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Old 08-02-2010, 18:46   #1
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Reality Check - Fractures Offshore

I have been sailing for more than thirty years, and a significant portion of that time has been offshore. I always worried about fracturing a bone when sailing offshore. I have slipped a few times and hit the deck, but never suffered a fracture.

I also worried that if I fell overboard while wearing a safety harness, the jerk from the harness could fracture some ribs. (When I was in a car accident, the seat belt broke my left femur, and the shoulder harness broke five ribs) I respect the power of a harness to cause carnage.

I once was thrown down the steps into the galley from the salon when a large sea knocked Exit Only sideways.

So far, there have been no fractures on Exit Only while sailing offshore.

The only fractures we suffered was when touring inland far from the sea. The only cruisers I know that had fractures also received them when they were off the yacht. In my experience, cruisers are much more at risk from fractures when they are onshore than when at sea.

What is the consensus? How many of you have suffered a fracture offshore, and how many of you know of a cruiser that suffered a fracture offshore? How many of you know cruisers who suffered fractures on land?
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Old 08-02-2010, 19:09   #2
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The Medical University of South Carolina is doing a study of cruisers right now. They're collecting data under a grant to find out what medical conditions plague cruisers at different ages. The data from their efforts should be available in the next couple of years and it'll be very interesting to see what problems are really encountered.

I know it doesn't answer your question but the results of a independent large survey will have more meaning - it's just going to take some time.

Dr. Jerry Reeves is the person behind the survey at MUSC.
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Old 08-02-2010, 19:16   #3
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I slipped on an icy deck last year and thought I had broken my leg. It was a hard, painful fall, but fortunatley nothing broken. My cousin slipped on his boat over the summer and broke his tib/fib - a bad one that laid him up for months. Fortunately he was at dock and only 20 minutes from the ER.

Fractures and boats do tend to go hand in hand. It's really not if - but when. Yet fortunately things have changed in the past century when a compound fracture automatically resulted in amputation. Hmmm, and we thought those pirate peg legs and hooks were just cliches.

A good way to spend a winter is in an EMT course.
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Old 08-02-2010, 19:22   #4
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A good way to spend a winter is in an EMT course.
I have to agree with that. My wife and I are both licensed EMT's. We've both served on our local ambulance squad for 17 years and have seen a lot. That part is hard to duplicate but knowledge about how to handle a medical emergency is always a good thing.
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Old 08-02-2010, 19:27   #5
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None of us have had a fracture, hope not to do so. The EMT course is a great idea. My son just finished what is called the "Wilderness First Responder" course. When talking with him about it, it also seems well worthwhile to invest the time.

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Old 08-02-2010, 19:31   #6
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Jeffrey,
It is a great investment of time and also a lot of fun - not to mention personally rewarding. I did intermediate EMT in '94 and then on to Paramedic a year later. Loved every moment of the courses. This training and many years working part time on an ambulance have served me, my family and many others well in our travels through remote parts of the world.
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Old 08-02-2010, 19:39   #7
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I'm an intermediate too. I really respect the skill and knowledge you paramedics have. Calling in the pro's like you really saved me quite a few times. I carry a fair amount of equipment and supplies onboard including a few IV setups. I've only ever used our equipment on injuries sustained by our dogs in the last 6 years though!

The suggestion about wilderness medicine is a good one too. We took a certification in that a couple of years ago. Knowledge is king for these types of things. It's something that can't ever be taken away from you either. Well, except for old age setting in!!
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Old 08-02-2010, 19:56   #8
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I have to second the wilderness first aid and first responder courses. I have done work with NOLS and the course is great (but is a time commitment)
NOLS - WMI : Wilderness Medicine Institute

The major difference between Wilderness and EMT training is time. Wilderness presumes a minimum of 12 hours before you will get to medical attention. The decisions are different if you can get someone to a medical facility in 60 minutes more or less.

A femur break is a great example. Left alone you are unlikely to survive if there are any complications. Allergic reactions, broken bones, head injuries, heart attack, lacerations, heat stroke, etc. Knowing how to stabilize and maintain (note the word correct has not appeared) means surviving. Being able to take a blood pressure, pulse, temperature, physical, and record the information for help (even remote help) can be critical.

My kids are too young to take the course but we covered the material with them after. Especially the Two rules:
1 Don't create a second victim.
2 What will kill them first?

If you are cruising where help is hours away, add Wilderness training to your education. Your loved one's lives depend on it - and yours too.
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Old 16-02-2010, 11:01   #9
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Last year I fractured a toe while putting groceries away (kicked the latch on the floorboard). Technically, it wasn't offshore and it healed on its own.

Over 10 years ago, I fractured my arm near my wrist when I fell in the cockpit of our monohull. Again, it wasn't offshore, it happened as we were docking.

Fair Winds,
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Old 16-02-2010, 12:30   #10
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How many of you have suffered a fracture offshore, and how many of you know of a cruiser that suffered a fracture offshore? How many of you know cruisers who suffered fractures on land?
Beth cracked a rib in an Atlantic gale - thrown against the edge of the nav desk.

I have broken my leg skiing.
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Old 16-02-2010, 13:35   #11
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I fractured my wallet and my bank account a couple years ago..it hasn't healed up yet...I could use a transfusion class and some EMT Emerengance Money Training....or we might need some wilderness training for the whole family pretty soon...
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Old 16-02-2010, 13:48   #12
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I tore ligaments in my right ankle whilst stepping aboard an open hull at work to do an inspection. The temporary steps inside the curvature of the hull wernt secured and slipped away as I stepped on them.
Once I had the ankle xrayd, I had confirmation of a fracture which I did 6 years before and didnt have treated.
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Old 16-02-2010, 14:52   #13
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I've had two broken bones in my life. Both minor, both on sailboats. One was a spiral fracture to my middle finger ending right at the joint. It looked like a dislocation. I wasn't offshore, but circumstances were it didn't get final treatment for over a month. (Because I then went sea kayaking) The time meant it had to be re-broken, chiseled out and reset. (which hurt way more than the initial break). As a consequence it has not healed as well as it would have with immediate treatment, but I accept that as being a part of lengthy outdoor ventures. I was a WFR, but in both cases that was of no help in treatment. Common sense and advanced care were the keys.

In regards to first aid training: I have been running an outdoor adventure program for over 20 years. My wilderness leaders are all at least WFA certified. However, I've never seen an example where first aid training really made a difference to the final outcome of an injury I've seen plenty of cases where action, judgement, and prevention made all the difference. I'm not down playing first aid. It can be helpful and can even save a life. I'm just saying I think often we'd be better off spending proportionally more time on incident prevention instead of incident treatment. Even a basic WFR course is 60 hours. How many incidents would be prevented with 60 hours of prevention training?

Who's with you? - After sailing with crew, I'm now going solo. Even for island cruising it makes me feel much more vulnerable should something go wrong.

A final thought: As a Red Cross instructor the biggest change I've seen over the years is an increased emphasis on contacting real professionals. I think this makes sense. Money spent on reliable, immediate communication may be the most valuable "first aid" you can have. There few places you can't have professional advice and/or rescue in a timely manner if you can communicate.
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Old 16-02-2010, 15:19   #14
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i am asuming a situation of singlehanded sailing,ithink that the best course of action is communications.its time to trigger the EPIRB etc. If you end up with a broken femur,i dont think that it would be possible for an individual to attempt to put a busted leg in splints.

How could you manage the pain?,its okay giving someone else diamorphine,but if you self inject then you would be incapacitated and unable to set the leg even if you had the nessesary medical knowledge.

I have not done an advanced first aid course but those with advanced medical knowlwdge could answer the question? is there a way of managing the pain whilst you await rescue?

A book that is well worth reading on this subject is by a Brittish mountaineer called Joe Simpson,this book is called touching the void.
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Old 16-02-2010, 15:41   #15
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Money spent on reliable, immediate communication may be the most valuable "first aid" you can have. There few places you can't have professional advice and/or rescue in a timely manner if you can communicate.
I can agree with the importance of communication, but there's quite a number of places where professional advice/rescue and timely manner are not available 24/7/365.

Fair Winds,
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