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First Aid on Board

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Prospector
Master Marine Consultant

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Canada
3159 Posts

Initially Posted - 03/05/2009 : 17:39:37

So my club is considering a First Aid Course early in the season to help our skippers Whether cruising or racing be better equipped to handle whatever arises out there.

I suggested a course like this one: http://www.wildmed.ca/wafa.html (4 days, improvisational first aid tailored to your environment)

I have been told that this is overkill and that all we need is a course like this one:

http://www.sja.ca/Ontario/Training/AtHome/Pages/EmergencyLevelFirstAid.aspx (One Day course, electives are limited to what the workbooks contain and what time allows *Make sure we get CPR!!*)

Am I nuts, or is a more robust training required when you come to situations that:

<ul><li>Occur aboard (limited resources/supplies, small working space, rolling and pitching environment) </li>
<li> Occur on shore excursions (identify to move vistim to ship, transporting victims, moving them in and out of dinks, and on to the boat, setting up and equipping shore camp/treatment centre) </li><li>Occur in the water (Diving accidents, drownings, hypothermia, recovery of passed-out victims </li></ul>

The biggest complaint from the club officers: if we get the wilderness course it will be too long, and we wont get CPR certification that is valid at work. To which I respond WHAT!?! You are saying no to a course that is specifically tailored to your environment (they will teach it in our marina - and even afloat) but you would rather have a course that is about how to handle an office emergency (basically call 911 and pray) because its short and you get a piece of paper?

Sorry this moved from seeking advice to a rant. I just can't believe the people who can't see forests for trees. Aye Carumba.

"Iris"
1984 FK/SR #4040
http://frosthaus.blogspot.com/

Take a minute to register your boat with the association!!
http://www.catalina-capri-25s.org/owner_questionnaire.htm

Edited by - Prospector on 03/05/2009 17:41:03

bigelowp
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USA
1776 Posts

Response Posted - 03/05/2009 : 17:48:55

Both courses have merit. I tend to agree with you that a course designed for being away from readily available medical care is more to point. I have a Boy Scout book on board as it seems to cover such events with McGiver solutions. I would suggest your club make both courses known and suggest that individuals make their own choice -- or do nothing if they are so inclined.

Edited by - on

delliottg
Former Mainsheet C250 Tech Editor

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USA
4479 Posts

Response Posted - 03/05/2009 : 18:57:43

One way to look at it is some training is better than none. While the four day course might appeal to you, it wouldn't to me, and I used to be a fireman a long time ago. If I were headed out into the wild & woolies, I'd be much more interested in a thorough course like that. I have a number of books on medicine at sea, and a fairly extensive first aid kit, and both of us have been through a recent Red Cross offered first aid course including CPR. However, if something catastrophic occurred, I'd still be calling for help. And it's not unreasonable for it to arrive in under an hour, but there's a fairly large contingent of USCG, Harbor Patrol, etc. in our immediate area. If we were headed out to Campbell River at the north end of the Strait of Georgia for an extended trip, I'd want to be more prepared.

However, all of this should be taken with a grain of salt, at least in regards to me, I've actually performed CPR a couple of times, stopped the bleeding from a femoral artery nick (bar fight, not my own), transported someone with a broken ankle down a sheer cliff face, run through walls of flame in brushfires, leapt tall buildings in a single bound & stopped locomotives. Sorry perhaps I'm bragging, but I feel I'm more prepared than a lot of folks out there.

That said, when Rita broke her foot Thanksgiving before last, I had no idea what to do in the situation we were in. Yes, I was able to provide first aid, and my brother & I got her to the end of the dock and into our truck successfully, but I still had six other people I was responsible for, a boat bobbing at the dock with three of my brother's grandkids & wife in it, and no way to get Rita to the hospital quickly. I couldn't leave the boat where it was, I couldn't go out & anchor it, we didn't have our dinghy, and swimming back wasn't an option in 40° water, motoring back to our marina would have been at least half an hour of banging her ankle up, and derigging the boat would take two hours. I had never before or since felt so helpless. Fortunately some good samaritans gave my brother a ride to our marina to pick up his car, and my sister in law was able to give Rita a ride to the emergency room while my brother & I derigged the boat for trailing. All the training in the world doesn't prepare you for when someone you love gets hurt badly, and I felt miserable for not being able to care for her as I felt I should have been.

Whew, that got a bit maudlin, huh?

Edited by - on

Dave5041
Former Mainsheet Editor

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USA
3758 Posts

Response Posted - 03/05/2009 : 20:05:49

It takes exstensive training and frequent practice to be competent in advanced skills. If you learn it but don't use it, you will forget it. A general first aide course from the Red Cross that includes CPR certification is what I would consider most appropriate. Most emergencies are not life threatening; what is important is to keep the patient stable, as comfortable as possible, and don't do further damage. A basic first aide course will cover that. Anyone can teach you CPR, but getting the paper means that you have learned to do it right - no further damage. I am certified in CPR, Advanced Cardiac Life Support, Pediatric Life Support, and Neonatal Resuscitation, but what I think is valuable aboard is knowing how to deal with cuts, bumps (head injury to broken bones), and burns (sunburn to fire). The really important things are knowing how to evaluate the seriousness of an injury, the time window for treatment, interim care measures, and how to get help.

Edited by - on

Kendall
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USA
146 Posts

Response Posted - 03/05/2009 : 20:37:32

I have American Red Cross AED, CPR, EpiPen, Oxygen, First Aid, and Lifegaurding. I think the not-so-common, common sense is your most important tool in an emergency. For training, it makes no sense to overwhelm yourself with information you will soon forget. The most you can do is practice your skills. At the camp I work at during the summer, we practice different rescues and CPR every single day. Because the card is good for a year, but I will forget everything I learned in a year. If you are that interested in an advanced first aid course then you should pursue it for yourself. You cant make your clubmates want to learn if all they want to do is charge an extra $1 per hour when they babysit.

Edited by - on

Dave Bristle
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Djibouti
10005 Posts

Response Posted - 03/05/2009 : 20:49:22

Chris... If many more club members will participate in a one day course including hands-on CPR, than a four-day course, I think there's some value to the former. CPR--knowing when as well as how--is the especially critical skill that should be taught and practiced. Then I would suggest having something like [url="http://www.amazon.com/American-College-Emergency-Physicians-Secondedition/dp/0756601959/ref=sr_1_3?ie=UTF8&s=books&qid=1236306689&sr=1-3"]this book[/url] aboard every boat. (I have one at home and one on the boat.) That combination might not make your members EMTs, but they'll be better prepared than before. In most situations other than cardiac arrest, you probably don't want to be totally reliant on memory, and the four days might not have covered a particular situation anyway.

Edited by - Dave Bristle on 03/05/2009 21:59:26

Prospector
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Canada
3159 Posts

Response Posted - 03/05/2009 : 20:56:34

OK so maybe I'm off base then.

Back about 10-15 years ago I was in competitve first aiding (which sounds weird even now as I type it) but it was really cool.

Basically teams of 4 would be thrown into a mock-up of a scenario and then judged on efficiency, triage, diagnosis, treatment, evacuation, and so on. The scenarios would range from a kid burning themself on a stove and an adult freaking out to car accidents, fires, etc. all situations demanded teamwork and keeping a cool head and creativity in assessing/treating the situation.

Since I have that background, to me its pretty much common sense that you would want to have as full and flexible a training as possible. Basically recognizing that just because something doesn't come in a plastic bag labelled "Splint" doesn't mean it can't be used for that. (My favorite splint is still a bicycle inner tube - but thats for one unique break, and I've never had a chance to use it in real life.)

I agree with your comment Kendall, that creative thinking and constant maintenance are key to being an advanced first aider. Add to that powerful leadership, and strong decision making skills, and you have a winning formula for when the skills are tested.

Dave B. I agree (mostly) with your comment, but if I am on a shore excursion in Georgian bay this summer, and my kid gets mauled by a bear while picking blueberries, it is unlikely that the best thing to do will be to make her as comfortable as possible until help arrives. It is those situations where wilderness, or situational first aid comes into play. How fast can you treat the critical wounds with what's on hand, what decisions can you make to move the victim to safety as quickly and painlessly as possible, and do you have the mental toughness to live with the outcome of those decisions?

To sit and wait for help up there would mean hours before trained help arrived. Once we make it to the north shore of Superior (mid-term goal) the window would be even longer.

Again, I am probably a little (a lot) over the top on this, but my background is in remote wilderness canoeing, and my training and competition was all supplied by the military, so to me prevention and training are pretty critical.

I go now to buy my lifesling...

Edited by - on

dlucier
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Virgin Islands (United Kingdom)
7583 Posts

Response Posted - 03/05/2009 : 21:36:37

I carry a nice first aid kit onboard. It's got band-aids of various sizes.

Edited by - dlucier on 03/05/2009 21:38:36

Dave Bristle
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Djibouti
10005 Posts

Response Posted - 03/05/2009 : 22:18:55

Not off base... Everybody's circumstances are different... For north woods excursions, you're exactly right, Chris. I probably should get a first aid and CPR refresher. This is a good reminder.

Edited by - on

Walt Oler
1st Mate

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USA
44 Posts

Response Posted - 03/05/2009 : 23:25:33

Several years ago, I participated in a Boy Scout sponsored wilderness first aid course led by [url="http://books.google.com/books?id=ujbRSDyozlAC&dq=wilderness+first+aide&printsec=frontcover&source=in&hl=en&ei=Zq6wSfPgLI7CMffy5eoE&sa=X&oi=book_result&resnum=13&ct=result#PPP1,M1"]Dr. William Forgey[/url] . He drew a distinction between "wilderness" first aid and "urban" first aid. In the latter, call 911 and help is coming. In the former, you may have to transport the victim to help or at least maintain the victim for an extended time until help can arrive. The surprising part was that in the case of wilderness first aide, cpr can not be sustained for an extended time and if started, may lead to an endangerment of the rescuer because of lack of attention to immediate safety threats. In other words, it may make you feel good, but it's probably not going to help. I would think that yaughting first aid falls into this category and that first aid training should focus on treatments of sickness, hypothermia, bleeding, broken limbs, and shock, etc.

Edited by - Walt Oler on 03/05/2009 23:29:34

Prospector
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Canada
3159 Posts

Response Posted - 03/06/2009 : 08:50:33

<blockquote id="quote">quote:<hr height="1" noshade id="quote">Originally posted by dlucier
 I carry a nice first aid kit onboard. It's got band-aids of various sizes.
<hr height="1" noshade id="quote"></blockquote id="quote">

So this is where I get to show just how far over the top I am... hailing back to the wilderness canoeing days, we always carried 2 FA kits. One was a "trail pack" and was limited to an assortment of bandages, some sport drink packets (for dehydration), a handful of aspirin, and other small quick things to handle trailside events like exhaustion, blisters, scrapes and small cuts. When we are sailing we keep that kit in the starboard cockpit seat storage (the one thats too small to be called a lazarette).

When canoeing we also carried a second major first aid kit that contained more serious bandages, tensors, surgical scissors, a wound stapler/suture thing, a couple of maxi pads (very absorbant for deep bleeding wounds - among other intended uses), irrigation equipment, and the list goes on. The thinking was that if anyone put an axe through their foot, fell from a cliff face, tried to stop a speeding locomotive or ran through a wall of flames, we would be able to treat them, but since these events occur less frequently than blisters and scrapes, it didn't need to be "right at hand". Aboard Iris we keep that kit in the hanging locker opposite the head.

We also have a fire extinguisher in each of those locations. (Never carried those for canoeing though

)

Having the 2 FA kits in separate packs was also a redundancy thing so that if a canoe was lost over Niagara Falls, at least one first Aid kit would be in the other boat. If we were travelling with only one canoe, then if one pack could be recovered, you at least had some supplies to work with. The key to wilderness FA though is being able to improvise. Knowing that natives used sphagnum as an absorbant for years (Stuff a sock full of dry sphagnum moss and you have a very absorbant dressing) before bandages were invented, knowing what plants are restoratives and how to use them, knowing what the reason for splinting is, and how you can re-create that effect even without a proper splint.

I think that on the boat, having the 2 kits is still a good idea. Boats leak, and it would suck to find a kit had been soaked so that nothing was useable. Things get dropped overboard, wind can make a mess of things, redundancy of critical systems is a good thing. But just as important as having the supplies is having the know-how to use them. I could have the fastest car at LeMans, but since I know nothing about driving at that level, there is no way I could do anything with it.

Although I carry this stuff all the time, the most commonly used article from the kits is the gatorade pouches. And once I learned to make Wintergreen tea, we don't even use it anymore. (Wintergreen naturally contains Salicylic acid, and so reduces the headache that comes with dehydration/heat exhaustion. It has a minty-wintergreen flavour which is very mild and agreeable, and because it is warm, it won't shock a system that has over heated. Being a tea, it will re-hydrate a person, although it does not contain the electrolytes that a sport drink does. To overcome this, you can add a little salt to the tea.) In fact, although I inventory the kits each season, I don't remember having to replace anything other than the "Disney Princess" bandages that suddenly were critical to have on my daughter's every boo-boo once we got them. ("Oh, there's no more princess band-aids? I guess I don't need one then...")

Of course the day I don't restock a kit, or it gets left home, some one will take a header on the companion way stairs and split their head wide open, while running to put water on their hand after burning it on the stove, concurrently dislocating their pelvis; leaving me without means to treat them. The gall of some people!

Edited by - Prospector on 03/06/2009 09:08:16

Sloop Smitten
Master Marine Consultant

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Response Posted - 03/06/2009 : 09:55:39

Keep it simple - Marry a nurse.
Worked for me!

Edited by - on

Nautiduck
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USA
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Response Posted - 03/06/2009 : 12:07:33

In addition to having a first aid kit that is probably like Don's (well, maybe a bit more sophisticated) we also try to use preventative measures. For one, we don't go picking berries where there are bears.

Edited by - Nautiduck on 03/06/2009 12:08:39

dlucier
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Virgin Islands (United Kingdom)
7583 Posts

Response Posted - 03/06/2009 : 15:10:11

Actually, I do have a nice first aid kit that has a whole bunch of stuff in it like cold packs, heat blankets, gauze, ace bandages, and...band-aids.

Edited by - on

John Russell
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Response Posted - 03/06/2009 : 15:35:47

I spent 23 years as a medic in the military, some of those years in pretty remote locations. I think I have this one covered.

Unfortunately, my wife and kids didn't. I guess I'd better not get hurt.

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delliottg
Former Mainsheet C250 Tech Editor

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Response Posted - 03/06/2009 : 15:59:24

<blockquote id="quote">quote:<hr height="1" noshade id="quote">I guess I'd better not get hurt<hr height="1" noshade id="quote"></blockquote id="quote">

This plays into one of Rita's biggest fears, that I'll get hurt or over board, or whatever so I'm out of the picture, and what does she do?

It's one of the reasons I signed us up for the FA class that we took, so she'd have more knowledge to work with, but as mentioned, if you never use it, you lose it.

She's also fearful of having to run the boat by herself, which is why I make her drive when we're setting or raising the anchor, or have her take us through a tack. I'm planning on many more of these types of drills this year to hopefully bring her confidence level up.

Somewhat surprisingly, she's taken a keen interest in the VORG race, and is beating the crap out of me (and a lot of you guys too). I view this as nothing less than training for our eventual cruising life, learning to read winds, planning routes, etc. Plus she's been asking more sailing related questions lately (and let me purchase a new spinnaker pole).

Edited by - on

Nautiduck
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Response Posted - 03/06/2009 : 17:38:31

I guess I'd better not get hurt.

In addition to the crew learning to sail, one of the critical skills is for them to know how to operate the VHF, GPS, etc so that they can make an emergency call and be able to describe the boat's location. I'm thinking about making up a laminated set of instructions to hang by the VHF.

Edited by - on

John Russell
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USA
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Response Posted - 03/06/2009 : 18:00:01

I have one that I think I got from the USCG Auxilary at a boat show. Although, it might have been from BoatUS or the USPS.?.?

Edited by - on

delliottg
Former Mainsheet C250 Tech Editor

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Response Posted - 03/06/2009 : 18:40:29

In our instruction manuals binder, on the first page is Davis' "Suddenly in charge" hard plastic card. I make a point of telling passengers where this is, just in case, and showing them how to set the VHF to 16 (it's normally scanning 9-13-16-22a), and where the DSC display is so they can call for help. We leave the binder on the settee where it can be easily found.

Edited by - on

Dave Bristle
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Djibouti
10005 Posts

Response Posted - 03/06/2009 : 22:54:26

Laminated instructions are a great idea... I've been working on a set that will be aboard this summer. One side is on making various types of calls on the VHF. The other is on basic functions for operating the boat, which of course is simpler on mine than on yours.

Edited by - on

sweetcraft
Admiral

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USA
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Response Posted - 03/07/2009 : 00:51:36

I'm getting the book and looking into local class of 1st Aid Refresher. Yes it's OK to plan one to four sessions so at least you can get started again with the first responders plan. Great thread as we all need a plan with our sailing activity. I have the Life Sling and the plan to use it. Now with this thread how to protect someone in need with first aid. I have been put to the test to get someone back on board without the Life Sling and because my sister and brother-in-law were on board we were able to get the young woman on board where we could give her first aid. She recovered but the experience really woke me up.

I like the discussion of a plan for if you have aid coming or if you have to prepare for long delay before help comes. Can you prepare your crew to help? The hard plastic cards by the numbers for easy directions of using the radio and one with instructions of running the boat, getting the sail down, starting the outboard, steering are questions that could be asked during an emergency.

Since a lot of us sail alone what would be the best plan if someone was in the water hurt? Get to them, control the boat, call for help, get them first aid and then? You really have to be prepared to make quick decisions and do your best with what you can do. This is really making me work on my basic plan of First Aid and be better prepared. The season is about to start and we have the North West Cruise too so I will be checking on my First Aid Pact on the boat tomorrow. What do you carry on board in your First Aid Kit?

Edited by - on

delliottg
Former Mainsheet C250 Tech Editor

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4479 Posts

Response Posted - 03/07/2009 : 08:00:46

Our first aid kit contains:
NSAIDS (Tylenol, Ibuprofen, aspirin, naproxen sodium): Pain & fever relief
Benadryl: relief from allergic reactions and congestion, sleep inducer
Ginger products (Altoids, gum, etc) relief from sea sickness
Anti sea sickness medicines: Bonine, including kids formula, etc.
Glucose lozenges, quick energy, treatment of diabetic reactions
Maxi-pads: for both their primary use, and as super absorbent wound dressings
Latex gloves
Heavy duty scissors
suture kit
Sewing kit
Dental floss (can be used for making stitches)
Xacto knife & spare blades, can be used as a scalpel
Lots of bandages, including kids type for boo-boos
Anesthetic gel
Sun screen/lip balm
Zinc oxide
Aloe & Solarcain for sunburns (we can hope to get them up here), but works for windburn too.
Instant cold paks (2)
Anti-sting pen rubberbanded to benadryl
Several ace bandages
Surgical tape
Super glue (easier than stitches & way faster)
Anti diarrheal
Caladryl
Betadine soap & scrub pads
Alcohol prep pads
Alcohol
Anti-itch cream
Emergency dental repair kit
dental wax
eye cup
eye patch

I'm sure I'm forgetting some stuff since I'm doing this from memory. All of this fits into a "bucket mouth" bag that's bright yellow (couldn't find a red one) & sits directly under the cabin ladder next to the tool box.

Edited by - delliottg on 03/07/2009 12:31:41

Dave Bristle
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Djibouti
10005 Posts

Response Posted - 03/07/2009 : 11:42:07

Some good ideas in that list, although I don't feel qualified to be using a scalpel...

Edited by - on

sweetcraft
Admiral

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USA
816 Posts

Response Posted - 03/07/2009 : 22:10:17

Thanks for the list,it is time to go over the on board kit just before the boating season. Your list will be added to my list and I use a water tight box from WM for storage and easy access. I need to work on labeling for containers and storage areas plus sail handling devices that are described in the on board operating manual . Someone else could take over and help if I become the victim. My daughter will be sharing the cruise this summer and I had better have the boat in order.

Edited by - on

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