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In our series of Safe Skipper blogs on first aid at sea, here are four common emergencies skippers should be prepared for at sea. Knowing how to cope with them could well save a life, while not knowing could result in an avoidable tragedy. In this blog we look at what to do in the event of a crew member choking, drowning, or suffering from hypothermia or fatigue.



If the larynx is blocked and the victim cannot breathe, give several strong blows between the shoulder blades while supporting their chest. If this fails to relieve the obstruction, try abdominal thrusts by standing behind the casualty, clasping your hands together, positioning them on their abdomen and pulling inwards and upwards four or five times. If the casualty becomes unconscious, begin CPR.


Someone who has been recovered from the water and is unconscious should be treated for drowning as follows:

  • Check for a blocked airway and signs of breathing.
  • Begin CPR if there are no signs of breathing.
  • When the casualty begins breathing, place them in the recovery position.
  • Treat for hypothermia and shock.
  • Remove wet clothes if possible and keep warm with blankets or warm clothing.

Monitor the casualty closely and when they regain consciousness be aware of the risks of secondary drowning, where the lungs are damaged after inhaling water. This can occur up to 3 days after the accident, so a casualty who has recovered from near drowning should always go to hospital for a check up.


Normal body temperature is 37ºC.  A person becomes hypothermic if their body temperature drops below 35ºC. The same applies to those suffering from hypothermia as to those suffering from seasickness and fatigue. That is, you should be alert for the early signs and take what action you can to remedy the condition as soon as possible.  At sea, hypothermia can occur gradually after prolonged exposure to cold, wet and windy conditions on deck, or more suddenly after immersion in the sea.

Early signs of hypothermia include: shivering, slurred speech, clumsiness, irritability and memory loss. The sufferer develops pale skin, slow breathing and a slow pulse. The next stage, severe hypothermia, is complete collapse and unconsciousness and if unchecked, the heart eventually stops.

Treatment of hypothermia:

  • If the casualty is breathing, put them in the recovery position, ideally below deck.
  • Keep the casualty horizontal and commence warming. Be gentle, as a hypothermic person’s internal organs are sensitive to physical shocks.
  • Replace wet clothing with dry warm clothing, sleeping bags or a space blanket.
  • You can warm the casualty by applying warm towels to their head, or by lying another crew member alongside them to share body heat.
  • Applying hot water bottles is also recommended but keep the temperature below 46ºC / 115ºF.
  • Give the casualty warm, sweetened non-caffeinated drinks.
  • Keep monitoring the casualty’s temperature, if it drops below 32ºC then severe hypothermia develops and you have a major emergency to deal with.

Signs of severe hypothermia are as follows:

  • Casualty stops shivering.
  • Skin appears blue or grey, partly swollen.
  • Pulse is slow or weak.
  • Casualty loses consciousness.
  • Little or no breathing.
  • Pupils may be dilated.

Treatment of severe hypothermia:

  • Send MAYDAY. The casualty needs urgent hospital care.
  • Handle with extreme care. The casualty is at risk from cardiac arrest.
  • Check for signs of breathing. If the casualty is not breathing, commence basic life support starting with rescue breaths and then chest compressions and the CPR cycle.
  • Re-warm slowly. Take care not to burn the casualty.
  • Monitor pulse and breathing constantly.
  • Do not rub the casualty’s skin or give them alcohol.


Fatigue can be a major problem at sea, as people begin to make mistakes when they are tired, whether incorrectly plotting a position, slipping on deck or becoming short tempered with others.  On a long cruise, it is a good idea to agree a watch system which everyone on board keeps to.

See also: Common medical emergencies at seaFirst aid at sea basics.

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