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IT

Memorizables

QuestionAnswer
Inside Tender Responsibilities Releasing door latches after seal made Comms with outside personnel First aid Monitoring vitals Administering Tx gas Monitoring patient for O2 toxicity Ensuring hearing protection Ensuring patient lying down, permit good blood flow to extremities
Primary objectives of Recompression Treatment Compress gas bubbles to smaller volume Allow sufficient time for reabsorption Increase O2 to blood and injured tissues
Guidance on Recompression Treatment -Treat promptly and adequately -Effectiveness of Tx decreases as time between symptom onset and Tx increases -Do not ignore minor symptoms -Follow TTs unless changes recommended by UMO -Multiple symptoms, treat most serious condition
Rules for Recompression Treatment (Always #1-5) 1. Follow TT, unless modified by UMO 2. Qualified IT in chamber all times 3. Maintain descent/ascent rates 4. Examine patient thoroughly at depth of relief or Tx depth 5. Treat unconscious patient for AGE/serious DCS, unless ruled out w/out question
Rules for Recompression Treatment (Always #6-10) 6. Use air TTs only ifO2 unavailable 7. Check for O2 toxicity if O2 used 8. If convulsion, remove mask, and prevent patient from harm, do not force mouth open 9. O2 usage IAW treatment table limitations 10. Check vitals/patient condition regularly
Rules for Recompression Treatment (Always #11-13) 11. Observe after Tx for reoccurrence of symptoms 12. Accurate time keeping and recording 13. Well stocked primary and emergency medkit
Rules for Recompression Treatment (never #1-5) 1. Permit shortening/alteration of TTs except under UMO 2. Wait for bag resuscitator, use barrier device and mouth-to-mouth 3. Interrupt chest compression more than 10 secs 4. Use O2 below 60 fsw 5. Fail to treat doubtful cases
Rules for Recompression Treatment (never #6) 6. Let people in chamber be in cramped position that might interfere with circulation
Primary medkit at SWRMC (diagnostic contents) Stethoscope otoscope BP cuff reflex hammer tuning fork pinwheel tongue depressors thermometer (non mercury) gloves skin marker pocket eye chart
Primary medkit at SWRMC (Emergency Treatment) OPA (size 4,5) NPA (32F, 34F) Lidocaine jelly BVM Suction and tips Needle D (14G 3.25") Cricothyrotomy kit Adhesive tape Elastic bandages pressure dressing tourniquet scissors 4x4's sterile cravats
Breathing gas mixtures and depths for treatments 0-60, 100% O2 61-165, 50/50 N2O2 166-225, 64/36 HeO2
CNS O2 toxicity in chamber, 1st occurrence -Off O2 -15 mins after symptoms subside, resume (5,6, 6A point of interruption. 4, 7, 8 no lengthening required)
CNS O2 toxicity in chamber, 2nd occurrence 5,6,6A -Off O2 -After symptoms subside (patient is relaxed and breathing normally for convulsion), decompress 10 fsw at 1 ft/min -Resume O2 at point of interruption -Happens again, then consult UMO
CNS O2 toxicity in chamber, 2nd occurrence 4,7,8 -Off O2 -Consult UMO
Secondary medkit at SWRMC (emergency equipment) LMA (size 4-5) 100cc syringe sterile lube End tidal CO2 detector Chest tube (32 and 36F) #11 blade/handle (scalpel) gloves surgical masks 10% iodine swab sticks 1% lidocaine 21G 1.5" needles/5 cc syringes kelly forceps
Secondary medkit at SWRMC (IV equipment) 16G, 18G needles/catheter IO infusion device IV sets Syringes (5, 10, 30 cc) Normal saline IV start kit Band aids, gauze
Secondary medkit at SWRMC (Misc.) Pulse Ox NG tube gloves urinary catheter assorted sutures sharps bin surgical kit - hemostats (clamps), surgical scissors, needle driver, sterile towels/gauze pads
Needle sizes 16G - largest 18G 20G 22G 24G - smallest
Created by: DivingKnowledge
 

 



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