Scenario – Male snorkeler floating unresponsive in water, following likely intracerebral event.
Scene – Offshore recovery. Strop winch by paramedic into aircraft with initial assessment on board then further assessment and treatment at landing site on nearby headland.
Patient – Cold and wet in wetsuit. Poor airway control. Poor ventilation. Weak pulse. Progresses to seizures and recurrent vomiting.
Challenges – Airway control, vascular access, seizure management, requirement for RSI.
Learning points from debrief for clinical practice :
- Preparation of the cabin for any water-based primary mission including doctor on wander lead, O2 and LMA out ready to go, access to suction and potential for two points of suction to be required
- Difficulties in assessment and monitoring of the cold, wet patient
- IO access through a cut wetsuit point
- Seizure control options including intraosseous, intramuscular and intranasal benzo usage
Learning points from debrief for Simulation practice :
- Combining medical scenario with full strop winch training a worthwhile activity
Thanks to John (doc),Hugh(para), Shane(pilot), Richo(aircrew), Einar(actor), Fergal (SRC), Luke (STAR)