Doc on Deck
By Gino C. Bottino, M.D.For the last 10 years, most authorities have agreed on the main principles in preparing for, and implementing, a crew overboard recovery. The five phases of recovery are
- establish and maintain visual contact,
- provide flotation immediately,
- stop the boat as soon as possible,
- maneuver to approach the victim, and
- effect recovery over the side.
- All five should be done as quickly as possible.
The sooner you can recover a crew member, the better. The fall itself can cause injuries, especially if the boat was traveling at high speeds. The stress of the event can cause a heart attack. Hypothermia and shock can occur in cold water even if it’s hot outside. You could also have an unpleasant encounter with marine life. The list of potential adverse events goes on.
Drowning poses the biggest risk in a crew overboard situation because many boaters don’t wear life jackets, especially when it’s warm outside. Drowning is the number one cause of boating deaths, and only 25 percent of drowning victims were wearing life jackets. As you can see, wearing a life jacket doesn’t mean you’ll be completely safe if you fall overboard, but it does increase your chances of survival.
Boats are built to keep passengers on board. As boaters, we usually put ourselves in situations that cause us to go overboard. Everyone knows the risk involved for men relieving themselves off the side of a boat, but they continue to do it. Hazardous attitudes have been well studied in risk assessment models. Below are five hazardous attitudes and their antidotes:
|Macho||Don't take chances.|
|Anti-Authority||Follow the rules; they are usually right.|
|Invulnerability||Know that it can happen to you.|
|Impulsivity||Not so fast! Think first!|
|Resignation||You are not helpless; you can make a difference|
Before leaving shore, all crew members should assess their fitness for the trip, especially the skipper, using the “I’M SAFE” checklist.
If you answer yes to three questions, consider not going out. If you say yes to four questions, don’t go. If your crew members shouldn’t go, don’t let them.
To provide immediate flotation, you must have the right equipment on board. If the crew member is already wearing a flotation device, you’re ahead of the game. Wearing flotation devices should be the standard on your boat. Flotation devices should be readily available and offered to all who step on board. The ship’s captain should insist everyone wear life jackets unless it’s obviously not warranted. If not worn, the life jacket should be out and readily available.
Other required flotation devices include a throwable float (usually a life ring). You also need a way to get flotation to crew overboard at some distance. The U.S. Navy found that it took from 20 to 70 seconds to deploy flotation. On a boat going 8 knots, this amounts to 270 to 945 feet! Even under the best of circumstances, it’s unlikely anyone could throw a life ring more than 20 to 40 feet.
The Lifesling device trails the life ring on a long floating line as the boat circles the victim until he or she can get to the ring. Different companies make different versions of this device. It remains the best option for getting a conscious victim back to the boat. Using the device with high winds and waves could take some time, so it’s not a perfect solution. I like weighted throwable flotation devices that inflate upon impact with water. Deploy as many flotation devices as you can.
Once in the water, a flotation aid that gets the victim as far out of the water as possible can be useful to limit the victim’s exposure to the elements. Although not required by law, race committees require such devices for any distance race. The crew overboard modules that deploy readily and inflate upon hitting the water have small rafts in them. Rescue platforms are available, and carrying life rafts for any offshore work is advisable. These devices make it easier to get a conscious victim back on board.
The crew must be able to get any victim back on board. On a racing boat or fishing boat with 10 or more crew, this usually isn’t a problem. When sailing shorthanded, however, having the manpower to hoist 200 pounds or more of dead weight aboard can be a huge problem. Each captain must have a plan and the equipment to bring the victim back onboard. You need to practice the method and make sure it works for you and your boat before relying on it. The Lifesling device mentioned earlier coupled with a properly rigged tackle to a halyard or the boom works well and has been available for some time. This helps with a person who could become incapacitated in the water after a while. If the victim is truly unconscious, you need another plan. The jibs aboard sailboats can be used to get under the victim’s body and hoist it up with the sheet. You can deploy similar standalone devices from any boat. Sometimes putting someone in the water is the only way to help a victim, which is fine as long as crew members can do this without becoming victims themselves. Think it through, and have a plan!
Once the victim is aboard, do you have the equipment to treat him or her? You must have a way to dry and warm the victim. To learn how to handle this, refer to my Doc on Deck articles on cold immersion and shock in the Fall 2017 and Winter 2018 issues of The Ensign at theensign.org/archive.
One final word on boat preparation: preventing a crew member from going overboard is the best course of action. On powerboats, lifelines and their supporting structures and bulwarks usually come standard. Have you checked their fitness to do the job? What about harness attachment points and jack lines in rough seas? I have added handholds to more than one boat, as the handholds on modern boats are usually inadequate.
If you want more on this topic, email firstname.lastname@example.org, and I’ll expand on the topic in a future Doc on Deck.
Gino Bottino, M.D., has had wide experience in medical practice and emergency medical matters. A member of United States Power Squadrons First Aid Support Team (FAST) and the Safety Committee, Gino also has a background in competitive sail racing and is familiar with health-related problems afloat.
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