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 have a look at the mechanism in an RTC for a spinal injury. The first thing we look at when we actually assess the patient is were they wearing a seatbelt or not. As you can see in this occasion, the seatbelt itself holds your pelvis in place and it also comes across the centre of your chest to hold the centre of your body and the upper part of your body in place. This is designed to keep you into the seat under impact. Unfortunately, the problem occurs that the upper part of the neck or the smallest and weakest part, the C-spine, still has flexation. And it also has a head on top of it, which gives it the same equivalent weight of a bowling ball. So when the car stops at high-speed, even though the seatbelt stops your body moving forward, your head and neck still travel forward. The head whiplashes, so you get the whiplash effect on your neck, and then you go back into the seat, and your head then impacts against the headrest, doing C-spine and upper neck damage.If the seatbelt is not worn, the patient comes forward from the seat, the head hits the windscreen. The windscreen, being on an angle tends to break the neck back and then the patient gets thrown back into the car, and the neck and head go back the opposite way. So we get a double impact for a contracture effect where the head gets taken backwards and then forwards and hyperextends the upper part of the neck. The other part of the neck is where all of your vital nerves are situated. So if you break your C-spine, between three and five of the vertebrae, you won't even be able to breathe on your own, because that's where the respiratory centre, it passes through for you to be able to breathe. And this is what, unfortunately, happens in an awful lot of high-speed crashes in particularly where seatbelts are not worn. So look for the wreckage again. Seat belts, were they being worn? Bulls-eyes on the windscreens, have they hit the screen? What impact has occurred on that particular vertebral column? And read that wreckage as to the damage on the patient.Signs and symptoms. Because it's your main vertebral column that all of your nerves fit down. The first sign and symptom people look for is pins and needles. Any sensation rubbing on a spinal nerve will create a sensation of pins and needles in the hands or the hands and the feet. They also look for movement. Can the patient move? So we do a test basically, movement and sense. Touch the back of the hand, and can they feel you touching the back of the hand? Hard or soft. If you pull a hair, it should be a painful stimulus. If it's a nice gentle rub, and they should be able to pick that up. If the channel of information going from the hand back to the brain and back to the hand is correct. First, we should feel a sensation. Second, we should be able to move the fingers on command. We don't want to tell the patient which handle, which foot we're touching. We just touch the hand. So is the information we get back is accurate. Can they move the fingers and can they feel you touching the hand?Then we move down to the feet, and we do the feet independently. Can they move the toes? Can they feel you touching their leg? That way, we can test movement sensation from lower limbs and upper limbs. And we can also test the pins and needles, and strain sensations, which gives us a good indicator along with a number of other checks, whether there is a high potential for the spinal injury. And if so, what precautions are we going to take to manage that patient on extrication to look after their back. Also, one thing that needs to be remembered, modern cars now have airbags, and seatbelt tension is fitted, to most cars are standard. And they are designed to try and help minimize the damage to neck, back, sides, pelvises, and everything else. So bare that in mind. First of all, have they been deployed? It takes a certain speed and a certain impact to actually deploy the airbag. All cars will have steering wheel airbags these days, but they also have passenger airbags. They quite often have airbags in the seat, the side of the seat, and also side-impact airbags that come down to the sides of the windows, if you get a side-impact into a lamp post or a tree.So, have the airbags been deployed? If they have, that is an indication that it was quite high-speed. And the second thing is to look for the damage to the patients. Quite often, the airbag will blow up into the patient's face, to cushion their face from hitting the screen or the steering wheel which can give your patient black eyes. It can also give you nose bleeds. But also, the steering wheel once, when they go off, can also sometimes impact on the back of the patient's hands, creating bruising or small crooks on the back of the hand, from the airbag exploding lost over driving. So look for airbags. One thing to be cautious of, if the airbags haven't deployed, it doesn't mean they won't. So remember, safety comes first. The first service will always carry seat steering wheel covers that go over the steering wheel before we start to work on the patient, just in case it delay deploys. They can deploy twice. Some will actually secondary deploy. And others, sometimes, if there is a malfunction with the detonators, can actually go off at the later date. So please be aware. Safety with steering wheel and airbags.
Spinal Injury in Road Traffic Collisions
Understanding the Mechanism
Examining the mechanism of spinal injury in road traffic collisions (RTCs) is crucial for effective assessment and treatment.
Impact of Seatbelt Usage
Seatbelts play a critical role in preventing severe injuries during RTCs. However, they may not fully protect the neck and upper spine.
Impact Without Seatbelt
Patients not wearing seatbelts are at risk of severe neck and head injuries due to the unrestrained movement caused by collision impact.
Signs and Symptoms
Recognizing signs of spinal injury involves assessing sensory and motor functions:
- Pins and Needles: Sensations of tingling or numbness in the hands or feet.
- Movement: Testing the ability to move fingers and toes.
- Sensory Perception: Assessing response to touch and painful stimuli.
Management and Precautions
Proper management of suspected spinal injuries includes:
- Stabilization: Immobilizing the patient to prevent further damage.
- Extrication: Handling with caution to avoid exacerbating injuries.
- Monitoring: Regular assessment of sensory and motor functions during extrication.
Consideration of Airbag Deployment
Modern car safety features such as airbags can impact injury severity:
- Airbag Deployment: Indicates the intensity of the collision.
- Injuries from Airbags: Bruising or facial trauma from airbag deployment.
- Safety Precautions: Utilizing protective covers for steering wheels to prevent accidental airbag deployment.
Conclusion
Understanding the mechanisms and potential consequences of spinal injuries in RTCs is essential for providing timely and appropriate medical care, ensuring better outcomes for patients.
- FPOS Extended unit 3 LO6.1 and 6.2