When the ambulance is six hours away

Every few months, Ashleigh Palinkas pulls out a set of rubber body parts she keeps among her supplies. “I have a fake hand, a severed thumb and an eyeball,” says the California Sea Grant Extension Research Associate. The items were sold as Halloween gags, but for Palinkas they serve as serious and potentially life-saving props. “The $12 I paid for these might be the best money I ever spent,” she says. 

California is famous for its cornucopia of seafood, from briny sea urchins and succulent Chinook salmon to sweet Dungeness crab and local specialties such as spiny lobster, sanddabs and white seabass. But this bounty comes at a price. Commercial fishing kills workers at a rate 40 times higher than the average profession. Every year, California fishermen risk drowning when vessels capsize or heavy seas sweep them overboard. Onboard machinery crushes others, or they're electrocuted. Still more suffer serious injuries that end careers.

For the past three years, Palinkas has been teaching first aid workshops tailored to the hazards fishermen face: slippery decks, gear that can sever limbs and seawater cold enough to kill. "Once you put a face to the industry — once you meet people who have lost a loved one or were injured themselves on the job — it drives home how absolutely dangerous this work is," Palinkas says.

A first-aid course built for the ocean

Federal law requires that commercial fishing vessels with more than two people on board must have at least one crew member trained in first aid and cardiopulmonary resuscitation, or CPR.  Fishermen can acquire these skills in any first aid and CPR class, such as those offered by the Red Cross for the public. But basic courses often fall short for fishermen, says Extension Specialist Theresa Talley, who helped set up the California Sea Grant’s Fishermen’s First Aid Safety Training (FFAST) as part of a larger ocean careers training program.   

Basic classes “usually train you to do CPR assuming an ambulance will be there within five minutes. If you're out at sea, that's not going to happen,” notes Talley. “Neither can you rush off to the emergency room to get stitches. Fishermen need training in how to deal with those things on a boat miles from shore.” 

Palinkas’s FFAST classes — which are part of a national network of training developed and launched by Oregon State University and Oregon Sea Grant — stretch over two days. “On the first day we cover chest compressions, rescue breaths and all the basic stuff: controlling life-threatening bleeding, dealing with impaled objects, burns, hypothermia, heat stroke and drowning incidents,” says Palinkas. “We also cover responses to different types of amputations.” 

What if a crew member is bleeding out?

On the second day, Palinkas moves the group to a boat. “We always hold classes near the harbor, so we typically use a participant's boat,” she says. The group spends the day running through scenarios: What if a crew member is bleeding out? What if their hand gets smashed? What if someone falls into the fish hold and the crew can’t get to them?

Palinkas hands out bandages, splinting materials and other supplies, then has the fishermen practice reactions to these situations. “I might tell them: It's a rough day at sea. You've been fishing for 12 hours. Suddenly, the boat hits a large swell, and you hear a crash. You go to the back deck and find your deck hand passed out. And go!” she says. 

She’ll discreetly brief one student on how to play the patient, acting out symptoms and using props as needed. “I tell my victims to have the rubber thumb on the ground next to them and hold their hand going, ow, ow, ow,” she says. The extra dose of realism never fails to get the class’s attention. “It catches everybody by surprise,” Palinkas grins. 

"We lose so many people every year"

She gets requests from up and down the coast, teaching between three and five classes per year, often filled to capacity. “People in different ports ask me, 'Hey, when can you offer this training in my region,’” says Palinkas. 

 John Mellor is one of the fishermen who has taken her workshop. Based out of San Francisco, he fishes commercially for crabs, sablefish and rockfish from his 40-foot boat High Hopes, usually with a crew of two. “Every day is pretty much a 20-hour day,” he says. “If somebody gets hurt when you’re five or six hours from shore, you really need to know how to deal with it.” 

Commercial fisherman Dick Ogg agrees. At 72, he’s still out on the water most days, fishing for crabs, albacore, black cod and other species out of Bodega Bay. “We lose so many people every year, and I know that this training will help save many,” he writes in an email. The first aid workshops inevitably also save money by reducing Coast Guard rescue costs and helping the industry avoid lost revenue when injuries cut trips short.

Some captains have changed how they operate their boats after taking the class, Palinkas reports. “They tell their crew that, for example, they're not allowed to lift a crab pot by themselves because they don't want anybody to tear a ligament in their knee.”

Paradoxically, California’s high seafood standards are part of what makes fishing in the state so risky, she argues: “California has some of the strictest fishing regulations in the world, which makes our seafood sustainable but also puts a lot of pressure on the fleets.” Short harvesting seasons, for example, might compel fishermen to head out even in unfavorable conditions. “They might fish through the night or in less than ideal weather,” says Palinkas. 

She tailors her classes to local fishing conditions. In Northern California, she emphasizes crushing injuries from crab traps and hypothermia. Southern California sessions focus on tuna hook impalements and heat stroke. After each course, Palinkas hands participants a free first aid kit for their boats. Besides standard bandages and antiseptic wipes, they contain items not found in a typical kit “like a military-grade tourniquet and blood-clotting powder,” Palinkas says. 

High demand, uncertain future

Lately, she’s struggled to keep up with the demand. Until recently, a grant from the U.S. Coast Guard and National Institute for Occupational Safety and Health (NIOSH) paid for the FFAST classes, ensuring that training remains tuition free. But this federal funding is currently held up, as part of a large-scale government restructuring that includes staffing reductions and the proposed dissolution of NIOSH by the U.S. Department of Health and Human Services. “We were lucky enough to be able to allocate other training funds to run these safety workshops through the end of 2025, but those funds are now also running low," says Palinkas.  “I'm unable to put any more trainings on the calendar for the time being.” 

Fisherman Mellor hopes the hiatus will be short-lived. These classes are extremely valuable for the industry, he stresses: “I hope they keep getting funded.” 

Palinkas also longs to continue her fishing first aid teaching. “What makes the work I do very rewarding isn't just being thanked by the fishers," she says. She's most moved when fishermen's families reach out to thank her for keeping their loved ones safer.

Commercial fishing “is an extremely, extremely dangerous occupation, but it's one that's critical to our food systems," she says. "When I hear from families — wives, daughters, cousin, anyone — it just absolutely makes my day. It makes my life."

Interview with Ashleigh Palinkas