Heat and cold injuries; drowning
Governing: STCW Table A-VI/1-3; Resuscitation Council UK 2025 First Aid guidelines; NHS hypothermia guidance. Builds on: L2.1.
Yacht crew work in the Mediterranean and Caribbean summer, on hot decks, in engine rooms, and around water. Heat is the most common environmental problem; cold and drowning are the most dangerous.
Heat
Heat exhaustion
Caused by heat and fluid loss. Signs include headache, dizziness, heavy sweating, pale clammy skin, cramps, nausea and a fast pulse. The casualty is alert and thinking clearly. Move them to shade, lie them down, cool them, and give water or oral rehydration if they can drink. If they do not improve quickly, or become confused, treat as heat stroke.
Heat stroke
RCUK 2025: suspect heat stroke if the person shows confusion, agitation, disorientation, seizures or unresponsiveness in a hot environment. Exertional heat stroke can happen at any temperature during hard physical work.
- Remove them from the heat; call for help.
- Passive cooling: remove excess clothing, move to a cool shaded place.
- Active cooling immediately. The gold standard is whole-body (neck down) cold water immersion at 1-26°C until core temperature falls below 39°C.
- Alternatives: cold shower, ice packs, ice sheets, a fan alone, evaporative cooling with mist and a fan.
- If core temperature cannot be measured, continue cooling for 15 minutes or until neurological symptoms resolve, whichever comes first.
- Cool first, transfer second, and keep cooling during transfer.
TIP — Prevention on deck Rotate crew off hot decks, schedule wash-downs for cooler hours, provide shade and water, and watch the new crew who are not acclimatised.
Cold
The NHS defines hypothermia as a body temperature below 35°C (normal about 37°C). On yachts it follows immersion, working on deck in winter, or long exposure in a wet tender.
| Recognise | Do | Do not |
|---|---|---|
| Shivering, pale cold skin, slurred speech, slow breathing, confusion, drowsiness | Move to shelter; remove wet clothing; wrap in blankets; insulate from the ground; shield from wind; handle gently; warm sweet drinks if fully alert | Hot baths, heat lamps, rubbing limbs, alcohol |
RCUK 2025 adds ground isolation: insulate the casualty from cold decks.
Drowning
RCUK 2025 drowning guidance:
| Who | What |
|---|---|
| Untrained in water rescue | Do not enter the water. Reach with a pole or boat hook, or throw a lifebuoy or rescue line |
| Trained rescuer, in water or boat | Call for help first; provide flotation; keep the head out of the water |
| In the water, casualty not breathing | If feasible and safe with effective flotation, give five rescue breaths |
| On deck or in the rescue boat | If unresponsive and not breathing, five rescue breaths, then standard CPR |
| AED | Dry the chest quickly, then follow prompts |
Continue until signs of life or help takes over. Any drowning casualty, even one who seems to recover, needs medical assessment.
WARNING — Rescuers drown too The tender, rescue boat or a thrown line is the safe way. Swimming to a panicking person without training or flotation often adds a second casualty.
CAUTION — Cold water casualties Cold water can protect the brain. Do not give up resuscitation early on a casualty recovered from cold water; continue and seek advice.