“Tell me and I forget, teach me and I may remember, involve me and I’ll learn.” – Benjamin Franklin
The Importance of Pre-Season Medical Training
I have been working in the superyacht industry for 13 years now, and during this time I have chatted with many captains and crew about their thoughts on pre-season medical training.
During these discussions, I have found there is a common theme that emerges – everyone strongly recognises the importance of this training, but most admit it is last on the list of pre-season preparations.
So why is this?
Crew quietly tell me that they feel extremely anxious about facing a medical incident, they are aware that they are likely to be first on scene, and would like to undertake as much training as possible. Captains & Officers tell me that they would very much like the same, but with the usual pre-season pressures – delayed yard periods, budgeting, provisioning and crew changes ‘if we have time or if we can squeeze it in’ are regular comments I hear.
However, I believe the reason that medical training is bottom of the list runs deeper, I believe it is because discussing medical incidents brings home the reality that we ourselves are susceptible to injury, we literally face our own mortality, and this is something no-one wants to think about.
So medical drills are scheduled every now and then, unlike the regular fire or man overboard drills, and medical kits are hidden away under a cabin bunk, out of sight, pulled out occasionally to find that one or another piece of equipment is not working or a part is missing.
We undertake the required basic training, and if or should I say when faced with a medical incident we hope that the little memory we have of the training day one, three or ten years ago, will be enough to see us through.
The unfortunate reality is that the chance of being involved in a medical incident working on a yacht is high. There are multiple calls a day to the major telemedical providers requesting assistance from their doctors (I used to work in the heart of one) and I am yet to speak to a captain that has never faced a medical incident either minor or major on one vessel or another.
This is unsurprising as it is after all a high-risk workplace, with heavy machinery, dangerous goods and high-speed toys, and a very real risk of fire, collisions, and falls overboard, most often many hours from a medical facility.
So let’s consider for a moment if the worst does happen, and we ourselves are the casualty, who would we want in this scenario to help us?
There are telemedical providers such as MSOS, who deeply understand remote medical care in the unique marine environment and start to act and support crew as soon as the call comes in 24/7.
But in the initial minutes before the call going in, it is the hands-on deck making life-saving and life-changing actions, there actions give the best chance of not just survival, but recovery to 100% capacity.
The primary choice for a first responder would be a medical doctor as part of the crew (my preference would be one that looks like George Clooney in ER).
For vessels without a medical professional on board, or in the rare instance that the doctor himself is the injured party (I have a true story about this) I would hope that the crew who assist me
-have first response training fresh in their minds
-know the equipment like the back of their hand
-and most importantly, do not freeze under the stress response for too long.
I would hope they quickly steady and secure the vessel, move me to safety, treat life-threatening injuries, take some accurate vital signs and look up my allergies and medical history whilst calling the telemedical provider.
This is the minimum care I would hope for myself in such a scenario.
So how does pre-season training support crew in responding to a medical incident?
On training days I run through action-based skills, and reinforce them through simulated scenarios and slowly I see a confident medical response team emerge, eventually able to handle any medical issue as smoothly and efficiently as the wheel change on a formula one car.
There are some providers moving pre-season training online, but covid allowing, I believe a day onboard with hands on practice with an in-person professional trainer is preferable, and assists crew in combatting the stress response by building brain muscle memory, so that when the initial impulse to freeze or flight kicks in, they are able recall the actions required to save life and limb, calling their crew on the radio to bring the medical kits, securing the airway, identifying life threatening injuries, and operating the defibrillator or oxygen system.
Scenario based training is extremely affective, and teaches or reminds crew how to work as a team, ensuring all onboard are ready to assume various roles confidently, whether that be stopping the bleed, taking vital signs or caring for panicking relatives, and using the systems of that particular vessel.
The trainer, who holds a current medical license, comprehensive maritime experience and strong teaching background, can provide the latest developments on guidelines, regulations and research each year, ensuring care is carried out with an up-to-date evidence base, and hopefully the deliver training in a fun and engaging way.
Questions on topics such as COVID or marine envenomation can be answered, and onboard equipment can be tested, issues identified and rectified, putting minds at rest.
Lastly the skills learnt in pre-season training can be applied on land – how to help a stranger on the street who collapses, how to help your child if they are choking, they are life skills, that I believe everyone should practice regularly.
To finish on a positive note, I find great reward in returning to a yacht each year and sometimes hearing heroic stories of crew stepping up as confident first responders, such as the stew who followed a guest from the dinner table recognising the international sign for choking (hands around the neck) and performed an effective abdominal thrust saving her life, or the crew member confident enough to utilise their training and perform CPR on the roadside after witnessing a motorbike accident in the Caribbean, buying the driver valuable minutes until an ambulance arrived.
So, in conclusion, let’s put medical incidents to the back of our minds, get on with running the vessel and enjoying life onboard, after scheduling our pre-season medical training day.
I would love to hear your thoughts so please feel free to get in touch.
By Sara Paterson DTN Bsc RN
Freelance Yacht Medic & Maritime Instructor, MSOS Trainer. firstname.lastname@example.org
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