Reducing the risks of an accident happening at sea is a priority for every skipper of a leisure vessel, as is reducing the chance of any of the crew becoming ill.
The first line of defence against a medical emergency at sea is to avoid it in the first place, which may sound obvious but should be at the forefront of a skipper’s mind. This can be done in a positive, relaxed manner and it is worth reassuring your crew that medical emergencies at sea are a rarity. At the same time there is a genuine need for the skipper to adopt a responsible attitude which means looking out for early signs of seasickness, making sure everyone moves about the boat safely, is wearing appropriate clothing, using sunscreen, is keeping hydrated and getting adequate rest.
It is important to make your crew aware of the potential hazards that a yacht underway presents, things like correct winch handling, the companionway steps and the boom, and ensure no one works on the engine when it is running. It is also important to be aware of any of the crew’s medical conditions and to make a note of any medication they have with them before you depart.
Knowledge and skills
At least one person on board should be trained in first aid and know how to administer the contents of the first aid kit, ensuring there are adequate supplies for the planned duration of the trip. All skippers and people who crew regularly are advised to do their basic marine first aid training ashore.
In the UK the one day RYA First Aid At Sea Course provides basic support and a working knowledge of first aid for those sailing within 60 nautical miles from a safe haven.
What to do in an emergency
If there is a medical emergency aboard, a swift response plus basic knowledge and first aid skills can help you get a dangerous situation under control and a potential disaster avoided. As skipper, you will need to decide which of the following courses of action to take:
- Does the situation call for immediate evacuation of the casualty?
- Should you sail directly to the nearest port?
- Should you sail to a port that is more convenient for you?
- Should you continue with your original passage plan?
In the absence of professional medical advice on board, it is vital to know how to assess the casualty’s condition and if needs be to administer first aid, to communicate the casualty’s condition accurately to professionals ashore and to understand what can be done to alleviate and control the situation. With this information, the skipper can then decide on a course of action.
While first aid is being given to the casualty, the safety of the crew and vessel must remain paramount. Ensure the vessel is kept well under control and out of danger. If necessary, slow the vessel down and alter course to prevent the casualty being bumped about.
Assessing a casualty
Start with a Primary Survey. The Primary Survey is also referred to as the ABC check: A for Airway, B for Breathing and C for Circulation.
Airway – First check that the casualty’s airway is open. If conscious, check for choking or suffocation. If unconscious, lift the chin with two fingers and gently tilt the head back to open the airway.
Breathing – Check the casualty’s breathing. Look, listen and feel for breathing for 10 seconds. If the casualty is not breathing, begin CPR immediately – ie chest compressions and rescue breathing (mouth-to-mouth).
Circulation – Check for signs of external or internal bleeding. Control severe bleeding with direct or indirect pressure.