Emergency oxygen onboard

[GrahamM376]

yes, but then you add the important caveat that if you suspect a person to be significantly compromised by respiratory disease then you will only allow them somewhat less than 15 l/min; shouldn't your starting point here be that if their lungs are shot then go straight for 25 l/min?
my point is that, on board a boat, it is safe to administer oxygen without monitoring or training. if either of those are available to you then so much the better as the lowest flow rate possible is essential to conserve supplies. if the op uses his chemistry set then even this isn't a consideration as it is of fixed flow rate and duration.(and, at £250 i would be reluctant to crack it open in the first place).

Maybe treatments & knowledge have changed over the 20+ years since I was involved with oxygen in rest home situation but, the instructions we received then was that there was a danger of giving too much to someone with emphysema, in that it could kill because the brain monitored oxygen rather than CO2 levels, whereas those sufferning from acute bronchitis or asthma could, and did, recive higher flow rates.

 

[bikedaft]

if the respiratory consultants vs A&E/anaesthetic consultants cannot agree on this one then perhaps we are unlikely to come to a consensus here on a sailing forum? ;-)

personally i have had to intubate/ventilate people with type II resp failure (blue bloaters) who have possibly been "pushed over the edge" by oxygen administration, but then there was a high chance that they may have deteriorated anyway. and in a hospital environment that's not too problematic.

back to the OP; these people are extremely/exceedingly unlikely to be able to crew or skipper a boat tho, never mind get up a hill. so i don't think it really applies for our scenario (as per OP)

 

[GrahamM376]

these people are extremely/exceedingly unlikely to be able to crew or skipper a boat tho, never mind get up a hill. so i don't think it really applies for our scenario (as per OP)

I never cease to be amazed by some, we have a legless (physically that is) guy in the yard who sails a cruising boat single handed.

 

[AHoy2]

.........
there are two situations i can think of where the administration of supplementary oxygen may increase the risk to a person; firstly, when the boat is on fire- the added oxygen would aid combustion but this increased risk could negated by the use of a demand valve supply. secondly, the prolonged use of oxygen to a 28 to 32 week premature baby, which may lead to retinal damage and even blindness, but these2 pounders are rarely seen on boats.
other than that i wouldnt worry too much about giving o2 to someone.

viago,
thanks for clearing the fog!

I had no idea that my OP would generate this level of debate but it has all been of value in helping me decide if:

a) it is ever worthwhile carrying oxygen on a cruising yacht and
b) how to provide such an oxygen supply for emergency use

From the discusion I can see no reason for not carrying emergency oxygen if the skipper considers it a reasonable adjunct to the first aid kit, there seem to be plenty of scenarios where oxygen (at any level) could be beneficial and definitely an improvement over none.

The probability of ever using the oxygen is low, but statistically I would argue that it is more likely than using a liferaft or offshore flare pack which many carry by default. In addition the oxygen can be a considered a "community" resource in that it can be used on the carrying boat, on adjacent boats in an anchorage, at the marina, on the beach etc..

Cost is not significant compared to liferafts, flares, fire extinguishers, duplicate (triplicate) plotters and other electronic non-essential gizmos.

Storage and maintenance are non-issues for some solutions.

In all probability I will add an emOx kit to the boat's first aid kit. I have spoken to two UK suppliers who carry stock and re-charge kits. Both confirm that the kit requires no on going servicing and has a long shelf life. If used the kit only requires replacement of the chemical packs used per 15 minutes oxygen supply. User training is minimal at the first aid level.

I hope others have benefitted from the discussion.

 

[bikedaft]

There will be safer onboard emergency oxygen available soon. This system comes in a bright orange thermal bag which holds a plastic cylinder containing pre measured amounts of manganese, platinum, hydrogen peroxide and sodium bicarbonate. Simply turn three knobs and the generator starts producing oxygen immediately. The unit generates six liters per minute of 99.97 percent pure oxygen for a minimum of 15 minutes and life saving oxygen for up to 30 minutes.

how much does this weigh, and how many litres of oxygen doe it produce? got any more info/weblink please?

 

[brokethebox]

A couple of people have already mentioned their 'Ships Captains Medical Course' or Medical care aboard ship as its known now, and those folk willl have been shown how to use, and look after their oxygen bottles.

For anyone who works in sailing they'll know that for a boat to be cat 0 it needs an oxygen bottle aboard as a part of the vast medical supplies those boats carry.

You can get them from LE west, or lots of other suppliers, in sets that need looking after or more expensively in one use easy use canisters.

In response to the person who said you'd need to carry a whole emergency departments equipment - we do!

It terrifies me that one day i may have to use some of the more serious parts of the kit, but good to know we have it.

J

 

[st599]

All boats should carry it. It's the shizzle for getting rid of your hangover.

When you're on a rib after a heavy session, a few breaths and you're good as gold.

 

[andygc]

this is a common misconception of the "hypoxic drive". it is a theory suggested some 40 years ago and yet to be substantiated by any reliable research.
if it does exist, which is extremely unlikely, then the, 1 in a million, affected person would not be on board a boat!

I find it depressing that this forum ends up providing a platform for disseminating such ignorance. Respiratory function has been a subject of in-depth study in aviation physiology since the earliest balloon flights. Sad to see the work of greats such as Bert and Ernsting dismissed so lightly.

I have to keep this simple – I’m not writing a text book.

In normal health, the principal drive for respiration is controlled by levels of CO2 in blood. If it goes up so does respiratory rate and depth – it’s handy to use the term minute volume, the amount of air moved in and out of the lungs per minute. If CO2 levels fall, minute volume goes down. That is called hypercapnic drive.

When man goes to altitude - certainly 10,000 feet or more - oxygen levels in the blood will fall without CO2 levels going up any significant amount. To compensate, a different set of sensors come into play - the hypoxic drive. Minute volume goes up. Because of that CO2 is washed out of the lungs and blood CO2 levels fall. If the hypercapnic drive was dominant the man would stop breathing. Fortunately, hypoxic drive is dominant, so he keeps on breathing and the higher he goes the greater his minute volume becomes.

The situation for the chronic bronchitic with severe emphysema is different (the blue bloater). He has large areas of lung that don’t work, so no gas exchange takes place. He is permanently and severely hypercapnic, and working at blood levels of CO2 outside the working range of the hypercapnic control system. He is, to a large degree, dependent on hypoxic drive. However, like all things in life, it is not that simple. What we do know from simple practical experience is that if you give a blue bloater a high concentration of inspired oxygen he is likely to stop breathing. The reason for doing so was in the past thought to be solely the loss of hypoxic drive. What now seems to be understood is that there are other factors involved. In practical terms the theoretical basis doesn’t really matter; the important thing is to resuscitate the man that you have just brought closer to death by giving a high oxygen flow rate.

As for carrying oxygen on boats, how soon can you get help? If you can get an ambulance or a ship alongside in 15 minutes then a chemical emergency oxygen pack might be useful. However, don’t forget what they were designed for - to get passengers in decompressing aeroplanes back from 40,000 feet to 10,000 feet without the healthy ones dying. If you are significant distance from help you would need either a large and heavy cylinder (there are plenty of duration tables available on the internet) or an oxygen concentrator (which needs a power supply and is unlikely to enjoy the environment in anything other than a superyacht).)