Imagine you are fishing 20 miles offshore when your friend slips climbing up to the flybridge and tumbles down to the deck. You look down to see him holding his left arm. A bone has pierced the skin, and he is bleeding. You grab that $29 “first aid kit” you bought at the marine store and open it to find gauze and bandages for small cuts... and a tube of antiseptic ointment.
Here is what I know about medical emergencies at sea: if Neosporin can solve your problem, then you aren’t experiencing a medical emergency. If you spend any amount of time more than 30 minutes from shore, you should consider owning a proper offshore medical kit and know how to use it. (I think you should have a good medical kit that you know how to use at home, too, but I’m cautious that way.)
The difference between offshore and your house is that you can’t always get an ambulance to your boat in under 15 minutes. Distance equals time offshore, so you’ll want to have the gear and the know-how to handle injury or illness for up to an hour without help. You’re going to need more than a pack of gauze pads and medical tape.
Stopping the Bleeding
A good medical kit has tools to handle serious bleeding. This includes large rolls of gauze and trauma dressings. These large, absorbent pads can be placed on open wounds and provide a way to apply direct pressure to the affected area. If you look for ways to stop bleeding, you will invariably run into “QuickClot gauze,” which I believe is useful in the field, but I recommend you stick with the more traditional ways of stopping bleeding: direct pressure and elevation. You don’t need to become a combat medic, but you do want to have more than a few two-inch gauze pads.
A proper medical kit has the tools you need to splint broken bones and injured shoulders, or to stabilize any other instance where one of your crew is unable to move a certain body part that normally moves. Stabilizing these injuries—especially on an unstable boat—will decrease the chances of further injury while waiting for help or making your way back to the dock.
You’ll also want a way to immobilize the spine. A “cervical collar” sounds like an intimidating device, but with some easy training, you can learn how to effectively and safely immobilize someone and prevent possible serious injury or paralysis. But first, you have to have a kit with collars in various sizes.
Some may think that I’m taking this idea too far. I mean, are you really going to need to completely immobilize someone on your boat? To put this into perspective, consider that if you fall and bump your head at home, the first thing a responding EMT will do is hold your head while his partner applies a cervical collar. There is only one way to determine if someone has fractured a vertebra (or any other bone for that matter): an X-ray. Not immobilizing the spine of someone who received a head wound on your boat is to use hope as a strategy. You’ll want cervical collars in your medical bag.
Airway, Breathing and Circulation
CPR training is great, and you should attend a course—boater or not. And while you can perform CPR without any tools at all, it is much better to have the tools of that trade in your kit. You don’t need a full oxygen kit with demand-valve respirator and resuscitation bag, but having the tools necessary to maintain an airway is a very good idea.
A solid medical kit will have what are known as NPAs or OPAs (nasopharyngeal airways or oropharyngeal airways). These devices hold open (make patent) the airway of both conscious and unconscious victims and ensure they stay open until you are relieved of patient care by a professional. Using these devices, like performing CPR itself, require training, but they are part of every EMT’s kit for a reason. In caring for the injured, an open airway comes first. Without a good airway, everything else you do to care for the injured is wasted time.
When you take CPR training, you should also learn to use an automated external defibrillator (AED). These devices are used to restore a working heart rhythm to patients who are in ventricular fibrillation. When used properly, they evaluate heart rhythms and apply shock if it is needed. There are no regulations requiring you have one aboard, but call in a possible heart-attack, and one of the first questions you’ll be asked is “Do you have an AED aboard?” That’s when you will wish you’d spent the money on one.
Handling real medical emergencies is easier with these advanced tools, but you will need good training and at least some practice (the occasional drill) to feel confident in handling these kinds of problems on board your boat.
I recommend (at least) the American Red Cross Adult and Pediatric First Aid/CPR/AED course. You’ll spend between $70 and $120 for this one-day course, but you’ll come away with the skills you need to handle basic first aid issues on your boat. I suggest getting the training before you decide on what gear to buy because using the equipment will inform your decisions about what you need to carry on your boat.
If someone gets seriously injured on your boat or has a real medical problem, you are going to need more than a few ace bandages. You are going to need the gear and know-how to handle things until help arrives or you can get back to the dock. Now is a good time to consider upping your skills and equipping yourself to handle that bad fall if it happens.