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TACTICAL MEDICINE TACMED España

TACTICAL MEDICINE TACMED España
by EMS SOLUTIONS INTERNATIONAL

NIVEL DE ALERTA ANITERRORISTA, España

Facebook EMS SOLUTIONS INTERNATIONAL

viernes, 7 de julio de 2017

Requirements to be Remote, International Medicine and Offshore Medicine. OIL Industry BOSIET and FOET


Remote and International Medicine
Offshore Medicine
***English is the official language***

1. Medical License more than 5 years graduate 


2. Medical License Number and Insurance 


3. Passport


4. Seman´s Book


5. Basic Offshore Safety Induction and Emergency Training (BOSIET)


From the original creators of the MIRA course, comes another industry-leading programme specifically designed for medical practitioners operating in challenging environments.

Incorporating the best elements of MIRA with the new gold standard FREC Level 3 syllabus, the ground-breaking course will challenge the most seasoned remote/hostile environment/expedition medic.
Students who pass the course will leave with updated and new skills as well as 2 accredited certificates from QUALSAFE and the ROYAL COLLEGE OF SURGEONS EDINBURGH respectively.
The course has been designed by Industry and Special-Forces veterans, providing only credible and ‘Real-World’ knowledge and skills to participants, trimming the fat off most courses currently available. We focus on both gold-standard and improvised techniques.
The FREC/MIRA Level 3 combined course includes:
– Roles/Responsibilities of the remote medic
– Catastrophic haemorrhage management
– Advanced airway management including surgical airways
– Chest injury management
– Shock management including sternal intra-osseous access
– Management of fractures/dislocations/sprains/strains
– Minor injury management
– Intermediate life support of adult/paediatric/infant/third trimester pregnant patients
– Altitude and Polar medicine
– Jungle and Desert medicine
– Poisons
– Burns & scalds
– Remote pharmacology
– Triage and mass casualty incidents in the remote setting
– Prolonged fieldcare
– Bites & stings (with industry experts and live specimens)
– The most immersive moulages currently available in the UK

The course includes over 13 hours of practical scenarios and moulages, ensuring each participant receives the finest one-to-one training, benefitting from our Instructor’s knowledge and experiences.

Overview
This training program is designed to meet the initial offshore safety and emergency response training requirements for personnel new to the offshore oil & gas industry.
The OPITO-approved Basic Offshore Safety Induction and Emergency Training (BOSIET) course provides students with a range of knowledge and skills relevant to working offshore and the proper emergency response procedures to include: safety induction, fire safety and self rescue, helicopter safety and escape, and sea survival inclusive of TEMPSC and first aid.
Course Length: 24 hrs

Course Price: ******

The Standard: The OPITO standards are a set of training and/or competence standards, produced and agreed by the offshore oil and gas industry covering a variety of offshore emergency response duties and occupational roles.
This course is accepted in most regions of the world where oil and gas industries operate.
Aim: The BOSIET will also equip students with the knowledge, skills, and confidence to respond appropriately in the event of an offshore emergency and to enhance their survivability through proper use of emergency equipment and procedures.
Course Objectives
The objectives of the BOSIET training are that students will be able to:
  • Identify the generic hazards which are specific to offshore oil & gas installations, potential risks associated with those hazards, and how controls are put in place to eliminate or reduce risks.
  • Identify key offshore related safety regulations and explain the basic safety management concepts.
  • Demonstrate, in a simulated environment, that they can use the safety equipment and follow procedures in preparing for, and during, helicopter emergencies - with particular focus on escaping from a helicopter following ditching.
  • Demonstrate sea survival and first aid techniques.
  • Demonstrate that they can effectively use basic firefighting equipment, and practice self-rescue techniques in low visibility situations, including smoke filled areas.
Topics Covered
MODULE 1 Learning Outcomes: Safety Induction
To successfully complete this module, students must be able to:
  • Identify the main offshore hazards and hazard effects/consequences; explain their associated risks, and how they are controlled.
  • Explain the potential environmental impact of offshore installation operations.
  • Identify key offshore installation safety regulations and explain the basic concept of these regulations.
  • Explain the principles of managing safety on offshore installations.
  • State the procedure for prescribed medicines offshore.
  • Explain the concept of alcohol and substance abuse policy.
  • Explain PPE requirements of working on an offshore installation.
  • Explain how to report incidents, accidents, and near misses on an offshore installation.
  • Explain the role of the offshore medic.
MODULE 2 Learning Outcomes: Helicopter Safety and Escape
To successfully complete this module, students must be able to demonstrate:
  • Donning an aviation transit suit, aviation lifejacket, and Emergency Breathing System (EBS) equipment and conducting EBS integrity checks.
  • Actions to take in preparation for a helicopter ditching and an emergency landing.
  • Actions following a controlled emergency descent to a dry landing with evacuation via a nominated exit.
  • Deployment, operation and breathing from the EBS in a pool utilizing personal air prior to Helicopter Underwater Escape Training (HUET) exercises.
  • Actions following a controlled ditching on water (including deploying the EBS and, on instruction from aircrew, operation of a push out window) and evacuation through a nominated exit to an aviation life raft.
  • Assisting others where possible in carrying out initial actions on boarding the aviation life raft, including mooring lines, deploying the sea anchor, raising the canopy and raft maintenance.
  • Escaping through a window opening which is underwater, from a partially submerged helicopter.
  • Escaping through a window opening which is underwater, from a partially submerged helicopter utilizing EBS.
  • Escaping through a window opening which is underwater, from a partially submerged helicopter utilizing an EBS and operating a push-out window.
  • Escaping through a window opening which is underwater, from a capsized helicopter
  • Escaping through a window opening which is underwater, from a capsized helicopter utilizing EBS.
  • Escaping through a window opening which is underwater, from a capsized helicopter utilizing an EBS and operating a push-out window.
  • Inflating an aviation lifejacket and deploying a spray visor in water.
  • Boarding an aviation life raft from water.
MODULE 3 Learning Outcomes: Sea Survival and First Aid
To successfully complete this module, delegates must be able to demonstrate:
  • Donning of a permanent buoyancy lifejacket prior to use in an emergency.
  • The correct actions when mustering and boarding a survival craft (Totally Enclosed Motor Propelled Survival Craft: TEMPSC) as a passenger during launching operations.
  • Fitting of a helicopter strop and correct body posture during winching.
  • Individual and group sea survival techniques, to include: swimming, getting into Heat Escape Lessening Position (HELP), wave-slap protection, towing, chain, huddle and circle.
  • Boarding a marine life raft from the water.
  • Immediate first aid actions, to include: Airway Breathing & CPR (ABC).
MODULE 4 Learning Outcomes: Firefighting and Self-Rescue
To successfully complete this module, delegates must be able to demonstrate:
  • Correct use of hand-held portable fire extinguishers and which ones to use for different classes of fires.
  • Self-rescue techniques with a smoke hood from areas where visibility is reduced due to smoke.
  • Self-rescue techniques with a smoke hood from areas where visibility is completely obscured.
  • Small group escape techniques with a smoke hood from areas where visibility is completely obscured.
Prerequisite
Training and assessment activities contained within this standard include physically demanding and potentially stressful elements. All personnel who participate in such activities must be physically and mentally capable of participating fully. Prior to participating in practical exercises, the student must be fit for training* and able to:
  • Hold their breath underwater for 10 seconds.
  • Move through water using their arms.
  • Wear and use a lifejacket and survival suit in a pool.
  • Re-breathe using an EBS for up to 30 seconds.
  • Sit in class for up to 60 minutes per session.
  • Step into a pool from a height of 1m / 3.2ft.
  • Use upper body muscles (lifting and pulling actions)when climbing in/out of a life raft.
  • Lift and operate a 12 kg / 26.5 lbs. fire extinguisher.
  • Wear a smoke hood in a potentially warm environment.
*Safety First: Safety Management Systems (SMS)regards your safety first and suggests the following: Candidates that are concerned with  participating in practical exercises due to current or pre-existing medical conditions should consult their primary care provider prior to the onset of the training program as to the nature and extent of the training.
All students must produce the following prior to the onset of training:
  • Valid (photographic) government identification
Written exam: Students will be required to take a 30-minute written test at the end of Module 1 as a method of checking that they have met all the Module 1 learning outcomes. It is an open-book test. A minimum test score of 80% is required.
SMS staff will deliver a series of explanations and demonstrations to deliver the BOSIET program. Delegates will be assessed against the learning outcomes specified by using direct observation, oral, and written questions
SMS staff will identify any gaps in students' learning and make reasonable effort to address the gaps to help students meet the learning outcomes.
Attendance Requirements: Daily attendance and 100% participation of each module is required to obtain BOSIET certification.
Course Administration: Each registrant will be registered with the Central Register (CR) operated by OPITO.
Retraining: Every four years (reference FOET).
Location: Only offered at our Lafayette location.

6. Advanced Cardiac Life Support-AHA


7. ATLS/PHTLS Trauma Course


8. OSHA Injury/ Illnes Initial Record Managment


9. MLC 2006 Medical Certificate https://www.gov.uk/government/publications/msn-1839m-maritime-labour-convention-2006-medical-certification


10. Full english speaker


11. Training (Instructor) CPR-AED, First Aid. 


12. knowledge of hygiene inspection


13. Air Medical Evacuation Training MEDEVAC



Air Medicial Medicine MEDEVAC
Offshore Helicopter EMS Operations
Credits EMSWORLD Magazine   


It is licensed in the state of Louisiana as an air ambulance, but this is not your typical air ambulance—not in its size or the scope of its mission. Its fuselage is 56 feet long with a rotor diameter of 56 feet. Its maximum weight is 26,000 lbs. The cabin is 20 feet long, six feet wide and six feet high. It has a maximum speed of 190 mph. Its mission is to provide medical and rescue services to the offshore oil industry in the Gulf of Mexico.

Vital Statistics

The helicopter is a Sikorsky S-92, and it’s crewed by five people: a pilot, copilot, flight medic and two rescue specialists. It is based in Galliano, LA, and operated by CHI Aviation. The operation is run on a subscription basis for oil companies with platforms in the Gulf of Mexico. CHI also has an AgustaWestland AW139 helicopter it uses for the same mission on an ad hoc basis for customers without subscription contracts for the S-92. They also get rescue assignments from the U.S. Coast Guard. Both ships are crewed 24/7.

The contract covers personnel on oil platforms, the ships that supply the platforms and the helicopters that transport the workers to and from the platforms. Containing one of the world’s largest oil fields, the Gulf of Mexico has about 5,000 oil-related structures, supported by dozens of supply ships and a fleet of over 400 helicopters. In 2014 these helicopters made 740,000 flights over the gulf and transported two million passengers.

“We use the S-92 because of its range, speed and payload capabilities,” explains David Jacob, CHI’s director of offshore operations and a longtime paramedic. “Some of the platforms are 200 miles or more offshore. We can carry a huge amount of rescue gear. Our rescue specialists are certified in vertical rope, confined-space and hazardous-atmosphere rescue. We can also rescue all of the passengers of the largest helicopters used for offshore transport if one ditches in the gulf.”

The S-92 is one of the newest helicopter designs. It has an all-glass electronic display instrument panel that incorporates the latest flight control, navigation, communication and engine systems. The helicopter can perform rescue missions day or night and in bad weather. It has a color weather radar that can also detect the oil platforms. It has dual GPS systems for navigation.

It also has forward-looking infrared (FLIR) and low-light television cameras in a gyrostabilized turret under the nose. The helicopter can be used as an airborne command post for an incident on an oil platform. Its crew can record and transmit imagery, and an oil company representative can be on board and talk with his personnel via the satellite phone in the cabin. They can also use it to see hot spots on an oil platform in case of a fire.

Another feature is a sophisticated autopilot system customized for search and rescue missions. It can automatically come to a 50-foot hover at any location specified by the pilot. Search patterns can be programmed and flown by the autopilot coupled to the GPS system to maximize search coverage. It is also equipped with dual rescue hoists in case one fails.

The facilities at Galliano are high-tech. The hangar is climate-controlled, which is especially important in the summer, with its high temperatures and humidity. The base has its own power supply, and the hangar is rated for a Category 3 hurricane.

Staffing and Training

It is licensed in the state of Louisiana as an air ambulance, but this is not your typical air ambulance—not in its size or the scope of its mission. Its fuselage is 56 feet long with a rotor diameter of 56 feet. Its maximum weight is 26,000 lbs. The cabin is 20 feet long, six feet wide and six feet high. It has a maximum speed of 190 mph. Its mission is to provide medical and rescue services to the offshore oil industry in the Gulf of Mexico. Vital Statistics The helicopter is a Sikorsky S-92, and it’s crewed by five people: a pilot, copilot, flight medic and two rescue specialists. It is based in Galliano, LA, and operated by CHI Aviation. The operation is run on a subscription basis for oil companies with platforms in the Gulf of Mexico. CHI also has an AgustaWestland AW139 helicopter it uses for the same mission on an ad hoc basis for customers without subscription contracts for the S-92. They also get rescue assignments from the U.S. Coast Guard. Both ships are crewed 24/7. The contract covers personnel on oil platforms, the ships that supply the platforms and the helicopters that transport the workers to and from the platforms. Containing one of the world’s largest oil fields, the Gulf of Mexico has about 5,000 oil-related structures, supported by dozens of supply ships and a fleet of over 400 helicopters. In 2014 these helicopters made 740,000 flights over the gulf and transported two million passengers. “We use the S-92 because of its range, speed and payload capabilities,” explains David Jacob, CHI’s director of offshore operations and a longtime paramedic. “Some of the platforms are 200 miles or more offshore. We can carry a huge amount of rescue gear. Our rescue specialists are certified in vertical rope, confined-space and hazardous-atmosphere rescue. We can also rescue all of the passengers of the largest helicopters used for offshore transport if one ditches in the gulf.” The S-92 is one of the newest helicopter designs. It has an all-glass electronic display instrument panel that incorporates the latest flight control, navigation, communication and engine systems. The helicopter can perform rescue missions day or night and in bad weather. It has a color weather radar that can also detect the oil platforms. It has dual GPS systems for navigation. It also has forward-looking infrared (FLIR) and low-light television cameras in a gyrostabilized turret under the nose. The helicopter can be used as an airborne command post for an incident on an oil platform. Its crew can record and transmit imagery, and an oil company representative can be on board and talk with his personnel via the satellite phone in the cabin. They can also use it to see hot spots on an oil platform in case of a fire. Another feature is a sophisticated autopilot system customized for search and rescue missions. It can automatically come to a 50-foot hover at any location specified by the pilot. Search patterns can be programmed and flown by the autopilot coupled to the GPS system to maximize search coverage. It is also equipped with dual rescue hoists in case one fails. The facilities at Galliano are high-tech. The hangar is climate-controlled, which is especially important in the summer, with its high temperatures and humidity. The base has its own power supply, and the hangar is rated for a Category 3 hurricane. Staffing and Training

“Acadian Ambulance provides the paramedics for our operation,” Jacob says. “They also provide all the medical equipment, protocols, 24-hour online medical control, and dispatching and flight-following services. We can use Acadian’s aircraft to back us up, and we may handle a local call for them with our AW139. Acadian ground operations span from Mississippi to Texas, so if we need additional equipment or personnel for an MCI, we can get them from Acadian ground ambulances.”

“The flight medics do not go through the rope and confined-space rescue training,” says flight paramedic Anthony Cramer, Jr., who is also an RN. “We do go through hoist training. In water rescues, the rescue swimmer would deploy and bring the patient into the helicopter, where the flight medic would then begin treatment. If the patient is on land, a vessel or an oil platform, the flight medic would be hoisted down to the victim, as well as a rescue specialist. There are always two people going down to the patient.

“The flight medics have a good working relationship with the rescue specialists. We pretty much live together when we’re on duty. The rescue specialists have a varied amount of medical training. The minimum is EMR, but many are EMTs and paramedics. They can work on the patient under the direction of the flight medic. Since we work so much together, they can anticipate the flight medics’ needs. It is just like a crew in the back of an ambulance.

“The flight medics work under the same protocols as the Acadian Air Med flight crews, which are pretty extensive. We can do RSI, CPAP and 12-lead ECG, and we carry a ventilator. We can initiate a lot of treatment before arrival at the hospital because of our long transport times. They have a protocol for what they call chemical extrication. They use it in case they have a patient who is trapped by machinery or has a difficult extrication from where they fell. They use etomidate as a hypnotic sedative. The patient isn’t aware and has no memory of the event afterward.

“Our calls run the gamut from trauma to medical,” explains Cramer. “There is a lot of heavy machinery and moving heavy equipment on oil platforms. We have all the medical-type calls found in any community. One of our biggest complaints is chest pain. We do 12-leads and can send them to the hospital while we’re en route. We also carry beta blockers and IV nitrates for STEMI patients. Once the hospital has the 12-lead, the ED doctor and cardiologist decide whether to bypass the ER and send the patient directly to the cath lab when we land. We have done that several times with very good results. If we need to talk with medical control for orders or to contact the receiving facility, we have a satellite phone as part of the communications suite on the helicopter.

“Acadian Air Med has a QA/QI process, and we are part of that as well. Our charts get reviewed like any other Air Med chart. We can also use the Air Med quality improvement coordinator for advice and opinions on patient care issues that occur. Our flight medics are all very experienced, and most have come from the Air Med side of Acadian. We work seven-on, seven-off, and many work shifts for Air Med to get more volume and keep their skills fresh.

“An MCI is a real possibility on oil platforms. Do people just need to be moved off a platform because it is on fire or in danger of sinking? Or was there an event that created a large number of casualties? If there is a medic stationed on the platform, he or she will have done the initial triage by the time the helicopter arrives. If not, we can begin to do the triage and packaging for transport. We might move victims to another close platform with medics on it and transport the more serious patients to shore. We can also use our AW139, and Air Med might be able to send some of their helicopters offshore to platforms. We can also pick up some Acadian Air Med crews and their gear on the way out to a known MCI.”

Due to the size and weight of the S-92, the crew may have to land at an airport near the hospital and have a ground ambulance transport the patient and flight medic from there. They’ll go to the most appropriate facility for the patient’s condition—STEMI center, stroke center, trauma center, burn center, etc. The dispatch center, which is Acadian’s, finds the closest, most appropriate destination so the crew doesn’t have to “shop” for a receiving facility.

“Almost 100% of our pilots and rescue specialists have military search and rescue experience,” says Jacob. “We have U.S. Air Force pararescuemen and rescue pilots, U.S. Coast Guard rescue swimmers and pilots, and U.S. Navy pilots and rescue swimmers. There is a large amount of trust among the crews because of that. We know we will revert to our military training when things get challenging. The crews rely on their crew resource management training, which they all had in the military. We all know how to communicate effectively in stressful situations.”

A Hazardous Environment

“Acadian Ambulance provides the paramedics for our operation,” Jacob says. “They also provide all the medical equipment, protocols, 24-hour online medical control, and dispatching and flight-following services. We can use Acadian’s aircraft to back us up, and we may handle a local call for them with our AW139. Acadian ground operations span from Mississippi to Texas, so if we need additional equipment or personnel for an MCI, we can get them from Acadian ground ambulances.” “The flight medics do not go through the rope and confined-space rescue training,” says flight paramedic Anthony Cramer, Jr., who is also an RN. “We do go through hoist training. In water rescues, the rescue swimmer would deploy and bring the patient into the helicopter, where the flight medic would then begin treatment. If the patient is on land, a vessel or an oil platform, the flight medic would be hoisted down to the victim, as well as a rescue specialist. There are always two people going down to the patient. “The flight medics have a good working relationship with the rescue specialists. We pretty much live together when we’re on duty. The rescue specialists have a varied amount of medical training. The minimum is EMR, but many are EMTs and paramedics. They can work on the patient under the direction of the flight medic. Since we work so much together, they can anticipate the flight medics’ needs. It is just like a crew in the back of an ambulance. “The flight medics work under the same protocols as the Acadian Air Med flight crews, which are pretty extensive. We can do RSI, CPAP and 12-lead ECG, and we carry a ventilator. We can initiate a lot of treatment before arrival at the hospital because of our long transport times. They have a protocol for what they call chemical extrication. They use it in case they have a patient who is trapped by machinery or has a difficult extrication from where they fell. They use etomidate as a hypnotic sedative. The patient isn’t aware and has no memory of the event afterward. “Our calls run the gamut from trauma to medical,” explains Cramer. “There is a lot of heavy machinery and moving heavy equipment on oil platforms. We have all the medical-type calls found in any community. One of our biggest complaints is chest pain. We do 12-leads and can send them to the hospital while we’re en route. We also carry beta blockers and IV nitrates for STEMI patients. Once the hospital has the 12-lead, the ED doctor and cardiologist decide whether to bypass the ER and send the patient directly to the cath lab when we land. We have done that several times with very good results. If we need to talk with medical control for orders or to contact the receiving facility, we have a satellite phone as part of the communications suite on the helicopter. “Acadian Air Med has a QA/QI process, and we are part of that as well. Our charts get reviewed like any other Air Med chart. We can also use the Air Med quality improvement coordinator for advice and opinions on patient care issues that occur. Our flight medics are all very experienced, and most have come from the Air Med side of Acadian. We work seven-on, seven-off, and many work shifts for Air Med to get more volume and keep their skills fresh. “An MCI is a real possibility on oil platforms. Do people just need to be moved off a platform because it is on fire or in danger of sinking? Or was there an event that created a large number of casualties? If there is a medic stationed on the platform, he or she will have done the initial triage by the time the helicopter arrives. If not, we can begin to do the triage and packaging for transport. We might move victims to another close platform with medics on it and transport the more serious patients to shore. We can also use our AW139, and Air Med might be able to send some of their helicopters offshore to platforms. We can also pick up some Acadian Air Med crews and their gear on the way out to a known MCI.” Due to the size and weight of the S-92, the crew may have to land at an airport near the hospital and have a ground ambulance transport the patient and flight medic from there. They’ll go to the most appropriate facility for the patient’s condition—STEMI center, stroke center, trauma center, burn center, etc. The dispatch center, which is Acadian’s, finds the closest, most appropriate destination so the crew doesn’t have to “shop” for a receiving facility. “Almost 100% of our pilots and rescue specialists have military search and rescue experience,” says Jacob. “We have U.S. Air Force pararescuemen and rescue pilots, U.S. Coast Guard rescue swimmers and pilots, and U.S. Navy pilots and rescue swimmers. There is a large amount of trust among the crews because of that. We know we will revert to our military training when things get challenging. The crews rely on their crew resource management training, which they all had in the military. We all know how to communicate effectively in stressful situations.” A Hazardous Environment

Oil platforms are built like ships, with compartments, vertical ladders and complex machinery. Dangerous chemicals and gases like methane and hydrogen sulfide are common, so the rescue specialists can extricate people from hazardous atmospheres with low oxygen using air tanks. They can also do vertical rope rescue for victims of falls or others who cannot use the ladders inside the platforms.

Hoist missions in the water and bayous have their own set of unique hazards. “In addition to looking for the normal hazards for a helicopter hoist operation, we are also looking for natural hazards such as sharks and alligators,” says Mike Fout, a rescue specialist instructor and former U.S. Navy rescue swimmer. “We also look for debris or contaminants in the water. In addition, we have to think about the sea state and water temperature. For contaminants, we will minimize our time in the water and use a direct-deployment rescue method where we’re never unhooked from the hoist cable. We also have dry suits we put on to minimize skin exposure.”

Many of the rescue specialists had this training in the military, but all of them are current with the necessary civilian certifications for these skills. They have to recertify every two years on all of them. They also adhere to international standardized training and hold internationally recognized certifications for their rescue skills. All the paramedics are nationally registered and certified by the states of Louisiana and Texas.

“When we’re first hired, we get qualified in one position on the team, and then we get dual-qualified with time as both hoist operators and rescue swimmers,” Fout says. “The goal is to have all rescue specialists dual-qualified.

“In addition to maintaining currency with the different helicopter deployment methods, day and night, we also have confined-space and vertical rope rescue training to stay current with. We do a lot of training. We try not to be idle. We will pull out our confined-space and rope rescue gear a couple times a week and train. Our hangar is about three stories high inside, and we can practice vertical rope rescue techniques in there.

“A new person gets qualified on the aircraft first and then is sent to different rescue schools. We work with Roco Rescue, which specializes in industrial rescue training, for high-angle rope and confined-space rescue training. Medical training is done by Acadian Ambulance.”

There is an instructor cadre that includes hoist operators and rescue swimmers who meet regularly to discuss new gear and new procedures they might want to adopt. If a new piece of equipment looks promising, they will get it and test it both in a static environment in the hangar and then with the aircraft.

The instructor cadre also meets to decide on future training needs, updates that might be needed in the process, and any improvements to the operation they might be able to make. They also look at how other civilian and military rescue units do things to see if they might want to add to or adjust their program.

“We are fortunate enough to have a large cross-section of military rescue experience,” says Fout. “Each brings their own experiences we can look at to see if something would be a good fit here.”

Conclusion

CHI’s S-92 helicopter is a combination rescue truck and critical care transport ambulance. It can handle rescue and medical incidents on ships, oil platforms and in the bayous and open water of the Gulf of Mexico. All of the people interviewed by EMS World said there is no better air ambulance and rescue helicopter anywhere in the world.

Barry D. Smith is an instructor in the Education Department at the Regional Emergency Medical Services Authority (REMSA) in Reno, NV. Contact him at bsmith@remsa-cf.com.

Oil platforms are built like ships, with compartments, vertical ladders and complex machinery. Dangerous chemicals and gases like methane and hydrogen sulfide are common, so the rescue specialists can extricate people from hazardous atmospheres with low oxygen using air tanks. They can also do vertical rope rescue for victims of falls or others who cannot use the ladders inside the platforms. Hoist missions in the water and bayous have their own set of unique hazards. “In addition to looking for the normal hazards for a helicopter hoist operation, we are also looking for natural hazards such as sharks and alligators,” says Mike Fout, a rescue specialist instructor and former U.S. Navy rescue swimmer. “We also look for debris or contaminants in the water. In addition, we have to think about the sea state and water temperature. For contaminants, we will minimize our time in the water and use a direct-deployment rescue method where we’re never unhooked from the hoist cable. We also have dry suits we put on to minimize skin exposure.” Many of the rescue specialists had this training in the military, but all of them are current with the necessary civilian certifications for these skills. They have to recertify every two years on all of them. They also adhere to international standardized training and hold internationally recognized certifications for their rescue skills. All the paramedics are nationally registered and certified by the states of Louisiana and Texas. “When we’re first hired, we get qualified in one position on the team, and then we get dual-qualified with time as both hoist operators and rescue swimmers,” Fout says. “The goal is to have all rescue specialists dual-qualified. “In addition to maintaining currency with the different helicopter deployment methods, day and night, we also have confined-space and vertical rope rescue training to stay current with. We do a lot of training. We try not to be idle. We will pull out our confined-space and rope rescue gear a couple times a week and train. Our hangar is about three stories high inside, and we can practice vertical rope rescue techniques in there. “A new person gets qualified on the aircraft first and then is sent to different rescue schools. We work with Roco Rescue, which specializes in industrial rescue training, for high-angle rope and confined-space rescue training. Medical training is done by Acadian Ambulance.” There is an instructor cadre that includes hoist operators and rescue swimmers who meet regularly to discuss new gear and new procedures they might want to adopt. If a new piece of equipment looks promising, they will get it and test it both in a static environment in the hangar and then with the aircraft. The instructor cadre also meets to decide on future training needs, updates that might be needed in the process, and any improvements to the operation they might be able to make. They also look at how other civilian and military rescue units do things to see if they might want to add to or adjust their program. “We are fortunate enough to have a large cross-section of military rescue experience,” says Fout. “Each brings their own experiences we can look at to see if something would be a good fit here.” Conclusion CHI’s S-92 helicopter is a combination rescue truck and critical care transport ambulance. It can handle rescue and medical incidents on ships, oil platforms and in the bayous and open water of the Gulf of Mexico. All of the people interviewed by EMS World said there is no better air ambulance and rescue helicopter anywhere in the world. Barry D. Smith is an instructor in the Education Department at the Regional Emergency Medical Services Authority (REMSA) in Reno, NV. Contact him at bsmith@remsa-cf.com.

ADVANCED AIR MEDICAL
 This program is available to those that are seeking advancement into air ambulance transportation. Medical Personnel that qualify to perform air ambulance transport will find this course informative and direct. This class follows the DOT 40-hour program and is one day of class with homework to return.

To take this course

14. Safety Audit


15. Knolege about develop MERP Medical Evacuation Response Plans



Ship Drill Rig Offshore 


16. Multicultural Knolege 


17. Tropical Medicine


18. Alcohol and Drug Tets


19. International Medicine


20. excellent fitness


22. To work offshore USA the Visa B1 OCS



B-1/OCS visas are issued to crewmembers of international vessels operating on the Outer Continental Shelf or Gulf of Mexico for more than 29 days.  In determining who qualifies for the B-1/OCS visa, Consular Officers take into consideration the individual’s responsibilities and activities on the ship, shipyard, or platform.
How To Apply   
      
To apply, please comply with the Nonimmigrant Visa Application ProceduresB-1/OCS applicants must select C1/D as their purpose of travel on the DS-160 application form.  The applicant should bring these documents to the interview in case the consular officer requests to see them.    
  1. Letter from the U.S. Coast Guard granting an exemption from the Outer Continental Shelf Lands Act Amendments in accordance with 33 CFR 141
  2. Seafarer’s Identification and Record Book (SIRB) issued by the Philippine Department of Transportation and Communication’s Maritime Authority (MARINA) 
  3. Seafarer’s Registration Card (SRC) issued by the Philippine Overseas Employment Administration (POEA), with attached signed photo
  4. First page of the original valid Overseas Employment Commission Certification (OEC) issued by the POEA or a POEA in-house processed OEC issued by certified agencies
  5. Seafarer recruitment agency guarantee letter with signature and all appropriate information; each seafarer must be issued an individual guarantee letter with each application. 
  6. Employment history – applicant’s job experience from age 21 up to present 
  7. All seaman’s books that have expired in the past ten years and any additional seaman’s book or passport which contains a U.S. visa 
  8. Signed and valid contract of employment in POEA format 
  9. Original Basic Safety Course (BSC) training certificate with Personal Safety and Social Responsibility (PSSR) (photocopies are not accepted) 
  10. College transcripts and diplomas (first-time seafarers) 
  11. Certifications of training (first-time seafarers) 
  12. Employment certification letters from previous employers (first-time seafarers)
  13. For seafarers taking unusual or uncommon seafaring positions, seafarer recruitment agencies must provide a complete job description and indicate whether the position is a temporary or permanent component of the ship’s crew.  In some circumstances, seafarer applicants may be requested to submit a complete itinerary for the vessel.
  14. Copy of the Appointment Confirmation letter. 
Notes:  
  • In certain cases, additional documents may be requested. 
  • All documents must be originals.  Photocopies will not be accepted, unless specified.  The applicant must submit these documents to the interviewing consular officer during the interview. The Nonimmigrant Visa Unit does not accept documents before the interview. Any documents received will not be returned and will be destroyed. Please note, however, that presentation of the documents will not guarantee visa issuance. Applicants must still qualify for the type of visa being sought. 
Guidelines for Document Submission    
      
Every seafarer recruitment agency should carefully check all seafarer applications prior to submission to ensure the form has been filled out correctly and completely. Incomplete applications will be denied.  Follow these guidelines when submitting documents: 
  • Remove plastic covers or jackets from SIRBs and passports.    
  • Remove excess papers and staples. 
  • The guarantee letter must be stapled to the back of the application form. All guarantee letters must follow the format described in the instructions found in the Embassy accreditation kit. Guarantee letters not in the correct format or without required information will not be accepted. 
  • The SRC must be attached to the inside front cover of the SIRB.
  • The POEA approved or in-house processed contract of employment and OEC must be stapled together inside the back cover of the seaman’s book. Original documents including the contract, OEC and SRC will be returned to the seafarer after the application is processed.
Note: The seafarer recruitment agency must contact the call center to make any corrections to inaccurate information before the applicant’s interview. 
B-1 Yacht Visas   
      
B-1 visas are issued to qualified applicants going to work on privately owned yachts.  A B-1 visa will permit applicants to stay in the United States or U.S. coastal waters for more than 29 days.  If you will be working on a privately owned yacht, you must comply with the Nonimmigrant Visa Application Procedures and comply with both the seafarer (C-1/D) and working visa (B-1) requirements.  B-1 Yacht applicants must select C1/D as their purpose of travel on the DS-160 application form.
Applicants going on privately owned yachts must present detailed information about the yacht (e.g. yacht specifications) and yacht owner (e.g. contact information) and must present the yacht’s itinerary at the time of interview.   
Helpful Links to Visit: 





OPITO Basic Offshore Safety Induction and Emergency Training - BOSIET





Information courtesy:





TELEFUNKEN AED (Totalmente Europeo)
DISPONIBLE EN TODA AMERICA
6 AÑOS DE GARANTIA (ECONOMICO)

Si utilizas el aparato en un paciente solo con enviar la data del aparato ENVIAMOS GRATIS PARCHE Y BATERIA (Nadie en el Mundo hace algo asi)

TELEFUNKEN AED DISPONIBLE EN TODA AMERICA 6 AÑOS DE GARANTIA (ECONOMICO)http://goo.gl/JIYJwk

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+34 640 220 306 (Numero Internacional en España)

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¿Por qué el Desfibrilador TELEFUNKEN?

El DESFIBRILADOR de Telefunken es un DESFIBRILADOR AUTOMÁTICO sumamente avanzado y muy fácil de manejar.

Fruto de más de 10 años de desarrollo, y avalado por TELEFUNKEN, fabricante con más de 80 años de historia en la fabricación de dispositivos electrónicos.

El desfibrilador TELEFUNKEN cuenta con las más exigentes certificaciones.

Realiza automáticamente autodiagnósticos diarios y mensuales.

Incluye bolsa y accesorios.

Dispone de electrodos de "ADULTO" y "PEDIÁTRICOS".
Tiene 6 años de garantía.
Componentes kit de emergencias
Máscarilla de respiración con conexión de oxígeno.
Tijeras para cortar la ropa
Rasuradora.
Guantes desechables.

¿ Qué es una Parada Cardíaca?

Cada año solo en paises como España mueren más de 25.000 personas por muerte súbita.

La mayoría en entornos extrahospitalarios, y casi el 80-90 % ocasionadas por un trastorno eléctrico del corazón llamado"FIBRILACIÓN VENTRICULAR"

El único tratamiento efectivo en estos casos es la "Desfibrilación precoz".

"Por cada minuto de retraso en realizar la desfibrilación, las posibilidades de supervivencia disminuyen en más de un 10%".

¿ Qué es un desfibrilador ?

El desfibrilador semiautomático (DESA) es un pequeño aparato que se conecta a la víctima que supuestamente ha sufrido una parada cardíaca por medio de parches (electrodos adhesivos).

¿ Cómo funciona ?

SU FUNDAMENTO ES SENCILLO:

El DESA "Desfibrilador" analiza automáticamente el ritmo del corazón. Si identifica un ritmo de parada cardíaca tratable mediante la desfibrilación ( fibrilación ventricular), recomendará una descarga y deberá realizarse la misma pulsando un botón.

SU USO ES FÁCIL:

El desfibrilador va guiando al reanimador durante todo el proceso, por medio de mensajes de voz, realizando las órdenes paso a paso.

SU USO ES SEGURO:

Únicamente si detecta este ritmo de parada desfibrilable (FV) y (Taquicardia Ventricular sin Pulso) permite la aplicación de la descarga. (Si por ejemplo nos encontrásemos ante una víctima inconsciente que únicamente ha sufrido un desmayo, el desfibrilador no permitiría nunca aplicar una descarga).

¿Quién puede usar un desfibrilador TELEFUNKEN?

No es necesario que el reanimador sea médico, Enfermero o Tecnico en Emergencias Sanitarias para poder utilizar el desfibrilador.

Cualquier persona (no médico) que haya superado un curso de formación específico impartido por un centro homologado y acreditado estará capacitado y legalmente autorizado para utilizar el DESFIBRILADOR (En nuestro caso la certificacion es de validez mundial por seguir los protolos internacionales del ILCOR International Liaison Committee on Resuscitation. y Una institucion de prestigio internacional que avale que se han seguido los procedimientos tanto de formacion, ademas de los lineamientos del fabricante como es el casodeeeii.edu

TELEFUNKEN en Rep. Dominicana es parte de Emergency Educational Institute International de Florida. Estados Unidos, siendo Centro de Entrenamiento Autorizado por la American Heart Association y American Safety and Health Institute (Por lo que podemos certificar ILCOR) Acreditacion con validez en todo el mundo y al mismo tiempo certificar el lugar en donde son colocados nuestros Desfibriladores como Centros Cardioprotegidos que cumplen con todos los estanderes tanto Europeos CE como de Estados Unidos y Canada

DATOS TÉCNICOS

Dimensiones: 220 x 275 x 85mm

Peso: 2,6 Kg.

Clase de equipo: IIb

ESPECIFICACIONES

Temperatura: 0° C – + 50° C (sin electrodos)

Presión: 800 – 1060 hPa

Humedad: 0% – 95%

Máximo Grado de protección contra la humedad: IP 55

Máximo grado de protección contra golpes:IEC 601-1:1988+A1:1991+A2:1995

Tiempo en espera de las baterías: 3 años (Deben de ser cambiadas para garantizar un servicio optimo del aparato a los 3 años de uso)

Tiempo en espera de los electrodos: 3 años (Recomendamos sustitucion para mantener estandares internacionales de calidad)

Número de choques: >200

Capacidad de monitorización: > 20 horas (Significa que con una sola bateria tienes 20 horas de monitorizacion continua del paciente en caso de desastre, es optimo por el tiempo que podemos permanecer en monitorizacion del paciente posterior a la reanimacion)

Tiempo análisis ECG: < 10 segundos (En menos de 10 seg. TELEFUNKEN AED, ha hecho el diagnostico y estara listo para suministrar tratamiento de forma automatica)

Ciclo análisis + preparación del shock: < 15 segundos

Botón información: Informa sobre el tiempo de uso y el número de descargas administradas durante el evento con sólo pulsar un botón

Claras señales acústicas y visuales: guía por voz y mediante señales luminosas al reanimador durante todo el proceso de reanimación.

Metrónomo: que indica la frecuencia correcta para las compresiones torácicas. con las Guias 2015-2020, esto garantiza que al seguir el ritmo pautado de compresiones que nos indica el aparato de forma acustica y visual, podremos dar RCP de ALTA calidad con un aparato extremadamente moderno, pero economico.

Normas aplicadas: EN 60601-1:2006, EN 60601-1-4:1996, EN 60601-1:2007, EN 60601-2-4:2003

Sensibilidad y precisión:

Sensibilidad > 90%, tip. 98%,

Especificidad > 95%, tip. 96%,

Asistolia umbral < ±80μV

Protocolo de reanimación: ILCOR 2015-2020

Análisis ECG: Ritmos cardiacos tratables (VF, VT rápida), Ritmos cardiacos no tratables (asistolia, NSR, etc.)

Control de impedancia: Medición9 de la impedancia continua, detección de movimiento, detección de respiración

Control de los electrodos : Calidad del contacto

Identificación de ritmo normal de marcapasos

Lenguas: Holandés, inglés, alemán, francés, español, sueco, danés, noruega, italiano, ruso, chino

Comunicación-interfaz: USB 2.0 (El mas simple y economico del mercado)

Usuarios-interfaz: Operación de tres botones (botón de encendido/apagado , botón de choque/información.

Indicación LED: para el estado del proceso de reanimación. (Para ambientes ruidosos y en caso de personas con limitaciones acusticas)

Impulso-desfibrilación: Bifásico (Bajo Nivel de Energia, pero mayor calidad que causa menos daño al musculo cardiaco), tensión controlada

Energía de choque máxima: Energía Alta 300J (impedancia de paciente 75Ω), Energía Baja 200J