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First Aid Priority

graham

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16 May 2001
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7,831
Couple of days ago swmbo flew through the air and headbutted the back of the spray hood . On reflection I think I should have dealt with her head injury before checking the spray hood frame was not bent.

Her injury was minor but serious side is how quickly an accident can occur first aid at sea is a bit different from.land based courses due to the longer time it is likely to take before professional help arrives.
 
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Stemar

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12 Sep 2001
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Home - Southampton, Boat - Gosport
Glad she's OK, more importantly, is the sprayhood OK? ;)

Having worked for an ambulance service for a good many years, what to do in the event of a serious incident has exercised my mind a fair bit but, fortunately, I've never had to deal with anything more serious than a hat overboard. On a fully crewed race boat, it should be possible, but two-up, ISTM that effective CPR isn't going to happen, not for the time a helicopter would take to get to me, even in the Solent, never mind somewhere more remote. I'd give it a go, but there comes a time when I'd have to think about my own survival. If I'm the one needing it, Milady's disabled, so there's no way she could do it, so goodnight. I do carry the wherewithal to control bleeding and treat burns; as for fractures, I'm never far enough offshore to do anything other than leave well alone and wait for the experts - and the Entonox. When Milady took a tumble and broke her humerus last year, there was no way she was moving without it
 

Plum

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UK East Coast
First priority, for anything serious, is to call the Coastguard. If you are not sure if it is serious, call them anyway. Time may be critical and you can't make up lost time. If there is blood dripping onto the floor or a breathing problem, you need help quickly. Also, once you have called the CG they can get a doctor on the radio/phone to you very quickly. I highly recommend a first aid course, and if you can find one delivered by a trainer that is also a sailor, even better.

Www.solocoastalsailing.co.uk
 
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Athomson

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First priority, for anything serious, is to call the Coastguard. If you are not sure if it is serious, call them anyway. Time may be critical and you can't make up lost time. If there is blood dripping onto the floor or a breathing problem, you need help quickly. Also, once you have called the CG they can get a doctor on the radio/phone to you very quickly. I highly recommend a first aid course, and if you can find one delivered by a trainer that is also a sailer, even better.

Www.solocoastalsailing.co.uk
One of my boat keen friends is a paramedic. The ultimate safety precaution taking him along :cool: Actually he's available for crewing on the Medway if someone wants his reassuring presence
 

V1701

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1 Oct 2009
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South Coast UK
This reminds me of being two-up in the middle of the night coming round towards Milford Haven in conditions we really should not have been out in, in a then new to me boat. Both of us in the cockpit clipped on having already had a couple of smaller things go a bit awry, we'd given up trying to do watches and rest below. I remember very well realising that there was practically no margin for error left and that was quite scary. Had one of us sustained any sort of injury heaven knows what would have happened...
 

johnalison

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Essex
We have never had a serious, or even just unpleasant, injury on board, touch wood. Some of our companions and club fellows have though, and it makes me feel that caution is the only solution since it is unlikely that one would be prepared well for anything serious when away from assistance. Injuries that have happened to friends include: concussion from the boom in someone who should have known better, a broken shoulder from a fall in the companionway, facial burns from an engine fire, and one death from falling overboard without a lifejacket.

I’m sure that a good first-aid kit and training are worthwhile, but, as the OP say, these things happen so quickly and unexpectedly that there comes a point where we have to accept that there are risks in sailing, even before one has left the marina.
 

johnalison

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One of my boat keen friends is a paramedic. The ultimate safety precaution taking him along :cool: Actually he's available for crewing on the Medway if someone wants his reassuring presence
We once met an old boy, I think in Flushing in a bar. He was sailing with three companions, which included his daughter who was a doctor, and an undertaker. He reckoned that he was well covered.
 

JumbleDuck

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SW Scotland
We once met an old boy, I think in Flushing in a bar. He was sailing with three companions, which included his daughter who was a doctor, and an undertaker. He reckoned that he was well covered.
A friend of mine discovered that he had a congenital heart attack when it failed while he was playing tennis. Luckily he was playing a doubles match with three GPs, who managed between them to keep him alive until the ambulance arrived, but even then it was a close thing and recovery took over a year.
 

Stemar

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A good starting point, but wofully inadequate.
Having done a few such courses, I reckon they're probably as good as you can get. It isn't the course that's woefully inadequate, it's the participants. I joked to someone on the last one I did that I'd been a first aider since the Cubs more than 50 years ago, and the only time I'd ever done any first aid was gluing my kids back together when they came off their bikes. On the few occasions I came across a real casualty, all I could do was go though Dr ABC and reassure them an ambulance was on its way. A one day course isn't going to turn Joe or Josephine Public into a paramedic.

I make no apology for going on about the following:
D – Danger
On the first step of DRABC, you need to determine whether it is safe to approach the casualty and that yourself and anyone else isn’t in a position also to become a casualty. For example; this could be stopping any oncoming traffic, looking out for live electricity, looking out for any places you could fall or trip over.

Once you can confirm there is no potential danger, you can begin to assess the casualty.

R – Response
Next, you need to try and get some response from the casualty so the casualty can tell you what is wrong with them. To do this, use the AVPU scale, which will help you scale the level of response from the casualty.

  • A – Alert: first of all, is the casualty moving or talking? If not, proceed to V.
  • V – Voice: Try speaking to the casualty loudly and clearly to see if they respond to speech. Make sure that you are in the casualty’s eye line so that they can see who is talking. If you get no response, proceed to P.
  • P – Place: Place your hand on the collarbone of the casualty and carefully but firmly shake them. At this point, you need to continue to speak to the casualty, making them aware of who you are. P can also stand for pain if the casualty responds as if they are in discomfort. If they do not show any signs of responsiveness proceed to U.
  • U – Unresponsive: at this point, you can assume the casualty is unresponsive.
A – Airways
Now you need to investigate why the casualty is unresponsive by checking their airway. To do this, you need to place the casualty on their back and tilt their head back. Place your hand on the chin and forehead and lightly tip back their head. With your fingertips on the chin of the casualty lift their mouth open to open the airways.

B – Breathing
When the airway is open; look out for any signs of normal breathing for 10 seconds. Look out for if the casualty looks to be breathing abnormally, infrequently or not at all. Start applying CPR if you notice any of these symptoms.

If the casualty is unresponsive but is breathing normally and isn’t in a state where they can be moved without damaging them further put them into the recovery position.

C – Call 999 / Circulation
If you reach this point and the casualty isn’t breathing you need to get someone to call 999 or if you are alone put your phone on speakerphone and do it yourself. Never start CPR until the emergency services have been called. If possible, get someone to go and get an AED while you speak to the emergency services and stay with the casualty
 

ProMariner

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6 Jan 2012
Messages
186
When my numbers up, I hope I go noisily, with a huge amount of mess and inconvenience. (Gary Larson)

I think it's this feeling of inadequacy that keeps us on our toes, a constant background narrative of 'what if' scenarios playing on your mind is no bad thing.

I try to compliment people moving around the deck well, ie crouching motion, keeping handholds close, and using deck fittings as toeholds, rather than telling them off for moving around carelessly. Slips, trips, and falls, the silent menace.

And was the spray hood frame ok? You can usually straighten minor bends, but if it's kinked at all...
 

capnsensible

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15 Mar 2007
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30,340
Location
Atlantic
The old Ship Captain Medical has changed a bit over the years....wel what it's called has. I think it was Medical Profficiency At Sea when I did it.

Anyway, best bit was when our course instructor sent us off for lunch with the words ' when you get back this afternoon, we are gonna do Death'.
 

colind3782

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18 Jan 2011
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Shropshire/Empuriabrava
Having done a few such courses, I reckon they're probably as good as you can get. It isn't the course that's woefully inadequate, it's the participants. I joked to someone on the last one I did that I'd been a first aider since the Cubs more than 50 years ago, and the only time I'd ever done any first aid was gluing my kids back together when they came off their bikes. On the few occasions I came across a real casualty, all I could do was go though Dr ABC and reassure them an ambulance was on its way. A one day course isn't going to turn Joe or Josephine Public into a paramedic.

I make no apology for going on about the following:
D – Danger
On the first step of DRABC, you need to determine whether it is safe to approach the casualty and that yourself and anyone else isn’t in a position also to become a casualty. For example; this could be stopping any oncoming traffic, looking out for live electricity, looking out for any places you could fall or trip over.

Once you can confirm there is no potential danger, you can begin to assess the casualty.

R – Response
Next, you need to try and get some response from the casualty so the casualty can tell you what is wrong with them. To do this, use the AVPU scale, which will help you scale the level of response from the casualty.

  • A – Alert: first of all, is the casualty moving or talking? If not, proceed to V.
  • V – Voice: Try speaking to the casualty loudly and clearly to see if they respond to speech. Make sure that you are in the casualty’s eye line so that they can see who is talking. If you get no response, proceed to P.
  • P – Place: Place your hand on the collarbone of the casualty and carefully but firmly shake them. At this point, you need to continue to speak to the casualty, making them aware of who you are. P can also stand for pain if the casualty responds as if they are in discomfort. If they do not show any signs of responsiveness proceed to U.
  • U – Unresponsive: at this point, you can assume the casualty is unresponsive.
A – Airways
Now you need to investigate why the casualty is unresponsive by checking their airway. To do this, you need to place the casualty on their back and tilt their head back. Place your hand on the chin and forehead and lightly tip back their head. With your fingertips on the chin of the casualty lift their mouth open to open the airways.

B – Breathing
When the airway is open; look out for any signs of normal breathing for 10 seconds. Look out for if the casualty looks to be breathing abnormally, infrequently or not at all. Start applying CPR if you notice any of these symptoms.

If the casualty is unresponsive but is breathing normally and isn’t in a state where they can be moved without damaging them further put them into the recovery position.

C – Call 999 / Circulation
If you reach this point and the casualty isn’t breathing you need to get someone to call 999 or if you are alone put your phone on speakerphone and do it yourself. Never start CPR until the emergency services have been called. If possible, get someone to go and get an AED while you speak to the emergency services and stay with the casualty
Just a couple of comments. If the casualty has no pulse and is not breathing, start CPR immediately. Bad CPR is better than no CPR.
These days it is recognised that it's important to stem any catastrophic heamorrhage first (C-ABC), using an improvised tourniquet if required to stop the bleeding. Get training and be as self-sufficient as is possible.
 

penberth3

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9 Jun 2017
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2,088
Just a couple of comments. If the casualty has no pulse and is not breathing, start CPR immediately. Bad CPR is better than no CPR.
These days it is recognised that it's important to stem any catastrophic heamorrhage first (C-ABC), using an improvised tourniquet if required to stop the bleeding. Get training and be as self-sufficient as is possible.
Strongly disagree with that. If alone with a casualty you should call for help first - already mentioned above. If not when do you stop CPR to make that call?
 

colind3782

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Shropshire/Empuriabrava
Strongly disagree with that. If alone with a casualty you should call for help first - already mentioned above. If not when do you stop CPR to make that call?
Your post would suggest that you are not alone but, if your are, put the phone on speaker while you're getting on the chest. The person you sent to swim for an AED might be better utilised to make the 999 call? After all, this thread is about first aid on a boat.
 

penberth3

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9 Jun 2017
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Your post would suggest that you are not alone but, if your are, put the phone on speaker while you're getting on the chest. The person you sent to swim for an AED might be better utilised to make the 999 call? After all, this thread is about first aid on a boat.
OP suggests one person and casualty, nobody mentioned swimming for an AED. And if you're at sea it's going to be VHF, not phone isn't it?
 

Thistle

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2 Oct 2004
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Here
Just a couple of comments. If the casualty has no pulse and is not breathing, start CPR immediately. Bad CPR is better than no CPR.
These days it is recognised that it's important to stem any catastrophic heamorrhage first (C-ABC), using an improvised tourniquet if required to stop the bleeding. Get training and be as self-sufficient as is possible.
The current advice is don't bother trying to check for a pulse - in adverse conditions it's likely to be difficult to find and looking for it may waste time. If the casualty is unresponsive and not breathing normally, call for help then start CPR .
 

penberth3

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The current advice is don't bother trying to check for a pulse - in adverse conditions it's likely to be difficult to find and looking for it may waste time. If the casualty is unresponsive and not breathing normally, call for help then start CPR .
Yes, that's right.
 

Sandy

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On the Celtic Fringe
Having done a few such courses, I reckon they're probably as good as you can get. It isn't the course that's woefully inadequate, it's the participants. I joked to someone on the last one I did that I'd been a first aider since the Cubs more than 50 years ago, and the only time I'd ever done any first aid was gluing my kids back together when they came off their bikes. On the few occasions I came across a real casualty, all I could do was go though Dr ABC and reassure them an ambulance was on its way. A one day course isn't going to turn Joe or Josephine Public into a paramedic.
Perhaps I am just a tad bias as I was a member of a Mountain Rescue Team for five years, but we are usually just a bit more than the maximum response times for the local ambulance trust to reach us.

I totally agree that a one day course is not going to make us into paramedics, but they could beef up patient management while we head back to the nearest safe haven or for the SAR helicopter/Lifeboat to arrive.
 
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