Medical emergencies

My medical kit is limited to what I feel I could use, with only such items as antibiotics and suturing kit being more than many short distance sailors might normally carry.

The only major emergency I've encountered was a severe hypo in a diabetic family member, who I gave IV glucose to. We used to sail in company with a severely egg-allergic sailor and I used to carry adrenaline injectable, but it has a short life.
 
think of what what oil rig paramedic types, or eg navy medics deal with - ie mostly GP stuff and (rarely) some trauma, + dental. i worry about the latter cos i wouldn't have a clue!

expedition type medicine courses eg Expemed that i used to teach on - admittedly land based, but remote medical emergencies. one of their main risks is RTC's, thankfully n/a to us :-) and main problems are again GP type stuff

so i take SAM splints + tape to make bigger splints. mild, moderate and opiate analgesia. antibiotics, ear drops, eye drops, sutures. cloves for teeth. dental repair kit. catheter? i suspect i was being over anxious about having an old bloke with known prostate problems along!

not a great amount of emergency stuff cos if you are far from land no point in stabilising a casualty if no onward plan. i do take ABC type stuff that i use for mountain rescue

military field dressings are good

body bag is (i believe) standard kit for longer voyages. packs small

when/where you going? hth

edit aspirin gtn glucogel salbutamol etc.

edit edit apologies for teahing you how to suck eggs!
 
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Lots of interesting stuff there. I can get too obsessed with making everything 'the best' but I guess there must be a happy medium for the average non-medic. Most first aid kits I see are pretty useless things designed in the 1800's and mainly consisting of rolls and rolls of white bandage. I think this harks from a time when the best medicine involved boiled water and clean towels. I think we can do better. I am thinking of a modular medical kit with a ready supply of essentials with most easy access I.e. Sun cream, anti sickness stuff, plasters etc. then basic first aid for the non medic, then advanced first aid and then full medic stuff. That way things are available in the order in which they are required and with appropriate information directed at the likely user.

I don't think it needs to be very big and being modular would allow for only bringing stuff suitable for the type of sailing one is doing. Of course it wouldn't cover everything but would be aimed at covering the most serious and the most common.
 
Some medical problems I have heard of at my club and elsewhere include head injury requiring steri strips or sutures hand injuries and in one case a broken arm. ( a 6 day voyage hurt on the first day and he only had one arm to start with).
Now for a doctor the chances are high that you might be called on to help other yachts with serious injury so the contents of the bag might be endless.
However for us non medicos. A first aid course and carrying of a first aid kit which complies with the yachting association requirements for ocean racing (to various levels) will if nothing else be indicative that you as skipper have taken the matter seriously and taken the best advice available. olewill
 
pmagowan said:
Lots of interesting stuff there. I can get too obsessed with making everything 'the best' but I guess there must be a happy medium for the average non-medic. Most first aid kits I see are pretty useless things designed in the 1800's and mainly consisting of rolls and rolls of white bandage. I think this harks from a time when the best medicine involved boiled water and clean towels. I think we can do better. I am thinking of a modular medical kit with a ready supply of essentials with most easy access I.e. Sun cream, anti sickness stuff, plasters etc. then basic first aid for the non medic, then advanced first aid and then full medic stuff. That way things are available in the order in which they are required and with appropriate information directed at the likely user.

I don't think it needs to be very big and being modular would allow for only bringing stuff suitable for the type of sailing one is doing. Of course it wouldn't cover everything but would be aimed at covering the most serious and the most common.
Click to expand...

Biggest problem I have found with any medical kit is the expiry date - can be v. expensive to keep up to date. If you are stocking up, ensure that you have the longest expiry date possible - don't let a pharmacy fob you off with expiry dates of <6 months!
 
As a Paramedic it would be easy for me to get carried away and have "one of everything" I use at work but I've found that a lot of stuff can be improvised, i.e. cardboard is very good for splints. I do carry wound closure glue and steristrips, together with IV cannulas in 2 or 3 sizes as the big ones can be used for the dramatic stuff like pneumothorax and cricothyrotomy! I have a unit of saline and a gram of IV paracetamol which is often better than morphine.

We only do coastal sailing in Spain and many meds are available over the counter including antibiotics so I don't go overboard (sic!)
 
I think almost every injury I've seen on a boat has been a burn or scald, a cut, bruise or other wound, or sunstroke/dehydration. Bandages, field dressings, gel burn dressngs and plenty of fresh water are all I've ever seen needed or used. The only really bad injury I've been involved with was a classic bang on head from the boom with a bad cut resulting - blood everywhere from a scalp wound. Ironically we had the SMO (Senior Medical Officer) from RAF Laarbruch and a Medical Branch Group Captain from Rheindalen on board so my contribution was limited to washing down the decks. The boat was a beautiful 100 square metre built by Abeking & Rasmussen in the 1930's so I think there was as much concern about the boat as the crew member.
 
pmagowan said:
In another thread there was a discussion about medical emergencies and what to do. I am currently looking into a general medical kit and was looking for other's experiences of medical emergencies or first aid that they have needed on board. What problems did you have? Did you have kit to help you? Did you know what to do? Did you get assistance if required? What type of kit, if any do you have on board?

That type of stuff.
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We have lived aboard for a number of years, our sailing has included quite a lot of ocean passages and remote locations. We are not doctors!
Over the years we have experienced a couple of 'serious' incidents. One was fortunately within a few days of hospital care ( gall stones that resulted in surgery) the other mid -Atlantic that was more challenging. Hand crushed in self-steering gear. No breaks but serious pain!

We have a good first aid kit- curated by relatives who are GP's.

Most commonly used items have included antibiotic creams for skin injuries-particularly in the Tropics. Antibiotic ear drops, common to acquire infections when diving and snorkelling. Rehydration sachets valuable after seasickness, high temperatures etc. Selection of painkillers in various strengths- up to morphine. Selection of antibiotics used for issues for tooth infections, chest infections and skin infections. Eye washes and drops.Treatment for minor burns.

I second the need for serious dental adhesive. Especially if you have crown or bridge work. The two part kind from a specialist company is, in our experience, the only one worth varrying.

Apart from the issue that needed surgery we doctored ourselves through minor injuries up to dengue fever. Our kit was invaluable-especially the issue specific antibiotics- these came with an 'idiots guide' matching the product with the symptoms. Mostly we knew what to do. We do carry the 'ships offices medical guide' as well as a copy of 'where there are no doctors'. We have obtained good information from both of them.
We carry, but have never used, sutures, needles,syringes, nitroglycerine spray, lignocaine-topical and a selection of medicines for common ailments from colds to constipation. Steroids and splints complete the kit.

I reiterate that this was over a number of years- around 15. Keeping the box up to date was simple as most countries sold replacments over the counter - no prescripion needed and usually at a far less price than paid in the uk!

Hope this helps.
 
any chance that you docs and paramedics can work together on a strategic list of medical kit please ?


Assuming

#1 a normal first aid box of plasters and minor kit, what about

#2 an offshore kit, for out of sight of land but within say 12 hours of a haven

#3 an ocean kit, for the long-distance sailors

OK, there will be overlap in specification, but a scaleable solution with list, for items #2 and #3 would be very very useful.


Worth thinking about please ?
 
pmagowan said:
Lots of interesting stuff there. I can get too obsessed with making everything 'the best' but I guess there must be a happy medium for the average non-medic. Most first aid kits I see are pretty useless things designed in the 1800's and mainly consisting of rolls and rolls of white bandage. I think this harks from a time when the best medicine involved boiled water and clean towels. I think we can do better. I am thinking of a modular medical kit with a ready supply of essentials with most easy access I.e. Sun cream, anti sickness stuff, plasters etc. then basic first aid for the non medic, then advanced first aid and then full medic stuff. That way things are available in the order in which they are required and with appropriate information directed at the likely user.

I don't think it needs to be very big and being modular would allow for only bringing stuff suitable for the type of sailing one is doing. Of course it wouldn't cover everything but would be aimed at covering the most serious and the most common.
Click to expand...
I attended a first aid course, (+regular refreshers), tailored towards dinghy and keelboat instructors, and some of the advice given was use labelled ziplock bags to segregate the kit into modules for dealing with different types of injuries, e.g. "Burns", "Broken Bones, etc., and to seal the box, (a drybag is better), so that if the seal is broken it is an indication that something has been used and replenishment may be necessary. Listing the contents on the label helps.If using this system it is also advisable to keep separate minor kits for "Cuts & Scratches" and "Headaches and Vomiting" . While organising it like this is obviously advisable for sailing schools, I see no reason not to do it on one's own boat.
 
For what it's worth, we use three 'medical/first aid' boxes.

One box is full of the standard every day over the counter medicines: pain relief, Imodium, indigestion relief, insect bite cream etc, plus any regularly taken prescription medicines. Known as the pills and potions box, it lives in the forward head locker.

Second box is actually a waterproof pouch and has all the usual plasters, small dressing and the like for dealing with everyday cuts and scrapes. Lives on a Velcro patch by the chart table where it's easy for anyone to get hold of.

Finally, the big orange box. This contains stuff for dealing with broken bones, major slices to someone and so on. It's mainly various dressings but also includes steri strips, splint material and a couple of foil blankets.

We've found that between our three boxes we can either deal with the stuff that's happened or to at least make a casualty comfortable and safe enough until we can get them to medical help. However, that's focused on cruising in European waters, never more than a day or two from shore.

If we were going further afield, I'd seek to expand the contents of the pills and potions box to include some broad spectrum antibiotics and some heavy weight pain relief. I'd also be seeking to ensure that any crew members with specific conditions had enough prescription medicine to see them through the trip plus a bit over as well as a knowledge of their specific problem along with the drugs needed to treat them should things go wrong.
 
sarabande said:
any chance that you docs and paramedics can work together on a strategic list of medical kit please ?


Assuming

#1 a normal first aid box of plasters and minor kit, what about

#2 an offshore kit, for out of sight of land but within say 12 hours of a haven

#3 an ocean kit, for the long-distance sailors

OK, there will be overlap in specification, but a scaleable solution with list, for items #2 and #3 would be very very useful.


Worth thinking about please ?
Click to expand...

That was my plan, if I get the time.
 
My wife had a quite invalidating synusitis (spelling?) halfway through a transat; meaning she had to remain in her berth the whole day.
We suspected it was a synusitis, we checked the symptoms on three books, then contacted by email the CIRM (*), submitting the whole report, the exact description of symptoms (IIRC she could or could not lean her head forward) and our opinion as to the diagnosis. We indicated we had the whole ocean drug kit suggested by French authorities.
The answer came within 20min, they confirmed suspected synusitis, they advised antibiotic treatment for XX hours. Much to our disconcert, we realised we the antibiotics were past their date, though we had valid ones for the kids: email back to Cirm asking if we could use the children preparation --> of course, just increase quantity to xx; Poor wife had to swallow a full glass of disgusting antibio for children :)
Anyway, a couple of days later (and some further email check contacts with CIRM) everything was back to normal :)

(*) fwiw, CIRM was the first medical institution (founded back in the '20s '30s) to give medical advice to sailors, it's free, they also speak English, contact by email, phone, telex, etc etc, if you want to check www.cirm.it
 
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