According to a research study by Donald Lloyd-Jones MD, a professor of Cardiology at Northwestern University in Chicago, IL, a man over the age of 40 has a one in eight chance of sudden cardiac death. The older you are and the more risk factors you have, up the odds. Examples of risk factors for heart attack or stroke include high blood pressure, high cholesterol, being overweight, smoking, drinking excessively, being inactive and having lots of stress. And if you look at your boss, the guests, your captain, it is worth considering that even if you yourself are not at risk, there are people around who may be.
A sudden natural death aboard a yacht does not dispatch many news crews to the scene; however, it is a scenario which Dr. Joshua Perper, the Chief Medical Examiner for Broward County Florida, says, “Happens all the time.” Dockwalk recently had the opportunity to sit down with Dr. Perper (whose name you may recognize from his role in the Anna Nicole Smith Autopsy and numerous television appearances) to learn the proper steps to take when someone dies suddenly and you are a day or more from port.
Step One: Make sure they are dead.
Seems like that would be obvious, however there is a reason why hospitals require a doctor to declare a person deceased. There are certain instances where a person may appear to be dead to an untrained person, so Dr. Perper makes the following suggestions.
If a person appears to have stopped breathing and has no pulse, double check that assessment by checking the neck for a carotid artery pulse and listening to the chest (with a stethoscope if there is one in your med kit) for any sign of breathing or heart beat.
Next, Dr. Perper says to check the victim’s eyes. Depending on the cause of death, pupils may be constricted or dilated, however if a person is deceased, their eyes will show no movement and there will be no pupillary light reflex if a light is directed at the eye.
The most definitive indicators of death are when the body becomes cold and stiff and in addition may show discoloration similar to bruising on the lower part of the body where blood has pooled from the effect of gravity. This is called “rigidity and lividity,” and they are reliable signs that a person is in fact dead.
Step Two: Call the Authorities.
It is not standard procedure for any Coast Guard agency to retrieve a dead body from a vessel in transit. Dr. Perper suggests that every vessel develop a written procedure for dealing with a death at sea. The first item of that procedure is to immediately contact authorities in your next port of call who, Dr. Perper says, may suggest modifications to your protocol - particularly if the victim appeared to have been ill prior to death.
Once authorities have been contacted, the scene of death and the body should be carefully photographed and documented right away, paying close attention to any items which seem suspicious – like signs of struggle or medicine bottles. Preferably this will be done by the captain and witnessed by another crewman or relative of the victim. The room where the victim died should be made off limits to the rest of the crew and guests. It should not be cleaned, altered or used until authorities have been able to examine it. Medical Examiner Perper also suggests that everyone aboard immediately produce a written statement regarding the victim in the days and hours before death.
Step Three: The Body
Dr. Perper suggests leaving the body in place for 24 hours, especially if there is any doubt the person is definitely deceased or if you are less than a day from port. After 24 hours, the body can be wrapped in plastic bags and ideally stored in a refrigerator or freezer. If the body cannot be preserved in-tact in cold storage, then using ice to preserve the body is a good second option. If the boat will not produce enough ice to keep the body preserved, then Dr. Perper says to wrap the body in additional layers of plastic and consider moving it to a tender or life raft which can be towed behind the boat.
Until a Medical Examiner can confirm a death from natural causes, it is important to preserve the scene and the body to the best of your ability. Though it may not be pleasant to think about, people can and do die aboard yachts. Although it is not the type of incident you want to think about when the unthinkable has already happened.