Wednesday, 30 April 2008

Skill fade

There is no doubt that over time skills fade with lack of use. The RNLI invests a lot of time and money training it's crews in order to provide them with the skills needed to deal with the incidents they attend. It's not surprising then that they also wish to analyse how effective any new course or training method is. With this in mind, during our exercise last night we had a fairly comprehensive and realistic medical incident to deal with.

Our second Coxswain Robert had brought a Severn class lifeboat from Poole containing the full 1st aid training team from Poole, Howard Ramm and three casualties. In the course of our exercise we were tasked to attend this 'casualty' which had experienced an explosion onboard. The ILB got there first and tied up alongside allowing one person to attend each casualty.

Gavin was dealing with a fellow who was unconscious, had no airway and an immediate life threatening bleed. In pretty short order he temporarily stemmed the flow with a fist in the groin, applied a CAT (Combat Application Tourniquet) and then established an airway whereupon the casualty began breathing. As soon as the ALB crew arrived he had enough hands to administer Oxygen and begin immobilising an open fracture to the lower leg.

Meanwhile Chad had begun his assessment of the second casualty. She had rapid and shallow breathing and was propped in a tripod position so was quickly assessed as 'Big Sick' despite having no injuries (she was complaining of chest pain). Chad moved her to a more comfortable position, made a great job of reassuring her then continued with his assessment. It turned out she was under investigation by her GP for a heart condition. Chad got out his check cards and correctly applied GTN and a dose of Aspirin.

The extra hands who had arrived onboard from the ALB were deployed to help with each of the casualties. Dave established an equipment cache while I visited each of the casualties to establish our priorities for evacuation. Interestingly it was our third casualty, dealt with by John Deas who became our highest priority, despite being a walker and so a P3. She had been caught in the blast and had burns to her hands, neck and face. John dressed her hands with 'cling-film' then put her on oxygen. Our concern was that her breathing was laboured and seemed to be getting worse. Needless to say we suspected internal burns to her throat and perhaps lungs so wanted her treated ashore as a priority.

And with that we began our evacuation, no easy feat with two moving boats at sea but achieved safely and speedily.

Our subsequent debrief seemed to show that we had mostly treated the right things and done enough to keep the casualties alive! Indeed all of the staff seemed pleased with the relatively low level of skill fade shown across the crew. That's not so say that there wasn't stuff that we'd forgotten, however, we seemed to have remembered a great deal more and were more confident than after previous courses.

A good result I feel.............


Anonymous said...


I think you all did very much better than you give yourself credit for. All 3 casualties correctly assessed, triaged and rapidly treated. No mean feat.
I was impressed by the knowledge reatained since I ran the course in December. Well done to all.
ps - for accuracy it was a Trent - not a Severn! - I had to find something to correct in the presence of excellent medical aid!!

lifeboatjohn said...

Of course I knew it was a Severn Paul! Oops.....

lifeboatjohn said...

Gosh, there I go again, meant to write Trent!!