O2Refr.Review1

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Oxygen Administration Refresher

• KNOWLEDGE REVIEW UPDATE

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Lesson outline

• Oxygen administration
• practicalities
• associated considerations
• equipment
• Resuscitation
• sequence
• implementation

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Administering oxygen (1)

• Start at the earliest opportunity
• greater nitrogen pressure gradient
• earliest reduction of tissue hypoxia
• Dont ration oxygen
• Oro-nasal mask 100 oxygen
• For second casualty
• use another demand mask or, if necessary, pocket
  mask
• accept faster consumption of oxygen

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Administering oxygen (2)

• Be prepared for a possible transient worsening of
  the casualtys condition
• Only administer oxygen to divers known to be
  suffering from a diving-related problem

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Fluids (1)

• For DCI counter dehydration with fluids
• still isotonic drinks best, otherwise
  water/squash
• give in small quantities (1 litre/hour)
• Do not allow administration of fluids to
  interfere with or delay administration of oxygen,
  or evacuation to recompression facility

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Fluids (2)

• Do not administer fluids if
• casualty is likely to vomit
• casualty is likely to inhale fluid
• general anaesthetic may be required
• If oxygen is not available, fluids alone are
  beneficial

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Posture

• For decompression illness or burst lung, lay
  casualty flat on back
• If decompression illness or burst lung are not
  involved
• legs may be raised to counter shock
• monitor for signs of respiratory embarrassment

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Nitrox

• The treatment for divers who have been using
  Nitrox is the same as for air divers
• If you run out of oxygen give the casualty the
  highest Nitrox available

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No Entonox

• Effective painkilling gas
• Carried on ambulances
• Provokes DCI

Blue bottles are bad for people who have been
diving!
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Missed decompression

• If a diver misses decompression stops for any
  reason, or is subject to a rapid ascent such that
  it is considered he/she may suffer decompression
  illness as a result
• administer oxygen
• do not wait for signs/symptoms to appear
• lay casualty down and keep casualty quiet
• contact the BHA/RN Diver Helplines (via the
  Coastguard if at sea) for advice on further
  action

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Other considerations

• Immersion shock
• keep casualty horizontal at all times
• discourage any movement or activity by casualty
• Oxygen toxicity
• oxygen can be administered to casualties of
  hyperoxia if necessary, provided that they are no
  longer exhibiting symptoms
• longer term (chronic) toxicity not likely in the
  first aid situation

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Oxygen resuscitation

• Some suitable positive pressure equipment is now
  available, features of this equipment are
• manually controlled
• will deliver 100160 litres/min on demand
• max resuscitation flow rate
• 40 litres/min
• equipped with pressure relief valve set to 45 cm
  water

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Resuscitation
check for breathing (10 secs)
If assistance available call emergency
services as early as possible
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Resuscitation sequence
2 breaths of AV
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Checking for circulation

• Checking for a pulse, when looking for
  circulation, is no longer recommended
• Check for
• breathing
• coughing
• any movement

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General considerations

• AV only
• check circulation still present approximately
  every minute
• CPR
• check for return of circulation only if
  significant improvement in casualtys condition
  apparent
• if confirmed, continue AV only as above
• CPR sequence (solo and two person)
• 2 ventilations,15 compressions
• chest compressions at a rate of 100 compressions
  per minute

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Recovery position
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Summary

• Oxygen administration
• practicalities
• associated considerations
• equipment
• Resuscitation
• sequence
• implementation
• Practical session to follow

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