First aid
Council directive 92/29/EEC of 31 March 1992 on the
minimum safety and health requirements for improved
medical treatment on board vessels
Author: J. Delosa
This paper reviews the problems in performing correct
volumetric or manometric mechanical ventilation inside
the chamber, blood transfusions and/ or administration of
vasoactive substances, control and surveillance of
infectious diseases and coordination between the surgical
and anaesthesiological procedures the patient may
require as often happens in patients with gas gangrene.
Problems concerning the medical and nursing staff are
also discussed, since these persons are often obliged to
stay under pressure.
Author: Unknown
This document is a presentation of Cardiopulmonary
resuscitation (CPR) and most 1st aid techniques that can
be used to initiate personnel not familliar with such
procedures.
Author: Jacek Kot
All medical devices introduced into the hyperbaric
chamber should be of an appropriate design and fit for
use in the hyperbaric environment and the manufacturer
should certify them for hyperbaric conditions. However,
until now only several medical devices are CE marked for
usage in hyperbaric chambers. Therefore users often need
to perform themselves checking of the medical equipment
needed for continuation of intensive care during
hyperbaric treatment. To make this task easier, this paper
presents review of reports of usage of medical devices
under increased pressure.
The International Labour Organization (ILO) Maritime
Labour Convention 2006 stipulates that all ships shall carry
a medicine chest, medical equipment and a medical
guide.
The International Medical Guide for Ships supports a main
principle of that Convention: to ensure that seafarers are
given health protection and medical care as comparable
as possible to that which is generally available to workers
ashore, including prompt access to the necessary
medicines, medical equipment and facilities for diagnosis
and treatment and to medical information and expertise.
Also consider the additional document Quantification
Addendum: International Medical Guide for Ships
Authors:
Martin A Croce, Louis J Magnotti, Stephanie A Savage,
George W Wood, Timothy C Fabian
An alternative to embolization or external pelvic fixation
(EPF) in patients with multiple pelvic fractures and
hemorrhage is a pelvic orthotic device (POD), which may
easily be placed in the resuscitation area. Little published
information is available about its effectiveness. This study
evaluated the efficacy of the POD compared with EPF in
patients with life-threatening pelvic fractures.
Author: John Penzo & Kirk Dobrowolski
This document provides comprehensive explanations
regarding drugs and their usage..
Author:
Schlaich C., Reinke A., Sevenich C., Riemer T., Oldenburg
M., 5 , Baur X., Horneland A., Jaremin BM., Nielsen.,
Wichtmann EM., Ioannidis., Brandal., Puskeppeleit M,
Denisenko I, Carter T, Nikolic N
This document has been published to help the non-
medical person in charge of medical care on board vessels
to make the best use of the medical chest and equipment
on board.
This document is the complement of the International
Medical Guide for Ships.
The University of Newcastle WHO Collaborating Centre
for Training in Pharmaco-economics and Rational
Pharmacotherapy was commissioned to develop a list of
recommended quantities of medicines listed in the third
edition of the International Medical Guide for Ships.
Authors:
M. Beuran, S. Paun, B. Gaspar, M. Vartic, S. Hostiuc, A.
Chiotoroiu, I. Negoi
There are many controversies related to the trauma
patient care during the pre-hospital period nowadays.
Due to the heterogeneity of the rescue personnel and
variability of protocols used in various countries, the
benefit of the pre-hospital advanced life support on
morbidity and mortality has been not established.
The authors reviewed the literature in what concerns the
basic and advanced life support given to the trauma
patients during the pre-hospital period.
This user manual relates to the DanMedical Analysis System
(D-MAS).
This manual explains how to set up and use D-MAS and
includes important safety information.
All information in this manual is based on D-MAS and the
standard factory default configuration.
This document is also availaible on DMAC’s website
Note that today defibrillators should be provided in all
chambers.
Author: Dr. Alan Moloff
This document, published by PYNG, a medical
equipement manufacturer, promotes the use of Pelvic
Stabilization devices.
Note that the mortality for pelvic fractures is very high due
to the major hemorrhage that can occur secondary to
pelvic fracture
This document is the method of use of the EZ-IO® Power
Driver, a sealed, hand-held, lithium battery powered
medical device for use with the EZ-IO® Intraosseous
Vascular Access System from Teleflex
(https://www.teleflex.com/usa/en/index.html).
This system can be used in any situation where
intravenous access is difficult to obtain in emergent,
urgent, or medically necessary cases. It is also described in
logistics/Mediical equipment
This document is a presentation published by PYNG
medical on the use of Pelvic Stabilization Devices.
Authors:
Emmanuel Cauchy, MD, Sandra Leal, MD, Marie-Anne
Magnan, MD, and Hugo Nespoulet, Ph
A hyperbaric chamber is available in most trekking and
high-altitude expeditions primarily to treat and prevent
altitude illness. The device reproduces a low-altitude
evacuation when descent is impossible (Bartsch et al.,
1993). Atmospheric pressure is increased inside the
chamber using a mechanical pump.
This paper does not discuss diving. However, it highlights
phenomenons linked to the use of decompression
chambers while at altitude
Authors: Jacek Kot
This paper aims to present current controversies
concerning the safety of medical devices and procedures
under pressure in a hyperbaric chamber, including:
defibrillation in a multiplace chamber; implantable devices
during hyperbaric oxygen treatment (HBOT), and the
results of a recent European questionnaire on medical
devices used inside hyperbaric chambers.
Authors:
Avi Shina, Erez Nissim Baruch, Amir Shlaifer, Ami Shovali,
Moran Levi, Or Yosefy, David Segal, Tarif Bader, Itai Shavit,
Avraham Yitzhak.
The authors examined the success rate and ease-of-use
ratings of an IO device, the NIO ® (New Intraosseous
Persys Medical, Houston, TX, USA) in comparison to the
Arrow ® EZ-IO ® (Teleflex Medical Research Triangle Park,
NC, USA) by novice users.
Authors:
Bistra Iordanova, Lingjue Li, Robert S. B. Clark, and Mioara
D. Manole.
Assessment of Cerebral Blood Flow (CBF) and
oxygenation is not routinely performed after cardiac arrest.
Limited clinical studies established the role of CBF and
oxygenation monitoring in prognostication after cardiac
arrest. Few studies suggest that guiding critical care post-
resuscitation to mean arterial pressures above the minimal
autoregulatory range might improve outcomes. Important
knowledge gaps thus remain in cerebral monitoring and
CBF and oxygen goal-directed therapies post-resuscitation
from cardiac arrest.
Authors:
Simon J Mitchell, Michael H Bennett, Phillip Bryson, Frank K
Butler, David J Doolette, James R Holm, Jacek Kot,
Pierre Lafère
Guidelines for the pre-hospital management of
decompression illness (DCI) had not been formally revised
since the 2004 Divers Alert network / Undersea and
Hyperbaric Medical Society workshop in Sydney, entitled
“Management of mild or marginal decompression illness
in remote locations”. The Diver’s Alert Network initiated a
recent review undertaken by an international committee
with members from Australasia, the USA, and Europe.
Publisher: Advanced Trauma Life Support (ATLS)
The American College of Surgeons (ACS) was founded to
improve the care of surgical patients, establishing and
maintaining a high quality of surgical practices.
In accordance with that role, the ACS Committee on
Trauma (COT) has worked to establish guidelines for the
care of injured patients.
Authors:
Gilles Guerrier, Christine Agostini, Marion Antona, Fiorella
ponzini, Anne Paoletti, Isabelle Martin, Jean-Michel
Ekherian, Christophe Baillard.
I-gel® is a second generation supraglottic airway device
from Intersurgical and predsented in our website through
this link: https://diving-rov-specialists.com/medical-
equip.htm, and through this link:
https://www.intersurgical.com/
The optimal size of the I-Gel remains unclear since the
manufacturer's weight-based formula (size 3 for weight <
50 kg, size 4 for weight 50-90 kg, and size 5 for weight >
90 kg) for the laryngeal mask airway I-Gel is not evidence-
based. The authors hypothesized that sex might also guide
the choice of I-Gel size.
Authors:
Johanna Wall, Sriveena Naganathar, Banjerd
Praditsuktavorn, Oscar F. Bugg, Simon McArthur,
Christoph Thiemermann, Jordi L. Tremoleda, and Karim
Brohi.
Cardiac dysfunction (CD) significantly contributes to
mortality in trauma patients who survive their initial injuries
following successful hemostatic resuscitation. This poor
outcome has been correlated with elevated biomarkers of
myocardial injury, but the pathophysiology triggering this
cardiac dysfunction remains unknown. The authors
investigated the pathophysiology of acute Cardiac
dysfunction after trauma using a mouse model of trauma
hemorrhage shock (THS)-induced CD with
echocardiographic guidance of fluid resuscitation to assess
the THS impact on myocardial integrity and function.
Authors: Maritime & coast guard agency
Application of the Merchant Shipping and Fishing Vessels
(Medical Stores) Regulations 1995 (SI 1995/1802) and the
Merchant Shipping and Fishing Vessels (Medical Stores)
(Amendment) Regulations 1996 (SI 1996/2821)
Notice to all Shipowners, Agents, Masters, Skippers of
Fishing Vessels and all Seafarers
Authors: James Eric Neal, Brett Lewellyn
The primary purpose of this study was to compare
intraoperative and postoperative complication rates for
upper extremity surgical cases performed on a standard
operating room (OR) table with similar cases done on a
typical hospital stretcher. Secondary measures reviewed
included surgical time, turnover, total OR time, blood loss,
tourniquet time, and postoperative complications.
Authors:
Muhammad Husaini Rahmat, Ruhaizin S, Rosalam CM,
Hassan A, Khairul Manami K and Indastri S.
This study aims to determine efficient ways of lifting the
body based on rescuers' preferences. From the results,
new stretcher design parameters were established.
Authors:
Florian Ettl, Eva Fischer, Heidrun Losert, Dominik Stumpf ,
Robin Ristl, Kurt Ruetzler, Robert Greif, and Henrik Fischer
This study aimed to compare the cardiopulmonary
resuscitation (CPR) quality of an automated external
defibrillator (AED) with and without additional video
instruction during basic life support (BLS) by laypersons.
Authors:
Matteo Paganini, Giulia Mormando, Sandro Savino ,
Giacomo Garetto, Giulia Tiozzo, Enrico M. Camporesi ,
Fabrizio Fabris, and Gerardo Bosco.
Hyperbaric chambers and underwater environments are
challenging and at risk of serious accidents. Personnel
aiming to assist patients and subjects should be
appropriately trained, and several courses have been
established worldwide. In healthcare, simulation is an
effective learning technique. However, few peer-reviewed
articles have been published in the medical literature
describing its use in diving and hyperbaric medicine.
Authors:
Álvaro Astasio-Picado, Paula Cobos-Moreno, Beatriz
Gómez-Martín, María del Carmen Zabala-Baños, and
Claudia Aranda-Martín.
The objective of this systematic bibliographic review is to
update the theoretical and practical knowledge and
strategies for the insertion and proper management of the
intraosseous route as an emergency vascular access for
nursing professionals.
NCCD is a compact, lightweight chest compression device
to be used as a substitute to manual chest compression
during CPR.
NCCD is powered by compressed gas, and designed for
use in hyperbaric environments.
This equipment is described in logistics/medical
equipment/NUI - Compact Chest Compression Device
(NCCD
https://diving-rov-specialists.com/medical-equip.htm
Authors:
Ronal Surya Aditya, Ah Yusuf, Fitriana Kurniasari Solikhah,
Setyo Budi Kurniawan, Siti Rozaimah Sheikh Abdullah
This document discusses research aimed at understanding
nurses' experience assisting patients on stretchers using
commercial flights in Indonesia.
Authors:
Yu Liu, MD, Yanshu Zhang, Lei Zhang, Hongliang Bai, Gang
Wang, MD, Litao Guo
The purpose of this study was to analyze the role of SimMan
in resident training of emergency skills.
Fortyfive 1st year medical residents were selected for this
study. All participants were divided into groups and each
participant performed different roles during training. Clinical
cases were selected using the tutor mode/auto mode in
the SimMan computer system in order to train and assess
each group. A pre-test was administered to the 45 residents
before emergency medical technician (EMT) skill training.
Finally, a post-test was conducted with SimMan after
training. Tutors scored the student’s performance and
recorded the overall time for the procedure.
Authors: Jianxun Li, Haoxin Fu, Kin Keung Lai, and
Bhagwat Ram
The mobile emergency system is a new emergency mode
that provides a solution to deal with increasingly frequent
sudden disasters by reasonably allocating mobile
emergency facilities and optimizing the allocation of
mobile emergency materials. The authors consider mobile
emergency cost and mobile emergency time as two
objective functions.
This paper establishes a multi-objective mobile emergency
material allocation model, and transforms the multi-
objective.
Authors: Kara D. Wyatt, Neha N. Goel, and Jessica S.
Whittle
High flow nasal oxygen is a relatively new option for
treating patients with respiratory failure, which decreases
the work of breathing, improves the tidal volume, and
modestly increases positive end-expiatory pressure.
Despite well-described physiologic benefits, the clinical
impact of high flow nasal oxygen is still under
investigation. In this article, the authors review the most
recent findings on the clinical efficacy of high flow nasal
oxygen in Type I, II, III, and IV respiratory failure within
adult and pediatric patients.
Authors: M Abdollahi, A Hosseini
This document describes the generation of H2S, its
mechanisms of toxicity, and the recommended treatment
procedures and precautions to be implemented at work.
Authors:
Jeroen Seesink, Stella Nieuwenburg, Theo van der Linden,
Joost J.L.M. Bierens
Little is known regarding the circumstances, outcomes,
and quality of operational lifeboat crews perform
cardiopulmonary resuscitation (CPR) and automated
external defibrillators (AEDs).
The authors aim to evaluate the circumstances, outcomes,
and quality of CPR performed by the Royal Dutch Lifeboat
Institution (KNRM) in out-of-hospital cardiac arrest (OHCA).
Authors:
Allart M. Venema, Marko M. Sahinovic, Albert J. D. W. R.
Ramaker, Yvette N. van de Riet, Anthony R. Absalom and J.
K. Götz Wietasch.
Crewmembers of the “Royal Netherlands Sea Rescue
Institution” (KNRM) lifeboats must wear heavy survival suits
with integrated lifejackets. This and the challenging
environment onboard (boat movements, limited space)
might influence Basic Life Support (BLS) performance. The
primary objective of this study was to assess the impact of
the protective gear on single-rescuer BLS-quality.
Authors: Malay Sarkar, Irappa Madabhavi, & Nagaveni
Kadakol
Oxygen is probably the most commonly prescribed drug
in the emergency setting and is a life-saving modality as
well. However, like any other drug, oxygen therapy may
also lead to various adverse effects. Patients with chronic
obstructive pulmonary disease (COPD) may develop
hypercapnia during supplemental oxygen therapy,
particularly if uncontrolled. The risk of hypercapnia is not
restricted to COPD only; it has also been reported in
patients with morbid obesity, asthma, cystic fibrosis, chest
wall skeletal deformities, bronchiectasis, chest wall
deformities, or neuromuscular disorders.
Authors: S. Nogue, R. Pou, J. Fernandez, and P. Sanz-
Fatal hydrogen sulphide poisoning usually occurs in
confined spaces. However, this report discusses two fatal
accidents in unconfined spaces. The first accident caused
the death of three workers who entered an unconfined
room in a silo of sludge at the same time that a truck
dumped several tons of sludge from water purification
stations. The hydrogen sulphide that had accumulated
inside the silo spilled out into the interior of the room due
to a ‘splashing effect’ caused by the impact of the dumped
sludge. The second accident occurred when the foreman
of a wastewater treatment plant entered one of the
substations to perform routine checks.
This Regulation aims to ensure the smooth functioning of
the internal market as regards medical devices, taking as a
base a high level of protection of health for patients and
users, and taking into account the small and medium-
sized enterprises that are active in this sector.
At the same time, this Regulation sets standards of quality
and safety for medical devices in order to meet common
safety concerns as regards such products.
Authors:
Surg Cdr Kamal Mishra, Surg Capt Gokul Krishnan
This document describes the effects of carbon monoxide
through historical examples. It also provides suggestions
for a better comprehension of the impact of this gas and
the methods to prevent them.
Authors: Seong-Yong Jeong, Young Kook Moon,
Joseph Wang, & Jong-Heun Lee
Accurately detecting and identification of volatile aromatic
hydrocarbons, highly toxic pollutants, are essential for
assessing indoor and outdoor air quality and protecting
humans from their sources. However, real-time and on-
site monitoring of aromatic hydrocarbons has been
limited by insufficient sensor selectivity. Addressing the
issue, bilayer oxide chemiresistors are developed using
Rh–SnO2 gas-sensing films and catalytic CeO2 overlayers
for rapidly and cost-effectively detecting traces of aromatic
hydrocarbons in a highly discriminative and quantitative
manner, even in gas mixtures.
Author: N. K. I. McIver
This document provides an historic of the decompression
procedures since the observations of Robert Boyle to
today. This description includes the therapeutic
procedures.
Publisher:
Undersea & Hyperbaric Medical Society
This document is a compilation of pratices made by UHMS
and published in April 2011. It is based in part on the USN
Diving Manual Revision 6; April 200 with Advance Change
Notices 15-102 , the Manual of the Medical Department
(ManMed) Change 126 - August 2005, the U.S. Air Force
Guidelines for Treating Altitude Decompression Sickness
(USAF Instruction 48-112), and Association of Diving
Contractors International (ADCI) Return to Diving
Guidelines after DCS - 2011.
Note that it could also be logged in “Diving & ROV
procedures” however the treatment side of the document
justifies to publish it in 1st aid.
Authors: Richard E. Moon, Simon Mitchell
This document details procedures to implement for
treating decompression accidents. This document is not
specific to commercial diving.
Publisher: US Federal Aviation Administration
This document from the US Federal Aviation
Administration was initially designed for personnel
working in airline companies. Commercial diving
companies and divers can use it to understand which
formation this personnel may have or may not have.
Authors:
Joost Bierens, Janet Bray, Cristian Abelairas-Gomez,
Roberto Barcala-Furelos, Stephen Beerman, Andreas
Claesson, Cody Dunne, Tatsuma Fukuda, Muralidharan
Jayashree, Anthony T Lagina, Lei Li j, Tom Mecrow, Patrick
Morgan, Andrew Schmidt, Jeroen Seesink, Justin
Sempsrott, David Szpilman, Ogilvie Thom, Joshua Tobin,
Jonathon Webber, Samantha Johnson, Gavin D Perkins,
on behalf of International Liaison Committee on
Resuscitation BLS/AED Task Force
The International Liaison Committee on Resuscitation, in
collaboration with drowning researchers from around the
world, aimed to review the evidence addressing seven key
resuscitation interventions.
Authors: Jan Schmitz, Felix Liebold, Jochen Hinkelbein,
Sophia Nöhl, Serge Thal, and Timur Sellmann
Cardiopulmonary resuscitation (CPR) during hyperbaric
oxygen therapy (HBOT) presents unique challenges due
to limited access to patients in cardiac arrest (CA) and the
distinct physiological conditions present during hyperbaric
therapy. Despite these challenges, guidelines specifically
addressing CPR during HBOT are lacking.
This review aims to consolidate the available evidence and
offer recommendations for clinical practice in this context.
Authors: Hiroki Nagasawa, Kazuhiko Omori, Kenichi
Muramatsu, Ikuto Takeuchi , Hiromichi
Ohsaka, Kouhei Ishikawa, and Youichi
Yanagawa
Traumatic cardiac arrest (TCA) is associated with poor
outcomes. Helicopter emergency medical services
(HEMSs) are often used to transport critically ill patients to
hospitals. However, the role of HEMS in the treatment of
TCA remains unclear. Therefore, in this study, we aimed to
determine the current status of patients with prehospital
TCA managed by HEMS personnel in Japan and compare
the outcomes of patients who experienced TCA before
and after the arrival of HEMS.
Authors:
Graham Johnson, Philip Bryson, Nicholas Tilbury,
Benjamin McGregor , Alistair Wesson, Gareth D Hughes,
Gareth R Hughes, Andrew Tabner
Chest compression often cannot be administered using
conventional techniques in a diving bell. Multiple
alternative techniques are taught, including head-to-chest
and both prone and seated knee-to-chest compressions,
but there are no supporting efficacy data. This study
evaluated the efficacy, safety and sustainability of these
techniques.
Authors:
Andrew Tabner, Philip Bryson, Nicholas Tilbury, Benjamin
McGregor, Alistair Wesson, Gareth R Hughes, Gareth D
Hughes, Graham Johnson
Provision of manual chest compressions in a diving bell
using a conventional technique is often impossible, and
alternative techniques are poorly evidenced in terms of
efficacy and sustainability. The first mechanical
cardiopulmonary resuscitation (CPR) device suitable for
use in this environment, the NUI Compact Chest
Compression Device (NCCD), has recently been designed
and manufactured. This study assessed both the efficacy of
the device in delivering chest compressions to both prone
and seated manikins, and the ability of novice users to
apply and operate it.
Authors:
Michele Salvagno, Federico Geraldini, Giacomo Coppalini,
Chiara Robba, Elisa Gouvea Bogossian, Filippo Annoni,
Eva Vitali, Elda Diletta Sterchele, Costantino Balestra, and
Fabio Silvio Taccone
Traumatic brain injury (TBI) and subarachnoid
hemorrhage (SAH) are critical neurological conditions
that necessitate specialized care in the Intensive Care Unit
(ICU). Managing cerebral perfusion pressure (CPP) and
mean arterial pressure (MAP) is of primary importance in
these patients. To maintain targeted MAP and CPP,
vasopressors and/or inotropes are commonly used.
However, their effects on cerebral oxygenation are not
fully understood. The aim of this review is to provide an
up-to date review regarding the current uses and
pathophysiological issues related to the use of
vasopressors and inotropes in TBI and SAH patients.
Click on the
octopus to return to
the top of the page
Authors:
Julang Fahman, Wilson Kores, Olivia Jeany Darmawan
Adji Saroso, Valerie Christianto, Cindytia Rosalina Putri
Djojomartono, Hosea Glory, Billie Edgara Herijanto, Naftali
Intania Kristianti Kosasih, Jonathan Abdiel Caesar
Nainggolan, Satria Budi Nugraha, Gabriella Putri Sabrina,
Edeline Samudra
This handbook offers essential guidance on recognizing
and handling common injuries and emergencies, as well
as performing basic life support through cardiopulmonary
resuscitation for non-professionals. Understanding that
many find it challenging to manage such situations, the
handbook includes straightforward, clear explanations
complemented by helpful images to enhance learning
and retention
Authors: Björn Jüttner, Christian Wölfel, Holger
Schöppenthau, Johannes Meyne, Carmen
Wohlrab, Henning Werr, Till Klein, Giso Schmeißer,
Karsten Theiß, Philipp Wolf, Oliver Müller, Thorsten
Janisch, Johannes Naser, Susanne Blödt, Cathleen,
Muche-Borowski
The S2k guidelines offer advice on diagnosing and
treating diving accidents. The treatment protocols for
breath-hold divers, children, and adolescents are similar.
