Medical Assistance - taken for granted?

[mickmul]

Here is an account of an an injury and treatment that I never thought would happen to me - I file it so others may learn from my mishap. Last week while skippering a Salina 48 cat in the Balearic islands we were tied up in a corner quay berth in beautiful Formentera, a quiet island, not heavily populated. After the most amazing meal in Hostal La Savina (best yet in the islands) we returned to the boat for a nightcap and chat. I went on deck to tighten the spring as we were moving gently after the slight tide rise of the evening, visually checking the (flush) hatches were closed as I went. Stepping over the visually closed hatches, I adjusted the spring and turned aft again. Bullet points:
1. I was barefoot (mistake)
2. Forward hatch was open a crack, but looked closed as I went forward.
3. My toe went between the hatch and gasket, which was razor sharp aliminium.
4. The pain from the sliced toe made me lose my balance, and my shin was ripped open on same gasket.
5. My wife stemmed blood flow and got crew member to call ambulance.
6. Ultimately I received 43 stitches for a split second lapse, 21 under my toe alone, and because of a pre-existing medical condition, without anaesthetic or pain killers.
Observations and questions:
Medical attention from my cool headed wife and once ambulance got to me was second to none.
If I had been at anchor or on passage I may not have survived because of condition mentioned. I have no spleen and cannot lose more than a little blood. (I accept I would never have been on deck barefoot on passage).
How many of us plan passages without checking facilities in case of emergency? (I knew there was a clinic on the island but had not checked for a 24 hr A&E - it will never happen to me. . .)
Should hatches have a green LED when sealed, red when not?
In future, I will visually check hatches from both fore and aft, as my height profile led me to believe all was safe - ironic, when it was I who had given the safety lecture. Hope this saves someone from a similar fate sometime . . . fair winds! p.s. this is how my toe feels. . .

[Vasco]

Sorry to hear about your accident but what kind of hatch has razor sharp edges? I go barefoot on my boat all the time and just get the odd stubbed toe.

[ssullivan]

I agree with Vasco. The real problem is the sharp edge to begin with. No edges on any boat should be sharp, including cotter pins sticking out of turnbuckles. Keeping these things in check prevents cuts on deck.

[Therapy]

Originally Posted by mickmul

If I had been at anchor or on passage I may not have survived because of condition mentioned. I have no spleen and cannot lose more than a little blood. (
. . .

Sorry you got cut so bad.

21 stitches under a toe seems like a lot unless it was the whole bottom of your foot. Did they charge by the stitch?

I don't have a spleen either but the "bleeding" fear is not there for me. What other "medical condition" makes it so for you?

Your point of "eternal vigilance" on board is noted.

[GordMay]

Originally Posted by mickmul

Here is an accoun ...
... If I had been at anchor or on passage I may not have survived because of condition mentioned. I have no spleen and cannot lose more than a little blood. (I accept I would never have been on deck barefoot on passage).. . .

Originally Posted by Therapy

... I don't have a spleen either but the "bleeding" fear is not there for me. What other "medical condition" makes it so for you?
Your point of "eternal vigilance" on board is noted.

I'm NOT Doctor; but I don't think the not having a spleen was much of an issue in your case.
Although the spleen can hold up to 3 quarts of blood, if the spleen is removed (due to injury), the body is equipped to take over the functions of the spleen with the liver and lymphatic system. . The chief risk following splenectomy is overwhelming bacterial infection, or post-splenectomy sepsis.

[hellosailor]

LEDs? No, just More Stuff To Break. I have to vote with the chorus, there is no reason for razor sharp edges on hatches. In fact, there is no reason for sharp edges, sharp countertop corners, or similar menaces in households, let alone boats.

As Frank Lloyd Wright noted (and his work had problems too) if you hang your coat on the back of a chair, and the chair falls over, THAT'S A BADLY DESIGNED CHAIR because that's how people hang their coats.

At the risk of being undiplomatic, and speaking from pesonal experience, perhaps the nightcap and some wine with dinner were also partly to fault?

Most of us give no attention to "Where's the nearest aid?" when traveling, unless we are trained to do so pointedly. I've noticed that even when you want to keep track of this, it isn't possible. Even within the US, typical GPS/mapping software--even for landlubbers--simply DOES NOT show hospital locations. I try to remember the big blue "H" signs on the highway, there's often no other clue.

By now, one hopes you've taken a bastard file and sandpaper to that hatch edge?

[Latitude9.5]

I've slammed my fingers in my lewmar hatches, felt like an idiot afterwards, but i wouldn't want anything sharp in them, you will eventually find a way to maim yourself.

Anyhow, if it happened on my boat I'd have stitched you myself

[Boracay]

As the fitting out of Boracay progresses I am continually surprised just how many potential injury points there are on a boat.

The builder left a number of nice sharp steel corners. I have just put a bit of foam rubber padding on the entrance to the forward cabin (I still have a sore head). All the trip points on the sole have to be fixed.

And I don't even want to think about the obstacle course that is the deck.

[ssullivan]

Originally Posted by Latitude9.5

I
Anyhow, if it happened on my boat I'd have stitched you myself

This is our approach as well. We are nearly always too far from medical help for a real emergency. So, we will do our best with CPR/First Aid and a little bit of "home surgery" if it comes to that.

We would like to get our hands on some local anesthetic, an O2 tank and some epipens.

We do have some great stuff for burns. Used it a couple times for 2nd degree localized burns and had good results - no infections or scarring.

[hellosailor]

Sean, the O2 tank can be purchased easily, and there are many for sale online from estate sales and the like. The epipen, any doc will give you an rx for, but they expire pretty quickly. I thought I had bookmarked it...
Seaside Marine International Drug Company, Inc.
Check that out for rxes for documented vessels.

What are you using for burns? A minor kitchen accident reminded me I've overlooked that at home as well, I ordered in some Thermadyne (Silvadene) cream for that reason, don't want to have to wait for an RX if I really do need it some time.

[Latitude9.5]

The silvadene is great, it even works on chemical burns, definitely a must onboard.

[dana-tenacity]

And when you have taken all reasonable precautions, forget about it and go enjoy yourself. Just accept that sometimes **** happens, and sometimes people on boats die.

[mickmul]

I suffered at age ten from platelet abnormalities and this recurred earlier this year as a "bolt of lightning", i.e., no contributary cause, just unlucky. The illness is known as ITP (Idiopathic thrombocytopenic purpura) and requires constant monitoring of platelet level. Thankfully, following the trauma last week my platelet count is above 300. (less than 50 is dangerous for anyone, and mine was down to 7 earlier in the year). The lack of a spleen requires a vaccination every 5 years to prevent the infection Gord mentioned, and when you're told to contact your haematoligist if you cut yourself shaving, losing blood at the level I did last week puts you face to face with your own mortality. Yes, the dinner wine and nightcap were contributory factors, and had me relaxed enough to go on deck barefoot - the hatch on this 4 week old boat was made by G**** - don't want to be too specific, it was my fault after all - yes yau are spot on dana . . . all reasonable precautions taken . . boats are for enjoying . . I'll tread more carefully in future though . . I guess we're all still learning. . .

[Whimsical]

Originally Posted by mickmul

made by G**** - don't want to be too specific,

Oh goody a game of hangman.
Can I add a letter Go*o*

I was looking at them for my boat but didn't see any sharp edges. I bought 2 of the escape hatches but am going with Lewmars for the deck.

Mike

[ssullivan]

Originally Posted by hellosailor

Sean, the O2 tank can be purchased easily, and there are many for sale online from estate sales and the like. The epipen, any doc will give you an rx for, but they expire pretty quickly. I thought I had bookmarked it...
Seaside Marine International Drug Company, Inc.
Check that out for rxes for documented vessels.

What are you using for burns? A minor kitchen accident reminded me I've overlooked that at home as well, I ordered in some Thermadyne (Silvadene) cream for that reason, don't want to have to wait for an RX if I really do need it some time.

Sorry... didn't see this post.

We are using a burn "gel" pad that is sold over the counter in drug stores. I'm trying not to wake up the wife, so I can't go rummaging around for the name brand. They are large pads. One side is a clear gel. They are very wet and soppy on the side that goes over the burn. They somehow re-hydrate the burned skin and keep scarring from happening. On minor burns (up to 2nd degree), if you keep using them you can actually have normal skin back within 24 hours or so - with not much evidence of ever even burning yourself in the first place.

Thanks for the ideas on where get the extra medical stuff.