Maritime health: Health in a lifeboat


Totally Enclosed Motor Propelled Survival Craft (TEMPSC) present the following challenges:

– Heat generated by the engine builds up and leads to heat stress and dehydration
– Atmospheric CO2 builds up inside the TEMPSC due to the engine within the craft. This can lead to nauseau, vomiting, dehydration, confusion and respiratory problems
– Fumes build up in TEMPSC which also lead to vomiting and dehydration and anxiety
– Engine noise levels lead to diminished capacity to communicate, fatigue and stress. The engine box noise must be dampened. The protocol should be that when the TEMPSC hits the water, the TEMPSC immediately sails away from the inward spiralling suction caused by the sinking ship. When at a safe distance (at least 300 meters, but preferably more), the sea anchor is thrown out and the engine put off, awaiting rescue
– Lack of windows causes absence of visual reference which exacerbates sea sickness. Lack of windows also leads to disorientation terms of day and night conditions. There must be artificial lighting inside the TEMPSC. Outside lighting must be in the form of an outside white fast-flashing light, self-contained and with an inside switch
– The lack of an outside deck on a TEMPSC makes duties on the outside near-impossible. It is therefore dangerous to save survivors in the water from the deck of a TEMPSC
– In high seas the TEMPSC rolls heavily from side to side leading to head and other body injuries of survivors walking inside the TEMPSC. The TEMPSC may even capsize but due to their hardy design self-correct during major storms. Survivors not strapped in are at risk of serious injuries
– During years-long storage water condensate that formed within the TEMPSC can in icy conditions ice over on the floor of the TEMPSC. Survivors are prone to slipping and falling on that icy floor. “Black heater” technology can prevent the build up of condensate. Water vapour condensation can lead to rusting and malfunction of engine
– Immersion suits are efficient when a survivor falls in the icy sea. There will only be a 2 degree Celsius drop in body temperature over a 6 hour period in water 1 degrees Celsius if the survivor is wearing an immersion suite. If the survivor wears an immersion suit in a TEMPSC they however develop heat stress
– Sea sickness makes sailors to become limp. They also start vomiting. They need to be strapped down into bucket seats by means of shoulder straps, with supportive soft head protection in order for their limp necks and heads not to slam against the TEMPSC’s hull during rolling in high seas
– Vomitus should accumulate in a central gully, which can be hosed down with water, leading to a sump, which can be pumped out with a hand pump
– If the ship’s route is very far from any quick rescue assistance, the ship’s doctor must ensure that there are a few hundred anti-emetic suppositories on the TEMPSC
– Every survivor should have access to 3 liters of water per day. The older regulations required only 1 liter per sailor per day. Other literature incated that the absolute minimum was 150 ml per day? Without water a person can only survive 3 to 4 days before succumbing. Without food a person can last approximately 75 days. The “Rule of 3” is sometimes quoted; 3 minutes without oxygen, 3 days without water, 3 weeks without food leads to death
– Odours in the TEMPSC can exaccerbate sea sickness. Ventilation designs may assist
– Hand rails and hand holds can prevent slips and falls
– Dedicated water dispensers above every emergency seat has been recommended but that complicates the question of water rationing

– Circulatory stress phenomenon (CSP) is the circulatory arrest and death of the hypothermic survivor as soon as they become active or stand upright. They need to be transported horizontally, preferably on stretchers. They can not scramble up the scrambling nets dangling on the side of the rescue craft. They should not walk. Even the hoisting of them in a “horse collar” of a retrieval helicopter can trigger CSP. Hypothermic survivors are preferably hoisted with double slings during helicopter retrieval in order to keep them horizontal. They are preferably lifted horizontally onto the rescue vehicle via a basket scoop

– FRC (fast rescue craft) is easiest way of getting survivors from the TEMPSC to the rescue craft.

– In the perfect world it would have been the best if the rescue craft would always be able to hoist all the survivors inside the TEMPSC onto the rescue craft. The challenge is that a fully-laden modern TEMPSC can weight up to 8.5 tonnes and few cranes can manage such weights, especially in rough seas
– Lowering of a basket stretcher is not without risk. The basket stretcher might slam against the rescue vessel’s hull during hoisting
– The swell and churning of rough sea can be diminished if a large maneuverable sea vessel can “wedge” the FRC or the TEMPSC between such a large sea craft and the rescue vessel. This can dramatically calm the sea and assist in safe transferral of the survivors and rescue personnel

– I have seen a TEMPSC been used as a MOB retrieval craft but then the TEMPSC was not laden to capacity and the sea was not extremely rough
– The triage call to transfer survivors on the TEMPSC to rescue vessel is made by the skipper on the rescue vessel. It would either be “standby until the weather clears”, “rescue at a later stage in order to prevent any casualties” or a force majeur scenario “rescue commences immediately irrespective of whether some indivuals may get injured due to the transferral process”. An example of the latter may be when it is clear that the TEMPSC is going to sink. Skipper experience or situational analysis will determine course of action
– FRC is the best way of transporting survivors from the TEMPSC to the rescue vessel. The FRC has the primary responsibility of retrieving survivors from the TEMPSC and retrieving survivors in the water. It has injury reduction only as secondary goal. TEMPSC are not always ideally designed at retrieving survivors from stormy water
– FRCs generally only carry bouyancy devices when there are mass casualties in the water. The problem that FRCs face is frequently lack of space on board