In more than 95% of mariners, seasickness can be prevented or treated effectively.  The old ‘sealegs’ usually steady to the ships rhythm within 72 hrs.  However, it can be incapacitating and dangerous to the point of impairing ability to run the ship, if not assessed and treated correctly.  Once established seasickness is the problem and with frequent reassessment, a course of action can be implemented which in most cases will mange the problem.

What causes seasickness?

The inner ear manages balance and comprises of a concentrated bundle of nerves that sense movement.  Movement messages are transmitted to the brain to gauge balance.  Increased movement and ‘swaying’ can agitate the nerves and bombard and overwhelm the brain with conflicting messages which stimulates the seasickness cascade.  Additionally, stimuli such as smells, tastes, cold, anxiety and fear can exacerbate the message mechanism.

Signs & Symptoms

Stomach – Loss of appetite, fullness of stomach, nausea, vomiting

Brain – Paleness & sweating, dizziness & drowsiness, headache, malaise, dry mouth or increase in saliva

Assessments

A structured assessment and support involve:

• Designating responsibilities to non-sick crew to keep a regular eye on the sick crew, provide support and cover duties
• Treatment of nausea – oral anti-seasickness meds, stay hydrated
• Initial treatment for vomiting and on-going treatment for 12-14 hr, 24-72 hr and more than 72 hrs. Have a bucket ready and/or ensure individuals are clipped in and harnessed if being sick over the side. Long term vomiting past 72 hours could result in a serious medical condition requiring potential evacuation.  Most likely injectable ant seasickness meds and fluid rehydration will be required

Its most important to get medical advice early and regularly.

Prevention – Some common-sense tips

• Start seasickness remedies 12-24 hours before embarking.
• Stay busy but do not do chart work, go below, cook or navigate.
• Stay in fresh air and fix gaze on land, clouds, stars or the horizon. This provides a stable reference point which helps maintain the head in a ‘still’ position and minimises or reduces movement thereby reducing a constant flow of messages to the brain.
• Keep hydrated (small sips pf water) and avoid heavy meals and alcohol.
• Dress appropriately, preferably more clothing than less.
• Sleep onboard the night before departure and get plenty of rest.

Treatments & medications

Of the medication options some work better than others for the individual and so each person will have their own preference.

The most common medications are listed below.  Start from the top until you find an option that works best for you.

• Cinnarizine tabs – Essentially an antihistamine and with no sedative effect
• Domperidone tabs – Antidopamine (peripheral), Non-sedating and well tolerated
• Prochlorperazine buccal tabs – Antidopamine (central), these tabs melt under the tongue and acts as an anti-emetic (to prevent vomiting). May have a mild sedative effect.
• Hyoscine hydrobromide tabs or patches – Anticholinergic, Sedative effect. The patches (also known as scopaderm patches) will result in blurred vision and dilated pupils so not recommended when on Watch
• Cyclizine Inj – Antihistamine, slight sedation
• Promethazine inj – Antihistamine, heavy sedation

For dosages, it is essential to consult a physician in particular if you are taking other prescription medications.

Alternative treatments

• Seabands that work on an acupuncture point on the wrists

• Ginger root

• A pair of glasses called the Boarding Glasses

How they work – They are described as ‘creating an artificial horizon in the periphery of the Visual field, using a blue liquid in the glasses frame without disturbing the central vision. The eyes have thus again access to the reality of the movement, the sensory conflict disappears instantaneously and the sickness of the transports fades in a few minutes. They seem to be highly rated but I should warn you they are not a sexy fashion item.

Safe Passage and Following Seas to the Caribbean-bound yachts this winter.

 

Medical Support OffShore (MSOS)

By Nick Stael Von Holstein

nick@msos.org.uk

www.msos.org.uk