Great First Aid Course For Offshore Voyagers

WRFA-May-BlairsPic-142

What does spending four days in the woods of Nova Scotia getting eaten alive by black flies have to do with offshore voyaging? Well I have to admit I was asking myself the same question, particularly at ten o’clock at night when faced with a horrible lake motor boat accident: One compound fracture, one head injury quickly leading to seizures and death, one severe hypothermic 300 meters over broken ground from the only clear area for the helicopter evacuation that might just save his life, and finally a missing three year old child and his understandably hysterical mother. Oh yes, said mother had a broken arm. Did I mention it was black dark?

OLYMPUS DIGITAL CAMERAAs you may have guessed by now, all of this was an exercise dreamed up by our chief instructor Blair Doyle (pictured left) during the four day Advanced Wilderness and Remote First Aid course Phyllis and I just completed. We soon learned to dread this slight smile since it meant that Blair had just dreamed up something truly fiendish for our training “pleasure”.

And get this, the above horror show was not the final test; the whole  four days was filled with such scenarios: An old cranky guy with a heart attack—how come they picked me for that role? A raving drunk that turned out actually to be a sober diabetic having a low sugar crash. A spine injured woman jammed between two rocks next to the lake. Bones sticking out of legs and blood everywhere. It might have been fake, but it sure looked and felt real.

WRFA-May-BlairsPic-047And often the problems presented in the scenarios were ones that we had not yet been instructed on. Welcome to “experiential training”: first you are exposed to and have to deal with the problem, and then you get the answer. What a great way to prepare a person for a medical emergency in the wilderness, because you know what? Out there, that’s exactly what it’s going to be like in an emergency. Mitigating the disaster will be 70% staying cool, thinking clearly and problem solving; and maybe 30% first aid knowledge—a lot like getting out of the yoghurt when things go pear-shaped at sea.

This is a great course for us offshore sailors, not only because the lessons are driven home with hands-on scenarios, but also because the course assumes that you are between several hours and many days from help, where just holding the injured person’s head to avoid further spinal injury or pressure stopping the bleeding for a few minutes while waiting for the EMTs is not going to cut it.

All weekend we were faced with the need to take action and not give in to the natural desire to do nothing or defer to others: We suspected a spinal injury, but if we didn’t move the person they would die of hypothermia. Frozen or paralyzed, it was our call. Of course we couldn’t be sure of our diagnosis, or really of anything. The course was all about hard decisions without enough information and too little time—a lot like the real world.

If you go offshore this is a great course that we highly recommend. And if you’re around Atlantic Canada, take it with Blair Doyle. He is a gifted instructor with a huge amount of experience, both in the wilderness and as a professional EMT.

Have you taken a first aid course to prepare you for offshore voyaging? Which one, and what did you think of it? Please leave a comment.

Like what you just read? Get lots more:


Please Share

Meet the Author

John

John was born and brought up in Bermuda and started sailing as a child, racing locally and offshore before turning to cruising. He has sailed over 100,000 miles, most of it on his McCurdy & Rhodes 56, Morgan's Cloud, including eight ocean races to Bermuda, culminating in winning his class twice in the Newport Bermuda Race. He has skippered a series of voyages in the North Atlantic, the majority of which have been to the high latitudes. John has been helping others go voyaging by sharing his experience for twenty years, first in yachting magazines and, for the last 12 years, as co-editor/publisher of AAC.

10 comments… add one
  • Michael May 28, 2011, 12:07 am

    Hi John,

    Great post! I’m finally glad to see someone with a more popular site mention the usefulness of wilderness medicine in the cruising setting.

    My wife and I are going to take the Wilderness EMT course provided by the National Outdoor Leadership School here in the States. Check out their site if you have time. http://www.nols.edu. They have all kinds of fun stuff for folks heading out on the road less traveled. EMT course might be overkill at a month of training but we feel it’s time and money well spent. Especially since we will get lots of practice working together as a team in stressful situations.

    Now something else since we are on the topic of medical training. I don’t think many sailors carry Automated External Defibrillators (AED’s). Commercial Airliners are required to have them and they are less then a few hours from help and normally have a lot less happening on board to stop your heart. On a boat there are all kinds of things happening that could stop your heart and you could be weeks from help! Check out the statistics. These things are super effective and they save several passengers a year. They range from basic start your heart models to ones that can serve as mini EKG machines that can record and transmit data to a doctor. Pretty cool…

    Thanks again for the post!

    Mike

    • John May 28, 2011, 7:57 am

      Hi Mike,

      Thanks for the kind words on the post.

      On defibrillators. We did receive training on one, not that you need much in that they are fully automatic and lead you through each step.

      However, be aware that in an offshore setting the actual life saving benefit is, according to the training we received, fairly small for this very expensive piece of equipment. The reason is that even though it may restart the patient’s heart, it will not have dealt with the causative problem, usually an arterial blockage, only a hospital can do that. So the person is likely to arrest repeatedly and eventually die anyway.

      As I understand it, in an urban setting the presence of a defibrillator brings the chances of resuscitation up to 5% from the 2-3% for CPR without one. But both these numbers assume that the patient will be in a fully equipped hospital within an hour, not the situation on an offshore boat.

      For those that are interested, here is a link to an excerpt from a book on how effective CPR is, or more accurately, is not.

      • Robert Bell May 30, 2011, 12:22 pm

        Hi John,

        I would like to point out that the causative problem used as an example (e.g. arterial blockage or anything medical) is not the only reason to have an AED. High voltage electrical accidents, or anything that might send an otherwise healthy heart into v. fib., are prime examples of where an AED would be very useful offshore. In these latter cases, the AED is highly effective…even days from healthcare. I could argue some other points in the medical cases also, but in my opinion the accident scenario is at least one example of the effectiveness of the AED that I haven’t seen disputed in the medical community. The CPR comment has merit, but the statistics are not as simple as some suggest (e.g. not separating witness versus non-witnessed arrests). There are a lot of variables that affect survival rates.

        That said, I am not promoting or suggesting these expensive items (AEDs) for people. It’s a personal choice and a personal opinion. However, being a former professional rescuer, and having performed CPR and used the defibrillator (even back when we had paddles) more times than I wish, I figure I would toss in my thoughts.

        BTW, why wasn’t the rescuer in your photo wearing their gloves? 🙂

        Robert

        • John Jun 1, 2011, 3:59 pm

          Hi Robert,

          All good points, thank you. Like you I’m not specifically recommending that cruisers don’t carry an AED, just that they are not the magic life saving boxes that the media and the companies that sell them would have you believe. We have decided that there are other places we can put our safety budget, which has a limit, that will give a better return than an AED, but each boat owner must make that decision themselves.

          • Dan Nov 20, 2014, 4:10 pm

            I have to maintain my CPR certification for professional reasons and have been trained on AED’s for years. AED’s are pretty fool proof if one does not panic. I agree their usefulness, as well as CPR, is minimal when away from an ER. The media oversells the effectiveness of CPR and AEDs, but having said that, I would want my wife to know CPR and I want an AED on board.

            While the usefulness of CPR or and AED hours from an ER is going to be minimal, CPR and AED could save a life in the marina. Just for the chance alone I think it is worthwhile knowing CPR and having an AED on board if one can afford the cost.

            And while the effectiveness of CPR and/or and AED offshore might be close to useless, if CPR and AED has to be used and the person is not brought back to life, one can at least tell the survivor’s family that all that could be done, was done. After all the person giving CPR and using the AED might be one of the surviving family members.

            Later,
            Dan

  • Ernie May 28, 2011, 9:54 am

    Hi John,

    When Bette and I began to solidify our plans for being off the beaten path a few years back, I had decided to work my way up through the ranks of emergency medicine at SOLO over in NH. Got all the way through their courses up to WEMT. Once completed, I felt that the only way t o keep my skills fresh was to work with a rescue squad. I proceeded to sign up with our local squad in town and have been running with them for the past 3 years every Monday. Being a volunteer squad, there is no financial benefit but they did put me through the next level of certification, EMTI, which taught me several new and valuable skills.

    I think this is a great way to learn more about emergency medicine, keep your skills fresh which is always challenging and…give something back to the community. I would recommend it to anyone that has the time and is planning an extended period away from immediate care.

    Regarding the AED, we will likely carry a small portable. They are very easy to use and if indicated, could be just the jolt that is needed to buy some time in the event of a cardiac arrest. You are correct though in that they are no substitute for hospital care at the earliest possible time.

    Thanks for posting on the topic…

    Happy northward sailing and we’ll be thinking of you guys…

    Ernie

  • Tim Allen May 28, 2011, 10:30 am

    I took a two-day Wilderness First Aid course at SOLO in North Conway, NH, last year — definitely more applicable to offshore sailing than the basic Red Cross First Aid course, where the take-home message was “call 911.” Highly recommended. But as with everything, you need to continuously practice!

    • Robert Bell May 30, 2011, 12:34 pm

      I would second Tim’s comment for those offshore sailing. The Wilderness add-ons are available for many of the medical certifications (Basic First Aid, First Responder, EMT). There are a number of organizations that offer them and they are highly worthwhile if you are going to be days from help. They also tend to be much more hands-on than the standard courses.

      And agree with practice…if you don’t practice it, you won’t perform it well in an emergency…just like any other preparation (e.g. MOB drills, heavy weather tactics, etc).

      Robert

  • Bob Hinden May 28, 2011, 1:19 pm

    Regarding the effectiveness of CPR, the way I heard it explained, is that you perform CPR after someone has died. That is, they are not breathing and have no pulse. For this to have happened they are very very sick. It’s not surprising that very few people are brought back.

    That said, it is worth trying. If it was me, I want to be one of the 2%.

  • RDE May 28, 2011, 1:30 pm

    My friend Denny Emory is a retired delivery skipper whose business supplies specialized medical kits for mountain expedition and offshore sailing voyagers. DennyEmory@earthlink.net

Only logged in members may comment: