Chapter 5: Boating Emergencies—What To Do
Proper response to accidents results from good training and common sense.
If an injury is minor, treat it immediately. If an injury is major, make the
victim as comfortable and safe as possible until medical personnel arrive,
assuming you have a way to call for help.
Cold Water Immersion and Hypothermia
Cold water immersion kills in several ways. The colder the water, the greater the chance of death. However, the initial reaction to cold water immersion can occur in water as warm as 77° Fahrenheit. By understanding how your body reacts to cold water, you
can prepare for and be better able to respond appropriately, thus increasing
your chance of survival.
There are four stages of cold water immersion.
Stage 1: Initial "cold shock" occurs in the
first 3-5 minutes of immersion in cold water. Sudden immersion into cold
water can cause immediate, involuntary gasping; hyperventilation; panic;
and vertigo—all of which can result in water inhalation and drowning.
Immersion in cold water also can cause sudden changes in blood pressure,
heart rate, and heart rhythm, which also can result in death.
Stage 2: Short-term "swim failure" occurs 3-30
minutes following immersion in cold water. The muscles and nerves in the
arms and legs cool quickly. Manual dexterity, hand grip strength, and speed
of movement all can drop by 60% - 80%. Even normally strong persons can lose
the strength necessary to pull themselves out of the water or even to keep
their head above water. Death occurs by drowning.
Stage 3: Long-term immersion hypothermia sets in after
30 minutes, at a rate depending on water temperature, clothing, body type,
and your behavior in the water. Cold water robs the body of heat 25 times
faster than cold air. Hypothermia occurs when your body loses heat faster
than it produces it, cooling the organs in the core of your body. Hypothermia
eventually leads to loss of consciousness and death, with or without drowning.
Stage 4: Post-immersion collapse occurs during or after
rescue. Once rescued, after you have been immersed in cold water, you are
still in danger from collapse of arterial blood pressure leading to cardiac
arrest. Also, inhaled water can damage your lungs, and heart problems can
develop as cold blood from your arms and legs is released into the core of
Your chance of surviving cold water immersion depends on having sufficient
flotation to keep your head above water, controlling your breathing, having
timely rescue by yourself or others, and retaining body heat.
Prepare for boating in cold water conditions by always wearing a secured life
jacket. Also wear layered clothing for insulation. Equip your boat with a means
for re-entry (ladder, sling, etc.) to use if you should fall into the water.
Learn to recognize symptoms of hypothermia. They are listed
here in order of severity.
- Shivering slurred speech, blurred vision
- Bluish lips and fingernails
- Loss of feeling in extremities
- Cold, bluish skin
- Rigidity in extremities
Of course, the best prevention is to take all measures necessary to avoid
capsizing your boat or falling into cold water in the first place. If you do
fall into or must enter cold water:
- Don't panic. Try to get control of your breathing. Hold onto something
or stay as still as possible until your breathing settles down. Focus on
floating with your head above water until the cold shock response abates.
- When your breathing is under control, perform the most important
functions first before you lose dexterity (10-15 minutes after
- If you were not wearing a PFD when you entered the water, look to see if
one is floating around you and put it on immediately. Don't take your clothes
off unless absolutely necessary. A layer of water trapped inside your clothing
will help insulate you.
- Focus on locating and getting everyone out of the water quickly before
you lose full use of your hands, arms, and legs. Try to reboard your boat,
even if it is swamped or capsized, or anything else that is floating. Get
as much of your body out of the water as possible. Even though you may feel
colder out of the water, the rate of heat loss will be slower than if immersed
- If you cannot get out of the water quickly, act to protect against rapid
heat loss. In as little as 10 minutes, you may be unable to self-rescue.
Your focus now should be to slow heat loss.
- Stay as motionless as possible, protecting the high heat loss areas
of your body, and keep your head and neck out of the water.
- Safety typically looks closer than it actually is, so staying with
the boat is usually a better choice than swimming.
- Adopt a position to reduce heat loss. If alone, use the HELP (Heat
Escape Lessening Posture) position; or if there are others in the water
with you, huddle together.
- If you must swim, conserve energy and minimize movement. Swim on your
back with your upper arms against the sides of your chest, your thighs
together, and your knees bent. Flutter-kick with your lower legs.
- Be prepared at all times to signal rescuers.
When treating victims of cold water immersion, you should:
- Get the victim out of the water as soon as possible. Remove the victim
from the water gently and in a horizontal position.
- Prevent further heat loss.
- Treat the hypothermia victim gently and to your level of training. Be prepared
to provide basic life support.
- Seek medical help immediately.
Heat Escape Lessening Postures
This position protects the body's three major areas of
heat loss (groin, head/neck, and rib cage/armpits). Wearing a PFD allows
you to draw your knees to your chest and your arms to your sides.
Huddling with other people in the water lessens
the loss of body heat and is good for morale. Also, rescuers can spot
a group more easily than individuals.
Carbon Monoxide Poisoning
Carbon monoxide (CO) is an invisible, odorless, tasteless gas that is produced
when a carbon-based fuel burns. CO can make you sick in seconds. In high enough
concentrations, even a few breaths can be fatal. Sources of CO on your boat
may include gasoline engines, gas generators, cooking ranges, and heaters.
Early symptoms of CO poisoning include irritated eyes, headache, nausea, weakness,
and dizziness. They often are confused with seasickness or intoxication. Move
anyone with these symptoms to fresh air immediately. Seek medical attention—unless
you're sure it's not CO.
To protect yourself and others against CO poisoning while boating:
- Allow fresh air to circulate throughout the boat at all times, even during
- Know where your engine and generator exhaust outlets are located and keep
everyone away from these areas.
- Never sit on the back deck, "teak surf," or hang on the swim
platform while the engines are running.
- Never enter areas under swim platforms where exhaust outlets are located—even
for a second. One or two breaths in this area could be fatal.
- Ventilate immediately if exhaust fumes are detected on the boat.
- Install and maintain CO detectors inside your boat. Replace detectors as
recommended by the manufacturer.
Before each boating trip, you should:
- Make sure you know where the exhaust outlets are located on your boat.
- Educate all passengers about the symptoms of CO poisoning and where CO
- Confirm that water flows from the exhaust outlet when the engines and generator
- Listen for any change in exhaust sound, which could indicate an exhaust
- Test the operation of each CO detector by pressing the test button.
At least monthly, you should:
- Make sure all exhaust clamps are in place and secure.
- Look for leaks from exhaust system components. Signs include rust and/or
black streaking, water leaks, or corroded or cracked fittings.
- Inspect rubber exhaust hoses for burns, cracks, or deterioration.
At least annually, have a qualified marine technician check the engine and
Natural air flows can suck
fumes forward onto the vessel.
Swimmers should never enter an enclosed
area under the swim platform—even for a second. One or two breaths
of the air in this area could be fatal.
Carbon Monoxide Poisoning Situations
|Descriptions of Various Carbon Monoxide Poisoning Situations
Blocked Exhaust Outlets can cause carbon monoxide
to accumulate in the cabin and cockpit area.
Another Vessel's Exhaust that is alongside can emit
carbon monoxide into the cabin and cockpit of your vessel. Your vessel
should be at least 20 feet from a vessel that is running a generator
Teak Surfing or dragging or water-skiing within
20 feet of a moving vessel can be fatal. If persons are using a swim
platform or are close to the stern, all gasoline-powered generators with
transom exhaust ports must be off.
Slow Speed or Idling causes carbon monoxide to accumulate
in the cabin, cockpit, and rear deck.
Station Wagon Effect causes carbon monoxide to accumulate
inside the cabin and cockpit if you are operating the vessel at a high
bow angle, if there is an opening that draws in exhaust, or if protective
coverings are used when the vessel is underway.
Responding to Other Serious Injuries
Here are some proper responses to accidents that can occur while boating.
- Shock: The seriously injured should be treated for shock
by keeping the victim warm, still, and in a lying-down position until medical
attention arrives. Elevate the feet several inches except in cases of head, neck,
or back injury or hypothermia.
- Bleeding: Bleeding usually can be controlled by applying
direct pressure to the wound. If the bleeding is minor, apply first aid.
If it is serious, apply a dressing, maintain direct pressure, and seek medical
- Burns: In cases of burns, the immediate goals are to relieve
pain, prevent infection, and treat for shock. Immediately place minor burns
in cold water and apply a dry bandage after the pain subsides. Seek medical
attention for more severe burns.
- Broken Bones: Seek medical assistance immediately for
broken and dislocated bones. Apply temporary splints with care. An improper
splint can result in lifelong disfigurement; but lack of a splint can lead
to hemorrhage, shock, or death.
- Head, Neck, or Spinal Injury: In cases of head, neck,
or spinal injuries, never move a victim more than is absolutely necessary.
The water can provide excellent support until medical personnel arrive. If
a victim must be moved, place him or her gently on a firm, full-length support.
A responsible vessel operator also keeps a first-aid kit
on board. It should be waterproof and include:
- Assorted gauze adhesive bandages and pads
- Cotton and cotton swabs
- Antiseptic medications and lotions
- Aspirin or aspirin substitute
- Latex gloves
- An extra towel