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VOL. 13 NO. 9
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First aid at sea

Dealing with illness and injury while afloat

First aid at sea

Medical problems can be more serious or exacerbated when afloat. Noise, vibration and constant motion can accelerate mental and physical fatigue. This leads to judgment errors and loss of situational awareness, which can compound problems resulting from rough seas or bad weather.

Seasickness (a form of motion sickness) results from irritation of the inner ear. Symptoms of motion sickness include nausea, vomiting, and vertigo. Seasickness can totally incapacitate an individual. Preventative treatment prior to departure can be helpful. If it occurs at sea, the individual should avoid enclosed spaces, staying topside to get fresh air and focus on the horizon rather than the boat’s movement.

More serious problems that could occur include diabetic shock, strokes, heart attacks, broken bones and serious lacerations. While some illnesses cannot be foreseen, use the crew and passengers’ medical history to anticipate problems. Fatigue may worsen some diseases and acute illnesses, making adequate rest important. The effects of alcohol may likewise adversely affect acute or chronic illness.

Assessment
Assess a sick person to decide whether intervention is necessary. Many illnesses are self-limiting and require no special treatment, while others may necessitate the person’s removal from the vessel. For example, seasickness usually can be overcome with time on long voyages. However, on short cruises, returning to port will cure the problem. It may be prevented with scopolamine skin patches applied behind the ear the night before the trip.

Several over-the-counter motion sickness medications, including Dramamine, Gravol, Bonine, Scopolamine and Emetrol, may help, but they may have side effects requiring medical consultation. Compression wristbands and powdered ginger capsules may help some individuals.

Calling for help
Following assessment, decide whether outside help is needed. If so, call the U.S. Coast Guard. Pressing the red button on the DSC-VHF marine radio linked to the boat’s GPS sends an automatically formatted distress alert to the Coast Guard. Otherwise call the Coast Guard on Channel 16 or use 911 on your cell phone. Many cell phones have GPS and can provide your location.

Serious medical emergencies
In serious medical emergencies due to illness or trauma, use the American Heart Association’s Chain of Survival to assess the patient. Is the person breathing? If not, the first step is to call for help. If on the water, activate your DSC enabled VHF radio’s distress button or declare a Mayday on Channel 16. When on shore, call 911. If you have CPR training, begin compressions. If you’re not trained in CPR, press on the center of the person’s chest, fast and hard. If available, use an automated external defibrillator in conjunction with CPR. If the patient is breathing, look for external bleeding and apply pressure to slow or stop it.

Notify the Coast Guard or local authorities whenever someone requires assistance beyond standard first aid. All boaters should take a CPR and first aid course. Check with the American Heart Association or American Red Cross for a course near you.

Traumatic injuries
Traumatic injuries include lacerations, bruising, sprains and fractures. Lacerations require attention to stop bleeding, adequate cleansing to prevent infection and removal of any foreign material, followed by application of a sterile dressing from the first-aid kit. Bruising, while painful, can be treated with an ice pack. Sprains require icing and wrapping with an elastic (Ace type) bandage to limit movement and provide support. Fractures should be splinted until the injured person can be transported to a medical facility.

Encounters with some marine life can be hazardous. Fire coral, sea urchins, barnacles containing Mycobacterium marinum, fish carrying dinoflagellate toxin, stingrays, barracuda, sea wasps, Portuguese man-of-war and sharks can cause injuries that require medical attention. Simple cuts by contaminated barnacles could have life-threatening results and should be treated by medical personnel immediately.

Many traumatic injuries occur due to fatigue with resulting loss of attention, so getting adequate rest and avoiding alcohol are important. Alcohol is often a contributing factor in many injuries.

Numerous books have been written about boating emergencies and first aid. Check your local bookstore and the American Red Cross. Before you go on a long cruise, consider consulting with a physician.

To learn more, take our Boat Handling course.
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