Medical info

[Sea Devil]

If there are any doctors on the forum I would be grateful if they would visit my medical page and see it the info is all right?
michaelbriant/sailing/medical

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[boatmike]

Bloody waste of time,
Not a word said about the treatment of Fray Bentos poisoning or dealing with common ailments like paranoid psychosis brought on by close encounters with IOW ferries.
And where's the brandy? Absolutely no bloody point getting ill if you can't have a brandy.
Should also have chapter on forumitis known to afflict at least half the sailing population... Treatment as above, copious supplies of brandy, gin, whisky, or rum until comatose. Works regularly for me.....

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[Talbot]

Would be better of providing a link to the on-line version of the <A target="_blank" HREF=http://www.mcga.gov.uk/c4mca/mcga-dqs_st_sf_seafarer_information/mcga-dqs_st_shs_seafarer_information-medical/mcga-dqs_st_shs_ships_capt_medical_guide.htm>Ship's Captain's Medical Guide</A> which has all the data you need.

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[Sea Devil]

But that's the book I reccomend - problem is it is aimed at merchant ships with the storage and refidgeration capacity far beyond a cruising yacht I have tried to reduce and simplify it. Ships Captain Medical Guide should be in every cruising boat IMHO...

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[roly_voya]

Thanks for the effort and aiming to use the internet to share knowlage and experience - BUT I think this is dangerouse ground, by all means make available list of provisions and exipment carried for particular trips as part of an expedition account lots of people will find it interesting. The problem here is that, to me, you seem to be straying into giving advice about what others should do rather than reporting what you have done. In practical terms eg your notes on carrying lignocain, yes it is the local anasthetic of choice for suturing and if you want to use it on yourself then fine (but difficult) the obvious reason for carrying it is hovever to use it on someone else. If you do you are practicing as an unlicenced medical practitioner and could get into seriouse trouble. To use any anasthetic you need to be both qualified and trained in the specific use of that drug so you are aware of side effects etc. In this case the risk of respetory failure, cardiac arrest or anaphalactic shock all of which can be fatal in a very short time. If you have a casualty with serious cuts the first aid treatment is to stanch bleeding with bandages (including as you mention 'steristrips') and get them to a medical facillity ASAP. To take the next step and set up something akin to a minor injuies unit is going to be beyond the means of the majority of small boats and there is not much in between.
Personally I carry a comprehensive first aid kit, a 'home medicine chest' similar to the average bartroom cabinate. I would (and have) carrying some drugs like antibiotics and stronger anagisics for specific trips but only in consultation with a doctor and under their specific administration advice and within my training and experience to use
This advice is given from a qualified nurse

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[cliffb]

I hear what you're saying, but doesn't common sense come into it somewhere? Personally if I were miles from anywhere and at risk of bleeding to death, I'd rather have someone have a 'go' at keeping me alive, rather than meet the Grim Reaper with the words, ' I'm only here because my crew said he'd be in trouble if he tried to save me'.

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[Talbot]

I noted that you recommended it, however the link I gave you on the earlier post provides an electronic version of the book!

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[Sea Devil]

roly_voya Hi,

Great to have feed back from a qualified nurse - I will try to incorporate your advice about getting medical advice. I am certain you are right about the problems of administering local anisthetics but I have found the Ships captains medical book gives a pretty good laymans discription of how to do it...

The reason I have included the advice to carry local anisthetics, sutures and anti-biotics are as follows. I had a crew fall and cut her head open from nose to centre top of her head - down to the bone and flaps of skin every where - 200 miles to windward north of Colombia and 3 days from Panama - nearest realistic land fall. Butterfly tapes would not hold the wounds together and difficult to shave and clean the wound properly and make tape adhear....

Two friends of mine on passage between Galapagos and Marquesas (3 weeks minimum) had a similar problem - he fell opening up a wound to the bone on his forehead from the eye back into the hair with a Y shape and big flaps of skin quite thick - she successfully using the book and sutures and local anisthetic sewed him up and dosed him with anti-biotics - he has a scar now. No rescue services out there either -

The above are my reasons for reccomending having this equipment in the boats medical bag but would be grateful for any further advice or your views.. I will try to emphise the importance of making radio contact with a doctor.
regards
michael

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[Sea Devil]

understand now - will insert the link
thanks
Michael

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[Sea Devil]

Talbot hi,
many thanks - I have transferred the link to the web site page. Very useful
regards
Michael

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[Benbow]

I think your advice on malaria is dangerous. You are propagating the myth of severe side effects from anti-malarials. There was a drug that caused major problems – larium – but it is no longer used except under special circumstances.

You really do need to take malaria seriously, cerebral malaria can take you from perfectly well to perfectly dead in a few hours. You are absolutely correct that avoiding mozzy bites is very important, impregnated bed nets are good. And there are no mozzys offshore. However if the risk is significant you should take antimalarials, I have been on them for long periods in the past and the only side effects were slight mouth ulcers. Every year a significant number of tourists die in malarial areas.


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[Sea Devil]

Benbow thank you for that
- my malaria treatement, purchased in the UK, warned of fatigue and you had to start taking them some time before arriving in the area -

I get the feeling you have both medical knowlage and practical experience - I will delete all reference to Malaria - Dengue fever appears to be more prevelent and there is no avoiding that except by not getting bitten..... As I understand it.
regards
Michael

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[Benbow]

I am not a medic, I am a biologist working on tropical protozoal disease. My advice on malaria would be: 1.Take it extremely seriously 2.Take INFORMED local advice 3. Avoid getting bitten.

The problem is that if you ask a UK-based Dr, they will just look up the area in a publication in which the lowest resolution is an entire country while in fact the risk is sometimes very localised. So the whole thing loses credibility when the traveller turns-up and finds no-one else is taking antimalarials. Right now I am in a country that a UK medic will tell you requires antimalarials, but I only take them when I move into high risk areas.

The other confusion is that locals will often tell you that they get regular bouts of malaria, it makes them feel a bit ill, they take a few pills and feel better. However, the death rate in infants is horrific, you are seeing those that, by luck or genetics, have survived long enough to acquire a degree of immunity. A Western traveller will be completely naive and very vulnerable. The other thing is that 'malaria' is often used to mean 'feeling a bit crap'.

I thought the rest of your page provided a useful heads-up on some possible medical emergencies for a cruiser. I have heard it said that you should never stitch a wound in the field because of the risk of ending-up with a deep seated closed-over infection. The argument is that a scar can always be sorted-out later while an infection can kill you. However, my completely unqualified opinion is that you need to understand the issues, judge each on the circumstances and if you really need some stitches to hold a very large wound together, I would do it.

HTH

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[Sea Devil]

Thanks for the trouble of looking at the page - I have deleted the malaria as you suggested but left a bit about dengue fever which quite a few boats had problems with in the tropics - no cure of course - just rest and rehydration but I have not ventured into advice.

I really did the page as so I like many boats was woefully equipped when I started out long distance sailing. In Panama I felt the need to be able to look after sick crew for up to what could be a couple of weeks - It is normally possible to get radio advice from a doctor but you do need a few more tools than stugeron, asprin and a bandage...

regards

Michael

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[hamish]

Hi

had a look at information but what antibiotics do you carry for people who are allergic to Penicillin et al.

Do you not carry a cephalosporin drug (3rd generation) and the catch all for the moment Ciprofloxicin, both in 250mg and 500mg strengths.

Might you include Conn Current Therapy Internation Edition, which is updated every 2 years.

As far as web site goes use, will read with interest voyage up Red Sea, but the underlines are not all links.

best regards

Hamish

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[Sea Devil]

Hamish than you for the feed back - no I do not have Cephalsoporin or Ciprofloxicin. Can you tell me a bit more about them and what you think I should say about them?

I have nothing for people allergic to Penicillin - really would not know what to carry for that?

Is Conn Current Therapy better than The ships captain medical book or additional?

Part of the problem is since I started (rightly I think) taking offshore medical treatments more seriously I have gone from a small plastic box of dettol, plasters and asprin to a holdall about a meter long!

Thanks for the notes about the links - which pages? I only started the site a couple of months ago with the aid of front page for dummys or similar and have found it a fairly steep learning curve and am very grateful for all input.

regards

Michael

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[hamish]

Hi Again,

Well, bacteria come in many shapes and sizes but roughly breakdown to gram positive and gram negative, Penicillin only works against gram poisitve bacteria.

Cephlosporins (some work better for gram positive than gram negative, and Ciprofloxicin can work againt both. I could go on but off shore sailors should carry both sets and discussions with own GP or other friendly doctor, whcih range of antibiotics to carry.

Long time ago, friends where off on Altantic circuit with 2 small children, so we included antibiotics of children strength and dosage. Mum is Doctor and I am medical microbiologist. Both now retired. Which is why I like Conn's current therapy.


If use want some background information re-typhoid then listern to RADIO 4 on Monday 11th October at 8PM. All about typhoid outbreak in UK.

If you want help with web site I will forward link problems via your site. I ended up installing hospital computer systems, so happy to help.

best regards

Hamish

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[Sea Devil]

Hamish hi,

Thanks for coming back - I have already adjusted my web site to reflect your last comments -

I set off from the UK to sail for a bit - spent 4 years in the med where a doctor is never more than a day or so away - then did the atlantic then...... After the atlantic I got serious about medical issues and ...... So I thought the medical page would get people away from plasters and dettol....

Would really love more feed back if you could arrange that! I do not want to give bad/poor info -

bit difficult to get radio 4 here in France - never tried however I had typhoid when I was a kid - unconsious a long time...

I think in small boats there is a limit to what you can carry/do but you do need a degree of self help - Not sure if an apendectomy (spelling???) is on the cards but compound fractures and many fevers are - I think..

Very grateful and would love to improove the web site

regards

Michael

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[trouville]

Wher in France? normaly radio4s ok?are you to far east?

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[trouville]

when is the transmition?(radio4) not the tyfoid

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