Is Basic First Aid Training Enough for Yacht Crew?

A lack of ongoing first aid training for yacht crew could turn a routine trip into a life-or-death situation – so what's the solution? 

First aid training is mandatory for those entering the yachting industry as part of the STCW Basic Safety Training, and further training is required for officers moving up the ranks. But what about everyone else? Many crew members in mid-level or non-officer positions aren’t required to pursue additional medical training, even though they could be the first responders in serious emergencies. For instance, deck crew pursuing their OOW 3000GT certification must complete the MCA Proficiency in Medical First Aid and Medical Care courses. But many deckhands don’t progress beyond Yachtmaster Offshore, engineers often stop after AEC 1 or 2, and chefs and interior crew have no further medical training requirements. Yet, as key team members or the primary point of contact with guests, they could find themselves responsible when emergencies strike. Would a stew recognize the signs of a heart attack or stroke? Should they?

Many crew and captains feel that the mandatory training isn’t sufficient to meet the unique challenges posed by maritime environments. And this training gap becomes even more pressing as superyachts increasingly cruise to remote locations, far from the conveniences of modern healthcare facilities. Medical situations on board can range from minor injuries to more severe incidents such as cardiac events, fractures, and other life-threatening emergencies. In these scenarios, the ability of crew members to provide immediate and effective first aid can make the difference between life and death.

The International Maritime Organization (IMO) has established guidelines for medical training on ships, but these guidelines may not be tailored to the specific needs of superyachts, which often operate with smaller crews and limited medical gear. As a result, many crew members lack the specialized training needed to handle emergencies effectively. Several challenges contribute to the lack of ongoing first aid training in the superyacht industry. Many cite lack of time, others lack of funds, and often it comes down to a lack of necessity. If they don’t HAVE to do it, they won’t.

The consequences of inadequate first aid training can be severe. Delayed or improper responses to medical emergencies may lead to worsened conditions, increased risk of complications, and, in extreme cases, loss of life. Beyond the human toll, incidents could have legal and reputational repercussions for yacht owners, operators, and the industry as a whole. First Mate Danny* recounted the story of how he nearly lost his fingers eight years ago on a large sailing yacht during a regatta. “Looking back with the experience I have now, I can see I was failed by my seniors. I wasn’t trained to handle those loads or use the equipment properly. When my hand got caught, there was panic. It wasn’t dealt with calmly; frankly, it was a clusterf***.” It took extensive physio and corrective surgeries for Danny to regain the use of his hand, but he’s been left with arthritis. When I asked if the yacht at least learned from the accident, he said, “Not at all. They made a lot of noise at the time about how they’d do better, but as usual, it was just all conveniently forgotten. The owner didn’t really feel like paying for training, and the captain couldn’t be bothered to push it.”

While some level of first aid training is covered in basic STCW safety training, many crew and captains feel that this simply isn’t sufficient for the unique challenges posed by maritime environments.

With the basic STCW training, only Survival and Fire Fighting have to be renewed every five years; why not the First Aid module too? Capt. Aaron* said, “ I insist on refreshing myself and my crew every year with a reputable company. I have a great owner who completely backs me up on this. Last year we had a freelance chef who managed to burn herself quite severely, and if my stew hadn’t jumped in to administer immediate first aid, she could have been left with a far worse injury.”

Medical Support Offshore (MSOS), a company with offices in Palma de Mallorca, Antibes, Southampton, and Fort Lauderdale,  offer medical support to offshore vessels. In addition to the MCA courses, they will tailor training for vessels and crew, offering specialist training, medical kits, telemedical support, and design consultancy.

Nick Stael von Holstein, MSOS Europe sales manager and new build manager, has 19 years in the industry. With a background in scuba diving, von Holstein was trained to run and operate hyperbaric chambers and is passionate about helping yachts and crew achieve their medical training goals. “Generally speaking, I think crew could do more regular first aid training, especially on board. When they conduct safety day training such as fire drills and man overboard, it would be easy to incorporate any number of first aid scenarios,” he says. “Keep in mind, it’s basic first aid we are teaching them, even the captains with the Medical Care course (previously called Ships Captain’s Medical). Their job is to provide primary first aid and maintain the person until they can get them to professional medical care. We recommend a full first aid refresher day on board at least once a year when a season is about to start and particularly with new crew joining. For me, it’s not done as regularly enough as it could be.”

"Consider the oil and gas industry, or commercial shipping — those operatives do regular first aid courses, and they’re in-depth."

MSOS has found their bespoke courses to be very popular. Their trainers are doctors, nurses, EMTs, and medical professionals who all have a passion for maritime medicine and have maritime experience, as von Holstein says, “not your average trainers.” Amanda Hewson-Beaver, one of those trainers, says, “Consider the oil and gas industry, or commercial shipping — those operatives do regular first aid courses, and they’re in-depth. I know a captain who runs a big sail yacht and they’ve had a couple of incidents and still they’re not doing more training. His excuse was that his ticket doesn’t require it.”

Von Holstein adds, “It really sits with the captain — some are very good at installing regular training programs, others and more the majority, less so.” Hewson-Beaver’s trained America’s Cup teams, race teams, plus several crews traveling to extreme or harsh environments, such as the Arctic. She focuses on high performance race and sailing yachts as she feels that’s where her strengths are (she has lots of experience racing and sailing) and moving forward would love to see companies like MSOS having trainers dedicated to different kinds of vessels in order to specialize.

It’s also important that yachts are equipped with the right gear to manage medical situations. Above and beyond the legal requirements, companies like MSOS can help the vessel tailor its equipment to their specific needs. But it shouldn’t stop there; kits should be maintained and inventoried regularly. MSOS maintain and manage this for their clients, to avoid any problems. Usually on the larger vessels, this will come under the chief officer or captain’s control, as they will hold the higher medical qualifications. It’s worth considering on smaller yachts with fewer crew where the responsibilities lie. Within a crew of four, it’s all on the captain; what happens if he/she is the one who needs the medical assistance? Crew need to be aware of their responsibilities and make sure they improve their own knowledge and skills in first aid, and not just expect or hope that someone else can help in a situation. Proactivity, education, and spreading the word is key.

But even if the captains and medical companies are on side, how do we then educate the owners who choose not to listen?

Capt. Bonnie* recalls when she was skippering an Oyster 885 that was headed off around the world with an active scuba diving itinerary. She had a conversation with the owners regarding carrying oxygen on board and, with the backup of the first aid kit medical company, advised them that carrying O2 was necessary. “A defib can keep someone alive long enough for a close-by helicopter rescue. But oxygen can help in all sorts of situations. They didn’t want to carry it because it would take too much room. We discussed it again the next day and they still refused to ‘waste’ space with it. But then, here’s the best part — the chef interrupted our meeting to ask if they wanted anything specific as she was going provisioning. FORTY-EIGHT JARS OF CORNICHONS! I lost it."

As the industry continues to grow, it’s clear that those of us in the “more first aid training” camp have a long road ahead. It’s imperative that industry leaders take proactive measures to address this gap. By implementing specialized training programs, raising awareness, and fostering a culture of safety, the superyacht industry can navigate the uncharted waters of emergency response far more safely, ensuring the protection of lives and the sustainability of its reputation.