Medical Emergency Readiness (Work in Progress)

[Foswick]

As part of a presentation on onboar medical emergency readiness, I have been working on a handout. The purpose is to give a list of topics and equipment to consider to evaluate one's own readiness. This isn't meant to be a list of "you must do everything on this list", but a list of "you should think about these things and evaluate whether your have addressed them or need to."

This is very much a work-in-progress and it is still pretty tied to the presentation that explains a few of these items in ways that this checklist leaves ambiguous. And, the resources section pretty much just has placeholders, right now. But, I would still be keen to get feedback/questions:

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Medical Emergency Readiness – Season Checklist
Review this annually to prepare for the boating season. Use it to identify training needs, update equipment, and plan for your crew's specific risks.

Talk about expectations with your crew. Whether you have a DNR or other formal directive, make sure everyone is on the same page about care expectations. Don’t let your crew wonder if they’ve done enough for you.

Crew Skills and Knowledge
Do at least two people on board know how to:

• Control the boat solo (in case the skipper is incapacitated)
• Perform a 30-second rapid assessment (AVPU and ABCD)
• Use the VHF, including DSC distress functions
• Locate and report lat/long coordinates
• Recognize heart attack symptoms
• Recognize stroke symptoms (e.g., F.A.S.T.)
• Administer aspirin to a suspected heart attack victim
• Perform compression-only CPR
• Perform rescue breathing (if gear and crew permit)
• Check and establish an airway
• Administer emergency meds (e.g., EpiPen, nitroglycerin)
• Control major bleeding
• Recognize and manage hypothermia
• Recognized and manage heat stroke
• Treat serious burns
• Apply or improvise a neck collar

Crew-Specific Medical Concerns
Does anyone have any of the following? Does at least one other crew member know about special considerations? Is this documented, on board, if appropriate? Where?

Tell EMS about all of these, when they arrive:

• Diabetes (glucose/insulin)
• Blood thinners (increased bleeding risk)
• Severe allergies (EpiPen)
• Seizures (What type? Triggers? Normal recovery?)
• Cardiac history or implanted devices
• Beta blockers
• Other medical condition
• Other medications
• DNR or advanced directive

Equipment and Supplies
Do you have or need these and are they in good shape and not expired?

• DSC VHF
• AED (pads and battery)
• PPE (gloves, mask, eye protection)
• CPR mask and/or bag-valve mask
• Pulse oximeter
• Trauma dressing
• Hemostatic agent (QuikClot, e.g.)
• C-collar or improvised horse collar
• Aspirin (81 mg)
• Thermometer (battery check)
• Trauma shears
• Medical tape (3M Transpore)
• Glucometer (glucose paste)
• Blood pressure cuff (stethoscope)
• EpiPen
• Narcan
• Crew-specific meds

Resources

• USCG District 13 Local Notice to Mariners: https://www.navcen.uscg.gov/sites/default/files/pdf/lnms/LNM13502024.pdf
• AHA Up-To-Date CPR Discussion: What is CPR
• Raritan Yacht Club – Medicine and First Aid for Offshore Sailors:

 

[Foswick]

Here is the updated resources section:


Resources

• USCG District 13 Local Notice to Mariners – Discusses the Coast Guards response guidelines in our region. (https://www.navcen.uscg.gov/sites/default/files/pdf/lnms/LNM13502024.pdf)

• American Red Cross – First Aid/CPR Training & Resources – Offers first aid and CPR/AED courses (online or in-person) and provides online guides for handling common emergencies. The Red Cross site covers maritime-relevant first aid topics like treating hypothermia, heat stroke, severe allergic reactions, and more. (Red Cross Training | Take a Class | Red Cross)
• American Sailing Association – “Handling Medical Emergencies at Sea” – A 90-minute online course focused on first aid training for boaters. It teaches how to handle medical issues in a sailing/cruising environment, covering necessary equipment, emergency decision-making, and offshore medicine techniques. (Handling Medical Emergencies at Sea)
• American Heart Association – Heart Attack & Stroke Signs – Official AHA guidance on recognizing heart attack and stroke symptoms and responding quickly. Explains warning signs (like chest pain or FAST test for stroke) and emphasizes immediate action (calling EMS and starting CPR) for these life-threatening emergencies. (Heart Attack, Stroke and Cardiac Arrest Symptoms)
• American Red Cross – Severe Allergic Reaction (Anaphylaxis) First Aid – Describes how to recognize anaphylaxis (life-threatening allergic reaction) and what to do. Includes first aid steps such as using an epinephrine auto-injector (EpiPen) if available, calling EMS, and treating for shock while waiting for emergency help. (Allergic Reaction/Anaphylaxis: Causes, Symptoms, How To Help | Red Cross)
• CDC – Hypothermia & Heat-Related Illness Guidance –Provides tips on preventing, recognizing, and first-aid treatment of hypothermia (dangerous cold exposure, common in cold water boating) and heat stroke or heat exhaustion (caused by extreme heat). It outlines warning signs (shivering, confusion, or, conversely, high body temperature and dizziness) and first aid measures to stabilize the person until help arrives. (Preventing Hypothermia and related pages on heat emergencies)
• CDC “Stop Overdose” – Naloxone (Narcan) Use – Explains how to respond to an opioid overdose using naloxone. This CDC resource describes where to get naloxone and how to safely administer it (nasal spray or injection) to reverse an overdose. It’s a useful guide for carrying and using Narcan on board in case of an opioid emergency. (Lifesaving Naloxone)
• “Stop the Bleed” Campaign (ACS/DHS) – A national program teaching the public how to control severe bleeding in an emergency (such as a serious cut or trauma on board). The official Stop the Bleed site offers simple instructions on using direct pressure, packing a wound, and applying a tourniquet to stop life-threatening bleeding, as well as information on training classes and bleeding control kits. (STB Home Page)
• Maritime Good Samaritan Law (U.S.) – Overview of U.S. laws protecting boaters who render aid. Explains that federal law (46 U.S.C. §2304) requires vessel operators to assist anyone in danger at sea if they can do so safely, and Good Samaritan provisions (46 U.S.C. §2303) shield those who help from liability as long as they act as an ordinary prudent person would. (The Good Samaritan – Safety of Life at Sea | Waterway Guide
• Advance Directives (DNR Orders) in Emergencies – General medical guidance on upholding Do Not Resuscitate (DNR) orders or advance healthcare directives. This resource explains what DNR means, how it’s documented, and how it guides responders in an emergency. It’s useful for understanding how such directives might apply if a boater has a DNR – essentially informing crew or rescuers about the person’s wishes regarding CPR or other life-saving measures. (Do-not-resuscitate order: MedlinePlus Medical Encyclopedia)
• BoatUS – On-Board First Aid Kit Essentials – A practical guide listing some of what to include in your boat’s first aid kit – from bandages, antiseptics, and medications (e.g., aspirin for potential heart attack) to tools like scissors, tweezers, gloves, and a first aid manual. This checklist has very little that would save a life, but it is a good start to a well-prepared kit. (https://www.boatus.com/expert-advic...essential-on-board-first-aid-kit-for-any-boat)

• Raritan Yacht Club – Medicine and First Aid for Offshore Sailors – About an hour-long video interview of Gary B. Nackman M.D. an offshore sailor with over 15,000 Bluewater nautical miles & 30 plus years of medical experience. Well worth the watch.
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