I recently did a first aid course, where the main thing I learnt was how to dial 111. (or 911 or 999 – for goodness sake why can’t the world agree on one emergency number!?!) We didn’t even get to bandage anyone up. Just dial 111 and give the person a plaster, we were told…

Dialling 111 (if you are in New Zealand) is all very well, if you are located around the corner from an ambulance. It isn’t going to do you much good if you are at sea and potentially days away from assistance.

So what is a seafaring adventurer to do? Stay at home, carry on working and living nearby to emergency services and wrapped up in cotton wool for the rest of our lives…? hmmm I don’t think so!

Yes faithful blog readers, tonight’s topic of learning for my Ocean Yachtmaster course is all about medical matters…

Step 1 – Stay healthy! 

Get regular health checks of all your bits & bobs. I recently had my moles checked. Before you head off overseas, make sure you have your eyes tested, visit a dentist, get a full check up with your doctor and a record of your immunisations, blood type, a note of any health issues and a prescription for any ongoing medications you require.

Did you know that you can load all your pertinent medical details and emergency contacts in to your mobile phone! Just click on the ‘health’ app on the iPhone, and then on the Medical ID button on the bottom right hand side – voila! This information can be accessed via the lock screen by selecting the ‘Emergency’ button on the bottom left hand side. Cool huh!?

Also check the places you are likely to visit and if necessary get vaccinated. Some of these vaccinations can take a long time, and a number of courses before you become immune. So check in advance.

If you are working on your boat – be sure to heed the health warnings on paint tins. Use protective clothing, gloves, glasses, dust masks etc. Those fumes and dust from things like antifouling are bad for you!

You might also want to consider health insurance. This of course will help you if you get sick or injured overseas. Hospital care can be astronomically expensive in certain countries.

Here in New Zealand we have ACC (Accident Compensation) which means that everyone in New Zealand has no fault comprehensive injury cover. Note this only applies to injury from an accident – as opposed to getting sick from an illness. This also applies for people visiting New Zealand and for New Zealanders overseas – so long as you are a NZ resident, pay tax here, and intend to come back to New Zealand. There is a bit of a grey area here – the law says you are usually covered for trips of up to six months, but this can be extended for longer periods.

So for example if you have an accident and lose your hand or something, you might still qualify for financial assistance from ACC to assist with getting a pirate-like hook, or some other more sensible prosthesis, along with other assistance.

Step 2 – Do a Marine Medic Course. 

This course goes way further beyond any standard workplace first aid course. We learnt all the basic bandaging stuff, right through to giving injections, doing stitches and how to look after a patient for a longer period of time.

No future as a plastic surgeon… (that is a pigs trotter by the way…)

Step 3 – First Aid Kit

Oceania Medical have some brilliant First Aid kits specifically designed for boats.

Yachting NZ Medical first aid requirements for boats going offshore are quite comprehensive. With this kit I think they presume you are going to the deepest darkest places where no hospitals exist, however you will be prepared for anything!

Keep a list of the medicines on board as you might also have to declare them in certain ports. Make sure you aren’t bringing in anything prohibited to any of the places you are visiting.

finger sliced in half…

Step 4 – Get some manuals

The Marine Medic course comes with a great handbook. But if you want some free downloadable booklets about all kinds of medical matters, then there is an amazing free resource available online here – The Ship Captain Medical Guide.

And When There is No Doctor – and No Dentist

These guides even give you advice on what to do if you are dealing with diseases, poisoning, ship wreck survivors, and – heaven forbid – dead bodies… eek!

Step 5 – Call for help

Before you go dishing out prescription medicines and stitching wounds, it is best to check with a doctor. Medical advice can be sought on the VHF and SSB radio by contacting the NZ Rescue Coordination Centre (and other countries also offer this advice too). Before you make the call on the radio, it helps to get as much background information as possible to be able to pass on to the doctor to help them make a diagnosis.

• Name of vessel, call sign, location, course, speed, origin, destination and closest port.
• Patient details, age, gender, ethnic origin etc
• Nature of illness/injury – when did it happen, history of the issue, how injury occurred, symptoms experienced
• Any pre-existing medical conditions, & medicines being taken
• Any medication you have given the person since the illness/injury began and how they responded to that. (What medicine they took, how much, when)
• Any allergies? have they consumed alcohol or drugs?
• Consciousness, temperature, pulse and respiration
• Appearance of affected parts, swelling/lack of movement/rash/bleeding etc
• Describe the general condition of the patient. How much pain they are in etc
• Any other relevant information – number of people on board, weather conditions, medical supplies available

The Ship Captain Medical guides also has a booklet about general nursing and how to care for and monitor a patient for a longer period of time.

With any luck after all that you will be able to treat your patient and carry on sailing to your destination and everyone will live happily ever after.

But if not…

Step 6 – Medevac

Should the patient require more urgent attention, there is a possibility that they may require a Medical Evacuation – Medevac. This could be on to a ship or in a helicopter. Let’s hope this never happens. But if it does here are some handy tips according to the books I’ve read.

• As well as all the patient info above, they will want to know your exact position, and may ask you to set off your EPIRB.
• Orange smoke flares or red hand held flares, or a torch can also help show your position. (Don’t use parachute flares when a helicopter is nearby or shine the torches directly at the helicopter)
• Give all methods of communication available – satellite or cell phone number, VHF SSB call signs etc
• Listen for instructions from the pilot as to how they want you to position the boat – communication is almost impossible when the helicopter is overhead due to the noise.
• Stash any loose gear away that could get blown around by the helicopter down draft
• Don’t touch the cable until it has been ‘earthed’ they will touch the cable in to the water or on the boat, wear gloves if you can.
• Do not tie the cable to the boat
• Make sure the patient is wearing a life jacket.
• Put their medical records, regular medication, passport and credit card in a plastic wallet to take with them.

I read a story somewhere about a man who was Medevac’d off a yacht in the Pacific I think, and the wife stayed on board the boat and sailed it to their destination on her own. A good consideration I think. It would be awful to have to be evacuated from the boat, and even worse if you also lost the boat in the process. Another good reason for having a boat that both people can handle alone if necessary.

Hypothermia

We had a conversation about this the other night, and none of us could agree on what was the best treatment for someone with hypothermia – which of course is quite possible to get when you sail around in the roaring 40’s down here in the Southern Pacific Ocean.

Symptoms

• Obviously they are going to be cold…
• Shivering
• Slurring speech, confusion, memory loss
• Shallow breathing
• Numbness in hands & feet
• Exhaustion and drowsiness
• Possible loss of consciousness

Treatment

• Warm them up SLOWLY
• Go inside & lay them down
• Remove wet clothes & wrap in blankets – hats, gloves, scarves, socks – warm clothing
• Warm their core first (not hands & feet) wrap hotties in a towel – do not apply directly to the skin
• Give warm sweet fluids – avoid alcohol and caffeine
• Monitor them constantly until they warm up.

Do not put them in a hot shower or bath.

Stay healthy people!

Have you ever had any major medical issues or injuries on a boat or any gems of advice to share?