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Know-how January 2007

First Aid Afloat

First Aid Afloat

Eventually Murphy’s Law will catch up with you. There might be an accident involving injury to someone on board while you’re under way, and it could be serious — something that must be tended to immediately. To be prepared for that very real possibility, I recommend at the very least that the skipper be trained in first aid, including CPR — but what if the skipper is the victim? Of course, I can’t cover many problems and treatments in this limited space, but here are a few I believe you must be able to deal with.

Rule 1: Don’t panic. Call for help but recognize that help could take time to arrive — time you might not have. This is where first aid comes into play.

Rule 2: Be sensitive to possible spinal injury.

Rule 3: Remember the ABCs of first aid: airway, bleeding, cardiac. Then prevent or treat shock.


1. CPR: Ascertain if the victim is conscious — ask, “Are you all right?” — has a heartbeat and is breathing. You can determine breathing by listening, seeing if a mirror held close to the victim’s nose and mouth fogs with condensation, and/or noting whether the chest is rising and falling. Check for a heartbeat by feeling for a pulse in the victim’s throat, below the angle of the jaw and about a finger’s width to the side of the Adam’s apple. If the victim isn’t breathing and there is no heartbeat you must start cardiopulmonary resuscitation, or CPR, immediately. More than one person on board should be trained in performing CPR. If you’re squeamish about the mouth contact, there are kits that enable you to breath into the victim’s lungs without physical contact through a one-way valve. If the victim doesn’t get oxygenated blood circulating to the brain very quickly the brain begins to die. Delayed resuscitation may keep the victim alive, but there’s a risk of brain damage if it’s delayed too long.


2. Shock: Shock occurs when there is insufficient blood flow to the brain. Sometimes it’s minor, sometimes life-threatening, but it’s present in all traumas: a blow or impact, heavy bleeding or dehydration, illness or infection, electrocution, etc. Passing out is a form of shock. Indicators include:

• pale complexion, even to the extent of being bluish

• moist, clammy skin

• shallow, rapid breathing (normal rate is 10 to 20 breaths a minute)

• rapid, weak pulse that can become very slow (normal pulse rate is around 60 to 90 beats per minute, though it can be as low as 50)

• eyes that may appear vacant or glassy or closed, pupils larger than normal

• sluggish responses

• loss of consciousness

First aid: If the victim is sitting, lower the head to encourage blood flow to the brain; if he or she is supine, elevate the feet with a pillow. Keep the victim warm. If the victim isn’t breathing, begin mouth-to-mouth resuscitation. (With the kit I described above, you’ll be safe from infection.) If there is no heartbeat, begin CPR. If he or she has lost consciousness, use smelling salts or something similar that you can hold under the nose.


3. Heat prostration, also known as heat exhaustion, results from dehydration and the loss of sodium from the system. Symptoms include headache, dizziness, nausea and vomiting, and moist, cool skin.

First aid: Put the victim in a cool, shady location with plenty of fresh air, and keep him or her warm. Hydrate the victim with water (or salted water) when conscious, and 30 minutes or so after hydration give sports drinks. Don’t give anything with baking soda.

Heat stroke, also known as sun stroke, results from overexposure to heat. It can happen very quickly, with dizziness, fainting or spots before the eyes. The skin is flushed, hot and dry, and there could be a fever.

First aid: Get the victim to a cool, shady place with good air circulation. Lay him or her down with the head slightly elevated. Hydrate the victim, but do not give stimulants. Sponge the torso, neck, head and arms with cool water. You’ll want to get the temperature down.