MCA Murder and Abortion Kit

[Dominic]

You asked if I was quite sure.
I am.
Got inspected last week and told to wind my neck in.

Hence the post.

MCA Cat 2 boats (the typical RYA course or UK charter boat) must carry these.

I was suprised.

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[Dominic]

Re: Having just done the RYA 1st Aid Course

I agree with your second paragraph. Being close to help.

Now look closely at the certificate you were given after your course.

The instructor has signed you off as having instruction on Cat C drugs.

Ask for your money back.



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[Dominic]

Sorry, I didn´t answer you in full.

The Blue Code that you refer to has an annex listing the first aid kit. That annex is now out of date and Merchant Shipping Notice 1726 applies.

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[Dominic]

You raise an interesting point.

A first aid kit put together under the auspices of the Health and Safety Executive must contain no drugs or medicines.

A first aid kit put together under the rules of the Maritime and Coastguard Agency must contain certain drugs and medicines.

(I understand that the two agencies have enjoyed a nice little turf fight over this)

The bottom line is;
Is this first aid kit for use on land or at sea ?

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[Dominic]

Re: What else don\'t we know about ????

You said...

"Over to Paul Gelder .... Come on YM, let's have a legal section in YM to tell us what a) we don't know and b) what we need to know."

I think it is called the RYA



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[MainlySteam]

Dominic - yes it is usual in most jurisdictions for sail training and skippered charter vessels to have to carry the same medical supplies a similarly categorised other commercial vessels. As I said in an earlier post, I am surprised by the medications required by MCA to be carried on small vessels, and they are not required in New Zealand for commercial vessels classed as being within 30 mins of medical assistance (taken to be 100 nm here, whereas I think it may be taken as 60 nm in UK from memory).

I think one of the problems is, and I have come across this before, is that the agencies creating rules and regulations are staffed by big ship people who do not really have a good understanding of requirements for small vessels. When the current rule for medical supplies was being drafted here there was a lot of input from small commercial vessels to limit the supplies to be carried, and in the end that is what happened. Perhaps some lobbying of the MCA by small commercial vessel operators in the UK would be appropriate.

John

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[Dominic]

I agree with your points but;

(this is the 60 mile rule)

The simple answer, which is the norm, is to carry 2 first aid kits.

One for general use and one in a sealed box marked "Only to be opened by an RYA Inspector on their annual visit."

This avoids all the hassle and expense of lobbying and rule changing.

We carry it, but only for show. Under no circumstances is it to be used.

Pure Khafka, but it keeps the Inspector happy.

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[alanporter]

As a retired naval medical officer I have read this thread with interest, and would like to add my ten cents worth.
First of all, as an experienced Navy man and also a lifelong yachtsman, I believe that any vessel sailing far offshore should carry an extensive, life-saving medical kit and that every member of the crew of a small vessel should have a basic knowledge of how to use it. This doesn't require several years of medical school, just a half day of examining the gear and reading the accompanying instructions.

After all, do you value the lives of your companions ?

Firstly, five sprays of glyceryl trinitrate will not kill. I have often administered up to six sprays within a fifteen minute period. A thumping headache will result from five sprays, not death. A severe angina attack can cause cardiac arrest, but a few sprays of GTN can save the victim's life.

Similarly, big doses of ergometrine can cause abortion, but if your young pregnant wife goes into spontaneous miscarriage while well out of the way of immediate help, do you watch her bleed to death, or do you save her life by giving her a shot or two of ergometrine ?

If your opinion is that potentially dangerous substances should not be on board, then get rid of your fibreglass cleaner, teak brightener, petrol, etc, as these are much more dangerous when taken internally.

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[Dominic]

Thanks for your input.
How many doses of glyceryl trinitrate will kill ?

The drug list I referred to is mandatory for many yachts which never leave the Solent.

My main worry was that using these drugs would cause more problems than not using them.

There is also the question of untrained skippers administering drugs - the current level of liabilty insurance is by no means adequate

By untrained I mean a passing mention of the drug on a one day course but the certificate has been signed off.

Also, I forgot to mention, no account is taken of having to carry the delivery means (a needle and syringe for example).

Nothing like a needle in the sciatic nerve to sharpen up ones reactions!

Please add more - I certainly don´t know what I am talking about - hence the original post.


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[MainlySteam]

Alan - I don't think I or anyone else, probably, disagrees with you with respect to offshore. The comments are related to vessels categorised as being "very close to shore" in MSN1726 (Category C vessels, within 60 nm of shore in UK, 100 nm in NZ) - my understanding is that is based on the likelihood that such vessels would be within a short time of professional medical assistance (my understanding is that 100 nm is based on 30 mins until professional medical assistance here). If there is justification for such vessels to carry those medications, then there is also justification for a great many persons, probably most who do not live in cities, to carry them in their cars and keep them in their homes - a claim I have never heard made.

John

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[BrendanS]

This is one of those areas where it is difficult to legislate for the differing degrees of competence of skipper or crew.
Certainly the RYA First Aid cert, given to trainees with no prior knowledge would not be sufficient to cover such usage. The trainer at a recent RYA FA course I attended was sufficiently aware that he asked the usage area that we would be working in, and asked if we were likely to have to carry such a kit. He then briefly covered what should be carried and mentioned both of the drugs mentioned in this thread. Very sensible attitude in my mind, and he was sufficiently qualified that he could have explained in far more detail their use.

I come from a medical background, but couldn't advise lay people to use them in other than extreme circumstances. However, if I was cruising a long way from medical help, then they are items that should sensibly be carried if you have people on board that are likely to require them (and believe me, you never know when people are likely to require them, as not all are honest about their condition)

However, in UK waters, if you are required to or wish to carry them, the best course is to put in a Pan Pan Medico call , and you will have a doctor to advise (usual caveats about having VHF or Sat) and avoid any doubt about your use and doseage.

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[Dominic]

Scottish Car Kit

Interesting comment -

Following it on-

Does the same apply to drivers in the highlands of Scotland ?

Never mind occupants of less densely populated countries.

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[Dominic]

Must disagree you most strongly here.

You said.........

"Certainly the RYA First Aid cert, given to trainees with no prior knowledge would not be sufficient to cover such usage."

The RYA first aid course is the course that covers the use of these drugs.

Look at the bottom of the certificate - the instructor signed you off as having instruction in Cat C drugs.

 

[BrendanS]

Can't agree. Many on these courses are new to first aid, and have no idea of basic principles. The RYA is a one day, and one day is not enough for the average person with no prior exposure to first aid to realistically cover the basics, never mind to know how to competently use the drugs. The topic was covered (competently) but I don't expect any RYA one day first aider to be able to use these drugs in a medical emergency. How would they know to discern between angina, heart attack, strained chest muscles, normal periods compared to an acute emergency.

I'd say that a Pan Pan Medico call would be rather sensible?

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[Dominic]

I agree with what you said.........

"The RYA is a one day, and one day is not enough for the average person with no prior exposure to first aid to realistically cover the basics, never mind to know how to competently use the drugs."

But

After that one day the Yachtmaster Instructor carries the drugs and is signed off to use them and is expected to use them.

Which was my original point.

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[MainlySteam]

Brendan - I do not know what the situation is there but of the medical emergencies I have heard over the radio here (you get patched through to the emergency department of a hospital for medical assistance) the advice is generally limited to keep the patient calm and comfortable and basic first aid if an injury (eg stopping bleeding). If sounds like any degree of seriousness at all, and you cannot make port faster than it will take a helicopter to be readied and sent to you, they just add that the helicopter is on the way. My understanding is that in the UK the first response is also to send assistance rather than let the crew attempt to handle the situation beyond basic first aid.

The only times I have heard the doctor ask what medications were on board has been in the case of vessels well out of the reach of helicopter rescue or assistance.

From the attempts I have heard made over the radio to decribe symptoms, I have my doubts whether a doctor could reliably make any sort of sensible diagnosis except in the case of accident where the injury is obvious. In fact, in most calls I have heard the caller has sounded as if they were in a managed state of panicstrickenness.

In case of misunderstanding, all the above only referring to close to shore vessels.

John

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[BrendanS]

Put it this way. The training level required for the RYA one day, is not in my mind sufficient that coverage of any drug usage should be included if the participants have never before been exposed to first aid training

I rather suspect that anyone that gets to yachmaster training has had previous exposure to first aid training, and that at least a decent proportion of them would be intelligent enough to use any drugs provided sensibly.

In the way the world currently works, there are a lot of gaps in this view, not the least legal side.

Personally, I'd rather have the drugs available, with the possibility of talking to a doctor first, then making the decision to use them if more immediate first aid wasn't available.

If I lived in the Scottish West Islands for instance, where immediate medical help is not always available, I'd stock a comprehensive first aid kit, and take a chance on being sued if I needed to use it.

A lot of the posts on this forum are dreadfully PC. I'd rather have the chance of saving someone, than not be well equipped enough. Having said that, I carry a basic first aid kit onboard my boat, as that is all you need for most coastal or cross channel work.

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[BrendanS]

You'd only be using cat c drugs in offshore situations in my mind.

Why do these threads always head off in silly tangents and point scoring.

If you read my post above, I stated that on the RYA first aid course, we were specifically asked if any of us were likely to be using first aid offshore, and when we responded negatively, the cat c drugs were covered, competently, but not as though we'd have to use them. As I said, a very sensible attitude to a one day course. The attitude of the instructor/examiner was that (and he was qualified to do it) was that he would cover the cat c usage if anyone was likely to be offshore and need it.

My point about Pan Pan Medico, was that (OFFSHORE, maybe I didn't make that point clearly enough previously, when in the unlikely position you'd be required to use cat c drug) you'd be pretty blood minded and stupid, if you did not try to make a pan pan medico call before you used the drugs.

I'll go further, if you did not make a pan pan medico call when you were perfectly capable of doing so (same caveat as before, you have vhf or sat capability and are able to talk to a coastguard ---err, can speak same language as you???? just before someone else nit picks) and did not do so, and then caused a medical problem, then you should have the book thrown at you quite rightly

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[MainlySteam]

Whoops - I was not challenging or points scoring. Also, I said nothing about first aid courses.

I was just stating how it was and was not intending to infer at all that a call for assistance was not the best approach. I did make the inference that even if one did that, any medications on board would probably never be used in close to shore situations here. I had thought the original post was about carrying medications, in particular MSN1726 Category C for "close to shore" commercial craft.

I did say I only believed the same applied with respect to response to a medical assistance call in the UK. I would be interested in what the situation is there, and now wish that I had put a question mark after my statement to that effect.

No hard feelings on my part Brendan, I value and agree with your comments.

John

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[Dominic]

I think I agree with you

I think we generally agree

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