuries
- Foxseal chest seals
- Abdominal Injuries
- Treating Snake Bites
- Types of head injury and consciousness
- Dislocated Shoulders and Joints
- Other Types of Injury
- Dental Injuries
- First Responder - Management of medical conditions
- Asthma
- Asthma Spacers
- When an Asthma inhaler is not available
- Accuhaler®
- Heart Attack
- Warning signs of cardiac arrest and heart attack
- Heart Attack Position
- Aspirin and the Aspod
- Stable angina
- Hypertension
- Pulse Oximetry
- Epilepsy
- Epilepsy treatment
- Meningitis
- Diabetes
- Blood Sugar Testing
- Poisons and Food Poisoning
- Shock
- Near and secondary drowning
- Cold water shock
- Allergic Reactions and Anaphylaxis
- Course Summary
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So let's take a look now, the box splints, they should come as a kit, the splint itself, packing from the hollows, if we have a fracture. And then straps to actually strap the good leg and the bad leg together for extrication purposes or moving purposes. The box itself is a foam soft pack with a hard base to give it some stability and support and a hard footplate to again, give the foot some support. Held together with Velcro straps which lock over the injury itself and fix the leg in place. They come in two sizes. There is a short box splint and this one is a long box splint. They are for low limb fractures, below the knee. Long box splints are never put on a fracture that's above the knee because all we do if we put it on a fracture above the knee is add weight and pain to the patient. They are for below the knee fractures, feet and toes. Fitting the measuring box splint to a lower-limb-fracture. Remember what we said that for a fracture below the knee to the tip of the turn.Two or three important things, if we put this on to a fracture above the knee, all we're doing is adding weight and flexation to the fracture itself. So it's always below the knee, with a false splint and if we've only got an ankle injury, we can use the small box splint, just to immobilize the ankle itself. On this occasion, what we're doing is we've got a mid-shaft fracture. The important thing is that we have to move it, but we have to move it with care. If we just lift the foot the fracture will flex and the pain will be excruciating, and we don't want to put the patient through any more pain than we can help. This is all about taking it nice and steady and being careful. We need to support the fracture, so when we lift the leg we only lift it a fraction, just enough to slide the splint underneath, and to reduce any flexation in that fracture to its absolute minimum, because all bones have arteries, blood vessels, nerves, so any flexation can create further problems for the patient.So the best position to actually move the leg is to use the underside of the ankle itself, where it comes away from the floor because we can quite easily go under there without moving whatsoever, and the other one is at the back of the knee, again, where we've got a hollow in the limb, and we can then slide our hands together slightly underneath the hand underneath the leg to actually support the fracture itself. The splint will then be slid underneath whilst the leg is slightly raised. So, Keith, give me a hand, hand underneath the ankle, hand underneath the knee, slide your hands towards the fracture and then gently lift, slide the splint underneath. And then, lower gently into the box. If there are any hollows, dips or anything that we need to support, we have the packing to allow us to do that. And quite often it's good to use gauze as packing underneath the hollows. We would use the clothing initially as a support mechanism to lift the limb completely, but now we would cut the clothing to actually expose, and have a look at what's going on to make sure there are no injuries, no bleeds going on that we currently can't see. We would also take the shoe off, by cutting the lace and exposing the toes so we can check for pedal pulses and we can check the cap refill to make sure that the fracture is not restricting blood flow to the foot or toes.Once we're happy with all that the splint is then tightened up. So basically the Velcro straps cross the box and lock on to the opposite Velcro on the other side. If there is a fracture area where a Velcro strap is, sometimes it's advisable not to tighten that particular Velcro strap up, because we don't want to apply pressure directly over the fracture itself. Once all of the straps are done, the foot plate comes up and the two Velcro straps cross over the bridge of the foot from one side to the other, and then the last strap goes over the bridge of the foot to lock everything in place. We have immobilised the foot, the ankle, the tibia and fibula to the upper limb. We would then either move the patient with the splint as they are or we could then go to the next stage where we move the good leg to the bad leg. We can splint both legs together and move as one solid fixed unit.
Using Box Splints for Lower Limb Fractures
Overview of Box Splints
Understanding the components and application of box splints for stabilising lower limb fractures.
Key Features
- Soft Foam Pack: Equipped with a hard base and footplate for stability.
- Velcro Straps: Securely fasten the splint, providing support and immobilisation.
- Two Sizes: Short and long box splints cater to different fracture locations.
Application Techniques
Choosing the Right Size
- Short box splints for fractures below the knee.
- Long box splints for fractures below the knee, feet, and toes.
Fitting the Splint
- Ensure the splint is positioned below the knee to avoid additional weight and discomfort.
- For ankle injuries, utilise the small box splint for immobilisation.
Proper Application
- Support the fracture to minimize pain and further complications.
- Slide the splint underneath the leg with gentle lifting, avoiding excessive flexation.
- Utilize the underside of the ankle or the back of the knee for support during movement.
Securing the Splint
- Fasten the Velcro straps, ensuring they do not exert pressure directly over the fracture.
- Check for any hollows or dips and use packing, such as gauze, for additional support.
- Inspect the limb for injuries and ensure proper circulation before tightening the splint.
Final Steps
- Once all straps are secured, cross the footplate straps over the bridge of the foot to lock everything in place.
- Immobilize the foot, ankle, tibia, and fibula to form a solid fixed unit.
Conclusion
Box splints provide effective immobilisation and support for lower limb fractures, ensuring patient comfort and safety during transportation and treatment.