First Aid
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First Aid is what it says it is! Usually administered calmly and quickly, and maybe by an unskilled person, emergency care for a victim of sudden illness or injury until proper medical aid and medical treatment is available. The notes below outline the major steps for dealing with the most common emergencies, but are not intended as a substitute for a first aid course. First aid may save a life or improve certain vital signs including pulse, temperature, a unobstructed airway and breathing. In minor emergencies, first aid may prevent a victim’s condition from worsening and provide relief from pain. First aid must be administered as quickly as possible. In the case of the critically injured, a few minutes can make the difference between complete recovery and loss of life.

First-aid measures depend upon a victim’s needs and the provider’s level of knowledge and skill. Knowing what not to do in an emergency is as important as knowing what to do. Improperly moving a person with a neck injury, for example, can lead to permanent spinal injury and paralysis.

Despite the variety of injuries possible, several principles of first aid apply to all emergencies. The first step is to call for professional medical help. Determine that the scene of the accident is safe before attempting to provide first aid. The victim, if conscious, should be reassured that medical aid has been requested, and asked for permission to provide any first aid.

Next, assess the scene, ask about details of the injury or illness, any care that may have already been given, and pre-existing conditions such as diabetes or heart trouble. Crew with special medical conditions and treatments should alwAY make the captain or yachts medical officer aware and ensure they have enough supply of medicines for the duration of the voyage. Unless the accident scene becomes unsafe try not to move the victim or further injury may result

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Initial Assessment and Treatment

First aid requires rapid assessment of victims to determine whether life-threatening conditions exist. One method for evaluating a victim’s condition is known by the acronym ABCs, which stands for:

A — Airway—is it open and unobstructed?

B — Breathing—is the person breathing? Look, listen, and feel for breathing.

C — Circulation—is there a pulse? Is the person bleeding externally? Check skin color and temperature for additional indications of circulation problems.

Recovery Position

Once obvious injuries have been evaluated and no evidence exists to suggest potential skull or spinal injury, place the injured person in the Recovery Position. Position the person to lay on one side with the head kept in a neutral position in line with the body so as the victim can vomit without choking or obstructing the airway.

How to Treat Shock

Shock may accompany any injury. Before treating specific injuries, protect the victim from Shock - a depression of the body’s vital functions that, left untreated, can result in death. Shock occurs when Blood Pressure (pressure exerted against blood vessel walls) drops and the organs do not receive enough blood, depriving them of oxygen and nutrients. The symptoms of shock are anxiety or restlessness; pale, cool, clammy skin; a weak but rapid pulse; shallow breathing; bluish lips; and nausea. These symptoms may not be apparent immediately, as shock can develop several hours after an accident. Shock victims should be covered with blankets or warm clothes to maintain a normal body temperature, given lots of reassurance and fresh air. The victim’s feet should be elevated. Because of the danger of abdominal injuries, nothing should be administered by mouth. If you are sure that further treatment is not needed, it is safe to give a cup of tea but never alcohol.


Safety First

Safety First is the product of prevention and intelligent anticipation. Inspect your boat regularly, looking for potential hazards and correct them. It may be tempting, in the privacy of mid ocean to expose hitherto unexposed regions of the body. Don't overdo it and protect yourself with generous dousing of anti sunburn creams, lipsticks and moisturizing skin oils. In the tropics wear light loose fitting clothing and a big hat. At night and in the cooler regions several layers of light cellular woolen garments are warmer than thick clothing.

As many accidents originate in the galley, always remember to protect the cook, wear an apron and install a convenient clip-on harness system to be used in rough seas. Hot perhaps, but it will help stop burns and bruises.

Always consider wearing your safety harness especially when conducting crew operations in rough conditions and at night. (Two lives were lost recently at sea by experienced skippers who were NOT wearing theirs when conditions warranted it)

The ISAF safety rules give you a list of medical requirements needed to be carried in the First Aid or Medical Kit to conform to its standards. These are adequate for local and coastal sailing trips and should be used as a guide and are in no way definitive. For sailors taking on lengthy ocean passages consult a doctor to obtain often restricted quantities of pharmaceuticals and to provide additional medical information.

It is a good idea to divide your medical kit into several parts in waterproof containers and stowed onboard in safe lockers.
1. Immediate injuries kit. i.e. for cuts, abrasions and dressings etc.
2. Illness kit for more prolonged illnesses.
Crew should become familiar with the contents, stowage, practical application and replenishing of the Medical Kit. Remember, No medical kit is completely adequate for every occasion.

The following selection of ailments are intended as a guide to some aspects of the medicine of Ocean Sailing. Further details on specific aspects of First Aid can be obtained from the St John's Ambulance Book and "Ship Captain's Medical Guide".

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Motion Seasickness

A disorder that afflicts many people in varying degrees when they are subject to swaying motions, yawing, and pitching. The disorder can be experienced on ships (seasickness), in airplanes (airsickness), or even when traveling by automobile (car sickness). It is most likely to occur when motion is induced by rough sea, turbulent air, or curving, up-and-down roads. In mild cases it may produce only minimal nausea, and in severe cases it causes vomiting, dizziness, unsteady gait, loss of balance, loss of coordination, and even severe prostration.

The disorder occurs because of excessive stimulation of the semicircular canals, a pair of minute organs located within the inner ears. Changes in position are normally recorded in the semicircular canals and transmitted to the brain. Symptoms can be minimized by riding in the center of a moving vehicle or over the wings of an airplane. A number of drugs, including meclizine (Antivert or Bonine), cyclizine (Marezine), and dimenhydrinate (Dramamine), when taken before exposure, are often effective in preventing motion sickness, although drowsiness may be a side effect. A recent success has been the wearing of specially designed pressure exerting wrist bands (See photo) that the manufacturers claim to prevent seasickness.

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Equip Travelers Motion Sickness Wristband.JPG (7567 bytes)


Scurvy

Scurvy is a disease caused by a prolonged deficiency of vitamin C, or ascorbic acid, in the diet. It is characterized by progressive bodily weakness, spongy and inflamed gums, loose teeth, swollen and tender joints, and a tendency toward ecchymosis, or absorption by the tissues of blood from ruptured blood vessels. Anemia often occurs as a direct result of such hemorrhage. Lack of vitamin C intake results in the adsorption and decreased production by the body of the intercellular material that supports the fibrous tissues and forms the cement substance of capillaries, bone, dentin, and cartilage. The disease may appear in adults after about six months of complete lack of vitamin C.

Scurvy became prevalent when sailors began to spend months at sea without fresh vegetables, and in such cases it was usually fatal. In 1795, lime juice was issued to all British naval vessels on the recommendation of the Scottish physician James Lind, who knew that the Dutch had employed citrus fruits for several hundred years; scurvy soon began to disappear among British seamen. Oranges and lemons, higher in vitamin C content than limes, have supplanted limes as antiscorbutic agents


How to Stop Bleeding

The quickest and most effective way to control bleeding is to exert direct pressure and try to draw the edge of the wound together.

If the injury is to a limb, raise it to reduce the flow of blood. Cover the wound, preferably with a sterile dressing and apply pressure. If it continues to bleed simply add more dressings on top.

If you suspect internal bleeding after an injury, loosen the casualty's clothing, monitor his pulse and respiration and seek medical aid immediately.

First Aid Bleeding Applying Pressure.JPG (9025 bytes)

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