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Training For the “When” Not “If”
Janine
Posted: Wednesday, July 20, 2011 6:45 PM
Joined: 02/05/2008
Posts: 392


Safety First is a new bi-monthly forum on Dockwalk.com written by maritime safety experts offering captains and crew safety tips, drill suggestions and strategies for handling real-life onboard safety scenarios.




There’s no time like the present to dig out those policies and procedures and dust off those training drills. By running though real-world medical scenarios and following a few best practices, you can get everyone on the same page and ready for the “when” not the “if.”

Here are eight tips to keep you ahead of the curve so you can proactively prepare for the next onboard illness or injury.


·     
Do the Drill. Unless you’ve experienced life in the military, nobody really enjoys running drills. Yet drills are a great opportunity for crew to “learn by doing.” Plus, they can be a great team builder, if you mix in some creativity. At a minimum, it’s best to get your medical house in order and conduct drills at the beginning of every season.

Tips:
Invite your medical trainer to join you during safety drills. Ask him or her to re-enact a sudden cardiac arrest scenario by placing my Automated External Defibrillator (AED) training unit on the bridge next to the yacht’s AED. Time the crew’s response from the moment the victim goes down to the time the first responder locates the AED and administers the shock. The first scenario generally takes about three minutes from start to shock. Then, by the third run-through, generally crew will have shaved off 90 seconds from the clock. When it comes to sudden cardiac arrest, 90 seconds could mean the difference between life and death.

·     
Perfect Your Procedures. Speaking of onboard drills, it’s a good idea — especially for the new crewmembers — to learn your yacht’s specific emergency procedures and train to the protocols. This will set the expectations for the season and teach the team how to work together as a group whether it’s during a galley fire, man overboard or medical emergency.

Tips:
Document your answers to these procedural questions: Will everyone have access to a crew radio? Do they know how to use it? How would they succinctly describe a worst-case scenario while maintaining composure in front of guests or the owner? Is it okay for them to use their vocal cords (after all, human nature is to shout when we’re anxious)? Who will communicate with the guests and owner if the captain becomes ill or injured? What are your written procedures and protocols, and where are they kept? Does your management company or medical provider have a copy of your protocols?

·     
Get Your “House” in Order. Ok. Back to the AED. Is everyone on the yacht—including owner, crew and frequent guests — aware of its location? Could they walk you to the exact location of the Epinephrine Auto-Injector? Often, medical equipment is scattered and stored in hard-to-find locations (such as under bed mattresses). Hiding kits makes sense when you want to keep a tidy house, but it’s not so great when you have only minutes to save a life.

Tips:
To get your house in order, consider moving your grab-and-go items — such as your First Responder Kit and AED — to a central and easily accessible location such as the bridge. Also, consider stowing your kits where accidents are most likely to happen. For example, another First Responder Kit should be close to the toys in the garage, the Pediatric Kit should be close to the children’s quarters and Burn Kits should be in the engine room, galley, garage and tender. Be sure to ask your medical supply provider about the recommended temperature ranges to store medications.

·      Date Your “Ex.” With so many medications on board — with varying expiration dates — it can be a bit daunting to keep track of it all. For example, who has the key to access the kits and controlled substances? Who is checking the “ex” dates and who is ordering replenishments? All of these people (if not the same person) need to be identified.

Tips:
To assist you in staying organized, several full-service medical providers offer an inventory management system and/or offer to have representatives conduct a medication and equipment audit on the vessel. Outside assistance or not, it’s recommended that you stay on top the expiration dates for your AED pads and batteries, and the epinephrine injector. When the rare, but life-threatening event occurs, you will want to be able to quickly access tools that are in proper working condition.

·     
Know When to Ask for Help. Nearly every vessel of a certain size has access to phone or radio to contact their land-based medical services advisor for routine or emergency medical support. Does everyone know the phone number and how to communicate with a doctor? Are they aware of the basic information that the doctor will request? Do they understand that being able to speak with an emergency room physician in a matter of minutes can make a real difference to the outcome?

Tips:
The crew should all be able to locate the emergency medical contact information (usually kept on the bridge) and successfully perform a test call to their medical services provider using the vessel’s radio and/or satellite phone.

·     
Get the Skills to Run Those Drills. The medical person in charge, generally, is a senior crewmember who is STCW-trained as the first responder and primary caregiver. However, it’s often the case that the designated medical officer is the person who bumps his head and needs stitches or comes down with food poisoning.

Tips:
Conduct a training audit. Assign a back up to your back up and schedule training accordingly. Even if you’ve had several crewmembers complete a three- or five-day advanced medical course, double check to see how many years it has been. Medical standards are changing all the time, including how to administer CPR. Consider creating a binder of all training certifications and reviewing them quarterly to allow proper time to schedule refresher classes. Most training providers will come onto the yacht, or meet the crew at pre-arranged locations, depending on your flag requirements.

·     
Know Your Resources. In addition to providing a number to call for onboard medical advice, most full-service medical providers include no-fee services and resources to ensure that guests and crew are well taken care of while traveling onshore. Unfortunately, more often than not, crewmembers are unaware of the additional resources available to them. Sometimes the valuable information stays with the person who signs the contract. During training, it’s a best practice to have the crew input the medical provider’s phone number — including the country code — into their cell phone for easy access away from the yacht.

Tips: During routine skills drills and the onboarding process, it is a best practice to discuss how to access your full suite of travel, medical and safety resources, if available. Topics of discussion can include: vaccination advice and referrals, pre-payment of medical expenses in the local currency, translation support, evacuation assistance, security advice, access to online travel information, referrals to doctors at port, etc.

·     
Know Before You Go.  Dengue fever and malaria — to name a few diseases — are concerns for the yachting community. That is why your crew, owners and guests should learn preventative measures and be current on all routine and recommended immunizations to decrease exposure in the areas you are visiting. Some maritime medical providers allow you to document your medical records online, and give the company’s doctors access to view your records, per your permission. Your maritime medical provider will serve as a reference via phone, and may be able to schedule visits and/or pre-pay your doctor visit expenses before departure. However, it’s best to check your contract. Many crew are unaware of the health risks associated with the itineraries. It’s important to keep them up to speed.

Tips: Contact your medical provider at least six weeks prior to departure to discuss your expected itinerary, past vaccination history, recommended shots and where to access a local healthcare provider to administer them. Allow four to six weeks for the immunizations take effect. Some schedules can be accelerated for travel, so you should still see your doctor if you are under the four-week mark. Additionally, check to see if your medical provider works closely with Centers for Disease Control, World Health Organization and local medical providers at the most popular ports of call.

Training for the “when” not the “if” is a matter of life or death. If you follow these eight tips for success, your crew will be well on its way to a safe and healthy sailing season ahead. 

 



By Renee Kempf, RN. Renee is a senior maritime medical instructor for MedAire’s yachting division and has trained hundreds to stay safe while living and working at sea. Qualified to train crew on a variety of maritime medical courses, including STCW, she enjoys sharing her at-sea and shore-side nursing expertise with students.

 


dragon
Posted: Friday, July 22, 2011 8:05 PM
Joined: 29/07/2008
Posts: 10


Sometimes it is good to know and say a prayer! Makes miracles!
dinahicks
Posted: Monday, November 28, 2011 10:57 AM
Joined: 28/11/2011
Posts: 1


Thanks for your post.It was really helpful.Saving life is not that easy but if you revive a patient experiencing cardiac arrest I believe it is indeed very fulfilling.However, I have read recently that Automated Electronic Defibrillators do not improve survival rates in hospitals.In short, automated electronic defibrillators are useful and effective in saving lives, but they are not necessarily the best option in hospital cardiac wards, where staff and nurses are trained in emergency cardiac care.I've read it here: Automated defibrillators could be costing lives in hospitals.Well, does this mean manual chest compression is way better than AEDs?.
Janine
Posted: Tuesday, November 29, 2011 10:22 PM
Joined: 02/05/2008
Posts: 392


The question above has been moved to its own forum. Please comment here

 
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