Emergency Action Plan (EAP)

When an injury occurs, an EAP should be activated immediately if the injured person:
Is not breathing
Does not have a pulse
Is bleeding profusely
Has impaired consciousness
Has injured the back, neck or head
Has a visible major trauma to a limb

Roles and responsibilities
Charge person
Clear the risk of further harm to the injured person by securing the area and shelter the
Injured person from the elements.
Designate who is in charge of the other participants.
Protect yourself (wears gloves if he/she is in contact with body fluids such as blood).
Assess ABCDs (checks the airway is clear, breathing is present, a pulse is present, and
There is no major bleeding).
Wait by the injured person until EMS arrives and the injured person is transported.
Fill in a accident report form.

Call person

Call for emergency help.
Provide all necessary information to dispatch (e.g. facility location, nature of injury,
What, if any first aid has been done).
Clear any traffic from the entrance/access road before ambulance when it arrives.
Wait by the driveway entrance to the facility to direct the ambulance when it arrives.
Call the emergency contact person listed on the injured persons medical profile.





Table of contents

1. Emergency Action Plan Checklist
2. Immediate first aid
3. Emergency services and what to say
4. Emergency information
5. Steps to follow when an injury occurs
6. Signs & symptoms with their treatment
7. Lost or missing diver(s) procedures














Emergency Action Plan Checklist
Access to
____ Mobile phone, battery well charged
____ Suitable first aid kit
____ Oxygen
____ Accurate directions to site
____ Pure water/ vinegar/ acetic acid
____ Emergency blanket
____ Plastic bags
____ Fruit juice/ sweets
First Aid Kit
____ Barriers: Latex or vinyl gloves, pocket mask.
____ Sterile gauze/ non adherent, dry pads.
____ Clinging rolled/ adhesive bandages/ tape.
____ Antibiotics: aspirin
____ Bandage scissors, tweezers, needle
Participant information
____ Personal profile forms
____ Emergency contacts
____ Medical profiles
Personnel information
____ Person in charge is identified
____ Call person is identified
____ Assistants (charge and cell persons) are identified

Immediate first aid when victim is out of the water
(Treatment is the same for suspected lung-expansion injury or decompression sickness.)
Step 1: Lay the victim on their back and keep them from moving

Step 2: Monitor ABCDS

Step 3: Contact EMS

Step 4: If the victim is conscious, calm him or her

Step 5: Keep the victims airway open

Step 6: If the victim is unconscious, check for breathing again
a. If not breathing, confirm not responsive and not breathing state
(if not done yet, send somebody quickly to cell EMS)
b. Administer two emergency breaths and proper CPR
Give 30 compressions of sternum then two breaths, repeat indefinitely until
EMS arrives ( if you have two rescuers DELEGATE)
Do compressions at a rate of 100 per minute for adults
Administer 100% oxygen through continuous-regulator (15L) with the
pocket mask system while administering two emergency breaths
Step 7: If victim is conscious & breathing, administer 100% oxygen through demand-
regulator valve system (Keep oxygen flowing smoothly until EMS arrives)

Step 8: Protect victim from excessive heat, cold.

Step 9: If a spinal injury is to be suspected, maintain the line head-neck-body and keep it
immobilize for the whole EFR.

Step 10: Arrange for immediate evacuation when EMS arrives.
Emergency Services and What to say ?
At sea All incidents: Coastguard By VHF CH16 or phone 999
Lives in immediate danger: Mayday (distress button)
Decompression illness: Pan Pan
On land Decompression illness: BHA/RN Divers helpline
England, Wales, Northern Ireland: 07831 151523
Scotland: 0845 408 6008
Near drowning: Ambulance 999 or 112
Lost diver: Coastguard/Police 999 or 112

EMS Communication script
Hay, my name is <give your first name> and Im calling you
from the following phone number< give the phone number
you call with>.
Im calling you for an emergency. We have < give nature of
the problem, illness or accident>.
We are at <give location>.
We have < give number of victim/patient> and there state are
<give gravity state of each patient/victim>.
For now, we have done <give first response and second
response that have been done, and any other measure
taken>.
<Respond to any question if possible, possibly asked by the
EMS>
<give SAMPLE information for each victim/patient if asked>
<wait until the EMS tells you to hang up,
or gives you any other inquiry
Emergency information



EVEN:__________________________________________________________

SITE: Porthkerris Divers , Porthkerris Cove, st Keverne, Cornwell TR12 6QJ

FACILITY OWNER/MANAGER ______________________________________

ALTERNATE CHARGE PERSON FOR FACILITY:__________________________

LOCATION OF FIRST AID KIT:_______________________________________

LOCATION OF MEDICAL PROFILES:__________________________________

LOCATION OF PHONES ON SITE:____________________________________


Phone numbers

Ambulance: 999 or 112

Coastguard/Police: VHF CH16 or 999 or 112

Hospital: 01872252708

DDRC emergency number 24hrs: 01752209999
The Hyperbaric Medical Centre
(Diving diseases Research Centre
Tamar Science Park
Research Way
Plymouth
PL6 8BU

Advise on diving related incidents phone
Royal Navy Doctor: 07831151523

Porthkerris Dive Site Grid Ref SW806227
Facility (where you are): 01326280620
Step to follow when an injury occurs

Step 1: control the environment so no further harm occurs

Stop all participants.
Protect yourself if you suspect bleeding (put on gloves).
If outdoors, shelter the injured participant from the elements and from any traffic

Step 2: Do a first assessment of the situation

If the participant:

Is not breathing
Does not have a pulse
Is bleeding profusely
Has impaired consciousness
Has injured the back, neck, or a limb
Has a visible major trauma to a limb
Cannot move his/her arms or legs or has lost feeling in them

If the participant does not show the signs above, proceed to step 3

Step 3: Do a second assessment of the situation

Gather the facts by asking the injured participant as well as anyone who witnessed
the incident.

Stay with the participant and try to calm him/her; your tone of voice and body
language are critical.

If possible, have the participant move himself/herself the playing surface. Do not
attempt to move an injured participant.

Step 4: Assess the injury

Have someone with first aid training complete an assessment of the injury
And decide how to proceed.

If the person trained in first aid is not sure of the severity of the injury or there is
on one available who as first aid training, activate EAP. If the assessor is not sure
the injury is minor, proceed to step 5.

Step 5: control the return to activity

Allow a participant to return to activity after a minor injury only if there is no:

Swelling / deformity / continued bleeding / reduced range of motion
Pain when using the injured part
Signs & Symptoms with their treatments





Signs & Symptoms Cause Treatment


Decompression sickness

Type 1:
o Pain In Limbs, chest
and joints.

Type 2:
o Breathing difficulties
o Unconsciousness
o Coordination loss
o Blurred vision
o Numbness and tingling
o Vertigo
o Paralysis
o Weakness and fatigue
o Pain in limbs, chest and
joints

Decompression
sickness (DCS)
DCS can occur up to
36 hours after last
dive.


For a breathing patient:

o Lay patient down give
100% pure oxygen
one a demand valve.
o Monitor ABCDs
Contact EMS.
o Prepare patient for
EMS evacuation.
o Take notes about the
divers latest 24h
activities.

For a none breathing
patient:

o Give 2 rescue breaths
and CPR.
o Give patient 100%
pure oxygen one
continuous valve
through the pocket
mask (15L/mn).
o Monitor ABCDs
Contact EMS.
o Prepare patient for
EMS evacuation.
o Take notes about
divers last 24h
activities.








Signs & Symptoms Cause Treatment


o Coughing
o Weak or non-
breathing
o Frothing around
mouth
o Cardiac arrest

Near Drowning


o If conscious, give 100% pure
oxygen using a demand
valve.
o If not, give 2 rescue breath
and administer 100% pure
oxygen from a continuous
valve though a pocket mask
(15L/mn).
o Put patient in recovery
position.
o Monitor ABCDs Contact
EMS.
o Treat for shock.
o Continue monitoring and
take the patient nearest
medical services even when
feeling better (prevent
secondary drowning).




o Coughing blood upon
surface or blood froth
coming out of mouth.
o Paralysis.
o Unconsciousness.
o Weak or non-
breathing.
o Dizziness, confusion.
o Strange behaviour of
character.

Lung over expansion
(rapid ascent)










o Lie patient in recovery
position.
o Give 100% pure oxygen
(15L/mn).
Continuous flow through
pocket mask if unconscious.
Continuous flow through
bag if unconscious (25L/mn
if necessary).
o Monitor ABCDs Contact
EMS.
o Evacuate to nearest
recompression chamber (to
prevent gas embolism).







Signs & Symptoms Cause Treatment


o Strong and rapid
pulse.
o Flushed and hot skin.
o No sweating.
o Unconsciousness.
o Possible brain and
organ damage.


Heat Stroke


o Provide shade,
remove diver
exposure suit and
other clothing.
o Cool diver by
sponging, misting
or fanning
(aggressively), ice
bath.
o Monitor ABCDs
Contact EMS.
o Evacuate diver to
medical centre.



o Weak and rapid
breathing.
o Weak and rapid
pulse.
o Cool and clammy
skin.
o Heavy sweating.
o Dehydration.
o Nausea and
weakness.


Heat Exhaustion


o Provide shade.
o Open or remove
divers exposure
suit.
o Provide lots of
fluids (non-
alcoholic or
without caffeine)
to 1L maximum.
o If symptoms
persist after a few
hours, contact
EMS.



o Uncontrollable
Shivering.
o Weak pulse.
o Blue fingers, lips and
toes.
o Confusion.
o Unconsciousness.


Hypothermia



o Move into warm
place.
o Apply heat to neck,
armpits and groin.
o Do not rewarm.
o Contact EMS.



Signs & Symptoms Cause Treatment


o Weak breathing.
o Pale moist clammy
skin.
o Nausea.
o Anxiety.
o Thirst.
o Rapid pulse.

Shock


o Lie patient flat.
o Maintain
temperature.
o No food or drink
(only water).
o Monitor ABCDs
Contact EMS.




o Pain.
o Puncture wound.
o Shock.
o Nausea.
o Paralysis.

Sea urchins sting and
fish spines



o Remove spines with
tweezers.
o Put affected wound
in hot water (30
90 minutes).
o Contact EMS in case
of serious
symptoms.



o Red swollen skin.
o Intense stinging
pain.
o Tentacles present.
o Shock.

Jelly fish sting


o Remove tentacles
with tweezers.
o Rinse wound with
vinegar.
o Rinse with sea
water (if not
polluted).
o Contact EMS in case
of serious
symptoms.









LOST or MISSING DIVER(S)


IF DIVERS HAVE NOT RETURNED WHEN EXPECTED OR A DIVER IS REPORTED
MISSING, THE FOLLOWING PROCEDURE IS TO BE FOLLOWED.

1. Position a look-out (as high as possible).
2. For a missing diver, question the buddy, if available, and record the following
detail;

Direction and strength of current.
Dive plan.
Place last seen.
Time last seen.
Status of air.
Maximum depth planned and reached.
Physical condition of lost diver.
Lost divers possible action in an emergency (eg prone to panic).
For a lost buddy pair, as much of the above detail as possible, should be
determined in consultation with the Dive Leader, and other relevant divers. This
detail should be written down for later reference.
3. Assess the degree of urgency (overdue or long overdue, taking into account the
divers plan and previous repetitive dive profile if known).
4. Recall all divers in the water if possible.
5. Organise personal and equipment for search.

Plan search with usual safety precautious considered ( Dangerous Depth
Time Air).

6. Phone for help
Coast Guard: VHF CH16 or 999 or 112
Porthkerris search and rescue dive centre: 01326 552516 (937812516)

If lose contact with your buddy under water, follow the lost buddy procedure.
Search for them for not more than 1 minute, then surface.