Abstract In addition to the well-publicized risks of severe injury or death in commercial fishing, our research suggests that—like many occupations—for every fatal injury there are many non-fatal injuries. These injuries may, nonetheless, lead to lost work time, disability, chronic pain or mobility limitations. Approximately 20% fishermen surveyed indicated they had an injury in the past season, with half resulting in lost time or modification to work. While prevention of these injuries is the first goal, it is critical that fishermen are prepared to respond to injuries that may occur. Most first aid courses, however, are geared toward land-based care, with rapid access to pre-hospital care and transport to clinics or hospitals. Wilderness or austere first aid uses basic principles of first aid, but tailors them specifically to settings in which resources are limited, such as to commercial fishing. This training project takes the USCG-approved Fisherman First Aid and Safety Training (FFAST), and sustains and effort demonstrating its effectiveness, scalability, and sustainability. We are proposing to strengthen a nationwide partnership to refine and promote training best practices and to increase capacity to provide commercial fishing-specific first aid training. The proposed renewal project will continue to refine best practices and strengthen partnerships to deliver commercial fishing-specific first aid training; sustain capacity to deliver commercial fishing-specific first aid training by re-certifying and training new instructors and strengthening the infrastructure to support them; and continue to deliver evidence-based, field demonstrated, USCG-certified first aid training to commercial fishermen across the United States. The project will have a robust evaluation protocol which will assess both the process of implementation and the empirical outcomes specific to each aim. This work will enhance the readiness of fishing crews to respond to emergencies at sea, thereby reducing their potential for disability and life threats. In addition, our project will promote a broader acceptance of the importance of injury prevention and control in commercial fishing across the United States, and promote fishermen themselves as crucial to staying safe while working on the water.