Medical emergencies on a boat: how best to handle them

Accidents, trauma, injuries. A medical emergency on board can always happen. Learning how to deal with these situations competently and without making mistakes according to sailing coach Luca Sabiu is crucial for a skipper, even on a mental level.

Medical emergencies on a boat, how to handle them

On boats, both racing boats but also cruising boats, you can get hurt. All it takes is an inattention, a momentary loss of balance, a frantic maneuver. The boating chronicle is full of accidents involving both ordinary sailors and experienced skippers: clumsy slips on deck, fingers sheared by a winch, boom strikes to the head. Not to mention burns, sudden witch’s blows, furious toothaches and animal bites or stings.

Resolving a medical emergency at sea, even a trivial one, can be complicated. It is just the context that is difficult: the boat is cramped and constantly moving, there may be bad weather or rough seas, and agitation and emotionality playing havoc. For example, imagine having to prepare and perform an injection for severe back pain in 30 knots and 4 meters of wave. Unfortunately, it is usually under these conditions that people get hurt on board. Even just reading a thermometer or sphygmomanometer to measure blood pressure can become a feat.

Common boating accidents become serious problems

In my career as a solo sailor and sailing coach, I have had 4-5 health emergency events happen to me. Once, for example, in the Gulf of Lion, a boy after being seasick for more than 20 hours began to experience pain and tingling in his left arm. Using the satellite phone, which I consider an integral part of my first-aid equipment on board, I contacted a doctor who conversed with the injured person and realized that it was not a heart attack but a consequence given by seasickness. The same doctor then gave us directions on how to monitor the situation and send these results via email on an hourly basis.

Another time a girl slipped disastrously during a straorza under gennaker and the fall gave her a bad ankle contusion with very severe pain. Even then, contact with a doctor on the ground provided important insight into how to treat the contusion and whether the ankle was broken or just bruised.

Give injections, splint an arm, put in stitches

One of my biggest fears when sailing with students or a shipowner is just that one of the crew members will get hurt. In this eventuality as boat captain I have an ethical, moral and practical obligation to handle the problem as best I can. The fear stems from the fact that, not being a doctor, I do not have enough expertise to handle such an emergency. And this awareness, combined with a certain psychological “discomfort,” I have found to be felt by many commanders like me.

All those sailors who cruise or race should be up-to-date on safety and medical emergencies. For example, learn how to give stitches or reduce a dislocation to a shoulder or even make a bandage and immobilize an injured arm by taking advantage of the mainsail splint. Studying and practicing all these small operations can always come in handy during our navigations, cope with an emergency, and make us feel more comfortable when navigating with friends, family, and especially young children. Today there are specific courses for sailors, as well as dedicated manuals, as well as many valuable resources on the web, including helpful video tutorials.

Medical emergencies. First aid kit: here’s what it should look like

On the subject of medical emergencies on board, the first aid kit we have on the boat is of course essential. This is mandatory equipment under Italian nautical law on boats sailing more than 12 miles from the coast (M.D. 03\2022).

Having it on board and knowing how to use it best are not the same thing. You need to know what medications and instruments to put in it, where to place it, and how to organize all the medical supplies for quick and intuitive access. When I participated in the “Mini Transat,” I confess that a world opened up for me on this issue. Since that time I have always worked carefully on the set-up and use of the first-aid kit aboard my boats.

In the time of medical emergency order and method of the box are really great allies. Have you ever looked for a medication when you have a headache that drives you crazy? Here, imagine what can happen in the case of more serious events. The medication box should be divided into two areas, instruments and drugs.

All the contents of the box should be divided into transparent watertight bags with their use indicated. It would also be good to divide it by topics: eyes, ears, bruises, back, anaphylactic shock, allergic reactions, fever, gastrointestinal problems, and so on. The same instruments should be gathered and selected: disinfectants, suture kits, trauma kits, saturimeter, thermometer, etc. A separate chapter concerns the placement of the first-aid kit on board, again an issue often underestimated by the ordinary sailor.

Can you handle transporting an injured person on the helicopter?

It may happen during a medical emergency on board that you have to carry out the recovery of the injured person from the boat. I can certainly have my say on the subject, given the overnight recovery I experienced in the middle of the Atlantic in the 2017 Mini Transat.

Retrieving the casualty by helicopter is a complicated maneuver because the rescuer cannot always retrieve the subject directly from the boat. Often the crew must place him on a floating stretcher, then place him safely in the water, then facilitate recovery with the winch while the helicopter is positioned with the bow to the wind. This may also mean maintaining a speed of 3-4 knots dry of sail, with the aircraft blades meanwhile spewing their 60-plus knots at close range.

C.I.R.M. doctors, valuable allies on board

Still on the subject of outside medical help, every sailor should finally know about the C.I.R.M. medical service, namely the International Radio Medical Center(www.cirmtmas.it). Founded by Prof. Guido Guida in 1935, it is a non-profit foundation that provides radio-medical assistance to all seafarers, of any nationality, on all the seas of the world. An absolutely valuable and totally free service that takes place 24 hours a day, 365 days a year. To get advice from one of the on-call physicians, simply contact C.I.R.M. either by phone (0659290263, landline or cellular) or by telex, fax and e-mail. The official languages are Italian and English.

Contacted physicians can assist the skipper or crew step by step by following the patient until recovery or eventual disembarkation. And in the most serious cases, they can arrange for the patient to be transshipped by ship or airplane to bring him or her quickly to the hospital.

Medical emergencies in boats – Conclusions

In short, managing a medical emergency on board is a complex and in some cases vital issue. Learning how to do this should also be part of the background of a knowledgeable and competent skipper in this subject, which, let us remember, is not trivial. Not only because it involves health and human life. But also because it has important legal and criminal implications. The wrong medication can cause a person’s death. Remember the penicillin accidentally administered to Mauro Mancini in the Surprise shipwreck? Knowing how to behave and what not to do to help someone in need is important. Most importantly, it makes us even freer to experience the sea as we like.

Luca Sabiu

Medical emergencies in boats: a course in Milan

For all those sailors who want to learn how to best deal with any kind of medical or health problem when sailing, sailing coach and sailor Luca Sabiu is organizing the theoretical and practical course “Management of Medical Emergencies on Board” in Milan, at the Lega Navale headquarters. It is taught by medical professionals, takes place over the weekend, and the next dates are October 5 and 6, 2024. Info: www.lucasabiu.com/corsi/safe-survie. Contact: segreteria@lucasabiu.com