Blue water

[Nick14]

A new 49’ Elling E4 can be delivered to any slip on the East Coast within 6 months upon placing the order! It may take 8 months for an E6. This is what I heard at the Newport Boat Show couple weeks ago.

6 months from ordering to delivery sounds very optimistic. Does that estimate come from people selling a boat, or actual owners experiences?

FWIW I (and many other recent boat buyers) have found sometimes significant differences between what a salesperson promises to secure a deal, and what happens in the real world.

Also FWIW at the Newport show I overheard a couple of people from a well known and respected trawler builder griping that sales people were telling buyers a year to delivery, but actual times were taking 2 years and they were taking heat from upset buyers being told it’s taking longer than promised.

 

[Hippocampus]

Most medivac programs only work if commercial airports are open and commercial flights are flying. This was a major issue for some people I know who had medical issues and could not be medevaced back to the US during the early and peak of Covid.. this has nothing to do with bluewater.
As regards bluewater-if you didn’t bring it with you you don’t have it. This means not only medical and surgical supplies but also the knowledge to meaningfully diagnose and intervene. Illness and injury are major potential issues and a reason most cruising folks want four for passages. With three you can remain functional and keep the boat moving forward. Some insurance companies dictate how many crew you must have for a particular passage and will want to review their sailing resume/credentials.

 

[Hippocampus]

Most medevac doesn’t work unless commercial airports and airlines are open and functioning. This was a significant issue during early and peak Covid. Two parts to medevac. Ship to shore but then shore to someplace that can deal effectively with the problem. Have knowledge that is had major impact to people I know who couldn’t return to the US for medical care.
The ship to shore availability is quite limited in many cruising destinations. It is generally unavailable in a timely fashion when on blue water. Rule is “if you didn’t bring it with you you don’t have it.” Although I’m a physician and wife is an RN we still arranged for remote consultations via satellite. This is helpful but not ideal. So carried extensive medical and surgical supplies as well as doing training and education.
Injury and illness are major concerns at a wholly different level than when within helicopter distance. Things can move quite quickly. So timely outside assistance likely to not be available. Even if you can stabilize the situation one crew is not on watch. That’s why most cruisers want at least four on the boat. Three can stand watches and move the boat forward. Many insurance companies will dictate how many are needed for a particular passage and will want to review experience and credentials.
We have run into some unusual challenges. Beyond infections and minor injuries DTs(I run a dry boat), cognitive impairment (B12 deficiency in a young crew was the cause), new onset seizures. This is not a theoretical concern. Probably a more major issue than weather.

 

[psneeld]

I know bluewater for MEDEVAC is really not a great option, but the Navy has parachuted SEALs in to save lives in the remote Pacific. Rare but an option. My point is being in blue water is NOT safer than coastal in so many ways. My cut on a lifetime at sea....if you are afraid of dying more than living.... going to sea in small vessels is not the wisest choice. It has risks that can be reduced but not eliminated.... an there are a few more risks than staying on land and living in decent civilization.

Crew is a problem, but if someone needs to be MEDEVACed, they probably aren't participating anyway. There have been instances where others have been brought to the vessel to backfill for crew.

I don't know how many MEDEVACs where you were actually part of the pickup and transport...I have been on many from the Bering sea to the Panama Canal. Commercial transport is often the minor problem in my experience unless you are hundreds of miles from the nearest land based hospital/advanced medical care. Even then the helo may leapfrog the patient to proper care if there are opportunities to refuel...which does include ships at sea with refueling/landing capabilities.

Discuss this further all you want but I have my opinions that you could never change....I will leave it at that.

 

[Hippocampus]

Not disagreeing with you. Your statements about ship to shore medevac are obviously better informed having done it for a living. But for the cruiser that’s only the first part of getting medical or surgical care. Believe most medevac involving cruisers isn’t just ship to shore but rather getting to someplace that can provide adequate care. Virtually every cruiser I have ever known doing blue water has bought some form of medevac insurance that includes from initial landfall to comprehensive care. This insurance commonly includes arrangements locally at the landfall country for initial care and stabilization or if available comprehensive care but then often transportation to the place supplying definitive care. Not infrequently there’s no helicopter involved as there’s no helicopter. Similarly the boat you’re on is going to be a faster transport than local services not infrequently . Guess I used medevac as a more comprehensive term than the narrow definition of ship to shore. The medivac insurance I had allowed advice via satellite for stabilization and treatment, advice about local care and help with arrangements, transportation out of the area to home or another country accompanied with appropriate care personnel during the transportation.

 

[Hippocampus]

Not disagreeing with you. Your statements about ship to shore medevac are obviously better informed having done it for a living. But for the cruiser that’s only the first part of getting medical or surgical care. Believe most medevac involving cruisers isn’t just ship to shore but rather getting to someplace that can provide adequate care. Virtually every cruiser I have ever known doing blue water has bought some form of medevac insurance that includes from initial landfall to comprehensive care. This insurance commonly includes arrangements locally at the landfall country for initial care and stabilization or if available comprehensive care but then often transportation to the place supplying definitive care. Not infrequently there’s no helicopter involved as there’s no helicopter. Similarly the boat you’re on is going to be a faster transport than local services not infrequently . Guess I used medevac as a more comprehensive term than the narrow definition of ship to shore. The medivac insurance I had allowed advice via satellite for stabilization and treatment, advice about local care and help with arrangements, transportation out of the area to home or another country accompanied with appropriate care personnel during the transportation. This is not uncommonly done involving commercial not governmental services.
You’ve seen the worse most extreme situations no doubt. I’m more focused on what’s likely more frequently encountered by the cruiser. The cruiser faces some of the same problems as the land visitor to undeveloped countries.

 

[Hippocampus]

Not disagreeing with you. Your statements about ship to shore medevac are obviously better informed having done it for a living. But for the cruiser that’s only the first part of getting medical or surgical care. Believe most medevac involving cruisers isn’t just ship to shore but rather getting to someplace that can provide adequate care. Virtually every cruiser I have ever known doing blue water has bought some form of medevac insurance that includes from initial landfall to comprehensive care. This insurance commonly includes arrangements locally at the landfall country for initial care and stabilization or if available comprehensive care but then often transportation to the place supplying definitive care. Not infrequently there’s no helicopter involved as there’s no helicopter. Similarly the boat you’re on is going to be a faster transport than local services not infrequently . Guess I used medevac as a more comprehensive term than the narrow definition of ship to shore. The medivac insurance I had allowed advice via satellite for stabilization and treatment, advice about local care and help with arrangements, transportation out of the area to home or another country accompanied with appropriate care personnel during the transportation. This is not uncommonly done involving commercial not governmental services.
You’ve seen the worse most extreme situations no doubt. I’m more focused on what’s likely more frequently encountered by the cruiser. The cruiser faces some of the same problems as the land visitor to undeveloped countries. There’s a huge list of things beyond immediately life threatening but still life threatening.

 

[Hippocampus]

Might want to look at deaths on the water. Both for number of people involved in the activity, time spent on the water both accidents, need for SAR, and deaths would have one believe protected waters more dangerous than coastal and coastal more dangerous than ocean travel. Can’t find the citation but will post if I do.
Unlike your CG and military experience where you had little choice as to what you might encounter cruisers pick their vessel, pick their time, pick their crew. Crime, drunk drivers, collision and most of the risks for sudden avoidable death don’t exist like on land. As explored here with a modicum of attention weather risks aren’t the big bugaboo some would make out comparing coastal to ocean.

 

[psneeld]

Wow, how little you think I know and have experienced in both pleasure and commercial boating beyond the USCG.. Think long and hard how the 3 add up/compliment each other over 60 years.

 

[Hippocampus]

This is a thread about bluewater. I posted to raise awareness there’s issues beyond the boat. I can cite multiple examples where medivac was needed and either involved governmental service only initially or not at all. More commonly governmental services were not involved or only tangentially to my knowledge.
Medivac insurance vendors offer multiple levels of coverage and support. It isn’t cheap. Especially for the higher levels that include support mid ocean. Unfortunately some who only have domestic coastal experience don’t fully consider the outliers and other concerns of international travel.
I have never had personal SARs rescue and hope that remains the case. Fortunately I think that need is rare. But as said above I’m aware of multiple incidents where subacute medical and surgical events did require evacuation to tertiary centers or home country.also the acute stabilization has occurred but further care is needed. I think those occurrences are more common than one would think. I also think remote consultation services via satellite can be extremely helpful.
I have never demeaned your extensive experience and expertise and greatly appreciate your prior service. But my experience and knowledge about blue water cruising and potential pitfalls is quite different apparently. Believe common things are common and we are discussing two fairly uncommon things. In my circle I know no one who has utilized SAR. I do know of utilization of commercial medivac services being used.
I just wanted to point out then when people consider blue water cruising beyond epirbs, satphones and such they should consider access to mid ocean support and medivac via non governmental agencies. I don’t understand what if anything this has to do with your experience in SAR.

 

[Hippocampus]

Some how posting with you often degenerates to your being hostile. Have no interest in this. Am interested in sharing to the gentle readers on this site.
Most people here are from North America. Think their interest in blue water likely involves eastern Caribbean or western Mexico. Bahamas isn’t part of the Caribbean and getting there doesn’t involve a prolonged bluewater passage. Some maybe considering South Pacific or farther afield.
In all these places SAR maybe limited. Not infrequently staffed by volunteers. Yes USCG has an extensive and highly skilled position out of PR. But their expertise is often not required or only takes you so far.
Examples
Persistent new onset diarrhea. Divert to Bermuda and flown home. Dx. UC(ulcerative colitis).
Burns while cooking. Divert to PR instead of BVI. Flown to Miami burn center. Received pain meds, cleansing, silver and dressings until landfall.
Ankle fracture and rib fractures. Pain meds on board then local setting. Then transport to home based tertiary orthopedic center for surgery and rehab.
Acquired wound (splincter on posterior thigh). Given P.O antibiotics but inadequate. Flown home immediately admitted and brought to surgery. Wide wound excision then ICU care for sepsis.
New onset poly arthritis and fever. Taken off watch. Given NSAIDs with partial benefit. Non aambulatory . Again diversion and flown home. New onset autoimmune disease.
Single seizure with full recovery. No diversion. Needed MRI/A, EEG monitoring. Not available locally. Found to have small embolic stroke of cardiac source. Anticonvulsants not required. Cardiac ablation instead and anticoagulant for awhile.
Can continue to cite possible events that may occur to the average cruiser not involving governmental agencies but where medivac insurance services were helpful in coordinating transport and care. Most long range cruising folks have made their money and raised their kids so are over 40
So for the average Joe/Jill think it’s wonderful SAR is available but think medivac is more likely needed for things not needing that level of intensity. That is and was my only point. Please don’t make this about you and your annoyance of me.