Skills assessment in drowning incidents by rescuers
- Autores: Roberto J. Barcala Furelos
- Directores de la Tesis: Antonio Rodríguez Núñez (dir. tes.), Santiago Martínez Isasi (codir. tes.)
- Lectura: En la Universidade de Santiago de Compostela ( España ) en 2021
- Idioma: inglés
- Tribunal Calificador de la Tesis: Joseph Bierens . (presid.), Felipe Fernández Méndez (secret.), Robert Greif (voc.)
- Programa de doctorado: Programa de Doctorado en Investigación Clínica en Medicina por la Universidad de Santiago de Compostela
- Materias:
- Enlaces
- Tesis en acceso abierto en: MINERVA
- Resumen
- español
El ahogamiento es una de las principales causas de muerte no intencional a nivel mundial. La prevención es la mejor estrategia pero no siempre es suficiente para evitar el incidente. Cuando una persona comienza a ahogarse, la supervivencia y pronóstico van a depender en gran medida del auxilio de un rescatador. Existen cuatro perfiles de rescatadores legos. No existe descripción ni recomendación científica sobre las técnicas de rescate empleadas por rescatadores legos, por lo tanto, de forma genérica el testigo sin experiencia no debe entrar en el agua para intentar un rescate, sin embargo, aquellos rescatadores que sin entrenamiento formal cuentan con experiencia acuática, están dentro del agua en el momento del incidente y disponen de material de flotación (ej. Surfistas), pueden ser un gran activo en la mitigación del ahogamiento. En relación a los socorristas profesionales, iniciar la RCP del ahogado de forma precoz es posible en tierra y en una embarcación de rescate, adaptando las técnicas al espacio, posición del rescatador y condiciones marítimas. El uso de equipos de protección personal (EPI) supone una serie de ventajas y también limitaciones en entornos acuáticos. El uso de mantas de plástico puede ser una alternativa real para no demorar el inicio de las maniobras y no supone una disminución de la calidad de la RCP. Los métodos de recuperación activos diseñados para socorristas, promueven un reajuste fisiológico más rápido. La ES puede ser una gran alternativa de recuperación después de un rescate acuático con gran demanda física.
- English
Background and purpose Drowning is one of the leading causes of unintentional death worldwide. Prevention is the best strategy but it is not always sufficient to avoid the incident. When a person starts drowning, survival and prognosis will depend largely on the assistance of a rescuer. The objectives of this thesis were to analyze the interventions that both bystanders and professional rescuers have been known to use until now, in order to study the different strategies for the improvement of physiological conditions on the basis of simulation-controlled studies and to evaluate the optimization of resuscitation techniques on board rescue boats, both before and during the COVID-19 pandemic.
Material and methods Six scientific publications make up this thesis. The first two papers are conceptual and descriptive, namely: a systematic literature review (PRISMA) and an expert consensus guide based on the COVID-19 literature review. The remaining 4 articles are controlled simulation studies with lifeguards, innovative in methodology, in which physiological, perceptual and skill aspects were analyzed during cardiopulmonary resuscitation (CPR) in case of drowning.
Results Four profiles of lay rescuers have been identified, with different skill levels, and risk gradation has been established according to the rescue technique used.
In professional lifeguards, the effect of electrostimulation (ES) on the recovery process after a rescue was found to be better than passive recovery.
The feasibility of cardiopulmonary resuscitation maneuvers has been verified by navigating on a rescue water craft (RWC).
In situations with risk of airborne transmission of aerosols containing infectious agents, the use of plastic blankets improves intervention start times without reducing the quality of CPR.
Conclusions The conclusions related to the hypotheses are summarized in the following three paragraphs: There are different profiles of lay-rescuers. There is no scientific description of recommended water rescue techniques for lay-people; therefore in general the lay-rescuer should not enter the water to attempt a rescue. However, lay-rescuers with aquatic experience who are in the water (e.g. surfers) can be a great asset in drowning mitigation.
In relation to professional lifeguards, initiating CPR of the drowning victim early is possible on land and on a rescue vessel by adapting known techniques to the space, rescuer position and sea conditions. The use of personal protective equipment (PPE) has a number of advantages as well as limitations in aquatic environments. The use of a plastic blanket may be an alternative to delay the start of maneuvers without diminishing the CPR quality.
Active recovery methods designed for professional rescuers promote faster physiological readjustment. Electrostimulation may be an alternative for recovery after a physically demanding rescue.
- español
