ʻO ka Boat Propeller Strike a me ECOS Kill-Switch Lanyard Rula: In-Water Hemorrhage Control¶

ʻO ka mea maʻamau maʻamau ʻekolu ʻāpana a i ʻole ʻehā ʻehā mau ʻili ʻili i waho a i ʻole sterndrive waʻa propeller e huli ana ma 3,200 mau kipi i kēlā me kēia minuke (rpm) e hōʻeha i ka 96 a 128 mau hopena o ka maka i kēlā me kēia kekona, e neʻe ana mai ka piko a i ka manamana wāwae ma waena o ke kino o ke kanaka i ** emi iho ma mua o hoʻokahi hapaʻumi o kekona**. I ka wā e paʻi ʻia ai ka mea ʻauʻau, wakeboarder, tuber, a i ʻole ka mea hoʻokele waʻa i hoʻokuʻu ʻia e ka mea wili moana, ʻaʻole ʻoki wale ka ʻili o ka ʻili o ka ʻili o ka ʻili: ʻokiʻoki lākou i kēlā me kēia 2.5 a i 5 mau kenimika (1 a 2 ʻīniha) pololei ma waena o ka neoprene, quadriceps a me gastrocnemius muscle bellies a me nā ʻōpū o ka gastrocnemius. femur, tibia, a i ʻole iwi poʻo, e hana ana i nā haʻihaʻi like ʻole a me ka hemorrhage nui i loko o ka wai a puni.

ʻOi aku ka weliweli loa ke ʻano o ka hana ʻana o ka hapa nui o nā mea hoʻoheheʻe solo a liʻiliʻi paha: ʻo ka "Circle of Death" holo holo moku. Ke hoʻolei ʻia ka mea hoʻohana o ka waʻa mana waena, ka waʻa bass, a i ʻole ka waʻa inflatable a hoʻolei ʻia i uka me ke komo ʻole ʻana i ka ʻulaʻula Engine Cut-Off Switch (ECOS) kill-switch lanyard, ʻaʻole holo ka waʻa kanaka ʻole ma kahi laina pololei. Akā, ʻo ka propeller rotational torque e huki koke i ka huila ʻaʻole i paʻa ʻole a i ʻole ka ʻauʻau mahiʻai ma kekahi ʻaoʻao, e laka ana i ka waʻa holo kaʻa ʻole i loko o kahi pōʻai paʻa kiʻekiʻe e holo pololei ana ma luna o ka mea hana i hoʻokuʻu ʻia i loko o ka wai. E ʻike i ka pale ʻana i ka moku holo holo kaʻapuni ma ka luʻu hohonu a i ʻole ka ʻauʻau ʻana e kū pono ana i kona radius huli, pehea e pani ai i ka pahu ahi a hōʻoia i ka Neutral ma mua o ka hoʻokokoke ʻana i kahi mea ʻauʻau, a pehea e hoʻopili ai i ka windlass a i ʻole ratchet tourniquet MA KA WATER MAMUA o ka hāpai ʻana i kahi mea make koko ma luna o ka hale noho o ka waʻa. E nana helu pilikia, ulia waapa, e lumo ana, a kahe koko.

E hana i kēia i kēia manawa¶

1. **Huki i ke kaula ʻulaʻula Engine Cut-Off Switch (ECOS) a i ʻole e hoʻohuli loa i ke kī hoʻāla (ʻaʻole wale i ka Neutral) i ka manawa e hāʻule ai kekahi i uka a i ʻole ma mua o ka hele ʻana o kekahi mea ʻauʻau i ka hope o ka waʻa.
2. Inā paʻi ʻia ka mea ʻauʻau a i ʻole ka mea i hoʻokuʻu ʻia e ka mea hoʻokele waʻa a he koko ʻulaʻula ʻulaʻula e kahe ana i loko o ka wai mai ka lima a i ʻole ka wāwae, e lele a komo i loko me kahi kōkua hoʻoluʻu a kau i ka windlass a i ʻole ratchet tourniquet HIGH AND TIGHT ma ka ʻaoʻao i ʻeha ʻOiai i loko o ka wai ma mua o ka huki ʻana iā lākou ma luna o ka moku. kahe i ke koko i ma lalo o 90 a 120 kekona; ʻO ka hakakā ʻana no ʻekolu mau minuke e kauo i kahi mea kaumaha a i hoʻoheheʻe ʻia i ka wai ma luna o kahi pū kiʻekiʻe a i ʻole ke kahua ʻauʻau ma mua o ka hoʻōki ʻana i ke koko he mea make pinepine; ike kahe koko.
3. Inā kiola ʻia ʻoe i uka a hoʻomaka ka pōʻai ʻana o kou waʻa holo ʻole iā ʻoe ("Circle of Death"), mai hoʻāʻo e ʻauʻau ma hope o ka waʻa a i ʻole e hopu i ka pū no ka piʻi ʻana i luna i ka wā e paʻa ana ka mana. hohonu) no laila e holo pono ʻole ka hull pāpaʻu a me ka ʻāpana haʻahaʻa i luna.
4. ** Hoʻolaha i kahi kelepona pilikia "MAYDAY, MAYDAY, MAYDAY" ma VHF Marine Channel 16 (156.8 MHz) A e kelepona i kāu helu pilikia kūloko (911 ma United States a me Kanada, 112 ma waena o ka European Union, 999 ma United Kingdom) me kāu mau kikoʻī GPS pololei a me ka ramp moku kokoke loa a i ʻole marina. nānā helu pilikia.
5. I ka hāpai ʻana i ka mea i hoʻopaʻa ʻia mai loko mai o ka wai ma luna o ka paepae ʻauʻau a i ʻole ka papa moku, e hoʻopaʻa i ko lākou kino i ke alo inā hiki a kākoʻo i ke poʻo, ka ʻāʻī, a me nā lālā haʻihaʻi. ʻO ka huki koke ʻia ʻana o ke koko nui, ka make hypothermic mai ka wai e hoʻoheheʻe ʻia ke koko ma nā ʻāpana haʻahaʻa (**circum-rescue immedia **) ike e lumo ana a hypothermia a me ka hau hau.
6. Ke palahalaha ka mea i make ma ka papa moku, e nana ua oki loa ka tourniquet iloko o ka wai i ke koko (e hookomo i ka tourniquet lua ma luna pono o ka mea mua ina e kahe mau ana ke koko, oi aku hoi ma luna o ka lole pulu neoprene manoanoa), e hoopili i na eha hohonu o ka ipuhao a i ole ka ma'i me ka gauze hemostatic, a e uhi i ka mea i pepehiia me ka pakeke maloo a i ole i ka pale pale pale pale koko. trauma**).

Ka lāʻau hoʻoholo: ʻo ke kuʻi ʻana o ka waʻa a me ka hoʻāʻo ulia pōpilikia¶

flowchart TD
    Start["Paʻi Pahu Waʻa a i ʻole Man-Overboard Emergency"] --> Scenario{"He aha ke kūlana koke o ka wai?"}
    Scenario -->|"ʻO ka ʻauʻau / ka mea holo lio i hahau ʻia e ka propeller i ka wai"| PropHit["1. PIʻI ENGINE HOPE (huki i ka lanyard ECOS / hoʻopau i ke kī); 2. Kiola i ka lele (life ring / PFD) a hiki koke i ka mea i pepehiia; 3. Ina he koko nui ka lala, e hoopili i ka Tourniquet HIGH & TIGHT I KA WAI ma mua o ka hapai ana; 4. E hoʻokiʻekiʻe ma luna o ka papa; e hoʻohui i ka tourniquet 2 a i ʻole ka ʻeha ʻeha inā pono"]
    Scenario -->|"Kaʻapuni ʻana o ka mea hana a me ka waʻa ʻole ('Circle of Death')"| Runaway["1. Nā mea ʻauʻau i hoʻokuke ʻia: E ʻau kū pololei i ka pōʻai a i ʻole DIVE DEEP (2+ m / 7+ ft) ke neʻe mai ka waʻa; 2. MAI hopu i ka aoao o ka moku e nee ana a i ole e hoao e kau malalo o ka mana; 3. Waapa hoʻopakele: Hoʻokokoke mai ka pōʻai waho; e kiola i ka laina polypropylene e lana ana ma ke ala kakaka i ka propeller ino"]
    Scenario -->|"Paʻi Propeller i ke poʻo, ka umauma, a i ʻole ka ʻōpū"| TorsoHead["1. E mālama i ka ea a me ka cervical spine stabilization i ka wai me ka hoʻohana ʻana i ka flotation; 2. E hoʻopaʻa i nā ʻeha o ka umauma omo me ka sila i hoʻoheheʻe ʻia a i ʻole ka plastic occlusive ma ka papa; 3. E hoʻopaʻa paʻa i nā ʻeha hohonu o ka ʻāʻī/axilla me ka gauze; 4. Hoʻolaha i ka MAYDAY ma ka VHF Ch 16 a me ka heihei i ka dock trauma i koho ʻia"]
    PropHit --> PostDeck["ʻO ka mea hoʻomaloʻo maloʻo, uhi i nā pākeʻe mahana e pale ai i ka hypothermia coagulopathy, a hoʻonohonoho i ka Coast Guard / EMS intercept"]
    Runaway --> PostDeck
    TorsoHead --> PostDeck

ʻO ka mechanics o propeller trauma a me ka "Circle of Death"¶

No ke aha e hoʻopilikia ai nā propellers moana i ka ʻoki ʻana i nā pae he nui a me ka haki ʻana o ka iwi¶

ʻAʻole e like me ka pahi hoʻokahi a i ʻole ka pahi ʻike, neʻe ka propeller kai i mua ma waena o ka wai ke kaʻapuni ʻana, e hana ana i kahi helical spiral o ka like kiʻekiʻe-velocity cleaver cleaver like:

1. Ke alapine hopena o ka lāʻau: ʻO ka ʻenekini V6 maʻamau a i ʻole V8 sterndrive e holo ana ma 4,000 rpm me ka 2:1 haʻahaʻa haʻahaʻa haʻahaʻa e hoʻoemi i ka propeller ʻekolu-blade ma 2,000 propeller rpm (33.3 kipi i kēlā me kēia kekona), e hāʻawi ana i 100 mau pahu kila pākahi i kēlā me kēia kekona.
2. Nā ʻoki "ʻoki palaoa" like ʻole: I loko o 0.15 kekona wale nō, e hoʻokau ka propeller i 15 hohonu, like, ʻoki ʻokiʻoki i hoʻokaʻawale ʻia he 3 a 6 kenimika (1.2 a 2.4 ʻīniha) kaʻawale ma ka lōʻihi o ka ʻūhā, ka ʻūhā, ke kua, a i ʻole ka iwi poʻo. Paʻi kēlā me kēia kanaka i ka ʻili, ka ʻiʻo, nā ʻaʻa nui, a me nā aʻalolo sciatic/femoral i ka wā e hahau ana i ka iwi o lalo e like me ke koʻi, e waiho ana i nā ʻāpana hāmama he nui (flail limb) a me ka ʻoki ʻana i ka ʻiʻo palupalu me ke koʻikoʻi i hiki ʻole i ke kaomi pololei maʻalahi ke pani i nā moku koko.
3. Ka hoʻohaumia ʻana i ka maʻi bacteria o ke kai: ʻO kēlā me kēia pā e hoʻolele ai i ka loko, ka muliwai, a i ʻole ka wai moana hohonu i loko o ka ʻiʻo iwi haʻihaʻi a me nā keʻena ʻiʻo i ʻoki ʻia. ʻO nā maʻi bacteria moana a me ka wai maʻemaʻe, ʻo ia hoʻi Aeromonas hydrophila i loko o nā loko wai/nā muliwai a me Vibrio vulnificus / Vibrio parahaemolyticus i loko o ka wai paʻakai mahana a me nā estuaries (e like me ke Kaiwa o Mekiko), e hoʻoulu i ka necrotizing fasciitis a me myonecrosis i loko o 12 a 24 mau hola inā ʻaʻole i mālama ʻia i loko o 24 mau hola. nā lāʻau lapaʻau. (Gulf of Mexico)

Pehea ka hiki ʻana o ka "Circle of Death" a me ke kānāwai USCG ECOS (46 USC 4312)¶

Ke pā ka mea hoʻokele waʻa (inā he waʻa lawaiʻa hoʻokele huila a i ʻole ka mea hoʻokele huila a i ʻole ka bowrider) i ka nalu, wakesurf roller, a i ʻole ka lāʻau i loko o ka wai a kiola ʻia mai ka helm me ka ʻole o kahi Engine Cut-Off Switch (ECOS) lanyard i hoʻopili ʻia:

• No ke aha e huli ai ka waapa i ka poai pa'a: I ka wili ana o ka propeller lima akau ma ka uaki ma ka wai paapu, ua hana ke kanawai ekolu o Newton i ka hele wāwae a me ka hookele hookele ma ka skeg o lalo. I ka manawa koke e haʻalele ai nā lima o ka mea hoʻohana i ka ʻauʻau mahiʻai a i ʻole ka hoʻokele paʻa ʻole, hoʻopaʻa ʻia ka hydrodynamic torque i ka motika waho a i ʻole ka hoeuli i ka starboard (a i ʻole ke awa).
• Ka loop lethal: Me ka hoʻomau ʻana o ka throttle i ka holo ʻana a i ʻole ka hoʻolālā ʻana i ka wikiwiki, laka ka waʻa ʻole i loko o kahi pōʻai mau 15-a-30-mika (50-a-100-kapuaʻi) a puni pono i kahi i hoʻolei ʻia ai ka mea hoʻokele a me nā kaʻa i loko o ka wai. I kēlā me kēia 4 a 8 kekona, hoʻihoʻi ka waʻa i ka poʻe ʻauʻau ma 20 a 40 mau knots.
• ** Nā lula ECOS Lanyard Federal a me ka honua:** Ma lalo o ** kānāwai federala o ʻAmelika Hui Pū ʻIa (46 U.S.C. 4312, i hoʻoholo ʻia ma 2021)** a me US Coast Guard (USCG) nā lula, nā mea hoʻokele o nā moku leʻaleʻa ma lalo o 7.9 mika (26 kapuaʻi) ka lōʻihi i lako ʻia me kahi ʻenekini hiki ke ʻoi aku ka ikaika o 115 paona a i ʻole 115 mau lio. pono e ʻaʻahu i ka loulou Engine Cut-Off Switch (ECOS) i nā manawa a pau e holo ana ka moku ma ka mokulele a i ʻole ma luna o ka wikiwiki o ka hoʻoneʻe ʻana (koe naʻe i loko o kahi hale paʻa). Hoʻokō ʻia nā lula pepehi kanaka like ʻole e ka UK Royal Yachting Association (RYA), Maritime New Zealand, a me Australian state marine authority.

Ke ola nei a hoʻokuʻu i ka moku holo "Circle of Death".¶

1. Inā ʻoe i loko o ka wai i ka pōʻai ʻia e ka waʻa kanaka ʻole¶

1. E hoʻoholo i ke kikowaena pōʻai pololei o ka moku a me ka neʻe ʻana o ka pivot: ʻAʻole noho ka waʻa pōʻai ʻole i hoʻokahi wahi kikoʻī; ʻO ka makani a me ke au e hoʻokuke mālie i ke ala pōʻai holoʻokoʻa i lalo i ka makani a i ʻole i lalo.
2. E ʻauʻau kū pololei i ke ala neʻe, ma waho o ka radius pōʻai: E manawa i ka holo ʻana o ka waʻa a e ʻauʻau ikaika mai ka ʻaoʻao o waho o ka pōʻai ma kahi kihi 90-degere i ka makani/ka neʻe ʻana o kēia manawa.
3. Inā holo pololei ka waʻa iā ʻoe, LUʻU LONO koke:
4. Mai ho'āʻo e ʻauʻau i waho i kahi waʻa 30-knot ma ka ʻili.
5. E hanu piha, pelu ma ka pūhaka (luʻu pike i luna), a ʻauʻau pololei i lalo i lalo a hiki i ka hohonu o ** ma kahi o 1.5 a 2.5 mau mika (5 a 8 kapuaʻi)**. ʻO ka ʻāpana haʻahaʻa o kahi kaʻa waho nui ʻaʻole hiki ke hoʻonui ʻia ma mua o 0.75 a 1.0 mika (2.5 a 3.5 kapuaʻi) ma lalo o ka ʻili wai.
6. Inā ʻoe e ʻaʻahu ana i ka ʻaʻahu ola inflatable e pale ai i ka luʻu ʻana, a i ʻole ka PFD foam, e ʻauʻau kū pololei i ke ala kakaka i ka wā e huli ai ka waʻa a hele ʻoe ma waho o kona kua (e hoʻomanaʻo ana i ka huli ʻana, ʻoi aku ka nui o ka hope a me ka propeller ma mua o ke kakaka).
7. ** MAI ho'āʻo e hopu i ka ʻaoʻao o ka moku kaʻapuni wikiwiki e piʻi ai i luna:** Ke hoʻāʻo nei e hopu i ke kakaka a i ʻole ka pū o ka waʻa e neʻe ana ma mua o 3 a 4 mau puʻupuʻu e wīwī ai i kou poʻohiwi mai kona kumu a huki pono i kou mau wāwae ma lalo o ka ʻau i loko o ka propeller wili.

2. Pehea e hiki ai i kekahi waapa ke hooki maluhia i ka moku holo kaapuni¶

Inā ʻoe e holo ana i kahi moku ʻē aʻe ma kahi kokoke a ʻike ʻoe i kahi moku ʻauʻau ʻole e kaʻapuni ana i ka wai:

1. E hoʻopōmaikaʻi i ka hoʻopakele ʻana i ka poʻe ʻauʻau mua inā hiki iā ʻoe ke huki pono iā lākou: E nānā i ka loop manawa o ka waʻa holo a hoʻokokoke i ka ʻaoʻao o waho wale nō inā palekana, a i ʻole e hoʻolei i kahi puʻupuʻu Rescue Throw Bag / Lifebuoy ma kahi laina lana lōʻihi no laila hiki iā ʻoe ke huki i ka mea ʻauʻau i waho o ka pōʻai me ke komo ʻole ʻana i ka loop loop.
2. Hino i ka propeller o ka waapa holo me ke kaula polypropylene e lana ana:
3. Mai huki i kou waʻa ma ka ʻaoʻao o ka moku holo holo kiʻekiʻe a e hoʻāʻo e lele mai kahi papa a i kahi papa e like me ke kiʻiʻoniʻoni; na ka nalu hikiwawe e paʻi iā ʻoe ma waena o nā hull a kiola paha iā ʻoe ma lalo o nā propeller ʻelua.
4. Akā, e kahe i kahi 15-a-30-mika (50-a-100-kapuaʻi) lana polypropylene ski kaula a i ʻole laina dock (a i ʻole he kaula i hoʻopaʻa ʻia ma waena o ʻelua fenders/lifejackets) ma ke ala o ke kakaka o ka waʻa holo mai waho o kona pōʻai.
5. I ka holo ʻana o ka waʻa holo ma luna o ka laina polypropylene e lana ana, e omo ana ka propeller wili i ke kaula i loko o ka pahu propeller, e ʻōwili paʻa ana a puni ka lāʻau prop a hoʻopaʻa i ka ʻenekini a i ʻole ka ʻako ʻana i ke kaula wili i loko o kekona.

Ka mālama ʻana i ka hemorrhage i loko o ka wai: no ke aha ʻoe e kau ai i kahi tourniquet MAMUA o ka hāpai ʻana i luna¶

ʻO ke kuhi hewa o ka hoʻopaneʻe ʻana i ka noi tourniquet a hiki i ka mea i pepehi ʻia ma luna o ka papa¶

Ke loaʻa i ka mea ʻauʻau kahi ʻeha hohonu o ka femoral, popliteal, a i ʻole brachial aʻaʻa mai kahi mea hoʻokele waʻa, ʻelua mau kumu physiological lethal e hoʻolalelale i ke kahe koko:

1. Ke uhi nei ka wai i ka nui maoli o ke kahe ʻana o ke koko: Ma ka ʻāina, 1.5 lita o ke koko ʻaʻa i hoʻokumu ʻia i loko o ka ʻauʻau weliweli ma ka papahele e koi ai i ka hana koke. I loko o ka loko a i ʻole ka moana, hoʻoheheʻe ʻia ke koko i loko o kahi ao ʻeleʻele i loko o ka wai, e kahe ana me ka ʻike ʻole ʻia aʻo ke kaomi ʻana o ka wai e holoi i nā ʻōpū koko.
2. ** ʻO ka pahele hoʻopaneʻe 2-4-minuke:** ʻO ka hāpai ʻana i kahi kanaka makua ʻeha, hopohopo, a ʻike ʻole paha e ʻaʻahu ana i nā lole pulu a i ʻole ka lole pulu mai loko mai o ka wai hohonu ma ka ʻaoʻao o ka waʻa a i ʻole ma luna o kahi alapiʻi 3-ʻanuʻu haiki he luhi a lohi, e lawe pinepine i 2 a 5 mau minuke. ʻO ka femoral artery i ʻoki loa ʻia ke koko ma 1,000 a i 1,500 milliliters i kēlā me kēia minuke, e hoʻihoʻi ʻole ʻia ai ka haʻalulu hemorrhagic a me ka exsanguination cardiac hoʻopaʻa ʻia i loko o 90 a 120 kekona. Inā hoʻopau ka poʻe hoʻopakele i ʻekolu mau minuke e hoʻoikaika ana i ka huki ʻana i ka mea i hōʻeha ʻia ma luna o ka moku ma mua o ka hoʻohana ʻana i ka tourniquet, ua paʻa mua ka mea i hoʻopaʻa ʻia i ka naʻau i ka wā e paʻi ai lākou i ka papa.

ʻO ka protocol step-by-step no ka hoʻopili ʻana i kahi tourniquet IN THE WATER¶

Pono kēlā me kēia waʻa mana, waʻa ski, a me nā moku holo moana ma kahi liʻiliʻi loa ** ʻelua mau pahu makani a i ʻole nā huakaʻi ratcheting i manaʻo ʻia e CoTCCC** (e like me ka C-A-T Combat Application Tourniquet, SOFTT-W, a i ʻole he ratcheting tourniquet e like me ka RMT / M2, nona nā niho ratchet i pulu pololei a ʻaʻole i blood i ka ʻaoʻao. ka pae hoʻokele a me ka ʻauʻau.

1. E hoʻopaʻa mua i ka lele: E hoʻolei i ke apo ola, e hoʻolei i ka cushion, a i ʻole e lele i ka hoʻohana ʻana i Personal Flotation Device (PFD) me kahi tourniquet i hoʻopaʻa ʻia ma kou lima a i ʻoki ʻia paha i kou ʻaʻahu. E hoʻopaʻa i ka puʻuwai o ka mea i pepehi ʻia i ʻole e pohō kekahi o ʻolua i ka wā e paʻa ana kou mau lima.
2. E kau i ka tourniquet "High and Tight" ma luna o ka lala I KA WAI:
3. Mai hoʻonele i ka manawa e hoʻāʻo ai e ʻoki i nā jeans a i ʻole e ʻili i kahi lole neoprene pulu i loko o ka wai.
4. E hoʻokuʻu i ka loop tourniquet i luna o ka lima ʻeha a i ʻole ka wāwae (a i ʻole e wehe i ke kaula ma kahi SOFTT-W / RMT a ʻōwili iā ia a puni ka lālā) ** i ke kiʻekiʻe i loko o ka ʻāʻī ('ūhā pili) a i ʻole ka ʻūhā (ma ka lima o luna) e like me ka hiki**, ma ka liʻiliʻi ** 5 a 7 kenimika (2 a 3 ʻīniha)** ma luna o ka ʻoki propeller kiʻekiʻe.
5. Huki i ke kaula pōʻai e like me ka hiki i ke kanaka ma mua o ka wili ʻana i ke koʻokoʻo makani makani a i ʻole ke kaomi ʻana i ka ratchet buckle.
6. E wili pinepine i ke kookoo makani (e like me 3 a 5 mau hulina, a oi aku paha ma luna o ka lole pulu wai mānoanoa) a laka ia i loko o ka pahu makani.
7. E hoʻokiʻekiʻe i ka poʻe pōʻino ma luna o ka waʻa ma ka ʻāʻī inā hiki:
8. E hoʻoneʻe i ka poʻe pōʻino ma luna o kahi wakeboard, papa heʻe nalu, papa kuli, a i ʻole ʻauʻau ʻauʻau i hāʻule i lalo no ka hana ʻana ma ke ʻano he iwi kuamoʻo/papa hāpai ʻia, e mālama pono i ko lākou ʻōpū a me nā wāwae e like me ka hiki ke pale i ka hāʻule ʻana o ke koko hydrostatic.
9. E noʻonoʻo hou i ka tourniquet i hoʻokahi manawa ma ka papa moku maloʻo:
10. Hoʻolaha hoʻopaʻa paʻa lole: Hoʻopiha ʻia nā wetsuits neoprene (3 mm a 7 mm mānoanoa) me nā ʻōpū micro-bubbles a me ka wai. Ke hāpai ʻia ka mea i hōʻeha ʻia i waho o ka wai ma luna o ka papahele, kahe ka wai mai ka lole wai a hoʻomaha nā ʻiʻo o nā lālā, hiki ke wehe i kahi tourniquet i loko o ka wai.
11. E nana pono i na eha propeller ma ka papa: ina e kahe ana ke koko ulaula a kulu mai paha mai ka lala, hoopaa i ka ipu makani i 1 a 2 huli hou a i ole ** e hoopili pono i ka tourniquet SECOND ma luna pono (kokoke i) ka tourniquet mua**, e oki ana i ka pulupulu pulu manoanoa ma ka lua o ka tourniquet ina pono; ike kahe koko.

Ka hoʻokele ʻana i ka umauma, ka ʻōpū, a me ke poʻo i ka hoʻopololei ʻana ma ka papa¶

Ke holo ka propeller ma ke kua o ka mea ʻauʻau, ka umauma, ka ʻāʻī, a me ke poʻo:

• Wehe Pneumothorax ("Sucking Chest Wound") mai Rib Strikes: Inā ʻoki ʻia ka ʻaoʻao propeller i loko o ka iwi ʻaoʻao a me ka pleura, e omo ana ka ea i loko o ka paia o ka umauma me kēlā me kēia hanu, e hāʻule ana ka māmā. Holoi koke i ka wai mai ka ʻili a puni ka ʻeha a kau i ka seal pahu i hoʻokuʻu ʻia (a i ʻole he huinahā o ka ʻeke plastik maʻemaʻe / foil i hoʻopaʻa ʻia i lalo ma ʻekolu ʻaoʻao e hana ai i ka pahu hoʻoheheʻe) i hiki i ka ea ke pakele i ka umauma me ka ʻole e omo hou ʻia.
• Pelvic, Gluteal, a me Perineal Strikes: Paʻi ʻia ka propeller ma ka ʻāʻī a me ka ʻāʻī ke kumu o ke kahe nui ʻana o ke koko a me ke koko ma ka ʻaoʻao o nā haʻi pelvic hāmama. Ma muli o ka hiki ʻole ke hoʻokomo ʻia ka limb tourniquet ma luna o ka ʻāʻī o ka ʻāʻī, ** e hoʻopaʻa paʻa i nā kahawai laceration hohonu mai lalo i luna me ka hoʻohana ʻana i nā ʻōwili hemostatic gauze a i ʻole nā ​​kāwele maʻemaʻe** a mālama mau i ke kaomi pololei ʻelua me ke kaumaha o kou kino piha; e hoʻopaʻa i ke pelvis ma nā iwi ʻūhā (greater trochanters) me ka hoʻohana ʻana i ka lau a i ʻole ka mea hoʻopaʻa pelvic; ike haʻi iwi.
• Kaohi ʻana i ka Hypothermia: ʻO ka mea ʻauʻau wai i nalowale i ka 1 a i ka 2 lita o ke koko e lilo i hypothermic koʻikoʻi i loko o nā minuke, ʻoiai ma kahi 30-degree-Celsius (86-degree-Fahrenheit) ʻauinalā kauwela, no ka mea, ʻo ka makani e pā ana ma luna o kahi moku hoʻopakele e hoʻoluʻu koke i ka ʻili pulu. ʻO nā wela kumu ma lalo o 35 degere Celsius (95 degere Fahrenheit) hoʻopau i nā enzyme hoʻopaʻa koko (hypothermic coagulopathy). E ʻoki i nā lole pulu i ka wā e hoʻomalu ʻia ai ke koko, e hoʻomaloʻo i ka ʻili, a ʻōwili i ka mea maʻi i nā kāwele maloʻo, nā ʻeke moe, a i ʻole kahi pālule waho wai ʻole i ka wā o ka holo kiʻekiʻe i ka pahu kaʻa kaʻa; ike hypothermia a me ka hau hau.
• Ka Ho'āʻo ʻana o Carbon Monoxide (CO) ma luna o ka poʻe ʻauʻau ʻauʻau i hōʻike ʻia: Ua huki ʻia ka poʻe ʻauʻau a me ka poʻe heʻe nalu ma kahi kokoke i ka transom o kahi holo moku holo mokuahi, wakeboat, a hale waʻa paha e loaʻa paha i ka maʻi ** marine carbon monoxide poisoning ("teak surfing" hypoxia)**, ka mea e hoʻoulu ai i ka huikau, ka luaʻi ʻana. Hoʻoponopono i ka 100 ka nui o ka oxygen kahe kiʻekiʻe i ka wā e hiki mai ai nā paramedics; ike kalapona kalapona.

Nā helu ulia pōpilikia āpana a me nā protocols oihana¶

Ma nā wai hāmama, kahakai, a i ʻole ka loko nui, e hoʻoheheʻe i ka Coast Guard / Marine Rescue ma VHF Channel 16 (156.8 MHz) a kāpala i kāu helu kelepona pilikia pilikia ma ka ʻāina i hiki i ka Coast Guard fast rescue boat a i ʻole helicopter ke keakea iā ʻoe ma ka wai ke holo ka moku kaʻa ALS ma kahi kokoke loa. E nana helu pilikia.

Nīnau pinepine¶

No ke aha e pōʻai hope ai ka moku holo kaʻa ʻole e holo ma luna o kāna mea hoʻokele i hoʻokuʻu ʻia ma mua o ka holo ʻana ma kahi laina pololei?¶

Ke wili wikiwiki ka mea hoʻolele waʻa ma ka ʻaoʻao hoʻokahi (maʻamau ma ka ʻaoʻao o ka uaki ma nā moku ʻenekini hoʻokahi), ʻo ke kūpaʻa ʻana o ka wai e kūʻē i nā ʻaoʻao angled e hoʻohua ai i ka torque rotational ikaika ("propeller walk" a me ka hoʻokele torque) ma ka ʻāpana haʻahaʻa a i ʻole ka hoe. ʻOiai ka lōʻihi o ka paʻa ʻana o ka mea hoʻokele i ka huila a i ʻole ka ʻauʻau mahiʻai, kūʻē lākou i kēlā ikaika me ka noʻonoʻo ʻole. I ka manawa e kiola ʻia ai ka mea hoʻokele i ka moku me ka ʻole o ka Engine Cut-Off Switch (ECOS) make lanyard, ua paʻi ka mīkini hoʻokele ʻole i kekahi ʻaoʻao, e hoʻopaʻa ana i ka waʻa i hoʻopaʻa ʻole ʻia i loko o kahi pōʻai paʻa kiʻekiʻe ("The Circle of Death") pololei ma kahi i hāʻule ai ka mea hoʻokele.

No ke aha he mea pōʻino ke hoʻokokoke aku i kahi kanaka ʻauʻau i ka wai me ka hoʻouna ʻana i ka waʻa ma Neutral a ʻo ka ʻenekini e hoʻomau mau nei?¶

ʻO ka mea mua, hiki i nā hoʻoili kai ma Neutral ke hoʻouna i ka huki hydraulic a i ʻole mechanical no ka milo mālie ʻana i ka propeller, a ʻaʻole hiki i ka mea ʻauʻau ke lohe a ʻike paha i ka huli ʻana o ka propeller ma lalo o ka wai. ʻO ka lua, ʻoiai e hilinaʻi ana ka mea hoʻokele ma luna o ka pū a i ʻole transom e kōkua i ka huki ʻana i ka mea ʻauʻau ma luna o ka moku, hiki i ka mea kaʻa, ke keiki, ka ʻīlio, a i ʻole ke kuli ponoʻī o ka mea hoʻokele ke kuʻi i ka throttle/shift lever i Forward a i ʻole Reverse, e wili ai i nā ʻauʻau kila ma 1,000+ rpm pololei i nā wāwae o ka mea ʻauʻau. E pani mau i ka ʻā ma mua o ke komo ʻana a i ʻole ka puka ʻana i ka wai kokoke i ka moku.

No ke aha e hoʻohana ʻia ai ka tourniquet i loko o ka wai ma hope o ka paʻi ʻana o ka mea hoʻokele waʻa ma mua o ka kali ʻana a hiki i ka wā e hāpai ʻia ai ka mea i pepehi ʻia ma luna o ka moku?¶

Paʻi ka mea hoʻoheheʻe waʻa i ka wāwae a i ʻole ka lima e ʻoki pinepine i ke aʻaʻa femoral, popliteal, a brachial paha ma nā wahi he nui. ʻO ke aʻaʻa femoral i ʻoki ʻia ke koko ma mua o 1 lita i kēlā me kēia minuke, e make ai ke koko i loko o 90 a 120 kekona wale nō, a ʻo ka wai a puni e holoi i nā ʻōpala no laila e holo ʻole ke koko. No ka mea, ʻo ka huki ʻana i kahi kanaka makua kaumaha, ʻeha, paʻa i ka wai mai loko mai o ka wai hohonu ma luna o ka pū waʻa a i ʻole ma luna o kahi alapiʻi haiki e lawe ʻia ana he 2 a 5 mau minuke, e kali ana a hiki i ka mea i hoʻopaʻa ʻia ma luna o ka papa e hoʻōki i ke koko, ʻo ia hoʻi, make ke koko i ka wā o ka hāpai ʻana. E kau i ka windlass a i ʻole ratchet tourniquet kiʻekiʻe a paʻa i ka lālā i loko o ka wai, a laila hāpai iā lākou i luna a nānā koke i ka paʻa.

E hana anei kahi tourniquet ma luna o kahi wetsuit neoprene ma hope o ka ʻeha propeller?¶

ʻAe, hiki iā ʻoe ke hoʻopili pololei i kahi tourniquet ma luna o kahi lole wai i loko o ka wai i ʻole ʻoe e hoʻopau i nā kekona makamae e hoʻāʻo e ʻoki i ka neoprene paʻa i ka wā e hehi ana i ka wai. Eia naʻe, no ka loaʻa ʻana o ka ʻūhā neoprene mānoanoa (3 mm a 7 mm) i ka huʻa a me ka wai e kahe ana i waho i ka wā e hāpai ʻia ai ka mea i hoʻopaʻa ʻia ma luna o ka papa moku, hiki i kahi tourniquet i kau ʻia ma luna o kahi lole wai hiki ke wehe iki ma hope o ke kau ʻana. E nānā koke i ka ʻeha i ka wā e paʻa ai ka mea i hoʻopaʻa ʻia ma luna o ka ʻili: inā e hoʻomau ke koko, e hoʻopaʻa hou i ke aniani makani a i ʻole e kau i ka tourniquet lua ma luna pono o ka ʻili mua ma hope o ka ʻoki ʻana i ka lole wai.

No ke aha e loaʻa koke ai nā ʻeha propeller waʻa inā e hoʻomalu ʻia ke koko?¶

ʻO nā ʻūhā wiliwili e hoʻoneʻe i ka loko, muliwai, a i ʻole ka wai moana i loko o ka ʻiʻo ʻokiʻoki a me ka iwi iwi hāmama. ʻO nā kino maoli o ka wai e hoʻopaʻa i nā bacteria ʻai ʻiʻo ʻino, ʻo ia hoʻi ʻo Aeromonas hydrophila i loko o ka wai hou a i ʻole ka wai paʻakai a me Vibrio vulnificus i loko o ka wai paʻakai mehana a me nā estuaries, e ulu nui ana i ka ʻiʻo pōloli o ka oxygen. Me ka ʻole o ka holoi ʻana i ke kaʻina hana koʻikoʻi i loko o kahi lumi hana a me nā lāʻau antibiotic intravenous ākea ākea (e hoʻohui i ka uhi ma mua o nā lāʻau antibiotic ʻili maʻamau), hiki i nā ʻeha propeller ke hoʻomohala i nā maʻi palupalu necrotizing i loko o 24 mau hola.

• Hāʻawi kēia alakaʻi i ka palekana moana, ka holo ʻana o ka moku holo, a me nā kaʻina hoʻomalu ʻana i ka hemorrhage i loko o ka wai a ʻaʻole ia e pani i ka hoʻonaʻauao palekana no ka holo moku a i ʻole ka mālama lapaʻau ʻoihana. E noʻonoʻo e lawe i kahi papa Kākoʻo Kākoʻo Kākoʻo US / RYA Powerboat a me kahi papa Stop the Bleed and First Aid ma o ke Keʻa ʻulaʻula, St John Ambulance, a i ʻole ke Kulanui o ʻAmelika Hui Pū ʻIa.*

Nā alakaʻi pili¶

• Nā pōʻino waʻa
• Hoʻokuʻi ʻia ʻo Jet Ski (PWC): no ke aha e hoʻokuʻu ai i ka throttle e make ai ka hoʻokele a me nā ʻeha orifice jet-nozzle
• ʻO ka luʻu ʻana
• Ke koko
• ʻO ka ʻoki a me ka mālama ʻana i nā lālā i ʻoki ʻia

Nā kumu a me ke alakaʻi kūhelu¶

• ʻAmelika Hui Pū ʻIa (USCG): *46 U.S.C. 4312 Pono e ʻoki ʻoki i ka ʻenekini (ECOS) Kānāwai Hoʻopaʻa ʻana i ke Kānāwai a me nā alakaʻi hoʻopaʻapaʻa hoʻopaʻapaʻa.
• Royal Yachting Association (RYA) & UK Marine Accident Investigation Branch (MAIB): Hoʻohana pololei i nā kaula pepehi ma luna o nā waʻa mana a me nā waʻa hiki ke hoʻopaʻa ʻia (RIB)
• Komite no ka Tactical Combat Casualty Care (CoTCCC) & American College of Surgeons (ACS): Hooki i ke koko: Maritime and Aquatic Tourniquet Application Protocols
• ʻO ka Wilderness Medical Society (WMS): Nā Kūlana Hoʻomaʻamaʻa Hoʻomaʻamaʻa no ka Lumo, Hoʻohaʻahaʻa, a me ka Hoʻokele Trauma Aquatic
• Nā kikowaena no ka hoʻopaʻa ʻana a me ka pale ʻana i ka maʻi (CDC, ʻAmelika Hui Pū ʻIa): Hoʻoponopono i nā maʻi Vibrio vulnificus a me Aeromonas hydrophila i nā ʻeha ʻeha wai