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"Pan Pan, Pan Pan, Pan Pan"
"All ships, all ships, all ships this is the yacht In deep trouble our positions is ***** 450nm ESE of Sydney bound for New Zealand and we have an injured crew member on board with a badly fractured leg. We require urgent medical assistance."

Now what happens?
Let us face it, there is no place more isolated than a yacht at sea and, in the case of above if it is blowing 30+ knots, you are well out of helicopter range.

If this message is sent via one of the correct emergency channels this will be picked up by Kordia via Charleville and relayed to AMSA in Canberra to deal with. One option, if you were in helicopter range, say 45 or 50 miles off the coast, perhaps you may expect them to dispatch a helicopter to assist. But what assistance can a helicopter offer in such a situation?
For land-based rescue and recovery, helicopters are ideal but this may not be the case for a yacht at sea especially in bad weather.

In the case of a Mayday call when the craft is sinking they can rescue the crew from the water or a raft. However, if you are calling in regards to a medical problem such above, or even worse a head injury caused by a boom strike, an amputated limb, broken ribs or a heart attack, there is very little a helicopter can actually offer a yacht in a seaway with its mast and rigging gyrating around. Other than, perhaps, dropping medical supplies or, if considered feasible, using one of AMSA’s self-righting life rafts if they have one on board to evacuate the patient, the helicopter is useless.

If the helicopter does not have a raft onboard and you, as skipper, insist you want to put the injured person further at risk and try to use this form of rescue you will have to either cast the victim into the sea or use your own raft. To do this you would need to deploy and inflate your own raft and somehow put the injured person into it, then let it trail a safe distance behind your boat so that they can safely be picked up from it.

But now, unless you have been able to safely recover the raft and kept it in a reusable condition, you will have no raft should another emergency arise.

O.K. I hear you say "why can't they drop a paramedic, let them swim over and we will pick them up?

From experience, even in controlled conditions let alone a seaway, the average modern yacht with its high freeboard and limited man overboard recovery equipment and experience, make recovery of someone from the water a more than difficult challenge. So even if the paramedic was willing to do so, it would be putting another life at risk and should not really be contemplated.

Similar issues may well apply in relation to patient recovery in rough sea conditions if any other vessel comes to your assistance. There is no way a rescue vessel can risk coming along side in a seaway for a patient transfer without risk of damage to one or both vessels.

Also, there are added risks involved in carrying out a patient transfer. However, they may be able to assist getting your yacht to calm water where the transfer could safely take place.

The best solution is that there be sufficient first aid training and supplies on board to cope with an medical emergency should it arise. But what level of training should be achieved for cruising yachts? Especially those contemplating a long distance cruise.

By removing the word 'races' and substituting the word 'cruises' the description of Category 1 yacht racing events contained in Australian Sailing's 'Blue book' is an ideal description of what a well-found cruising yacht should be set up to cope with: “offshore races of extended duration and well offshore, whereby boats must be self-sufficient for extended periods of time, (must be) capable of withstanding heavy storms and prepared to meet serious emergencies without the expectation of outside assistance.”

The book also calls for at least two crew members to hold a current first aid certificate, now called 'Provide first aid'. However, given the description of offshore events above, is this really good enough especially for Cruising yachts who we know will be far from “outside assistance”?

The Provide First Aid unit of competency: HLTAID003, is an excellent entry-level course that provides the skills and knowledge required for a first aid response, life support and management of casualty(s) until emergency-qualified help arrives. In other words for the 20 minutes or so until the ambulance gets there, but unfortunately we have no ambulance’s at sea.

It does not cover how to seek medical advice, how to look after the patient for hours or even days until hands-on professional help can be received, or how to correctly draw up and safely give an injection. So where does that leave us?

The CYCAs SOLAS took the initiative and funded 'The medical management for mariners course' (MMM), a course designed specifically to give those who go to sea in yachts. Be it cruising or racing, MMM is designed to provide the expertise to manage most if not all types of medical emergencies for hours or even days until professional help can actually be received.

Up to now the access to the MMM course has been restricted to NSW and has been taught by the medical and nursing staff in St Vincent’s Hospital Simulation Centre. But in order to expand this training Australia-wide we have sourced a training company called Medaire. They have offered to provide training using the MMM curriculum and we are currently in the process of negotiating with them to teach this course.

A great bonus, for those who complete the course undertaken with Medaire, is they will have access to the Medaire 24 hour, 7 day medical emergency advisory centre. This is as a back-up to the Royal Flying Doctor Service who we currently advise be utilised if emergency Medical advice is sought.

Medaire currently supplies training, medical advice and equipment to all the major airlines including Qantas, Virgin and Singapore Airlines.

Currently, Australian Sailing have been approached to upgrade the Blue Book and recommend this level of yachting first aid training and support for Category1 events.

At 10am on Sunday October 30, in order to ensure sailors receive the correct information as to the best way to actually seek assistance and what can actually be expected when an emergency call such as a Mayday or a Pan Pan call is made, the Cruising Yacht Club of Australia has invited the major organisations involved in dealing with such an emergency to attend a safety information day at the CYCA Clubhouse in Rushcutters Bay.

In attendance to provide information regarding its role in an emergency and answer any questions you may have will be representatives from: Kordia, Australian Maritime Safety Authority, NSW Ambulance Helicopter, NSW Water Police, Marine Rescue NSW and Medaire.

The day is free and open to anyone who goes to sea to attend. All we ask is that you please signal your intention to attend by following instructions on the CYCA website or contacting the CYCA Reception (02)82927800.
John Keelty
Cruising Yacht Club of Australia

CYCA

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