In most first aid manuals, calling 911 or 999 is one of the first things the first aider is supposed to do, the thought process being that professional help is typically close by, if not just around the corner. At sea though, this is not always the case, and in some situations professional medical help may be several hours, if not days away. For the sailor therefore, joining a first aid course which is geared towards a marine environment is highly beneficial.
As well as learning first aid out of duty, interest, work obligation or otherwise, many sailors find themselves doing first aid courses primarily for certification purposes. This is because under ISAF Category One racing requirements, at least 30% of a boat’s crew must have first aid certification. I know many would share my sentiment when I say that for anyone with a busy work life, having to renew ones first aid certification every few years is quite a chore. I undertook my last one two years ago, and was sceptical as to the necessity of renewing it, and had it not been for my planned participation in some off shore racing this year, I might not have done. What surprised me though was just how much I had forgotten in two years. Confused by my memory of old CPR classes in the early 1990s I could have sworn the ratio of chest compressions to breaths was 10 ten to 1 (nowadays the recommended number is 30:2). And as for the timing, I think without the refresh I would have compressed at a significantly slower rate (recommended rate being 100 compressions per minute). In short therefore, whilst achieving the desired effect of updating my certificate for three years (it previously only lasted for 2 years – bonus!), I now also feel far more able to assist in a first aid situation.
The course which I attended in Hong Kong at the RHKYC, is officially titled NSC First Aid Course, Standard First Aid, CPR & AED Refresher, is designed around the US National Safety Council and is the refresher version of the full course with the same name. The only difference between the two is that the full course goes into more detail across all parts, is therefore stretched over four sessions rather than two, and is more costly. Each session was scheduled between 6.30-9.30pm.
As the course names suggest, both versions are split into two main sections. The First Aid section teaches essential theory and techniques in managing common injuries and conditions. For instance:
- puncture wounds
- cuts and bleeding
- internal bleeding and bruising
- head injuries
- eye injuries
- heat exhaustion & heat stroke
- breathing difficulties
- sea sickness
We practised applying bandages, slings and splints; we also discussed wound cleaning, pain killers, and which drugs help which conditions. One of the exercises required us to select drugs for a number of conditions, quite a challenge when faced with more than twenty choices. This highlighted very clearly the need for all boats to have a clear list with an explanation of the uses of each medicine kept on board, as well as to keep a track on expiry dates.
CPR & AEDs
The second part of the course was on CPR (cardiopulmonary resuscitation) and the use of AEDs (automated external defibrillator). We learnt to use two types – ones with a voice instruction for each step, and ones with simple warning lights and indicative diagrams.
Most Clubs and many public places nowadays have these in a readily available position for assisting anyone who has had a heart attack (the RHKYC has two or three of them including one in the main bar). The great thing about AEDs is they do much of the work for you. Once you have attached the pads in the right place the machine will work out for itself if an electric shock is necessary, and when, and how strong. They also instruct the user when the patient can be touched and when to continue with CPR once the shock/s have been administered. AEDs can be purchased from approximately US$ 1,000 upwards. Not cheap, but in the grand scheme of yachting gear, a worthy investment, possibly a life savings one. I particularly think that for anyone with regular older crew on their boat, these should be given even more serious consideration.
We finished the course with some practical first aid scenarios – four of us were asked to leave the room and plan for how we would action a urgent first aid scenario, where a yacht was rolled with several crew below. We were assumed to be those in decent shape, having to take control of the situation we would find below. From burns, chopped off fingers, internal bleeding (all complete with fake props and fake blood), we entered a room that can only be described as carnage. Without going into the detail, the main takeaway was that if resources allow, one person needs to stand back to take an overall view of the situation, and if possible stay back. This allows for everyone else to get on with helping those in need, whilst at least one person is able to observe, receive communications and give instructions based in his or her assessment of where help is needed most.