| The Ship's Captain Medical Guide |
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Armstrong Global is very proud of its humble efforts to help sailors and mariners, amateurs and professionals, to enjoy the sea better and sail more safely. That is why we decided to help the UK maritime Coast Guard to distribute the Ship's Captain Medical Guide.
Here is a direct link with the source of the various chapters that you can download for free and print. A brief introduction follows.
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Introduction
When a ship is in port, or near to port where hospital and
other expert medical attention are available, the first aid
treatment necessary aboard ship is similar to that practised
ashore. At sea, in the absence of these facilities, trained ships’
officers are required to give types of treatment beyond that
accepted as normal first aid.
The content of this chapter covers the knowledge of first
aid necessary for the safe and efficient immediate treatment
of casualties before they are transported to the ship’s
hospital or to a cabin for any necessary definitive treatment
of the type described in Chapter 4.
However, anyone aboard ship may find a casualty and
every seaman should know three basic life-saving actions to
be given immediately while waiting for trained help to
arrive. These are:
n to give artificial respiration by the mouth to nose/mouth
method;
n to place an unconscious casualty in the unconscious
position;
n to stop severe bleeding.
Priorities
On finding a casualty:
n ensure your own safety;
if necessary, remove the casualty from danger or danger
from the casualty (but see the note below on enclosed
spaces);
n give immediate treatment to the casualty who is not
breathing and/or whose heart has stopped, is bleeding
severely or unconscious – others can be treated later;
n send for help.
If there is more than one unconscious or bleeding casualty:
n send for help;
n treat the most serious injury first in the order of:
• not breathing and/or heart stopped;
• unconsciousness.
• serious bleeding;
If the casualty is in an ENCLOSED SPACE:
n DO NOT enter the enclosed space unless you are a trained
member of a rescue team acting under instructions;
n send for help and inform the master.
It must be assumed that the atmosphere in the space is
hostile. The rescue team MUST NOT enter unless wearing
breathing apparatus which must also be fitted to the casualty
as soon as possible. The casualty must be removed quickly to
the nearest safe adjacent area outside the enclosed space
unless his injuries and the likely time of evacuation makes
some treatment essential before movement.
6 THE SHIP CAPTAIN’S MEDICAL GUIDE
General principles of first aid on board ship
The general principles are:
n make a rapid examination of the patient to assess responsiveness and the extent of the
injury;
n check breathing, heart and look for serious bleeding;
• if breathing has stopped, give artificial respiration;
• if the heart has stopped, give heart compression and artificial respiration;
• arrest serious bleeding;
n handle the patient as little and as gently as possible so as to:
• prevent further injuries; and
• prevent further shock;
n see that the patient is put in the most comfortable position possible and loosen tight
clothing so that he can breathe easily;
n do not remove more clothing than is necessary and, when you do, remove it gently. With an
injured limb, get the sound limb out of the clothing first and then peel the clothes off the
injured limb, which should be supported by another person during the process. If cutting
clothes is indicated to expose the injured part, do so. In removing a boot or shoe remove the
lace and, if necessary, cut the upper down towards the toecap; keep onlookers away.
n always remember that shock can be a great danger to life and one of the main objects of
first aid is to prevent this;
n you may have to improvise splints, bandages etc. (Figure 1.23);
n do not give alcohol in any form;
n do not move the patient until he is fit to be moved. Bleeding should be arrested, fractures
immobilised and shock treated. See that the necessary personnel and equipment for
smooth and efficient transport are available;
n never consider anyone to be dead until you and others agree that:
• breathing has stopped;
• no pulse is felt and no sounds are heard when the examiner’s ear is put to the chest;
• the eyes are glazed and pupils are dilated;
• there is a progressive cooling of the body.
(For a further description of the diagnosis of death Chapter 12).
General assessment of the situation
Once it has been established that there is no immediate threat to life there will be time to take
stock of the situation. Reassurance and quick and effective attention to injuries and
compassionate treatment of the injured person will alleviate his condition. Remember:
n a calm and systematic approach should be adopted;
n give nothing by mouth;
n protect the casualty from heat or cold, remembering that in the tropics open steel decks can
be very hot;
n never underestimate and do not treat as minor injuries:
• unconsciousness
• suspected internal bleeding
• stab or puncture wounds
• wounds near joints (see fractures);
• possible fractures
• eye injuries |
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