MAIB Report

[Jelly]

Greetings All

I got sent this MAIB report link, about a some power boat teaching.
Appologies if you have seen this before - but it makes you think
(couldn't find a thoughtful smilies) about how close you might have come to problems before.

http://www.maib.dft.gov.uk/sd/0202/24.htm

Any comments ?
Jelly

[dmoore]

Interesting, for me especially about the guy in the Diabetic coma, as I am diabetic myself.

Managing diabetes whilst doing strenous activity is no more complicated than normal life but does require a different mind set. I think the comment about being fit for the activity is valid and the health services should be far more forthcoming with advice about this. I sail inc offshore racing, RIB, play rugby and rock climb and do not have a problem. I wont bore this forum with my techniques but if it is of interest then email direct.

dave.moore@virgin.net

[DM]

I found the maib report interesting for various reasons. In this age where everyone is more safety conscious, people will spend thousands on safety gear such as epirbs, vhf, gas lifejackets etc. and then spend three quid on their first aid kit. I have found that most people who use boats responsibly have some form of first aid knowledge but this needs to be adapted for use on the water. As the report says, some conditions can be aggravated by the marine environment and its distance from medical help. Also each activity has its own tendencies towards different types of injury. dmoore, in his reply, states that he has his own techniques for managing his medical condition when at sea and rightly so. I would have thought that the instructor who collapsed into coma would have supplied one of his colleagues with a glucagon syringe and the knowledge to administer this by intramuscular injection which is quite simple to do as many relatives of diabetics have been trained to do. The moral of all this is go out and buy a decent first aid kit, adapt it for any special needs of the crew, open it up and learn how to use it. D.M.

[Garygee]

Your commants are very correct David but they need to be tempered by what most people can do and what knowledge people have.

It is likly that the instructor was hypo glycemic and while glucagon could have helped it relied on the liver having any free sugar to release. In many cases glucagon needs to be used in conjunction with something like hypo stop applied to the mouth or gums. In fact in may cases just hypo stop would do the job.


I am not in favor of people trying to do more than they are trained or happy with. Giving IM injections can go wrong where you cant really make a mess of giving hypo stop or somthing similar.

If people have specific problems it is important that they make this known to other people and what to do if things go wrong. However what to do must be what most people with BASIC first aid can do SAFELY.

I totaly agree that most first aid kids are not good enough but what is added to them should match the ability of the people who will use them.


Regards Gary

[DM]

Greetings Gary, I fully agree with you that people should not attempt procedures that they're not trained for. I don't recall saying that they should. In fact I think its actually a criminal offence to carry out procedures for which you are not qualified. I think this is to prevent brickies from doing liver transplants or something like that. The point I was trying to make ( perhaps poorly) is that the instructor should have been aware of the fact that he may develop hypo or hyperglycaemia and have the remedy on hand. Especially as he was in charge of three trainees. As dmoore says " you need a different mindset". I would restate the fact that the admin of an IM glucagon, (by someone trained to do so, in effect a simple procedure. ) would have been appropriate. Your experiences may differ from mine but I have found that, as in this case, if the coma is deep enough to require hospitalisation, rubbing hypostop into the gums would not effect recovery whereas glucagon works 9/10 times. Perhaps this forum is not the place for a medical debate, but between us I think that we have made the point that a bit more thought should go into the content of a basic first aid kit and its usage.

Regards David.

[Garygee]

Totaly agree david

As you say everyone should work withing the limit of the knowledge and agree that if a specific problem is known measures should have been in place to deal with it.


As far as first aid kits go, think we agree many are lacking. Maybe we could somtime post whats in our to give some food for thought. (leaving out whats not approprite ).

Maybe have a chat ofline via e-mail on medical matters as while I dont do it for a job its a subject I find very interesting.

Regards Gary

[dmoore]

Something has occured to me, if the instructor had diabetes how did he qualify? I have a yachtmaster ocean but cant get the commercial endorsement required to be a yachtmaster instructor. Is this requirement different for Power Boat instructors?

On the possible treatments for Hypo's, I find Hypostop on the gums largly ineffective by the nature of the timing required for it to have the desired effect and I am not at all happy with anyone giving me an IM injection - the degree of training as to when to administer would preclude all but my closest friends and my partner. I look on it the same way as I do when I am driving, I make sure that my BM's are in order before I set out and I have become a master of doing blood tests on the go. I can do a blood test in F8 conditions on my sailing yacht (never tried it on the RIB) as I do offshore racing and could be on the yacht for 4-5 days at a time. I keep a good supply of fun size mars bars and leaded coke on hand (they are in my first aid kit on both boats.

[John Kennett]

Originally posted by dmoore
Something has occured to me, if the instructor had diabetes how did he qualify? I have a yachtmaster ocean but cant get the commercial endorsement required to be a yachtmaster instructor. Is this requirement different for Power Boat instructors?

As far as I remember there are no medical requirements for RYA powerboat instructors. A medical certificate is certainly not required, and nor is a commercial endorsement for that matter.

IMO it all comes back to the problem that the RYA still don't appreciate what can be done with a small powerboat!

John

[Jelly]

Greetings John et al.
I you need to pass a medical to get the comercial endorsment.
I understand that there is a shake up in the training schemes coming with the recent new appoinments.
Weather they will start understanding the difference between cruisers, safety boating and racers is yet to be discovered
Most people think safety boats for sailing have to be atleast 4m, having spent alot of time in an avon 3.10m on safety I can tell you it is possible to right a drascome or wayfairer with something that small, more use for toppers and oppies though.

Jelly

[John Kennett]

Originally posted by Jelly
you need to pass a medical to get the comercial endorsment.

Yes, but you don't need a commercial endorsement to be a powerboat instructor (unless the rules have changed recently!)

John