OR Medical Guide
Created by Drake M.
1.0 Introduction
In this document, the following situations will be described and an explanation of how a lifeguard properly deals with these types of situations.
The situations are as following: Jellyfish stings, Shark attacks, Drownings, Sand Flea Bites, Dehydration, Sun Burns & Heatstroke, Bone Fractures, Spinal Injuries, Seizures, and Strokes.
1.1 Medical Scenarios
Jellyfish Stings
Whenever someone gets stung by a jellyfish see down to the 3 steps below for appropriate treatment and see the symptom lists to determine which case you are dealing with.
The symptoms of a normal jellyfish sting are:
Burning/prickling/stinging pain
Red-brown or purplish tracks on the skin
A print of the tentacles visible on the skin
Itching
Swelling
Throbbing pain that radiates up a leg or an arm.
The symptoms of a severe jellyfish sting are going to be as follows:
Stomach pain
Nausea
Vomiting
Headache
Muscle pain or spasms
Weakness
Drowsiness
Fainting
Confusion
Difficulty breathing
Heart problems
Step 1: Get out of the water and apply TQ to prevent the spread of toxins
Step 2: Stop the stinging
Remove tentacles with pair of tweezers
Soak affected area in hot water (104-113°F or 40-45°C)
Step 3: If qualified, Treat the Discomfort
Shark Attacks
Whenever someone gets attacked by a shark depending on the severity or location of the injured body part you may proceed as follows for the following cases during this:
Bite Wound
When a shark produces a bite wound on your victim proceed with the following steps to allow proper treatment:
Locate the wound and, if on a leg/arm, apply a tourniquet depending on severity.
Clean the wound as best able and prevent any sand from entering the wound.
Apply gauze or a pressure bandage depending on the severity of blood loss.
Treat discomfort if qualified by providing pain relief.
Body Dismemberment
When a shark tears off a victims limb proceed with the following steps to allow proper treatment:
Locate the dismembered part and apply a tourniquet to prevent further blood loss.
Clean around the wound and prevent any sand from entering the wound.
Apply gauze and or a pressure bandage.
Insert an iv if needed determining by the amount of blood loss if qualified.
Treat discomfort if qualified by providing pain relief.
Drownings
A lifeguard deals with drownings every now and then so it is important to get the first steps right in order to give the patient the best chance of recovery.
Below here the steps are explained regarding drownings and how to give them the best chance with the ABC Check:
Airway, Check the patient’s airway and make sure it is all clear so that oxygen can properly flow towards the lungs.
If any water or obstruction is visible make sure to lay the patient on their side if no suctioning device is available in an attempt to get the water out and or clear the obstruction that is blocking their airway.
Breathing, Check if they are still breathing. A normal respiratory rate is between 12 and 20 breaths per minute.
Anything below that and rescue breaths or the bag valve mask should be applied in order to help the patient breathing.
Circulation, make sure that oxygen is properly flowing into the patient's body by feeling for a pulse. The best and easiest place to check for a pulse is on the neck.
Below here the steps are explained for CPR and how it is properly performed. Before doing this make sure to attach an AED to the patient in order to allow the AED to shock them as described in the procedure:
Step 1: Compressions:
Cross your hands and push on the chest as in the shown picture.
Step 2: Rescue Breaths:
Open the patient's mouth and make sure the tongue is not blocking the airway.
Take a deep breath and then breathe into the patient's mouth by putting your mouth on theirs and making sure no air can escape.
Then breathe out into theirs and keep this up. For reference see this picture.
A bag valve mask can also be applied instead of rescue breaths in order to help the breathing. Apply the mask over their face and squeeze the bag every 2 seconds.
Step 3: Defibrillation:
Dry the patient's chest and attach an AED. Listen to the AED and what it is advising, if it advises no shock keep going with steps 1 and 2 until it is detected again.
What always needs to be remembered here is to never touch the patient when it is detecting any shockable rhythm because this can influence the outcome and when shocking this will electrocute you.
Proceed with the procedure until vital signs are regained. In the case of after 5+ minutes of attempting CPR no signs of life have been regained you may stop your actions and declare your patient DOS. This is due to the fact that the brain can survive only for 5 minutes without oxygen.
Whenever you have a patient come back after drowning keep in mind that they are not in the clear yet There is still a chance of secondary drowning as there still could be water in the lungs so if they are conscious ask them if they have any difficulty breathing and if so keep assisting their breathing with the bag valve mask.
Sand Flea Bites
Sand flea bites are not an emergency matter but can be quite irritating to the patient as the bites produce a large amount of itching. The treatment for this is as follows:
Step 1: Place an ice compress on the affected area.
Step 2: Treat the discomfort. This may be done by providing ibuprofen as this reduces the itching.
Dehydration
A lifeguard will deal with dehydration every now and then and the proper procedure will allow the patient to recover more quickly. The symptoms are as follows:
Signs of mild or moderate dehydration include:
Thirst
Dry or sticky mouth
Not peeing very much
Dark yellow pee
Dry, cool skin
Headache
Muscle cramps
Signs of severe dehydration include:
Not peeing or having very dark yellow pee
Very dry skin
Feeling dizzy
Rapid heartbeat
Rapid breathing
Sunken eye
Sleepiness, lack of energy, confusion, or irritability
Fainting
The treatment is as follows:
Provide small amounts of water if the patient is able to drink. Don't give them too much as they will cough it all back up if too much.
If the patient can't keep the fluids in and if qualified then you may provide the patient with a saline iv. The saline iv slowly helps to rehydrate the body. If BLS consider reaching out over the radio for ALS or start transport if the patient is willing.
Stay with the patient, determine if they are recovering or not. If they are still degrading or not showing any sign of improvement it is recommended to start transport.
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