The Triton


Your first aid skills only diagnose in regards to appendicitis


Last month, I was on break, teaching a night class for pharmacy students, when my telephone rang. It was my father and he was calling me from his cell phone. I immediately knew something was wrong; my dad never uses his cell phone.

He informed me my mother’s appendix had burst, that she was in the hospital and that she would require emergency surgery. After class, I rushed to the hospital to be by my mother’s side. I am happy to report, after two weeks, my mom’s condition has improved greatly and she is slowly returning to normal.

Appendicitis is the inflammation of the appendix and is a true medical emergency. Practically, the only treatment is the surgical removal of the four-inch organ, which dangles off the beginning of the large intestine.

The medical community agrees that the appendix can be removed without causing any adverse health consequences but its function is unclear. Some theories indicate that it is part of our immune system in childhood.

Another theory is that the appendix is a vestigial organ, one that was useful to our ancestors who ate different foods and needed it to aid in digestion, but which is now nearly useless.

If an inflamed appendix is not removed, it will perforate or burst, causing infectious waste to spill into the body’s abdominal cavity resulting in peritonitis.

Peritonitis is the inflammation of the peritoneum, the layer of cells lining the inner wall of the abdomen and pelvis. Left untreated, appendicitis and peritonitis are often fatal.

My mother was lucky. She lives close to a hospital and, within hours, a qualified surgeon was removing her appendix. Now, imagine you are onboard a yacht and either you, one of your crew, or a guest is having severe abdominal pain. How far are you from qualified medical care? If left untreated, appendicitis can be serious, even deadly.

The first thing to know is that anyone can develop appendicitis. It mostly strikes people between the ages of 10 and 30. But, as in my mother’s case, it can also strike people in their late 60s.

The Mayo Clinic lists the following signs and symptoms of appendicitis. If you or a member of the crew exhibit any of these symptoms, seek medical attention immediately.

Early on, the most common symptom is an aching pain in the torso that moves around a bit.

There may be some nausea and sometimes vomiting, which may persist, despite a loss of appetite.

As the inflammation spreads, the pain may become sharper and more severe. The abdomen may swell a bit.

Eventually, the pain settles in the lower right abdomen near the appendix at what’s known as the McBurney point. This point is about halfway between the navel and the top of the right pelvic bone.

The condition carries a low-grade fever that starts after other symptoms appear.

There can be constipation and an inability to pass gas, but there can also be diarrhea.

While at sea, there is little anyone can do to treat appendicitis. If appendicitis is suspected, contact a doctor and alert the captain that emergency medical treatment may be required soon. If appendicitis is suspected before heading out to sea, get checked out before leaving port.

Avoid giving the patient anything to eat or drink as this could complicate or delay surgery. Avoid laxatives, antibiotics or pain medications because these can make diagnosing the problem more difficult and increases the risk of rupturing the appendix.


Keith Murray, a former firefighter EMT, owns The CPR School, a first-aid training company. He provides onboard training for yacht captains and crew and sells and services AEDs. Contact him at 877-6-AED-CPR, 877-623-3277 or Comments on this column are welcome at

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