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Rescue in Bream Bay, DIY style


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This is an excellent thread.

And we should all read it and share experiences. 

Also the current up-to-date best practice for resus in drowning cases would be damned useful. I did a resus (defib etc) course a month ago, and was a little disappointed that it was entirely aimed at resus after cardiac events. No info on drowning or electrical accidents.

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7 hours ago, DrWatson said:

This is an excellent thread.

And we should all read it and share experiences. 

Also the current up-to-date best practice for resus in drowning cases would be damned useful. I did a resus (defib etc) course a month ago, and was a little disappointed that it was entirely aimed at resus after cardiac events. No info on drowning or electrical accidents.

Hers 2 confusing statements from <r Google

Drowning adult:

Call 999. Perform chest compressions to the time of "Staying Alive". Do not give rescue breaths. Continue compressions until help arrives.

 

 

Turn the drowning person's head to the side, allowing any water to drain from his or her mouth and nose. Turn the head back to the center. Begin mouth-to-mouth resuscitation on land, if possible, or in the water if the injured person needs immediate life-and-death measures.

 

And what I actually thought was cpr with patients head tilted so water etc could drain.End of the day doing something is better than nothing.

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22 minutes ago, harrytom said:

Call 999. Perform chest compressions to the time of "Staying Alive". Do not give rescue breaths. Continue compressions until help arrives.

The reasoning now is that every time you do a compression cycle, air has been pumped in and out of the lungs in an amount that will ensure enough oxygen has entered the system. Heart compression and thus movement of blood is so essential that it is more important to maintain chest compressions and not to bother with the breathing part.
Of course none of that is possible if the person is in the water. It is considered that the person when in water may have only just stopped breathing and the heart is still pumping, so resus by giving breaths may keep a persons heart pumping till you get them to shore.
The turning of head to side is only temporary to drain exess water from airways etc. The person should then be placed on their back and checked for pulse and then chest compressions started if no pulse found

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55 minutes ago, wheels said:

The reasoning now is that every time you do a compression cycle, air has been pumped in and out of the lungs in an amount that will ensure enough oxygen has entered the system. Heart compression and thus movement of blood is so essential that it is more important to maintain chest compressions and not to bother with the breathing part.
Of course none of that is possible if the person is in the water. It is considered that the person when in water may have only just stopped breathing and the heart is still pumping, so resus by giving breaths may keep a persons heart pumping till you get them to shore.
The turning of head to side is only temporary to drain exess water from airways etc. The person should then be placed on their back and checked for pulse and then chest compressions started if no pulse found

But the second statement says to rescue breath,thats the confusion.

So which one is right??

Do not give rescue breaths.   or        Begin mouth-to-mouth resuscitation 

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1 hour ago, harrytom said:

Hers 2 confusing statements from <r Google

What does DrDave recommend during the offshore first aid course?

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30:1 is what is currently taught at NZ First aid courses although last year the breath had been suspended due to covid risks even for ambo staff.

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55 minutes ago, Sabre said:

30:1 is what is currently taught at NZ First aid courses although last year the breath had been suspended due to covid risks even for ambo staff.

Yeah that hold still, but what about getting water out of their lungs?

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I was discussing it with a Fairly high up First Aid trainer and they had said that the dropping of the breaths part was in consideration and most likely going to be adopted at some stage, but they had no firm confirmation that it would be dropped or when.

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The official info in NZ is maintained on the New Zealand Resuscitation Council's site. https://www.nzrc.org.nz/

CPR here which still talks of a ratio of 30:2 for compressions to breaths but many organisations suspended the breaths due to COVID and I've heard the same as Wheels - the compressions move an adequate amount of air so if in doubt or on your own - focus on those.

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Decades ago I went to the only course I could find that seemed remotely applicable. Something lije First Aid when there isnt a doctor. It was in Sydney. 

In nearly every circumstance they said " make the patient comfortable till help arrives ".

Waste of money as i was heading into the southern ocean. 

 

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16 hours ago, harrytom said:

Do tell Kevin.What would you do?You wont know they cant tread water until you there and as you said not approach as they can pull you under.

Still awaiting Kevins answer but not holding my breathe

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4 hours ago, DrWatson said:

What does DrDave recommend during the offshore first aid course?

Have a crack at resuscitation but say goodbye

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1 hour ago, Dtwo said:

Have a crack at resuscitation but say goodbye

Dr Dave's course notes when I did it in 2017

Module 2: MAJOR TRAUMA

·        Examples – Hit in head by Boom during an uncontrolled Gybe, hit by an exploding winch or block etc

·        It happens… In Moreton Bay last year, Rum race. Gybe and hit crew on head with boom à Intracerebral bleed and many broken facial bones + depressed skull fractures

 

·        TAKE YOUR OWN PULSE

·        SAIL THE BOAT FLAT!! People commonly forget this

·        ABC = Airway, Breathing, Circulation

·        Conscious?  ?breathing  NO

·        If no  CPR

·        N.B. CPR in community has a 1% chance of GOOD recovery!

·        Hence if doing CPR at sea TOAST

·        However – you still attempt it, but be prepared for bad outcome.

·        Difficult as it is one of your crew mates

·        A debrief is ESSENTIAL afterwards

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7 hours ago, Dagwood said:

The official info in NZ is maintained on the New Zealand Resuscitation Council's site. https://www.nzrc.org.nz/

CPR here which still talks of a ratio of 30:2 for compressions to breaths but many organisations suspended the breaths due to COVID and I've heard the same as Wheels - the compressions move an adequate amount of air so if in doubt or on your own - focus on those.

Yip - it’s “thirty to two - no matter who”

compression rates have changed multiple times over the years, but the emphasis is on pushing originated blood around the system. If the blood isn’t moving, then nothing is getting oxygen. 

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2 hours ago, Kevin McCready said:

I don't answer silly questions

so you dont the answer?? simple question following your statement"a person cannot tread water will pull you down"so what are you suppose to do??

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1 hour ago, harrytom said:

so you dont the answer?? simple question following your statement"a person cannot tread water will pull you down"so what are you suppose to do??

I don't think chasing Kevin around is going to advance the thread much HT. Best move on ay. At the end of the day, there are going to be situations where people will die. No one wants to say it, but there will be a point where you need to decide if it is you or them. Most of the time, that is going to be them, we just don't want to say that.

The exception being kids. I think a lot of parents would put themselves in extreme, basically fatal danger to try and save their kids.

Thinking about the rescues I've been involved in, on both sides of the ledger, they've all be rather un-dramatic. Towing boats drifting in the English Channel, one out of the shipping lane engineless in fog (mine, unfortunately, I wasn't in charge though...)

Most recently I helped a young guy (mid teens) who was trying to swim from Ti Point to Omaha across a f**king ripping tide, after a day's spear fishing. He was skinny, cold and tired, but thought he could do it. With weight belt and spear gun etc.. His bigger mate had already done it. Just after sundown... in winter. I stopped him and gave him a lift back in my car. Randomly had a hot flask of water in my car so feed him warm tea, chocolate and peanut butter. Had my surfing gear with me so put him in my warm poncho to dry off and warm up. Their biggest problem was they hadn't caught enough fish for dinner, so I then drove them to the shop for extra food. They were camping in a tent behind an empty house in Omaha. Very random. It was a shitty evening for me to go for a walk, but I felt like some fresh air before having dinner with mates. Chance encounter, right place right time.  I doubt it would have ended well if he tried it.

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11 hours ago, marinheiro said:

Dr Dave's course notes when I did it in 2017

Module 2: MAJOR TRAUMA

·        Examples – Hit in head by Boom during an uncontrolled Gybe, hit by an exploding winch or block etc

·        It happens… In Moreton Bay last year, Rum race. Gybe and hit crew on head with boom à Intracerebral bleed and many broken facial bones + depressed skull fractures

 

·        TAKE YOUR OWN PULSE

·        SAIL THE BOAT FLAT!! People commonly forget this

·        ABC = Airway, Breathing, Circulation

·        Conscious?  ?breathing  NO

·        If no  CPR

·        N.B. CPR in community has a 1% chance of GOOD recovery!

·        Hence if doing CPR at sea TOAST

·        However – you still attempt it, but be prepared for bad outcome.

·        Difficult as it is one of your crew mates

·        A debrief is ESSENTIAL afterwards

Thanks for this. 

I'm actually interested in the CPR in community numbers. 

Many of these I suspect are resusitation after an incident caused by an underlying condition. I'd like to know a couple of things:

Firstly, how does this improve if someone has access to an AED within the first 5-10 minutes? from my course I understood it was that success could be increased to as much as 30%, but the course was in Swiss german and despite living here for some 14 y, I'm not sh*t-hot at that crazy speak.

Secondly, what are the success rates of community CPR for drowning victims, being that many will not likely be coupled to an underlying medical condition?

Thirdly, how does the success of resus after near drowning improve if an AED is available (time is hard to tell here cause accurately determining the time of non-breathing in a drowning victim is kinda difficult. Time from immersion?

Another reason I ask is that I'm considering adding a defibrillation device to the inventory on FIREFLY. Around €2k, for a reasonable one over here. The way I see it, that could easily be the difference between saving the life of a crew member or not, or of someone else in the anchorage, or someone you fish out of the sea.... and we all know that a lot of cruisers are no longer as fit or as young as they believe themselves to be. If that €2K spend saved a life I would consider it extremely well spent money. If I kept it 14y and put 2 new batteries in it and didn't need it I would also consider it $ well spent. 

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20 minutes ago, aardvarkash10 said:

€2K on safety equipment instead of a new sail?  What is this madness???  😂

I'm not allowed the sail unless I can categorise it as safety equipment...

 

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