By ANTHONY POZUN, B.S., R.N.
Many of us who sail love its sense of adventure, enjoyment and freedom. When we venture out on our vessels, however, we leave the safety and convenience of our homes and face many different challenges on our own. One of the most challenging is a medical emergency at sea. Whether we sail close to home in a bay or sound or travel long distances, the time, speed and distances involved limit our ability in seeking and receiving outside medical help in an emergency. Whereas on land we may get help in a matter of minutes, on the water it may be indeed many minutes or hours before receiving professional help. To an extent, we sailors must learn to become self-sufficient. This includes having some basic knowledge of First Aid.
While modern medicine has had amazing advances throughout the years, it is equally amazing though how little has changed with regard to emergency medical care away from home. This article is not meant to provide specific recommendations regarding medical aid at sea, but to give a practical approach to obtaining sufficient knowledge of emergency care, and keeping some useful equipment on board for use during an emergency. In this article I will address two categories of how most of us sail:
• Local boating, where nearby friends can render aid or summon help quickly and professionals may render aid in a timely manner.
• Coastal cruising away from home, perhaps hours away from help.
Within these two categories you will be able to communicate with medical personnel, and or deliver a sick or injured crew to an emergency room within hours. Most common onboard emergencies, though, will be treatable without outside assistance, at least initially and limit further injury. In order to do these on board treatments you need a reference of medical knowledge – either yourself or a book – and some basic medical equipment. Most of us may not have the necessary knowledge or the stamina to treat without some help and the following medical emergency references would be of value.
Note: For any reference guide to be of any value, it should be read thoroughly before a situation happens. This is not a comprehensive list, as there are hundreds of worthy publications available to those who do some research.
First Aid Afloat by Doctors Eastman & Levinson
Pocket Emergency Medicine by Hamedani
First Aid Afloat by Robin Horworth
On Board Medical Emergency Handbook by Briggs & Mackenzie
First Aid Companion by Hillincourt
Emergency Medical Care by Brady
If you are unprepared for an emergency despite your knowledge and available references, your VHF and/or cell phone should enable you to gain access to shoreside medical advice. The local police or fire departments, and/or the Coast Guard may offer advice and or be able to put you in touch with doctors and other medical professionals.
Once you have made an informed decision that your knowledge, references and your ability are adequate to treat the current situation, you would probably need some medical supplies, say those in a good on-board medical kit. Many retailers, boating supply houses, specialty outdoor stores and medical supply houses offer good quality (although often expensive) medical kits. But all kits may not be specific to your usage and needs. With a bit of planning and research, you can assemble a kit specific to your needs and particular use. Your kit can be put in an ordinary plastic (doesn’t rust) tool or fishing tackle box of sufficient size to hold your amount of supplies. Listed below are some necessary supplies. Note: Some items must be prescribed by a doctor.
Some basic First Aid – certainly not everything:
1. Attend to severe bleeding first. To stop bleeding, use clean gauze, applying direct pressure to wound; elevate wound above the heart; apply pressure to pressure points (brachial inside of bicep, femoral inside of thigh); apply tourniquet just above wound***used only as a last resort when if bleeding continues, person will die immediately.
2. Wounds with impaled objects or imbedded glass. Do not remove object; cover with clean gauze, wrap loosely; do not apply any heavy ointment or cream; clean/close wounds if possible; wrap to stop bleeding; keep immobilized; and keep out dirt.
3. Eye wounds Protect eye; keep out of the sun; cover with gauze patch; do not cause pressure.
4. Bruises, contusions and sprains Apply ice immediately; use an ace bandage to immobilize; put no pressure on the joint, limb, etc.; and limit movement.
5. Fractures and dislocations Immobilize limb; splint limb in place as found (never reset the bone or limb); use gauze cover to stop any bleeding.
6. Burns If slight, soak in cold water. If skin is broken, cover same with gauze (air hurts); do not apply ointment or cream; treat for shock (elevate feet).
7. Fainting spells Have person lie down and elevate feet. Monitor their breathing.
8. Heat poisoning and heat stroke Remove from sun/heat; cool off slowly; give water sparingly.
9. Ingested poisons/substances Give copious amounts of water; induce vomiting only if ingested substances are non-acid (may burn on the way out).
10. Stings/bites/imbedded small objects/spines Clean area; remove stinger or hook; apply antibiotic/Ambesol; cover with clean gauze or band aid
11. Cardiac arrest/cessation of breathing Call for immediate help; remember ABC:
A. Airway Clear airway of obstruction; with person on back, lift their chin.
B. Breathing Listen and look for chest movement. If none, start mouth-to-mouth.
C. Circulation Lack of heartbeat: perform chest compressions.
Cruising can be great fun and freedom, but with that fun and freedom comes responsibility. If you don’t have a First Aid kit, buy or prepare one for the sake of yourself, your loved ones and crew. Look into buying an emergency medical reference(s) to keep on board. Local bookstores, Amazon and many other online sites can get you what you will need. If you have never taken a First Aid course or it’s been awhile since you took one, contact your local American Red Cross chapter or fire department and attend a basic First Aid course. With a little preparation, research and work, most emergencies at sea can be handled without loss of life or limb. Happy and safe sailing.
A retired Detective Sergeant with the Nassau County Police Department, Anthony Pozun holds a New York State license in professional nursing and currently teaches recruits at the police academy. A boater and sailor for 45 years, he teaches basic boating and sailing courses for the United States Power Squadron.
Editor’s note: Although this is a comprehensive list of aids and remedies, it should be used as a reference only and not be relied upon as a guide to treatment.