Captains and crew of charter fishing operations are accustomed to being prepared for the unknown. It is the one thing that an experienced ship can always count on is the inability to prepare for all contingencies. On a seagoing vessel, it is imperative to have primary and secondary plans in place for emergencies and accidents. One needs to be prepared for dangers to the vessel, the operator, and the passengers. This brief is not intended to serve as a replacement for common sense and good judgment. Rather, it is a way to refresh your commitment to the safety of your passengers and crew.
ACTION CHECKLIST:
· Stop and take a deep breath.
· Remain calm, cool, and collected.
· Be the Captain that you are!! Take charge.
· Be smooth, efficient, but not hasty.
· Act fast – but go slow.
· Before starting to help someone else, assess the situation and make sure the situation is safe FOR YOU!! Check the environment around you and others first.
· Perform an initial assessment of the injury or condition. Treat immediate threats to life or limb.
· Perform a focused assessment. by examining the person for problems and gather pertinent information. Ask about allergies to environmental things or medications
· Take another deep breath and plan what to do. Treatment must be considered and carried out. Is extrication or evacuation needed? Do I need to act quickly or slowly? Stay and treat or quick to shore? Should I “Stay or go, fast or slow”? Help may need to be requested.
· Keep a written record of the emergency.
· Be ready to give a verbal report
· Act in the best interest of the most people.
FIRST AID KIT CONSIDERATIONS:
There is no perfect first aid kit, so you should consider your needs. Consider the length of your trip, the size of your group, and where you will be traveling. Don’t EVER pack something into your kit that you don’t know how or when to use. You should also be aware of each item, risks and benefits, and how best to locate it in your kit and when to implement it as part of a first-aid treatment plan.
Considerations for a First Aid Kit
Keep your first-aid products in a labeled plastic box. These can be kept inside of a waterproof bag.
o First - Protect Yourself!!
Disposable gloves – 12 pair; Nitrile or vinyl; NOT LATEX…
Antiseptic towlettes
CPR breathing barrier
o Cleaning
Soap (1 bar)
Alcohol sanitizing gel ( 1 travel size bottle)
Alcohol pads (12)
Betadine pads (12)
Hydrogen peroxide (spray or bottle)
Povidone-iodine solution – cleaning wounds
Irrigation syringe (2) versus saline wound wash
Sterile scrub brush
o Equipment, Procedures, and Splinting
Scissors – Fine tip (1 pair)
Trauma shears - (1 pair); Wide blunt tip, they reduce the risk of cutting the patient while working on an injury
Tweezers (1 pair); Must have for splinter removal and/or small cuts and scrapes that need a little extra attention in the field
Safety pins (12); Great for securing bandage materials or other materials incorporated into an improvised splint.
70 # braid loop for hook extraction
Oral thermometer
Rescue Mask
Tourniquet; Be familiar with it’s use and risks. Only for life threatening bleeding
o Bandages, Dressings, and Splints
Assorted adhesive bandages (1 box)
Knuckle adhesive bandages (1 box)
Liquid bandage; Dermabond is a brand name. Consider some small “super glue” tubes (0.07 oz tubes) for emergencies.
Wound closure strips; “Butterfly or Steri-strip® type.
Benzoin swabs; These provide a natural sticky layer on your skin to allow bandages to stick better and stay on longer.
Elastic bandages, 3-inch wide (2)
Adhesive tape, 1-inch rolls (4)
Duct tape, small roll (1) – “you never know…”
Sterile gauze pads, 4 x4 inch (12)
Triangular bandage / sling (2)
ACE wrap
Kerlex / Kling (or equivalent), 3-inch rolls (2)
Coban self –adhesive bandage, 2-inch roll (1)
SAM splint – Waterproof, reusable splint for immobilizing injured bones and joints.
OTC – Over the Counter Medication List
Aspirin
Tylenol (acetaminophen)
Motrin (ibuprofen)
Excedrin for migraine (Tylenol, aspirin, and caffeine)
No Doz – caffeine supplement
Pepto Bismol tablets
Cough drops – Fisherman’s friend
Benadryl – in the event of allergic reaction
Bacitracin ointment (1 tube)
Hydrocortisone cream, 1% (1 tube)
Electrolyte supplements – (powder form to add to water bottles); Gatorade or Propel; Liquid IV
Motion Sickness Medicines and treatments; Dramamine, Bonnine, Ginger tablets, Motion sickness bands
Environmental Protection; Sunscreen, BugSpray
o Warm and Cold
Instant cold compress versus “zip loc”ice from fish cooler
Space blanket
o Other first aid / emergency items to consider
ZipLock bags –Ice from the fish cooler to apply to area of injury
Duct tape; Again….you never know..
Epi pens; adult and junior; for life threatening - severe anaphylactic reactions
Narcan; For saving a life; I believe that you can go into any pharmacy and ask for a “free Narcan”. NY State will “bill through your own insurance; however, some pharmacies offers a coupon to make it “free”. You can also get “refills” every 15 days; Check the expiration date. Easy to use and a “great idea” to have on your boat!!
CPR; Take a CPR class (often offered online); Barrier mask – available on Amazon; Again, you could save a life… The life you save, could be yours…. Bring a friend!!
AED – Automatic External Defibrillator; Huge expense…Can save a life…. IF a witnessed event (collapse); this is the most likely thing which would save a life if used early… Easy to use… the AED “tells you what to do”…. Around the docks…familiarize yourself with these and know where they are found….
EPIRB;
SARSAT Registration for EPIRB https://beaconregistration.noaa.gov/RGDB/index·
Handheld VHF with GPS
Always restock your kit for each trip, checking expiration dates, making sure that sterile items haven’t been open or damaged, and add any additional items that might be needed for special trips (longer duration).
Of note, it is important to remind passengers to bring extra supplies of their medications on the trip as needed!!
Conditions for Charter Captains to be Familiar with
CPR
Hook injuries and cuts caused by fish teeth, gills, and fins are the most likely seen injuries on your boat. If you travel to distant places or don’t want to come off the water, you may want to invest in a suture kit.
Common Fishing Injuries
Heat Stroke
Hypothermia
Shivering is likely the first thing you will notices as the temperature starts to drop; because it is the body’s defense against cold temperature. It is attempting to warm itself. Signs and symptoms of hypothermia include:
Shivering
Slurred speech or mumbling
Slow, shallow breathing
Weak pulse
Clumsiness or lack of coordination
Drowsiness or very low energy
Confusion or memory loss
Loss of consciousness
Bright red, cold skin (in infants)
Someone with hypothermia usually isn’t aware of his or her condition because the symptoms often begin gradually. Also, the confused thinking associated with hypothermia prevents self-awareness. The confused thinking can also lead to risk-taking behavior.
Psychological Tips and Techniques for the Charter Captain:
The 5 Components of Psychological First Aid
1. Create a Sense of Safety Creating a sense of safety means you communicate to the brain’s fight or flight system that the stressful situation is over. You can do that by shielding the patient from a disturbing scene or explaining to the individual that they’re safe. Reinforce this by showing them what you’ve done to make the scene safe, like moving them away from a precarious edge or pointing out that the thunderstorm has passed and the weather has calmed.
2. Create Calm This is important both before and while responding. Speaking and acting calmly can show your patient they’re in a safe place and can start calming themselves. If you’re struggling to calm yourself or your patient, use simple tools like taking a deep breath, counting to four, then letting your breath out slowly, and coaching your patient to do the same. It’s hard to calm someone else when you don’t feel calm yourself, so check your own composure before helping your patient.
3. Create Self and Collective Efficacy Efficacy is your ability to produce a desired result. You can help your patient foster self-efficacy by making them an active part of their own rescue. Remind your patient of their existing strengths, allow them to care for themselves or help their companions, and involve them in decisions about their care. This helps them overcome the feeling of helplessness that sometimes comes with a traumatic event. They’re no longer a victim, but a part of the team.
4. Create Connection Creating connection helps the patient tap into the social supports that surround them. You can create connection by building an on-scene relationship with your patient: use their name and build a rescue partnership. This also includes connecting the patient with loved ones or even pets.
5. Create Hope Hope in this context means the belief that, although the current situation may be grim, it can get better. To build hope, point to specific, accurate, and positive facts about the event, and discuss next steps that are realistic and predictable. Maintaining hope is as important for the individual patient as it is for your team as you provide care.
References and Sources Used:
1. Tilton, B. Wilderness First Aid Manual.
3. SaltwaterSportsman.com May 2022