WHEN FISHING TRIPS TURN INTO ER.

Byline: Jeremy Bagott Latitude 34

Dave Guthmiller and his uncle were on a two-day trip aboard the sport-fishing charter vessel Mustang out of San Diego. At daybreak in Mexican waters, Guthmiller's uncle got up from his bunk, then passed out and could not be awakened.

Although there was an emergency-room physician aboard, the doctor hadn't brought his medical bag on the trip, meaning there was little he could do.

``The skipper called the Coast Guard,'' said Guthmiller, 38, of San Bernardino, ``and they responded with a rescue helicopter. They lowered a medic onto the boat to assess the situation and decided to evacuate my uncle in a litter basket.''

Emergencies happen on fishing trips, but care will vary from crew to crew. And with today's litigious society, many times a crew's hands are tied. If you're concerned about how medical emergencies are handled on your boat, it's best to ask ahead of time.

Guthmiller, whose uncle turned out to have had a severe reaction to medication he was taking, gives high ratings to the Mustang's skipper and crew for being prepared for the emergency. Aside from the benefits of occasionally having an off-duty medical professional aboard, certified ships' masters do possess basic first-aid skill, at least in theory.

To apply for the appropriate ``masters'' operating license, the Coast Guard requires that all applicants provide proof of completing an approved first-aid course within the past 12 months, as well as a current and valid cardiopulmonary resuscitation certificate.

``The Coast Guard and the sport-fishing industry do an excellent job of enforcing the standard,'' said Richard Helgren, owner of Helgren's Sportfishing in Oceanside.

About a year ago, a passenger aboard one of Helgren's boats suffered a heart attack. There was a doctor aboard, but the man couldn't be revived.

``We were off San Clemente Island at the time,'' said Helgren. Even though he was clearly beyond resuscitation, the Coast Guard came and got him; they were there in minutes.''

Some sport-fishing landings go a month or more without as much as a fish-hook injury. But it better be more significant than that to hail the Coast Guard because, officials said, they won't come out for injuries that are less than life-threatening, unless there's trauma or shock. Something like a broken bone by itself won't bring a chopper overhead; the ``patient'' must be stabilized to endure the boat ride home.

But some things can be done without the Coast Guard.

Curt Putnam of Rancho Cucamonga was on a seven-day charter in Mexican waters in June 1998 when a passenger was found unconscious in a companionway.

``It was quickly determined that he had been eating (the seasickness medication) meclyzine by the handfuls and that a swollen prostate had shut down his urinary output,'' Putnam said. ``Having had a similar problem, the (vessel) carried a catheter kit.''

A doctor was on a nearby charter vessel. The physician was put into a dinghy and motored over to the other boat, where he catheterized the ailing man and otherwise stabilized him. The crew made quick time back to San Diego, where the man was taken to a local hospital.

And, of course, there likely will always be anglers who feel crews don't do enough in emergencies, especially when it comes to seasickness; some crews aren't particularly sympathetic. The truth is, their efforts are limited by today's legal environment.

Though the threat of litigation has made many skippers reluctant to do much more than hand out Band-Aids, passenger safety and well-being is still a captain's primary responsibility.

``We haven't gotten to the point where we have passengers sign waivers before we will pull out a fish hook,'' said Helgren, ``but I can see that day coming.''

On the subject of fish hooks - a skipper's most frequent first-aid challenge after seasickness - if one is lodged in a sensitive place, like around an eye, Helgren's skippers won't try to extract it.

``We do have a special way of removing fish hooks from hands,'' Helgren said. ``We turn the person so he's facing away, have him close his eyes, grab his wrist and squeeze it hard. Half the time, we've removed the hook and the guy is still standing there with his eyes closed, wondering when it's going to be over.

`` `Hey, you can open your eyes, it's out,' we have to tell 'em sometimes.''