UCT-1 Inside Tender > Inside Tender > Flashcards

Inside Tender Flashcards

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1
Q

What are the responsibilities of the Inside Tender pertaining to chamber operations?

A
  1. Dog Door
  2. Ensure patient is laying down for adequate blood flow
  3. Communicate with topside
  4. Don hearing protection
  5. Administration of treatment gas
  6. Gather Vitals
  7. Monitor for signs of CNS O2 Toxicity
  8. Provide First Aid
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2
Q

What is CNS O2 Toxicity?

A

It is a result from having exposure to higher Partial Pressure of Oxygen while at depth.
Poisoning can occur whenever the Partial Pressure rises above 1.3ata for a diver in the water. Or 2.4ata for a diver in a dry area.

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3
Q

What are the Signs and Symptoms of CNS O2 Toxicity?

A 
Visual symptoms
Ear symptoms 
Nausea 
Twitching or tingling 
Irritation 
Dizziness 
Convulsions
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4
Q

What are the 3 stages of a convulsion?

A

Tonic

Clonic

Postictal

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5
Q

The stage of a convulsion when all of the muscles are stimulated at once and lock the body into a state of rigidity.

A

What is the Tonic stage of a convulsion?

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6
Q

When the brain fatigues and the number of impulses slows. The random number of impulses to various muscles may cause violent thrashing or jerking.

A

What is the Clonic stage of a convulsion?

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7
Q

The depression phase of a convulsion. The patient is usually unconscious and quiet for a while. For CNS O2 convulsions the diver will usually have a clear memory of everything up to the the onset of the convulsion but nothing of the convulsion itself.

A

What is the Postictal phase of a convulsion?

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8
Q

What are the 8 responsibilities of the Inside Tender upon entering the chamber?

A
  1. Dog the Door
  2. Have patient lay down for optimal circulation
  3. Communicate with Topside
  4. Ensure hearing protection is being used
  5. Administer treatment gas
  6. Collect Vital Signs
  7. Monitor for signs of CNS O2 Toxicity
  8. Provide first aid
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9
Q

What are the 6 parts of a Neurological Exam?

A
  1. Mental Status
  2. Coordination
  3. Motor skill
  4. Cranial Nerves
  5. Sensory
  6. Deep Tendon Reflexes
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10
Q

What are you looking for during the Mental Status part of a Neurological exam?

A

Mental Status is best determined when you first see the patient and is characterized by their alertness, orientation, and thought process.

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11
Q

What are you looking for during the Coordination part of a Neurological exam?

A

To verify the patient has normal coordination capabilities. Normal walking, balance, and rapid hand movements.

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12
Q

What are you looking for during the Cranial Nerves section of the Neurological Exam?

A
  1. Olfactory-sense of smell
  2. Optic- vision
  3. Oculomotor- light in the eye
  4. Trochlear- Follow the tip of my pen
  5. Abducens- Follow the tip of my pen
  6. Trigeminal- facial sensation
  7. Facial- facial muscles
  8. Acoustic- hearing
  9. Glossopharyngeal- gag reflex
  10. Vagus- say ahhhh
  11. Spinal Accessory- turn head shoulder shrug
  12. Hypoglossal- tongue twisters
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13
Q

What are the timelines for a Treatment Table 5?

A

Complete relief within the first :10 minutes upon reaching 60’ and starting first O2 period.
Treatment time is 2 hours and 15 minutes not including the decent time.

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14
Q

What can be treated utilizing a TT5?

A
  • Type 1 DCS not including Marbling
  • Asymptomatic Omitted D
  • Treatment of resolved symptoms following in-water recompression
  • Follow-up treatments for residual symptoms
  • Carbon monoxide poisoning
  • Gas Gangrene
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15
Q 
What are normal Vitals?
Blood Pressure 
Heart Rate
Respirations 
O2
Body Temperature
A 
BP: 120/80
HR: 60-80 
Respirations: 12-16
O2: 96-100%
Temp: 98.6°
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16
Q

What are the Signs and Symptoms of AGE?

A 
Unconsciousness
Weakness
Paralysis 
Numbness
Ears ringing or roaring
Blurred or Distorted vision
Dizziness 
Fatigue 
Pins and Needles
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17
Q

What are the signs and symptoms of DCS Type 1?

A

Pain
Marbling
Swelling

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18
Q

What are the Signs and Symptoms of DCS type 2?

A 
Unconsciousness
Weakness
Paralysis 
Numbness
Ears ringing 
Blurred vision 
Dizziness 
Fatigue 
Pins and needles
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19
Q

What are the signs and symptoms of Mediastinal Emphysema?

A
  1. Substernal chest pain
  2. Tightness or dull ache in chest
  3. Pain radiating to shoulder or upper back
  4. Pain swallowing
  5. Coughing
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20
Q

What are the signs and symptoms of Subcutaneous Emphysema?

A
  1. Fullness in throat
  2. Change in Voice
  3. Difficulty Swallowing
  4. Rice Krispies (crepitus)
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21
Q

How do you treat subcutaneous and mediastinal emphysema?

A

Mild symptoms: breathing 100% O2 on surface

Severe Symptoms: Shallow recompression under the direction of UMO

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22
Q

What are the signs and symptoms of a Pneumothorax and tension pneumothorax?

A 
Sudden sharp chest pain
Shortness of breath 
Labored breathing 
Weak pulse 
Increase heart rate 
Anxiety
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23
Q

What is the CPR compressions to rescue breath rate?

A

30 compressions

2 Rescue Breaths

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24
Q

When can you discontinue CPR?

A
  1. When you have been relieved.
  2. Signs of Life
  3. Shocking with AED
  4. Pronounced Dead by Dr.
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25
What are the signs and symptoms of shock?
1. Decrease in Blood Pressure 2. Rapid weak heart rate 3. Profuse sweating 4. Light headed 5. Nausea 6. Cyanosis 7. Confusion 8. Clammy Skin
26
How do you treat shock?
1. Ensure adequate breathing 2. Control bleeding 3. Administration of O2 4. Elevate lower extremities 5. Avoid rough handling 6. Prevent loss of body heat 7. Keep patient lying down 8. Give nothing by mouth
27
How do you pack the Scrubber?
Fill 1/3 Tap Tap Tap Fill 1/3 Tap Tap Tap Fill 1/3 Tap Tap Tap
28
What markings do you put on the scrubber after filling it?
- Name of person filling it. - Signature - Expiration date of sodasorb
29
What is a POIS?
Pulmonary Overinflation Syndrome
30
How many POIS’s are there and what are they?
There are 4 POIS’s 1. AGE 2. PNEUMOTHORAX 3. SUBCUTANEOUS EMPHYSEMA 4. MEDIASTINAL EMPHYSEMA
31
What is Hypoxia?
Hypoxia is an abnormal deficiency of oxygen in the arterial blood.
32
What are the signs and symptoms of Hypoxia?
1. Loss of judgment 2. Lack of concentration 3. Lack of muscle control 4. Drowsiness 5. Weakness 6. Agitation 7. Euphoria 8. Loss of consciousness
33
How do you treat hypoxia?
Treat with basic first aid and 100% oxygen.
34
What is Hypercapnia?
Hypercapnia is an abnormally high level of carbon dioxide in the blood and body tissues.
35
What are the signs and symptoms of Hypercapnia?
1. Increased breathing rate 2. Shortness of breath 3. Confusion 4. Inability to concentrate 5. Increased sweating 6. Drowsiness 7. Headache 8. Loss of consciousness 9. Convulsions
36
How do you treat Hypercapnia?
1. Decrease level of exertion to reduce level of CO2 | 2. Ventilate the hat to wash out bad air
37
What are the Emergency Procedures for the TRCS?
1. Rapid increase in Pressure. 2. Rapid decrease in pressure 3. Fire in the chamber 4. Loss of O2 in the TRC 5. Loss of O2 in the TL 6. Loss of primary air
38
What kind of I.V. Fluids may be used in the chamber?
1. Lactade Ringers | 2. Normal Saline
39
What type of clothing may be worn inside the chamber?
1. 100% cotton | 2. Diver swim trunks made of 65% polyester and 35% cotton material is acceptable
40
How do you extinguish a fire in the chamber?
1. Wetted towel 2. Bucket of water 3. Fire extinguisher if applicable in the chamber. 4. Suppression/deluge system
41
What is the Pre-Dive Maintenance for the chamber?
OP1 and OP2 Modified Pre-Dive OP1M and OP2M
42
What is the Post-Dive Maintenance for the Chamber?
Modified | OP5M and OP6M
43
What valves control the Scrubber for the TL?
ALPV 20 under the console ALPV22 inside the TL above the the scrubber
44
What valve controls the Scrubber for the TRC?
ALPV-9
45
What treatments may be used when the temperature is above 104°?
None Intolerable
46
What treatments may be performed when the temperatures is between 95° - 104°?
1. TT5 2. TT9 Max 2 hours in the chamber
47
What treatments may be performed when the temperatures are between 85° - 94°?
1. TT5 2. TT6 3. TT6A 4. TT1A 5 TT9 Max of 6 hours in the chamber.
48
What treatments may be performed when the temperatures are below 85°?
1. All treatments may be performed. | 2. Unlimited time
49
What are the prerequisites for a SQUEEZE?
1. There must be a gas filled space. 2. The gas filled space must have rigid walls. 3. The gas filled space must be enclosed. 4. The space must have lining membrane with an arterial blood supply and venous drainage that penetrates the space from the outside. 5. There must be a change in ambient pressure.
50
What kind of squeezes are there?
1. Middle Ear Squeeze 2. Sinus Squeeze 3. Tooth Squeeze 4. External Ear Squeeze 5. Thoracic Lung Squeeze 6. Face Squeeze 7. Body Squeeze 8. Reverse Squeeze
51
What is nitrogen narcosis?
A state of euphoria and exhilaration that occurs when a diver breaths a gas mixture with a nitrogen partial pressure greater than 4 ata.
52
What are the symptoms on Nitrogen Narcosis?
1. Loss of judgment or skill 2. A false feeling of well-being 3. Lack of concern for job or safety 4. Apparent stupidity 5. Inappropriate laughter 6. Tingling or vague numbness of the lips, gums, and legs
53
When can a Patient sleep during a treatment?
1. During air breaks while deeper than 30’ fsw | 2. Anytime as long as the depth is 30’ or shallower.
54
How do you monitor a sleeping patient?
Based on their vitals.
55
What type of thermometer is used in the chamber?
( Non Mercury Type )
56
Can you use Sodasorb past the expiration date?
Yes Chamber must be equipped with O2 and CO2 Monitors.
57
When should an Inside Tender complete a Neurological Exam during a treatment?
Every change in depth. When the supervisor asks for one.
58
What category chamber is the TRCS?
Cat D - BIBS overload dump - CO2 Scrubber - Air BIBS - O2 and CO2 Monitor - Sufficient air to press the IL once and OL twice to 165 FSW - Sufficient air to press the IL and OL once to 165 fsw and enough air for one tender and two patients (when not on O2) to breath Air BIBS during one TT6A with maximum extensions.
59
What are the 6 Levels muscle strength is graded as?
``` 0- Paralysis, no motion possible 1- Profound weakness. Flicker or trace 2- Severe weakness. Able to contract muscle but cannot overcome gravity 3- Moderate weakness. 4- Mild Weakness. 5- Normal ```
60
How long does the inside tender have to wait after a TT5, TT6, TT6A, TT1A, TT2A, TT3?
Must have a surface interval of 24 hours.
61
Inside Tenders that have done TT4, TT7, and TT8 should not fly for how many hours?
Must wait 72 hours.
62
Any patient that is on a Treatment must wait how long before flying?
All patients must wait 72 hours prior to flying.
UCT-1 Inside Tender
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