Cruising medication

[PilotWolf]

I agree. Flamazine is excellent.
If someone broke a femur mid Atlantic it would be a major problem stabalising the break, dealing with shock and controlling the pain. I remember being advised that I’d run out of strong pain relief very quickly. If you’re desparate, and you’ve got some local anaesthetic (eg 1% Lignocaine etc) we were advised to try a femoral block. I seem to remember the pneumonic was NAVAL. Nerve Artery Vein Lymph but I’m very glad I haven’t had to try it. I remember staying in Fort Blockhouse Gosport and there were some junior Drs who used to ask what we’d learned that day. There was a look of horror on their faces when we’d say something like, “Today we did ring blocks and finger amputations”. The joys of offshore sailing with big crews. (I’m also glad I’ve never had to apply much of what I learned. )

+1 for flamazine.

Remember also that drugs have different mines in countries outside the UK.

Also depending where you are you may have the resource of contacting a large ship who will have some form of medical kit on board including statements et cetera. And almost certainly better communications equipment that you do.

I’m sure the school where you do your course will also have some advice.

The course I did was 5 days and at the time I was a paramedic, we were taught things that as a paramedic we would’ve loved to have been allowed to do on the road. I believe some of them have now been added to the ambulance service training.

W.

 

[colind3782]

The course I did was 5 days and at the time I was a paramedic, we were taught things that as a paramedic we would’ve loved to have been allowed to do on the road. I believe some of them have now been added to the ambulance service training.
W.

What things are we talking about? I wonder if our current training is up to that standard? PM if you prefer.

 

[rotrax]

We spend 5-6 months aboard cruising in normal times.

Our understanding Dentist gave me a precription for Dental Antibiotics which we keep on board, and our GP a perscription for wide spectrum infection antibiotics, again kept on board.

Our first Island Packet, recently arrived from across the pond had morphine syringes in the First Aid Kit.

We disposed of those toot and sweet!

 

[ShinyShoe]

The conversation seems to have drifted from the OP's question...

1. Can he get a prescription for more than 28days? That depends on what it is for. (a) some medicines can not be prescribed (in the UK) for more than 28days by anyone even privately (b) the NHS has rules about residency for treatment (c) there may be clinical reasons not to supply very long supplies [e.g. a need to monitor treatment] (d) due to Brexit there is additional scrutiny of stockpiling.
2. Ships medical supplies - you need the kit to deal with an emergency, but likely with advice from a medic remotely.

 

[johnalison]

I used to divide medicines into cheap ones and expensive ones. Cheap ones (pence) could be given in three month amounts and thus save money, but expensive ones were often a pound per day and would be restricted to one month’s supply. For most people going abroad the rules would be the same, but I considered boats to be British territory and would normally be generous. For myself, I have been allowed four months’ supply without question and emergency antibiotics for a pre-existing condition. I regularly took about £1,000 worth on cruises. For emergencies, the private prescription route is the simplest legal way of doing things and I see no reason why a doctor should be unhelpful about this. I never made an additional charge to NHS patients for this.

For essential drugs, I would want to establish their availability when abroad before departing. As for NHS prescribing, it depends largely on the rules but also on how unreasonable the prescriber wants to be.

 

[dansaskip]

Quite frankly your doctor is being unreasonable . I have a long standing condition that requires medication which I obtain under prescription. When I explained to my doctor that I was going cruising in the Pacific I had no problem with him giving me a prescription for 6 months supply and no problem with the pharmacy fulfilling it.
I also found it very useful to get a letter (in my case from the hospital consultant) setting out my condition and detailing the medication I was taking. Armed with this I was able to get supplies in other countries (eg French Caribbean islands and New Zealand), when I ran out.

 

[PilotWolf]

What things are we talking about? I wonder if our current training is up to that standard? PM if you prefer.

This was way back at least 15 years ago I think.

But we were taught suturing, OI needles, catherization, crIcs, chest decompression and sure there were others.

I know some of those are taught now - make to the practitioner paramedics. Ally has change since I left the service.

W.

 

[duncan99210]

I said it earlier but in along post, so I’ll say it again. The NHS is sticking to one months supply AT THE MOMENT. That’s because of uncertainty over Brexit and the concerns about needing some medicines to support Covid. That will change in the spring as things stabilise and you’ll be able to get 3 months supply from the NHS.

 

[ShinyShoe]

I said it earlier but in along post, so I’ll say it again. The NHS is sticking to one months supply AT THE MOMENT. That’s because of uncertainty over Brexit and the concerns about needing some medicines to support Covid. That will change in the spring as things stabilise and you’ll be able to get 3 months supply from the NHS.

Certainly more likely in Spring.

Some GPs have always been keen to limit supply others less keen. Most are reluctant to do more than 2 months routinely

Quite frankly your doctor is being unreasonable .

We have far too little information to know if that is the case.

The GP has to be convinced it is safe. If something goes wrong 5months into a 6month prescription that should have been monitored every 2-3 months... Who is liable? There is a reason prescription medicines are prescription medicines...

There are also a reasonable number of medicines that legally can not be supplied for more than 28days on a single prescription...

 

[12 Year Plan B-)]

Thanks to all. Many useful contributions giving practical advice...much food for thought...

 

[PilotWolf]

https://lvassembly.files.wordpress.com/2018/12/Ship-Captains-Medical-Guide-22nd-Ed.pdf

Or you buy the actual book.

There was also an app for the IPhone but mine now opens some other set of pages.

W.

 

[john_morris_uk]

I said it earlier but in along post, so I’ll say it again. The NHS is sticking to one months supply AT THE MOMENT. That’s because of uncertainty over Brexit and the concerns about needing some medicines to support Covid. That will change in the spring as things stabilise and you’ll be able to get 3 months supply from the NHS.

I’ve picked up two months supply or four medications a month ago and again two months before that...

 

[colind3782]

This was way back at least 15 years ago I think.

But we were taught suturing, OI needles, catherization, crIcs, chest decompression and sure there were others.

I know some of those are taught now - make to the practitioner paramedics. Ally has change since I left the service.

W.

We now do all of that except suturing, we use glue, and catheters but ECPs do catheters and sutures.

 

[PilotWolf]

We now do all of that except suturing, we use glue, and catheters but ECPs do catheters and sutures.

I originally qualified as a paramedic early nighties - my HCP number is 80! The previous was 007 and yes I got the jokes!

I think I’d done most of them by the time I left in mid 2000. But the same we used glue.

But things have moved on and a lot not for the best what what I understand.

W.

 

[BobnLesley]

I am a UK sailor who anticipates being afloat in less populated areas of the South Atlantic...Most importantly for an ocean sailor is having an arsenal of Antibiotics. Does anybody out there have any advice?

No idea with regard to your ongoing prescription needs, but in the expectation that your route to the S Atlantic will take you via the canary Islands, then for an antibiotic reserve, malaria prophylactics and things like yellow fever/rabies jabs, you'll obtain those much more easily and at a fraction of the UK costs from the Seaman's Clinic in Las Palmas.

 

[colind3782]

I originally qualified as a paramedic early nighties - my HCP number is 80! The previous was 007 and yes I got the jokes!

I think I’d done most of them by the time I left in mid 2000. But the same we used glue.

But things have moved on and a lot not for the best what what I understand.

W.

I qualified as a paramedic in 94 and my HCP is 5983 although we didn't register with them in Shropshire until much later and what a con it's turned out to be! I still enjoy the job though.

 

[PilotWolf]

I

I qualified as a paramedic in 94 and my HCP is 5983 although we didn't register with them in Shropshire until much later and what a con it's turned out to be! I still enjoy the job though.

The job and most of the people I worked with were great. It was the management and political issues that I had issues with.

Patients didn’t seem to matter anymore.

W.

 

[dansaskip]

I said it earlier but in along post, so I’ll say it again. The NHS is sticking to one months supply AT THE MOMENT. That’s because of uncertainty over Brexit and the concerns about needing some medicines to support Covid. That will change in the spring as things stabilise and you’ll be able to get 3 months supply from the NHS.

Well I beg to differ I just got 3 months supply 1 week ago.

 

[[163233]]

It's worth bearing in mind that some meds go off quite quickly.

Perhaps it's worth investing in a -70C freezer.....

 

[Sharky34]

We've never had a problem with GP doubling up on prescriptions each year to give us 6 months supply. Each time we go to Boots, they say it's not allowed but still dispense them when I say OK, we'll go to another pharmacy. When occasionally we've run short, having a photocopy of prescription and tablet box with name and dose on, has made it easy to get more supplies, sometimes over the counter but for some medication a local doctor's prescription.

My local pharmacy, stated that they cannot issue a prescription if you have 7 days existing stuff left.