Since the swelling is tongue localized and soft, it should be possible to establish a BLS airway around or past it without any surgical proceedures. I keep minimal airway stuff in my kit. This kit goes with me to dive sites and on boats.divemed06:
Solve the Diving First Aid Scenario!
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Have you removed his gear?
Is the tongue swollen because a strap or dry suit neck seal was constricting around his neck, causing the tongue to swell?
Spinal cord injury other than from the base of the neck to the skull would be very unlikely, as his BCD or BP&W with a tank on it would do a very good job of protecting it in a fall. Most likely he would have fallen face first if it were a fall injury. So check for signs of a head injury.
I would strip his gear, then cut his neck seal with my shears of knife. Seeing that rescue breaths were not working, this would be done in all haste, as the relief of any constriction around the neck will help.
With a soft tongue swollen to the point of shutting the airway, I would get a tube past his tongue. If no tube were handy, I would cut a LP hose to about 20 to 30 cm. A high-pressure hose would not do, as it's diameter is much smaller than the LP hose.
Check for spinal cord injury by hand, then evacuate the victim with as much care as possible. Leaving him there in a remote area is not an option. If complications arose while you were gone, he would die. I would rather risk being sued over being a pallbearer at his funeral.
Is the tongue swollen because a strap or dry suit neck seal was constricting around his neck, causing the tongue to swell?
Spinal cord injury other than from the base of the neck to the skull would be very unlikely, as his BCD or BP&W with a tank on it would do a very good job of protecting it in a fall. Most likely he would have fallen face first if it were a fall injury. So check for signs of a head injury.
I would strip his gear, then cut his neck seal with my shears of knife. Seeing that rescue breaths were not working, this would be done in all haste, as the relief of any constriction around the neck will help.
With a soft tongue swollen to the point of shutting the airway, I would get a tube past his tongue. If no tube were handy, I would cut a LP hose to about 20 to 30 cm. A high-pressure hose would not do, as it's diameter is much smaller than the LP hose.
Check for spinal cord injury by hand, then evacuate the victim with as much care as possible. Leaving him there in a remote area is not an option. If complications arose while you were gone, he would die. I would rather risk being sued over being a pallbearer at his funeral.
H2Andy
Contributor
divemed06:
you don't say?
Scubamedicjoe
Contributor
First let me put into a paramedics view.
First remember that possible head injury clue slippery rocks (not seeing any injury or fall never now)
Second some of him being tired could just be the effect of the on coming seizure, as there are many types of seizures.
Third recent diving possible DCS
Now to answerer some of your questions!!
With no phone or house ECT available, you have some choice's to make one sure he breathing, with pulse if not take action.
With him breathing and pulse if theyre a way to administer O2 DO SO.
If he's seizing there you have several other problems one weather to move him or not, remember it's better to be paralyzed then dead, or as a last resort
(Life over limb). But my first thought is a seizure or head injury from a fall
Try to make him comfortable, O2 if possible if in no danger i.e. water waves animals heat ect then you have to make a very uncomfortable decision, to leave him get help or not. The key is hear with out help may die with going getting help may die.
So what choices I would stabilize as much as possible and get help. You could thing about moving with the best spinal precautions you can to be honest with out additional help and equipment not going to happen.
This is almost a no win scenario. Its one I wouldn'tt want to be in thats for sure.
Some hints learn the modified Jaw thrust to keep airway open if his swollen tongue.
With that look for obvious injuries even bites or stings, with him not answering or being conscious its going to be extremely hard to access his neurological functions.
And what his past History is for that matter.
My self I would do this, as personally I feel this is no right or wrong answer
One you can play it as safe as possible, stabilize and go get help.
Or you can assist his air way give oxygen if possible and if true seizure most last under min unless it
S status epileptic then have many back to back, but since you dont know his History ECT your starting off in hole to begin with.
You could also choice to move him to the vehicle and drive to help. Man this is a tough call.
Allot depends on conditions location and how well you feel to take care of said patient too. There is a lot I left out due to this can get really ugly as there are many things to consider in treating this patient and many ways to treat this patient if this makes since.
First remember that possible head injury clue slippery rocks (not seeing any injury or fall never now)
Second some of him being tired could just be the effect of the on coming seizure, as there are many types of seizures.
Third recent diving possible DCS
Now to answerer some of your questions!!
With no phone or house ECT available, you have some choice's to make one sure he breathing, with pulse if not take action.
With him breathing and pulse if theyre a way to administer O2 DO SO.
If he's seizing there you have several other problems one weather to move him or not, remember it's better to be paralyzed then dead, or as a last resort
(Life over limb). But my first thought is a seizure or head injury from a fall
Try to make him comfortable, O2 if possible if in no danger i.e. water waves animals heat ect then you have to make a very uncomfortable decision, to leave him get help or not. The key is hear with out help may die with going getting help may die.
So what choices I would stabilize as much as possible and get help. You could thing about moving with the best spinal precautions you can to be honest with out additional help and equipment not going to happen.
This is almost a no win scenario. Its one I wouldn'tt want to be in thats for sure.
Some hints learn the modified Jaw thrust to keep airway open if his swollen tongue.
With that look for obvious injuries even bites or stings, with him not answering or being conscious its going to be extremely hard to access his neurological functions.
And what his past History is for that matter.
My self I would do this, as personally I feel this is no right or wrong answer
One you can play it as safe as possible, stabilize and go get help.
Or you can assist his air way give oxygen if possible and if true seizure most last under min unless it
S status epileptic then have many back to back, but since you dont know his History ECT your starting off in hole to begin with.
You could also choice to move him to the vehicle and drive to help. Man this is a tough call.
Allot depends on conditions location and how well you feel to take care of said patient too. There is a lot I left out due to this can get really ugly as there are many things to consider in treating this patient and many ways to treat this patient if this makes since.
H2Andy:you don't say?
You'd be suprised as to what some people will do after seing a few episodes of ER!! We had a lady come into the Emergency Department once with a persistant nose bleed and she had trouble breathing....pinching her nose didn't help so she decided to apply a tourniquet...well were does one apply a tourniquet for a nose bleed? Around the neck of course! She figured the the blood was coming from her heart and this would be a good way to stop the blood from flowing to her nose... :06: Funny how her breathing got better after we took off the tourniquet!!! True story!
Oh yeah, in WFA they taught us that a tourniquet is a safe, effective way to stop bleeding!
Provided, of course, you want them to eventually cut off whatever you're tying up.....
Provided, of course, you want them to eventually cut off whatever you're tying up.....
If you are two hours from help and no cell phone and you can get me into your vehicle, please take me. I'll risk the spinal injury. If I was the rescuer then if I could I'd load the injured into my vehicle, Tough call I know and I would prefer not to move the injured but I'm looking at a couple of hours before help arrives and we've already got a problem with the airway. At least in the vehicle,while I'm driving "like a bat outa' hell" I can try to keep an eye on them. Right or wrong I'm taking 'em with me.
Firediver
Contributor
divemed06:
Your main priority is suspect head and spinal due to the conditions involved as it is an unwitness happening. This would be done in your scene survey. <Slippery rocks, he's in a strange position with tank on>.Check Responsiveness<Alert,Verbal, Pain, Unresponsive>... You want to imobilize the head and neck best you can. then check your ABC's airway, breathing, Circulation. If you have a certified course you should know how to preform the modified jaw thrust for people withe a suspected head and spinal who are not breathing. If breathing and unconcious I would administer oxygen if I have it. <this would mean leaving him in the position found as long as it does compromise airway and returning to my vehical to retrieve the oxygen and any first aid kit I may have>. I would then try to remove the heavy equipment as best as possible with out moving the head or neck. (You can imobilize the head in neck with blankets and two rocks on each side of his head.) When the seizures start, time them and make a note how long it lasts. Then when it stops re assess the situation ABC's. If still breathing check for any other injuries... to make sure they won't become life threating later.. this would only be a rapid check. Then I would decide to transport. <I would try to think of ways to make the transport to the vehical the easiest way possible...> Using a clothes drag to help support the head and neck on my forearms. and drag them to the vehical. I would put them in the backseat and continue to use what I had around to keep the head and neck imobile.. blankets, jackets towels.. etc.... Then I would transports them.. I know gear is expensive but I would just leave the gear there. If you had a cell phone but lets say no service in the area, when I get service I would call the hospital then call a friend to pick up the gear. Otherwise leave it behind. Me personally I would make the drive to the nearest health facility, but some may stop at the nearest residence and call 911 from there and wait for an ambulance so you can closely watch your buddy for any change... there are so many what IF's when transporting alone it all depends on the person. Also everyone is different on how they would react to seeing their dive buddy in trouble. my first reaction to this senario is he slipped and fell and hit his head on a rock..<which could explain the seizures from a head trauma> but as First aiders we don't need to diagnose just provide first aid for the showing symptoms to the best way you know how.....
THis was an excellent senario.. maybe we should get more here on the board so we can all keep out First Aid skills tip top.......?????
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