Medical Emergency While Cruising

Anout three weeks ago I went to bed feeling fine. Three hours later I awoke to severe stomach pains and vomiting. Knowing what this was (Pancreatitis, because I've had it before), I had my wife drive me to the emergency room where I was drugged and admitted to the hospital for four days, then sent home with more drugs. I'll leave out the minor details, but I'm just now getting back to where I can function and make rational decisions.

I say all that to say this - What if I had been on a multi week cruise and anchored in a remote area 200 miles from home when this happened? I suppose the Coast Guard might come get me off my boat and take me to a hospital, but what about the boat? My wife can't operate it by herself and at 3:00 AM, there won't be any marinas open if she could find one. And assuming she went with me to the hospital, how could she get back to the boat anyway? Would TowBoatUS go get the boat and tow it to a marina?

There's a lot to think about and I wonder if anyone here has been through something like this or has thought about it enough to have a plan or suggestion.

BoatUS has a Trip Assist policy as an ad-on to their membership.

BoatU.S. Trip Assist provides you with over 20 benefits when traveling more than 100 miles from home, including (Subject to Terms and Conditions):

• 24-hour emergency and routine medical advice
• Medical, Dental, and Legal referrals
• Emergency Medical Evacuation
• Vessel and vehicle return (in a medical emergency)
• Delivery of Prescription medication
• Lost document assistance
• Emergency cash advances
• Language and interpreter assistance
• Guarantee of medical expenses
• Medical monitoring
• Repatriation
• Compassionate visit from a family member

US Power Squadron has a Skipper Saver course designed for that situation. I have not seen the curriculum but it would be worth a look. As we plan for a cruising boat, I told my wife she has to know how to get to help; drive the boat toward help, know our current location and use the radio. Kinda like a pilot friend told me; aviate, navigate, communicate. Since you knew of a pre-existing condition, your physician may be able to prescribe something for those first few hours. My $.02 anyway!

In areas where it might take days for help to arrive, this book comes highly recommended;

Medicine for Mountaineering: And Other Wilderness Activities: Amazon.ca: James Wilkerson: Books

Lena can operate the boat by herself although the docking may not be pretty. We are members of DAN and at $55/year it a good deal.

As a DAN Member, you automatically receive DAN TravelAssist and up to $100,000 of evacuation assistance coverage. This benefit is effective for both diving and nondiving medical emergencies. Evacuation coverage begins when you travel on a trip at least 50 miles (80 km) from home and call the DAN Emergency Hotline (+1-919-684-9111) for assistance or evacuation.

Scuba Diving Medical Safety Advice

We also participate in Ham nets where we have access to medial assistance.

One of our best references is The Ships Medical Chest and Medical Aid at Sea, by the Office of the Surgeon General. You can buy it or download it for free at:

http://www.fas.org/irp/doddir/milmed/ships.pdf

This is why my wife likes to boat on canals.
She can always jump to shore and call a taxi.

Ron, You raise a very good point. Many couples we meet are in a situation where the spouse has very little or no idea of how to handle the boat. This is a very bad idea and we encourage all couples to be sure both can easily handle the boat alone well before cruising starts. Susan is just as capable as I am in boat handling and anything less could spell disaster. If the mission can't be accomplished together on your boat than a good on-the-water training course should be a must. Chuck

My CG Auxiliary flotilla offers a "Suddenly in Command" class to the public to cover that situation.

rwidman said:

There's a lot to think about and I wonder if anyone here has been through something like this or has thought about it enough to have a plan or suggestion.

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Yes, actually, my wife, some four years ago. Not the same emergency as you experienced but life-threatening nevertheless. A 911 sort of thing.

While the situation was resolved (which required a transfer of 13 units of blood), the thought of a repeat, however slight the chance, was very much on our minds as we were scheduled to take a three-week cruise to Desolation Sound two months time.

My wife did not want to change our plans but this is a somewhat remote area with help not readily available. So we put together a list of all the medical facilities in the area--- Campbell River, Powell River, Nanaimo, Comox, etc.--- along with their emergency contact phone numbers. We also included the Canadian Coast Guard facilities with their direct phone numbers. And we included the phone numbers of helicopter and floatplane companies in the area that could provide an airlift if needed.

The trip was totally uneventful in the medical sense, but we have kept this list on board and actually plan to add to it to include the same sort of information for the US waters we boat in.

Like other posters above, my wife can operate and navigate the boat as well as I can or better although her docking experience is minimal.

Should the day come when we can take a long cruise up the Inside Passage we will install satcom on the boat and expand our list of hospital, Coast Guard, and chopper/floatplane company contact numbers to include the whole area we would be boating in .

A couple I know were boating on the Hawkesbury River/Broken Bay system. Husband had a massive throat hemorrhage, collapsing inside the head against the door. Water Police attended the boat after a call, taking him to the Ambulance they pre arranged at a wharf, and all ended well.
Trust your emergency services in an emergency, except our ambulance service has a bad habit of demanding street locations, even if you call from a boat. There is also a volunteer ambulance boat in the area operating from Dangar Isl. a residential island.

I'm glad you recovered and are able to resume your lifestyle

In our part of the world we are lucky to have the Volunteer Marine Rescue units stationed at reglar intervals up the main part of the Queensland Coast. We have several just serving Moreton Bay. One is encouraged to enroll and pay a yearly subscription, which added to a Govt (not huge) grant, allows them to offer rescue and retrieval service up most of our coast. If such an emergency happened here, once alerted via VHF, (usually), or cellphone, EPRIRB as last resort, they would attend, medivac the subject, and assist the remaining crew to return the boat to home port. It's nice to know the sevice is there, and well worth the sub. We also routinely log on with them when going out, with boat ID, number aboard, cellphone numbers, ETR etc, so they keep a watch out. I have occasionally forgotten during a routine day out to log off by the time estimated, and been rung or called not long after, just to check we were ok, so they are on the ball, all right.

As Peter B has stated we have VMR and Coast Guard, similar volunteer orgnisations but different, covering a reasonable part of the coastline inshore.
Once you venture offshore you are on your own.
This is where a good HF radio and /or sat phone come into play.

HF is good as you are talking to everybody on the frequency and possibly someone close handy.
One can also radio up medical help and rescue choppers via the main radio stations.

Even up the coast here in Queensland one can find yourself pretty isolated and out of VHF and phone range so one has to be prepared.

If I went missing ( I sometimes take of in the dinghy fishing for hours at a time & forget the handheld VHF) my Missus reckons she would just get on the radio make a call saying she had a very good 50 ft cruiser for sale very very cheap.
She says she would have a couple of brokers alongside in next to no time.

Not like Peter B being a medico I have to rely on others or at least be able to contact.
I have a very comprehensive medical kit on board , put together by a free diving medico mate of mine.
I have also over the past 40 years done a lot of advanced medical courses as part of my sea going quals.
No I won't take out your appendics.
Cheers
Benn

Peter B said:

In our part of the world we are lucky to have the Volunteer Marine Rescue units stationed at reglar intervals up the main part of the Queensland Coast. We have several just serving Moreton Bay. One is encouraged to enroll and pay a yearly subscription, which added to a Govt (not huge) grant, allows them to offer rescue and retrieval service up most of our coast. If such an emergency happened here, once alerted via VHF, (usually), or cellphone, EPRIRB as last resort, they would attend, medivac the subject, and assist the remaining crew to return the boat to home port. It's nice to know the sevice is there, and well worth the sub. We also routinely log on with them when going out, with boat ID, number aboard, cellphone numbers, ETR etc, so they keep a watch out. I have occasionally forgotten during a routine day out to log off by the time estimated, and been rung or called not long after, just to check we were ok, so they are on the ball, all right.

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Over here our main VMR is called. VN6DI. They are great. When joined up and pay a yearly fee. They provide support 24/7 and give you a unique callsign that is registered to our with all of your info, the boats info and next of kin info. Our callsign is FG4085 and stays with us for life. no matter what boat we have we just transfer the boat details over and it's happy days. If we travel outside of VN6DI coverage then the other VMR's we log on to and off from have access to our records

Well, it seems if I lived in Australia, I would be pretty well covered. I don't though so that's not going to help me.

I have Medicare and secondary insurance and a prescription drug plan so the medical part is covered. I won't be leaving the USA so repatriation will not be a problem.

If I'm anchored in some remote location on the AICW I'll need to get off the boat and to a hospital. I assume the Coast Guard or local emergency responders will take care of that if I can get them my position on the water. I should be able to tell them myself but I really need to teach my wife how to do it. Would the DSC button on the VHF do that, assuming the chart plotter is powered up?

Next, assuming that my wife goes with me to the hospital (she will), I need a way to get the boat to a dock or marina where it can stay until I'm well enough to take it home or can arrange for someone else to bring it home.

Surely my situation is not unique so does anyone else have a plan for this type of situation?

Would your insurance carrier have any thoughts on this?

chc said:

Would your insurance carrier have any thoughts on this?

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That's an interesting thought. I'll ask them. I was thinking TowBoatUS might tow the boat to a dock but again, I'll have to ask.

DSC will work just fine to pass your position if you have a registered, current MMSI and the GPS is feeding position information. I still would back it up with a PLB/EPIRB.

The towing assistance companies are funny about Non-covered items. I don't believe any of the companies cover the situation of a disabled captain. That's not to say an individual franchise wouldn't help to some degree or all the way...but I don't think it's a covered service with any company....you may have to pay unless your hull insurance will cover all/part to prevent further damage and no the towing company can't arbitrarily claim salvage rights.

I would do it and probably my towing boss would too...depending....

As a former Coastie and being in the situation to do the MEDEVAC or be aware of one...I can't tell you how many times I volunteered to return a vessel to homeport when the captain was disabled.....though I was never approved or never worked out due to regs/time available...

A great rescue happened a few years back in the South Pacific that is worth relating. A US sailor got blood poisoning on a remote atoll. The USCG flew a SEAL team who parachuted to him, adminitered IV antibiotics and sailed him/his boat 1500 or so miles to the nearest hospital. Now that's SAR at its best and anyone who says the US Gov't doesn't care about them...maybe Washington, DC...but the boys in the field will do whatever they can and whatever it takes!

Ron: Wanted to pass on the experience of a boat owner here in the Marina I'm staying at right now. He was solo on a boat on the ICW near Melborne when he fell at the helm from a pretty severe stroke. He was unable to stand or move very much with the paralysis that struck his right side. His speech was slurred by he managed to key the mike on the VHF and did his best to call for help. The CG operator was trained to detect a possible stroke victim and worked with him with speech and key strokes until they had his approximate position, which was really precarious if I recall (near rocks at an inlet). The CG arrived with one of their big inflatables very quickly and took tow of the boat away from danger. Once it was determined that the boat was undamaged, a Captain on-call was brought to pilot the boat into a nearby marina where it stayed until his family could make other arrangements. He's OK, but he never recovered fully from the stroke and now lives here as a gate guard of this Marina.

Although such things may not be standard procedure, my Admiral and I were invited to many CG events where "what if" discussions took place. If you're doing the AICW, I would be confident that they have your case thought through.

I do not believe it's standard procedure for the USCG to worry about the vessel unless it looks to be a hazard to navigation. They don't want/need the liability of assuming your command.

I can see where some USCG commands would be prepared to take the vessel someplace...I was at several that wanted nothing to do with the issue...I wasn't happy with those chuckleheads....

Rwidman, maybe we have good help here, but could you be underestimating your own services? There is nothing like the painful emergency you had to highlight the issue, but I cannot see an emergency service leaving your good lady or your boat stranded while they take you to medical care. Emergencies vary which makes it hard to plan ahead fully.
Never used my DSC, but heard one used, in error, It got a fast radio response; Mrs. R should know how to use the VHF.

As some of the guys here in Aus say they join up with the local VMR or Volunteer Coast Guard but their coverage is only small in the scheme of things and both organisations are different entities and do not necessarily correspond with each other.
All good if you cruise in a relatitively small geographical area.
Cheers
Benn

BruceK said:

Rwidman, maybe we have good help here, but could you be underestimating your own services? There is nothing like the painful emergency you had to highlight the issue, but I cannot see an emergency service leaving your good lady or your boat stranded while they take you to medical care. Emergencies vary which makes it hard to plan ahead fully.
Never used my DSC, but heard one used, in error, It got a fast radio response; Mrs. R should know how to use the VHF.

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Sure they could...anchor up you boat, take any passengers to a local wharf and that's it....rescue services aren't responsible for personal belongings.

My wife is not comfortable operating the boat and I've stopped trying to get her to be comfortable. However I do quiz her every month or so on how to active the DSC and ask her to show me our lat/long position on the GPS.

We mostly cruise the ICW and I've often wondered if I was disabled how emergency responders would reach us if anchored even if they knew our location.

I guess the boat is far down the list of concerns if a real emergency happens. But worth thinking about for sure.

If I was taken off the boat by rescue My wife would drive the boat to the nearest safe harbor, using the Garmin Chartploter, the Toughbook running PolarNav, and the Ipad running Garnin Blue charts, All of which she knows how to use, and has used.

Sure, she might ding it up a bit docking, but a good shore crew could prevent that.

She would rent a car, and drive to where ever I am. She is a attorney, and god help those who stand in her way.

I love her and have for over 25 years

Mike

Sceptic said:

If I was taken off the boat by rescue My wife would drive the boat to the nearest safe harbor, using the Garmin Chartploter, the Toughbook running PolarNav, and the Ipad running Garnin Blue charts, All of which she knows how to use, and has used.

Sure, she might ding it up a bit docking, but a good shore crew could prevent that.

She would rent a car, and drive to where ever I am. She is a attorney, and god help those who stand in her way.

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You're missing a couple things here:

Both times this happened to me it was 3:00 AM. There's not likely to be a good shore crew around. Or a car rental agency.

She probably wouldn't know where the nearest (or any) marina was located.

Being concerned whether her husband was going to live or die, I suspect she would elect to go directly to the hospital with me. I would need her to fill out the paperwork anyway.

I expect I would be in the ER, semi concious with my wife by my side and the boat anchored off the ICW somewhere. I would probably be in the hospital for a few days and then on drugs for a couple weeks.

What I am trying to do is figure out how I get from that situatio to back in my home with my boat in a (hopefully my home) marina.

Depends on the situation...but passengers aren't always allowed in helicopter medevacs and if you are truly in a remote area....say 50 miles from the nearest USCG boat station..and it's life threatening...chances are it may be done by helo.

This thread has given me a chance for some introspective thinking. My wife knows how to drive the boat, but probably doesn't know how to start it, shut it down, maneuver it near a dock, etc. She also has a limited knowledge of the VHF.

I see some additional training on the schedule for this summer so she'll become much more comfortable doing these things.

rwidman wrote -

“She probably wouldn't know where the nearest (or any) marina was located.”

That may be standard practice on your boat but not on mine. Melissa is following the chartploters all the time and scanning ahead on the Toughbook to look at Active Captain. Over 20,000 miles of cruising we’ve developed a routine.

Co-captains on the little DeFever, The only thing I do that she doesn’t is docking, but it the end that doesn’t matter. She knows the basics. Boats can be fixed.

If you are willing to spend enough money, rental cars are always available. You might have to buy a car right there in the parking lot, but so what? It's only money.

Mike

Sceptic said:

rwidman wrote -

“She probably wouldn't know where the nearest (or any) marina was located.”

That may be standard practice on your boat but not on mine. Melissa is following the chartploters all the time and scanning ahead on the Toughbook to look at Active Captain. Over 20,000 miles of cruising we’ve developed a routine.

Co-captains on the little DeFever, The only thing I do that she doesn’t is docking, but it the end that doesn’t matter. She knows the basics. Boats can be fixed.

If you are willing to spend enough money, rental cars are always available. You might have to buy a car right there in the parking lot, but so what? It's only money.

Mike

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Agreed 100%. It's common sense that at least two people ( the Cpt. any one other) knows how to operate the vessel and equipment and my admiral knows how to do both.