Managing a Suspected Heart Attack Onboard a Superyacht – The Emergency Management Plan Every Crew Should Know

What happens when a guest suffers a suspected heart attack onboard your yacht, hundreds of miles from the nearest hospital?

This is one of the most serious medical emergencies a superyacht crew can face. Your team’s response in the first few minutes will determine the outcome—whether the guest survives, deteriorates, or goes into cardiac arrest.

In this post, I’ll walk you through a clear, professional Emergency Management Plan (EMP) for handling a heart attack onboard—designed for superyacht crews operating in remote, high-stakes environments.

1. Scene Safety & Situation Control

Action:

• Secure the area—remove bystanders, check for hazards

• Assign crew roles immediately: first aid lead, communicator, support

• Keep the deck clear for potential CPR

Why:

Managing the scene prevents panic, reduces risks to the casualty and crew, and ensures a focused, structured response.

2. Initial Casualty Assessment (DRCABC)

Action:

• Danger: Ensure the scene is safe

• Response: Assess level of consciousness (AVPU scale)

• Airway: Is it clear?

• Breathing: Check if the casualty is breathing normally

• Circulation: Look for signs of shock (pale, clammy skin, weak pulse)

Why:

A rapid assessment tells you if the casualty is still responsive or has already gone into cardiac arrest. It also prevents you from missing early signs of deterioration.

3. Identify the Signs of a Heart Attack

What to Look For:

• Chest pain or discomfort (tightness, pressure, squeezing)

• Pain radiating to jaw, neck, arms

• Shortness of breath, nausea, sweating

• Pale or grey skin tone

• Anxiety, sense of impending doom

Why:

Early recognition buys you time to treat and possibly prevent cardiac arrest. Some guests—especially men—minimize symptoms. Stay alert.

4. Immediate First Aid Treatment

Action:

• Call for the medical kit and AED immediately

• Give 300mg aspirin (if conscious and not allergic) – have them chew slowly

• Apply high-flow oxygen (15L/min) if available

• Position the guest half-sitting to ease strain on the heart

• Monitor oxygen saturation, breathing, and pulse continuously

Why:

Aspirin reduces clot formation. Oxygen reduces the workload on the heart. Positioning keeps the casualty comfortable and improves oxygenation.

5. Send for Help – Activate Medical Protocols

Action:

• Inform the Captain immediately

• Activate your yacht’s Accident and Medical Management Plan

• Call Telemedicine support (MSOS, THEMIS, MedAire)

• Prepare for possible medevac or diversion

• Record observations, times, and all actions taken

Why:

Time is critical. Getting expert medical advice early ensures you’re following the latest protocols and ready to escalate to evacuation if needed.

6. Prepare for Cardiac Arrest – Be Ready for CPR/AED Use

Action:

• Have the AED ready and place pads per protocol

• Assign CPR roles and clear deck space

• Be prepared for sudden deterioration

Why:

Heart attacks can deteriorate fast. Studies show survival improves drastically if an AED is ready and CPR is initiated without delay.

7. Reassure the Guest – Psychological First Aid Starts Now

Action:

• Speak calmly and explain every action

• Never leave the casualty alone

• Manage the guests/family on scene sensitively

Why:

Fear worsens cardiac workload. A calm, confident crew reassures the casualty and maintains control of the scene.

8. Ongoing Monitoring and Decision-Making

Action:

• Reassess every 5-10 minutes

• Watch for unconsciousness or erratic breathing

• Prepare for onboard care or handover to medical professionals

Why:

Heart attack casualties are unstable. Continuous monitoring ensures you don’t miss the moment they slip into cardiac arrest.

Why This Plan Matters for Superyacht Crews

A suspected heart attack is not just a medical emergency—it’s a leadership challenge.

✔ Early aspirin and oxygen save lives

✔ Preparation for deterioration prevents panic

✔ Telemedicine support aligns with MCA and industry best practice

✔ Psychological support for crew and guests begins in the moment

On a superyacht, you are the frontline medical team.

Your structured response—calm, prepared, and by the book—makes the difference between a guest surviving or becoming a casualty.

Next in this series, we’ll cover:

What happens if the casualty goes into cardiac arrest? Performing CPR, AED use, and handling death onboard.