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redhead · 01-04-2018, 12:24

I'm trying to wrap my head around this subject, the more I think about it, the more I realize it's a huge issue.

This is what I've come up with so far:

First Aid - everyday scrapes, burns, scrapes, stomach/headache-y type OTC stuff. Needs to be accessible at a moments notice.
Trauma - sutures, splints, pain management, severe nausea/dehydration. This also needs to be somewhere very accessible, but not sitting out in a cabin.
Medications - prescriptions and perhaps OTC meds not used on a daily basis. This also needs to be nearby. (Although we are lucky enough that we take no prescription meds now.)

I'm fairly happy with my three categories, my conclusion that they should all be pretty accessible is what has me going in circles. I don't have enough room to keep them all handy at a moments notice. Or do I need to rethink this and make sure they ARE all handy at a moments notice?

I've ordered the book "Where There Is No Doctor" upon a friend's recommendation.

I'd like some real-world experience. Once again, thanks all.

Paul L · 01-04-2018, 13:33

I think clear labeling in relatively small bags is most important. When some trauma occurs, you want to be able to quickly sort through the med kit and find the appropriate stuff. Categories like large bandages, burn care, eye care, etc makes it a lot easier to make decisions and take action under stress.

puffcard · 01-04-2018, 13:40

First aid is kept in main cabin. Medication and over the counter, which is huge on our boat is two plastic boxes. We cruise 7 months a year. Leave the first aid and trauma, but take most drugs off the boat, during the summer...too hot.

**JPA Cate** · 01-04-2018, 14:38

Ideally, you want a smallish lockbox for medications, clearly labeled. Sometimes Customs are interested, and i was asked by a Customs Officer to remove anything containing codeine from my medicine chest and store it somewhere else, one time.

Remember, you will want some medications stored in your grab bag, and those should be in a waterproof container...if it's only meds for seasickness, you may need them in a life raft, which is far less stable that your 63' ketch. Consider suppositories against vomitting, also. (Won't work if the person is going at both ends, though.)

Our boat has only one head, but all the categories you mentioned are stored there. It is good to have it all in one place, so you know where to hurry to.

There is one exception, though, I keep the burn ointment in the fridge, although some people use honey.

Ann

kas_1611 · 02-04-2018, 08:42

I have 2 First Aid kits on board.

The main "ships" kit consists of a purpose made First Aid Kit (actually a Mountain Leaders kit) in a foldout red package along with a click lock plastic box. This contains everything I need to deal with most incidents up to and including heart attack. I'm not a ships doctor or medic so I don't keep any medications other than aspirin, paracetemol and ibruprofen as I am not authorised to distribute any medications.

My second kit is a waterproof outdoor activity kit that lives in my grab bag by the liferaft in the cockpit locker. It contains everything I need for minor injuries and for dealing with an abandonment.

Both kits are easy to get to and are kept up to date with everything checked for expiry dates on an annual basis.

The only thing to consider if you are storing medications is they often have to be in a cool, dry place away from direct sunlight. This suggests the bilge in a secure waterproof container. Plus you need to ensure you can check dates regularly.

There's probably no ideal answer as we will all have our own needs, spaces to store etc.

Wallaby · 02-04-2018, 09:20

First, everyone on board is responsible for their own prescription medications.
After that, there is:
1. A Mini kit in each head/cabin with a few bandaids, antiseptic, waterproof tape, and headache pills
2. A Grab and run kit kept at the companionway. Essential life support beginning with an Israeli bandage plus a dozen or so other items for serious emergencies. It's never been used.
3. The tackle box (filled with what most serious boaters would call a first aid kit. Kept in a locker in the main salon and checked every season.
4. The mega-kit (seldom used and stashed in a cool, dry locker), courtesy of the ship's medical officer/RN, this suitcase is stuffed with everything medical needed for out-of-the-way voyaging. You want a neck brace? Antibioitics? Surgical instruments? There are separate packs for dental etc. It even has IV drips and high-intensity LED lights.
5. Survival Kit (in the liferaft's Grab bag.)

toddster8 · 02-04-2018, 11:18

Well, I have a plan, though it is several "projects" down the list. I think it will actually be a kind of fun project. My boat is just too small to have duplicative regular and emergency stores. This year, I am building-out cabinets on the starboard side where there is now only an open ledge. One cabinet at the base of the companionway to be reserved for "critical stores:" first aid kit, survival kit, medicine box, ships documents, emergency signals, EPIRB, handheld VHF, flashlight, captains wallet, phone, etc.
Although the face will look like the other cabinets, unlike the others, this one will have a foam-core fiberglass shell, so that the whole thing can be yanked out in an emergency to serve as the "ditch kit," and will float. Because of the irregular shapes of boats, this will necessarily have to be a custom project. My day-hiking pack, with the usual going-ashore stuff, fits on the shelf right next to it, where it can also be quickly grabbed.

This is somewhat inspired by the "life cell" product, but that seems quite expensive and there is no real good place for it on my boat.

The question of medicines seems a bit variable, as some people will have medications with specific storage requirements (i.e. refrigeration.)
At my home, stocks of medicine are in a sealed dry container in a refrigerator. For those needed daily, a smaller "working" bottle is in the kitchen. Not sure that will work when "home" is the boat.

Lake-Effect · 02-04-2018, 11:40

Just a quick plug for the Safety at Sea course. A friend of mine was entering a long-distance race (LO300) and one of the requirements was completing this course, so I took it with him just for the opportunity. As well, we take basic First Aid courses from time to time.

As important as having the right stuff is knowing how to handle a medical crisis.

ArmyDaveNY · 02-04-2018, 12:57

Quote:

Originally Posted by Lake-Effect

As important as having the right stuff is knowing how to handle a medical crisis.

I would say even more important since one can use field expedients in the case of most trauma.

ArmyDaveNY · 02-04-2018, 13:11

Quote:

Originally Posted by toddster8

Well, I have a plan, though it is several "projects" down the list. I think it will actually be a kind of fun project. My boat is just too small to have duplicative regular and emergency stores. This year, I am building-out cabinets on the starboard side where there is now only an open ledge. One cabinet at the base of the companionway to be reserved for "critical stores:" first aid kit, survival kit, medicine box, ships documents, emergency signals, EPIRB, handheld VHF, flashlight, captains wallet, phone, etc.
Although the face will look like the other cabinets, unlike the others, this one will have a foam-core fiberglass shell, so that the whole thing can be yanked out in an emergency to serve as the "ditch kit," and will float. Because of the irregular shapes of boats, this will necessarily have to be a custom project. My day-hiking pack, with the usual going-ashore stuff, fits on the shelf right next to it, where it can also be quickly grabbed.

Great idea!

ArmyDaveNY · 02-04-2018, 13:37

It sounds like there are two of you on board. Are there any additional crew? Will you ever single hand?

I ask because having more people gives you more options on where you will keep things. If you are single handing, and suffer trauma, you may not be able to get to the supplies. Some trauma equipment, in particular splints, are awkwardly shaped and are not as easily stored as other supplies. If you have several crew, one can retrieve the needed equipment while the other(s) stabilize the injury and the patient. If you are limited in personnel, then the whole process becomes more difficult. If you are alone, then the location of the trauma equipment is very important. Generally, breathing, bleeding, and anaphylaxis (severe and dangerous shock) are very time sensitive, while most trauma is less time sensitive. One should stow the first aid supplies accordingly. Keep in mind that if there are two of you, and one is injured, then you are effectively alone.
The first aid kit doesn’t need to be immediately available in the open, but should be easily accessible without the need to do serious digging. In a perfect world the first aid kit and critical medicines (heart pills, insulin, serious allergy, etc.) should be available within a minute or two. A good location is close to the ditch back for equally quick access. Some medicines require refrigeration so these should be clearly labeled and up front in the icebox or refrigerator. Equipment such as splints most likely are not readily available due to their size and shape.

In terms of splints, two of my favourites are the cardboard splint and the air splint. The cardboard splint is probably the best overall in terms of stabilization, versatility, comfort, ease of storage, ease of use, etc. A cardboard splint can handle injuries to all extremities with the sole exception of the fractured femur. A cardboard splint is just a long flat piece of cardboard that can be manipulated into various shapes. It needs to be a couple of feet long and is easily stored in many areas such as behind or under cushions, in a sail locker against a bulkhead or attached to the bottom of the lid, etc. Cardboard splints are inexpensive, fairly easy to stow, and very worth having around. In several emergencies I’ve even made my own from available cardboard.

The air splint is good but harder to use, and few yachts carry them. It is however easily compactable, and is good to have if one is a ways from professional treatment. It can greatly reduce further injury including nerve damage, and provide more comfort especially if the seas are rough.

There are field expedients for many things that will eliminate the need for storage and special equipment. Battens can be used as splints although they are nowhere near as good as cardboard or air splints. Under most cushions are panels that provide support to the cushions and access to the storage under the cushions. These can serve as a backboard in an emergency. Storage is no longer an issue since they already have a spot and don't need additional space. If one plans in advance, one can even cut hand holds, and a further benefit will be ventilation for storage when the cushions are lifted. One can also make cervical collars from various items, usually using towels and some support, such as foam cushions, cardboard, etc. A cervical collar may be important in the case of falls and head injuries such as getting whacked by the boom. One can even provide traction for a broken femur (a very dangerous injury since the upper leg muscles are so strong they will pull the leg up several inches, with a very real possibility of internal bleeding and major damage as the broken bone cuts through anything in its way) with a harness for the upper body and an ankle harness made from a cravat. One then applies traction by pulling. Depending upon where one is, a winch or block and tackle can be used just enough to counter act the muscles and it can be secured, reducing fatigue on those provide assistance. Sail ties can be used as tourniquets.
In all cases, the more severe the potential injury or illness, the more access one needs to the gear. It’s also important to have things easily found by those who are perhaps unfamiliar or less familiar with the boat.
In case anyone is wondering, I worked for several years on a paramedic rig while in college and again a few years after the Army. While in the Army I was a combat engineer and later as an officer, I was in tanks and cavalry. In both cases the value of a good and readily available kit was proven both in theory and sadly, also in practice. A good set of field expedients is also well worth while, and in most cases eliminates the need for bulky, specialized gear.

redhead · 03-04-2018, 08:53

Quote:

Originally Posted by ArmyDaveNY

It sounds like there are two of you on board. Are there any additional crew? Will you ever single hand?

I ask because having more people gives you more options on where you will keep things. If you are single handing, and suffer trauma, you may not be able to get to the supplies. Some trauma equipment, in particular splints, are awkwardly shaped and are not as easily stored as other supplies. If you have several crew, one can retrieve the needed equipment while the other(s) stabilize the injury and the patient. If you are limited in personnel, then the whole process becomes more difficult. If you are alone, then the location of the trauma equipment is very important. Generally, breathing, bleeding, and anaphylaxis (severe and dangerous shock) are very time sensitive, while most trauma is less time sensitive. One should stow the first aid supplies accordingly. Keep in mind that if there are two of you, and one is injured, then you are effectively alone.
The first aid kit doesn’t need to be immediately available in the open, but should be easily accessible without the need to do serious digging. In a perfect world the first aid kit and critical medicines (heart pills, insulin, serious allergy, etc.) should be available within a minute or two. A good location is close to the ditch back for equally quick access. Some medicines require refrigeration so these should be clearly labeled and up front in the icebox or refrigerator. Equipment such as splints most likely are not readily available due to their size and shape.

In terms of splints, two of my favourites are the cardboard splint and the air splint. The cardboard splint is probably the best overall in terms of stabilization, versatility, comfort, ease of storage, ease of use, etc. A cardboard splint can handle injuries to all extremities with the sole exception of the fractured femur. A cardboard splint is just a long flat piece of cardboard that can be manipulated into various shapes. It needs to be a couple of feet long and is easily stored in many areas such as behind or under cushions, in a sail locker against a bulkhead or attached to the bottom of the lid, etc. Cardboard splints are inexpensive, fairly easy to stow, and very worth having around. In several emergencies I’ve even made my own from available cardboard.

The air splint is good but harder to use, and few yachts carry them. It is however easily compactable, and is good to have if one is a ways from professional treatment. It can greatly reduce further injury including nerve damage, and provide more comfort especially if the seas are rough.

There are field expedients for many things that will eliminate the need for storage and special equipment. Battens can be used as splints although they are nowhere near as good as cardboard or air splints. Under most cushions are panels that provide support to the cushions and access to the storage under the cushions. These can serve as a backboard in an emergency. Storage is no longer an issue since they already have a spot and don't need additional space. If one plans in advance, one can even cut hand holds, and a further benefit will be ventilation for storage when the cushions are lifted. One can also make cervical collars from various items, usually using towels and some support, such as foam cushions, cardboard, etc. A cervical collar may be important in the case of falls and head injuries such as getting whacked by the boom. One can even provide traction for a broken femur (a very dangerous injury since the upper leg muscles are so strong they will pull the leg up several inches, with a very real possibility of internal bleeding and major damage as the broken bone cuts through anything in its way) with a harness for the upper body and an ankle harness made from a cravat. One then applies traction by pulling. Depending upon where one is, a winch or block and tackle can be used just enough to counter act the muscles and it can be secured, reducing fatigue on those provide assistance. Sail ties can be used as tourniquets.
In all cases, the more severe the potential injury or illness, the more access one needs to the gear. It’s also important to have things easily found by those who are perhaps unfamiliar or less familiar with the boat.
In case anyone is wondering, I worked for several years on a paramedic rig while in college and again a few years after the Army. While in the Army I was a combat engineer and later as an officer, I was in tanks and cavalry. In both cases the value of a good and readily available kit was proven both in theory and sadly, also in practice. A good set of field expedients is also well worth while, and in most cases eliminates the need for bulky, specialized gear.

This advice is golden. We are two - in our 60's, fit, but the inevitable is creeping up stealthily...we are heading north (currently in the PNW) this year with no additional crew and then we will go where we want to. If we decide to cross the Pacific at some time, we will take crew and that's another whole first aid issue. I can't thank you enough for your input, it's made me realize the issue is a bigger one than I had thought and I need to do some serious research.

ArmyDaveNY · 03-04-2018, 09:11

Quote:

Originally Posted by redhead

This advice is golden. We are two - in our 60's, fit, but the inevitable is creeping up stealthily...we are heading north (currently in the PNW) this year with no additional crew and then we will go where we want to. If we decide to cross the Pacific at some time, we will take crew and that's another whole first aid issue. I can't thank you enough for your input, it's made me realize the issue is a bigger one than I had thought and I need to do some serious research.

You are very welcome. Don't be afraid, but do be prepared! As someone earlier mentioned, a first aid course is worth it's weight in gold. You will see that treatment for most injuries and illness is not complicated however a little practice helps a lot. It's in many ways like sailing or a MOB (man overboard) drill; practice makes perfect, or at least good enough. When you're on a long passage, and you've fixed everything that needs fixing, the noon sighting is done, laundry is done, and you don't feel like writing or filming any more, practice using a splint or applying a dressing. Good luck!

P.S. Here is something else to consider. Injuries and illness don't happen very often but if they do, don't be squeamish or think about what might happen. Take action! Too often people are afraid to touch the injury. The person is already in pain and stabilizing the injury will help to reduce not only further injury but pain too. The sooner you take action the better off you will be.

redhead · 03-04-2018, 09:43

I'm not too worried about panicking, my other half was an ambulance driver back in the day and I always rush toward the car accident, not away from it. He has over 50 years of sailing under his belt, I have half that.

My thoughts turn to the fact that we are Atlantic (New England and Florida) sailors and the Pacific up along British Columbia offers tremendous challenges for sailing and one of them is that people are few and far between the further north you go. Independence and safety means carrying many more spares aboard than we ever needed and this will include health, emergency and communications that we took for granted in the gentler and more populated Atlantic.

Once again, thanks!