Dockwalk magazine’s column, Worst Case Scenario by Kelly Sanford, highlights a hypothetical situation that captains may experience and offers advice from experts on how to handle it. The February 2012 column details the responses necessary for injuries that occur after an accident on board.

The deck crew secure the harness to the first Jet Ski and lift it from its cradle. The swell causes a pendulum effect once the Jet Ski is raised from its chocks; worried the ski might hit the boat while being lowered, a deckhand climbs on the Jet Ski with a fender. The effort is successful, and he returns to the flybridge for a second trip down.

Amused by the sight of the deckhand descending on a Jet Ski with a fender, the owner films the process on the aft deck with his cell phone. To keep the ski from knocking into the fashion boards, the deckhand leans in to position the fender when the harness suddenly gives way, sending the deckhand and Jet Ski falling. Due to his position, the deckhand’s body flips over forward; his lower body hits the rail below and then crashes into the water alongside the Jet Ski.

The owner witnesses the entire event. As his crew rush to the deck- hand’s aid, it becomes clear that the situation is life threatening. Over- come by the events, the owner starts experiencing chest pains and has trouble breathing. A relaxing day at anchor has suddenly become a multiple casualty situation and a matter of life or death.

Setting aside the urge to revisit why the protocol of riding on any- thing being lowered by the davit is not acceptable, there is the subsequent worst-case scenario. Peril now has two people in need of urgent medical assistance in a location far from immediate hospital access.

For the best possible outcome in a situation like the one described, the crew’s level of preparedness is going to be the determining factor. “For yachts that will navigate to remote areas, there should be a thorough risk management plan known and understood by the yacht manager, captain and the chief medical officer...[and] the captain and crew should have an emergency contact sheet readily available for quick reference,” says Scott Stamper, senior vice president at Atlass Insurance.

The possibility of a multiple-casualty situation is just one of many reasons all crew need to have regular practice and training with emergency situations and basic understanding of the procedural protocol following an accident.

“The yacht should have an emergency plan and practice drills occasionally whenever there are any crewmembers on board,” says Rob Carron, vice president of Marsh’s Luxury Yacht Practice. “All crewmembers should be required to attend these drills. Everyone on board should be aware of where the emergency equipment is stored and be current with how to use the equipment in [a] time of need.”

In a busy season, drills can become cursory and occasionally delayed due to schedule demands. Yet the potential to be blindsided by a serious medical emergency is a constant factor. There is no quick-fix compensation for full preparedness, but keeping all emergency equipment and information readily accessible and well placarded will bolster the emergency training and management plan aboard.

In the event of a life and limb situation, access to dedicated telemedical assistance almost certainly will be an asset and potential game changer. “MedAire or other similar companies, if pre-contracted, are [an] excellent risk management tool,” says Stamper. “They are globally available to provide a wealth of medical related consultation and services; however, they will not be paying the expenses associated with treatment and/or medical evacuation.” For this reason, among the list of emergency contacts should be the yacht’s insurers. “The expenses for emergency medical evacuation via aviation resources are typically approved only when coordinated by the insurer,” Stamper says. “In most circumstances, medical evacuation is warranted only when loss of life or limb are a potential.”

“Always seek the best possible immediate medical attention available at the time of need,” Carron says. But, while efforts are being made to stabilize the injured, if it’s clear that emergency transport will be required, Carron echoes Stamper’s advice to “contact your insurance broker or carrier as soon as possible. The carrier will assign a representative who will assist with related questions and [the] procedure to follow.” Obviously, this is a priority secondary to the immediate medical needs of those in peril.

It’s important to note that certain criteria will deter- mine whether a medical evacuation will be covered by insurance or whether those costs — which can be substantial — will fall on the owner’s shoulders. Even if a medical evacuation is deemed necessary, “This would not necessarily include a flight back to the U.S. or EU, but to the nearest suitable medical facility,” Stamper says.

In addition to making preparations for medical situations, and aside from needing to be well versed in the workings and logistical requirements for running the yacht, savvy captains should take time to learn the nuances of the yacht’s Protection and Indemnity insurance so they know what to do and what to expect in an accident’s wake. “There are many different policy wordings...all with varying levels of coverage,” says Natalya Russkaya of Atlass Insurance. “A properly written policy will cover most losses, but ultimately the captain should act as if they did not have insurance and take every possible precaution to preserve life, limb and property.”