Accidents. Resuscitation. AED. Should AED be mandatory on diving boats?

[SapphireMind]

You haven’t lived until the victim has barfed in your mouth. Which will happen, no matter how alive or dead they are.

And this is why working in the hospital is so much better LOL I always have a bag Plus I just put an ETT in for bagging which is so much easier

 

[Wookie]

And this is why working in the hospital is so much better LOL I always have a bag Plus I just put an ETT in for bagging which is so much easier

Yes. On the dive boat, they barf.

I learned to carry a bag in my kit.

 

[rongoodman]

The T1 did not have a glucose injector (and before a few posts ago, neither did i even know there was such a thing).

FWIW, it isn't actually a "glucose injector", it's a drug called Glucagon which allows the body to access sugar stored in the liver as glycogen. The up side is that you don't need IV access to use it, it can be injected into a muscle. The down side is the patient has to have enough stored glycogen to be useful, which isn't always the case.

 

[Wookie]

Autoinjector, like epipen? I’ve never come across one, I’d be hesitant to use it without some guidance. The glucose in the cheek seemed to work wonders.

 

[Pat.D]

Glucagon injection is also a one shot deal... when we inject it, the liver dumps it's reserves of glycogen. Most of the time this is enough to get the PT back to a level of consciousness where we can administer glucose orally. The problem is that it often will take a little while for the PT's system to build back up those reserves so if he crashes again...

I don't know if it's made in an auto-injector format. I've only seen bottle/syringe kits (high risk PT's will often have the kit in a bright red or orange plastic case).

 

[SapphireMind]

Yep it's an autoinjector, just like an epipen. And Pat D. is right, like an epipen too, it's a one time thing with not a long half life, so you can't just give it and they're fine to continue. They need to see someone most likely, and have a regular intake of glucose. (epi pens are similar, if you use one, they only last a short period, they are intended to buy time to get to better, longer-acting medication)

Like an epipen, it's one of those things that while it's not ideal to give someone a medication they don't need, it is unlikely to harm people. If there's a diabetic, they become unconscious for unknown reasons, look for their pen. Buccal (cheek/gum) absorption is pretty decent, but it depends on the form of glucose. You can also look for their pump if you can - it's keeping on giving them insulin while they are unconscious - and pop it out until they are conscious again. But for generic advice, just look for a glucagon pen and don't be afraid of it

Edited: Whoops, Dr. Google says I'm wrong about the autoinjector. I guess I assumed (incorrectly) I never actually have looked at my friend's glucagon kit

 

[tursiops]

I used to work at a Federal agency where we described some of the folks as, "Not always right, but never in doubt."

 

[Radoo]

Ideally we should all give rescue breaths when dealing with a cardiac arrest no matter what the aetiology is. It can only improve the outcome.
Not read much about this but I can imagine that the decision to recommend compression only cpr was taken after it was noticed that cpr with both rescue breaths and compressions delivered by bystanders was associated with poorer outcome when comparing to compression only cpr. This is probably multifactorial due to delays in proving effective chest compressions due to confusion about timing, communication during cpr, single vs multiple rescuers, etc. These of course are retrospective studies reflected by the quality of evidence in the recommendations- “weak or very weak evidence”. Nobody will do a clinical trial to get stronger evidence.
Regarding Insulin and Glucagon please take care as some of the pens look similar. Read what’s written on them and make sure you don’t give Insulin. As previously mentioned, glucose will make your DKA/HONK worse but won’t kill you as quick as hypoglycaemia will do. Always assume that someone is hypo rather than hyper unless you have a blood sugar reading.

 

[rongoodman]

I like the HONK acronym--never run into it before(or a patient with the condition, thankfully).

 

[caydiver]

Radoo used a great word “ideally”. Yes ideally we should be able to save everyone, every time and all should walk away happily. Realistically it cannot happen. From some who has a small dive op this discussion has become one upmanship on who knows what instead of a discussion about what would realistically work on a dive boat and perhaps what makes sense in one situation and not another We cannot be prepared for every eventuality but would like to. Autoinjector or epipen, realistically it is just not going to happen whether in a mall, hospital, 40 feet from shore or a livaboard in the middle of nowhere.