EUROP Assistance knew the risks when it was appointed medical assistance supplier to the BT Global Challenge.
For the second year running, the assistance company was appointed by Ace Europe, the insurer of the yachts and their crews, to work on the world's toughest yacht race.
The BT Global Challenge takes sailors around the world against prevailing winds and currents and into extreme conditions. This year Europ has already provided assistance to the boats 250 times.
The rescue teams have airlifted a competitor suffering appendicitis off the Canadian coast, and repatriated another after the sailor was knocked over by a wave and injured his knee on the way from the UK to America.
Europ also repatriated two crew members back to the UK after they sustained serious injuries in an accident off the Australian coast.
Challenge founder Sir Chay Blyth said having Europ Assistance's help meant the organisers could be confident in putting together a gruelling race.