First aid qt

[slingshot187]

Hello

I am very new to diving but I have been a Emt for many years. I was watching the rescue diver video and they didn't mention Glucagon or Epipens. I know about medical releases and your own responsibility to do this for yourself. I wonder do they show how to use them in case they can't do it for themselves? I know what most are thinking "I don't want to get sued" . In Wisconsin we have the good samaritan law. If you try to help in best intentions you will not be responsible if it doesn't work.

Also what about poisonous snakes and spiders. You find them all the time in boats and shore lines. I know there has to be a limit to the things one can teach but these few thing can save many people. They might teach this at a higher level that I don't know about. If you know please post here.

 

[261311]

To my understanding most of all rescue/ first aid techniques taught in diving instruction is really to stabilize and provide assistance until trained EMT's such as yourself arrive (even something as life-saving as CPR I believe is classified as stabilizing since the hospital is still required afterwards). Dealing with epipen administration specifically I believe would really be between yourself and your buddy (I'd be concerned about the waterproof ability here so I'll say it's on the boat/ shore waiting) there would be little knowledge to that sort of thing.

Side note, I don't believe a doctor would clear you to dive if you had to dive with an epipen due to a life threatening allergic reaction to something in the water.

As far as venoms/ stings, limited knowledge, again- it's to stabilize until you can make it to a hospital with an appropriate antidote.

 

[slingshot187]

as for the epipen i'm thinking on the line of bee's and like peanut allergies. not so much water stuff. I know lots of people who swim and dive that have epipens. I'm just wondering if they teach it.

 

[Hawkwood]

As current first aid training is required as a prerequisite for a Rescue course, presumably the use of Epipens etc. would have been covered in that first aid course.

I know we must cover their use when teaching FA in Canada.

 

[Doc]

I am not a medical doctor, but I have played doctor a few times..... (So- go check with a real doctor!)

I know there has to be a limit to the things one can teach but these few thing can save many people. They might teach this at a higher level that I don't know about. If you know please post here.

Sure, it's taught at all sorts of higher levels, much of it coms through life experience. The patient absolutely must be encouraged to pre-identify. there are many non-invasive ways to do this, just get it done.

In your example: If someone has an epi-pen with them, thus they have the potential need for use, it is incumbent upon them to advise someone they are with of this fact. You can explain to a monkey how to use one in 30 seconds. Even if they screw up, they really can't screw up. Commercial scrip models are not packaged to be waterproof. It will wait until you get back to your gear bag.

Usually gross allergic reactions to sea critters are very unanticipated. No one really understands how susceptible they are to reef/pellagic toxins until they enjoy the big moment. If you don't have an epi-pen, give them a few Benadryls to start. the Good Samaritan is well understood in third world countries. Most any physician who has a clue as to tropical environments will give you a scrip for an Epi Pen. I usually leave it behind upon exit with the local bush doctor. Did I mention Benadryl? Most likely the best and first line medication for allergic reaction.

No doctor will ever "clear you to dive" if you have any disqualification that could get them in trouble if you did wind up sneezing.

In your example: If someone has a diabetic issue, they should at least wear an Medic Alert bracelet or dog tags while out in adventure-land. For the assist to occur, it must be understood where the patient is located in his distress. The use of a pin prick blood sugar meter is pretty intuitive once you have done one kind of meter at lest one time, but teaching this to the unwashed masses would be like PADI's struggles with talking about just 1 or all 75 dive computers... where do you start/stop? Once you determine that their blood in <60mg/dL that might explain why they are all snoozy. Melt some raw sugar in a spoonfull of water and save having to remember to buy orange flavored commercially available GlucoGoo. Sugar is sugar. Just know what is needed. If the victim already has very high blood sugar, the external symptoms may be similar, but the likelihood of this presentation is minimal.

As far as venoms/ stings, limited knowledge, again- it's to stabilize until you can make it to a hospital with an appropriate antidote.

The limited knowledge that is taught might be "to stabilize". This works only if there is available an "appropriate antidote".

The level of limited knowledge needed
expands proportionately
with the distance to
a Level 1 Trauma Center.

 

[The_Aviator_1]

As an EMT-Basic/EMT-I/EMT-P Instructor, we teach EMT-Basic's that they are only to "assist the patient in self-administration" of auto injectors. As a NAUI Advanced Rescue Diver I recall in the course work that it only briefly touches on first aid and advanced administration of medications such as auto injectors would require a conscious patient to provide instructions regarding site and use (assuming they couldn't read the easy instructions printed on the side). In the end, the good Samaritan laws will only protect you as long as you work within your scope of practice, and there are many different conditions which could result in misdiagnosis as an allergic reaction/hypoglycemia etc and the best course of action for anyone would be supportive care, oxygen and rapid transport to an advanced provider. Even with the best of intentions a civil and potentially criminal suit could be brought against you if you exceed your level of training.

 

[Steve_C]

One of my main dive buddies carries an epi (not on dives). Part of our on the way to dive site dive planning is for him to show me where it is and review how to use it. That's been my general experience. Training done by the potential patient.

 

[261311]

The limited knowledge that is taught might be "to stabilize". This works only if there is available an "appropriate antidote".

The level of limited knowledge needed
expands proportionately
with the distance to
a Level 1 Trauma Center.

Didn't think I'd have to explain that, given certain venom's and poisons can kill in rapid time and not all antidotes are readily available. However, if we're talking about common "critters" that illicit toxicological reactions to victims in a certain region, most hospitals in high-tourism areas will have antidotes, it's all about avoiding lawsuits. ie. Near me in Parry Sound, Ontario the Massassauga Rattlesnake is a venomous (though not a lethal class) rattlesnake, while the national park doesn't keep antidote on hand for the idiots who get bitten (and you have to fill that requirement because their defenses are primarily to hide, run and then rattle if you persist) the local hospital does. Before I even went there I researched how to treat/ assist in this sort of venom and what it does. Usually takes 6-12 hours to do any damage (is anti-clotting and thus has a cardiac failure risk over time), has 2 reported deaths and is easily treatable. Frankly speaking, before you travel anywhere foreign a baseline amount of research on how you can fall ill and how to correct that from animals, food or the general populous is just good due-diligence. I would not however say that you would want to get first aid training to treat a bite from a black mamba, because of how quick and deadly it is. Yes they have antivenoms, but that's essentially if you're rich and were bitten outside of a treatment facility. It would be a better investment to have a course in family law for the last will of those bitten in secluded areas.

 

[g1138]

When I was first certified as a California Lifeguard, we were trained on how to administer an Epipen. When I transferred to a kids program, twice (once as a lifeguard, another as a professionally rated diver), we were told that liability would not allow us to administer Epipens. If need really had to be, we would have to put the Epipen in the kid's hand and then "help" them administer it.

I do not know if this is because of the underage children factor, or because of change in professional rescuer policy (considering levels below EMT aren't trained for needle work).
Outside of my lifeguard training, I've never been trained in Epipen use. For the purposes of scuba diving, it's strictly evacuate, stabilize, and call for higher medical assistance. There is no invasive medical attention that's trained into recreational or professional rated divers (DM, Instructor etc)
I think the most invasive procedures taught are to bleed a wound, give oral fluids if victim is able to drink, and apply a chemical pack (heat or cold). So we're really talking just basic office first aid.

In your case, since you have the training, you can make the call to perform a higher standard of medical care.

 

[TMHeimer]

I know how to use an epipen, but not from courses. I'va taken EFR twice and St.John Ambulance in Canada. The latter was much more in depth and a full day course. Neither really went over anything in class regarding stings, venoms, etc., but both manuals have sections covering that, so I guess the idea is you should just read about it.