Game Changer

Our location in the Caribbean, on the north-central coast of Panama

Two doctors, a firefighter, three tanks of pure oxygen, a defibrillator, and a team of fellow cruisers doing non-stop CPR couldn’t save him. What happened in our anchorage recently, in the San Blas islands off the Panamanian coast, only a few boat lengths away from ¡Pura Vida!, was a sadly enlightening experience for us.

One of the biggest fears among liveaboard sailors is medical emergencies. Many of us are in isolated anchorages with no hospital, or even clinic, within fifty or more miles.

It would first take us hours to sail to the nearest town on the mainland. A ride to the city would take hours more.

Even those near more densely populated islands, where services do exist, might find that those services are rudimentary or that accessing them from a boat at anchor is close to impossible. We are at the mercy of whatever the local population can provide. That population might not have a rescue boat or helicopter. It might not even have an ambulance once you’re lucky enough to make it to shore.

We all have well stocked first aid kits, filled with general supplies and medications for cuts, bruises, stings, and infections. Some go further with things like suture kits, epinephrine, nitroglycerin, and tourniquets. However, most of us are woefully unprepared for a true medical emergency. Those of us, especially, who are far removed from even basic medical services, should be ready to fend for ourselves. We are now realizing that we have not been ready.

We’ve always carried pure oxygen in case of a dive related injury, aware that it may not be us in need of it. Whether it’s for our benefit or for other cruisers, we know that we need even more equipment onboard to help keep us alive in an emergency.

Our oxygen kit is about the size of a small, carry-on suitcase

Neither of us on ¡Pura Vida! has medical training beyond CPR and PADI Rescue Diver certification, so I am in no way offering medical advice, but this is what we plan to have onboard as soon as we have access to it. There is no guarantee that any of this will save lives, but having these items certainly won’t hurt. Of course, even basic training in first aid and CPR is recommended, but without it, or if a medical professional is not nearby, even someone without training can learn to utilize the following:

We already have a kit containing two easily transportable, D-sized tanks (5lbs each, when empty). In the case of a dive injury, the first line of defense is oxygen.

Of course, it’s prescribed for all manner of emergencies, so having oxygen onboard is a good idea for everyone. The drawback is they are quickly depleted. Our two tanks, in constant flow, last only about 30 minutes. However, that 30 minutes could be enough for resuscitation. Having them filled is not always an easy task, so once they’re emptied it may be some time before we can find a refill station.

Defibrillator (AED)
Personally knowing three cruisers in the past year who have suffered from heart problems onboard has convinced us that we need one of these handy.

A tiny automatic external defibrillator like this packs a surprising punch.

They are compact and foolproof, walking the user through every step, even alerting you if a shock is not recommended. Employing one at the first sign of cardiac distress could be the difference between life and death.

Airway Kit
Oxygen won’t help if there’s no way to get it into the lungs.

This small collection of hoses might be the key in keeping someone breathing, especially if the patient suffered an allergic reaction that has closed the airway.

(To any medical professionals among our readers: If you have suggestions of other equipment you believe we should have onboard, please feel free to recommend them.)

Other Lessons Learned
Do not hesitate to regard your situation as an urgent medical emergency. Do not wait to ask for assistance from nearby boats. Declare a mayday if you believe a person’s life is in danger. We will drop everything to come to each other’s aid when asked. And no one will mind if it turns out to be less serious than originally considered. We all want the best for our fellow sailors.

Know your location, and the correct name and pronunciation of the nearest island. Know your exact coordinates! Write them down when you drop anchor, or have a device (e.g., VHF radio, cell phone app, chart plotter) from where you can quickly retrieve these numbers to relay them to emergency personnel.

Determine the local emergency number in every locale. In Panama and the San Blas islands it’s 911. These numbers tend to work on any cell phone network, even if your SIM card is not from the local provider. It was using this method that contact was finally made in English and Spanish with local authorities when attempts via VHF failed.

If you have an emergency communication device, such as a satellite phone or Garmin inReach, keep it charged at all times. The distress button on such devices may be your best option for a rescue.

This model inReach has proved reliable since 2015. They have since been updated.

Consider purchasing evacuation coverage. We currently have membership in DAN (Divers Alert Network), which offers coordination of emergency airlift within the Caribbean for residents of the U.S. and Canada. However, this may no longer be valid for us in our current situation as full-time liveaboards. There are other options which we will be exploring.

Take a wireless, handheld VHF radio with you at all times and keep it powered on. The wife of the man in distress had tried repeatedly to reach another cruiser, a doctor, on land, to no avail. We seldom take our radio ashore, but will start doing so now.

Despite the sorrowful outcome of the events that recently occurred in our anchorage, it was uplifting to witness the way the cruising community mobilized to come to the aid of fellow sailors. It seemed that everyone was ready to jump at the chance to offer whatever equipment and/or expertise possible. Support for the man’s wife is ongoing by those who have altered their plans to help her manage her affairs. Money was even collected to help replenish depleted medical supplies.

We have chosen to live in remote areas to enjoy the path less traveled, but this means we must be better prepared. Despite the difficulties we may encounter out here, the camaraderie makes it all worth it in the end.


  1. OMG…Pura Vida!
    Many many thanks for your earnest + urgent-inspiring message!
    We have had our share of medical challenges but are grateful that we haven’t been put to the ultimate test!
    We may be heading your way post-May… hope we can connect!
    Hasta la vista… until then if we converge!

    And – again – thank you for sharing!

    ❤️! Sarah + Rick + High Spirits

    1. Until now our worst emergencies were superficial compared to this. Sadly, it took something of this magnitude to serve as a wake up call. We hope to see y’all again!

  2. Do you have the regular DAN or the DAN boaters? I was going to call them to discuss last time we were in the States and didn’t. Wanted to see if we needed to convert the regular medical policy to the boater policy given our status.

    1. We have regular DAN coverage, which we’ll be canceling since it no longer covers us. We’re looking in to other options now, and will share our findings when we do.

  3. Thanks for sharing, we have been looking into having an AED onboard, didn’t think about Oxygen tanks will look into that too.

  4. I was going to call them to discuss the last time we were in the States and didn’t. I felt like I was riding with you on that scary passage and so glad to hear y’all were never in danger. we do not have much at all, just some first aid.

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