Florida Sea Base News

While I am not a doctor, nurse nor EMT, I have been receiving first aid training for about 45 years through Scouting, scuba courses and as a police officer.  So I have been around the block a time or two.  One of the best new things I learned at the BSA Wilderness First Aid Instructor Course taught last week at the Florida Sea Base is to administer 50 mg of Benadryl® if someone is using an epipen® for anaphylaxis.  Anaphylaxis is a serious concern at all three National High Adventure bases due to our remoteness.  Of the three, the Florida Sea Base is probably closer to professional medical care.  However, it is not unreasonable to expect a delay of four hours or more even when trying to receive medical attention in the Keys.  PLEASE CLICK ON READ MORE.

Let’s take a Scuba Adventure scenario as an example.  There are usually 24 scuba participants, three divemasters, one mate and one captain aboard the vessels we use for the Scuba Adventure program.  Let’s say it’s 10:30, the vessel is anchored and the dive briefing has been completed.  The divers are doing pre-dive buddy checks and making last minute adjustments.  During the briefing, the divers were told to be back aboard at 11:30.  By 10:35 the divers are splashing in and descending.  By 10:45 the last divers are submerged.  The captain and mate (who also serves as the rescue diver) are vigilant in watching the sea surface for trouble.  The three divemasters are underwater watching their crews.  At 11:00 a diver encounters a Portuguese Man-o-War, is stung and bolts to the surface.  The divemaster is obligated to stay with his seven  other divers and see them safely to the surface.

In the meantime, the captain and mate spot the conscious diver flailing on the surface.  The rescue diver dons mask, snorkel, fins and a rescue tube and begins swimming to the diver.  While the rescue diver is towing the diver to the boat, the divemaster is herding the rest of the crew aboard.  The captain is deploying the underwater emergency recall system and notifying the Florida Sea Base and the US Coast Guard of the situation.  Even with the diver aboard, the vessel cannot leave the dive site until all divers are safely aboard and accounted for.  If just one team does not hear the recall, that means the last divers won’t be back aboard until 11:30.  Even then, it is going to take precious minutes to recover the anchor and get the vessel underway.  Divemasters are tending to the diver who is going into anaphylaxis.  The diver has an epipen and injects himself with assistance from his adult leader.  One of the divemasters is administering emergency oxygen to the diver.  At 11:45 the diver becomes unconscious, but is still breathing.  At 12:00 shock has taken over and the diver quits breathing.  Another divemaster begins performing CPR while the captain continues what may very realistically be a one hour drive back to the Florida Sea Base.  Staff members at the Florida Sea Base will have notified the paramedics and they will likely be standing by at our fuel dock to receive the patient.  By the time the boat is secure at the dock and the EMTs have the patient in the ambulance almost two hours have past since the accident occurred.  The hospital is 20 miles away and on our two lane highway, the ambulance will struggle to average more than 50 miles per hour.  That works out to another 30 minutes before the ambulance arrives at the hospital and the patient is actually in a room being attended to by a doctor.  It is now 14:00 (2:00 p.m.).  The good news is there is a recompression chamber at the hospital.  Hopefully all is well.  Or is it?  It the chamber is occupied or inoperable, a helicopter ride to Miami is now in order.  There goes another hour.

So in the best of cases three hours is not unrealistic from the time of the accident to receiving professional medical care in a hospital.  And that’s on a dive boat that can run at 20 knots or better.  Now imagine the scenario about a sailboat that can make 5 knots.  It could take four hours (or more) just to get to shore.  So anaphylaxis is a realistic concern.

Do you see why I don’t sleep well?