plenary session submarine rescue shortened
TRANSCRIPT
ANAESTHETICS AND SUBMARINE MEDICINE
PLENARY SESSION
MICHAEL REID 16 JUNE 2014
Submarine medicine is a subspecialty branch of diving and hyperbaric medicine
ANZCA Certificate in Diving & Hyperbaric Medicine (course work, research and practical experience)
http://www.anzca.edu.au/training/diving-and-hyperbaric-medicine
Why are Anaesthetists ideally suited for the submarine escape/rescue role.
International Focus
Kursk
Kursk submarine disaster, 12 Aug 2000- Sunk in 108m, 118 perished
International Submarine Escape & Rescue Liaison Office
http://www.ismerlo.org
Submarine Escape verses Rescue
There are two methods for evacuating a submarine
Escape
Rescue
Submarine Escape
Submarine Rescue
Retrieving LR5 Submersible Rescue Vehicle on deck
Transfer Under Pressure
Type B Recompression Chamber
Submarine rescue – unpredictable, mass casualty situation in a hostile environment with resource constraints
Considerations Trauma
(orthopaedic/burns/internal injuries)
Respiratory compromise
Decompression Sickness
Barotrauma (CAGE)
Hypothermia
Petrochemical contamination
Radiation exposure
Recompression Chamber Space
Oxygen supplies
Number of Survivors (reverse triage)
Retrieval – aeromedical evacuation
Iatrogenic Decompression Sickness in rescue personnel.
Surface weather conditions
Decompression Sickness
DCS classified in three types
Type I – mild, typically affecting muscloskeletal, cutaneous and lymphatic systems.
Type II – severe, typically affecting neurological system. Of the neurological cases, approximately 5 % may manifest pulmonary manifestations ‘the Chokes.’ This can lead to right sided heart failure, circulatory collapse and death.
Cerebral Arterial Gas Embolism (CAGE) – usually stemming from high venous gas loads (with patent foramen ovale) or pulmonary barotrauma with gas entraining into arterial circulation.
DCI classification system
Evolution
Organ system involved
Time of Onset
Gas Burden
Evidence of Barotrauma
Comments and Questions
The foundation for submarine medicine lies with these organisations!