The child is stable, but her mother is standing in front of you demanding that you go to shore, now. The captain is on the satellite phone to a doctor she has never met, in a country neither of them is in. Nobody is panicking. This is not a failure of the system: this is exactly how medicine at sea works.
Telemedical Advice
A telemedical advice service puts a doctor on the end of a radio or satellite link, at any hour, normally free of charge. That doctor cannot see the child. They depend entirely on the quality of the information you give them.
Useful information includes:
- The age and approximate weight of the child.
- What happened, and when. Exact times matter enormously.
- What you observed, and how it has changed since.
- Known allergies, asthma, existing conditions and regular medication.
- What has been done so far, by whom, and with what.
- What is actually available in the ship medical stores.
Vague information produces vague advice. Write things down as they happen, on paper. You will not remember accurately afterwards.
The Evacuation Decision
The captain decides, informed by the doctor. There is no single right answer and every option carries cost and risk.
| Option | Considerations |
|---|---|
| Manage onboard | Doctor advises it is safe; monitoring continues |
| Divert | The whole vessel to the nearest suitable port |
| Tender ashore | Fast if close in; exposed and weather-dependent |
| Helicopter evacuation | Range, weather, night capability, deck clearance |
Coordination usually runs through the relevant rescue coordination centre. Lifting a child off a moving yacht by helicopter is a serious undertaking with its own risks. That is precisely why the decision belongs to the captain on medical advice, and not to the crew member who is most frightened.
Immersion: The Non-Negotiable
Any child who has been in the water and has choked, inhaled water or lost consciousness even briefly must be assessed by a doctor, even if they now appear completely fine. Do not let anybody, including a parent who wants the holiday to continue, talk you out of escalating that.
Documentation
Every incident is recorded: the accident/incident report, the deck and medical log, the times, the observations, who advised what, what was taken from the medical stores. This is not bureaucracy. It is the clinical handover to the receiving hospital, the record for the flag state, and the protection of everyone onboard. Complete it while it is still fresh.
Onboard Notes
- Find the yacht telemedical contact details and the incident report form before you need them.
- Record times on paper as they happen, not from memory later.
- Never talk anybody out of an escalation. Argue for one instead.
- Preparatory study only. Awareness, not first aid training. This course teaches no techniques and does not qualify you to treat a child. A current, practically assessed paediatric first aid certificate from an approved provider is required.