This is why the RYA insist that a MOB goes to hospital

GrahamD

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So should I go to hospital every time I've been for a swim.? :rolleyes:

Not unless you have breathed in or swallowed a lot of water. Most people with these problems will have been in some difficulties. The precautionary principle should be applied.
 

Colvic Watson

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So should I go to hospital every time I've been for a swim.? :rolleyes:

That's a bit of an ignorant reply. Sudden unexpected immersion as in an MOB often causes an involuntary in-breath when the head is under water, it's part of the shock process and is not the case when you jump in deliberately. That involuntary breath can suck water into the lungs, hence the sensible precaution of a hospital check.
 

JumbleDuck

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That's a bit of an ignorant reply. Sudden unexpected immersion as in an MOB often causes an involuntary in-breath when the head is under water ...

If every dinghy sailor who ever capsized went to hospital, just to be on the safe side, A&E departments would be even more bursting at the seams than they are. A quick google suggests that hospital visits are recommended only when there are symptoms of dry or secondary drowning - the chap in this report had blood coming out of his nose, for example.
 

Triassic

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The RYA advice is a typically corporate response from any organization that is expected to offer a view or have a policy on anything remotely related to "Health and Safety". These responses rarely take into account any level of common sense because they simply cannot afford to rely on it being present in any situation, or if it is anyone being prepared to take responsibility for using it. What happened to this chap, although very sad, is actually quite rare and it is likely there were other medical reasons for him being more susceptible than others. Yes it's something we as sailors should be aware of, but to suggest every MOB has to go to hospital is in my humble view an over-reaction. It's a bit like telling you to have your boat lifted out of the water every time you ground it just in case the keel falls off next time out.
 

ronsurf

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That's a bit of an ignorant reply. Sudden unexpected immersion as in an MOB often causes an involuntary in-breath when the head is under water, it's part of the shock process and is not the case when you jump in deliberately. That involuntary breath can suck water into the lungs, hence the sensible precaution of a hospital check.

This is what I was led to believe. I actually only learnt about this a couple of weeks during an ICC assessment. I'd seen no literature or guidance referring to it at all. When you dive in, or capsize a dinghy, or swim you are conscious and not inhaling any water. If someone gets knocked into the water, they (or even you) are completely unaware if they've taken a gulp of air/water, or are even conscious. They could be unconscious for a minute or two, but come round by the time you get to them.

It seems a sensible precaution to take a MOB in for obs, or even a proper check over by someone who knows what they are doing, which is not something you can do while sailing a boat. I'm more surprised that this information isn't more widely publicised so that more skippers are aware of it. Hopefully this sad case can help raise awareness and reduce the risk of it happening to others.
 

Triassic

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It seems a sensible precaution to take a MOB in for obs, or even a proper check over by someone who knows what they are doing, which is not something you can do while sailing a boat.

OK, lets just look at the practical implications of that for a moment. You are for example sailing your 32' AWB five miles offshore when your 32 year old crew member trips on the side deck and goes over the side. You luff up immediately, chuck him the Dan buoy and after he has managed to stop cursing at the auto inflating lifejacket you made him wear he swims to the buoy and you pull him back on board without further incident. He is now on deck dripping all over the cockpit and your priority is deciding if you should make him take all his clothes off before letting him go below or cancel the Mayday your wife has put out because "that is what the RYA told her to do on her crew course".

Are you now going to alter course for port so that you can get him ashore and call an ambulance to take him to the nearest hospital, call out the lifeboat for a Medevac, or tell him to go and put some dry clothes on and be more careful where he walks next time?

For those of you that ticked the first option, and most definitely the second, congratulations. You are the reason the NHS and our emergency services are under the strain they are so when there is a real emergency and there isn't the resources available to deal with it effectively please don't look elsewhere for the reasons why.
 

ronsurf

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you pull him back on board without further incident.

Good luck with that one. Assuming they get back on board I would call for the emergency service. At least call them and get their advice. There is no way I would want a death, or even want to deny any medical attention to anyone on board a boat I was skippering. That's my rule. I would never want to answer the question: Why didn't call for help? YMMV.

I once watched someone step down from their boat on to the pontoon at Noss Mayo. There was a startling crack and he fell over. Turns out his hamstring had snapped. Not life threatening, but serious. The guy is in pain. I suppose you could give him aspirin, tell him to man up and sail back home to Portsmouth. But the skipper called an ambulance. The disappointment that his annual cruise was over was obvious, but care of his crew took precedence.
 

Topcat47

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I DID NOT KNOW THIS WAS POSSIBLE! Thanks for the posting, it's definitely something else to consider when dealing with a MOB situation. I suppose there are associated symptoms which accompany such a situation. If anyone knows what they are, please post them here. Following the coast guard's appalling handling of a boom knock-out situation on a cruiser last summer, I don't have confidence that there'd be an appropriate response to a request for medical advice/assistance that I used to prior to the re-organisation.
 

Sandy

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OK, lets just look at the practical implications of that for a moment. You are for example sailing your 32' AWB five miles offshore when your 32 year old crew member trips on the side deck and goes over the side. You luff up immediately, chuck him the Dan buoy and after he has managed to stop cursing at the auto inflating lifejacket you made him wear he swims to the buoy and you pull him back on board without further incident. He is now on deck dripping all over the cockpit and your priority is deciding if you should make him take all his clothes off before letting him go below or cancel the Mayday your wife has put out because "that is what the RYA told her to do on her crew course".

Are you now going to alter course for port so that you can get him ashore and call an ambulance to take him to the nearest hospital, call out the lifeboat for a Medevac, or tell him to go and put some dry clothes on and be more careful where he walks next time?

For those of you that ticked the first option, and most definitely the second, congratulations. You are the reason the NHS and our emergency services are under the strain they are so when there is a real emergency and there isn't the resources available to deal with it effectively please don't look elsewhere for the reasons why.
As the skipper it is your call, make sure you are happy with it as you sit at the inquest looking at the crew's wife and children as the Coroner states that the death was avoidable had you come into port.

I know of no lifeboat crew, helicopter crew, ambulance crew, A&E consultant, junior doctor, matron, staff nurse or hospital cleaner who will criticise you for getting your crew into their care, but hey ho I take it you have never lost close friends through an accident at sea or on the mountains.
 

JumbleDuck

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For those of you that ticked the first option, and most definitely the second, congratulations. You are the reason the NHS and our emergency services are under the strain they are so when there is a real emergency and there isn't the resources available to deal with it effectively please don't look elsewhere for the reasons why.

At my local sailing centre on a windy weekend recently there were a bunch of Picos out, with one going over every five minutes or so. The ambulances would never have stopped. Shame, because the children seemed to be enjoying themselves.
 

JumbleDuck

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As the skipper it is your call, make sure you are happy with it as you sit at the inquest looking at the crew's wife and children as the Coroner states that the death was avoidable had you come into port.

I know of no lifeboat crew, helicopter crew, ambulance crew, A&E consultant, junior doctor, matron, staff nurse or hospital cleaner who will criticise you for getting your crew into their care, but hey ho I take it you have never lost close friends through an accident at sea or on the mountains.

How many cases of dry/secondary drowning have there been after MOBs? How many of them were completely asymptomatic?
 

Colvic Watson

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At my local sailing centre on a windy weekend recently there were a bunch of Picos out, with one going over every five minutes or so. The ambulances would never have stopped. Shame, because the children seemed to be enjoying themselves.

Did you have so much time on your hands that a silly post like that seemed constructive? There have been several informative explanations about the difference between a dinghy capsize and an MOB but the science is perhaps beyond some people and they'd rather bicker and trivialise.
 

JumbleDuck

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Did you have so much time on your hands that a silly post like that seemed constructive? There have been several informative explanations about the difference between a dinghy capsize and an MOB but the science is perhaps beyond some people and they'd rather bicker and trivialise.

Why factors common to all MOBs do you think are invariably lacking in dinghy capsizes?
 

JumbleDuck

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You will need to ask the Secretary of State for Health for that statistic. He may, or may not, collect the data.

Google suggests that (a) secondary drowning accounts for between 1% and 2% of all drowning fatalities in the US and (b) there are always warning symptoms.

The idea that anyone who ever falls into the water - except children, because reasons - needs to be rushed to hospital is not, as far as I can see, well supported by the evidence.
 

capnsensible

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Google suggests that (a) secondary drowning accounts for between 1% and 2% of all drowning fatalities in the US and (b) there are always warning symptoms.

The idea that anyone who ever falls into the water - except children, because reasons - needs to be rushed to hospital is not, as far as I can see, well supported by the evidence.

Try this to explain some of the complications.

http://www.beyondcoldwaterbootcamp.com/en/first-responders/113-circum-rescue-collapse

The whole cold water boot camp is a great insight into the problems we all may be unfortunately faced with.
 

Tranona

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Google suggests that (a) secondary drowning accounts for between 1% and 2% of all drowning fatalities in the US and (b) there are always warning symptoms.

The idea that anyone who ever falls into the water - except children, because reasons - needs to be rushed to hospital is not, as far as I can see, well supported by the evidence.

Why do you insist on expanding the advice to include dinghy capsizing? you are falling into the trap of trying to justify your position by introducing something that is not there (Just as triassic was doing earlier).

The advice is about MOB - which is in itself very rare - and where the conditions that might lead to secondary drowning are more likely. If you read about the condition, you will see that not only is it rare in drownings as a whole, but the symptoms are observable and can take up to 24 hours to become apparent.

So trying to expand it (in your eyes) to include kids capsizing their dinghies is just scaremongering and diverting attention from the real issue.

A MOB is a serious issue and is not the same as a quick dip as a dinghy capsizes, and given the difficulty in recover and likely other injuries it makes sense to seek help. This will not lead to a massive increase in A&E admissions - simply because MOBs are rare.
 
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