After deciding to sell up and sail around the world my husband was insistent that we took a First Aid at Sea course. I wasn’t so eager – my position on First Aid has always been, ‘oh – someone else will be around to do that CPR stuff…’ However, after thinking about things for a while, I realized that at sea, First Aid knowledge might be the difference between someone I love living or dying. Yikes.
Yes – there is a such thing as First Aid at Sea or First Aid for Boaters!
Lucky for us, hubby found a First Aid course that was designed for captains, skippers, crew on boats, yacht owners, cruise ship crew, cargo ship crew and anyone else living or making passage on the sea. Read about all the Sailing courses we took here.
While on a boat there are three main issues when treating a casualty
One is lack of space, another is the potentially unstable environment (sailing in bad weather or rolling seas) and the most poignant is the potentially long response time from medical professionals. Rather than getting an emergency response team within 5 – 10 minutes, like we’re accustom to on land, we might have to wait hours, days and in extreme cases, weeks.
On land, First Aiders often need to buy minutes to help save a life. Aboard a sailing vessel, the length of time necessary to keep a casualty alive is most likely to be much longer. That being said, the First Aid course is much more comprehensive than the typical course taught during land based courses.
Our excellent teacher, Sue Johnson (one of the best in the industry, I’ve been told), taught us about the standard First Aid components: CPR, choking, burns, fractures, dealing with common health issues (heart problems, epilepsy, diabetics, allergies, stroke, etc.), bug and sea creature bites/stings and much more. And she also related everything to the added complications of being on a boat.
During the class I created a list of 10 things that made an impact on me. They were things that I never knew about or never considered and thought they were well worth sharing. See if you find any of these of value…
10 things I learned from taking a First Aid course
1. Handling a medical evacuation? Pack your casualty with medical notes, detached body parts, their passport and some money.
When having a crewmember evacuated from your vessel (most likely by air), pack with them the following things:
- Written record of events (what happened, how, when, for how long, etc.)
- First Aid given – any vitals taken (blood pressure, temperature, etc.) and any drugs administered.
- Any missing parts, like fingers – you need to put them in a bag, trap air in the bag, wrap them in cloth and keep them cold but not frozen. Put in Fridge or in a cooler. Keeping detached body parts cold will massively increase the chances of the parts being saved.
- Pack the person with their passport and money! It’s possible they will be discharged from the hospital, can’t easily get back to the boat and will need their passport and money to get somewhere.
2. It’s possible to survive a drowning incident only to die later from a thing called secondary drowning.
Even if someone survives a Man Over Board (MOB) incident and/or inhales water and/or drowns, the casualty can still die hours later from a thing called secondary drowning. This issue really freaked me out. Imagine the trauma of saving someone; perhaps performing CPR and getting them to regain consciousness only to have them die a few hours later? Secondary drowning is caused by fluid collecting in the lungs that then causes an inflammatory reaction. The alveoli become enlarged and hardened. The even crazier thing is that there’s a way to prevent secondary drowning but you need to know it exists! By injecting the drug, Frusemide, it will allow the lungs to stabilize.
3. There are quick fixes to keep someone alive but you need to know what they are.
There are very handy medical solutions to potentially life threatening issues, but you need to know they exist, have them in your First Aid Kit for Boat and know how to use them. As mentioned above, there’s a drug available will prevent secondary drowning. There are also granules that quickly cause blood to clot (Celox) – if someone is losing a lot of blood, you can pour the granules over the wound, apply pressure, elevate and the blood clots immediately. There are automatic injecting needle pens (Epipens) that help individuals experiencing anaphylactic shock (severe allergy reaction) by delivering a shot of adrenalin into the muscles. If there is a quick fix to an otherwise life threatening issue, wouldn’t you want to know about it? Wouldn’t you want to have it on board? First Aid at Sea is serious business – isn’t it?
4. It’s only a bump on the head – she’ll be fine!
I can’t tell you the amount of times I’ve rammed my head into our forward cabin. Sometimes I hit it so hard my head has bounced backwards. Luckily, however, I’ve never done serious damage (some may disagree)! The unfortunate thing about head injuries is that you can’t see internal damage. Furthermore, it could take days for symptoms and serious problems to appear. After someone hits their head, it’s important to write down the details of the accident and monitor them over several days. Things like CFS (Cerebrospinal Fluid) could leak out the nose, mouth or ears. The casualty could act strange, have impaired speech; complain of headaches and more. The worrisome thing is that a person could have an accident, seem fine and days later run into severe trouble. Head injuries need to be treated with upmost care.
5. Leave that large piece of glass in your guests arm!
Foreign bodies in the body need to remain in the body. If a crew member gets a large piece of glass stuck in their body, a piece of metal through the leg or any foreign body larger than specks, it’s very important to leave it in! The foreign body could be near or partially through an artery and pulling it out will only cause a larger problem. Considering that help might be hours or days away, it’s important to prevent a more serious issue. Stop blood loss, clean the wound and bandage the crewmember as best as possible protecting the body and the foreign object. Get them to a doctor as soon as possible.
6. I didn’t know our deck hand was a diabetic!
Take the medical history of crew and guests aboard. Be proactive rather than reactive. If a guest or crewmember has a health issue – perhaps they are asthmatic, epileptic, diabetic, or has heart complications, it’s better to know that from the start rather than finding out during a complication. Seasickness and dehydration can easily cause people to forget to take medicine or take too much. Furthermore, if they’re vomiting it could be a serious issue if the crewmember is not getting their meds regularly. If regular drugs are taken or inhalers are used, request that they are kept in a central location where everyone knows where they are.
7. What do you mean it’s going to take 5 hours for help to come – our casualty will be dead by then?
The time it takes for the emergency services to get to you could be hours, days and even weeks – not the 5 -10 minutes like we’re accustom to on land! What will you do if someone stops breathing and it’s going to take an hour for a helicopter evacuation? What actions will you take if a crewmember slices an artery, you can’t stop the blood, and help is at least 6 hours away?
When you step on board a sailboat, whether you’re with your family, friends or crew someone needs to know how to keep a person alive for hours/days and not just a few minutes. It’s also important that you’re not the only one that knows First Aid either – who’s going to take care of you if you go down?
8. Burns have to be treated in a very particular way.
Burns keep burning underneath the skin. They will continue to do so until they are completely cooled down. Best remedy is running water for 10 to 20 minutes (may not be practical on a boat). Failing that, get some medical cold packs or gels to diffuse the heat. Putting a burn in a bucket of water is better than doing nothing, however it’s not as effective as running water or the medical gel packs that diffuse the heat.
Never use bandage tape on or near the burn – the burn can spread and then taking the tape off could cause agony. Once the burn is completely cooled down you can wrap it in cling film or use a paraffin non-sticky bandage and then gauze to soak up any oozing finishing it off with a bandage wrap. Burns can cause a large loss of liquids so make sure that the casualty starts drinking liquids to avoid dehydration.
9. Keeping casualties on deck is sometimes better than succumbing to a knee-jerk reaction to bring them down below.
And this is especially for anyone that has gone unconscious. If something happens and you have to get the casualty off the boat, it’s easier to work with them up on deck rather than trying to haul them out from below. Throughout my whole First Aid for boaters training a common theme mentioned was think first and then act. Just because someone looks like they’re having an asthma attack doesn’t mean it’s necessarily asthma.
Just because someone looks like they’re having a heart complication doesn’t mean it’s their heart. The key is to make sure the airway is clear and breathing is as easy as possible. After that, you’ll want to ask questions. Make observations and build up a collection of information that will better help you to take action.
10. Remind crew and guests to bring extra pills, medications, inhalers.
It’s possible that passengers can get seasick and vomit pills up or the boat could get storm bound. Odd things can happen while at sea, so remind guests to bring extras. Furthermore, if you’re carrying an asthmatic or sever allergy sufferer on board, make special arrangements. Make sure their inhaler or medicines are stored in a central location where everyone can find them easily.
References to consider having on board
Below I selected a few items from Amazon to consider purchasing. When in a state of emergency it’s easy to forget things. And after time lapses, procedures like CPR can be forgotten. It’s good to have a few quick reference guides, books and laminated instructions (good for not getting wet and destroyed) on board. Check these out:
Bonus point: Although there’s a lot of sand near a boat it’s not the place to put your head
This last point is really for me. I think I was afraid to know how to do CPR or how to help people in an emergency. My thinking was, ‘well, if I know how to do it, then I might be the one who has to do it. And if I’m doing CPR, what if I don’t do it right and the person dies’.
It’s a rather random thought process but I suppose it’s head in the sand thinking.
HOWEVER, now that I fully understand and have practiced doing CPR, I’m not afraid of it. I know I can do my best and my best just might save a life. Without my knowledge, I’d flail around like an idiot and regret my ignorance for the rest of my life.
There are loads of things out there that can support a medical emergency. It’s better to know about them and use them rather than panic and freak out. Having medical reference books on board is imperative. Also, having a knowledge on how to contact medical radio advice is key (using your VHF or SatPhone).
To find out more about a First Aid at Sea courses, Google ‘First Aid for Boaters’ to find local courses.
Make sure you find a course that caters to boaters; standard First Aid courses are definitely not extensive enough.
To look into taking a course with the teacher I had, Sue Johnson, whom I can’t recommend enough, contact her on UK 07515 683 187 or email her at aj@jwmarine.co.uk. Sue lives on the River Hamble along the south coast of England. She, however, teaches in schools all over the world.