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  #551  
Old 07-16-2014
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Re: Ocean baby rescue underway off Mexico

passing emt cert for cattle boat driving, his former profession, 50 ton cpt, fishing tour (cattle) boats, san diego, his boating experience, en toto. is not emt work or experience at all in any way shape or form. he got to drive after a stint of putting bandaids on hoooked fingers.
when i lived in sd i asked around as to what the requirements were to work the cattle boats--i didnt wanna be captain, i just wanted to work the boat-- lol.. yes emt required for service on a cattle boat,. and minimum 50 ton master to drive em
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Last edited by zeehag; 07-16-2014 at 05:44 PM.
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  #552  
Old 07-16-2014
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Re: Ocean baby rescue underway off Mexico

For whatever it's worth, EMTs are not trained to, nor authorized to, administer drugs. At least not when I was certified in my 20s. I did so as a dive instructor at the time.
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  #553  
Old 07-16-2014
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Re: Ocean baby rescue underway off Mexico

Quote:
Originally Posted by Minnewaska View Post
For whatever it's worth, EMTs are not trained to, nor authorized to, administer drugs. At least not when I was certified in my 20s. I did so as a dive instructor at the time.
A lot of people in their 20s administer drugs they're not authorized to. Not that that has anything to do with ocean sailing.
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  #554  
Old 07-16-2014
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Re: Ocean baby rescue underway off Mexico

Quote:
Originally Posted by Minnewaska View Post
For whatever it's worth, EMTs are not trained to, nor authorized to, administer drugs. At least not when I was certified in my 20s. I did so as a dive instructor at the time.
I'm really talking more about the parental aspect of this than the EMT aspect. However, the EMT aspect would certainly imply more training/knowledge, or at least the drive to get more training/knowledge on these kinds of things for their own kid/infant than the typical parent of same.

Again, the driver here to me is their willingness to put themselves and their kids at far higher risk with this kind of passage - which, I think, naturally implies and requires a far higher level of readiness. Solving the issue of a kid spitting out the medicine you're trying to give her is a medical emergency for an EMT? Or a mom?

Everything they needed they had right there. They just didn't know how to get the medicine into a kid that didn't want it. How much of that is on the satphone company?
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Last edited by smackdaddy; 07-16-2014 at 10:40 PM.
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  #555  
Old 07-17-2014
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Re: Ocean baby rescue underway off Mexico

Before I was a PA, I was an EMT. Let me tell you the big downside of being an EMT. They can't possibly train you in all the stuff you need to know to make a real medical diagnosis. To do that, you need Medical School, PA or NP school. Unfortunately in EMT school, they pretty much ONLY teach you the bad stuff. That's okay for your role, because your role is to watch for the bad stuff, and take them bodily to the hospital for the medical providers to sort out.

Problem is, everything seems bad. I'll give an example. As a young, 20something healthy EMT, I was grocery shopping, and I got into my car. I looked at my stereo, and all the numbers were jumbled up. Damn! Stereo must be broken. Then I looked up at a street sign, which I know reads "NW Market ST". Problem was, what I SAW was "NW _________ St". The middle part was inexplicably missing.

I immediately drove myself to the closest ER (about 5 blocks away) and the symptoms rapildly progressed until the entire left half of my vision was gone. I was completely freaking out, thinking stroke, or retinal detachment, or retinal artery occlusion. All very bad things.

The ER doc comes in, is totally unimpressed and after about a 3 minute history and exam, and says I'm having a painless migraine. He's going to leave and just wait and it should resolve. He refused my pleas for a CT or MRI.

Of course, he was right. 20 minutes later, everything was back to normal. As a Doc, he had enough training to know that a healthy 20something essentially CAN'T have an embolic stroke or retinal artery occlusion and there was no history to suspect retinal detachment and 10-ish percent of all migraines are painless and I was just experiencing the "aura" before my painless migraine. As an EMT I had a list of things it could be, but they were only catastrophic things.

Point being, if I was on a boat at the time, I would have called MAYDAY without a doubt.

Generally the more medical training you have, the better, but there are select cases where it can put you in the "knows just enough to be dangerous" category. It's "possible" that his EMT training helped him to want to push the button on the EPIRB because his list of known possibilities for kiddo's issue were only a select list of bad bad things. At my current level of training and experience, my list of what can be happening to kiddo in similar circumstances includes a lot of benign things...

MedSailor

PS As far as administering the drugs, he was doing that as a non-trained person. He got advice by sat phone to administer them by the Mexican doctor. It's exactly the same as when you go to your doc and he/she prescribes antibiotics. You "administer" them to yourself on their order. Eric didn't unilaterally decide to start giving his kids oral antibiotics and steroids. No IV meds were given.
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Last edited by MedSailor; 07-17-2014 at 12:30 AM.
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  #556  
Old 07-17-2014
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Re: Ocean baby rescue underway off Mexico

Med - I completely understand, and agree with what you're saying in general. And I want to make it clear that the mayday in this case was the best possible outcome. Absolutely no argument there.

BUT, in the larger context of taking such a long, isolated passage with young children, why did they have onboard prescription-strength medication and even (apparently) the oral syringes to administer it in non-tablet form - without the knowledge of how to administer it to an uncooperative child?

In other words, if you're going to have a fully stocked "medical-grade" kit, shouldn't you have the requisite basic knowledge of how to use it? Isn't it more dangerous to have these potent "tools" in the first place if you have no idea how to use them?

You are absolutely the expert here, and I will defer to your opinion. But it is very strange to me that something this "basic" would confound a trained EMT - or even a mom - to the point we saw in this particular incident and this resulting lawsuit. And, more importantly, it begs the question of, IF this was the straw that could break the camel's back for this family, why and how could they feel comfortable being so far away from the medical care they so obviously relied on? It just doesn't add up.

From what I've seen, this isn't about diagnosing an illness or even formulating a dosage...it's about a technique for getting medicine down a young child who doesn't want it. That's a different kettle of hamsters than diagnosing a painless migraine isn't it?
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Last edited by smackdaddy; 07-17-2014 at 12:45 AM.
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  #557  
Old 07-17-2014
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Re: Ocean baby rescue underway off Mexico

Admittedly I haven't read every word of this thread for the past few pages, so apologies if I missed the part about not being able to give meds by mouth to the kiddos. I can tell you though that nothing in the EMT training would help with this.

My kiddo got croup a couple months ago. My well meaning doc prescribed solu-medrol (a steroid) in oral liquid form and we were given a syringe. My kiddo puked up every single dose. After speaking with a co-worker MD of mine, it turns out that this particular steroid (commonly prescribed) is in a formulation that is more likely to induce puking than ipecac. Bad situation all around, and at this point I was a PA with plenty of training and experience. I still couldn't get the meds down my kid, but that had more to do with the fact that this preparation really shouldn't exist because nobody can actually administer it.

My point about the EMT part was just to point out (without judgement) that this training (which is focused on bad things) could have paradoxically counted against him. I don't fault him at all for pushing the button when he did, knowing his situation and his level of knowledge.

MedSailor
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  #558  
Old 07-17-2014
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Re: Ocean baby rescue underway off Mexico

On the lawsuit I have nothing to add. Let's see what happens.

On cruising with kids I agree with you Smack that carrying appropriate medication and being more than casually familiar with it and how to administer all onboard medication is a very good idea. I think what the actual situation was on RH is hard to know.
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Last edited by chall03; 07-17-2014 at 04:57 AM.
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  #559  
Old 07-17-2014
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Re: Ocean baby rescue underway off Mexico

Quote:
Originally Posted by smackdaddy View Post
....However, the EMT aspect would certainly imply more training/knowledge....
Naturally, Med did a pretty good job of explaining the irrelevance of EMT training to administering meds to an infant.

Their dosing issue, however, was more understandable than you're giving them credit for. Since the antibiotic was being partly spit out, some was ingested. It's a legit concern that they were uncomfortable dosing again, with a random estimate of what was expelled. Failing to get enough in would concern them that the infection could lead to septic shock. That he would have understood from his EMT training, although, your training would be to administer O2 and get the patient on the bus and to the hospital in the next 15 mins. That's it.

Quote:
Again, the driver here to me is their willingness to put themselves and their kids at far higher risk with this kind of passage - which, I think, naturally implies and requires a far higher level of readiness.
No beef with that point. I would not have made the decision to go on the passage. But, I still defend their decision as their own for their own family. It was not a guaranteed failure, like the Bounty sailing into a hurricane.

Quote:
Solving the issue of a kid spitting out the medicine you're trying to give her is a medical emergency for an EMT? Or a mom?
I hope there are no Mom's out there that just make up the proper method and amounts for re-dosing their kid.

Quote:
Everything they needed they had right there. They just didn't know how to get the medicine into a kid that didn't want it. How much of that is on the satphone company?
I see no chance that their law suit is successful. However, if the phone worked, they would have received proper instruction, as demonstrated by using the rescuers phone, and would have been on their way. Even among all the conflicting information, I see nothing that would suggest otherwise.

The speculation that their boat would have crumbled somewhere in the passage is possible, but unprovable. If the kid got better with the re-dose and stayed better, I see no indication they would have called SAR due to boat condition a that time. That may have resulted down the road, but we can't know that.

In the moment, they had a kid that relapsed once already. While better after being administered meds from their kit, they would be understandably concerned over it happening again, or being presented with another medical issue they could no longer get help with. At this point they know they have no way to contact help. I doubt the SAR team offered to leave them their phone.
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Last edited by Minnewaska; 07-17-2014 at 08:02 AM.
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  #560  
Old 07-17-2014
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Re: Ocean baby rescue underway off Mexico

I'll say it again, very little kids can get very sick very fast. Going offshore with a toddler was mistake number one. I have no problem with taking a toddler day sailing or coastal cruising. But taking a very small child offshore is the equivalent of playing Russian Roulette, particularly if the child has just recovered from a serious infection. If they would have waited until the younger child was a few years older before trying an ocean crossing (thus giving everyone involved some more sailing experience, and allowing time to make sure that the boat was in seaworthy condition), and made damned sure that everyone was healthy before leaving, the chances are that 95% of the "drama" of this story would never have happened.

Having little kids doesn't mean putting ones life "on hold", it just means doing different things with ones life for a few years.
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