First Aid Afloat deals with some of the medical problems you may face on the water, including bites and stings, bleeding, burns, hypothermia, seasickness and sun exposure
Every vessel should carry a suitable first aid kit, which can be bought from your local Honda Marine dealer. The kit should contain adequate wound and burn dressings, and a booklet explaining basic first aid procedures.
Chemists stock simple kits that can be supplemented with sunscreen lotion, seasickness tablets, a felt-tip pen (for recording injuries and treatment, to inform medical staff if necessary) and a pair of side-cutting pliers for removing fishhooks. Clearly mark the kit as first aid and keep it in a sturdy, watertight container where anyone on board can reach it.
Bites and stings
Bites or stings from sea snakes and some jellyfish can cause breathing and circulation problems. It’s vital in all of these instances to keep the patient calm, assured and rested, monitor their airway, breathing and circulation (ABC) and get medical help urgently.
If necessary in the most serious cases, you may also need to begin resuscitation immediately and continue until medical help arrives.
The following steps are also recommended for particular bites and stings:
• Prevent patient from rubbing the area
• Pour vinegar over the affected area to deactivate the stinging capsules and prevent
further venom release
• Apply icepacks to relieve pain
• Apply a pressure immobilisation bandage to the affected limb.
￼Stingrays and other venomous spines
• Immerse area in water as hot as the patient can tolerate, to help relieve the pain.
• Don’t use pressure bandages (i.e. tourniquets).
Small cuts can be treated easily by washing with a disinfectant solution and closing with a suitable dressing. The most effective way to stop bleeding is to apply pressure directly to the wound. Elevating the limb also will help control bleeding.
If a patient has massive bleeding—from a propeller strike for example—you may have to apply a constrictive bandage as a last resort, but more standard bandaging—if it will stop the bleeding—is preferable.
• Use a broad (5-7.5 cm wide) soft rolled bandage, strip of material or wide belt
• Apply the bandage to the upper part of the limb to completely cover the arterial pulse, but keep clear of limb joints
• Encircle the limb several times
• If bleeding appears to increase, slowly release the bandage—this reduces the risk of a surge of blood increasing bleeding further—and reapply immediately
• Once correctly applied, record the time on the patient’s forehead.
• The bandage must not be covered up by clothing.
• Transport the patient to hospital as soon as possible.
Immediately and gently cool the burned skin with plenty of cold water (sea water is excellent). Never burst blisters or cut away clothing unless it’s a chemical burn, which might continue to eat into the clothing and skin beneath.
Cover the area lightly with a clean, dry, sterile burns dressing or clean cloth, and keep the patient calm and assured. Seek medical assistance as soon as possible.
Hypothermia is a serious medical condition resulting from heat loss due to prolonged immersion in water or insufficient protection in cold, wet or windy conditions, so it’s particularly relevant to boat users.
The loss of core body temperature in vital organs such as the heart, lungs and kidneys can cause death quickly. The risk is increased if the person is anxious, hungry, exhausted or mentally low.
Hypothermia is not always easy to recognise. The person may no longer even feel cold, which can disguise the real risk.
Early signs of hypothermia may include:
• lethargy and difficulty in reasoning
• poor sense of touch and clumsiness
• slurred speech
• developing muscle rigidity
• swollen lips, hands and feet.
As the condition develops, more critical symptoms include:
• rigid muscles
• very slow, weak pulse and breathing
• uneven heartbeat
• cold and bluish-grey skin
• dilated and unresponsive pupils
• death-like appearance
To reduce the risk of hypothermia on board:
• keep warm and dry
• avoid fatigue—rest if tired
• eat and drink normally, to prevent dehydration
• avoid alcohol—it increases pulse rate and body heat loss
• avoid seasickness
• be aware of special medical needs
To slow the development of hypothermia in the water:
• put on extra clothing before entering the water— but be careful to choose clothing that won’t
absorb water and weigh you down too much
• protect the head, neck, hands, feet, chest and groin from heat loss
• minimise swimming and strenuous activity
• adopt the heat escape lessening posture
Careful treatment of a person with severe hypo-thermia is crucial and involves the following steps:
• Do not massage their skin
• Shelter them in a warm environment, away from wind and cold.
• Replace wet clothes with dry
• Keep them horizontal, in the ‘shock’ position (on their back, with legs bent and raised), and minimise their movement
• Restore core temperature gradually—the body’s shock at too-rapid warming can kill
• Share body warmth with them
• Breathe across their mouth and nose
• Apply gentle warmth to head, neck, chest and groin
• Give warm sweet drinks (not alcohol), if conscious
• Administer cardiopulmonary resuscitation (CPR) if necessary
• Seek medical advice
• Keep them under continuous observation
Seasickness can be avoided in many cases if you sleep aboard the vessel the night before (subject to what type of vessel you have), to let your body get used to the motion. Of course, this is not always possible.
Otherwise, you can take seasickness tablets as advised by a doctor or chemist, but be aware that some may make you drowsy. Experienced sailors keep their diet free of rich, fatty foods and alcohol both before going to sea and while aboard.
If you feel seasick, keep busy and stay in the fresh air, away from enclosed areas where fuel fumes and food odours may collect. Avoid the ‘head down’ position, as this aggravates illness. Nibble on a dry biscuit, or chew barley sugar or dried fruit. Ginger is also considered a good remedy.
Boat users are particularly susceptible to ultraviolet (UV) radiation from the sun, because of the additional radiation reflecting off the water. UV radiation is present during daylight all year, but is strongest between 11 am and 3 pm during daylight savings time (10 am to 2 pm other times).
Clothing offers the best sun protection: wear a long-sleeved shirt and a hat that covers the face, ears and neck (a dark colour under the brim will help reduce glare off the water). Also apply to exposed skin a water-resistant, broad-spectrum sunscreen with a sun protection factor (SPF) of at least 15+ and a lip sunscreen.
Apply the sunscreen 20 minutes before going out and reapply it every two hours.
To treat serious sunburn, apply a cool, moist compress to the affected area but do not break any blisters. Give plenty of fluids and seek medical attention quickly.