Emergency Care Refresher

Written by DAN Staff

Being able to quickly and correctly provide emergency care during a dive incident can be the difference between a positive outcome and a fatality. Regardless of your level of personal experience with emergency management and response, providing adequate care requires regular refreshers of even the most basic skills, such as measuring vital signs. Accurate assessment of an individual’s condition not only provides EMS personnel with a good baseline for care, but can also help expedite needed medical interventions, and provide a valuable timeline of a patient’s condition. How well do you know your basic life support skills? 

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Time

Time is a fundamental metric in emergency response. Regularly recording the patient’s condition and the corresponding time is important to creating an accurate timeline of the patient’s symptoms. A timeline can be used to determine whether the patient’s condition is worsening and can dictate medical interventions. Seriously ill patients should have their vital signs reassessed every few minutes, while patients who are stable may reasonably have their vitals checked less frequently.

Level of Responsiveness

A patient’s level of responsiveness (LOR) can be one of the most revealing indicators of well-being. LOR is generally measured with four basic questions:

  • What is your name?
  • Where are we?
  • What time is it?
  • What happened?

If an individual can answer all of these questions with reasonable accuracy, you can quantify the LOR as “Alert and Oriented to Person, Place, Time, and Event,” which is frequently written as “A+Ox4.” In the event that a person can’t respond to these, or is unconscious, you can further measure LOR by determining if the patient is responsive to verbal or physical stimuli. While this measurement may provide useful information to professional responders, it’s not likely to change the care  you provide as a dive professional.

Pulse

Pulse can be a very effective indicator of an individual’s wellness, especially if you measure strength and regularity of the beat in addition to frequency. To assess a pulse, place two fingers gently on either the carotid artery on the neck, or on a patient’s wrist just beneath the base of their thumb. If you difficulty finding a pulse, first confirm the location of your fingers, and then make sure you aren’t pressing too hard or too gently. Note not just the speed at which the heart beats, but also the strength and regularity of the beat, these can be important factors when determining injury severity.

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Respiration

Constantly monitoring a patient’s breathing is a crucial emergency care step. Because many people will alter their breathing if they know you’re trying to count their breaths, begin counting respirations immediately after measuring the patient’s pulse. Pay close attention to the sound of breath and listen for wheezing, gasping, or labored breathing. These can indicate the existence of specific conditions and be valuable information for healthcare personnel.

For more information on diver health and safety visit diversalertnetwork.org.

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