Joined: 02/05/2008 Posts: 392
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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.
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Joined: 29/07/2008 Posts: 12
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Sometimes it is good to know and say a prayer! Makes miracles!
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Joined: 28/11/2011 Posts: 1
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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?.
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Joined: 02/05/2008 Posts: 392
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The question above has been moved to its own forum. Please comment here
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