First Aid While on the Boat

dannc · Apr 28, 2014

psneeld said:
First Aid - most first aid along the coastal US is good but with the internet...only a click away. Things like paramedic skills are great but hard to fit into an already busy schedule and hopefully with the click of an EPIRB....the USCG will be there within the hour. From 35 years as a first responder on the water...buy an AED and learn how to use it...CPR is overrated to the max on the water (read wilderness)

ActiveCaptain said:
...

I've had the unpleasant opportunity to perform CPR multiple times. It is never like it looks on TV and patients never cough and wake up after it. But CPR does something critically important - it keeps the patient alive until more definitive care is available. The main issue with cruising is that the medical response time increases from under 10 minutes on land to 30-45 minutes on water (and even longer). 50 miles out to sea, yeah, CPR won't matter - the patient is going to die. But that's quite a rare mode of cruising for most of us. For a significant amount of our time on the water, we're within VHF response to some fire department. You'd be amazed.

This is one of the reasons why it is so important for a significant other to be able to operate the boat and keep it moving and in safe water. It's got to be near second nature because they might be having to render emergency care at the same time during a very, very stressful situation.

Bottom line - learn CPR now unless you've had a course in the last 2 years. It is not a waste of time at all and it's not something to ignore. It's simple and it will save the life, probably of someone you love.

When I posted my list, I kept it very broad and First Aid can mean many things.

I have had First Responder training in two states and my CPR certification is kept up to date. The wife will need to take some classes before we go.

I don't think I have ever had more than two, maybe three, CPR classes that were the same. Seem like every couple of years the training changes slightly. The course changes are usually by being simplified but also there are new techniques to use or NOT use. Having CPR training is good but it is better to maintain CPR certification. The last few cycles have incorporated AED usages which is very important and CPR itself was simplified again.

When people say CPR, they always are thinking of breathing and chest compressions, though with the latest training, it is all about compressions, compression and compressions. Frankly, in the past, the more important part of CPR class is the choking training. CPR does not have a high success rate but some chance of success is better than no chance. I would think the odds of being brought back from a heart stoppage on a boat on the water would be even smaller than someone in a house with EMS service a few minutes away.

Today, the other important part of CPR training is in the use of AEDs. These things are pretty full proof, they are designed for anyone to use them, and they have a higher success rate than CPR alone. I looked up the cost of an AED on Amazon and they started at $1,100. I would think that an AED on a boat would have a better chance of bringing someone back to life than plain old chest compressions. I don't think most people are going to be able to do chest compressions for the time it takes for rescue services to get to the boat on the water, at least in the places we intended to go.

Thinking about places we were cruising in FLA, I would think most of the time the boat could get to shore quickly but if there were only two people on the boat, getting the boat to land means no CPR.... One of the various LE agencies MIGHT be able to get a boat on scene but that could take some time. Flip side, is that other boaters could board and lend a hand....

Chest compressions just move blood to supply O2 to the dead person's organs to buy them time. The person is dead. Breaking their ribs ain't gonna hurt them. They are dead. You buy the person time until better equipment arrives to revive, but it is doubtful CPR will revive a dead person, however, some chance is better than no chance. I doubt my wife could perform CPR for more than 20-30 minutes and she works out...

I just had a class on about tourniquet usage which has greatly changed that what was taught in the past. In the past, I was taught to never completely tighten a tourniquet to stop blood flow. The latest training is to stop the blood flow and there are tourniquets out there that can easily be used on handed. Of course, you can get these on Amazon.

It seems that it is far more likely to have to use a tourniquet or other first aid techniques on a boat than CPR compressions or AED usage. Choking would be at the top of my list of most likely to used rescue skills.

Having said all of this, I feel like a dunce. :facepalm:

I have a list of emergency equipment we should have on a boat and I DID NOT have an AED listed! :facepalm:

I do now.

Later,
Dan

Jeffrey S · Apr 28, 2014

We have an AED onboard along with a small ambulance of medical supplies. To add to what Dan wrote (which was great), even if you don't have an AED, CPR is nearly free to learn. Learn it. Here's a perfect example why...

We were anchored last night behind Butler Island off the Waccamaw River in South Carolina. There were two other boats anchored with us. Chances are, neither of them had an AED. But if horns started going off in the middle of the night, we would have gotten in our dinghy along with the medical jump kit we have prepped and ready to go, and would have been at their boat within 5 minutes. Even with that quick response, closer than any on-land emergency response could be expected, brain tissue starts to die at 4 minutes. CPR is the one thing that will stretch out those 4 minutes to 45+ minutes, certainly enough time for me to jump onboard and defibrillate the patient.

The key to all of it is knowing CPR yourself and understanding the communications and alert mechanisms available to get help at anchor or at a marina (or even at home). You might not be an EMT but we might be anchored right next to you with 40 years of combined ambulance experience.

And for what it's worth, in our 11+ years of cruising, I've run off to 2 emergencies by dinghy and 2 at marinas.

BandB · Apr 28, 2014

I never even learned CPR before, had no first aid training. My wife did have some as most teachers have. But when we knew we were going to spend time on the water, some not so close to medical help, we got serious about training and supplies. As we looked down the courses offered at the Maritime School we have gone to, they jumped out as us. We might have to one day be the first responder, be the medical officer on board, be the only one there to help. So we've taken that seriously and gotten training, plus kits plus subscribed to a medical service. Have we gone overboard? Sure hope we've done far more than we'll ever need. But ActiveCaptain speaks of four times. Our only time ever was a wreck we saw on the lake and we just went and fished people out of the water. Fortunately none hurt badly. It was also within a quarter of mile of shore.

One we intend to take sometime along the way is Fire Fighting. Sure hope we never need it either. We look at these sort of like insurance. You hope you don't ever need them.

Nsail · Apr 28, 2014

ActiveCaptain said:
We have an AED onboard along with a small ambulance of medical supplies. To add to what Dan wrote (which was great), even if you don't have an AED, CPR is nearly free to learn. Learn it. Here's a perfect example why...

We were anchored last night behind Butler Island off the Waccamaw River in South Carolina. There were two other boats anchored with us. Chances are, neither of them had an AED. But if horns started going off in the middle of the night, we would have gotten in our dinghy along with the medical jump kit we have prepped and ready to go, and would have been at their boat within 5 minutes. Even with that quick response, closer than any on-land emergency response could be expected, brain tissue starts to die at 4 minutes. CPR is the one thing that will stretch out those 4 minutes to 45+ minutes, certainly enough time for me to jump onboard and defibrillate the patient.

The key to all of it is knowing CPR yourself and understanding the communications and alert mechanisms available to get help at anchor or at a marina (or even at home). You might not be an EMT but we might be anchored right next to you with 40 years of combined ambulance experience.

And for what it's worth, in our 11+ years of cruising, I've run off to 2 emergencies by dinghy and 2 at marinas.

What would be the best, or proper, or preferred, method of alerting others in an anchorage that help is needed (assuming no cell coverage)?

If during the day, my thoughts would be VHF first, then just yelling if close enough to others, and finally in a dinghy looking for help.

At night, I think most VHF's are off (mine normally is). The horn does seem like it would get attention. If I heard one in the middle of the night, the first thing I would do is look around and then turn on the VHF.

Any guidance or experience would be appreciated.

BandB · Apr 28, 2014

Nsail said:
What would be the best, or proper, or preferred, method of alerting others in an anchorage that help is needed (assuming no cell coverage)?

If during the day, my thoughts would be VHF first, then just yelling if close enough to others, and finally in a dinghy looking for help.

At night, I think most VHF's are off (mine normally is). The horn does seem like it would get attention. If I heard one in the middle of the night, the first thing I would do is look around and then turn on the VHF.

Any guidance or experience would be appreciated.

I would think first you want to wake them so horn, then VHF and scream....whistle too if you have one handy. Enough noise and you'll get attention.

Jeffrey S · Apr 28, 2014

Nsail said:
What would be the best, or proper, or preferred, method of alerting others in an anchorage that help is needed (assuming no cell coverage)?

Here's the rules we give in our seminar about medical emergencies.

If you're tied up at a marina:
1. Dial 911

2. Blast your horn 5 times or make a lot of noise, scream, etc.

If you're underway or anchored:
1. Issue a Mayday on channel 16 or using DSC - it is a completely valid reason for issuing a Mayday. Of course, it needs to be a real medical emergency which includes not knowing or understanding what's happening to someone else.

2. Blast your horn 5 times or make a lot of noise, scream, etc.

All of this assumes the incident is happening in the US.

It's also OK to issue a Mayday while tied up at a marina if you really just don't know what to do. The CG will arrange for 911, Fire, Ambulance, etc based on the need. I've been on multiple ambulance calls that were arranged through the CG with no patient/family/bystander interaction.

Nsail · Apr 28, 2014

ActiveCaptain said:
Here's the rules we give in our seminar about medical emergencies.

If you're tied up at a marina:
1. Dial 911

2. Blast your horn 5 times or make a lot of noise, scream, etc.

If you're underway or anchored:
1. Issue a Mayday on channel 16 or using DSC - it is a completely valid reason for issuing a Mayday. Of course, it needs to be a real medical emergency which includes not knowing or understanding what's happening to someone else.

2. Blast your horn 5 times or make a lot of noise, scream, etc.

All of this assumes the incident is happening in the US.

It's also OK to issue a Mayday while tied up at a marina if you really just don't know what to do. The CG will arrange for 911, Fire, Ambulance, etc based on the need. I've been on multiple ambulance calls that were arranged through the CG with no patient/family/bystander interaction.

Great information. Thank you!

caltexflanc · Apr 28, 2014

At anchor, don't forget your flares. And the loud hailer. Most people in the anchorage will have radios off. As Jeff is trying to tell us, in a true emergency, anything and everything goes. He puts it in order, Mayday first, which will occupy some time with the CG, just let them know you need to send some signals to the surrounding area, then the kitchen sink.

psneeld · Apr 28, 2014

Nsail said:
What would be the best, or proper, or preferred, method of alerting others in an anchorage that help is needed (assuming no cell coverage)?

If during the day, my thoughts would be VHF first, then just yelling if close enough to others, and finally in a dinghy looking for help.

At night, I think most VHF's are off (mine normally is). The horn does seem like it would get attention. If I heard one in the middle of the night, the first thing I would do is look around and then turn on the VHF.

Any guidance or experience would be appreciated.

Radio...Mayday
DSC Emergency Button
EPIRB/PLB
911 cell phone..but don't waste a lot of time holding or explaining
Horn...5 or more short blasts and scream help...

Again your time has to be split between sounding alarm and attending to emergency.

That's what is funny about Captain's licenses...you have to have First Aid/CPR for initial...then it's not required in all cases to keep renewing it...the USCG's philosophy is that the captian is responsible for the vessel...and only indirectly to it's passengers.

Northern Spy · Apr 28, 2014

*16 in Canada on a cell phone will connect you directly to the Canadian Coast Guard Officer on Duty at a MCTS for an emergency.

I didn't realize the USCG did not offer the same service until a Google search a few minutes ago.

psneeld · Apr 28, 2014

Some places used to have *CG but I think it was so underutilized...the USCG gave it up...but I'm not positive what happened to it or what it evolved into.

FlyWright · Apr 28, 2014

psneeld said:
First Aid - most first aid along the coastal US is good but with the internet...only a click away. Things like paramedic skills are great but hard to fit into an already busy schedule and hopefully with the click of an EPIRB....the USCG will be there within the hour. From 35 years as a first responder on the water...buy an AED and learn how to use it...CPR is overrated to the max on the water (read wilderness).

psneeld said:
That's what is funny about Captain's licenses...you have to have First Aid/CPR for initial...then it's not required in all cases to keep renewing it...the USCG's philosophy is that the captian is responsible for the vessel...and only indirectly to it's passengers.

Unlike the commercial world of for-hire boating, most TFers consider their 'passengers' health and safety to be of paramount importance. We're not commercial skippers going for some license renewal here. Most of us are travelling with our loved ones and their comfort, health and welfare is first and foremost in our minds.

I don't understand why anyone would argue against CPR training for recreational boaters. That's either a bad joke or just poor advice and I hope no one takes your seriously. It just doesn't make sense unless one is just trying to be argumentative. And thanks for another reminder of your 35 years of walking on the water! I almost forgot.

psneeld · Apr 28, 2014

FlyWright said:
Unlike the commercial world of for-hire boating, most TFers consider their 'passengers' health and safety to be of paramount importance. We're not commercial skippers going for some license renewal here. Most of us are travelling with our loved ones and their comfort, health and welfare is first and foremost in our minds.

I don't understand why anyone would argue against CPR training for recreational boaters. That's either a bad joke or just poor advice and I hope no one takes your seriously. It just doesn't make sense unless one is just trying to be argumentative. And thanks for another reminder of your 35 years of walking on the water! I almost forgot.

If I explained it...you would just call me argumentative...

And I can understand why you wouldn't understand...

Anyone interested feel free to PM me.

Jeffrey S · Apr 28, 2014

psneeld said:
And I can understand why you wouldn't understand...

Anyone interested feel free to PM me.

No, come on. It's a discussion - we're all friends.

My wife was a CPR instructor. I've read books on the efficacy of CPR - there's a great one called Sudden Death and the Myth of CPR:
Sudden Death and the Myth of CPR 1st (first) Edition by Timmermans, Stefan published by Temple University Press (1999): Amazon.com: Books

I actually show that in one of our lectures. There are misconceptions about CPR and what it does. Let's get them all out and judge the valid ones from the rumor ones.

Capt.Bill11 · Apr 29, 2014

FlyWright said:
Unlike the commercial world of for-hire boating, most TFers consider their 'passengers' health and safety to be of paramount importance.

Unless you are just being sarcastic, as a full time captain for the last 30 years I take exception to that. The captains and crews I know take their boat owners, guests and passengers safety very. very seriously. We have to take basic STCW training and as we move up in license size we take more and more advanced safety training. Along with performing on board drills to keep the skills we learn fresh.

And since the USCG is the organization mandating these increases in training, I'd say this statement is a load: "the USCG's philosophy is that the captian is responsible for the vessel...and only indirectly to it's passengers.".

BandB · Apr 29, 2014

Capt.Bill11 said:
Unless you are just being sarcastic, as a full time captain for the last 30 years I take exception to that. The captains and crews I know take their boat owners, guests and passengers safety very. very seriously. We have to take basic STCW training and as we move up in license size we take more and more advanced safety training. Along with performing on board drills to keep the skills we learn fresh.

And since the USCG is the organization mandating these increases in training, I'd say this statement is a load: "the USCG's philosophy is that the captian is responsible for the vessel...and only indirectly to it's passengers.".

I totally agree with Bill. The Captains I've met and known are very serious about safety. In fact, it's often owners who try to push them into unsafe actions. Now I do not doubt there are Captains out there who aren't as responsible. In fact, I know on some of the larger charters alcohol use has become an issue with some Captains. But I do believe the bad Captains are the exception. I have many Captain friends and they are all very safety conscious and very protective of passengers and crew. Broad labeling and generalizations based on a few bad people in any profession is always unfair.

BruceK · Apr 29, 2014

Carrying a Defibrillator.
We had a member, also an Ambulance paramedic, now an instructor, talk at one of our Club meetings about first aid on the water. He has a sideline selling defibrillators, and was very persuasive that survival prospects were far better with one, than CPR. I guess he would say that, but I think he`s right.
We considered one for the Club but figured it would never be in the right place at the right time. Cost was above 2K AUD, the machine talks you through using it on a patient as you go. Obviously if you actually need one the 2K is nothing, if you never need it,(you never want to), the value is uncertain. Fortunately the "Admiral" is First Aid qualified.
We had a friend take ill at night on the Hawkesbury River, 20 miles north of Sydney. He had a throat hemorrhage, got himself wedged in the head, door closed, collapsed. I think his wife called for help on the VHF(cell is lousy up there), Water Police came, got him out, were met by a waiting ambulance on land, transferred him to hospital, all ended well. But if we call 000(=911) for help on a boat, emergency services have been known to demand you supply a cross street! You tell them you`re on a boat, but....The Water Police however, can be a godsend.

Peter B · Apr 29, 2014

As a medic, if I can just clarify a comment made quite correctly by Dannc, re the CPR being more about compressions and less re the breathing, when he said…
When people say CPR, they always are thinking of breathing and chest compressions, though with the latest training, it is all about compressions, compression and compressions. Frankly, in the past, the more important part of CPR class is the choking training..

This is relatively new in CPR, and has been a major advance in terms of members of the public being more ready to step in and do it. It has been shown that effective cardiac compression also compresses the rib cage (which is springy, after all), sufficiently that there is sufficient airflow, as long as the airway is clear - I emphasise that - without trying to also actively ventilate the patient - (not until oxygen via mask or tube is available anyway), so THE GOOD NEWS IS it is no longer expected one must try to perform mouth to mouth breathing, which of course was naturally the big turn-off. I wouldn't do it to a stranger either.

Just thought that point was worth highlighting, as just compressing is far easier, and can be kept up longer, especially if people do it in short shifts, and with as little interruption as possible. The speed needs to be about 2 compressions a second, with downward movement about 6-8cm = 2-3 inches. One CPR instructor I heard caught people's attention by saying "do it in time with a brisk version of the BG's song, 'Stayin' alive"…you remember that stuff…
Great post Dan.

Jobe · Apr 29, 2014

Thanks for all the info. Do you do two quick compressions and pause a second or just keep compressing two a second continuously? (I think I may have 'Stayin' Alive' stuck in my head all day. And I was just getting over Disco. ****.)

Jeffrey S · Apr 29, 2014

BruceK said:
and was very persuasive that survival prospects were far better with one, than CPR. I guess he would say that, but I think he`s right.

There are consistent studies showing the same outcomes. For a patient in cardiac arrest (which is what the topic of AED's is really about), if you arrest in a hospital and only receive CPR only, you have a 2.4% chance of survival. If you're outside a hospital, the survival rate drops to 1.6%. Within the reasons for going into cardiac arrest, CPR is quite effective for drowning. But that's not what the typical trawler owner with known or unknown heart disease is worried about.

Add an AED and the numbers change dramatically. Apply an AED within 4 minutes and the survival rate jumps to 75%. This is why there are so many AED's in malls, airports, schools, and boats.

So looking at that data, CPR is a waste of time, right? Except CPR's goal isn't survival. CPR's goal is to stop the clock before 4 minutes. When done properly, you are giving extra time to allow an AED (onboard, from the boat next door, or from a racing ambulance) to be applied. In that role, CPR is critical and will save someone.

It's interesting that in the show ER, 80% of patients receiving CPR coughed and woke up. It just doesn't happen that way.

Jeffrey S · Apr 29, 2014

Jobe said:
Do you do two quick compressions and pause a second or just keep compressing two a second continuously? (I think I may have 'Stayin' Alive' stuck in my head all day. And I was just getting over Disco. ****.)

The CPR class is about a 2 hour class with practice on dummies while being watched by an instructor for advice and help. You can't, under any dream of being responsible, learn how to do it through a couple of forum questions. Don't even think of going down that route.

Andy G · Apr 29, 2014

Well, I have learnt a few things here.

Good posts Dan, Pete & AC.

Two months ago I found myself in Canada, catching up with some of my kids who are working in Whistler. One of my older boys works as night security in a hotel, he was on duty when a guest had a massive heart attack in her hotel room.He worked on the lady for about 15-20 minutes till the para medics arrived,administering both mouth to mouth and CPR.

He managed to get her breathing, but unfortunately the lady subsequently died.

When we sat down and he talked about that night, I began to realise what a traumatic situation it must have been. Nothing remotely like the neat, calm CPR training sessions we had in our first aid course. This was a room full of people yelling, crying, convulsions & vomit set against a desperate race against time. I asked him how he coped, he said he just concentrated of what he had been taught, and kept counting aloud.

I have no idea how first aid courses are run now, however I think it would be beneficial, in addition to the technical training, to provide some explanations and descriptions of what you may have to deal with while putting your training into practice.Which I think after talking to my son can be pretty confronting.

Jeffrey S · Apr 29, 2014

You don't concentrate on the bad calls. You remember the lives you've saved. But things like this are like boaters getting together, talking cruising. You always end up talking about the worst weather you've been out in!

We live in the town where the Maine Maritime Academy resides. Classes start in late August. We usually leave for cruising in the beginning of September so we still overlap with the students a little. The worst call for me was that first weekend of school starting. Four 18 year olds ran off to the next town, drank, and sped back into town flipping their car at a curve. I wasn't on duty but I was advanced life support for the town and maintained a beeper. At 11 pm the call went out and I went directly to the scene. Two of the kids were hurt. The driver was pinned and unresponsive. I took him as a patient and let the next EMT take the other patient who was screaming (screaming patients are good patients).

The flipped car stopped any of us from getting in and I couldn't do more than assess breathing, pulse, etc. He had a very weak and thready pulse which is bad. I kept talking to him about help being there and to try to hold on, etc. The ambulance showed up and I got the cardiac monitor. As I pulled up his shirt to get the leads on, it was a very uncomfortable feeling like the last heat of his body was escaping out of the shirt - his core was already too cool. I reached in to slap the leads on his chest to find that he was flat lined. And no matter what you see on TV, that's not a rhythm that you can shock back to life. He was gone. The drug protocol happened but there's no way you're coming back from a flat line due to trauma.

It pissed me off that some parent who just wished their freshman son well as they went off to school needed to get a call from the police that night. And it was all due to drunk driving that I didn't need to be a part of or witness.

I had trouble sleeping for 2 weeks after that.

Andy G · Apr 29, 2014

ActiveCaptain said:
You don't concentrate on the bad calls. You remember the lives you've saved. But things like this are like boaters getting together, talking cruising. You always end up talking about the worst weather you've been out in!

Your are right, but the point I was trying to make is that for 99.5% of us we will never have to put our training into use, and if we are the .5% we probably will only use it once in our life.

We never get a chance to concentrate on the good outcomes( if the survival figures for CPR are correct).

You are a professional, you have training and experience, you have a fair idea what is going to confront you when you are called out.

What I'm saying is perhaps it would be beneficial, as part of the first aid training, for an instructor to sit down with the class and pass on their experience, warts and all. It may shock the class, but no where near as much as the real thing will do if they are ever called on to use CPR in a real life situation. At least you are giving them an idea of what to expect.

dannc · Apr 29, 2014

Peter B said:
...

Just thought that point was worth highlighting, as just compressing is far easier, and can be kept up longer, especially if people do it in short shifts, and with as little interruption as possible. The speed needs to be about 2 compressions a second, with downward movement about 6-8cm = 2-3 inches. One CPR instructor I heard caught people's attention by saying "do it in time with a brisk version of the BG's song, 'Stayin' alive"…you remember that stuff…

To really drive this home...

The new techniques being taught in CPR today is why people who have had CPR in the past need to get recertified. The CPR techniques have really changed over the last few years to make things simpler and more likely to help the patient.

I was really impressed with the last recertification class I had this year and I have been certified, hmmm, maybe I should rephrase that :rofl:

, for decades. My first CPR class was more than a few decades ago when I as in 9th grade. There is a great difference in CPR now, compared to then, and today's CPR is much easier to do and provides better odds for the patient.

AED usages was added 4-6 years ago in my area and while using the devices is pretty easy, the AED talks you through its setup and use, training will help speed up deployment. The faster the rescuer starts working on the patient, the better the odds for the patient.

Either the updated CPR techniques, or the AED training, is more than enough reason to take or retake a CPR class, but both together make the training very much worth the time investment.

Later,
Dan

dannc · Apr 29, 2014

Jobe said:
Thanks for all the info. Do you do two quick compressions and pause a second or just keep compressing two a second continuously? (I think I may have 'Stayin' Alive' stuck in my head all day. And I was just getting over Disco. ****.)

You really have to take a class learn CPR and there is more to CPR than compressions and timing. CPR is not hard to do per say, but proper hand placement and technique is critical. I have never seen CPR "performed" anywhere close to correctly on a TV show or movie.

The Red Cross, hospitals, and I noticed our gym, schedule CPR classes. They gym I go to has an rather aged population and they have built the gym to handle emergencies. Each floor in the gym has an AED and their are emergency alarms that are at FLOOR level. First time I have seen that and it make perfect sense.

Later,
Dan

BandB · Apr 29, 2014

Yes, most of us will never use those skills or hope we never do. And when we do, we won't always be successful. The entire subject is frightening. In class just the very thought of something bad happening to my wife shook me up, but then I thought of being unprepared and just standing there not even being able to try helping her, not knowing how or being equipped, and it only made me want to learn more. On land, I was always content thinking someone else would be there to help. Now when we're out on the boat maybe we're over protected now with equipment and with several of us trained. But I've always valued knowledge in all areas and certainly in first aid I now value it.

Crossing the Atlantic is in our future, still a few years away. Someone was asking the other day though "But what if" and went on to talk about something that could happen four days from the nearest land. We immediately launched into what we'd do and the equipment we'd use and the steps we'd take and while one of us working on the patient the other contacting Medaire. Is it a perfect plan? No, there are none of those. But we realized the courses had already paid for themselves just in what we now knew, even if we hoped never to have to use it beyond scrapes, sun burn, colds, etc.

dannc · Apr 29, 2014

Andy G said:
ActiveCaptain said:

You don't concentrate on the bad calls. You remember the lives you've saved. But things like this are like boaters getting together, talking cruising. You always end up talking about the worst weather you've been out in!

Your are right, but the point I was trying to make is that for 99.5% of us we will never have to put our training into use, and if we are the .5% we probably will only use it once in our life.

We never get a chance to concentrate on the good outcomes( if the survival figures for CPR are correct).

You are a professional, you have training and experience, you have a fair idea what is going to confront you when you are called out.

What I'm saying is perhaps it would be beneficial, as part of the first aid training, for an instructor to sit down with the class and pass on their experience, warts and all. It may shock the class, but no where near as much as the real thing will do if they are ever called on to use CPR in a real life situation. At least you are giving them an idea of what to expect.

Click to expand...

You might be surprised how often you will use first aid and/or CPR training.

I have "used" my training off the job at least six times that I can quickly count. One of those events was when our oldest started to choke and did the classic hands to throat movement. I saw what was happening, jumped over a couch, pulled the kid out of the high chair, put them head down at a 45 degree angle and popped their back. Out popped the food. I looked at our child in the face and the kid looked at me with a "Whats Up?" look so I put said child back in the chair. The kid picked up more food and kept on eating like nothing had happened.

The wife and I aged a few years and my hair turned gray.

The whole event took less time for me to do than for people to read about.

Now here is the thing. In CPR class, I would bet there is maybe 30 minutes of training covering choking babies and of that maybe 5-10 minutes is working on the baby dummy. Back in the day, I would likely have had the class maybe four times before this incident so not much "practice." I don't remember if the first CPR class I took even covered choking children. Even with the limited amount of training time I had, when it was time to move, I moved, and did the technique... I doubt our oldest would be alive if I had not had the training and used it.

This is the only time I have to ACTIVELY use CPR or first aid training. Notice the word ACTIVELY. There are have been other times were I have been at incidents and evaluated people's health. That too is part of CPR and first aid. Knowing when to NOT use CPR or other first aide is just as important to knowing when to use. You might still need an ambulance but if everyone is breathing and not bleeding much, EMS can run at a safer speed. No need to run lights and siren which is risky for the crew and the public.

Now maybe I am just lucky or unlucky but I have used my training outside of work quite a few times. Even on vacation but that is another story.

A CPR instructor may give you real live examples or maybe not. It really depends on the instructor and how the instructor feels about passing along that information.

I think every class I have had talks about the patient puking on you if you perform breaths. They also mention breaking and cracking ribs when doing CPR. They may or not mention the success rate.

The success rate is not important.

If one is performing CPR, the patient is D E A D. You can't hurt them. They Be D E A D. Cracking their ribs maybe not sound good but the patient is DEAD and they ain't feeling it.

Even if CPR has a poor success rate, and it does, if one does nothing the patient is going to stay DEAD. If one does CPR, the patient has some chance of NOT being dead. Some chance, is much better than no chance.

Often times CPR is continued even though everyone knows the patient is gone. Why? For the patient's families mental health. If the family is watching a loved one die, showing them that everything that could be done, was done, can help them deal with the situation. This might be your most beneficial outcome.

Later,
Dan

Jeffrey S · Apr 29, 2014

The postings here have been great. I'd just like to add one thing. The reason that my wife and I created our medical emergency talk for cruisers is that, without question, the number one thing we'd experience when arriving at a scene is multiple family members stopping us saying things like, "I know there is something we should have been doing - what was it?" We'd have to gently ask them to wait until the patient was taken care of before talking to them, often the next day. EMS is taught to "treat the family" so if grandpa stopped breathing and everyone stood around watching him die, we'd have to go back and tell them that there was nothing that could have been done. It's just not the right thing to tell them that there was a good chance they could have kept him alive.

What we wanted to create was a lecture about all the things you should have known to do before EMS arrives and tailor it for being on a boat. Having the lecture happen before there is an emergency makes all the difference. We've received about a dozen emails over the last 4 years from people who were able to use the skills and ideas at home or on their boat. That's really the best complement we can receive.

You can get to all our slides for the talk but the slides don't have all the content - they're really about keeping the talk on track and focused for us. There are many example scenarios for boats given and ways to look at what can/should be done. The slides are at:
https://activecaptain.com/articles/medical/intro.php

dannc · Apr 29, 2014

BandB said:
... On land, I was always content thinking someone else would be there to help. Now when we're out on the boat maybe we're over protected now with equipment and with several of us trained. But I've always valued knowledge in all areas and certainly in first aid I now value it. ...

Crossing the Atlantic is in our future, still a few years away. Someone was asking the other day though "But what if" and went on to talk about something that could happen four days from the nearest land.
...

The reality is that the most dangerous thing we do is get in a car and drive...

What scares me about driving, is not MY driving, it is the idiots that are driving near me.

I can control my driving but there is not much I can do about theirs. One of them hit our car once, and if I had not seen it coming, had not had drivers training and experience I don't think I would be typing at the moment...

I use a chainsaw quite a bit. We have forested land and Momma Nature likes to drop trees for us to use to heat the house.

:lol: Sometimes, Momma Nature just kills the trees and does not bring them down for me which provides me with more dangerous work to do.

Now, running a chainsaw is rather risky but I minimize my risk by having certain rules I follow and wearing safety equipment. However, one rule that OTHERS state, is to never run a saw by yourself which is a good rule but if I followed that rule, we would still be living in the city. I evaluate risk, think about the Oh S...t, and go from there...

Now, there are a bunch of people hurt with a chainsaw each year, I think the number is over 30,000 people in the US that go to a hospital, but some people do die, usually with a kickback of the saw into the neck. My attitude is that the saw will kill me if it touches me so I do everything I can to minimize that possibility.

I mention chainsaws because I was once taking the wife, should I call her Admiral? :rofl:

, to the hospital and saw a guy trimming Crepe Myrtles. Well, he did not have the right safety gear and he was cutting over his head. :facepalm:

Perfect setup of a kickback into his neck which would almost certainly been fatal even though he was just around the corner from the ER at one of the best Trauma Centers in the US...

When I mention our desire to cruise overseas or my Duckitis, to coworkers, they think we are nuts. They bring up storms, pirates, etc.

They worry about these unfamiliar risks, which in many cases can be avoided or handled, while everyday they do what is far riskier, get in a car and drive. :rofl:

There was a full and half marathons in Raleigh a few weeks back and not one but TWO men dropped dead in the race. Both were in their 30s.

These guys went down, and even with EMS at the event, it did not change the outcome. A few years ago, a coworker's wife went for a walk and dropped dead.

Just before this happened, a coworker who was in great health, ate well, and exercised, had a heart attack when he went for a run one day!

This kinda tells me I should NOT go to the gym tonight and just go home and be a Lounge Lizard in the Lazy Boy! :rofl:

I think many people over rate unfamiliar risk and under rate familiar risk...

What one needs to do is to try to correctly rate risk and plan and prepare for worst case. Which for this thread, is to get some easily learned first aid and CPR classes, and carry appropriate equipment and medicines on the boat.

Later,
Dan

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