First Aid Afloat
A closed fracture does not break through the skin. An open fracture is when the bone punctures it.
A fracture of a bone is certainly a possibility at sea, with boats heeling over and crew members moving around the boat.
One way of reducing the risk of fractures is to ensure your crew move around the boat with bent knees, weight low and the golden rule of one hand for the job and one hand for the boat.
There are two types of fractures that we may come across.
Open and closed fracture: open fracture is where the broken bone has punctured through the skin, closed fracture is where the broken bone is still under the skin.
The signs and symptoms of fractures are:
• Unnatural position
• Open wound
• Non weight bearing on the limb
Be aware that these signs and symptoms are very similar to sprains and strains. If you are unsure treat as a fracture
How to deal with the fracture when at sea:
• Check for dangers
• Check for level of response and for normal breathing
• Ask the crew member to support the injury with their other hand or other available item (cushion or sleeping bag)
• Treat any severe bleeding
• Possibly a Pan Pan or seek medical advice from the coast guard on VHF channel 16
If assistance will be some time you may need to consider splinting the limb, but only if you really need to.
• Splint injury in the position you found the crew member. Do not try to straighten and minimize movement while splinting.
• For closed fractures apply a cold compress to area to reduce swelling.
• Use the secondary survey to check for other injuries, the pain of the fracture may mask other serious injuries.
Fractures can be very painful particularly on a moving boat in a rolling sea. Make your crew member as comfortable as possible and make for your port of refuge. The Coastguard may well send a lifeboat with pain relief to assist you.
(check out the new First Aid Afloat app by Paul Hopkins)