USK Course of Action Scenario Response(s)
April 2006
"Seasick Paddler"

One of your group members during an eight-mile day tour gets seasick at mile three. There are eight on the tour. The conditions are good with slight rolling seas. What is your course of action?

Considerations & actions from Wayne Horodowich:

Givens from the scenario being presented:

One member gets seasick
You are in a group of eight
Mile three of an eight-mile day tour
Good conditions
Slight rolling seas

Considerations for each given:

One member gets seasick
Seasickness usually goes from bad to worse
A seasick paddler can get incapacitated and unable to stay upright
Danger of capsizing while vomiting
Possibility of aspiration of vomit
Others sometimes get sick when they see some else vomit

You are in a group of eight
You have a number of people to possibly help
There could be a chance that others could get sick

Mile three of an eight-mile day tour
You are, at most, three miles to a take out point
The seasick paddler may be on the water for, at most, an hour more
Mile three may be near the planned lunch spot

Good conditions
Allows us more options

Slight rolling seas
Rolling seas will only enhance the illness
Rolling seas can get more of the group sick

General considerations not mentioned:

Were medications taken for prevention?
Is there any other complicating illnesses/injuries?

Things to know about seasickness

I have to admit I am an expert at being seasick. For the ten plus years I taught Scuba diving I was sick on every trip out on the boat to the Channel Islands off of Santa Barbara (I went out at least three times a month.) When I started kayaking along the SB coast I was sick on every trip for 6 months. I went out a few times a week. Due to my desire to pursue these sports I learned to endure. I also learned a lot about being sick.

Those who have experienced seasickness can tell you they just want to die and be put out of their misery. Once they get sick the game is over. It takes incredible fortitude to continue when you are sick. I have not found a reliable medication that helps once someone is sick.
I have observed in others and experienced myself a temporary feeling of relief once I vomited. However, if I was till on the moving boat the feeling came back with a vengeance. I also learned that the need to vomit will continue even if there is nothing left in the stomach. Therefore I trained myself to drink water after I vomited so I would have something to get rid of instead of the all too painful "dry heaves." In addition it is good to try to stay hydrated when expelling liquid. From my experience "dry heaves" are very violent to the body. Having water in the stomach has helped me even though it is difficult to ingest anything while feeling sick. I look at drinking water as the lesser of two evils when seasick.

During this temporary relief time, I found it beneficial to get the victim to shore as quickly as possible. Since they think they are feeling better they will be able to paddle. Don’t be fooled that they are OK. In all of the cases of seasickness I have experienced in teaching kayaking, no one got better while on the water. The best case was some queasy ones were able to keep from getting totally sick by constantly scanning the horizon and constantly moving. In addition they found it helpful if they stayed cool by regularly splashing water on their face.

I also learned that you need to teach someone where to throw up when in a kayak. When we would spot someone turning "green" we would go over and ask him or her how he or she was doing. We would establish how bad off they were. If they needed support or a tow we would do it. We told them if they had to vomit to do it on their spray skirt and NOT lean over the side unless someone was stabilizing them. If someone leans over and capsizes while vomiting we run into another problem. Since the regurgitation process is a spastic-like contraction of many muscles there is no breathing going on while expelling. The first thing most of us do after vomiting is inhale. I would hate for that inhalation to happen while the seasick person was underwater due to a capsize as a result of leaning over to vomit. If the seasick person gets sick on their spray skirt they can easily wash it off.

In addition to the physical effects we need to address the emotional aspects of seasickness. Many are too embarrassed to say anything until it is too late. If caught early, perhaps they could be helped before they were fully sick. Once sick there is little regard for anything. If they experience that temporary relief they will try to convince you they can continue. As I mentioned earlier, they should get on solid ground.
The best approach to seasickness is prevention. One can try over the counter medications or prescription medications but both have a tendency cause drowsiness. The are also pressure bracelets for the wrist. Some folks respond to keeping a small piece of Ginger in their mouth. The seasick medications need to be taken before getting on the water (follow the recommended times that come with the medications.)
I am not a big fan of dispensing medications. If you decide to give out medications you better know what the victim is also taking and how the medications will interact.

When I have novices on the water, who don’t yet know if they are prone to seasickness, I try to keep them moving and watching the horizon if there are rolling seas. We also have early bail out plans for seasick paddlers.

For those who always get sick here is hopeful ending with my problem of constantly being sick. I thought I would never get what is commonly referred to as "sea legs." After those six months of paddling and getting sick, my seasickness stopped coming. My body got accustomed to the motion. However, even after getting my sea legs I had a few instances where I became queasy. The closest to getting sick was a result of trying to fix someone’s foot pedals in rough seas. I had my head in their cockpit with my head tilted to the side. I was fine one minute and then in an instant I felt my old nemesis coming back. I sat up instantly and watched the horizon. I had someone else fix the pedals. I was on the edge for the rest of the day. Drinking water, splashing water on my face, watching the horizon and moving kept me from full sickness. I believe if you want it bad enough you will get your sea legs. The medications didn’t work with me.

Course(s) of Action for the seasick paddler scenario:

After my experiences with seasickness this is what I would do. I would find out how bad off the seasick paddler is at the moment. Have they vomited? Can they paddle? Are they too dizzy?

I would have someone with a strong stomach stabilize the seasick paddler, in such a position, so they didn’t have to watch the process, just in case. With the rest of the group (out or ear shot of the sick paddler) we would decide where the best take out point is along the way. As a side note, this should have already been done by the more experienced in the group at home before the trip hit the water. Then the big decision is whether the group stays together or not. Since one is sick it could be a good excuse for others who may be on the edge to get out too.

Many people prefer not to vomit in public. They will do anything to hold it in. Knowing there is a temporary relief after vomiting I try to encourage the sick paddler to take care of business so they can get some temporary relief.

Since the conditions are good we have the option of splitting the group. In rough conditions I want all of my resources with me, if possible. Of course, conditions can change but you can determine the likelihood by observation and weather radio. If it were a short distance to the nearest bail out point, I would take the whole group. After leaving the sick on shore, those that wish to continue can head on their way. As mentioned above, mile three may be near the planned lunch spot or rest stop. If the group stayed together shuttles and splitting up matters can be discussed on the beach rather than on the water, thus minimizing the time the sick paddler had to stay on the rolling seas.

If the person is sick and cannot paddle they need to be towed. I recommend a rafted tow. The number of people towing the two-person raft is up to the group and its resources (tow ropes and towing experience.) If there were only two of you, a contact tow would be your solution.
Since moving forward and watching the horizon are very helpful in preventing the onset of seasickness, I have had queasy paddlers paddle around the group (and watch the horizon) during breaks when we had rolling seas. Deck mounted compasses keep you from looking down on your lap. When using a deck mounted compass watch the horizon and only do a quick glance down at the compass to maintain your heading.

Suggestions to avoid the situation:

You cannot prevent seasickness on all trips
Seasoned paddlers will know if they are prone to it and will usually have their preferred methods of prevention
Raise the thought of prevention on a novice trip in the advertising
Juice and coffee for breakfast does not help the situation
Movement and watching the horizon help prevent the onset
Deck mounted compasses are better than looking down at one on your lap
If it is a compass run switch the lead regularly

Lessons learned:

People do get sick on the ocean so be prepared
Have planned bail out points
Don’t let someone capsize while vomiting
Educate to vomit on the spray skirt
Once they are sick they need to be off the water
A rafted tow is highly likely if very sick (have tow ropes)
Seasickness occurs more often with novice paddlers
Keep the seasick victim well hydrated
People will not usually admit they are sick until they are sick
Encourage paddlers to speak up when they first feel queasy


Response(s) from our readers:

Gary from California writes:

Beyond the facts as given, I'll further assume that the party of 8 are somewhat consistent and proficient in their abilities. If so, the group can focus on resolving the sick paddler situation without having the additional concerns of shepherding one or more weak paddlers.  Although it isn't stated, perhaps you're lucky and there is a double in the group. Perhaps you are doubly lucky (as I was on one open crossing) and the sick paddler is in the double with a strong partner. If not, the group might consider an on-water transfer to get the sick paddler into the double with a strong partner. If instead the group is in 8 singles, it's time to break out tow lines. This is one of many reasons for having tow lines (plural) along in a group. A discussion of different towing configurations could go on and on, but with a group of this size I would suggest 2 paddlers towing in tandem configuration and a third paddler alongside the debilitated paddler to stabilize him and offer moral support. This will share the towing load and keep the sick paddler from capsizing, assuming he is significantly ill. I would also suggest that the stabilizing paddler be someone not susceptible to "sympathy" sickness. That person may be treated to the sick paddler repeatedly giving vent to his nausea in close quarters.  That is not the place for someone with a delicate stomach. The group doesn't need a second sick paddler.  

Assuming the group has stabilized the stricken paddler and rigged the tow, two questions remain:  (1) split the group or stay together, and (2) turn back or continue. In a "leaderless" group, both questions should be group decisions with consideration given to the sick friend. Although there are 8 paddlers present and the group could be split and still provide adequate support for the ill paddler in the favorable sea & weather conditions, my vote would be to err on the side of caution and stay together. If the sea conditions hold, that's a good thing. If things were to begin to deteriorate, towing a sick paddler at least 3 miles could turn into a Batan death march of a paddle. Staying together will also allow rotating the towing paddlers for fresher people.  As to continuing or turning back, this should also be decided with consideration for the sick paddler. Be aware that he may try to minimize his misery and "gut it out" for the sake of his friends continuing. Evaluate his input carefully. On the other hand he may be praying to get off the water as soon as humanly possible. Those people who have never experienced sea sickness can't fully relate. There is no feeling quite so miserable. One person described his seasick experience to me as first thinking he was going to die, then he was afraid he wouldn't. Since the scenario specified this being a day paddle and not a crossing or first leg of a multi-day trip, and if the group cannot land to give the sick paddler quick relief, my vote would be to turn back. Even so, that still yields a 6-mile paddle with some practice in towing and incident management thrown in. After landing, some of the group members may elect to paddle some more after their friend is safely recovering on shore.


Steve from California writes:

My course of action in this month's scenario would be to first get out my first aid kit (it's always in my day hatch), and ask my sick companion if he wanted any anti-nausea medication.

If that worked and he felt like continuing, we would. If not, I would gather the group and ask for a couple of spare paddles and paddle floats. I would then rig up an outrigger so we could tow the incapacitated paddler without fear of capsize.

If that didn't work, I would have another paddler raft up with him and we would tow both people back to the launch point.

Seasickness rarely goes away by itself and can be totally incapacitating. I wouldn't risk making a bad situation worse by ignoring it.


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