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Internal and spinal injury add to challenges at sea

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Boats move; we all know that. Sometimes boats move a lot and sometimes not as much but they are almost always moving. When a person walks around on a moving object, they can fall, and the chances of failing greatly increase with age, medication and intoxication.

But how do you know if someone who has fallen is seriously injured, and how do we move someone who is seriously injured?

First, when I teach a class for a land-based client, I almost always tell them it is a bad idea to move an injured person with internal injuries. On land, I use the Double-D rule. Only move someone if they are dead or in danger. Otherwise, call 911 and wait for emergency professional help.

At sea, calling 911 and waiting for help may not be an option, so the rules are different onboard.

Anytime someone falls, always ask yourself if there could be internal damage. Is there an injury you can’t see?

And anytime you suspect spinal injury, do not move the affected person unless it is immediately necessary. Permanent paralysis and other serious injuries may happen if you move an injured person improperly.

Always assume a person has a spinal injury if:

  1. The fall victim sustained a head injury and you notice a change in their level of consciousness.
  2. The fall victim complains of severe pain in the neck or back.
  3. The injury has exerted substantial force on the back or head.
  4. The fall victim complains of weakness, numbness or paralysis.
  5. The fall victim lacks control of his or her limbs, bladder or bowels.
  6. The fall victim’s neck or back is twisted or positioned oddly.

Often, emergency personnel will hold the victim’s head stable until a C Collar and backboard can be applied. But onboard even the largest of ships, often a long backboard is not available. This is where a shorter, vest-type backboard called a KED will come in handy.

One of the tools often used by emergency personnel is a Kendrick Extrication Device. A KED is a spinal stabilization device used to remove victims trapped inside motor vehicles. Typically used in conjunction with a cervical collar, the KED is a semi-rigid brace that secures the head, neck and torso in an anatomically neutral position. This position reduces the possibility of additional injuries to these regions during extrication. Commonly carried on ambulances, the KED is typically applied by a first responder.

If you have never seen a KED before, it’s worth looking at a YouTube demo. They are easy to use and I often incorporate their use into my onboard training classes. I always suggest yachts carry them when a long backboard is not a viable option for potential spinal injuries.

Another option to the long, hard backboard is the Ferno Vertical Rescue Stretcher. I just used one of these for the first time in training last week. It has many benefits over the old hard backboard as it rolls up to store in a relatively small space.

The major downside I experienced with this device is the straps are not very intuitive. They are not color-coded quick connects like we see on the KED, but with training, crew will become proficient in their use. This could prove to be a valuable piece of equipment in any yacht’s medical kit.

When next performing emergency drills, I suggest incorporating a man-down scenario with possible spinal injury. Try the drill in the engine room or crew quarters, or in even tighter places such as heads and storage compartments.

Try all of these spinal injury drills with your current backboard and C-Collar, then grade the crew’s performance. Hopefully, they will get an A.

Keith Murray, a former firefighter EMT, owns The CPR School, a first-aid training company. He provides onboard training for yacht captains and crew and sells and services AEDs. Contact him at 877-6-AED-CPR, 877-623-3277 or www.TheCPRSchool.com. Comments on this column are welcome at editorial@the-triton.com.

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