The art of drowning

[Richard B]

Originally posted by Mike Garside
...I was more concerned that nobody had seen me do such a stupid thing than I was worried about my situation...

Funny how you retain a sense of pride in the face of disaster! Good presence of mind to make for the mooring buoys, Mike.

[DM]

Another common cause of death in the marine environment is loss of blood. Bleeding can be external or internal. Sharp knives, spinning props, hitting hard objects, hands/feet/heads caught in moving machinery etc. all take their toll.Early arrest of haemorrhage is important as it will lessen the effects of clinical shock which is what usually kills you. There are five classifications of wound. Incision, laceration, puncture, contusion ,GSW(gunshot, stabbing wound).

Management of Haemorrhage.

Lay the victim flat which lessens heart rate and subsequently bloodflow.
Raise the injured part above the level of the heart if possible. Apply direct pressure to the wound with a bandage. If you're stocking your first aid kit, buy conforming bandages and gauze squares. These are much easier to apply when bouncing about in a f6. For severe bleeding, direct pressure is not usually enough. Use indirect pressure by applying constriction to the nearest pulse. i.e. for leg trauma, use the femoral pulse in the groin, for arm/hands, use the brachial pulse found on the inside of the elbow. Other major pulse sites are found in the neck, (carotid), in the shoulder(subclavian), back of the knee and wrist. Do not remove foreign bodies (e.g. knife) as this will increase the blood loss sometimes massively. Do not apply tourniquets as these will kill the tissue beyond the site (necrosis) if left on to long. Bleeding can often look far worse than it is, as blood is viscous, a liitle goes a long way. Half a litre will cover an area of 4 square feet. The average adult has 10 pints so you can afford to lose about three of these before you're in the mire. A broken femur can lose you 4 litres in extreme circumstances so early intervention is vital. With a fractured pelvis (called a book fracture because victims complain of a sensation of feeling wide open) you can lose the lot. Head wounds can bleed massively from only a tiny wound because of the large amount of blood vessels there.

more to follow........

[crazyhorse]

A near wetting and Mayday,

I had been given the oppertunity by the private owners of a Arun lifeboat to assist in helping deliver it from Fleetwood to Liverpool.

The new owners were real good fun but wernt sure at that time of much about the craft at the time.

They were renowned for a good time and a lough.I got down to the dock and it was realised that we hadnt got enough juice for the trip so the boat had to be moved about 200 yds to the fuel pontoon.On arrival at the pontoon One of the owners jumped ashore with the painter and tried to tie it up,as he jumped he held on to the rope and it was a little shorter than the distance to the pontoon.So in he went,off the stern of this Arun with both engines in gear and running.

I jumped onto the pontoon and shouted for the engines to be cut,as this was being attempted,the good fun chap was grabbing at my anckles from in the dock as he was swimming to stay afloat.

I remember thinking this must look like a bad rendition of a Riverdance as I swiftly kept moveing my ankles away from his
Grasping hands. I got him out bye leaning over and pulling him up bye his shirt/pants/braces,all the time I was aware of this 38 tonn boat drifting about with no sternline on and waighting for a windshift.

This was just the start,as we were on the trip halfway there,I was down below fiddling about with the colour Radar on my own thinking what a nice piece of kit this is,when on the vhf came a Mayday real clear and loud.
I jumped up and made the others aware,as they had been up top in the sun.The radio crackled and liverpool coastguard was asking the vessel for its position and name.This continued for what seemed some time,with no responce.The others came down from the top and I explained,We were near this vessel that had put out a mayday as I had heard it on the vhf. And the coast guard was looking for her.In a rather sheepish tone the chap who had gone in the drink ealier,said well it was me,you see I just got my vhf liscence and I was showing x how good I was on the radio and didnt realise it was not on intercome but on Transmit?

I immedietly contacted the Coast guard and explained that the person who had transmitted the Mayday had made a mistake!
and I appologised profussley, and they were very good about it.

The interesting thing here is how people respond under instant
panick,as on board we had a Yaghtmaster Instructer with loads of sea time,and I was a Freeloader along for the ride,at the critical moment when I asked and realised what had happened,I turned to him and asked what should we do?,his immediete knee jerk reaction and verble advice was turn the radio off?. Im glad to say being a bit stroppy has its advantages and I wasnt going to do that,I imformed the coast guard immedietly of the mistake.

And that was that.

Crazyhorse

[DM]

A consequence of blood loss is hypovolaemic shock which is a clinical syndrome causing a dangerous lowering of blood pressure. If untreated it can lead rapidly to death.

The body requires three intact mechanisms to function.

Effective heartbeat, an adequate quantity of blood, blood vessels without any holes in them and the ability to constrict and dilate according to the bodies needs.

Without going into too much detail, the body has compensatory systems to cope with blood loss. Eventually, unless remedial action is taken, these systems will be overcome. There are 4 stages of shock.

Stage 1

15 percent blood loss. Pallor to the skin, pulse rate up to 100bpm, at this stage, no change in BP.

Stage 2

30 percent loss. clammy skin, pulse exceeds 100bpm, breathing rate increases. At this stage, the body is at the limits of its compensatory capability.

Stage 3

30-40 percent loss. victim agitated, restless, pulse rate greater than 120bpm. Blood pressure below 100mmhg.

Stage 4

More than 40 percent loss. Victim cyanosed(blueness of skin) decreasing level of consciousness, very rapid weak pulse with laboured breathing., Blood pressure is now below 70mmhg. Average for a healthy adult is 120/80

Other signs can include nausea, vomiting, thirst, pupils slow to react, faintness.

more to follow.......

[Manos]

Just curiosity (which killed the cat at the end hope it does not kill me LOLOL) did you get this staff out of military book on servival??
I just faintly remember that when I was with the Greek Airforce we use to have a Greek book based on servival and reviving people etc with staff like this.
But that was about 25 years ago and possibly I'm wrong

[DM]

Keep airway open. Keep checking this as airway patency may change with levels of consciousness.

Lay the victim flat, legs raised.
Treat other injuries i.e. immobilise fractures. stem blood loss
Keep victim at normal temperature, do not overheat or allow to become cold. N.B. Advanced practioners will keep victim cold. This is to allow the peripheral blood vessels to constrict, thereby allowing more blood to the core systems. Also, using advanced techniques, they will only allow the BP to reach 80 percent of its normal levels.
Constantly check pulse, breathing rate and depth and level of consciousness. Give nil by mouth. Vomiting may aggravate the patency of airway.

Besides hypovolaemic shock(blood loss, burns etc.) there are other types of clinical shock.

Cardiogenic. (Poorly functioning heart)
Neurogenic. (Inefficient control of dilation/constriction of blood vessels.)
Anaphylactic shock. (Reaction to bite or wasp sting.)
Toxic Shock. (disease such as meningitis)

Children and young people succumb to shock far quicker than adults as their compensatory mechanisms are not as well developed.

Head injuries do not induce shock. If shock is present in a head injury victim, there must be another injury elsewhere, possibly internal. Do not confuse head injury with a superficial scalp or facial wound.

[DM]

Originally posted by Manos
Just curiosity (which killed the cat at the end hope it does not kill me LOLOL)

No Manos, these snippets have been gleaned from 26 years in the emergency services.(Land paramedic unit, helicopter, M/cycle, once on a sledge and FRC.) Its what I do every day. Not for much bl**dy longer though!!!!

David

P.S. When you were in the Greek airforce, did they allow you to do any plane spotting?

[Manos]

Originally posted by davidmanning

P.S. When you were in the Greek airforce, did they allow you to do any plane spotting?

LOL
Actually I was flying helicopters. However I 'spoted' a lot of planes during my time LOLOL. Good job I wasn't a British tourist that didn't know how to read the signs all in Greek LOLOL .
What did you expect Greece has a population of 10 mill and a VERY difficult language and these British Tourists didn't know how to read Greek??? My,my,my

Have to go now to catch a plane for Cyprus. Be online again tonight.

[Brian]

David,
All this stuff is important and vital and I do not want to minimise it's value in any way.
Just to tell you that after reading it.......I suddenly don't feel very well at all.
Think it must be queasyitus.
Is there any cure for this?

Brian (Palid of Paignton) Elliott

[DM]

Dear Pallid of Paignton, my sincerest apologies for being the cause of your recent incapacity. I would prescribe a double Glenfiddich, repeated at regular intervals, until either the malaise passes or suddenly, you don't give a damn anymore.......


D.M.(M.D.)

[Dirk Diggler]

I would just like to say thank you for curing my imsomnia.

[DM]

I was distraught to hear that you suffer from insomnia but it pleases me to know that I was instrumental in putting you to sleep.



Thanks to all who added their personal experiences to this thread. I think it emphasised how even strong swimmers can get into difficulties.

David.

[Aging Youth]

Hi Dave,

Thank you for your efforts, it is always good to take a refresher in what to in the event of an accident.

However, last saturday I was out in Langstone Harbour when the call came out that a person had fell ovrboard near to the langstone run (out going tide run 9knts). The emergency servics were deployed and eventually they found the person.

Sadley he was pronounced Dead On Arrival.

The write up in said he was an very experienced and safety concious skipper who had years of experience. He had just droppped his daughter and boyfreind on shore then went to tie up onto his swing mooring. Apparently he slipped and fell into the water. When his body was found (outside the harbour) he had NO LIFEJACKET ON!

I think this is a stark reminder to us all that it can and dose happen.

He leaves behind a wife and daughter. ALWAYS, ALWAYS were a lifejacket or bouyancy aid. NO EXCUSES.

[Manos]

This is a very sad storry but a lesson for all.
In cold climates (warm also) one should alsways have a life jacket on until is on dry land.
The hard don't care boy-racer attitude is for light headed I would say!!
Very sad storry indeed.
The sea needs RESPECT!!

[cawsand]

time marches on and we make progress - or do we???

The new 8th edition FA manual tells us there is no indirect pressure to treat serious bleeds. (torniquets having been out for years - but not apparently for bleeding infantrymen on the field of battle)

The manual also instructs that we check for circulation in a resus casualty only by looking for signs of breathing, coughing, choking and movement. No touch of the cheek or look at the casualty colour. (and certailny no check of the pulse)

After decades of being told we will kill a casualty if we compress the chest of someone with a heartbeat, the chances of anyone not getting cpr coming out of UK waters would appear unlikely? Anyone have any stats on survival levels from water based RB and CPR situations??

Anyone carry a face mask in their FA kit afloat? The RNLI use a small plastic tube - 15" x 1/2" dia. from the mask to the mouth of the resuscitator - no facial contact - no loss of teeth falling off the wave on the way back.

Just a thought or two.................fwiw RogerC

[crazyhorse]

I have seen and used that face mask you are talking about and it does work very effectivly,I will see wether there are any available for purchase as they do do the trick very well.

And what better thing to add to your own experiance of life that you were able to help somebody else live theres.

It has to be the best thing a Man/Woman could do.

[Manos]

Originally posted by crazyhorse
.....I will see wether there are any available for purchase

If you do give us the site mate. Will you!!
I'm interested too!!

[crazyhorse]

will do

[DM]

Originally posted by cawsand
The manual also instructs that we check for circulation in a resus casualty only by looking for signs of breathing, coughing, choking and movement. No touch of the cheek or look at the casualty colour. (and certailny no check of the pulse)

This manual is wrong to say this. Absent respirations can be a late sign of cardiac arrest (believe me, I've seen it.) The only way to assess cardiac output is to feel for a pulse (rate, rythym. strength) although colour will give some guide but not always so. (carbon monoxide poisoning makes you look very healthy, even in death.)

Average survival rate from CPR is in the low percents.(1-3) Pros with all their kit and drug therapy manage about 19 percent. The problem with CPR is that even if its done well, the output is only 30 percent of a normal heartbeat. Also, if a cardiac arrest victim, needs defibrillating, it doesn't help to be in a wet environment cos' everybody standing around watching gets whacked as well which p*sses them off somewhat.

Face masks for resus can be bought from S.P Services in Telford. If theres enough interest, Ill get a batch.

David.

[Manos]

Originally posted by davidmanning
Face masks for resus can be bought from S.P Services in Telford. If theres enough interest, Ill get a batch.

What is the cost David?? I am seriously interested