
Read the U.S. Coast Guard’s annual boating statistics and you would think it never happens; the most common reason a boater calls Mayday, the topic of so many news stories involving rescue, the thing that many maritime rescuers respond to most of the time barely gets a mention. Though collisions are the most common mishap on the water, they are rare for offshore cruisers and can be easily avoided. It’s not flooding or fire or even breaking down that cause the most serious problems at sea and no matter how good a mariner you are, your boating skills cannot help you avoid this one. All you can do is prepare.
What is most likely to go wrong at sea? You are. Medical problems with people on boats far outweigh problems with boats as reasons for distress calls. If you are not sure that you believe that, I’ll stay here as you pause in your reading to click this search link. When you pick your jaw up, come back to this article and learn how to avoid making the news that way and how to prepare for a not-so-unlikely medical problem on your next trip.
Time vs. Distance
Every mile from the dock is another four minutes (on average in a fast boat) from a hospital. Even in the middle of a short run from Fort Lauderdale, Florida, to Freeport in the Bahamas, for example, you are a good two or three hours – at least – from advanced medical care. Distance can be dangerous if you’re not truly prepared for an unexpected problem — and it takes more than just having a first aid kit aboard to be truly prepared.
You should know the medical history and health concerns of every passenger on your boat and they should know yours. Too many times fishing buddies have no idea what medications their friends are allergic to or whether they are diabetic or have a heart condition. These things matter to responders and since the trip to the ER from the fishing grounds is four times longer than from the dock, these answers can make a huge difference to a successful outcome.
The obvious awkwardness of asking your passengers about their private medical history or in telling them yours is a problem, but there is an easy, free, and painless solution. I’ve got a one page letter, sealed in an envelope, with everything the doctor would need to know about me. Take me to sea and I’ll hand it to you at the dock. “In case I can’t talk for any reason,” I’ll tell you. “You don’t need to know what’s in it; just hand it to the EMT who shows up and tell them what you know about what happened to me.”
My own letter has my medical history, drug allergies, my primary physician’s name and number, and contact information for my closest relatives. I’m fortunate to not take any medications but if I did, they would be on there.
If this seems like too much, consider how simple and how free it is and then weigh that against how valuable it would be should you or a passenger experience a stroke, or chest pain, or appendicitis, or anything else you saw in the link above. If you still think it is too much, consider this: I’ve never medevaced a professional mariner where the ship’s captain didn’t hand me an envelope with everything the doctors might need to know about the patient I was taking from him. If it’s not too much for the pros, then why should you have a problem?

Drugs Allowed on Board
A half-day trip can turn into an unplanned overnighter a dozen ways. Run aground or throw a prop or blow a fuel line and suddenly you’ll be missing lunch back at the marina for sure — and possibly still at sea when you planned to be back in time for your blood pressure meds. On more than one occasion (every year) the inconvenience of waiting for the tide to rise turns into a Mayday because a diabetic didn’t bother to pack that important prescription.
Your hard rule for passengers (and yourself) should be, “Prescription meds come aboard or you don’t.” You have to insist and never assume. How much is enough? My rule is enough doses for 24 hours or four times the planned length of the trip, whichever is greater. Better to have it and not need it than to need it and not have it.

Training and Gear
All professional mariners, from the Captain to the deck hands, are required to have first aid training and they have to know CPR. Their boats have AEDs (Automated External Defibrillators) as well. Recreational boaters do not. Here’s the thing; the sea doesn’t have any idea if you are a pro or an amateur. The risks are identical.
Do what you want but there are two kinds of EMTs in the Coast Guard, those who have performed what we called “public relations CPR” and those who hope they won’t have to. If someone on your boat has a heart attack that progresses into V-fib and you don’t have the training and the tools, things get grim quick.
Remember time vs. distance: With just some basic training and the right kind of gear, your boat becomes a much safer place. The most common mishap at sea is far less likely to occur on your vessel and you’ll be better prepared to handle it if it does.