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Old 04-04-2015, 12:55   #1
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Injured person extraction/transfer

I've experienced a couple of emergencies, that have require the retrieval and transfer of injured people from boats and am not at peace with the procedures. The close space of recreational boats, creates challenges to remove injured persons, who can not move themselves. My ultimate goal is to make these rescue procedures a living document for rescue personnel to start thinking about how to perform close quarter extractions while stabilizing the patient and protecting the rescuers from injuring themselves. I've done a little poking around, but have not come across much info.
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Old 04-04-2015, 13:13   #2
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Re: Injured person extraction/transfer

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I've experienced a couple of emergencies, that have require the retrieval and transfer of injured people from boats and am not at peace with the procedures. The close space of recreational boats, creates challenges to remove injured persons, who can not move themselves. My ultimate goal is to make these rescue procedures a living document for rescue personnel to start thinking about how to perform close quarter extractions while stabilizing the patient and protecting the rescuers from injuring themselves. I've done a little poking around, but have not come across much info.
I would strongly suggest since this subject is very much on your mind taking a medical first aid course but then followed by a Medical Person in Charge course at a maritime school. I felt totally unprepared *well, didn't just feel, I was" for such events. We also carry a rather substantial medical kit and subscribe to a medical service we can utilize to advise us and assist us (Medaire). Now there are probably some EMT courses one could take that would be much the same. If you're 100 miles offshore, you're not going to get the person to medical care quickly in the best of circumstances, so you're going to have to be the one to make the moves that might save a life.

The one place that only so much can be done is the transfer from boat to helicopter. However, if you've done what you can in advance and make sure those on the helicopter fully understand the situation then hopefully they'll handle it the best possible. I've known them on occasion when the person has been somewhat stabilized but may have a serious injury that moving them around could worsen, not to try the lift but let you head to shore or wait on a vessel to arrive.
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Old 04-04-2015, 14:16   #3
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Re: Injured person extraction/transfer

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Now there are probably some EMT courses one could take that would be much the same.
EMT Basic is very limited in scope as far as medical training goes. You get a lot of emergency scene safety which may or may not apply in a marine rescue environment. You get very basic instruction in airway, shock management, Basic Life Support, basic trauma management, and almost nothing for your average "illness".

The course is geared towards first responders who do their best to stabilize (not manage) the situation until more advanced care can get to the patient. Even if you were to advance to EMT-I (Intermediate) or EMT-P (Paramedic) your skill set is worthless without a lot of adjunctive equipment. The latter, EMT-P is a 1200 hour course commitment AFTER you complete 400 hours of EMT-B! Even after you are done, there is continuing education requirements of 40+ hours per year.

In short, take a course oriented towards a ship board environment and you will be well versed in the typical at sea emergency and not be burdened with how to be safe on the side of an interstate highway.
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Old 04-04-2015, 15:07   #4
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Re: Injured person extraction/transfer

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.... My ultimate goal is to make these rescue procedures a living document for rescue personnel to start thinking about how to perform close quarter extractions while stabilizing the patient and protecting the rescuers from injuring themselves...
Close quarters extraction...
Search and Rescue in caves comes to mind.
Just like on a boat, you cannot rush an ambulance or fly an helicopter to rescue an injured caver/speleologist.
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Old 04-04-2015, 16:32   #5
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Re: Injured person extraction/transfer

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Originally Posted by svmonju View Post
I've experienced a couple of emergencies, that have require the retrieval and transfer of injured people from boats and am not at peace with the procedures. The close space of recreational boats, creates challenges to remove injured persons, who can not move themselves. My ultimate goal is to make these rescue procedures a living document for rescue personnel to start thinking about how to perform close quarter extractions while stabilizing the patient and protecting the rescuers from injuring themselves. I've done a little poking around, but have not come across much info.
Take a drive down to USCG Air Station Miami in Opa Locka and talk to the rescue swimmers.

Their collective knowledge and training may have some info you need and they may point you in the direction of other info.
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Old 04-04-2015, 17:24   #6
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Re: Injured person extraction/transfer

I've been certified in EMT, and I understand the necessity of careful "packaging" of a victim. I am going to be building a flat, lightweight backboard, with handholds and strap holds, for storage in one of my boat's amas. I built some several years ago when I had a house in Baja, and it got used a surprising number of times. It was a remote area, so being able to get someone from a car seat, a bed, or from the ground or beach, was a necessary task. I plan on making mine with some leftover honeycomb, graphite cloth and epoxy, painting it yellow or orange, and fitting reflective tape on it. There will be an attached bag with harnesses, a lifting sling, and a head/neck immobilization (foam blocks) kit. You can raise a victim from the water, once they are strapped, and get them aboard, then down below into a bunk, without physically moving the person's body, and keeping them in a horizontal position. I'll see if I have any old photos.

Found one online:

Heck, these are cheap and lightweight, I'm just going to buy one: Junkin: Plastic Backboard, Bright Yellow - theEMSstore

They even have head immobilizers at a reasonable cost: Kemp USA: Head Immobilizer - theEMSstore
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Old 04-04-2015, 18:24   #7
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Re: Injured person extraction/transfer

Wow! Things have sure changed in emergency medical treatment. Check this out:
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Old 04-04-2015, 18:46   #8
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Re: Injured person extraction/transfer

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Wow! Things have sure changed in emergency medical treatment.
That's just a start too as the marine kits include a ton of items. Plus one can't overlook the need for prescription meds. Actually MCA has set some standards for all boats traveling over 150 nm offshore. As to splints there are a variety of options for immobilization including some vacuum splints.
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Old 04-04-2015, 19:13   #9
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Re: Injured person extraction/transfer

Won't an AED solve everything?

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Old 04-04-2015, 19:44   #10
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Re: Injured person extraction/transfer

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Originally Posted by svmonju View Post
I've experienced a couple of emergencies, that have require the retrieval and transfer of injured people from boats and am not at peace with the procedures. The close space of recreational boats, creates challenges to remove injured persons, who can not move themselves. My ultimate goal is to make these rescue procedures a living document for rescue personnel to start thinking about how to perform close quarter extractions while stabilizing the patient and protecting the rescuers from injuring themselves. I've done a little poking around, but have not come across much info.
I work as a first responder, and have spent a few years in the harbor station. I've packaged and removed quite a few victims from recreational (and commercial) boats. Here are some thoughts:

The old "C-spine immobilization based on mechanism" has been history for almost a decade. Now it's symptoms only or "altered with mechanism." This simplifies things a lot.

Assuming that your victim requires full cervical precautions, leave the backboard outside. A KED is great for this but is technically not rated for lifting. We have a board made by Yates that covers that niche. It's a thousand times easier to move someone around a boat if their legs can articulate. The reason to apply cervical precautions is to avoid further potential harm until the spine can be cleared by X-ray. If you don't have rapid access to an ED, it probably isn't going to matter, because at some point you're going to have take them off the board uncleared.

If it's a sailboat, sometimes you can get lucky and just use a halyard through the companion way. Another great tool for use in boats is a Doty Belt. They're mostly used for adding handles to bariatric patients, but we carry the normal person size as well. A couple folks topsides, a couple down below, and handles to grab. Simpler is faster. Works for splinted appendages as well, just add a person to tend the splint on the way out.

It's hard to make blanket statements about methods because every instance is unique. Just a few basic tools and your creativity is all you really need.

You can make your own Doty Belt for peanuts, it's just some stitched webbing, rubber hose, buckles and velcro. We used to carry a halfback board, one could easily be fashioned with some plywood, straps, buckles, and a router. Add a "Combi-Cot" type litter and I think you could handle 99% of removals with those three things. You could probably put all that together for under $100 DIY.

Good luck, and good for thinking ahead.

JRM

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