Basic HTML Version
www.alertdiver.com
|
55
Respiratory distress in a remote setting must
be recognized and treated without delay.
The “tripod position” may indicate breathing
difficulty.
T
he aging population of divers along with medical
advances allowing people formerly unable to
participate in adventure sports to do so means an
increased potential for medical emergencies in
remote places. When we head out to hike, dive, fish or explore,
we bring our personal medical histories with us. Dive operators
are well aware of this; they require completion of medical forms
in which divers must list known illnesses, conditions, allergies
and medications. Many conduct this practice primarily to
ensure they’re protected in the event of legal issues, but they also
recognize the value of such information in an emergency. In fact,
this information is important enough that recreational divers and
outdoor enthusiasts should consider sharing it with each other
even when adventuring outside the context of a professional
dive or travel operation. Perhaps more important, they should be
prepared to provide basic assessments and treatments should a
medical emergency occur in the backcountry or on the water.
RespiRaToRy emeRgencies
Respiratory emergencies warrant quick action; people who are
unable to breathe will die within minutes unless an appropriate
intervention is forthcoming. Reasons a person may find it
difficult or impossible to breathe include anaphylaxis (severe
allergic reaction), asthma, foreign-body airway obstruction and
lung injury. Lung injuries generally are not manageable in the
field; when a lung injury is suspected, administer oxygen, and
seek medical care by the quickest means possible. Suspect lung
injury if respiratory distress occurs after diving. Rescuers should refer to their CPR
training for proper treatment of foreign-body airway obstructions.
People who are experiencing difficulty breathing may assume the “tripod position”
(hands on knees), and gasps or wheezes may be audible. When asthma is the cause
of breathing difficulty, a medication such as an albuterol inhaler may be needed.
People with asthma should have the necessary medication available; help them take
it if they have trouble doing so on their own. An asthma attack may be provoked by
exercise, dry air, cold, smoke or other factors.
Anaphylaxis is the result of exposure to an allergen; the substance may have been
consumed, inhaled, injected or simply touched. Remove the allergen from the patient
if possible, or remove the individual from the offending environment. If a person
with a known allergy has difficulty breathing following exposure to an allergen, it is
appropriate to administer (or assist the patient in administering) epinephrine if it
is available and you know how to do so. Other signs it is appropriate to administer
Medical Emergencies in
Remote Environments
B y B r i a n H a r p e r , W - e M T , D M T
F I E L D M E D I C I N E
//
RESEARCH, EDUCATION & MEDICINE
S T E P H E N F R I N K