First aid at sea – the complete guide for boaters

Immediate first aid at sea – what to do first

The priority sequence follows ERC Guidelines 2025. For a collapsed, unresponsive person, early alerting and early CPR are what save lives. Do not wait to see how it develops.

1. Make the scene safe. Your own safety first. Stop the boat, engage autopilot or neutral, and consider the propeller, the sea state and any fire or gas hazard before you go to the casualty.
2. Check for response. Speak loudly and shake the shoulders gently. “Are you all right?”
3. No response: shout for help and call 113 immediately. Put the phone on speaker so your hands are free.
4. Send someone for the defibrillator (AED) if one is available on board or in the harbour.
5. Open the airway – head tilt, chin lift – and look, listen and feel for normal breathing for up to 10 seconds.
6. Breathing absent or abnormal, or you are unsure: start CPR now.
7. Control catastrophic bleeding in parallel with hard direct pressure if there are several of you.
8. Distress at sea: send a VHF DSC Distress alert and a Mayday on channel 16 in parallel if there is more than one of you on board.

Sources: ERC Guidelines 2025, Helsenorge, Norwegian Resuscitation Council. Last verified June 2026.

113, VHF or Mayday – which do you use?

Sending a DSC distress alert

On a VHF with DSC: lift the red cover and hold the distress button until the set transmits. The DSC alert sends your MMSI, and normally your position and the time as well, provided the radio has a valid GPS position – either its own receiver or a position fed in over NMEA from the plotter. The radio then switches to channel 16, where you follow up with the voice Mayday. If the radio has no GPS position, give your position verbally on channel 16.

Distress – the vessel or someone on board is in danger

Fire, flooding, grounding, capsize, a man overboard you cannot recover. VHF is the primary channel at sea because the nearest boat is almost always faster than anything coming from shore.

1. Lift the red cover and hold the distress button until the set sends DSC Distress.
2. The radio switches to channel 16 by itself. Then send the voice call below.
3. No answer: repeat. No VHF: call 120 or 112.

Distress – medical emergency on board

With DSC on board, VHF is still the first choice in a medical emergency. The DSC alert sends your MMSI and position to coast radio automatically; the voice call on channel 16 is what the boats around you hear. You need both.

1. Send DSC Distress, then Mayday on channel 16 with your position and what is wrong with the person.
2. If you have mobile coverage, have someone else call 113 in parallel.
3. Start life-saving first aid immediately. If there are several of you, alerting and first aid happen at the same time.
4. Ask coast radio for Medico if you need medical guidance along the way.

No VHF – call 113

113 is the medical emergency number. It dispatches an ambulance or air ambulance, alerts the rescue coordination centre when needed, and talks you through the first aid while help is on its way.

1. Call 113. Put the phone on speaker so both hands are free.
2. Say first that you are calling from a boat, and give your position: degrees and decimal minutes from the plotter or phone, or a place name and distance from a known point.
3. Give the boat name, the number on board, and where you can be met: quay, beach or at sea.
4. Do what the operator says, and do not hang up until you are told to.

Without VHF you also reach the rescue coordination centre on 120 or 112. A handheld VHF with DSC is the cheapest improvement you can make to your emergency preparedness on board.

Neither DSC nor coverage – use what you have

Without DSC and without coverage you depend on being seen or heard. Start life-saving first aid, and get someone else to raise the alarm.

1. VHF without DSC: call other boats on channel 16.
2. Use distress signals: red handheld flares, parachute rocket, smoke, a mirror, a torch, sound signals.
3. Head for land or towards other traffic if the casualty’s condition allows, and call 113 as soon as you have coverage.
4. If you carry an EPIRB or PLB and the situation is life-threatening: activate it.

This scenario is the reason an EPIRB or PLB is recommended for trips outside mobile coverage.

Assistance – nobody is in danger

1. If you need assistance without immediate danger to life – a tow, drifting towards land, someone ill who needs to get ashore – the correct signal is PAN-PAN on channel 16, not Mayday.
2. If you only need practical help, an ordinary call to coast radio on channel 16, or telephone 120, is enough.
3. Coast Radio South: +47 51 69 00 44. Coast Radio North: +47 75 52 89 25.
4. Give your position, boat name, number on board, and what the problem is.
5. Secure the boat while you wait, and keep the VHF on.

Contact details verified against the Joint Rescue Coordination Centre and Radio Medico Norway, September 2026. The state took over the coast radio service from Telenor on 1 January 2026: the Joint Rescue Coordination Centre runs the radio operator service, the Norwegian Coastal Administration owns the technical infrastructure, and the Norwegian Maritime Authority keeps the ship radio register. The content is Sikkerhet Om Bord’s recommendation, not a legal requirement for pleasure craft.

Medical advice at sea: Radio Medico

Coast radio stations keep a continuous listening watch on channel 16 and will connect you to the duty doctor at Radio Medico Norway. The service is free and available around the clock. The Norwegian Maritime Authority states that recreational boaters can also reach a doctor (Medico) directly through the coast radio stations.

1. Call coast radio on channel 16 and ask for Medico. You can also call +47 51 68 36 01 directly, or 120 and ask for Medico.
2. Have the checklist below ready before you call. The doctor needs numbers, not impressions.
3. If the patient also needs assistance – a tow or transport ashore – without immediate danger to life, the correct signal is PAN-PAN on channel 16. A call purely for medical advice is an ordinary call. If the condition is life-threatening it is Mayday, not PAN-PAN.
4. If the condition worsens: escalate to DSC Distress or Mayday, or call 113.

What to say: the ISBAR checklist

The structure follows ISBAR, the established format for verbal patient handover in Norwegian healthcare. Radio Medico Norway is run by the Norwegian Centre for Maritime and Diving Medicine at Haukeland University Hospital and is relayed through the coast radio stations. The checklist itself is Sikkerhet Om Bord’s recommendation.

CPR in cardiac arrest and drowning

1. Confirm cardiac arrest: no response and no normal breathing. A pulse check is not required of lay rescuers.
2. Call 113 on speaker and send someone for the defibrillator.
3. Place your hands in the centre of the chest, arms straight, and compress 5–6 cm at 100–120 per minute.
4. After 30 compressions: give 2 rescue breaths if you can and are willing. Continue 30:2. For a child, a trained rescuer uses 15:2 after 5 initial breaths.
5. Switch the defibrillator on as soon as it arrives and follow the voice prompts. Continue CPR until the AED says to stand clear.
6. Swap the person doing compressions roughly every 2 minutes so quality does not fall off.

Survival falls significantly for every minute without CPR and defibrillation. Good CPR with early AED use is the most important thing you can do while waiting for rescue.

Sources: ERC Guidelines 2025, Norwegian Resuscitation Council, Helsenorge. Last verified June 2026.

Choking and airway obstruction

1. If the person can cough: let them cough. It is the most effective way to clear the airway.
2. Ineffective cough but still conscious: bend them forward and give 5 firm back blows between the shoulder blades with the flat of your hand.
3. No effect: give 5 abdominal thrusts – arms around the abdomen, fist between navel and breastbone, pull inwards and upwards.
4. Alternate 5 back blows and 5 abdominal thrusts until the airway is clear or help arrives.
5. If the person becomes unconscious: lower them to the deck, call 113 and start CPR.

Anyone who has had a choking episode treated with abdominal thrusts should be assessed by a doctor afterwards.

Sources: Helsenorge, ERC Guidelines 2025, Norwegian Resuscitation Council. Last verified June 2026.

Drowning and non-fatal drowning

1. Your own safety first. Reach out, throw a line or a lifebuoy, or use the boat. Avoid going in yourself.
2. Get the person quickly and safely out of the water. Keep the body as horizontal as you can during recovery if they have been in cold water for a while.
3. Check response and normal breathing.
4. No or abnormal breathing: give 5 initial rescue breaths, then CPR 30:2.
5. Alert 113 and/or VHF DSC / Mayday for a serious incident.
6. Keep the person warm – hypothermia often follows drowning and complicates the assessment.

Sources: ERC Guidelines 2025, Helsenorge. Last verified June 2026.

Major bleeding and tourniquets

1. Direct pressure straight on the bleeding with your hand and a dressing or cloth. Press hard and do not let go.
2. Apply a pressure bandage and maintain the pressure. Lay the casualty down.
3. For life-threatening bleeding from an arm or leg where direct pressure does not stop it, or for amputation: use a prefabricated windlass tourniquet.
4. Place it 5–7 cm above the wound, not over a joint. Tighten until the bleeding stops. Note the time. Do not loosen it.
5. Alert 113 or VHF. Keep the casualty warm – shock and cooling are both risks.

• An improvised tourniquet is a last resort, not a standard recommendation.
• Pressure points in the groin or armpit are no longer recommended.

Sources: ERC Guidelines 2025, Norwegian Resuscitation Council / Norwegian First Aid Council. Last verified June 2026.

Burns on board

1. Stop the burning process and move the person away from the heat source.
2. Cool with running, lukewarm water (about 20 °C) for 20 minutes. Use lukewarm water on children.
3. Remove jewellery and clothing that is not stuck. Do not pull away material that has burned onto the skin.
4. Cover with a clean, non-fluffy dressing or a suitable burn dressing.
5. Keep the rest of the body warm so the casualty does not cool down while you cool the burn.

• Do not use ice or ice-cold water.
• Do not apply fat, toothpaste or similar to a burn.
• Do not burst blisters.

Seek medical help for large or deep burns, burns to the face, airway, hands or groin, or any burn to a child.

Sources: Helsenorge. Last verified June 2026.

Hypothermia and cold-water immersion

• Get the person out of the water and wind and into shelter. Handle gently – sudden movement can trigger a dangerous heart rhythm.
• If you have dry, insulating material: cut the wet clothing away quickly, systematically and with as little movement as possible, and wrap them immediately – including over the head.
• If you do not: leave the clothes on and wrap the person in vapour-tight material (plastic, a tarpaulin) with blankets outside. Undressing someone without shelter and a dry alternative adds heat loss.
• Always something between the person and the deck. A wool blanket, a sleeping mat or a sail bag. A cold, wet deck pulls heat out of someone whose clothes are completely dry.
• Add heat to the chest, armpits and back: heat packs, a hot water bottle, body heat. Warm, sugary drinks for anyone awake who can swallow safely – it adds little heat, but it keeps the blood sugar up, and shivering is the body’s own heat production. No alcohol.
• Keep the person horizontal in severe hypothermia.
• Unconscious or not breathing normally: start CPR and alert 113 or VHF.

• Do not massage the arms and legs.
• Do not give alcohol.
• Do not rewarm too fast with strong, local heat.

Why horizontal recovery matters

Collapse during and just after rescue is a recognised phenomenon – circum-rescue collapse. After a long time in cold water the body has drawn blood in towards the core, and the water pressure around the legs has helped hold the blood pressure up. Lift the person straight up into a vertical position and that hydrostatic support disappears at the moment the heart is cold and vulnerable. The blood pressure can fall sharply, and in the worst case cardiac arrest follows – sometimes only after the person is aboard.

In practice on board: use the bathing platform, a halyard, a strop under the arms and behind the knees, or a tarpaulin as an improvised stretcher. Keep the person horizontal afterwards, avoid sudden movement, and let them lie down – not stand or sit upright – even if they seem alert and well.

The mechanism is described in the cold-water rescue literature (circum-rescue collapse) and in ILS Medical Position Statement 12, and is established practice in the rescue services. ERC 2025 states, for its part, that in-water measures must not delay recovery when resuscitation is needed.

Cooling happens without anyone going in the water

The most common cooling on board does not happen in the sea – it happens on the deck. A cold, wet deck pulls heat out of a person whose clothes are completely dry, and an injured person loses heat faster than an uninjured one: pain, blood loss and shock all reduce the body’s own heat production.

• Insulate underneath, not just on top. A wool blanket, a sleeping mat or a sail bag between the person and the deck – for anyone who ends up lying down, injured or cold, even on a fine summer day.
• Warm, sugary drinks for anyone awake who can swallow. It adds little heat in itself, but it keeps the blood sugar up. Without blood sugar the body cannot shiver, and shivering is its own heat production.
• No alcohol. It creates a feeling of warmth while increasing heat loss.

Sources: ERC Guidelines 2025, Helsenorge. Last verified June 2026.

Carbon monoxide poisoning in a boat

Carbon monoxide is an odourless, colourless gas from combustion – engine, heater, generator and cooker. Symptoms are headache, nausea, dizziness, confusion and unconsciousness, and they are easily mistaken for seasickness or a hangover.

1. Fresh air immediately – out on deck or open up.
2. Shut off the source if it is safe to do so.
3. Evacuate everyone from the affected space.
4. Call 113 if there are symptoms. If unconscious or not breathing normally: start CPR.
5. Do not enter a dangerous atmosphere without protection or fresh air.

Prevention: a CO alarm in a boat should be fitted by the berths and in living spaces, particularly where there is a heater, engine or generator.

Sources: Helsenorge, Norwegian Poisons Information Centre. Last verified June 2026.

Winch, crush and fall injuries

Winches, sheets and halyards cause typical maritime injuries. Crush injuries often cause internal damage even when the skin is intact.

• Stop the force: release the winch or sheet, secure the rig and the boom.
• Bleeding: hard, direct pressure; pressure bandage.
• Fracture or deformity: support and immobilise in a comfortable position, for example with a SAM splint. Do not straighten a deformity.
• Suspected internal injury: keep the casualty still and warm, watch for shock – pale, cold, clammy, rapid pulse – and alert early.

Sources: Helsenorge, Norwegian First Aid Council. Last verified June 2026.

Head injury and concussion

• Keep the head and neck as still as possible if the fall could have injured the neck.
• Control any scalp bleeding with gentle pressure.
• Observe consciousness and breathing closely for the first few hours.
• Unconscious but breathing normally: place in the recovery position with neck control and call 113.
• Any of the warning signs above: call 113. After a head injury the person should not be alone for the first 24 hours.

Sources: Helsenorge. Last verified June 2026.

Chest pain and suspected heart attack

• Call 113 early – do not wait for the pain to pass.
• Let the person sit or half-lie still and avoid all exertion.
• Loosen tight clothing and reassure them.
• Aspirin may be appropriate – give it only after agreeing it with 113, and not in known allergy or bleeding.
• If unconscious or not breathing normally: start CPR and fetch the defibrillator.

Sources: Helsenorge, ERC Guidelines 2025. Last verified June 2026.

Stroke – speak, smile, lift

• SPEAK: ask them to say a simple sentence – is the speech slurred or unclear?
• SMILE: ask them to smile or show their teeth – is the face uneven?
• LIFT: ask them to lift both arms – does one drift down?

Other signs: sudden numbness down one side, visual disturbance, severe headache or loss of balance. Note the time the symptoms started – it matters for the treatment. Call 113 even if the symptoms pass.

Sources: Helsenorge. Last verified June 2026.

Anaphylaxis and severe allergic reaction

• Suspect anaphylaxis with rapid onset of breathing difficulty, swelling, widespread rash or circulatory collapse after food, an insect sting or medication.
• If the person has their own auto-injector: help them use it immediately in the outer thigh. It can be given through thin clothing.
• Call 113 and say you suspect anaphylaxis. Follow their instructions – if 113 asks you to use an available auto-injector, do it.
• Lay the person flat with the legs raised; if breathing is difficult the upper body can be raised slightly. Do not let them stand up suddenly.
• No improvement after 5–10 minutes and another auto-injector available: give a second dose on instruction. If unconscious or not breathing normally: start CPR.

Sources: Helsenorge, ERC Guidelines 2025. Last verified June 2026.

Seizures and epilepsy

• Move dangerous objects away, put something soft under the head, and loosen tight clothing around the neck.
• Do not hold the person down and do not put anything in their mouth.
• Time the seizure.
• When the convulsions stop: check breathing and place them in the recovery position.
• Call 113 for a seizure over 5 minutes, a new seizure without waking in between, injury, a seizure in or near water, or a first known seizure.

Sources: Helsenorge. Last verified June 2026.

Low blood sugar (hypoglycaemia)

• Suspect low blood sugar with sudden confusion, shaking, cold sweat or aggressive, “drunk” behaviour.
• Awake and able to swallow: give fast sugar (juice, glucose tablets, honey), repeat after 10–15 minutes if needed, then something slower to eat.
• Unconscious: no food or drink. Recovery position and call 113.
• No improvement, or you are unsure of the cause: call 113.

Why it is easy to miss at sea

Low blood sugar, cooling, seasickness and intoxication look strikingly alike: confusion, shaking, cold sweat, unusual or aggressive behaviour. On board they often arrive together – the seasick crew member does not eat, brings back up what they did get down, and stands out in the wind on deck. If you have someone with diabetes on board, it is worth knowing whether they have eaten, and when.

Sources: Helsenorge. Last verified June 2026.

Eye injury and chemical splash

• Irrigate immediately with clean, lukewarm water or eye wash – hold the eye open and flush from the nose side outwards for at least 15–20 minutes.
• Remove contact lenses if you can.
• Contact the Poisons Information Centre (+47 22 59 13 00) for chemicals, and a doctor for persistent problems.
• Embedded foreign body or penetrating injury: do not rub, do not remove. Cover both eyes loosely – the eyes move together – and seek medical help or call 113.

Sources: Helsenorge, Norwegian Poisons Information Centre. Last verified June 2026.

Electric shock and shore power

• Make the scene safe: switch off shore power, the main switch or the breaker, or pull the plug. Do not touch the person until the current is off.
• Check response and normal breathing. If unconscious or not breathing normally: call 113 and start CPR, using the AED.
• Cool any burns at the entry and exit wounds with water and cover them.
• Even if the person seems unhurt: seek medical assessment – current through the body can cause heart rhythm disturbances afterwards.

Sources: Helsenorge. Last verified June 2026.

Adder, weever fish, ticks and jellyfish

Adder bite

• Stay calm and move as little as possible – activity spreads the venom faster. Let the casualty be carried, not walk.
• Call 113 for serious symptoms such as vomiting, dizziness, fainting, breathing problems or rapidly increasing swelling.
• Contact the Poisons Information Centre or a doctor for assessment of any adder bite, with a low threshold for children, the elderly, pregnant women, anyone in poor general condition, or a bite to the head or neck.
• Do not cut the bite.
• Do not suck out venom.
• Do not apply a constricting band.

Weever fish sting

The venom is broken down by heat. Immerse the stung area in hot water at about 40–45 °C – as hot as the person can tolerate without scalding. Check the temperature with an unaffected part of the body first to avoid scalding, particularly on children. Treatment often takes 30–45 minutes, occasionally up to 90 minutes, or until the pain clearly subsides. Remove any visible spine fragments, clean the wound, and contact the Poisons Information Centre or a doctor for severe or persistent pain, signs of infection, or reduced general condition.

Jellyfish

• Rinse the tentacles away with seawater, not fresh water, without rubbing.
• Relieve the pain with hot water at about 40–45 °C until it eases – 10–20 minutes is often enough, but treatment can continue for up to about 30 minutes. Watch for scalding.

Ticks and tick removal

• Remove ticks quickly. The risk of Lyme disease rises markedly once a tick has been attached for more than 12–24 hours.
• Grip the tick close to the skin with tweezers or a tick remover and pull straight out.
• Watch for a spreading red ring or rash, fever and general illness in the weeks afterwards – see a doctor if symptoms appear.
• TBE vaccination is worth considering for anyone who is bitten often in known risk areas, particularly along the coast of southern Norway. Weigh it against current advice from the public health authorities or your doctor if you spend a lot of time in vegetation on islands and coastal rock. There is a vaccine against TBE, but not against Lyme disease.

Sources: Norwegian Poisons Information Centre, Helsenorge, Norwegian Institute of Public Health. Last verified June 2026.

First aid for children and infants

• CPR in children: 5 initial rescue breaths, then 30:2 for lay rescuers – 15:2 for trained rescuers – at 100–120 per minute, compressing about one third of the chest depth.
• Infants under 1 year: two fingers on the chest; for choking use back blows and chest thrusts, not abdominal thrusts.
• Adrenaline auto-injector (the child’s own): help them use their own pen on instruction from 113 – 150 µg for children 15–30 kg, 300 µg above 30 kg.
• Burns and fever: children cool down more easily – use lukewarm water and keep the rest of the body warm.
• Have a low threshold for calling 113 – children can deteriorate quickly.

Sources: ERC Guidelines 2025, Norwegian Resuscitation Council, Helsenorge. Last verified June 2026.

What belongs in a boat first-aid kit

A good maritime first-aid kit covers bleeding, burns, cooling and wound care, and survives damp and salt. Choose the level according to where you go and how far you are from help.

Separate the three things: the acute measure (what you do), the equipment (what you carry) and the prevention (what you plan). Equipment has to be combined with training, practice and correct distress alerting.

Recommended equipment by boat type

Equipment alone does not make a boat safe, and it does not replace training. The right approach is to combine knowledge, practice and proper distress alerting with equipment that suits the trips you actually make.

Relevant equipment from Sikkerhet Om Bord

Remember: equipment has to be combined with training, practice and correct distress alerting. No product makes a boat safe on its own.

Sources and editorial basis

The content has been checked against recognised professional sources. Sources last verified June 2026.

Frequently asked questions