When an emergency call came in at midday on 12 July to the Maritime Rescue Coordination Centre (MRCC) in Bremen, operated by the DGzRS, it was immediately clear that every minute counted. South of Neustadt/Holstein, a 60-year-old skipper had collapsed on board his motorboat, which was around 15 metres long. According to the sea rescue service, he had apparently suffered a cardiac arrest.
Whilst his wife immediately began resuscitation, the emergency control centre alerted the sea rescue boat “Henrich Wuppesahl”. An emergency doctor and a paramedic from the land-based ambulance service also went on board.
Just ten minutes later, the sea rescue team reached the motorboat. The medical team took over the resuscitation efforts. In the meantime, a fellow boater had taken the stricken boat in tow, so that the patient could be handed over to an ambulance at the harbour and subsequently taken to hospital in a critical condition.
An emergency for which every crew should be prepared
This incident impressively demonstrates just how quickly a relaxing sailing trip can turn into a life-threatening emergency. Especially at sea, valuable time is often lost before professional help arrives. This makes it all the more important for skippers and passengers to be fully proficient in first aid.
First and foremost, it is crucial to distinguish between a heart attack and cardiac arrest. Both conditions affect the heart, but require different emergency measures.
Heart attack: The heart is still beating
In the event of a heart attack, the person affected is usually conscious. Typical symptoms include severe pain or a feeling of tightness behind the breastbone, shortness of breath, cold sweats, nausea or pain radiating into the arms, back, neck or jaw. However, particularly in women, older people and those with diabetes, the symptoms can be significantly less specific.
Anyone noticing such symptoms should immediately call the emergency services on 112 or via VHF radio channel 16 and give their position as accurately as possible. The boat should be secured. Ideally, another person should take the helm or the autopilot should maintain the course. The person affected should be kept calm, with their upper body slightly raised, and monitored constantly. If their condition deteriorates or they lose consciousness, they must be checked for cardiac arrest.
Recognising cardiac arrest
Cardiac arrest usually occurs suddenly. The person affected no longer responds when spoken to, is unconscious and is either not breathing at all or is breathing only sporadically. This sporadic breathing is not normal and must be treated as respiratory arrest.
Irreversible brain damage can occur after just a few minutes without an adequate supply of oxygen. Therefore, the rule is: it is better to start resuscitation once too often than once too little.
Act immediately and start resuscitation
If the person is unresponsive and not breathing normally, help must be called for immediately. At the same time, the boat should be secured so that the crew can focus entirely on the patient.
Cardiopulmonary resuscitation (CPR) should then begin immediately. This involves performing 30 firm chest compressions in the centre of the chest. The depth of compression should be around five to six centimetres, and the rate should be between 100 and 120 compressions per minute. Anyone who is confident in administering rescue breaths should give two breaths after each compression. If this is not possible or desired, chest compressions are performed continuously.
If there are several people on board to help, they should take turns approximately every two minutes. Resuscitation should continue without interruption until professional help takes over or the person affected is breathing normally again.
When a defibrillator can help
Automated external defibrillators (AEDs) are increasingly common on larger pleasure craft, in marinas and at clubhouses. They can significantly improve the chances of survival.
The device automatically analyses the heart rhythm and only delivers a shock if a shockable heart rhythm is actually detected. This virtually eliminates the risk of incorrect use. The voice prompts guide even those with no medical training step by step through the resuscitation process.
Preparation begins before setting sail
The recent incident off Neustadt/Holstein shows once again that medical emergencies are by no means rare. Anyone who regularly undertakes longer voyages should refresh their first-aid skills regularly and familiarise themselves with the procedures on board.
It is equally important to clearly allocate tasks within the crew: Who will make the emergency call? Who will perform CPR? Who will keep the boat manoeuvrable or prepare to hand over to the emergency services? Such arrangements take only a few minutes before setting off, but can be crucial in an emergency.
Should an automated external defibrillator be standard equipment on larger pleasure craft and in every marina, or is regular CPR training more important? Please share your views and experiences in the comments.
Lars Bolle
Chief Editor Digital
