Tony Pozun is New York State Registered Professional Nurse, American Heart Association registered CPR first aid instructor and a retired Nassau County Police Officer/Detective Sergeant with 35 years of service. Tony is also an avid long distance sailor and a regular contributor to Cruisers Net. Thank you Tony!

Sailing Injuries
By Anthony Pozun, BS, RN.

Anthony Pozun is a New York State registered professional nurse and former Detective Sgt., EMT, first aid basic and advanced courses instructor at the Nassau County police Academy. He is a current member and certified instructor for the United States power squadrons for sail and basic boating courses of instruction. He has been an avid boater and sailor for 50 years. He has sailed intensively on Long Island sound with his wife Barbara for the past 30 years. He has traveled and sailed the East Coast including the Intracoastal Waterway from Northport to Florida and the Bahamas and back again. He currently sails a Catalina C 400 Mystical Paradise, sailboat set up for long-term cruising. He has written many sails and first aid, articles, which have been published in many local and national boating periodicals.

Sailing as a pastime, hobby or a full-time leisure activity, can be both fulfilling and enjoyable. A sailboat has many working parts necessary to convert wind into propulsion to use the sailboat. These many working parts need to be respected, and preplanning is essential in their usage. The many working parts and movement of these parts and the sailboat itself, can cause accidents, falls, collisions, which may lead to injury sometimes severe. But with a little bit of planning and forethought, before its usages, the sailboat and its many working parts, can be enjoyed without injury.

This article will discuss the possible incidents and accidents, leading to injuries, and will give some suggestions for preplanning, prevention, commonsense rules, on dealing with the many working parts of a sailboat to prevent injuries. Additionally, at the end a basic primer on basic first aid including some of these of injuries will be discussed. These incidents include falling overboard, falling down hatches, falling, tripping on working lines and devices around the deck or cockpit. Hand and finger injuries as well as swinging boom injuries will be discussed. Running aground or hitting fixed objects will also be covered. Cooking aboard injuries, maintenance injuries, and seasickness although not a true injury, will be discussed. One overriding principle to be used to prevent accidents occurring, is to preplan in one owns mind what needs to be accomplished, how to do it, what can go wrong, how injury can be prevented.

Being swept overboard is one of the most fatal type injuries that can occur on a sailboat. But most overboard incidents can be avoided with the application of certain precepts. These include using a little common sense, some preplanning caution and a thorough examination and assessment of one’s environment and surroundings. Put together this is all called prevention. The main thought of any person should be “stay on the boat”,” stay on the boat”,” stay on the boat”. Asking oneself to do I need to work on deck, what pitfalls are present, i.e. low or no lifelines, low freeboard, open transom, etc., that could lead to going overboard. All crew members working on the sailboat should at least wear a PFD, personal flotation device. A member alone on deck, at the helm, or a lone sailor, should always wear a PFD, with a safety harness and tether attached to the boat, because no one will see him or her being swept overboard. Mentally crewmembers or guests should obey the adage when moving about; “one hand for me, one hand for the boat”. They should move about low to the deck, slowly and purposely always keeping one hand attached to the boat. Because we cannot always prevent persons going overboard, certain safety equipment should be available on the sailboat. This may include main overboard poles, life rings, throw rings, floatable, cushions. A hoist, PFD’s with GPS locators, all items to assist retrieval of persons thrown overboard. Secondly , Captains and their crew should practice man overboard drills to see how it’s done, to deal with any issues that arise, so in a real incident they know what to do.
Another serious incident is falling through open hatches and walkways. This can result in injuries ranging from contusions to serious fractures. Again, a little prevention through preplanning will help. The adage “one hand for me one hand the boat “must be observed. When moving about a moving or stationary boat one must move cautiously, slowly, and with purpose. Rushing about only causes injuries. Crew members or guests before sailing should study the locations of hatches, companion ways, and other openings which could cause a fall. Think before you move, move slowly, should be your mental condition. Owners of boats may mark those areas of danger with protective foam, and or highlight with bright colors or decals to warn others.
A third incident that may occur is tripping and falling on deck and cockpit lines and many devices used during sailing. These injuries include bruises, contusions and fractures to toes, feet, lower limbs and upper limbs from tripping and falling. Preplanning and Prevention is the key to prevent these injuries. First, study your environment, know what can trap or trip you i.e. lines, cleats, blocks, winches, and many other devices which may bite. Always move slowly purposely keeping one hand for you one hand for the boat as your mantra. Always wear sturdy shoes, boat shoes or sneakers. Never move about the boat with sandals, Flip-flops, other loose footwear or barefoot. Think before you move, ask yourself is this necessary, and what can happen to me.
A fourth type of incident which can lead to serious consequences is swinging boom accidents. The boom on a sailboat is constantly moving, is heavy and has a tremendous amount of force behind it. Injuries are many and include concussions to the head, injuries to the body and even being swept overboard. Crewmembers and passengers should always assess the possibility of being struck by the boom. Some prevention includes, not moving about, not standing up completely, and watching for accidental jibes or tacks which may cause accidental movement of the boom. Crew and guests should always listen to commands of the captain, during tacks and jibes, and only move about if it is necessary as part of their job. Before moving, think of what the task is, stay low, move slowly and purposely, again keeping the adage “one hand for me one for the boat.”
Another incident which can cause serious injury is hitting another object, boat, fixed dock etc. or sandbar, which causes immediate stoppage of the boat. In these situations, persons may be thrown about. Injuries occurring from this include contusions, abrasions, fractures, concussions and many worse. Preplanning and prevention is the key to preventing these types of injuries. Always know where your boat is, what are my depths, where are the hazards I may encounter. Common sense and preplanning must always be used to control the direction and motion of the boat. Captains and crew must constantly be observant for these hazards and prepare to avoid them. Use of charts, maps, radar or sonar if available, previous knowledge or information should be diligently applied. If there is ever a question or unknown information which causes a dangerous condition, captain or crew should immediately slow or stop the boat, reassesses the situation and if necessary contact, via radio persons that know the area and may help. The Coast Guard, Tow Boat US, Sea Tow, Harbormasters, or even local commercial fisherman are persons with a wealth of information about local areas unfamiliar to the boater. The avoiding of any object should be the focus of a crewmember or the captain.
Cooking on a boat is not like cooking at home on a steady platform. Because of movement of boat, hot water, steam, flames, may move, surfaces may move, items may shift resulting in burns, cuts from knives, or appliances, injuries to body from movement. Preplanning and prevention may help: know your environment; are there possible splashes of hot fluids, loose items, sharp edges, that will hurt me. Cruising crew should always think of what they are going to do, secure loose items, obtain necessary tools before they start. Always know the limits and capacities of cooking systems, danger or flame, spillage possibilities and other things that may injure. They should always know the location of emergency gas shutoff switches, fire extinguishers, and procedures of what to do in case of fire. Again, they should move slowly purposely and obey the adage one hand for me one hand for the boat. If cooking underway, person in galley should use available handholds and or be tied in to secure locations to prevent falls.
Seasickness although not a true injury, is an illness that can cause much dismay pain and discomfort as to ruin the crewmembers or guest day and/or trip. Often called motion sickness, mal de mar, “I want to die syndrome”, and many other terms, it can be a wrenching illness. It is caused by one’s brain and central nervous system receiving conflicting signals from the inner ear and the eyes. It can occur out on the ocean or on a calm day in a bay with devastating results. The symptoms may include: dizziness; nausea; vomiting; painful stomach; balance problems; feeling of movement when there is none. Prevention before the onset of seasickness is perhaps the only cure. Medically there are medications and devices which may be taken including, Bonine Meclizine, Benadryl and others. Accu bands which create pressure on key pressure points on the wrist, have been known to prevent seasickness also. Avoiding heavy greasy meals before or during sailing, avoiding caffeine drinks, and avoiding those foods which is known in the past to cause sickness will help. While on board sit in the middle of the boat, keep your eyes open on the water and boat, keep busy if possible, hydrate with water, ginger ale, cola syrup, eat ginger cookies, saltines etc. Do not go below. Sometimes sleep can cure the illness. Often the only cure may be to get oneself on dry land. In any event prevention before the onset seems to be the most diligent cure.
Because a sailboat as many working systems, maintenance is necessary. Performing maintenance can cause a myriad of injuries if not thought out ahead of time. First know your limitations is this a job I can do for myself or left to professionals. Know your equipment engine parts and other moving parts i.e. blocks, lines, winches, electrical, booms. Moving or standing rigging can catch or hit body parts, causing simple to massive injuries. If there be a choice of working on Dynamic versus Stagnant machinery systems, working on stagnant, non-moving or non-charged systems is always preferred: Hands or other body parts may get caught in a moving engine; The charged Electrical system may cause serious burns; Rigging under load (which has tremendous release force capabilities) will cause serious injuries. Preplanning safety includes making sure these systems are all shut down and not under load. Plan move slowly and purposely. Have all tools available/ think before acting. Use extreme caution if it is necessary to work on Dynamic, moving or charged systems, i.e. engine adjustments, electrical adjustments, rigging and sailing repairs. When working on boat on dry land be sure ladders are safe and secured to the boat. Be particularly slow and cautious on ladders, move slowly and cautiously as falls from heights to the ground may be catastrophic.

Some basic first aid, certainly not everything.

1. Attend to severe bleeding first. Remember DEPT use clean gauze, apply Direct pressure to wound; Elevate wound above the heart; apply Pressure to pressure points (brachial inside of bicep, femoral inside of thigh); apply Tourniquet just above wound***used only as a last resort., when if bleeding continues, person will die immediately.
2. Cardiac arrest /cessation of breathing/ call for immediate help, remember CAB
C Circulation, lack of heartbeat- perform chest compressions
A Airway, clear airway of obstruction person on back /chin lift
B Breathing, listen and look chest movement if none- start mouth to mouth

3. Wounds with impaled objects or imbedded glass/ do not remove object, cover with clean gauze, wrap loosely, do not apply any heavy ointment/crème. Clean wounds/ close wounds if possible, wrap to stop bleeding, keep immobilized, and keep out dirt.
4. Eye wounds/ protect eye keep out sun cover with gauze patch, do not cause pressure.
5. Bruises Contusions sprains/ apply ice immediately, ace bandage to immobilize, put no pressure on joint limb etc., and limit movement
6. Fractures/ Dislocations/ immobilize limb/ splint limb in place as found (never reset bone/ limb) use gauze cover to stop any bleed.
7. Burns/ if slight soak in cold water. Skin broken cover same with gauze (air hurts) do not apply ointment or cream, treat for shock (elevate feet)
8. Fainting spells/ have person lie down elevate feet. Monitor /watch breathing.
9. Heat poisoning and heat stroke/ remove from sun/heat, cool off slowly, give water sparingly
10. Ingested poisons substances/ give copious amounts of water; induce vomiting only if ingested substances are non-acid (may burn on way out).
11. Stings bites imbedded small objects spines/ clean area remove stinger or hook apply antibiotic/Ambesol, cover with clean gauze /band aid.
13. Water Hypothermia- remove person from water immediately. Remove wet clothing cover with space blanket or dry blanket. Re heat body slowly warm (not hot wrapping), warm liquids Monitor vitals, TX for shock.
14. Shock- from loss of blood to brain/ other trauma–. Have person lie down elevate feet monitor all vitals watch especially for breathing. Give o 2 as needed.
15. Head injuries concussions –treat open wounds as above. Have person lie down, check and monitor vitals, closely continue to monitor breathing and vitals. Get immediate help.

Whether it be day sailing in the bay or cruising on the coast, sailing is an adventure. But it is a working adventure with an environment of many moving parts and systems. These working dynamic systems must be worked with and respected. The sailor must constantly assess and reassess his surroundings and actions to those surroundings, for to ignore them may lead to serious injury and more. Boat and crew preparation as well as planning is essential. Sailing can be rewarding and absent of accidents and incidents. Where sailors prepare their boat with regards to safety, have a plan, know and using known safe techniques, use non-sense approaches, analyze tasks and move slowly, they will insure a safe and happy voyage. This is true for the big ocean sailor, as well as the small day sailor.

Fair winds and happy sailing to all…author