Suggestions for Boating Safety and Health
Disclaimer—the Calusa Cruise Club has compiled this information based on materials found on a variety of sites, resources, and member experience; Calusa Cruise Club does not warrant the material or offer it as a standard but as a guide to assist members in developing their own safety and boating tools and it does not replace medical advice from a professional.
As you develop your personal boat safety and health plan consider the following questions to help you determine the materials and equipment you need on the boat.
- How long or far will I be gone? (you may need 2 kits, one for near home and one for longer term cruising in low resource areas)
- How many passengers will I have? (do any have medical/health issues)
- What type of activities are planned? (what could go wrong?)
- Someone on your boat needs to have first aid and CPR training.
Additionally, boat operators should have a boating safety course.
- Important: Many of you share rides or end up bringing people offshore you do not know well.
Quick standards before heading out—be sure everyone knows where life jackets are and consider wearables; be sure everyone knows where the first aid kit is and that it is accessible; ask if anyone has medical issues and if so, share them with a designated person on the boat (this can be critical information in cases of seizures, heart attacks, allergies), have appropriate medications with all persons who have special needs such as Epi-pen, Nitroglycerine, etc. Have sunscreen cream or lotion, hats, and long clothing to protect from sun and use them, don’t get burned.
- Have appropriate safety equipment on board
Signaling devices, lighting, horns, life jackets in appropriate sizes, and throw-able rescue equipment, boat hooks, be aware of Coast Guard and Florida Marine Patrol requirements. Carbon Monoxide and Gas fumes detection equipment may be needed especially on boats where sleeping and cooking accommodations are present. Exhaust fans for ventilation of motor fumes as recommended for your type of boat.
- Set up a regular time to review your safety equipment
Put it on your calendar (if electronic calendar is used set an alarm to remind you)--schedule 1 month prior to expiration of your flares for example.
- Check weather and sea conditions prior to leaving the dock and act accordingly.
- File a float plan with someone who has contact information and instructions on what to do if you do not check in or if you experience difficulties or emergencies.
Have a contact on land that you will check in with daily by a set time, give a list of ports of call and approximate times in writing to the person on land. If they do not hear from you by a set time they are to attempt contacting you (phone, text, VHF radio, etc—specify this in your plan) and if no luck, to contact the Coast Guard with your itinerary so that further attempts to contact you can be made.
- DRINKING WATER is important especially in Florida weather.
Assure you have adequate amounts for your passengers and yourself. This can also be used for washing wounds and cooling persons who become overheated.
- DESIGNATE A SOBER CAPTAIN, drinking alcohol and operating a boat is dangerous.
- FIRST AID EQUIPMENT
There are many ways to set up a first aid kit and it needs to be customized to your needs. The following items are suggestions on where to start in putting your kit together, there are many suppliers who offer boating first aid kits as well but they are generally limited in scope and may not be suitable for your planned excursions.
Keep your kit in an accessible place and be sure everyone knows where it is.
Include in the first aid kit:
- VHF Radio
- Cell Phone (even an old phone will connect to 911)—if you will be in a place where other languages are spoken have a translator app on your phone
- A good first aid instruction book—many of these come with purchased first aid kits, you can also download instructions such as Red Cross First Aid app for Android and iOS free (go to your play or Apple store), or go to this link and Download from this site free: Where There Are No Doctors and Where There Are No Dentists http://hesperian.org/books-and-resources/ . There are other available books such as Advanced First Aid Afloat by Peter Eastman and John Levinson. Having a book does not replace the need for basic knowledge of first aid.
SPECIFIC ITEMS: number of items depends on the potential length of time and distance to care, these are basics, you may need to have other items depending on your plans, and a few of these will be listed as optional items
- Adhesive bandages (band-aids)—multiple sizes—be sure some are waterproof
- Medical tape—1 or more
- Electronic thermometer
- Steri-strips or butterfly bandages to close wounds that have gaps in edges and pull open
- Antiseptic wipes
- Hand cleaner, soap and water is best but if none is available remove debris from hands and use alcohol based hand cleaner
- First aid/burn cream, triple antibiotic cream
- Gauze bandage roll—multiple rolls for large injuries
- Compression or stretch bandage (ace wrap, at least 3 inches wide)—3 rolls
- Gauze pads—10 or more
- Motion sickness tablets, patches, or use Benadryl if necessary (caution these cause drowsiness)
- Non-aspirin pain and fever relief tablets
- Aspirin (do not give to children under 6—can be used for adults with heart attack or stroke symptoms, use caution with people who are on blood thinner medication, if possible consult with medical personnel prior to use for suspected heart attack or stroke)
- Benadryl for minor allergies (if someone has known allergies that result in anaphylaxis they should have an epi-pen or equivalent)
- Anti-acids (optional, depends on the length of your trip)
- Anti-diarrheals (optional, depends on the length of your trip)
- Cold pack (you can purchase these that when activated automatically start cooling but remember you can fashion one from ice in your cooler or freezer and a zip lock bag, plastic glove, or other container, cover with a soft cloth rather than placing directly on skin)
- Large wound pad—1 or more
- Sting relief wipes or a topical lotion, some people add an over-the-counter steroid cream to the kit
- Gloves (these protect the care giver and the injured) and can hold ice or warm water when tied at the opening
- A mouth to mouth micro shield for resuscitation (get this when you take your CPR course)
- Sturdy shears that will cut wire and other heavy materials
- Hot packs can be purchased that when activated start warming (if you have power on the boat or hot water this can be fashioned from a cloth, plastic glove, or heat able pad) these may be especially helpful in colder weather when exposure can lead to hypothermia.
- Have extras of essential medications that are regularly taken and that could be lost or damaged by moisture, etc. (have appropriate packaging for damp atmosphere)
- Moleskin adhesive
- A roll of duct tape may have multiple safety and health uses.
- Water proof matches or lighter
- Sugar packets (or other source of quick sugar for low blood sugar emergencies)
Optional items based on your plans and health issues:
- Blood pressure cuff and stethoscope
- Syringes and needles
- For travel to low resource areas consider obtaining medications such as antibiotics, rehydration packets, antifungals, prescription pain meds, muscle relaxants, anti-anxiety meds, a suture kit, and recommended items for the area you plan to visit. Plan ahead and have appropriate vaccines administered. Be sure your Tetanus is up to date.
Establish a regular review of the kit, start by making the first review scheduled on the calendar (set an alarm to remind you if electronic calendar is used) 2 weeks prior to the first expiration date in the kit, then set the next one for the 2 weeks prior to the next expiration date etc.
So that’s the list…Now break it down.
Whatever you bring with you offshore is only useful if you know how to use it. Understand what you have and how to use it!
- VHF Radio: This alone will save lives! If you have any medical or safety conditions concerns do not hesitate to ask for help!
- Cell phone, keep an old one charged and in the first aid kit because it can still call 911. Can have translator apps which help when a different language is spoken. If you know you will be in an area where the language is different, learn a few key phrases for emergencies.
- First Aid Instructions: anyone who operates a vessel should have CPR training. Any further training is a plus. The American Heart Association is one source for classes but others are available as well. In an emergency you don’t have time to read a lot of how to instructions, in other less urgent situations you may have time to research the issue.
- Bandages and Gauze pads and Tape: Good for minor cuts/scrapes, fashioning splints and stopping bleeding. Stretch compression bandages can hold pressure on a wound or a dressing in place.
- Motion sickness tablets/patches: For those of you who have been sea sick, this is a must! There are many options but understand there are medications that help to prevent sea sickness (scopolamine patch) and others that treat motion sickness once it already happens (ex. Dramamine, Bonine)
- Anti-inflammatory, pain and fever medications: help control discomfort and Aspirin may help in instances of heart attack or stroke (discuss with medical assistance via cell phone or VHF radio before administering for these symptoms if possible)
- Cold Pack: Help relieve pain for bumps and bruises and even stings
- Sting relief medication: Good for relief from stings above and below the surface, and sunburn
- Burn cream: Don’t get burned! But if you do, something that will help to cool you is good to have.
- Benadryl: Good for mild allergic reactions, if there are known allergies that may lead to anaphylaxis an epinephrine supply or epi-pen is necessary
- Breathing barrier, CPR Mask, or micro-shield for resuscitation: Ask about this when you take your CPR class.
- Moleskin to cover blisters so that they don’t get worse, or use duct tape and gauze to cover.
- Matches or lighter may be necessary to have fire for signaling or other things like melting rope ends, heating, etc.
This is a great place to start. Adding more advanced items will depend on the activities planned and your training level.
- Sometimes you have to make do with less than ideal situations:
Care in low resourced areas, MacGyverism
Have a plan: Discuss ahead of time who will be in charge in types of incidents that might occur (Type your resources—for example, if you have a medically trained person they are in charge for health incidents, if you have an experienced mariner they are in charge of boat related incidents). Do drills of “what if this or that occurred” – work through scenarios and discuss what works and what needs to change. Example: person overboard—what are the steps you take, go up a notch and what happens if the person retrieved is not breathing, what if there is a head wound, what if a body part is severed, what does carbon monoxide poisoning look like and what do you do, etc.
https://careflightcollective.com/2017/03/17/macgyver-medicine/ This site gives some ideas and photos on how to make a tourniquet to stop severe bleeding, be sure it is severe and needs to be done to save a life because tourniquets can lead to loss of a limb—know what you are doing. This site also lists other places to read so that you are prepared for thinking about how to manage an unexpected and unintended injury.
SOME ITEMS THAT YOU MIGHT FIND MULTIPLE USES FOR:
- DUCT TAPE: wrap a sprained ankle, splint a broken limb, make butterfly bandages for a cut, make a sling, attach bandages and/or make a pressure dressing (place a folded wash cloth or other clean material over the wound and tape down tightly), blister care (cover blister with gauze and then duct tape)
- Splints may be a boat hook, gaff, fishing rod, any sturdy item that can be strapped to a limb to help immobilize (roll up a magazine or charts if all else fails)
- You can take the Head door off and use as a stretcher if necessary.
- Stings from sea rays can be relieved with warm water.
- Super glue can close a small wound.
- T-shirt materials make excellent slings
- Padded bras can be absorbent bandages
- Wine corks could plug a hole in the hull, or have a bung plug or tapered cone
- Cut the eye or barb off a hook. See the picture for how to remove a hook from your skin; if you only need to push it through to remove this will allow that.
- Tampons or sanitary pads: Be a hero! And these can absorb bleeding.
- Tourniquet and Combat Gauze (Quik Clot): They only work if you know how to use them, so get proper training. However, for major bleeding (shark attack, propeller, etc) you would only have minutes to act. These items could make all the difference. Do you have these or other high risk activities that would make these useful?
- OTHER TIPS JUST FOR THE GOOD OF THE ORDER
- You can’t stop a heavy boat that is out of control with your leg or arms, to cushion an impact consider your throw-able life ring or preservers—drop them between surfaces not your body.
- Use care when using a boat hook, it can break if under stress and fragments can go flying!
- Heat stroke—the person may have hot wet or dry skin, nausea, vomiting, and disorientation. Call 911—heat stroke is life threatening. While awaiting help, if possible move the person to cooler place, remove or loosen clothing, and cool the person. Immerse in cold water or shower, rotate wet iced towels on the body and observe for changes in condition. When responsive give small amounts of cool water to drink slowly. Heat exhaustion is usually milder and involves loss of fluids from exertion in high heat situations, it can occur with excessive vomiting or diarrhea in high heat situations too. Treatment is similar with cool cloths on the skin and fanning the person, if vomiting or can’t drink small amounts call 911.
- Recognize carbon monoxide poisoning, have a detector and check it regularly, but sometimes carbon monoxide poisoning can occur when swimming near a boat that has a generator running or in other instances. It is especially dangerous when people are sleeping or intoxicated because symptoms may not be clear and death can occur before anyone realizes there is a problem. If suspected get the person to fresh air, turn off all combustible engines, and get to emergency care.
Symptoms of carbon monoxide poisoning:
- Dull headache
- Nausea or vomiting
- Shortness of breath
- Blurred vision
- Loss of consciousness
Electrocution-- The danger from an electrical shock depends on how high the voltage is, how the current traveled through the body, the person's overall health, and how quickly the person is treated. Call 911 immediately if any of these signs or symptoms occur:
- Cardiac arrest
- Heart rhythm problems (arrhythmias)
- Respiratory failure
- Muscle pain and contractions
- Numbness and tingling
While waiting for medical help, follow these steps:
1. Look first. Don't touch. The person may still be in contact with the electrical source. Touching the person may pass the current through you.
2. Turn off the source of electricity if possible. If not, move the source away from you and the affected person, using a nonconducting object made of cardboard, plastic or wood.
3. Check for signs of circulation (breathing, coughing or movement). If absent, begin cardiopulmonary resuscitation (CPR) immediately.
4. Prevent shock. Lay the person down and, if possible, position the head slightly lower than the trunk, with the legs elevated.
- Bloody Nose—lean slightly forward, pinch nose blow the bridge where cartilage and bone meet, hold 5 to 15 minutes. May also apply ice pack. Get medical attention if bleeding does not stop in 20 minutes, if there is headache, dizziness, ringing in ears, or vision problems.
- Object in the Eye—try to dislodge by blinking several times, if not successful rinse with running water (take out contacts first if present and possible to remove). Do not rub the eye or try to remove an embedded object. If there is a splash of chemical or embedded object get immediate medical attention.
Also seek medical attention if pain or swelling persists after object is removed.
- A sprain—RICE (rest, ice, compression, and elevate)—alternate ice on for 20 minutes and off for 20 minutes for first day of injury, wrap with an ace bandage and elevate, stay off the injury for at least 24 hours, after that warm compresses may help. Do not keep on working through the pain because more serious injury can occur. If not improved in a few days seek medical care, it may be a bigger injury.
- A burn—first degree is redness, second degree is blisters, third degree is broken or blackened skin. Immediately place burn under cool running water or in a bath or apply cool wet towels. Apply a loose bandage to first and second degree burns. Do not put an ice pack on major burns because it can damage further. Do not pop blisters because you risk infection. Do not apply butter or other creams to open burns. Get immediate ER (911) attention for third degree, electrical or chemical burns or if the victim is coughing, has wter eyes or has trouble breathing. Go to the ER for second degree burns larger than the palm of your hand.
- A blow to the head—if unconscious call 911. If bleeding treat as any other cut but follow up with a doctor in case there are internal injuries. Ice can help reduce swelling. Do not leave victim alone especially when sleeping, wake them every 3 to 4 hours and ask simple questions to make sure there are no brain injuries. Call 911 for seizures, dizziness, vomiting, nausea, or behavior changes.
- Choking—if someone can’t cough strongly, speak or breath and face changes color to red or blue they are choking. Call 911. Have the person age 1 or older lean forward and strike their back with your palm between the shoulder blades 5 times. If that does not work place a fist above the belly button and cup the fist with other hand and push in an up toward the ribs 5 times (Heimlich). If you are alone press your abdomen against something firm, like a counter or chair back or use your hands to create pressure to dislodge the object. Do not offer water or anything else to someone who is choking. Even when an object is dislodged there may be remaining pieces, always call 911.
- Poisoning—if unconscious or having trouble breathing call 911. In other cases call Poison Control Hotline (888-222-1222). Be prepared to tell what was involved how much, when and age and weight of victim. Do not wait for symptoms to get help. Don’t give ipecac or induce vomiting until instructed to do so—the substance can cause damage coming back up. Do not eat or drink anything unless the hotline tells you to do so. Always get medical care.
- Open wounds—place clean cloth or gauze on the injury and apply pressure to stop bleeding. For minor cuts and scrapes wash with soap and water and apply thin layer of antibiotic ointment and cover with bandage. Do not apply ointment or wash large, deep, profusely bleeding wounds—get medical help. If there is an object protruding do not try to remove it, instead get immediate help or call 911. If it is a deep puncture, becomes red or tender, there is a fever, or swelling, or red streaks around it, see a doctor.