THE FOLLOWING ARE COMPILED LIST FOR OFFSHORE MEDICINE EMERGENCIES
PRESCRIPTIONS AND OTHER ITEMS FOR MEDICAL PURPOSES
to be used by professional CAREGIVERS

PAS/BLS
SCENE

❑ Recognize and safely manage scene dangers including personal protective equipment
❑ Establish number of patients.
❑ Determine MOI.


INITIAL ASSESSMENT

❑ Rapidly assess Critical Systems status ( Circulatory, Respiratory, Neurologic ).

Basic Life Support

❑ Demonstrates ability to assess the Critical Systems and determine need for interventions.
❑ Demonstrates rapid repositioning of patients with Critical Systems problems and potential spine injury.
❑ Demonstrates proficiency in CPR and FBAO according to AHA standards.
❑ Demonstrates proficiency in NPA and OPA use.
❑ Demonstrates proficiency in BVM use and PPV. technique.
❑ Demonstrates proficiency in AED use.

Focused Assessment

❑ Accurately completes physical exam for traumatic and non-traumatic patient.
❑ Vital signs (P,R,S,C,T). B/P and lung sounds if applicable.
❑ SAMPLE History

Treatment and SOAP formatting

❑ Create an accurate problem list.
❑ Create an accurate anticipated problem list.
❑ Create a treatment plan.
❑ Fill out a SOAP note.

Spine Assessment

Assessment

❑ Verify context and obtain consent from patient.
❑ Demonstrate ability to roll patient in a spine stable manner for assessment purposes with a second rescuer.

 Demonstrate spine assessment guidelines by evaluating:

❑ patient’s mental status and reliability.
❑ spine pain and/or tenderness
❑ Motor/ sensory exam (as outlined in text)
❑ Document findings upon completion of procedure.
❑ patient’s mental status and reliability.
❑ spine pain and/or tenderness
❑ Motor/ sensory exam (as outlined in text)
❑ Document findings upon completion of procedure.
❑ Verify context and obtain consent from patient.
❑ Demonstrate ability to roll patient in a spine stable manner for assessment purposes with a second rescuer.

Demonstrate spine assessment guidelines by evaluating:
❑ patient’s mental status and reliability.
❑ spine pain and/or tenderness
❑ Motor/ sensory exam (as outlined in text)
❑ Document findings upon completion of procedure.

EXTRICATION / Immobilization

Demonstrates ability to measure and properly apply both a:
❑ manufactured cervical collar
❑ improvised cervicol collar
❑ Demonstrates ability to participate and lead in a rescue team which can properly move a potentially spine injured patient from various body positions onto backboards and litters.
❑ Demonstrates ability to participate and lead in a rescue team properly immobilizing a patient in both a backboard and litter.

Wilderness Rescue

Patient and Litter Carries

❑ Demonstrates ability to create a “piggy back” carry system using webbing, rope and other available materials.
❑ Demonstrates ability to participate in a rescue team on rough terrain using appropriate carrying and passing technique

Improvised Litters

❑ Demonstrates ability to build improvised stretchers and litters for non-spine injured patients.
❑ Demonstrates ability to build a “hypothermia wrap” in a litter or backboard.

Wounds and Burns

❑ Using BSI Technique, shows ability to expose bleeding area and apply eel aimed direct pressure (WADP)
❑ Demonstrate ability to create a pressure bandage.
❑ Identify the context and situations in which removal of impaled objects is appropriate.

Allergies/Anaphylaxis (sticks lab) 

❑ Prepares injection site
❑ Examines syringe for presence of excessive air and purges appropriately. L-3
❑ Successfully performs injection.
❑ Disposes of syringe appropriately.

 Musculoskeletal System

Stable Injuries 

❑ Assess distal CMS before beginning treatment.
❑ Assess musculoskeletal injury and correctly identify stable injuries.
❑ Appropriately and effectively treat stable injuries.
❑ Re-assess distal CMS upon completion of treatment.

UNStable Injuries 

❑ Assess distal CMS before beginning treatment.
❑ Assess musculoskeletal injury and correctly identify unstable injuries.
❑ Appropriately and effectively treat unstable injuries, including:
❑ Lower leg, ankle and knee.
❑ Upper arm, forearm, and wrist.
❑ Re-assess distal CMS upon completion of treatment.

Shoulder Dislocation Reduction

❑ Verify wilderness context and obtain consent from patient.
❑ Check distal CSM before proceeding with reduction, including sensation in deltoid region.
❑ Demonstrate ability to reduce dislocation using traction, abduction and external rotation.
❑ Demonstrate alternative method of reduction (hanging, scapula manipulation).
❑ Stabilizes area post reduction and re-assess distal CSM.

Patella Dislocation Reduction

❑ Verify wilderness context and obtain consent from patient.
❑ Check distal CSM before procedure (not critical).
❑ Demonstrate appropriate patella reduction technique.
❑ Stabilizes area post reduction and re-check CSM.
❑ Demonstrate appropriate patella reduction technique.
❑ Stabilizes area post reduction and re-check CSM.

Digit Dislocation Reduction</span class=”font-681074″>

❑ Verify wilderness context and obtain consent from patient.
❑ Check distal CSM before procedure.
❑ Demonstrate appropriate digit reduction technique.
❑ Stabilizes area post reduction and re-assess distal CSM.

TRACTION SPLINTING

❑ Demonstrates correct assessment of fractured femur that would benefit from traction splint.
❑ Assesses distal CSM
❑ Properly manages injury and applies:
❑ Manufactured traction splint ❑ Improvised traction splint
❑ Re-assess distal CSM upon completion of treatment.

SUGGESTED READING:

Merck Manual and Your Offshore Doctor books are good for quick references. Quick diagnosing is the Merck manual… brief and to the point in almost layman’s words.

SUGGESTED MATERIALS:***

 

laminated list of ailments and medicines taken and allergies for each of the crew members***

    • Blood Pressure cuff, stethoscope,otoscope (??),thermometer, and pulse oxymeter for giving vitals in case you call to shore MD
    • Gausses various sizes
    • Latex or non-latex gloves sterile and/or non sterile
    • Suture kit
    • Sutures various sizes
    • Dermabond (glue)
    • Steri-strips 10cm, 15cm and 30cm bandages
    • Antiseptic solution for would cleansing
    • Microdancyn spray
    • Syringes 3cc, 5cc, 10cc , 20cc
    • Needles
    • Insulin needle for anesthesia (freezing or numbing)
    • SAM Splints
    • Pneumo/air/inflatable splints
    • Oxygen tank (small portable) With Oxygen mask or nasal tips
    • IV solutions
    • IV starter kit
    • IV catheters
    • Tape/micropore or other for skin
    • Anesthetic
    • Topical,
      • lidocain creams
      • Local injectable 2%
      • Local spray 10

       

OINTMENTS:

Furacin cream (shrek snot) for burns
Mupirocine scrapes and cuts
Sun block FTP is up to you (depends on sun worshiping status)
Topical anesthetic (look above)
Hydrocortisone cream 1% (bites, burns solar and other) Antihistamine gel (bites, stigs etc)
Kankha soluction (kankha sores)
Pain ointment/cream Piroxicam gel Diclofenac gel Arnica cream (natural product)

 

PAIN MANAGEMENT:

 

NSAIDs Advl (Ibuprofen),
Tylenol (acetaminophen/paracetamol),
Aleve (naproxen)
*Toradol (ketorolac),
*dexketoprofen
* injectable vials available and combination sublingual available


OPIODS

Tramadol (light opiod),
Tylex CD (acetaminophen with codeine),
lertus CD (diclofenac with codeine higher dosage)

Cortisone:

oral and injectable Dexamethasone,
Betamethasone,
Hydrocortisone
prednisone

ANTIBIOTICS:

Wide spectrum antibiotics.
Amoxicillin/Clavulanic acid: upper respiratory infections, ears, sinuses
Azithromycin: Diarrhea, respiratory infections
**Ciprofloxacin: UTI, diarrhea, sinus, respiratory infections
***Sulfa drugs Bactrim/Septrim/Bactiver etc UTI, diarrhea, skin infections, Good combination drug with others
Clindamycin: skin infections, cellulitis
Ceftriaxone injectable: very wide spectrum. when you can’t swallow pills.
** makes you sun sensitive, fda and who recommend limited uses *** sun sensitivity If allergic to penicillin avoid ceftriaxone and amoxicillin

MISC. PRODUCTS:

Seasickness, dizziness, nausea/vomiting:
Difenidol , vial or oral tablets
Stugeron forte tablets
Meclizine/pyridoxine, vial or oral tablets
Ondasetron tablets
(Zofran) Anxiety/stress: Clonazepam 0.5mg tablets
Alprazolam 0.5mg tablets
NoseBleeds: Afrin or equivalent in nose spray Fungus: Lamisil cream
Yeast infections; fluconazole capsule 150mg (1 time dose)
Vaginal suppositories box with 10 Vagitrol V cream
Heartburn/acid reflux/GERD: Omeprazole, pantoprazole, nexium all oral Riopan (magaldrate) (ulcers, gerd, gastritis) Stomach cramping: Panclasa oral, butilhioscina oral and inj. vials Anti-diarrheal: Treda tabs, hidrasec caps, loperamide tab

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