PADAMS - EFA

Prevention of Alcohol and Drug

Abuse in the Maritime Sector –
Emergency First Aid
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 COURSE OUTLINE

PART – I
Prevention of Alcohol and Drug Abuse in the Maritime Sector

 INTRODUCTION

a. Why the Concern?

b. Why the Workplace?

 COURSE OUTLINE

PART – I
Prevention of Alcohol and Drug Abuse in the Maritime Sector

 MODULE I

a. Nature and Extent of Alcohol and Drug Problems

b. Alcohol and Alcoholism

c. Drug and Drug Dependence

 COURSE OUTLINE

PART – I
Prevention of Alcohol and Drug Abuse in the Maritime Sector

 MODULE II

a. Self-assessment

b. Levels of Prevention

c. Role of Sectors/Entities Involved

 COURSE OUTLINE

PART – I
Prevention of Alcohol and Drug Abuse in the Maritime Sector

 MODULE III

a. Importance of Policies and Program

b. Main Components of Drug and Alcohol Policy

c. Levels of Policy Maker

d. Drugs Permitted Onboard

 COURSE OUTLINE

PART – II
Emergency First Aid

 INTRODUCTION

a. Importance of First Aid

b. Objectives
 COURSE OUTLINE

PART – II
Emergency First Aid

 FIRST AID

a. Emergency Action Principles

b. Air, Breathing, Circulation (ABC)

c. Emergency Care

d. Radio Medical Advice (RMA)

 COURSE OUTLINE

PART – II
Emergency First Aid

 COMMON ILLNESS/INJURY AND ITS

CORRESPONDING FIRST AID

a. Poisoning

b. Hypothermia

c. Shock

d. Head Injuries
 COURSE OUTLINE

PART – II
Emergency First Aid

 COMMON ILLNESS/INJURY AND ITS

CORRESPONDING FIRST AID

e. Burns

f. Wounds

g. Fracture
 COURSE OUTLINE

PART – II
Emergency First Aid

 ARTIFICIAL RESPIRATION

 CARDIOPULMONARY RESUSCITATION
Prevention of Alcohol and
Drug
Abuse in the Maritime
Sector
Expectations
 INTRODUCTION
Seafaring is international in nature and the
shipping industry as a whole has become
increasingly conscious of the impact that
drug and alcohol abuse can have on
operations.
 INTRODUCTION

The use of alcohol and/or drugs in

general is increasing globally, and the
impact of the substance abuse can be
seen in the workplace.
 OBJECTIVES
To provide working knowledge of the
main components of the alcohol and drug
problems, including and understanding of
the implications of alcohol and drug
abuse for fellow seafarers, the family,
shipping companies, manning agencies
and countries
 OBJECTIVES

To appreciate the importance of the

effects of alcoholic beverages on their
behavior in the workplace or elsewhere.
 OBJECTIVES

To increase compliance with pertinent

laws, policies and regulations.
WHY THE CONCERN?
 WHY THE CONCERN?

Substance abuse undoubtedly contributes to

lower performance and productivity.
 WHY THE CONCERN?

 1st Test: before any alcohol ingestion

 10 % could not perform all tasks correctly
 2nd Test: after reaching a BAC of 0.10/100 ml
 89 % could not perform all tasks correctly
 3rd Test: 14 hours later
 68 % could not perform all tasks correctly
WHY THE WORKPLACE?
 WHY THE WORKPLACE?
Drug and alcohol abuse causes 500 million
lost workdays each year.
It is estimated that 10-30 % of the
accidents at work are related to drug and
alcohol.
 WHY THE WORKPLACE?
Drug and alcohol abuse is an important
factor in accidents, absenteeism and
illness.
 WHY THE WORKPLACE?

Absenteeism is 2 – 3 times higher for drug

and alcohol users than other employees;
Employees with chemical dependence
problems may claim 3 times as many
sickness benefits and file 5 times as many
workers’ compensation claims;
 WHY THE WORKPLACE?

In many workplaces, 20-25 % of accidents

at work involve intoxicated people
injuring themselves and innocent victims;
and
On-the-job supplies of drugs and alcohol
account for 15-30 % of all accidents at
work.
 OVERVIEW

Collisions, explosions, groundings, fires,

sinking or capsizing, oil pollution,
personnel injury or even death can be
catastrophic to all concerned.
 OVERVIEW

Drug and
Alcohol Consumption

Performance &
Productivity
 VOCABULARY
1. Enzymes – are biomolecules that catalyze
chemical reaction
2. Implicit – implied rather than expressly stated
3. Workplace – any or all places where people
are employed
4. UNDCP – United Nations International Drug
Control Programme
 VOCABULARY
5. OCIMF – Oil Companies International Marine
Forum
6. Jurisprudence – Science of law
7. Administration – Government of the state
who’s flag the ship is entitled to fly
8. EMS – Emergency Medical Services
9. RMA – Radio Medical Advice
 VOCABULARY
10. GMT – Greenwich Mean Time
11. Cyanosis – bluish color of the skin and
mucuos membrane due to insufficient oxygen
in the blood
12. Pharmacology – a branch of science that deals
with the study of drugs and effects

PADAMS-EFA
 MODULE I

NATURE & EXTENT OF ALCOHOL

& DRUG PROBLEMS
SHIPBOARD SETTING AS A
WORKPLACE
The ship is both a home
and a workplace for crew
members. The special
nature of the shipboard job
is characterized by its
vulnerability to maritime
disasters resulting to
considerable loss of life
and property at sea.
SHIPBOARD SETTING AS A
WORKPLACE
Causes of Maritime Accidents / Disasters

Technical Factor

Human error
 SHIPBOARD SETTING AS A
WORKPLACE
 Key Factors in the Maritime Industry
-A unique workplace
-Demanding work environment
-Social isolation
-Mixed social/ethnic/cultural environment & customs
-Job insecurity
 SHIPBOARD SETTING AS A
WORKPLACE

 Key Factors in the Maritime Industry

-Short term work contracts

-Limited health promotion
-Frequent changes in vessel ownership
-Flag-state legislation enforcement standards
-Noise, dust, climatic etc. stressors
SHIPBOARD SETTING AS A
WORKPLACE

Special Nature of Maritime Work

SHIPBOARD SETTING AS A
WORKPLACE

Contributing Factors to Alcohol

and Drug Abuse Among
Seafarers
 ALCOHOL &
ALCOHOLISM
Drugs in Alcoholic Beverages
PSYCHOLOGICAL EFFECTS OF
WINE
“It discloses secrets; ratifies and confirms
our hopes; thrusts the coward forth to battle;
eases the anxious mind of its burden;
instructs in arts. Whom has not a cheerful
glass made eloquent! Whom not quite free
and easy from pitching poverty.”

Horace
Roman Poet
“Drink Less, Live Better”
and so
“Count Your Drinks!”

ILO Slogan
Alcohol Consumption
Patterns
Number
of
Persons

Alcoholics
Normal
Drinkers

Consumption Level
Liter per
Year

20 40 60 80

Age
DRINKING PATTERNS AND
LEVELS OF RISKS

Social Drinking
Hazardous Drinking
Harmful Drinking
DRINKING PATTERNS AND
LEVELS OF RISKS
HAZARDOUS DRINKING
A World Health Organization memorandum
recommends the term hazardous drinking refer to
that level of alcohol consumption or pattern of
drinking that it should persist, is likely to result in
harm to the drinker
DRINKING PATTERNS AND
LEVELS OF RISKS

HARMFUL DRINKING
Is defined as alcohol use that has already resulted in
adverse mental or physical defects.
 DRINKING PATTERNS AND
LEVELS OF RISKS
HARMFUL DRINKING
Results:
- the frequent state of intoxication drinking bouts;
- the physical deterioration caused by high intake
of alcohol on a regular basis; and
- the social and personal consequences of
dependency
 REGULAR USE,
INTOXICATION, DEPENDENCE

Dependence

Regular
tiIntoxicaon Use
 STANDARD UNITS OF
ALCOHOL
1 unit 6 units 8 units 20 units

Dessert
Beer Red Wine Liquor
Wine
 STANDARD UNITS OF
ALCOHOL

= = = = 1

½ 1 glass 1 glass
1 drink
bottle 12 cl of 8 cl of
33 cl of = = dessert = of
red
liquor
beer wine wine
 1.5 cl pure 12.8 g.
1 unit = =
alcohol alcohol
 STUDY ON HARMFUL
DRINKING

It was concluded that men drinking more than

21 units of alcohol per week and women
drinking more than 14 units per week had a
significantly increased risk of medical
complications, social problems and increasing
dependency.
 POST ALCOHOL
IMPAIRMENT SYNDROME
Reaction time
Motor performance
Sight
Mood
Learning and memory loss
Intellectual performance
ALCOHOL TOLERANCE IN
MEN & WOMEN

Women have generally lower balance

for alcohol than men in the same body
weight.
ALCOHOL TOLERANCE IN
MEN & WOMEN

The number of the female drinkers in

the general population is increasing in
any parts of the world.
 Distribution of Alcohol Consumption across Social Groups

80
70
% of total 60
population 50
40
30
20
10
0
<5 5-10 10-30 >30

Liters per year

Risk of Alcohol Related Problems Acroos Consumption Categories

70
60
% of total
50
population
40
Sick Leave
30
Arguments
20
Fights
Accidents 10
0
<5 5-10 10-30 >30

Liters per year

 Total Distribution of Alcohol Related Problems Across
Consumption Categories

70
60
% of total
50
population
40
Sick Leave
30
Arguments
20
Fights
10
Accidents
0
<5 5-10 10-30 >30

Liters per year

HOW MUCH IS TOO MUCH?
 MEN WOMEN

HIGH RISK INTAKE 21 UNITS 12 UNITS

LOW RISK INTAKE 14 UNITS 9 UNITS

In 3 Conditions:
- at least 3 days a week without alcohol
- no more than 4 units on drinking days; and
- never during pregnancy or while at work or driving
22 STOP 12

18 CAUTION 11
13 GO 9
ALCOHOL IS ALSO A
DRUG…
EARLY INDICATORS OF
ALCOHOL ABUSE
Heavy drinker
Increased tolerance to alcohol
Drinks quickly
Eat lightly or skips meal when drinking
Concern or worry about drinking
Intellectual impairment
 EARLY INDICATORS OF
ALCOHOL ABUSE
Accidents where alcohol is involved
Tardiness/absenteeism from work due to drinking
Most friends are heavy drinkers
Most leisure activities involve drinking
Frequent use of alcohol to relieve stress, anxiety,
depression
Has attempted to cut down on drinking with limited
success
 CLASSIC SIGNS OF
ALCOHOLISM
Very heavy drinker
Morning drinker
Blackouts, memory lapses when drinking
Impaired control over the alcohol consumption
Compulsive drinking style
 CLASSIC SIGNS OF
ALCOHOLISM
Experiences severe alcohol withdrawal reaction
Repeated attempts to cut down on drinking have
failed
Gross cognitive deficits
Social Degeneration
 DRUGS AND
DRUG
DEPENDENCE
 Proper Use of Drugs
Does it refer to use only in
medicine, or to use only according
to doctor’s prescription?
 DRUG MISUSE
In medicine, drug misuse would apply to
seeking, prescribing or using of any
other drug for any purpose other than
the prevention or treatment of the
diagnosed disease or the alleviation of
physical or mental discomfort.
 DRUG MISUSE

Medical:
1. Treatment or prevention of diagnosed
disease.
2. Alleviation of physical or mental
discomfort.
 DRUG MISUSE

Recreational:
1. Relief from anxiety
2. Achievement of a state of disinhibition or euphoria
3. Ahievement of altered states of consciousness
4. Expansion of creative abilities
 DRUG MISUSE

Recreational:
5. Attempts to gain interpersonal or
external insights
6. Escape from uncomfortable or oppressive
surroundings
7. Experience of altered states of mood
 DRUG MISUSE
Drug misuse, then, may be describe as the use of
any drugs (legal or illegal) for a medical or
recreational purpose when other alternatives are
available, practical or warranted or where drug
use endangers either the user or others around
him.
Why Do Workers Abuse
Drugs?
Employees may also abuse drugs and
alcohol:
To fit in with peers
To make money by selling
To make a statement as a form of protest, act of courage
or to impress others
Out of ignorance, such as not knowing the dangers,
thinking they can handle it or not thinking it affects their
work
 To treat their own maladies with self-prescribed
medical cures or pain relievers
VARIOUS FORMS OF DRUG
ADDICTION
Physical Addiction

Environmental Addiction

Psychological Addiction
USE OF ILLEGAL / ILLICIT
DRUGS
NARCOTICS
- Are drugs that relieves pain, often induce sleep
STIMULANTS
- Are drugs that relievesmild depression,increase
energy and activity
DEPRESSANTS
- Are drugs that reduce tension and anxiety
USE OF ILLEGAL / ILLICIT
DRUGS
HALLUCINOGENS
- Are drugs that affect sensation, thinking, self
awareness and emotion
CANNABIS
- Are drugs from a common hemp plant, provides
hallucinogens with some sedative properties
CARDINAL SIGNS OF DRUG
DEPENDENCE
1. The substance is taken in larger amounts or over long
periods of time than originally intended

2. Attempts to reduce use of substance are made, but

unsuccessful
CARDINAL SIGNS OF DRUG
DEPENDENCE
3. Considerate time is spent in activities that are
necessary to acquire the drug

4. Intoxication or withdrawal symptoms occur during

times when they are hazardous, or when they
interfere with everyday responsibilities
CARDINAL SIGNS OF DRUG
DEPENDENCE
5. Important activities are given up in order to obtain and
use drugs
6. Drug use continues despite the development of
psychological, social or physical problems that are
caused or aggravated by the drug use
7. Tolerance occurs and greater amounts of the drugs are
taken to achieve the same effect
CARDINAL SIGNS OF DRUG
DEPENDENCE
8. Withdrawal symptoms occur upon abrupt
discontinuation of the drug.

9. The person resumes regular drug use, even after

stopping the drug and having experienced serious
adverse cosequences as a result of its use
 USEFUL INDICATORS
LINKED TO DECLINING
WORK PERFORMANCE:
1. Absence from work

2. Work experience

3. Habits and Moods

 Signs and Symptoms
Developing

Illness Related to Substance

Abuse
GROUP PRESENTATION
Module II

PREVENTION OF ALCOHOL
AND DRUG ABUSE IN THE
MARITIME SECTOR
SELF-ASSESSMENT
Reflection - Introspection
Why do we use alcohol?

How do we use alcohol?

What is Alcoholism?
 Is there someone in your life
whose
drinking should be concerned
of?
ASSESSMENT TOOLS

AUDIT
(Alcohol Use Disorder
Identification Test)
 ASSESSMENT TOOLS

CAGE Questionnaire
1. Have you ever felt you should Cut down on your drinking?
2. Have people Annoyed you by criticizing your drinking?
3. Have you ever felt bad or Guilty about your drinking?
4. Have you ever had a drink frist thing in the morning to steady
your nerves and to get rid of a hangover (Eye-opener)
 ASSESSMENT TOOLS

MAST Questionnaire
(Michigan Alcohol Screening
Test)
LEVELS OF PREVENTION

Primary Prevention

“To Keep Green People

Green”
LEVELS OF PREVENTION
-Primary Prevention

The basic facts on alcohol and drugs and

their effects on health

How alcohol and drugs affect society

(shipboard, family or community)
LEVELS OF PREVENTION
-Primary Prevention

The drug users susceptibility to

HIV/AIDS and other diseases

The danger and penalties involved in drug

trafficking
LEVELS OF PREVENTION
-Primary Prevention

Special consideration in crossing national

frontiers

The need for a company policy

The assistance/professional service

available
LEVELS OF PREVENTION
Primary Prevention

“Kindness Can Kill”

LEVELS OF PREVENTION

Secondary Prevention

“Return From the Amber Zone Back to

the Green Zone”
LEVELS OF PREVENTION

Tertiary Prevention

“Whole Person Recovery”

 ROLES OF
SECTORS/ENTITIES
INVOLVED
GOVERNMENT

-Legislation

-Financial Burden

-National Anti-substance
Abuse Program
 Employee’s Assistance
Program
-Paying sick leave to employees with drug
or alcohol problems who agree to undergo
treatment

-Protectingseniority and promotion

prospects during and after treatment
 Employee’s Assistance
Program
-Authorizing leave to attend outpatient
clinics

-Providing financial assistance for

treatment or family support
 Employee’s Assistance
Program
“It should be made perfectly clear that
employees who agrees to use the services
that the program offer will not be
penalized in any way.”
 SEAFARER’S UNION

The role of union leaders is to optimize the

work environment for employees and thus
contribute to higher productivity

Workers’ representative are responsible for

protecting the rights of the employees
 SHIPPING COMPANIES

It is the concern of ship owners to have

their vessels with healthy, productive and
highly competent officers and rating
onboard.

It is also their role to establish prevention

program.
 MANNING AGENCIES

Recruitment of competent and qualified seafarers

for overseas employment onboard various
ocean going vessels owned by foreign
principals worldwide.
 SENIOR AND JUNIOR
OFFICERS

To provide shipboard training and to give

factual information regarding the risk involved
and the harmful effects of alcoholand drug on
the job, ship, company, shipmates and family.
 RATINGS

Awareness and understanding of the

implications of substance abuse for fellow
seafarers, their company, country and family.

PADAMS-EFA
 MODULE III

POLICIES AND PROGRAMMES ON

ALCOHOL AND DRUGS IN THE
MARITIME SECTOR
 IMPORTANCE OF
POLICIES/ PROGRAM
 Provides rationale for the views or actions of an
organization
 Aims to avoid, reduce or eliminate the use, misuse
and abuse of alcoholand drugs onboard
 Then avoiding or preventing maritime accidents
and incidents related to drug and alcohol problems
 DRUG AND ALCOHOL
POLICY
Main Components
Control Component
 Drug taking and use (unauthorized use) of
alcohol is prohibited onboard
 All officers and ratings are not allowed to
take alcohol/drug while at work or to report
to work while under the influence of these
substances
 DRUG AND ALCOHOL
POLICY
Main Components
Control Component
 Disciplinary action will be taken against
anyone violating the policies
 Prescription must be retained by the user to
verify that the drug was obtained for a
medical condition
 DRUG AND ALCOHOL
POLICY
Main Components
Assistance Component
 Drug and alcohol prevention strategies will be
initiated by the shipping company/manning
agency/seafarers’ union through the
development of an employee assistance
program (EAP).
 DRUG AND ALCOHOL
POLICY
Main Components
Assistance Component
 Seafarers are encourage to seek medical advice
and other support for alcohol and drug
problems.
 After successful treatment the seafarer will be
able to resume work
 Information should remain confidential
 LEVELS OF POLICY
MAKERS
 Regional and International Levels

National Levels

Company Levels

Union Levels
LEVELS OF POLICY
MAKERS
Regional and International Levels

HRM – Human Resource Management

 LEVELS OF POLICY
MAKERS
National Levels (Philippines)
Conduct of Test
Refusal to Undergo Test
Termination/Dismissal Due to Alcohol
or Drug Abuse
 LEVELS OF POLICY
MAKERS
National Levels (Philippines)
Standard Employment Contract
Code of Ethics
LEVELS OF POLICY
MAKERS
National Levels (Norway)
 Provisions have been stipulated
for Norwegian Ships with the
aim of preventing intoxication
while on duty and protecting
employees
 LEVELS OF POLICY
MAKERS
National Levels (Norway)
Act of 16 July 1963 No. 2
Penal Code of 22 May 1902 No. 10
Section 422 – Paragraph 2
Section 426
 LEVELS OF POLICY
MAKERS
National Levels (Norway)
Seaman’s Act of 30 May 1975 No. – Section 8 –
Sub-section 1
Regulations of 3 February 1986 pursuant to the
Seaman’s Act Section 4, 8 and 28
LEVELS OF POLICY
MAKERS
National Levels (U.S.A.)
Rule Making Process
Drug and Alcohol Abuse
LEVELS OF POLICY
MAKERS
Company Levels
Drug Use
Alcohol Abuse
 LEVELS OF POLICY
MAKERS
Company Levels
Industry Measures
Medical Examinations
Company’s Drug and Alcohol Policy
 LEVELS OF POLICY
MAKERS
Seafarers’ Union
Safeguarding Individual Workers’ Right
Protecting the worker against safety and
health consequences of drug and alcohol
abuse
LEVELS OF POLICY
MAKERS

Seafarers’ Union
Prevention not Punishment!!!
 POLICY OBJECTIVES

Drug and Alcohol Policies should:

Provide general education and
assistance to workers about the health
risk of drug and alcohol abuse;
 POLICY OBJECTIVES

Drug and Alcohol Policies should:

Identify workers who have a drug and
alcohol problem in a non-threatening way
which does not violate the rights of
workers in general;
 POLICY OBJECTIVES

Drug and Alcohol Policies should:

Act as a deterrent to safety sensitive
workers attempting to do their jobs
under the influence of alcohol and
drugs; and
 POLICY OBJECTIVES

Drug and Alcohol Policies should:

The central principle of all drug and
alcohol policies should be the
prevention of health and safety
problems related to the use of drugs or
alcohol, not the identification and
punishment of workers.
 DRUGS PERMITTED
ONBOARD
Controlled Drugs
Medical Supplies
Lifeboat Medical Stores
 DRUGS PERMITTED
ONBOARD
Importing & Exporting Drugs
Valid License
Will specify the substance
License’s validity period
Ports to be used
 DRUGS PERMITTED
ONBOARD
Other Drugs
Prescribed or OTC (Over-The-Counter)
ALCOHOL PERMITTED
ONBOARD
 SELF - AUDIT

PADAMS-EFA
 EFA
Emergency First Aid
Expectations
 INTRODUCTION

“SAFETY FIRST”...
“YOUR SAFETY IS YOUR
UTMOST PRIORITY”
 FIRST AID

Immediate care given to a person who

has been injured or suddenly taken.It
includes self help and home care when
medical assistance is not yet available
or delayed
 NEEDS AND VALUES

1. To minimize if not totally prevent

accident
2. To train people to do right thing at the
right time
 NEEDS AND VALUES

3. To help rather than to harm a victim

4. Proper and immediate care is necessary
to save life and limb
 OBJECTIVES

To alleviate suffering and pain

To prevent added/further injury or danger
To prolong life
CHARACTERISTICS OF A
FIRST AIDER
1. OBSERVANT
2. RESOURCEFUL
3. GENTLE
4. TACTFUL
5. SYMPATHETIC
 “DEVELOPING FIRST
AID COMMON SENSE IS
IMPORTANT IN GIVING
FIRST AID CARE”
 FIRST AID CAN:

Reduce the effects of injuries and medical

emergencies
Keep a seriously injured person alive
Mean a difference between a short and a
long hospital care
EMERGENCY ACTION
PRINCIPLE
1. Survey the scene
2. Do a primary survey
3. Activate transfer facility
4. Secondary survey
5. Call EMS
SURVEY THE SCENE:

1. Is the scene safe?

2. What happened?
3. How many people are injured?
4. Identify yourself...
DO A PRIMARY SURVEY
OF THE VICTIM:
A - Airway

Does the victim have an airway?

DO A PRIMARY SURVEY
OF THE VICTIM:

Head-Tilt-Chin-Lift Maneuver
DO A PRIMARY SURVEY
OF THE VICTIM:

B - Breathing

Is the person breathing?

DO A PRIMARY SURVEY
OF THE VICTIM:

C - Circulation

Is the person’s heart beating?

ACTIVATE TRANSFER
FACILITY

If its possible to gain assistance from

a medical team, obtain RMA.
DO A SECONDARY SURVEY
OF THE VICTIM:
1. Interview the victim
i. Identify yourself as a trained first aider
ii. Give victim consistent care
iii. Ask how he or she feels
iv. Ask if he or she has any allergies to any
medicine
DO A SECONDARY SURVEY
OF THE VICTIM:
2. Getting the vital signs
i. Pulse Rate – 60-80/min
ii. Respiratory Rate – 12-20/min
iii. Skin Appearance
a. Temperature
b. Moisture
c. Skin Color
DO A SECONDARY SURVEY
OF THE VICTIM:
3. Head to Toe examination
a. Start with the head and check all parts
b. Look at the pupils
- Dilated
- Constricted
- Equal size
DO A SECONDARY SURVEY
OF THE VICTIM:
3. Head to Toe examination
c. Check for fluid or blood in the ears,
nose and mouth
d. Run your hands gently on the neck
checking for pain or signs of injury
while also looking for bruises
DO A SECONDARY SURVEY
OF THE VICTIM:
3. Head to Toe examination
e. Feel the collar bone for fracture
f. Run your hands along the chest to
check the rib cage for pain and
deformity
g. Presss gently on the victims abdomen
DO A SECONDARY SURVEY
OF THE VICTIM:
3. Head to Toe examination
h. Now move to the shoulders arm and
hands
i. Move your hands down the arms to the
fingers, one arm at a time. Ask the victim
to wiggle his/her fingers
DO A SECONDARY SURVEY
OF THE VICTIM:
3. Head to Toe examination
j. Move your hands over the hips and check for
any fracture
k. Check the legs and feet in the same
manner as you did the arms and hands.
Ask the victim to wiggle his/her toes
It will take about 2-3 min to finish the examination
THE GOLDEN RULES OF
EMERGENCY CARE
 Obtain consent, when possible
 Think for the worst, It’s best to
administer first aid for the gravest
possibility
 Call or send for help
 Remember to identify yourself to the
victim
THE GOLDEN RULES OF
EMERGENCY CARE
 Provide comfort and emotional support
 Respect the victims modesty and physical
privacy
 Be as calm and as direct as possible
 Care for the most serious injury first
THE GOLDEN RULES OF
EMERGENCY CARE
 Assist the victim with his/her prescribed
medication
 Keep onlookers away from the injured
person
 Handle the victim to a minimum
 Loosen tight clothing
RADIO MEDICAL ADVICE
 Particulars of the ship
 Name of the ship
 Call sign
 Date and time (GMT)
 Course, Speed and position
 Port of destination
 Local weather
RADIO MEDICAL ADVICE
 About the Patient
 Surname of casualty
 Other name of the casualty
 Rank
 Job onboard
 Age and Sex
RADIO MEDICAL ADVICE
 Illnes/Injury
 When did the illness/injury first began?
 How did the illness/injury occur?
 What did the patient complaint of?
 Does the patient have consciousness or
not?
RADIO MEDICAL ADVICE
 Result of Examination
 Vital Signs
 Describe the general appearance of the
patient
 List what you believe the patient’s
injuries in order the importance and
severity
RADIO MEDICAL ADVICE
 Treatment
 Describe the first aid that have been
carried out
 List all the medicines that the victim
has taken
 EVACUATION BY
HELICOPTER
 It is essential that the ship’s position
should be given as accurately as possible.
 Give details of your patient’s condition.
 Information to the bridge and engine room
watches.
 The ship must be on steady course giving
minimum ship motion.
 EVACUATION BY
HELICOPTER
 An indication of relative wind direction
should be given.
 Clear as large as an area of deck as
possible and mark the area with a large
letter “H” in white.
 All loose particles must be securely tied
down or removed from the transfer area.
 EVACUATION BY
HELICOPTER
 Never hook the hoist cable of the
helicopter to any part of the ship.
 The winch wire should be handled only
by the personnel wearing rubber gloves.
 The survivor is placed in the stretcher,
strap in such a manner that he could not
slip or fall out.
 EVACUATION BY
HELICOPTER
 At all times, obey the instructions of the
helicopter crew.
 Place all the belongings of the victim in a
plastic container.
 FIRST AID KIT
Contents:
 Iodine solution
 1 large standard dressing
 2 medium standard dressing
 4 small standard dressing
 8 triangular bandages
 FIRST AID KIT
Contents:
 cotton wool
 safety pin
 Sticking plaster
 Scissors
 Pencil and Paper

PADAMS-EFA
 Common
Illness/Injury &
Corresponding
First Aid
 POISONING

1. Food Intoxication
2. Drug Overdose
3. Corrosive Agents
4. Gas
 POISONING
Mode of entry:
1. ingestion
2. injection
3. inhalation
4. direct contact
 POISONING
Diagnosis:
1. Latent Stage
- Interval between the entry of
poison in the body and appearance
of the first symptom or sign.
 POISONING
Diagnosis:
2. Active Stage
- Signs and symptoms are
already present.
 POISONING
Signs and Symptoms:
- Headache
- Nausea and vomiting
- Drowsiness
- Changes in sensory
 POISONING
Signs and Symptoms:
- Unconsciousness
- Convulsion
- Pain
 POISONING
Signs and Symptoms: (if severe)
- Rapid and weak pulse
- Cyanosis
- Difficulty in breathing
- Prolonged unconsciousness
 POISONING
Prevention:
- Knowledge of the basic safety
precautions
- Protective clothing and breathing
apparatus
 POISONING
Universal Antidote:
- Tannic acid
- Activated Charcoal
- Milk of Magnesia
 HYPOTHERMIA

A state in which an individual

body is below the normal
range
 HYPOTHERMIA
Related Factors:
- Exposure to cold
- Inadequate clothing
- Aging
- Malnutrition
 HYPOTHERMIA
Signs and Symptoms:
- mild shivering
- cold skin
- cyanotic nail beds
- poor judgment
- memory loss
 HYPOTHERMIA
Treatment Management:
1. Prevent further decrease in body
temperature
2. Maintain patient’s airway/maintain
ventilation
3. Provide supplemental oygen to
offset decreased oxygen demands
37
36 Marked shivering Confusion
35 Disorientation
34 Amnesia
33 Progressive muscle rigidity

32
31 Shivering ceases

30
29 Dilated pupils that Possibly abnormal

28 still reacts heart rate

27 Unconsciousness

26 No pupil reflexes
Muscle relax
25
Apparent death/death
24
 SHOCK

 Is a syndrome characterized by hypo

perfusion of the body tissues
 Any condition that prevents cells
from receiving an adequate blood
supply
 SHOCK

Classifications:
- Hypovolemia
- Cardiogenic
- Vasogenic
 SHOCK
Signs and Symptoms:
- Increase heart rate
- Increase respiratory rate
- Decrease blood pressure
 BURNS
An injury to the skin resulting from:
- Thermal heat
- Cryogenic
- Chemical
- Nuclear Radiation
- Light Burns (eyes)
 BURNS
Classification according to degree:

- First Degree
- Second Degree
- Third Degree
EYE INJURY
HEART ATTACK /
CARDIAC ARREST
BITES & STINGS
 HEAD INJURIES
Signs and Symptoms:
- unconsciousness
- blood
- open fracture
- brain damage
 HEAD INJURIES

Signs and Symptoms:

- vomiting
- headache
- drowsiness/confused
- PR below 60
 HEAD INJURIES
Types:
- bruise
- wounds
- concussion
- fractures
NAMES OF DRUGS

1. Generic
2. Brand Name
3. Chemical Name
EFFECTS OF DRUGS

1. Therapeutic
2. Side effect
3. Drug toxicity
4. Drug allergy
EFFECTS OF DRUGS
5. Drug tolerance
6. Cumulative effect
7. Drug interaction
ACTIONS OF DRUGS
IN THE BODY
1. Absorption
2. Distribution
3. Biotransformation
4. Excretion
FORMS OF DRUGS
1. Tablet
2. Capsule
3. Caplet
4. Syrup
5. Elixir
FORMS OF DRUGS
6. Suspension
7. Suppositories
8. Liquid
9. Powder
10.I.V Fluids
DOCTOR’S ORDERS
- O.D. - Once a day
- B.I.D - 2x a day
- T.I.D. - 3x a day
- Q.I.D. - 4x a day
- HS - hours a sleep
DOCTOR’S ORDERS
- AC - before meal
- PC - after meal
- STAT - now/immediately
- PRN - as necessary
LAYERS OF THE SKIN

Epidermis

Dermis

Subcutaneous
FUNCTIONS OF THE
SKIN
1. Prevents the loss of body fluids
2. Protects the tissues from infections
3. Helps regulates body temperature
4. Provides location for the sensory
perception
 BURNS

1. Thermal heat
2. Cryogenic
3. Chemical
4. Nuclear Radiation
 CLASSIFICATION OF
BURNS
1. First degree – only the epidermis is affected
2. Second degree – involves the epidermis and
dermis
3. Third degree – involves the entire dermis plus
portions of subcutaneous fats
 FIRST AID ACCORDING
TO EXTENT
1. Immerse in cool water if possible
2. Cover with clean cloth
3. Elevate the extremities
4. Assess the ABC
5. If severe pain, give morphine sulfate
6. Do not apply any oinment
 SHOCK

- Is a syndrome characterized by hypo perfusion

of the body tissues
- Any comdition that prevent cells from receiving
an adequate blood supply can interfere with their
metabolism and produce shock
 CLASSIFICATION OF
SHOCK
1. Hypovolemia – condition that reduces the volume
within the vascular compartment by 15-25 %
Cause:
- Extensive blood loss i.e. Bleeding coagulation
disorders, surgery loss of body fluids other than
blood extensive dieresis
 CLASSIFICATION OF
SHOCK
2. Cardiogenic – inability of the heart to pump
sufficient blood extensive dieresis
Cause:
- Cardiac Tamponade
- Restricted Pericarditis
- Pulmonary Embolism
- Myocardial Infraction
 CLASSIFICATION OF
SHOCK
3. Vasogenic – massive dilation of the blood vessels
Cause:
a. Neurologic
b. Anaphylatic Shock
c. Septic Shock
SIGNS AND SYMPTOMS
OF SHOCK
1. Increase heart rate
2. Increase respiratory rate
3. Decrease blood pressure
 WOUND
- Any break of the continuity of the skin, mucus
membrane or tissue
Cause:
- accidents, falls and/or mishandling of sharp
objects
CLASSIFICATION OF
WOUND
1. Open wound – actual break of the skin
2. Close wound – involve underlying tissue
 TYPES OF WOUND
1. Abrasion – scraping
2. Puncture – cause by sharp pointed objects
3. Incision – “Clean Cut” cuts from sharp bladed
object
4. Laceration – “Dirty Cut” break or tearing of the
tissue
5. Avulsion – forcible separation or tearing of the
tissue from the victim’s body
 FIRST AID
1. Prevent/Stop bleeding
a. Direct pressure
b. Pressure to pressure point
c. Evaluate the affected area
- uses the force of gravity to help reduce blood pressure in
the injured area and it shows down the flow of blood
- touniquet and/or cold packs application
 FIRST AID
2. Prevent infection
a. Wash thru running water
b. Antiseptic – Agua oxinada, betadine
c. Dressing
d. Bandage – to add pressure
 FRACTURE
- Any break in the continuity of the bone.
Classification:
1. Open – perforation/actual break in the skin
2. Close – involve underlying tissue
Cause:
Motor vehicle accidents and/or fall
 FRACTURE
Pain – continues with increasing severity, swelling,
discoloration of the skin and crepitating/granting
Sensation felt upon examination due to rubbing
together of the fragments
If open fracture – bone is very visible through the
skin
 FIRST AID
1. Lift open fracture
a. Clean through running water to minimize
chances of infection
b. Elevate injured extremity above the level of the
heart until initial swelling begins to subside
 FIRST AID
2. Immobilization – splint or bandages to prevent
further injuries

Applying wound dressing

 FIRST AID
2. Immobilization – splint or bandages to prevent
further injuries

Nose bleeding:
Pinch the soft part of the
nose firmly for 10 minutes
 FIRST AID
2. Immobilization – splint or bamdages to prevent
further injuries

Applying direct pressure

to a wound
 FIRST AID
2. Immobilization – splint or bamdages to prevent
further injuries

Applying pressure
bandages
 FIRST AID
2. Immobilization – splint or bamdages to prevent
further injuries
Applying & Securing
Tourniquet:
Never cover the touniquet
with clothing or bandages;
Never loosen the tourniquet
unless a physician advices it
 FIRST AID
2. Immobilization – splint or bamdages to prevent
further injuries
Treatment of a sucking
chest wound
FUNCTIONS OF
BANDAGES
- Adds pressure
- Immobilization
- Prevents further infection
TRIANGULAR BANDAGES
Methods:
Open phase:
1. Head: top side
2. Face: back of the head
3. Chest: back
4. Hand: foot
5. Arm sling
6. Under-arm sling
 TRIANGULAR BANDAGES
Methods:
Cravat phase:
1. Forehead: eye 5. Elbow: knee
2. Ear: cheek, jaw 6. Palm pressure bandage
3. Shoulder: hip 7. Palm bandage open hand
4. Arms: leg 8. Sprained – ankle bandage
TRIANGULAR BANDAGES
Apex
1. Open

Face

End End
Base
TRIANGULAR BANDAGES
2. Cravat

1 fold broad
TRIANGULAR BANDAGES
2. Cravat

2 folds semi-broad
TRIANGULAR BANDAGES
2. Cravat

3 folds narrow
 APPLYING SLING AND
CRAVAT BANDAGES

Sling

Cravat Broad

For dislocated shoulder

 APPLYING SLING AND
CRAVAT BANDAGES

Cravat semi-broad

For dislocated shoulder

 APPLYING SLING AND
CRAVAT BANDAGES

For head injuries

Cravat narrow
Artificial Respiration
&
Cardiopulmonary
Respiration
End of Seminar

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