VESSEL POLICY
Southeast Fisheries Science Center - Miami Facility
(Updated April 2007)
I.Purpose and Scope:
The Southeast Fisheries Science Center – Miami Facility’s Small Boat Safety Program is designed to establish operational procedures that comply with US Coast Guard regulations and the requirements of NOAA Administrative Order (NAO) 217-103 (Appendix V.) to ensure the safety of the crew and passengers of SEFSC small boats. Many SEFSC research activities rely on small boats to achieve mission objectives. These directives apply to all powered small craft: Class A (<16’--R/V Dingy), Class I (16’-26--R/V Polar, R/V Privateer, R/V Miller), and Class II boats (26’-40--R/V Aldo Leopold and R/V Palmata) owned or operated by SEFSC, regardless of the geographic area of operation.
II. Vessel Operator Certification:
Only qualified NOAA employees and NOAA/University of Miami contractors are authorized to operate SEFSC - Miami vessels for official purposes. A qualified small vessel operator shall assume sole responsibility for the safe operation of the vessel but may assign other crew members to serve as helmsmen or to stand an anchor watch.
To be qualified, vessel operators must:
Be familiar with and obey the NOAA and SEFSC - Miami vessel policies. These policies shall be reviewed annually and operators shall sign a statement of understanding and compliance
(Appendix III.).
Submit proof of an approved US Coast Guard Auxiliary or US Power Squadron boating safety class, or the equivalent USCG or NOAA approved vessel operator training course. Operators holding any USGC license also qualify.
Submit proof of current CPR and First Aid certification.
Receive a familiarization checkout by the Small Boat and Diving Operations Officer (SBDOO) or Vessel Operations Coordinator (VOC) for each specific vessel to be used.
Sign a ‘Request for Permission to Drive a Non-UM Vehicle or Boat’ (Appendix IV) if the operator is a CIMAS contractor.
III. Vessel Availability, Reservations and the Online Float Plan:
A. Vessel availability – Vessel usage or precedence may be assigned at the discretion of the Division Director. All NOAA vessels are available for use by all SEFSC projects provided the following requirements are met:
Vessel is not being used by the primary project or will not be required by the primary project in the immediate future (time enough to repair any minor problems: 2-3 business days).
Vessel will be operated by a qualified NOAA small vessel operator provided by either the primary project or a lending project.
Reservations- Boats and towing vehicles may be reserved in advance through the SEFSC
Online Float Plan at: https://grunt.sefsc.noaa.gov/FloatPlan/
Users must log-on and fill out a temporary float plan for the block of time they wish to reserve.
If a boat or towing vehicle will not be needed, the reservation must be canceled promptly. Do not schedule blocks of time in advance if the need is uncertain, unless approved by the Division Director. If another user has reserved a boat or vehicle for the period of time needed, that user may be contacted or the Small Boat and Diving Operations Officer consulted for resolution of the scheduling conflict.
Online Float Plan- Users must file an Online Float Plan prior to and for each day of operations.
On the same day the vessel is to be used, place a copy of the completed float plan on a clipboard on the outside of the dive locker door. Remove the float plan at the completion of operations for the day and place it in the vessel’s clipboard log (located inside the dive locker). If plans change and the vessel or towing vehicle is not used as indicated on the Float Plan, ensure that these changes are entered into the Online Float Plan since Small Boat Fund expenditures are assigned to PI’s based on this information.
Information on the float plan shall include: name of the operator, crew and visitors, contact information, date, time of departure and estimated time of return, area of operation, type of operation, and the name of a contact person at SEFSC or your location who knows your plans and how to communicate with you (e.g., cell phone number and VHF Channel). If the trip is scheduled to return after normal working hours, confirm that the contact person is aware of this and is able to respond after hours if there is an emergency.
For multi-day trips departing from a location other than SEFSC, please contact the SBDOO or VOC ahead of time to discuss you plans. When on travel, make sure that communications with the onshore contact person are made on a daily basis.
IV. Safe Vessel Operation Requirements:
A. Equipment --The boat operator is responsible for ensuring that all US Coast Guard required safety equipment is on board and operable/sufficient:
Flare kit, first aid kit, air horn, fire extinguisher(s), PFD’s, oars/paddle, and one throwable PFD.
A complete list of required equipment by vessel class is found in NAO 217-103 (Appendix V). In addition, SEFSC policy requires on board all boats at all times:
1) Compass.
2) Manual (hand-held) bilge pump and 12V bilge pump (boats with air space between the deck and hull)
3) One console mounted and one hand-held VHF radio transceiver
4) GPS
5) Cellular telephone
6) Fresh drinking water
7) Tool kit and spare parts
8) Charts of the working area
9) Anchor w/ rode
10) EPIRB/PLB required when working more than 2 miles offshore, outside of protected sounds and bays. Recommended equipment includes: portable power source, sun block, flashlight(s), user manuals for all equipment, and adequate protective outerwear. Please see the Operations Procedures Checklist (Appendix I) for more information.
B. Operational Procedures
1) Operations Procedures Checklist (Appendix I): Keep a copy of this checklist in the towing vehicle and onboard the vessel and refer to it before initiating any operations.
2) Float Plan and Emergency Contact Information: Ensure that this information is posted and/or made available to the SBDOO, VOC or a Responsible Person for ALL crew and passengers before departing.
3) Vessel Logs: Vessel operators shall record trip details in the vessel log book, with particular attention to noteworthy pre-existing conditions, maintenance items and safety concerns. Prior to departure, the log book should be reviewed for outstanding items that have not been addressed. The operator should confer with the SBDOO to initiate an investigation or repair before using the boat.
4) Minimum and Maximum Number of Persons: At least two people are required on board a vessel during all operations, except for transiting to or from the boat trailer or fuel dock or when two vessels are operating together. The second person shall serve as a lookout when underway and assist the vessel operator as needed. Do not exceed the personnel or weight limits of the vessel, which are printed on the vessel’s placard and/or stated in the vessel’s Risk Assessment.
5) Personal Floatation Devices (PFD): A USCG or NOAA approved Personal Floatation Device (PFD) with whistle and light-emitting unit shall be worn by each person at all times that a vessel is being operated, including a vessel at anchorage. During dive operations, divers may wear a FULL wetsuit, drysuit or BCD in lieu of a PFD. SEFSC inflatable PFD’s may be signed out from the Dive Locker or are assigned to individuals that are frequently involved in small boat operations. Refer to the NOAA PFD Policy (Appendix VI) for approved PFD types.
6) Radio Usage: Operators and crew are required to monitor channel 16 while underway, unless communicating on another channel (i.e., NOAA working channel 82A).
7) Class Restrictions: Class A and Class I boats (less than 26’) are not permitted more than 7 miles offshore while operating in the ocean. Exceptions require approval by the Division Director.
8) Permits : Ensure that required sampling permits are maintained aboard during operations and that appropriate law-enforcement agencies are notified as to when and where sampling will be conducted, if necessary.
9) Prohibited Items/Activities: Alcohol is NOT permitted aboard SEFSC small boats or vehicles.
No forms of fishing gear (i.e., hand lines, rods, reels, lines, lures, jigs, hooks, bait, nets, etc.) shall be carried on SEFSC small boats, nor shall any crew engage in fishing activities unless: (1) fishing is in conjunction with a SEFSC sampling or research activity, and (2) the Division Chief has authorized the use of fishing gear and fishing activities. Other recreational-type activities that are prohibited include, but are not limited to: surfing, skiing, racing, and lobster diving.
10) Dive Operations: NOAA Dive Regulations will be followed during all scuba diving and snorkel operations. Anticipated dive profiles should be included in the Online Float Plan. An oxygen kit, diver first aid kit, dive flag and the Diving Accident Management Plan (DAMP-Appendix II) for the area of operation shall be present and accessible on board at all times. A Divemaster or lead diver will be appointed by the Unit Diving Supervisor. One person must remain topside aboard the vessel anytime divers are submerged in the water. In case of an accident, the DAMP will be followed.
11) Other Considerations: The vessel operator and crew must be familiar with the Rules of the Road, navigation, emergency procedures, and the location of emergency equipment. All vessels shall be operated at conservative speeds and in a courteous manner favorable for a good NOAA image.
If you observe another boat in distress, use good judgment when rendering assistance. NOAA small boats may be used to transport disabled boaters or to tow non-NOAA boats in order to protect the marine environment or to assist in medical emergencies or potential life-threatening situations. Protect yourself and NOAA from liability by establishing, in writing, that you are acting in good faith and cannot accept responsibility for any damages. Refer to the DAMP-Appendix II for US Coast Guard contact information.
The following incidents must be reported: 1) unintentional grounding for more than 24 hours, 2) damage to a protected natural resource, 3) discharge of oil or gasoline that causes a sheen, 4) fire and/or explosion, 5) a breach of hull integrity or significant decrease in the vessel’s seaworthiness, 6) damage in excess of $10,000, 7) extensive flooding and/or sinking, 8) an injury requiring more than basic first aid, and 9) loss of life. Follow NAO 217-103 sec 7.08.
Violations of the SEFSC Vessel Policy or Federal, state and local statutes regarding safe vessel operations will be the responsibility of the vessel operator, for which his/her qualification may be suspended or revoked following a formal investigation. Damage to a vessel due to gross operator negligence or misuse will be repaired by the associated project’s funds.
VI. Hull Identification:
SEFSC vessels need not display a Florida registration number, as they are classified as Public Domain. Follow visual identification schemes in NAO 217-103 Appendix B.
VII. Boat and Trailer Maintenance:
It is the responsibility of all users to clean and prepare each vessel, trailer, and towing vehicle for the next user and to perform minor repairs/maintenance that can be done in the field or after returning to the lab. Refer to the Operations Procedures Checklist (Appendix I). These repair and/or required maintenance actions include, but are not limited to: freshwater rinse-down of all external surfaces, proper flushing of the engine, lubrication of moving parts, topping off of gasoline tanks, plug/fuse/bulb changes, trailer lighting system repair, fluid replacement, bottom painting, gellcoat /rubrail repair, and replacement of expended or expired inventory of the required safety equipment. Report mechanical, electrical and structural problems beyond your capabilities to the SBDOO or VOC in order to coordinate repairs. If in doubt as to whether you should report a problem, DO! In most cases, minor and routine repairs will be covered by the SEFSC Small Boat Fund. If repairs must be done in a location other than at SEFSC, an ABYC Accredited or Certified boat repair shop should perform the work after approval by the SBDOO. Turn in all maintenance and required safety equipment purchase receipts to the SBDOO or VOC. Expenses for these items must be tracked in order for the cost to be distributed to all users.
During the off-season (NOV-APRIL), the primary project personal for a vessel shall be responsible for initiating a monthly vessel assessment to include preventative maintenance and exercise of the vessels engine, steering gear and other time-susceptible systems. Vessels that are used by multiple project groups shall be addressed monthly by each group on a rotational schedule, as determined by the SBDOO.
VIII. NOAA personnel on non-NOAA vessels:
Personnel should determine if the non-NOAA vessel is safe to embark by inquiring if the vessel has passed a Coast Guard safety inspection recently and contains all the required safety equipment aboard. Vessels operated under another agency will follow that agency’s regulations. Vessels that are chartered and operated by SEFSC personnel will follow NOAA and SEFSC regulations.
IX. Visitors aboard NOAA vessels:
Written authorization from the Division Director or their appointed representative must be obtained for all visitors prior to boarding a NOAA vessel. Vessel operators should list all non-governmental employees as visitors on the Float Plan (excluding CIMAS contractors and/or university students routinely involved in the project). Ensure that emergency contact information for all visitors is available onshore and aboard the vessel. To add a NOAA or CIMAS employee that is routinely involved in boating operations as an ‘employee’ or ‘user’ of the Online Float Plan, contact the SBDOO.
Appendix I: Operations Procedures Checklist
Appendix II: Diving Accident Management Plans (DAMP)
Appendix III: Vessel Operator Compliance Form
Appendix VI: Request for Permission to Drive a Non-UM Vehicle or Boat (See Small Boat and Diving Operations officer)
Located at www.sbp.noaa.gov under POLICY
Appendix VI: NOAA Personal Floatation Device (PFD) Policy
Located at www.sbp.noaa.gov
AppendixI.
OPERATIONS PROCEDURES CHECKLIST
Departing SEFSC or other location (trailering)
1). Enter Float Plan and post copy (outside of dive locker)
2). Checklist of required items:
|
Items usually kept on the vessel GPS and depth-sounder VHF (fixed) Fire Extinguisher (2 for class II vessels) Flare kit with a whistle or horn. First Aid kit Throwable PFD Drinking water and coolers with ice Tools and spare parts (boat plugs) Nautical Charts Compass Hand-held bilge pump Anchor Oars/paddles EPIRB (Class II, Class I when +7 miles offshore) |
Items obtained at SEFSC PFD’s (one per person) Vessel Log Boat keys and gas card Hand-held VHF Portable power source Cell phone Weather/Tide Reports (radio, Internet)
Dive operations only Dive Accident Management Plan Oxygen First Aid kit Dive flags and buoys Dive equipment and sampling gear |
Boat/Trailer Preparation
1). Retract foot winch fully, lock hitch ball into hitch socket and attach safety chains to the vehicle
2). Attach trailer taillight connection and test brake and directional lights
3). Check the trailer’s emergency brakes (if applicable, disengaged backing lock-out mechanism)
4). Check tire pressure (truck and trailer) and ensure trailer hubs are greased
5). Tighten tie-down straps from boat to trailer
6). Check boat batteries and raise boat motor to secure on rest-block. Turn batteries OFF if traveling far!
7). Lower bimini top and antennas (if necessary)
8). Make sure all gear is stowed properly so that it doesn’t blow out/fall off
9). Check fluids in boat and truck (steering, fuel and oil)
10). If traveling far, ensure that there is a spare trailer tire, lug wrench, trailer jack, scuba tank/LP fill whip, and spare taillight kit.
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Returning to SEFSC and Wash Down 1). Refill fuel tanks 2). Turn off all electronics 3). Battery switch to OFF 4). Remove boat plug(s) 5). Lower engine and flush for at least 5 min. 6). Wash down boat and trailer 7). Lubricate parts as necessary 8). Stow checked-out safety gear 9). Remove personal gear from boat 10). Note additional information in vessel log 11) File away Float Plan and notify onshore contact of return.
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1). Undo tie-down straps, bow-safety chain/winch hook
2). Insert boat plug(s) (if applicable)
3). Engage battery and unsecure engine from rest-block
4). Check fluids (steering, gas, and oil) and prime fuel line
5). Lower engine into the water to start
6). Check gauges and observe water circulation stream
7). Raise bimini and antenna
8). Test bilge pump
9). Test electronics (radio, cell phone, GPS, sounder)
10). Test nav lights if operating at night
11). Report appropriate information in vessel log
1
VEHICLE CHECK
OK OK
FUEL _____ LIGHTS _____
OIL _____ WIPERS / FLUID _____
POWER STEERING FLUID _____ BRAKES _____
COOLANT LEVEL _____ TIRES / PRESSURE _____
MIRRORS _____
Discrepancies: __________________________________________________________
__________________________________________________________
__________________________________________________________
TRAILER CHECK
OK OK
LIGHTS _____ TIRES / PRESSURE _____
SAFETY CHAINS _____ SPARE TIRE _____
WINCH / CABLE _____ TIE DOWNS _____
BOW SAFETY CHAIN _____ WHEEL CHOCKS _____
LICENSE PLATE _____ BUNKS/ROLLARS _____
Discrepancies: __________________________________________________________
__________________________________________________________
__________________________________________________________
Note: The vehicle operator is responsible to ensure that the vehicle and trailer are in roadworthy condition and that serious discrepancies are cleared prior to departure. All discrepancies shall be reported to the Small Boat and Diving Operations Officer or Vessel Operations Coordinator.
AppendixII.
DIVING ACCIDENT MANAGEMENT PLAN
for NOAA SEFSC Diving Ops in the Miami/Biscayne Bay, FL area
CONSCIOUS AND ALERT DIVER
ABC’s: Evaluate patient’s Airway, Breathing, and Circulation.
DIVE BUDDY—recall and evaluate all other divers.
Activate EMS: Call 911 to report the diving accident. If unable to contact 911 EMS system, contact U.S. Coast Guard Sector Miami at (305)535-4472 or hail them on VHF radio, channel 16. The EMS dispatcher will notify emergency medical land transportation. Planned destination for treatment:
Mercy Hospital, 3663 South Miami Ave, Miami FL 33133 near Coconut Grove.
Treat: Put the patient on 100% oxygen using a positive-pressure/demand oxygen resuscitator and perform First Aid as necessary.
Gather information; Evaluate the patient and gather additional information about the incident (this may be done before or during transport, depending on the severity of the case):
Perform and record results of 5-minute field neurological examination.
Record patient vitals and as much information about the dive as possible.
Interview the patient’s dive buddy for additional information.
Secure patient’s dive gear for examination. (Do not disassemble gear or exhaust any air from the diving system).
Transport the patient to Mercy Hospital, Coconut Grove for further evaluation. During transit, treat as follows:
Continue oxygen administration.
If decompression sickness is suspected, or any other type of pressure-related injury (arterial gas embolism, pneumothorax, etc.), allow the patient to remain in the position of comfort (Do not raise the patient’s legs). Place the patient on his/her side if nauseated or vomiting. Always maintain a clear airway.
If not nauseated and not experiencing altered level of consciousness, give the patient water to drink and 1 aspirin orally.
Observe patient for shock or changes in condition.
Evaluate buddy for onset of similar pressure related symptoms.
Send all information about the dive and post-dive observations with the patient to the hospital, including results of field neurological examination. If possible, the patient’s buddy should also be transported.
UNCONSCIOUS or NON-RESPONSIVE DIVER
A. ABC’s: Evaluate patient’s Airway, Breathing, and Circulation.
DIVE BUDDY—recall and evaluate all other divers.
B. Activate EMS: Call 911 or alternatives as indicated above.
C. Execute lifesaving techniques: As needed, start CPR and rescue breathing using a positive- pressure/demand oxygen regulator. Stabilize the patient as best you can for immediate transport.
D. Transport the patient to the harbor or port facilities closest to the dive site where a local ambulance or medic unit should be standing-by to evacuate the patient to Mercy Hospital Emergency Room. If possible, the patient’s buddy should also be transported. If there is a problem transporting the patient to the nearest harbor or if the time delay is significant (>2 hours), call or radio the USCG at (305)535-4472 or VHF channel 16, to arrange air evacuation of the patient. The USCG air evacuation team will coordinate with Mercy Hospital. Site personnel should review procedures and prepare for helicopter evacuation.
E. During transport, monitor ABC’s, vitals, and continue O2 administration. Gather any information about the incident and follow procedures as outlined above for treatment of a conscious diver if the patient regains consciousness.
Medical Assistance and Recompression Chamber Contact Information.
NOTE: Before commencing dive operations, the Divemaster will contact the primary recompression chamber to ensure that the chamber is operational and available to receive patients. If the primary chamber is not operational, alternate facilities should be contacted.
Primary recompression chamber facility:
Mercy Hospital, 3663 South Miami Ave. Coconut Grove, FL 33133
(800) No-Bends (662-3637) or 305-854-0300
Alternate Recompression Chambers:
1st alternate: Jackson Memorial Hospital, 1611 N.W, 12th Ave. North Wing 101, Miami, Florida, 33136.
E.R: 305-585-6901, Hyperbarics (305) 585-3483
2nd alternate: Mariners Hospital (Director Denis Holstein), mile m. 91, Tavernier/Key Largo. Hyperbarics: (305) 434-1603
After hours and weekends Mariners Hospital E.R. 305-434-1600
Contacts for Medical Advice:
CAPT Albert Exner, USPHS, Seattle, WA
Cell (206) 265-1568 or Office: 206-526-6474 or Home: 206-282-1884
DAN Duke University Medical Center, Durham, N.C.
(919) 684-8111 or 1-877-5DANPRO 24 hour emergency numbers
MOC-Pacific Medical Officer on call (206) 409-8725 (cell)
MOC-Atlantic Medical Officer on call (757) 615-6619 (cell)
DIVING ACCIDENT MANAGEMENT PLAN
for NOAA SEFSC Diving Ops in the Key Largo (Upper/Middle Keys), FL area
CONSCIOUS AND ALERT DIVER
ABC’s: Evaluate patient’s Airway, Breathing, and Circulation
DIVE BUDDY—recall and evaluate all other divers.
Activate EMS: Call 911 to report the diving accident. If unable to contact 911 EMS system, contact U.S. Coast Guard Group Marathon (305)743-6388 or Group Islamorada (305) 664-4404 or hail them on VHF radio, channel 16. The EMS dispatcher will notify emergency medical land transportation. Planned destination for treatment:
Mariners Hospital mile m. 91, Tavernier/Key Largo.
Treat: Put the patient on 100% oxygen using a positive-pressure/demand oxygen resuscitator and perform First Aid as necessary.
Gather information; Evaluate the patient and gather additional information about the incident (this may be done before or during transport, depending on the severity of the case):
Perform and record results of 5-minute field neurological examination.
Record patient vitals and as much information about the dive as possible.
Interview the patient’s dive buddy for additional information.
Secure patient’s dive gear for examination. (Do not disassemble gear or exhaust any air from the diving system).
Transport the patient to Mariners Hospital, Key Largo for further evaluation. During transit, treat as follows:
Continue oxygen administration.
If decompression sickness is suspected, or any other type of pressure-related injury (arterial gas embolism, pneumothorax, etc.), allow the patient to remain in the position of comfort (Do not raise the patient’s legs). Place the patient on his/her side if nauseated or vomiting. Always maintain a clear airway.
If not nauseated and not experiencing altered level of consciousness, give the patient water to drink and 1 aspirin orally.
Observe patient for shock or changes in condition.
Evaluate buddy for onset of similar pressure related symptoms.
Send any and all information about the dive and post-dive observations with the patient to the hospital, including results of field neurological examination. If possible, the patient’s buddy should also be transported.
II. UNCONSCIOUS or NON-RESPONSIVE DIVER
A. ABC’s: Evaluate patient’s Airway, Breathing, and Circulation.
DIVE BUDDY—recall and evaluate all other divers.
B. Activate EMS: Call 911 or alternatives as indicated above.
C. Execute lifesaving techniques: As needed, start CPR and rescue breathing using a positive- pressure/demand oxygen regulator. Stabilize the patient as best you can for immediate transport.
D. Transport the patient to the harbor or port facilities closest to the dive site where a local ambulance or medic unit should be standing-by to evacuate the patient to Mariners Hospital. If possible, the patient’s buddy should also be transported. If there is a problem transporting the patient to the nearest harbor or if the time delay is significant (>2 hours), call or radio the U.S. Coast Guard Group Marathon (305)743-6388 or Group Islamorada (305) 664-4404 or VHF channel 16, to arrange air evacuation of the patient. The USCG air evacuation team will coordinate with Mariners Hospital. Site personnel should review procedures and prepare for helicopter evacuation.
E. During transport, monitor ABC’s, vitals, and continue O2 administration. Gather any information about the incident and follow procedures as outlined above for treatment of a conscious diver if the patient regains consciousness.
III. Medical Assistance and Recompression Chamber Contact Information.
NOTE: Before commencing dive operations, the Divemaster will contact the primary recompression chamber to ensure that the chamber is operational and available to receive patients. If the primary chamber is not operational, alternate facilities should be contacted.
Primary recompression chamber facility:
Mariners Hospital (Director Denis Holstein), mile m. 91, Tavernier/Key Largo. Hyperbarics: (305) 434-1603
After hours and weekends Mariners Hospital E.R. 305-434-1600
Alternate Recompression Chambers:
1st alternate: Mercy Hospital, 3663 South Miami Ave. Coconut Grove, FL 33133 (800) No-Bends (662-3637) or 305-854-0300
2nd alternate: Special Forces Underwater Operations Group (Naval Facility) Naval Air Station Fleming Key, Key West, FL 33040, DMO Cell: 305-797-2712 (Dr. Stabile), 24 hour chamber number: (305) 293-4156
Contacts for Medical Advice:
CAPT Albert Exner, USPHS, Seattle, WA
Cell (206) 265-1568 or Office: 206-526-6474 or Home: 206-282-1884
DAN Duke University Medical Center, Durham, N.C.
(919) 684-8111 or 1-877-5DANPRO 24 hour emergency numbers
MOC-Pacific Medical Officer on call (206) 409-8725 (cell)
MOC-Atlantic Medical Officer on call (757) 615-6619 (cell)
DIVING ACCIDENT MANAGEMENT PLAN
for NOAA SEFSC Diving Ops in the Key West, FL area
CONSCIOUS AND ALERT DIVER
ABC’s: Evaluate patient’s Airway, Breathing, and Circulation
DIVE BUDDY—recall and evaluate all other divers.
Activate local EMS : Call 911 to report the diving accident. If unable to contact 911 EMS system, contact U.S. Coast Guard at (305)292-8856 or hail them on VHF radio, channel 16. The EMS dispatcher will notify emergency medical land transportation. Planned destination for treatment:
Lower Key Medical Center, 5900 College Road, Key West, FL.
Treat: Put the patient on 100% oxygen using a positive-pressure/demand oxygen resuscitator and perform First Aid as necessary.
Gather Information: Evaluate the patient and gather additional information about the incident (this may be done before or during transport, depending on the severity of the case):
Perform and record results of 5-minute field neurological examination.
Record patient vitals and as much information about the dive as possible.
Interview the patient’s dive buddy for additional information.
Secure patient’s dive gear for examination. (Do not disassemble gear or exhaust any air from the diving system).
Transport the patient to Lower Key Medical Center, Emergency Room for further evaluation. During transit, treat as follows:
Continue oxygen administration.
If decompression sickness is suspected, or any other type of pressure-related injury (arterial gas embolism, pneumothorax, etc.), allow the patient to remain in the position of comfort (Do not raise the patient’s legs). Place the patient on his/her side if nauseated or vomiting. Always maintain a clear airway.
If not nauseated and not experiencing altered level of consciousness, give the patient water to drink and 1 aspirin orally.
Observe patient for shock or changes in condition.
Evaluate buddy for onset of similar pressure related symptoms.
Send any and all information about the dive and post-dive observations with the patient to the hospital, including results of field neurological examination. If possible, the patient’s buddy should also be transported.
Based on the evaluation by the physician at Lower Keys Medical Center, the patient may be transported to an appropriate Hyperbaric Treatment Facility.
II. UNCONSCIOUS or NON-RESPONSIVE DIVER
A. ABC’s: Evaluate patient’s Airway, Breathing, and Circulation
DIVE BUDDY—recall and evaluate all other divers.
B. Activate EMS: Call 911 or alternatives as indicated above.
C. Execute lifesaving techniques: As needed, start CPR and rescue breathing using a positive- pressure/demand oxygen regulator. Stabilize the patient as best you can for immediate transport.
D. Transport the patient to the harbor or port facilities closest to the dive site where a local ambulance or medic unit should be standing-by to evacuate the patient to Lower Keys Medical Center Emergency Room. If possible, the patient’s buddy should also be transported. If there is a problem transporting the patient to the nearest harbor or if the time delay is significant (>2 hours), call or radio the USCG at 305-292-8856 or VHF channel 16, to arrange air evacuation of the patient. The USCG air evacuation team will coordinate with Lower Keys Medical Center. Site personnel should review procedures and prepare for helicopter evacuation.
E. During transport, monitor ABC’s, vitals, and continue O2 administration. Gather any information about the incident and follow procedures as outlined above for treatment of a conscious diver if the patient regains consciousness.
Medical Assistance and Recompression Chamber Contact Information.
NOTE: Before commencing dive operations, the Divemaster will contact the primary recompression chamber to ensure that the chamber is operational and available to receive patients. If the primary chamber is not operational, alternate facilities should be contacted.
Primary recompression chamber facility:
Special Forces Underwater Operations Group (Naval Facility) Naval Air Station Fleming Key, Key West, FL 33040
DMO Cell 305-797-2712 (Dr. Stabile),
24 hour chamber number: (305) 293-4156
Alternate Recompression Chambers:
1st alternate: Mariners Hospital (Director Denis Holstein), mile m. 91, Tavernier/Key Largo (305) 434-1603
After hours and weekends Mariners Hospital E.R. 305-434-1600
2nd alternate: Mercy Hospital, 3663 South Miami Ave. Coconut Grove, FL 33133 (800) No-Bends (662-3637) or 305-854-0300
Contacts for Medical Advice:
CAPT Albert Exner, USPHS, Seattle, WA
Cell (206) 265-1568 or Office: 206-526-6474 or Home: 206-282-1884
DAN Duke University Medical Center, Durham, N.C.
(919) 684-8111 or 1-877-5DANPRO 24 hour emergency numbers
MOC-Pacific Medical Officer on call (206) 409-8725 (cell)
MOC-Atlantic Medical Officer on call (757) 615-6619 (cell)
AppendixIII.
I, ___________________________, have read and fully understand all aspects of the NOAA small boat policy, NAO 217-103, and the Southeast Fisheries Science Center – Miami Lab Vessel Policy. I will follow these policies.
______________________________ ___________
Signature of vessel operator Date