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Spinal care during sea rescue


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Sharing experience doing sea rescue in spinal; injured patient

Sharing experience doing sea rescue in spinal; injured patient

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  • 1. Spinal Care during Sea Rescue: HUKM experience Ismail MS, Azhar AA, A.Khaldun, Shalimar A, Muszaphar SS. Dept of Emergency Medicine HUKM
  • 2. Introduction• Spinal injury NOT common but very devastating.• The higher the injury level the worse will be the outcome• Most victims are in their prime time• Significant loss of work-force to family and community and the nation
  • 3. Spine injuries• Incidence : 40 per million (US) : 15 per million (UK)• In Malaysia: Incidence 19.8 per 1000 MVA victims had spinal injuries• 57.89% involve the cervical spine• SCI was only 5.3%• Mean age : 29.7 years old• Age peak: 20-24 male 25-29 female• Majority : Male
  • 4. • Spinal care is very important• Should receive utmost attentionDuring primary survey & resuscitationSpinal immobilization > spinal clearanceRegardless of the situation
  • 5. Important reminders• Early diagnosis is essential, prompt Mx planning for spinal & spinal cord injuries- reduce the morbidity & mortality• Early stages- life-saving procedures takes priority.• Movement of non-immobilized pts with unrecognized, unstable vertebral injuries put the spinal cord at high risk. TOTAL SPINAL IMMOBILIZATION• medical & legal consequences.
  • 6. Spinal immobilization On the land
  • 7. • Awareness: well created• Well understood• Much emphasis has been put• Indications- clear• Rescuers are quite well trained with the technique
  • 8. Spinal column Cervical Thoracic Lumbar Sacrum Coccyx
  • 9. In the sea• Most of time it is forgotten• Indication not clear• Technique not well described or understood• Not many rescuer know how to execute the procedure• Not much attention are put into it.
  • 10. Our experience• Put to test during the national level mock disaster drill in Kuala Terengganu• Difficulty was noted and address to• Feedback• Improvement proposed
  • 11. The TEAM
  • 12. The equipment
  • 13. Semi rigid Cervical Collar
  • 14. Full set-up forspinal care duringSea/ aquatic rescue
  • 15. The transport
  • 16. The training and technique
  • 17. Training for the aquatic rescue
  • 18. Vice grip vsIn-line immobilization
  • 19. • Assess airway and breathing• Cervical collar if indicated3. Any injury above clavicle4. Neck pain5. Neurological sign6. Unconsciousness7. History of diving
  • 20. Putting the cervical collar• Use adjustable collar• Applied the collar while another rescuer is supporting the head-neck with in line immobilization• *Need to loosen / open the buoyancy vest
  • 21. Putting the patient on the aqua spinal board
  • 22. The sea rescue• Sea condition was quite rough• Wind was 35 knots• Waves was between 1.5- 2.0 m
  • 23. In the sea• Condition slight different• Waves- much stronger• Wind quite strong• Helicopter downdraft was quite powerful• Getting to the victim is more further away• Technique remained the same
  • 24. Conclusion• Spinal care in aquatic injuries should receive equal emphasis just like their counterpart on land injuries• Spinal care technique should be taught to all rescuer whether it is on land or water.• Spinal care (immobilization) technique can and should be applied to all indicated patients.
  • 25. Thank you for your kind attention Terima kasih