IS CRUISING A SAFE ACTIVITY? JOHN DUGGAN, PO Cascais
All sensible cruisers take seriously the issue of safety on board. The horrors of a man overboard situation, sinking or fire on board are the subject of endless discussion but how safe is cruising under sail, when seen through the respective of personal injury, below the level of life-threatening?
I’m prompted to reflect on this, based on my own impressive list of afflictions suffered over the past five or six seasons:
[font=Symbol]· [/font]Bruised ribs and a badly twisted shoulder, due to slipping while ascending the companionway
[font=Symbol]· [/font]A busted Anterior Cruciate Ligament (the one that stops your knee from folding like a collapsed marionette) caused by a bare-footed slip on a wet deck
[font=Symbol]· [/font]Further damage to my shoulder, from winching in a bad position
[font=Symbol]· [/font]Sea sickness and sundry rashes.
I’ve since come across a surprising number of people with bad shoulders, due to over-extension of the arm when winching. One cardinal rule – don’t winch with one arm only; get over the top of the winch in a stable position and use both arms. The shoulder is a complex joint and surgery may be the only solution to a bad tendon injury. While shoulder injuries are a “sore point” with me, they are far from the only common injury, as may be seen in the following extract from a study by Wilderness & Environmental Medicine:
“From 1188 respondents, a total of 1715 injuries and 559 illnesses was reported. The top 3 injuries for keel boats were leg contusions (11%), hand lacerations (8%), and arm contusions (6%), and in dinghies they were leg contusions (13%), knee contusions (6%), and leg lacerations (6%). The most common mechanisms of injury were “trip/fall,” “hit by object,” and “caught in lines.” Tacking, heavy weather, and jibing were the most common factors contributing to injury. The rates of injury and severe injury in this internet-based survey were 4.6 and 0.57 per 1000 days of sailing, respectively. Of the 70 severe injuries, 25% were fractures, 16% were torn tendons or cartilage, 14% were concussions, and 8% were dislocations. The median rate of lifejacket use was 30%, and median rate of sunscreen use was 80%. Sixteen percent of sailors reported sunburn over the prior 12 months. Seven percent of sailors reported use of alcohol within the 2 hours preceding injury. Conclusions.—The most common injuries in both keel boats and dinghies are soft-tissue injuries to the extremities. Severe injuries and illnesses in sailing are uncommon in this study population.”
The full study report may be seen here https://www.wemjournal.org/article/S1080-6032(10)00204-8/pdf
The following was contributed by my friend and experienced sailor, Dr Geoff Chadwick:
1. Trauma. Rib fractures are a common consequence of being thrown around by sudden motion. These are painful but require no specific treatment except in the emergency situation of tension pneumothorax where the lung is punctured and inexpert intervention will do more harm than good. Fingers are the other common injuries so ordinary band aids are vital for cuts and adhesive tape for fixing an injured finger to the one next to it.
2. The first aid kit should be visible in the saloon not stored in a rarely used locker. The contents should be reviewed annually as commonly used items like bandaids run out first.
3. Seasickness. Puke in a bucket not over the side. Although sufferers tend to stay on deck for fresh air, in my experience they are better off in a bunk to keep warm, with a bucket beside them. Electrolyte salts or simply sugar in water are useful but not if they cause distress.
4. Skin problems. Skin infections and irritations are common. Most ailments will respond to alcohol gel hand cleaner which is now widely available. Of the proprietary skin creams E45 is good.
5. Teeth. Simple emergency dental kits are inexpensive and safe to use for broken teeth or lost fillings.
6. Medical help. There are online resources which can evaluate symptoms and help deciding whether evacuation (dangerous in itself) should be considered
[color=rgb(34, 34, 34)]I invite readers to share their experiences and recommendations.[/color]
Posted on behalf of: John Duggan February 2019
Vice Commodore, OCC