Diver First Responder (DFR) Module E: Oxygen Administration Theory and Practice DFR JAN 2011: MODULE...

Diver First Responder (DFR)

Module E: Oxygen AdministrationTheory and Practice

DFR JAN 2011: MODULE E: OXY ADM

DFR CourseDFR Course

Module Title Content

A PHECC CFR Course Basic Life Support & AED

B Diving Emergencies 1 Barotrauma

C Diving Emergencies 2 Non-Pressure Related Emergencies

D Diving Emergencies 3 Emergency Care

E Oxygen Treatment Theory and Practice

2DFR JAN 2011: MODULE E: OXY ADM

In Module E: we will CoverIn Module E: we will Cover

• Oxygen AdministrationOxygen Administration– Common terminologyCommon terminology– When to use and when not to use oxygenWhen to use and when not to use oxygen– Characteristics of oxygenCharacteristics of oxygen– Administration of oxygen (+practical)Administration of oxygen (+practical)– Dangers of oxygenDangers of oxygen– Presentation of oxygenPresentation of oxygen– Preparation for usePreparation for use– Delivery devicesDelivery devices


Common TerminologyCommon TerminologyTerm Definition

Indication Uses for a medication / drug

Contra-indication Circumstances where a medication should not be given

Medical Emergency Acute injury or illness that poses an immediate risk to a person's life or long term health

Symptom What the patient experiences

Sign What the care-giver sees


Learning OutcomesLearning Outcomes

On completion, candidates will be able to

• Identify indications for oxygen administration• Identify contra-indications for oxygen• Handle oxygen safely• Administer oxygen to divers only• Identify / use correct delivery device


Oxygen AdministrationOxygen Administration


Indications for OxygenIndications for Oxygen

Helps restore tissue oxygenation by Helps restore tissue oxygenation by Improving oxygen availability in:Improving oxygen availability in:

• Diving related injury• Suspected / potential diving related injury• Shock / severe haemorrhage• Carbon monoxide poisoning• Respiratory / cardiac arrest• Medical emergencies


Conditions Requiring OxygenConditions Requiring Oxygen

• Decompression illnessDecompression illness• Gas toxicityGas toxicity

– including Oxygen Toxicityincluding Oxygen Toxicity

• Rapid AscentRapid Ascent• Near DrowningNear Drowning• Respiratory DistressRespiratory Distress• StrokeStroke

• Chest Pain / Heart Attack / Chest Pain / Heart Attack / Cardiac ArrestCardiac Arrest

• Injury / ShockInjury / Shock• Head injuryHead injury• Smoke inhalationSmoke inhalation• Shortness of breath Shortness of breath • Airway obstructionAirway obstruction


OxygenOxygen

9

Characteristics Characteristics

•Odourless, colourless gasOdourless, colourless gas•Present in the atmosphere at 21%Present in the atmosphere at 21%•Absolute necessity for lifeAbsolute necessity for life

CFT RecommendsCFT Recommends

•Divers administer oxygen only to diversDivers administer oxygen only to divers•Divers must be qualified in administration of oxygenDivers must be qualified in administration of oxygen•Minimum 600 litres at every dive siteMinimum 600 litres at every dive site


OxygenOxygen

10

Administration •As close to 100% as possibleAs close to 100% as possible•Flow rate of 15 litres per minuteFlow rate of 15 litres per minute•Three common delivery devicesThree common delivery devices

Contraindications Contraindications •Chronic chest / breathing problems (unlikely in Chronic chest / breathing problems (unlikely in divers)divers)


OxygenOxygen

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DangersDangers

•NO SMOKING / NO OPEN FLAMESNO SMOKING / NO OPEN FLAMES•Stored under pressureStored under pressure•Care needed when handling cylindersCare needed when handling cylinders•Can saturate clothing causing them to ignite fastCan saturate clothing causing them to ignite fast•Open valve very slowlyOpen valve very slowly

Fire HazardFire Hazard•Supports rapid combustion (oxygen fire) – often Supports rapid combustion (oxygen fire) – often following an explosionfollowing an explosion


Typical Cylinder SizesTypical Cylinder Sizes

12

Commonly Used CylindersCommonly Used Cylinders

•AFAF•FF•JJ•CDCD (commonly used by EMS; however limited capacity: 460 litres)(commonly used by EMS; however limited capacity: 460 litres)


Recognition of Oxygen CylindersRecognition of Oxygen Cylinders

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• Various sizes – check capacity(CFT recommends 600 L be available)

• Some identified with black body/white collar

• Others marked ‘Oxygen’

• Label indicates type of gas


Preparation for UsePreparation for Use

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• Open valve briefly to clear out any water or grit(snort the valve only by facing it away from yourself and personnel nearby)

• Ensure “O” ring clean and intact• Ensure connecting face clean• Open valve slowly• Use only the appropriate regulator• Never lubricate valves• Keep free from oil or grease• Finger-tight adequate when connecting regulator


Oxygen Delivery DevicesOxygen Delivery Devices

15

POCKET FACE MASKPOCKET FACE MASK(single use)

WHO?WHO?•For unresponsive diver while giving CPRFor unresponsive diver while giving CPR

HOW?HOW?•If available, oxygen can be connected at a flow rate of 15 L.P.M.If available, oxygen can be connected at a flow rate of 15 L.P.M.•Can deliver up to 50% oxygenCan deliver up to 50% oxygen



16

NON-REBREATHER FACE MASK(single use)

WHO?

•Preferred device for delivering supplemental oxygen to spontaneously breathing divers whether conscious OR unconscious

HOW?

•Oxygen connected at a flow rate of 15 L.P.M.•Reservoir bag must be completely filled prior to fitting on diver’s face•Can deliver up to 90% oxygen with a good mask-to-face seal



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Demand ValveDemand Valve

WHO?WHO?•For conscious, spontaneously breathing diverFor conscious, spontaneously breathing diver•May not be tolerated by diver with breathing May not be tolerated by diver with breathing difficultiesdifficulties

HOW?HOW?•Demand valve connected directly to oxygen cylinderDemand valve connected directly to oxygen cylinder•This can deliver up to 100% oxygenThis can deliver up to 100% oxygen


Be familiar with Emergency KitBe familiar with Emergency Kit• Location of cylinder, key* and regulatorLocation of cylinder, key* and regulator

(consider (consider placing key on cord around cylinder neck + spare in boat box)placing key on cord around cylinder neck + spare in boat box)

• Type of regulator: Pin Index or Bull-NoseType of regulator: Pin Index or Bull-Nose• Delivery device(s): Face Mask/Non-re-breather/DVDelivery device(s): Face Mask/Non-re-breather/DV• Ensure cylinder is filled or replaced after each useEnsure cylinder is filled or replaced after each use• Not for use to blend NitroxNot for use to blend Nitrox

* if applicable* if applicable


Patient ManagementPatient Management

• Remove diver from water• Monitor A-B-C - Commence CPR if appropriate• Deliver O2 – 15 litres per minute• Alert EMS


Module E: Oxygen AdministrationModule E: Oxygen AdministrationWe have covered:

• Common terminology• When / when not to use• Characteristics of oxygen• Administration of oxygen• Dangers of oxygen• Presentation of oxygen• Preparation for use• Delivery devices• Familiarity with kit



Practical SessionPractical Session

22

Am I confident in my ability to administer oxygen to an ill or injured diver ?

Small groups

• Assemble kit using various delivery methods/devices• Administer oxygen at correct flow rate• Disassemble kit


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Diver First Responder (DFR) Module E: Oxygen Administration Theory and Practice DFR JAN 2011: MODULE...

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