Drowning Arrests
What is the difference between submersion and immersion?
Submersion involves the patients mouth and nose being below the surface of the fluid; whereas immersion involves the patient being in the fluid, but with their mouth and nose not under the water.
At what body temperature is a patient considering hypothermic?
Below 35 celseius
At what age can patients be intubated?
12 years old +
Who may insert an OG tube?
HART ECS only
What does METHANE stand for?
Major incident standby or declared, Exact location, type of incident, hazards, access/egress, number of patients, emergency services present or required.
Water is defined as 'icy cold' under what temperature?
Six degrees celsius
At what temperature in hypothermic arrests do we stop providing ALS drugs?
At and under 30 Celsius
What is the inclusion criteria for a HART ECS paramedic to intubate a patient?
Patient in cardiac arrest with an inability to adequately oxygenate and ventilate a patient using other adjuncts.
When is the insertion of an OG tube indicated?
In a patient in cardiac arrest aged 12 years or older, who is intubated and there is suspicion of excess air or water in the stomach
Describe our Draeger set.
Self contained
Two-stage
Open circuit
Positive Pressure
Compressed
Air
Breathing Apparatus
Describe the differences in management of patients who have drowned in salt vs fresh water?
Trick question - there are no differences.
What is the time interval for administration of cardio-active drugs in an arrest suspected to be hypothermic (with temperature range of 31-34.9) in origin?
Double the time period.
Following insertion of ET tube, how many ventilations must be completed with waveform capnography to confirm placement?
Seven ventilations
Name one complication that could arise with OG tube insertion?
coiling in the posterior pharynx
dislodged ET tube
How long is the decontamination procedure for a PRPS wearers?
12 min (with a partner)
Name the two of the three factors that influence outcomes for drowning patients?
Duration in water
Severity of hypoxia
Water temperature
At what temperature in hypothermic arrests do we stop providing ALS drugs?
Below 30 celsius
What acronym (and its associated meaning) can be used to simplify a difficult intubation?
O - oxygenation
H - head elevation
E - external laryngeal manipulation
L - laryngoscope blade
P - Pal: change operator
Following insertion of the OG tube, what must always be with the tube?
A 'not checked' sticker
What gases do the Micro5 test for?
Hydrogen Sulfide
Hydrogen Cyanide
Oxygen
Carbon Monoxide
Lower Explosive Limit (of methane)
Define circum-resuce collapse and how to mitigate it according to the JRCALC
Circulatory collapse associated primarily with a sudden drop in blood pressure following patient being extricated from the water. Mechanism is suspected to be related to the loss of the waters pressure on the patient.
Mitigation by attempts to keep the patient horizontal, but not at the expense of delaying the rescue.
Defibrillation should be withheld after how many shocks in what rhythm, until what temperature has been achieved?
VF persists after three shocks, withhold defibrillation until the core temperature is above 30 celsius.
List the kit required for an intubation
BVM or ventilation circuit
x2 suction
x2 direct laryngoscope blades
x2 laryngoscope blades
x2 tracheal tubes
10mL syringe
BougieIGEL
catheter mouth
thomas tubeholder
filter
ETCO2
Explain why excess water in the stomach is harmful to a patient in cardiac arrest.
Water in the stomach impedes mechanical ventilation and cold water in the stomach makes the patient colder.
What drugs (and dosages) are in our duo-dote?
2.1mg atropine
600mg paraloxidime