“We are looking at the challenges the COVID environment [creates] on board a yacht, and the consensus of opinion seems to be that you can’t just assume the person doesn’t have COVID-19; you have to make the assumption that they do,” says Brent Palmer, RN, director medical instructors & strategic customer relationships for MedAire. “The downstream effects of COVID-19 are only now being thought about from the point of view of emergency medicine on board and how that will have to change with a highly infectious droplet virus.”
In addition to ensuring that crew have access to Personal Protective Equipment (PPE), including an N-95 or equivalent surgical mask, face shield, and gloves, one of the biggest changes, Palmer says, lies in how to administer emergency CPR.
“The downstream effects of COVID-19 are only now being thought about from the point of view of emergency medicine on board and how that will have to change with a highly infectious droplet virus.”
For first responders ashore, he says, the interim recommendation has been to place a piece of cloth such as a T-shirt or towel over the victim’s face to reduce the risk of aerosols and start hands-on CPR. “This is suitable when an ambulance is only seven minutes away, but what about if you are seven hours from port?” he asks, adding, “Yacht crew are trained to a much higher standard than the general public and they also have equipment on board that can provide a high degree of safety during a resuscitation.”
Palmer recommends that crew use a bag valve mask — a standard item in many yacht medical kits — to administer the breaths to the victim instead, after first adding an inline aerosol/virus filter to the mask in order to prevent any aerosolized fluids from escaping the patient’s mouth. “The addition of aerosol/virus inline filters to bag-valve masks and demand valves will reduce the risk and allow ventilations to continue,” Palmer says.
This new procedure requires additional training by the crew. MedAire will deliver virtual “tune-up training” to its yacht clients along with their new medical kits, he says. “This is an interim standard until we can find the final solutions,” Palmer added. “It has been used by ambulance crews, but it’s the first time we are applying it to all our yachts.”
This article originally ran in the August 2020 issue of Dockwalk.