Experience with First Aid & Medical Emergencies at Sea

[Kings Gambit]

My wife & I were coastal cruising over the holidays; I got a bad sore throat and needed lozenges. Neither I, nor crews of the other two boats with us, had any. One said, "I checked my First Aid kit, but there weren't any." That gave me occasion to open my own store-bought "First Aid Kit" for a peek, and I decided that it was a total joke!! So I stated researching "First Aid" on the boat and the contents of kits, etc. A lot of different stuff is suggested among various publications or web sites, but what to do with each item, i.e., its purpose there (except for band-aids) is a bit a of a mystery. I just recently learned that the 1" adhesive tape is for taping the rib cage if ribs are broken. I did not know that. I wonder how many here have ever had to delve into that WM First Aid Kit for an "at sea" emergency; was it adequate? What type of treatment did you have to do? Should Rx drugs or other internally applied medications be a standard part of "the kit"? If so, your store bought kit is not going to have 'em so the kit will not be adequate.

 

[JK_Boston_Catalina310]

Get this book: http://www.amazon.com/Marine-Medici...ywords=ADVENTURE+MEDICAL+KITS+Marine+Medicine

It's written by a doctor who is has sailed the Newport to Bermuda race and is very well put together. I have attended a seminar by the doctor and he does a great job of telling you what is important and what stuff you already have that could be used in a pinch.

The adventure kits from West Marine are a good base and well laid out. They are expensive though. You can put together you own kit for cheaper.

Good luck and fair winds,

Jesse

 

[Ron20324]

Just an assumption, but I doubt any first aid kit (unless assembled by a doctor) will include anything that gets put into your body. Liability,

 

[inarathree]

If you google search for it, there are quite a few documents on what you need for a medical emergency kit. Check the ISAF site for offshore requirements (see attached PDFs).

You can try this:
http://www.oceanmedix.com/?_siteid=...ddd05181db68514&action=sku&sku=cOM-marine3000

You can ask your doctor to write prescriptions for medications like Percoset and Dramamine, if you explain why you are asking for them. I also asked my doctor if there was a number I can call if i need emergency help while off shore (or not near shore). But my doctor is a long time family friend.

Keep in mind that like other parts of sailing, if you don't know what you are doing all the equipment in the world isn't going to help. Take a first-aid class.

 

[CloudDiver]

I was trained as CLS in the Military (Combat Life Saver), this is just a step above standard First Aide/CPR but not quite the level of a Field Medic or Corpsman. The idea is to be able to preserve life in the 'golden hour' prior to Medevac for combat related trauma. Hopefully at sea you wouldn't have to deal with injuries that require major bleeding or a collapsed lung. I would guess that concussions could be a factor, and that is a scary injury to deal with.
I think for sailors one of the best skills to have is good judgment on what level of treatment you can do immediately, the need for follow on care, and when to evacuate a patient with haste. So think a little like this;
Level 1. A minor injury that can be treated aboard without risk of further injury or infection (a band aide and antibiotic ointment). Sail on happily.
Level 2. An injury that requires immediate attention from a full first aide kit and will reduce the patients ability to sail. Provide treatment to prevent further injury or infection and follow on care is required, however these is no serious risk in the amount of time it take to reach a care facility on your own vessel.
Level 3. A more serious injury, this requires immediate and possibly advanced first responder care to trauma. All haste should be made to return to port at once for follow on care at a trauma center via a faster vessel in the area or Medevac from Coast guard.

That's really basic, and there are some grey areas. It could be broken down into more levels, but the bottom line is knowing what you can treat to what degree and when to seek further professional medical care and how quickly you can get there. When in doubt, get to a clinic or hospital as fast as you can safely.

On You Tube, look up Patriot Nurse. She does medical seminars more for the Survivalist/Prepper crowd, but some really good info there. Like 5 antibiotics that can cover just about anything, What Pharma companies don't want you to know about expiration dates, and how 'Vet-grade' drugs could save your life.

 

[Kings Gambit]

Learning a lot already here, already. The book (Weiss & Jacob) appears very comprehensive. An FA class I'm sure covers a lot, but what about "hands-on" and the treatment-decision process? Let's get practical. What are the most likely injuries/conditions requiring treatment aboard? Jammed/broken fingers or toes? Lacerations (cut your finger nearly off while cutting bait?). Can everybody suture? Is there sterile suture or Dermabond in your WM KIT? Concussion, as mentioned. Severe sprains. [Hey, where do you get ice on a sailboat that's underway for a week?] Broken rib/forearm from falling hard on the combing? Severe allergic reaction? Poisonings, including CO? Does anyone carry oxygen? That's certainly not in YOUR KIT!! [I read that the recommended treatment for poisoning now is to call the Poison Center Hotline!] Drowning. Hypothermia. Severe seasickness. Puncture wounds. Rope burns. Illnesses from pathogens. Shock. Then, there's the chronic things not necessarily boat related: risk of stokes, heart attacks, diabetic issues, appendicitis, etc. Anything in YOUR KIT for a heart attack?

 

[Jackdaw]

My next marine medical purchase.

 

[Kings Gambit]

My next marine medical purchase.

Ha! That's a different kit!!

 

[shemandr]

I agree that the widely available kits are a joke.
If I were to sail offshore significantly, I would have a consultation with my MD for an assessment of my health risks, and design a kit that could cover those risks. For instance, if you are diabetic you need your medication, and a means of raising your blood sugar quickly because hypoglycemia is a medical crisis while high blood sugar is not. I don't think it's practical to carry medication or medical devices for every situation.
If you're not offshore, I think it's prudent to have medication to treat sudden severe allergic reactions (Anaphylaxis), asthma attacks, a hypoglycemic crisis, dehydration/sun stroke, angina attacks, maybe antibiotics (Most people misuse them and some have life threatening reactions) and to treat injuries until medical assistance is available. That means control bleeding, splint limbs or joints, apply ice, etc. And to get professional medical assistance ASAP!
I have a defibrillator. It may be a good idea to bring it on the boat or anywhere else. It could save someone's life - I'm the most likely candidate. But I question whether someone inexperienced could be effective using it even though they are very automated. Folks underestimate the stress of a medical emergency and how that makes decision making more difficult. I've seen well meaning people begin chest compressions when the victim was clearly breathing. If possible stick to the simple things. ABC

 

[Kings Gambit]

I agree that the widely available kits are a joke.
If I were to sail offshore significantly, I would have a consultation with my MD for an assessment of my health risks, and design a kit that could cover those risks.

That focuses it. If I'm sitting on a mooring ball at Isthmus Cove, Catalina Island, and a guest on my boat falls down the companion way due to not holding on properly (i.e., one hand for the boat), hits the cabin sole and breaks his/her arm, I can apply First Aid--don't even need the kit. Roll him over, immobilize the arm, observe/treat for symptoms of shock, then call for help. That's First Aid!!

But what if I'm 1000 n.mi. downwind in the Pacific SE trades in the annual Pacific Puddle Jump, heading for islands still 2,000 n.mi. distant? It's I who falls and breaks me bloody arm! Only the wife aboard. Now what do you call it? Still First Aid or medical emergency that you have to be equipped to handle COMPLETELY? Open THE WM [or some other inexpensive] KIT--what's there? Some aspirin, band-aids, gauze bandages up the ying-yang, tongue depressor, plastic tweezers, some antiseptic wipes, etc. Just have a look and you'll see. No strong pain killer, no splint material, no triangular bandages, no instructions, etc. Whadya do-- call 911 on the Iridium phone? I dunno. [And that's just one example of many things that could happen.]

 

[All U Get]

Mine is very simple:

Rum & Gin - Better than throat lozengers or use salt water
Aspirin - Four baby (81 mg) for heart attack, should have had a check-up before leaving
Benadryl - allergies, bites, can't sleep
Band-aids and duck tape - anything bleeding or small splinting
BP cuff - slows bleeding to extremities
Pillow - nice soft splint
life jacket - stiffer splint
Oars, winch handles, magazines - rigid splints
Vinegar, peroxide, and rubbing alcohol if I can't find the antiseptic salve.
YoYo

All U Get

 

[justsomeguy]

YoYo? That's more of a weapon, isn't it?

Yes, gargling with Jack Daniels instead of throat lozenges. Good topic here.

 

[Bad Obsession]

Most minor first aide things aren't really that big of a deal. The kit I carry at work is designed for a big deal.

I am a patrol supervisor for a police department and I am a lead Instructor Trainer for a type of training called MACTAC (Multiple Assault Couter-Terrorism Action Capabilities). Part of that training I have a combat medic or TEMS (Tactical Emergency Medical Supplement) certified person to instruct my classes. The training is to deal with really bad stuff (gun shot wounds, etc).

At work I put together a TEMS kit for myself. Here are some of the contents:
Quickklot
SWAT Tourniquet
CAT Tourniquet
Israeli H Bandage
Medical Tape
Gauze
Bowlin Chest Seal (could also carry Asherman)
Shears
Pressure wrap
2 pairs of gloves
Band aides
Para cord
2 flashlights
2 sharp knives
Large permanent marker

Okay, so this is a worst case scenario kit for blow outs (gun shot wounds) and it is designed similar to what military carries into battle. Still, I can do a pretty good job of controlling most types of bleeds with this kit. I can also deal with broken bones and other bad injuries. You could experience any of these things at sea and it could take a lot of time to get the coast guard to pick up a wounded person. During this time the person could bleed out. If anyone knows about the "Golden Hour" then you will know a little about what I am eluding to.

I tend to carry this kit with me when I cruise.

The scary part is that I single hand so that means that I may need to do self-first aide.

 

[Gunni]

Think you have this backwards. You need to get the 1st aid training first, then assess your risk matrix and acquire your kit. First aid is about having treatment options and they don't all need to be in a kit you bought at the store. Most of them are in your head (training). With a little training and reflection you will will know what you really need, and what you can improvise. Once you become informed and trained you will find that your doctor will prescribe as needed, and there are companies that specialize in boater medical kits, properly packaged.

Starting with American Red Cross first-aid training is a good place to inspire the what-if problem solving process. Might consider volunteering for your local FD - they train their people, and you get OJT.

 

[shemandr]

Think you have this backwards. You need to get the 1st aid training first,...

OK. I don't have a disagreement with this.
[/QUOTE] Starting with American Red Cross first-aid training is a good place to inspire the what-if problem solving process. Might consider volunteering for your local FD - they train their people, and you get OJT.[/QUOTE]
Excellent suggestion.

 

[Chris & Lenore]

Nobody mentioned the "standard" book carried on boats without a doctor - "The ship captains medical guide".
You can download it in parts from: https://www.gov.uk/government/publications/the-ship-captains-medical-guide
It covers off just about everything that can befall a sailor at sea (and in port too).
I also have it as an app on my phone and tablet.

Chris

 

[justsomeguy]

"Don't panic" is a good start. Being able to simply look at a serious wound requires some kind of stamina.

If you're singlehanding, shock may be a real problem, especially during the aforementioned "golden hour".

Again, good topic.

 

[Stu Jackson]

My wife & I were coastal cruising over the holidays; I got a bad sore throat and needed lozenges. Neither I, nor crews of the other two boats with us, had any.

Our boat is our second home/cabin the woods on the water. We try not to have to drag specific stuff down with us each time we go out (once a week). So, over the years, our medicine cabinet onboard is like the one at home. Why not? I have backups of my.our specific medicine, and just about everything else one would have at home. Unless you use your boat so rarely that material will decompose on the boat, stock it up. For adventures further afield, we prepare necessary supplements.

 

[All U Get]

YoYo? That's more of a weapon, isn't it?

Yes, gargling with Jack Daniels instead of throat lozenges. Good topic here.

Pssst, Your On Your Own, YoYo.


[knows about the "Golden Hour"] Bad O I've thought about this a bit while cruising. At 5-6 Kts it will be a while to get ashore. We have options.

All U Get

 

[Kings Gambit]

Our boat is our second home/cabin the woods on the water. We try not to have to drag specific stuff down with us each time we go out (once a week). So, over the years, our medicine cabinet onboard is like the one at home. Why not? I have backups of my.our specific medicine, and just about everything else one would have at home. Unless you use your boat so rarely that material will decompose on the boat, stock it up. For adventures further afield, we prepare necessary supplements.

Yeah, the irony is that I forever had lozenges in my travel kit which I take aboard, but where the lozenges eventually melted somehow so I threw them out w/o getting replacements, etc. So, I agree; but a home-like medicine cabinet is not really a First Aid Kit, etc. All of this just led me to full discovery of the inadequacy of my FA kit aboard to really do much of anything except bandage a [small] bleeding wound, in addition to the need for more medications stocked aboard. Home grown remedies [Gin & Rum] mentioned earlier may assist recovery but don't do much if there is pain/discomfort in the throat. [I still have my tonsils!!] Eventually got to a Ralph's store and sucked down > 20 lozenges over a couple of days until it subsided. Lozenges contain benzocaine, a topical anesthetic, that works better than RUM! If I had been at the islands 40 n. mi. from "services", I would have suffered quite a bit more!!