The BLS (Basic Life Support) First-Aid and SNSI Oxygen Provider course are prerequisites for the SNSI Snorkeling Guide course. Therefore, you have already received training in first-aid techniques. In this section of the SNSI Snorkeling Guide Manual, you will learn how to apply these techniques with limited resources available at the site. In your career as a Snorkeling Guide, you are more likely to encounter accidents occurring out of the water than during excursions. These may include sprains, fractures from falls on rocks or the boat, or cuts from mishandling a knife.
Cuts and bleeding
Cuts or lacerations can cause varying degrees of bleeding, depending on their depth and the type of blood vessels affected. Arterial blood loss occurs in spurts, synchronized with the heartbeat, and is bright red, while venous bleeding is a steady flow of dark red blood. In both cases, the first-aid goal is to stop or limit the blood loss.
Venous Hemorrhage
Tamponade the wound with sterile gauze, available in your first-aid kit, without removing the first layer, to promote clotting. If bleeding is extensive and gauze is insufficient, a beach towel can be placed over the gauze and held in place with a weight belt, which should be fastened loosely just to secure the towel. If the wound is on a limb and there are no fractures, elevate the limb.
Arterial Hemorrhage
This is more serious and indicates a deeper wound. As with venous bleeding, tamponade the wound. Additionally, use pressure points between bone and skin to lessen the blood flow and encourage clotting. Be careful with pressure points—apply pressure for a minute, then pause. Never use a tourniquet or strap to tighten above the wound unless performed by a doctor, as they can manage potential complications from the sudden pressure drop when the tourniquet is released.
Bleeding from Head Injuries
The first aid for head injuries involves covering the wound with sterile gauze without tamponing. Try to keep the victim seated with their head elevated. Tamponing a head injury can lead to the formation of a clot, potentially causing dangerous intracranial pressure.
Eye Injuries
Initially, protect the injured eye and also cover the uninjured one with a bandage. Since the eyes move in unison, covering only one means the injured eye will still move, potentially causing further harm.
Skeletal injuries
Skeletal injuries are common and can be categorized as follows:
Sprains
These occur when a joint is forced beyond its normal range of motion, injuring the joint capsule and ligaments. This can lead to tearing and varying degrees of damage. Symptoms include intense localized pain, immediate swelling due to fluid and blood leakage, and painful but possible joint movements. First-aid involves resting the joint, preferably elevated to aid venous return. Apply ice or immerse the area in cold water to reduce pain and swelling. Avoid tight bandages and vasodilating ointments initially; after 48 hours, ointments that help absorb fluids can be beneficial.
Dislocations
This is when a bone is displaced from its joint, causing damage to the joint capsule and ligaments. A dislocation is ‘full’ if the bones have completely lost connection, or ‘subluxation’ if the joint contact is altered but not entirely lost. Common sites include the shoulder, elbow, jaw, and hip. Symptoms are sharp, localized pain, spreading pain around the joint, increased pain with any movement, and inability to use the joint. Immobilize the injured part in its current position. For a dislocated shoulder, use a rolled-up towel under the armpit and a weight belt (without weights) to fashion a sling.
Fractures
These are breaks in a bone due to excessive force. Fractures can be ‘closed’ (bone remains covered by skin and muscle) or ‘open’ (skin and muscle torn, bone visible). A closed fracture can be linear (aligned bone parts) or compound (misaligned bone parts). Symptoms include severe, localized pain, inability to move the affected area, and deformity. Swelling and bruising appear later. Treat any suspected fracture as real: immobilize before moving the victim. Use rigid supports like fins, secured with a weight belt, for immobilization.
For open fractures, cover the wound with sterile gauze or the cleanest available material and tamponade any bleeding.
Conclusion of first-aid
In all emergency situations, it’s crucial to continually monitor the victim’s state of consciousness. Fear, pain, and the injury itself can disrupt blood or oxygen supply to the body, initially affecting peripheral tissues and eventually vital organs, potentially leading to shock. Symptoms of shock include extreme weakness, nausea, vomiting, agitation, anxiety, confusion, and intense thirst. As the provider of aid, you must remain calm and clear-headed to prevent and treat shock. Reassure the victim about their condition, have them lie down, and if possible, elevate their legs slightly (20-30 cm) above their head. Maintain their body temperature, avoid giving them food or drink, and frequently check their vital signs. In case the victim is still wearing a diving suit during any injury, do not attempt to remove it forcefully; instead, carefully cut it off.