As a boat operator, you are responsible for your safety and the safety of your passengers. A first aid kit is not an item required by regulation, but it is highly recommended that you carry one, and it is also recommended that you carry plenty of water and beverages that can replace lost electrolytes as well as energy snacks for your passengers.
Preparing for exposure is a lot easier than treating exposure, but we will discuss how to handle varying degrees of sun and heat-related factors. I would much rather everyone use preventative methods rather than treating heat injuries, but here goes for those who find themselves with sun or heat related injuries.
Sun Burn
Sunburn is the most common injury to happen on the water. You can become sunburned even on cloudy days. UV rays that are reflected by the water compound the effect.
SYMPTOMS: Sunburn appears as redness, swelling, or blistering of the skin. Other effects of overexposure to the sun are fever, gastrointestinal symptoms, malaise, and pigment changes in the skin.
PREVENTION: Staying in the shade when possible is a start. However, just getting out of direct sunlight is not always enough since sun can be just as harmful when reflected off a bright surface, such as sand or water. Sunscreen lotion with a sun protection factor (SPF) of 15 or higher should be used. Protective clothing such as a hat with a brim and sunglasses with UV protection for eyes should be worn.
TREATMENT: Most sunburns do not appear fully until exposure to the sun for several hours. Treatment consists of applying cool wet towels to the affected area. Cooling the skin temperature is very important. Keeping the skin moist but being wary of what product is applied is also essential. Many lotions contain perfumes, alcohol, or wax that will only aggravate the burn. Several types of first aid sprays give fast but short-lived relief.
Dehydration
Dehydration is also a very common consequence of a day on the water. Dehydration is enhanced by constant winds. The temperature does not have to be warm for you to become dehydrated.
DEFINITION: A loss of fluids and electrolytes through the kidneys, perspiration and respiration. Two to three liters of water is required to maintain hydration. No caffeine.
SYMPTOMS: When 6 to 10% of body fluids are lost, symptoms increase in this order:
- Dry mouth
- Dizziness
- Headache
- Difficulty in breathing
- Tingling in the arms and legs
- Skin color turns bluish
- Indistinct speech
- Inability to walk
- Cramping legs and stomach
PREVENTION: Drinking fresh clean water is the best and easiest method to replace fluid loss and prevent dehydration. Almost all fluids are suitable including fruit juices, soups, and water. Drinks that do not contain sodium (salt) are recommended. Crewmembers should drink plenty of fluids throughout the day, especially in warm, dry climates. Taking along an ample supply of water is a must during prolonged periods away from a water source.
TREATMENT: Remove from further exposure to heat and/or sun and should receive prompt medical attention.
Heat Rash (Prickly Heat)
We have all had it, but you may not have known the mechanism or the danger of having heat rash. It is more than just an annoyance.
DEFINITION: Breakdown of the body’s ability to perspire. Decreased evaporative cooling of the skin.
SYMPTOMS: Heat rash interferes with sleep, resulting in decreased efficiency and increased cumulative fatigue, making the individual susceptible to more serious heat disorders. Heat rash also accelerates the onset of heat stroke. Symptoms are:
- Pink or red minute (tiny) lesions.
- Skin irritation (prickling).
- Frequent, severe itching.
PREVENTION: Rotate crew duties between heat related and cool.
TREATMENT: Remove from heat and apply cool, wet towels.
Heat Cramps
Heat cramps can be quite painful and debilitating. In addition, they can lead to more serious consequences such as heat stroke.
DEFINITION: Painful contractions caused by excessive salt and water depletion. Legs drawn up, excessive sweating, crying out in pain.
PREVENTION: Stay hydrated and cool. Stay in the shade if possible.
TREATMENT: Heat cramps can be treated by placing the victim in a cool place and encouraging the victim to lie down in a comfortable position. Cool drinks should be offered to replace fluid loss. Solutions containing electrolytes, like a sports drink, are also useful; however, the ingestion of excessive salt should not be allowed. Cramped muscles must not be treated with heat packs or massage. Prompt medical assistance is recommended for severe or persistent conditions.
Heat Exhaustion
Heat exhaustion may occur on long boating trips where the fishing action is heavy and the weather is hot and humid. It is a life-threatening condition in and of itself and is always a medical emergency.
DEFINITION: Heat exhaustion typically occurs when people exercise heavily or work in a warm, humid environment where body fluids are lost through heavy sweating. Fluid loss can result in a decrease of blood-flow to vital organs. In heat exhaustion, sweat does not evaporate as it should, possibly because of high humidity or too many layers of clothing. As a result, the body is not cooled effectively.
SYMPTOMS: When suffering from heat exhaustion, a person collapses and sweats profusely. The victim has pale skin, a pounding heart, nausea, headache, and acts restless.
PREVENTIVE MEASURES: Pace yourself and be aware of passengers who are overdoing it. Sometimes you just have to stop, rest, and replace lost fluids.
TREATMENT: First aid and medivac. It is time to make that emergency call for assistance if you can’t return to the dock quickly. Persons with heat exhaustion are likely to go into shock and should be observed closely at all times until medical help can be obtained. If possible, move the person to a cool place. Have them take off extra layers of clothes, and cool them by fanning them and putting wet towels on their body. Have them lie down and put their feet up if they are feeling dizzy. Have them drink water or sports drinks, but only if they are awake, not confused, and not vomiting. If untreated, heat exhaustion may progress to heat stroke.
Heat Stroke
DEFINITION: Heat stroke is a major medical emergency and results from the complete breakdown of the body’s sweating and heat regulatory mechanisms. Heat stroke or “sun stroke” is caused by operating in bright sun or working in a hot environment, such as an engine compartment. The onset of heat stroke is very rapid.
SYMPTOMS: The major symptoms of heat stroke are:
- Red skin, hot and dry to the touch (cessation of sweating)
- Characteristic body temperature above 104° F (40.0° C)
- Headache
- Weak and rapid pulse
- Confusion, violence, lack of coordination, delirium, and/or unconsciousness
- Brain damage (if immediate medical treatment is not given)
PREVENTION: Observe your passengers to make sure that they are not steadily progressing from a minor heat-related problem towards heat stroke. No fish is worth risking the health of you or your passengers. You must cut the trip short when you realize someone onboard is having heat-related problems that cannot be relieved by rehydrating or moving to a cooler location on the boat.
TREATMENT: Heat stroke is the most serious of all heat disorders and is an immediate threat to life. There is a high mortality rate associated with heat stroke. It is important to remember that heat exhaustion is the result of overloaded heat balance mechanisms that are still functioning. Heat stroke strikes the victim when the thermo-regulatory mechanisms are not functioning, and the main avenue of heat loss, evaporation of sweat, is blocked. The patient must be treated immediately, or death may occur. It is best to carefully remove the victim to a cooler environment and seek medical assistance.
Summary
A fun day on the water can turn deadly quickly if the boat operator or his passengers experience a sun or heat-related medical problem. Heat-related problems can quickly progress from minor to major unless they are recognized and treated early.
