What You Should Know About Boating Injuries

Whether we like it or not, injury is a risk that we face every day. Accidents happen, and when they happen on board a boat, whether far out on the open ocean, or in the middle of a lake, things are significantly complicated by our distance from assistance. Your preparedness and ability to identify and treat common boating injuries is critical out on the water.

First Aid Kit

Most any commercially available first aid kit will do the trick, or you can assemble your own. Use a waterproof container that floats. According to the Department of Homeland Security, a basic first aid kit should include the following items:

- Two pairs of Latex, or other sterile gloves (if you are allergic to Latex).
- Sterile dressings to stop bleeding.
- Cleansing agent/soap and antibiotic towelettes to disinfect.
- Antibiotic ointment to prevent infection.
- Burn ointment to prevent infection.
- Adhesive bandages in a variety of sizes.
- Eye wash solution to flush the eyes or as general decontaminant.
- Thermometer
- Prescription medications you take every day such as insulin, heart medicine and asthma inhalers. (rotate medicines to account for expiration dates.)
- Prescribed medical supplies such as glucose and blood pressure monitoring equipment and supplies.
- Scissors
- Tweezers
- Petroleum jelly or other lubricant
- Aspirin or non-aspirin pain reliever
- Anti-diarrhea medication
- Antacid (for upset stomach)
- Laxative

On board a boat, I recommend that you add the following items

- Meat tenderizer
- Vinegar
- A pair of needle-nosed pliers
- Motion-sickness medication
- Disposable vomit bags
- An emergency blanket
- Fresh Water (changed regularly)
- An eye pad
- A flashlight with extra batteries

Now lets look at some common boating injuries and ailments, and how to treat them.

Fish hook

As fishing is one of the most common pastimes enjoyed by boaters, it's only natural to expect the occasional snag. If you do get caught by a fish hook, remain calm, and assess the situation. You should not attempt to remove a fish hook that is caught in or around anyone's eyes. If this is the case, gently cover the eye with a pad and/or gauze and try to keep the victim from moving their eye. Seek professional medical help immediately.

If the hook is not in or near the eye, you might consider removing it yourself. If it appears to be embedded deeply in muscle, or is near to a major vein or artery, it is still advisable to seek help. If you do opt to take it out yourself, your approach will be different depending on how deeply the barb has entered the flesh. First, remove and lines, bait, sinkers, or other objects attached to the hook. If the barb is near the surface, and has not penetrated too deeply, it's likely that you can gently work the hook backward out of the wound without causing much damage. If you're lucky enough to be in this situation, remove the hook, clean the wound carefully, apply your antibiotic ointment, and bandage the site.

If the barb is too deeply embedded to pull out, you'll need to force it forward. Use your pliers to remove any other barbs on the hook, and then carefully push the hook forward and out of the victim's flesh. Follow the natural path of the hook if at all possible, to avoid further injury. When the barb is exposed, cut it off with your pliers, and carefully back the hook out of the wound. Clean and dress the wound carefully.

CPR

CPR, or Cardiopulmonary Resuscitation is a means of keeping oxygenated blood flowing after the cessation of a heartbeat. Keeping oxygen flowing to the brain in this way can prolong life in an emergency. CPR is not a substitute for professional help, and is meant to be a first response only. While these directions will help you in an emergency, they will not take the place of an established CPR course. There are a lot of variables surrounding the procedure, both in the realms of assessment and performance, and the CPR courses offered in your community are the very best way of learning the procedure. In general terms, to perform CPR (on an adult), you should do the following:

- Ensure that the scene is safe - some situations that may look like a heart attack may have environmental causes. Electrocution is an example that can endanger you as a care-giver. Ensure that you can safely approach the victim before stepping in.
- See that help is sought, either via cell-phone, sat-phone, or radio, make sure that someone has summoned help. Have them turn the boat toward the nearest or most accessible port or landing. If you are alone with the victim, you'll need to assess the situation carefully, but generally-speaking, you'll be more helpful piloting the vessel toward professional assistance or communicating with responders than performing CPR.
- Determine whether or not the victim is breathing. To do this, place your ear right up against the victim's mouth and nose. Simultaneously, you will attempt to feel their breath on your ear, hear any breath sounds that may be present, and observe their chest for the tell-tale rise and fall of breath. If they are breathing, continue to monitor their breathing, do not move the victim, and seek assistance. If they are not breathing, proceed to the next step.
- Position the victim on their back - be careful not to move or jar the head, neck, and spine more than absolutely necessary - try to roll the victim in one smooth motion.
- Open the victim's airway by gently tipping their head backward and lifting their chin - check for breathing again. If they are still not breathing, look for an airway obstruction, both visually, and by sweeping your fingers through the back of their mouth. If there is no obvious obstruction, you'll need to administer rescue breathing.
- Pinch the victim's nose while covering their mouth with yours. Gently breathe air into their lungs through their mouth. Watch for a resultant rise of the victim's chest. If the chest does not rise, reposition their head and try again.
- Check the victim for a pulse. If there is no pulse, you'll need to administer CPR.
- Place your hands, palm down, one on top of the other, on the victim's chest, about two finger-widths above the bottom of the breastbone. Lean forward, positioning the weight of your upped body above your hands.
- Push down on the victim's chest, compressing the chest one to three inches. Compress the chest 15 times in succession.
- Give two more rescue breaths. Repeat with 15 chest compressions followed by 2 rescue breaths until the victim starts breathing, help arrives, another person takes over for you, or you are too exhausted to continue. Check for a pulse and breathing every 4 rotations.

Don't forget to keep up your training. CPR certifications expire for a reason. The practice and advances you learn periodically by keeping up your certifications ensure that you will be as prepared for emergencies as possible.

Bleeding

There are many boating mishaps that can result in mild or serious bleeding. For most wounds, try the following:

- Apply direct pressure to the site of the wound using clean towels or gauze.
- If your gauze soaks through with blood, apply more gauze directly over the first bandage - do not remove the original bandage, as that will also remove any clotted blood and will restart the bleeding.
- Once the bleeding has been controlled, on small wounds, it is usually safe to remove your bandages, clean the wound, and redress the wound cleanly.

For larger wounds, direct pressure and elevation are still your best bets. Avoid applying a tourniquet in all but the most extreme of emergencies, as even a well-applied tourniquet can result in serious long-term injury up to and including the loss of limbs.

Jellyfish Stings

In most cases, jellyfish stings are a painful nuisance, and little more. Still, these stings are common, and quite painful. Contrary to popular belief, scraping at the site of the sting is not a good idea. Make a paste out of a powdered meat tenderizer and apply it liberally to the area. The meat tenderizer will break down the proteins, and lessen the severity of the sting. Vinegar is also effective in neutralizing jellyfish stings. In a pinch, the old remedy does indeed work - urine will actually help. Observe the victim for an anaphylactic reaction. In most cases, everything will be fine. No matter what you do, jellyfish stings are painful, and will take a while to stop hurting. Don't panic.

Hypothermia

Hypothermia is defined as the drop in a body's core temperature below 95 degrees. When you spend all day surrounded by water - a most excellent conductor of heat - hypothermia can be a concern. Symptoms can be as mild as shivering, and as severe as slurred speech, motor control problems, extreme disorientation, and coma. Treatment for hypothermia is as follows:

- Remove the victim from the cold - if they're in the water, get them out! If it's cold and wet outside, get them below deck or to shore, pronto.
- Remove any wet clothing. Now is not the time to be shy. Wet clothing will slow the victim's recovery. Get them out of wet clothes and dried off as quickly as possible.
- Wrap the victim in blankets, or if they are able, dress them in warm, dry clothes. Doing both isn't overkill.
- Chemical hand-warmers are okay, if you have them. Place them in armpits, groin, hands, and feet for the most effectiveness.
- If they're able, allow the victim to sip warm liquids. No alcohol should be used.
- If the victim does not recover quickly and completely, seek medical assistance.

Call for Help

For land-lubbers, help is only as far away as the nearest phone. In this day of cell phones, on many lakes, ponds and near-shore areas, the same is true. Keeping your cell phone charged is a great way to ensure that you can get help when you need it. What if you don't have a cell phone, or are not in an area serviced by your cellular provider? Sometimes 911 will work, even if your phone shows no bars of service. Cell providers sometimes share towers in order to provide emergency services so it's worth making the call, regardless. If you have a radio, calling for the coast guard or emergency providers is easily done. On a CB, tune your radio to channel 9 (27.065 MHz), which is reserved for emergency traffic only. On VHF-FM, you want channel 16 (156.8 MHz). Emergency Radio Call Procedures, according to the US Coast Guard, are as follow:

1. Make sure radio is on
2. Select channel 16
3. Press/hold the transmit button
4. Clearly say: "MAYDAY MAYDAY MAYDAY"
5. Also give:
- Vessel name and/or description
- Position and/or location
- Nature of emergency
- Number of people on board
6. Release transmit button
7. Wait for 10 seconds - if NO response repeat "MAYDAY" call.

If, for some reason, you find yourself in trouble, have no means of calling for help, and cannot head for port - for example, if you have no propulsion - there are several recognized signals that are meant to be seen or heard from a distance. In no particular order, here they are:

- Hold a paddle or oar in the air, blade upward.
- Hang a distress flag from a paddle or mast - distress flags are available at any marine supply store.
- At night, flash S-O-S in morse code. Three short flashes, followed by three long flashes, and three short again. You can buy emergency flashers that signal this on their own.
- Signal S-O-S with an air-horn or whistle, as with the light above.
- Use a signal flare, either hand-held or from a flare gun. Be careful not to ignite your boat or gear. Don't fire a flare gun straight up, or you risk playing the Wile E. Coyote role in your rescue.

There is no substitute for preparedness on the water. Sailors, boaters, and water-sports enthusiasts should all strive to learn the basics when it comes to boating injuries and first aid. Be safe.