Land
A student has been on the boat for 3 days and hasn't used sunscreen. You notice his back is glowing red and is showing water blisters. You should...
Talk to his chaperone about the sunburn. Student needs to wear a shirt and cover up the sunburned areas if they are going to continue on the field trips. After the water, you could rinse the area with fresh water and apply aloe. You can also use ice packs to ease the pain. Encourage the student to not pop the blisters as well as PUT ON SUNSCREEN.
A student slams into the boat engines on a super wavy day trying to take off their fins. You should...
Very situation dependent scenario, by likely treat it like a head/neck/spinal injury. Stop the student from moving, stabilize the head and neck, assess their responsiveness and breathing. Activate EMS if a serious injury is suspected. Keep them in the position found (and in the water) unless you need to move them for safety (waves are really bad), CPR, or to control life-threatening bleeding. Move yourself and the student away from the engines (likely to the end of the tagline until EMS arrives). Contact the coast guard/ wait for EMS to arrive and assist with removing spinal injury from the water.
You are at Nest Key and a student starts panicking as big red hives start appearing on their body from bug bites. You should...
Immediately assess the student for signs of anaphylaxis, including breathing difficulty, swelling, or signs of shock. Reassure them to help calm their panic, and prepare to take emergency action as you make your way back to the boat. Rinse the affected areas with fresh, clean water and blot it dry. You can soak the area in vinegar (won't make the situation worse). You can also apply antibiotic wound ointment or hydrocortisone cream. To reduce swelling and pain, apply a cold pack.
A student is experiencing severe skin irritation while trying on the snorkeling equipment for the first time. You should...
Very situation dependent... Do not ignore the student's frustrations. Be sensitive to the student's feelings. Find an appropriate accommodation for the student.
ex: student with blistering eczema (like open wounds) on feet - didn't wear fins in calm bodies of water. At reef, did foot cleaning care routine
ex: neck rash from snorkel vest - put a shirt on, rinse with fresh water, put on hydrocortisone cream
What EAP site would you proceed to from each location:
Roddy --> ?
Nest Key --> ?
Horseshoe --> ?
Tarpon Island --> ?
Roddy --> Port Largo Park
Nest Key --> Key Largo Ranger Station
Horseshoe --> Garden Cove/ Shipwrecks
Tarpon Island --> Reef House Resort and Marina
Kids were playing volleyball and a student took a volleyball to the face causing a bloody nose. You should...
Make sure you have gloves/PPE on. Have the student pinch their nostrils together while sitting with their head slightly forward. This prevents blood from pooling in the back of the throat, which can lead to choking or vomiting. Keep the nostrils pinched shut for at least 5 min before checking to see if the bleeding has stopped. If it hasn't stopped, keep the nostrils pinched shut for another 5 min out. If it still hasn't stopped after 10min or if severe or gushing, activate EAP and call EMS. Make sure to clean up any blood on the ground with gloves and antibacterial cleaner.
If a student makes contact with a Portuguese Man-O-War, you should...
1. Carefully remove tentacles with gloved hands and tweezers. Preferable to lift/ pull them off than scrape
2. Use seawater (not freshwater) to flush the area
3. Use heat pack on affected area for at least 20 min
4. Spray bactine (has lidocaine to relieve pain)
- not life-threatening unless allergic reaction occurs
Students didn't listen to your safety briefing and rubbed their whole arm up against fire sponge. You should...
Get the student out of the water and away from the sponge. Avoid further rubbing or contact with the affected skin. Rinse/flush the exposed area with clean water, and assess for signs of a serious reaction. Dry the skin gently by blotting it, not rubbing. Soak the area in vinegar for 10-30min. After the soak, rinse with soap and water and apply hydrocortisone cream. Do not apply hydrocortisone before removing the spicules, as it can worsen the initial reaction. If they develop difficulty breathing, severe pain, shock, or other serious symptoms, activate EMS and provide care as trained.
If there are spicules present, they should be removed if possible using adhesive tape, a thin layer of rubber cement or products used for facial peels.
Its really hot outside and a student faints while you are giving the swim test talk. You should...
Fainting is caused by a sudden decrease in blood flow to the brain. Someone about to faint often becomes pale, begins to sweat and may feel weak or dizzy.
Position them on their back and perform a rapid assessment.
- If responsive + breathing: conduct secondary assessment, check for injuries. If no injuries, place them in the recovery position so their head is at the same level as their heart and loosen any tight clothing. This returns blood flow to the brain and quickly recover.
- If not responsive, but breathing: activate EAP, call EMS, if no injuries place them in recovery position.
- If not responsive + not breathing + no pulse: activate EAP, call EMS, start CPR immediately, use AED as soon as possible.
A student slips on the deck of the boat getting back on after snorkeling and smacks their head on the bench. You should...
Keep the student still in the position found and assess for a head/neck/spinal injury. Check for serious symptoms such as confusion, vomiting, vision problems, seizure, loss of consciousness, severe headache, or trouble breathing. Call 911 if serious symptoms or another life-threatening condition is present and proceed to EAP location. Monitor them closely for changes in responsiveness or condition while waiting for help.
A student was running around campus without shoes on and cuts their foot on a rock. You should...
Put on gloves/PPE if available. Apply direct pressure to stop the bleeding. If it is a minor cut, clean/flush it with soap and water (or any antibacterial spray like bactine, preferred) and cover it with a clean dressing. If the bleeding is severe, continuous, or spurting, call 911. Because the cut came from a rock, have the student seek medical care if the wound is deep, has debris that cannot be removed, or may need tetanus protection.
It's a wavy day at the reef and one of your students starts struggling to breathe from overexertion (their med chart says they have asthma). You should...
Safely assist the student out of the water, have them sit upright in a position of comfort, and assist them with their prescribed quick-relief asthma medication (such as their inhaler). Monitor their breathing and call 911 if the breathing difficulty is severe, does not improve, or worsens.
You're with a group of itty bitty teeny tiny 4th graders in the mangroves in the dead of winter when the water is like 52 degrees. During critter talk, one of your kiddos starts exhibiting shivering, pale skin, and disorientation. What is happening and what should you do?
Hypothermia Symptoms: shivering, pale skin, disorientation, abnormal/ slow heartbeat, and in the worst cases, shivering can stop altogether.
Actions: find a way to warm up the person by moving them to a warmer place, removing wet clothing and putting them in dry clothes, but rewarm them slowly. Use the emergency heat blanket and heat packs from the first aid kit. Contact emergency services depending on the severity of the situation.
The students were diving down to the hotel, but wouldn't spread out in the group. One friend dives down too close to their friend and smacks them in the face with their fins. You hear the student say that they think they can taste blood in their mouth. You should...
Assess their airway and breathing, and check for signs of a head/neck/spinal injury (blood or loose teeth can block the airway). You can use an active front rescue, but just make sure that they are leaning forward so they don't choke on blood as you safely assist them out of the water. If you do not suspect a head/neck/spinal injury, have the student sit while leaning slightly forward or place them in the recovery position on their side to allow blood to drain from the mouth. If able, have the student hold a gauze pad to the sit of bleeding and apply direct pressure to stop the bleeding.
Lip Bleeding = rolled gauze pad b/w lip and gum
Tongue Bleeding = gauze pad + direct pressure
Tooth Knocked Out = rolled gauze pad in space left by the missing tooth, gently bite down to apply direct pressure (try to locate the missing tooth, only pickup by the crown, not the root).
It is a super hot day during the summer and the chaperone starts experiencing dizziness, a headache, and flushed skin. What is happening to the chaperone and what should you do?
Heat Exhaustion/ Stroke Symptoms: changes in mental status, pale/flushed skin, vomiting, headache, dizziness, or weakness.
- rapidly cool them (ex: immerse them in cold water, apply ice packs) and activate EAP (call EMS) if necessary
A kid tries to run down the stairs, but they are wet and he slips. He falls down the stairs and is now unconscious at the bottom. You should...
Yell “Code Red” to activate EAP. Check responsiveness and breathing, call 911 and get an AED. If he is not breathing normally or is only gasping, begin CPR and use an AED immediately. If he is breathing, do NOT move him unnecessarily. Because a spinal injury is suspected, leave him in the position found unless you must move him to provide CPR, control severe bleeding, or protect him from an immediate danger. Continue monitoring breathing and responsiveness until EMS arrives.
Your students were stupidly chasing around a lionfish at Hardbottom and one of them got stung, you should...
1. Flush the wound with water
2. Keep injured area still
3. Very uncommon for the spine to be lodged in the skin
4. Soak area in hot water/ use heat pack for at least 20min
5. Apply bactine to clean the area
6. Monitor wounds and recommend a follow up with medical professionals if necessary.
You're snorkeling at Tarpon Island and the students kicked up a ton of Cassiopeias. One student starts to go into anaphylactic shock from the jellyfish sting. You should...
Activate the EAP by yelling "Code Red." Get the student out of the water, call 911/get emergency equipment, and immediately assist with or administer their prescribed epinephrine (epi-pen) if trained. More likely, place the epi-pen in their hand and help them guide it down to their thigh to administer. Have them hold in place for 3sec after the click is heard. Note the time of injection and any change in the person's condition. Have them sit comfortably or lie down if showing signs of shock, monitor breathing and responsiveness, and be prepared to provide CPR if needed.
A student was goofing around with their friends in the lagoon. They swam a little too close to the posts and sliced their leg open on an oyster. You should...
Safely get the student out of the water, put on gloves/PPE if available, and check the severity of the bleeding. Apply firm, direct pressure with a dressing. Identify the type of wound (likely a laceration) and if the bleeding is life-threatening, activate EMS and use a tourniquet on the leg if trained. Monitor for shock and continue checking the student until help arrives. Student may need stitches.
A student has recently been diagnosed with diabetes and starts complaining that they feel dizzy and have a headache after snorkeling. You should...
Immediately talk to the student and the chaperone. If they have a plan in place, follow their diabetic plan first. Inform the student's parent.
If there is not a plan in place... Identify that the student is experiencing Hypoglycemia (excessively low blood sugar levels, too little food, more exercise than normal). If awake, give them sugar (recommended for children - 15g, adults - 20g). If they do not feel better within 10min of taking sugar or the condition worsens, activate the EAP and call EMS.
A student was running on the cement walkway in front of the car gate and wiped out on the wet spot, smacking their head and landing on their arm. You should...
Head strike + fall onto an arm = don't let the student get up and walk away. Because they struck their head, tell them NOT to move. Keep them still, assess responsiveness/breathing, check for serious head-injury symptoms/ concussion, and have someone contact 911 if emergency signs are present. The arm should be treated as a possible fracture until evaluated. Look for pain, swelling, bruising, deformity, inability/unwillingness to move it, numbness/tingling, unusual color or temperature, or bone protruding through the skin. Apply a cold pack wrapped in a tin, dry towel to reduce swelling and pain, but for no more than 20min at a time. Only splint if you must move the individual.
RICE (rest, ice, compression, elevation). If person cannot bear weight on injury for short period of time, may need more professional medical attention.
Your students were being super loud and noisy, splashing around at Deep Blue and a shark came up and bit one of your students on the thigh thinking they were food. You should...
1. Activate EAP immediately by yelling "Code Red" to your staff and remove students from water as fast as possible.
2. Determine best method to control the bleeding: direct pressure, tourniquet, or both.
3. Direct Pressure: place a dressing on the wound. Press as hard as you can, directly on the wound add additional gauze on top as needed. Hold the pressure until the bleeding stops
4. Tourniquet: Continue to apply direct pressure until tourniquet is in place. Position tourniquet 2-3 inches above the wound, between the would and the heart. Tighten until bleeding stops. Secure tourniquet so it stays tight. Do not loosen or remove. If bleeding hasn't stopped, a second tourniquet can be placed above the first.
5. After the bleeding has stopped, make sure to monitor the person for signs of shock and give care as needed until in more advanced medical care.
Your students are swimming around the mangroves collecting marine debris. One of your students finds some sheet metal and accidentally cuts themselves trying to free it from the mangrove roots. You should...
Get the student out of danger/back on the boat, put on gloves/PPE if available, and assess the bleeding. Apply firm, direct pressure to the wound with a dressing. If the bleeding is life-threatening, activate EMS and use a tourniquet if the wound is on a limb. Monitor the student for shock and changes in responsiveness or breathing. The sheet metal itself should not be pulled out if it remains embedded. Put pressure around the object and seek medical care and tetanus protection.
A chaperone wasn't holding onto the railing as they made there way down the lagoon steps. They slipped on the algae and landed hard on their back. You should...
Stop the person from moving and assess them for a head, neck, or spinal injury. Maintain in-line stabilization, and call EMS. Make sure to approach them from the front so they can see you without moving their head. You should keep them on the stairs until EMS arrives so as not to risk making the injury worse.
You can call for a backboard, and use the backboard extrication technique (head immobilizer device and head splint) to safely remove them from the water if and only if their are other life-threatening injuries (like they stop breathing). If they are responsive and breathing, just keep them on the stairs until EMS arrives.
One of your students has epilepsy and you notice they are staring off into space and start convulsing. You should... (decide what boat this is on)
Activate the EAP by yelling "Code Red" and have the captain slowly stop the boat. Protect the student from injury, clear nearby objects, and do not restrain them or put anything in their mouth. Depending on the boat, move them to floor, dry box, or keep them on the bench if no room on the ground (protect their head with a towel?). Place the student in the recovery position on their side (if possible) and let the seizure run its course. Monitor them and time the seizure. Once the seizure ends, check breathing, and stay with them until they are fully recovered. Call EMS no matter what and slowly make your way to an EAP site. This situation is very case dependent.