Simulation Debrief 25/4/13 – Water water everywhere, nor any time to think…


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)

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