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Responding to a Medical Emergency

Next to a fire at sea, the scariest prospect working aboard a luxury yacht is responding to a medical emergency of a guest or crew member, whether it occurs onboard or while they are ashore. Let’s face it, the medical care that we have come to expect, living in a wealthy country, may not be the medical care we will receive in a smaller poorer island nation that does not have the benefit of necessary emergency and trauma resources.

A case in point, while I was working as a yacht captain in St. Lucia, two guests on another yacht were victims of a tragic motorcycle accident. A husband and wife, on a motorcycle rented for a fun day of touring, each lost a leg in the mishap. Sadly, the emergency care system in St. Lucia was not equipped to handle that single incident. The lone emergency room doctor on duty that day, a volunteer surgeon from the neighboring island of Martinique, could only offer the couple a chilling choice. The severely injured couple had to decide which one of them would receive medical care first. The husband quickly offered that his soul mate should be sent into the operating room right away. Thus his wife’s life was saved, but he lost his own while awaiting the trauma care he desperately needed.

While this is an extreme case, it raises an important issue. How much medical training should there be aboard a yacht, and which crew members should be trained?

The medical training requirements for yacht crew by STCW 95 (Standards of Training and Certification for Watchkeepers) are straightforward. All crew members are certified in Elementary First Aid as part of their Basic Safety Training. However, it is only those crew on the deck officer career path (Master, Chief Mate and Officer of the Watch) that must take additional medical training. “Every deck officer is required to be trained to the level of Proficiency in Medical First Aid and masters and chief mates are required to hold a certificate of Proficiency in Medical Care.” If there is a specific crew member who is designated to provide medical care, he or she must also hold the Proficiency in Medical Care certificate.

STCW 95 also recommends a “prearranged system shall ensure that medical advice by radio or satellite to ships at sea, including specialist advice, is available 24 hours
a day.”

While serving as captain aboard a large sailing catamaran, I was delivering that yacht from the British Virgin Islands to Savannah, Ga., for a refit. The owner’s son and wife decided to join the paid crew for the experience, and do some scuba diving along the way. We found an interesting wreck off South Caicos which would prove to be a challenging dive. A small airplane had crashed about a mile off the coast in about 100 feet of crystal clear water. Later that night while we were back underway, the owner’s son complained that he was losing his peripheral vision. I knew from my medical training that this was tunnel vision, a symptom of decompression sickness, and a rapid response was needed. Contacting the USCG via our satellite email service allowed us to reroute immediately to Providenciales, which had the nearest emergency hyperbaric chamber. After 24 hours in the chamber, the owner’s son recovered without any permanent damage to his body.

As a crew member, your responsibility for the safety of guests while they enjoy their yachting vacation onboard also extends to their use of water toys, riding in the tender and their excursions ashore. In addition, there are many hazards aboard a yacht that can cause a crew medical emergency. Working with cleaning chemicals, mechanical equipment, and electrical circuits on a daily basis all entail accidents waiting to happen. Doesn’t it make sense that you earn medical care certifications above and beyond what is required by STCW 95? Taking a course to become certified in Medical First Aid is an excellent start if you are serious about your career in the yachting industry. This certification will not only provide an additional margin of safety aboard your yacht, but it will also make you a more valuable crew member during a future job search for a berth aboard that perfect yacht you are looking for.

 

Capt. Jeff Werner is a Senior Instructor with International Crew Training in Ft. Lauderdale, and is a 23 year veteran of the yachting industry.

 

Ask the Experts! Stumped by an On the Water crisis? Ask the Gurus at International Crew Training! Send thoughts and questions to editor@allatsea.net

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