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Old 16-12-2015, 10:01   #1
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Medical Emergencies at Remote Cruising Destinations

My girlfriend stepped on a stingray a few days ago and wound up in the emergency room due to a severe reaction to the venom. There she was pumped full of steroids, Benadryl and morphine. Her foot was x-rayed and bandaged and then she was given prescriptions for Cipro and pain killers upon being discharged.

This REALLY got me thinking. Just before this happened, we had spent a day visiting a good friend who recently got back from an 8 year circumnavigation. My friend who was an avid diver said that he didn't dive much at all during his cruise because of medical issues associated with being bitten, stung, cut etc. In fact it didn't sound like he spent much time in the water at all.

So, what to do while cruising. I've read threads about medical supplies one should carry onboard including a debate on AEDs. I'm obviously no doctor but it seems the likelihood of death is REAL if for instance a person has a severe allergic reaction to a number of toxins one may encounter if not near a competent medial facility. Not to mention all the other bad stuff that can happen.

I'm curious if other cruisers avoid water activities while at remote locations.

Thanks...
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Old 16-12-2015, 10:14   #2
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Re: Medical Emergencies at Remote Cruising Destinations

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Originally Posted by Saleen411 View Post
I'm curious if other cruisers avoid water activities while at remote locations.
Thanks...
So far just just Crocs, sharks and Jelly fish which probably doesn't count as you would avoid them anywhere you were.
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Old 16-12-2015, 11:10   #3
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Re: Medical Emergencies at Remote Cruising Destinations

I just brought the competent medical facility with me. The biggest problem with being in the water is coral cuts, which can lead to tropical ulcers if not properly treated.
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Old 16-12-2015, 12:22   #4
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Re: Medical Emergencies at Remote Cruising Destinations

We swim, dive and fix stuff all the time without worry. My wife and I are both registered nurses and we have a complete medical kit onboard including an AED.
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Old 16-12-2015, 12:26   #5
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Re: Medical Emergencies at Remote Cruising Destinations

Saleen,

The short answer is that we didn't worry about it much. We carried an extensive medical kit, and were prepared to take our chances.

Don's right, among the cruising community, un- or inadequately treated coral cuts were the most common issue and can lead to septicemia. Here, it is the immediate care after the wound is sustained that is most important, followed up as necessary, and is all doable. Even tiny cuts must be cleaned carefully. (Elsewhere on CF there are threads about what to use and why.)

The presence of crocs does make us modify our behavior, though. So, for us, it partly depends on which hazard you're facing.

For instance, we "shuffle" when we walk in the sand, to spook the stingrays away. Very thorough cleaning of that stingray sting is essential. Absent the hospital, the person has to wear and bear the pain.

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Old 16-12-2015, 12:52   #6
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Re: Medical Emergencies at Remote Cruising Destinations

i AM the competent medical facility.
btw the treatment for sting ray is hot water immediately. if no hot water, pee on it. same thing. pee is sterile. so to avoid stings, wear shoesies in water ....and shuffle in sand.

helpful hint from antiheloise.
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Old 16-12-2015, 13:20   #7
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Re: Medical Emergencies at Remote Cruising Destinations

The likely hood of death is real wherever one is. 100% likely, in fact.

For us, we enjoy our cruising to the fullest, rather than insulate ourselves against the odds to match the equivalence of being in a major 1st world city next to good medical facilities. That would really restrict our cruising enjoyment and we might as well just go back to land and watch TV and putter in the garden.

We don't swim with crocs, but then again, driving in Baltimore scares us more. And is a higher risk activity.

Infected cuts are the highest probable health risk where we are. It isn't just coral. A dorsal spine prick while cleaning a fish, a minor slip of the knife while cleaning a conch, a scraped knee in the sand - all of these can actually become life-threatening fairly quickly if it is certain bacteria.

We just take precautions - I wear gloves when spearfishing and cleaning fish, wetsuits around coral, etc. If we have significant cuts, we stay out of the water for a bit.

Sunburn is our greatest threat, though. And my eye doctor said I have more floaters than normal for my age due to sun (I am never without quality sunglasses, but the sun is brutal).

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Old 16-12-2015, 13:23   #8
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Re: Medical Emergencies at Remote Cruising Destinations

Step #1 would be to take a "Wilderness Medical" course, which gives you the knowledge to correctly assess a situation and act on it. There are some for sailors, at major boat shows, etc., and others simply "wilderness" medical in general.


There are books (including a great free one online, someone will know the URL for it) about "When there's no doctor" which can give you a good start inexpensively.


But the first thing to get, is some knowledge.


On the west coast of Florida, they literally talk about "doing the stingray shuffle" because that helps you avoid stepping on them while they're around. So you also want to ask the natives, or whoever boards/clears/etc. your boat, if there are things to beware of.


In terms of medical supplies? There are already some very long threads about that, a lot depends on what YOU have been trained to use and how comfortable you are in using it. Otherwise, medevac insurance and a good "radio" may be a best bet.
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Old 16-12-2015, 14:33   #9
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Re: Medical Emergencies at Remote Cruising Destinations

Thank you all for the replies.

So I gather that it's business as usual, even if hundreds of miles from a medical facility.

Evidently, my cruising friend had seen enough in 8 years to keep him on his boat most of the time. At least he arrived home hale and hardy after 8 years of full time cruising the world.... age 70 with just a trick knee.
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Old 16-12-2015, 14:39   #10
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Re: Medical Emergencies at Remote Cruising Destinations

[QUOTE=Saleen411;1989343]
So I gather that it's business as usual, even if hundreds of miles from a medical facility.


I've seen more carnage around docks than anywhere else.
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Old 16-12-2015, 14:47   #11
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Re: Medical Emergencies at Remote Cruising Destinations

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btw the treatment for sting ray is hot water immediately. if no hot water,
Hi Zee,

Yea, that's the first thing the medical staff did....hot water as warm as she could stand while they did all the other stuff.

Obviously shoes help, but I've seen pics of barbs that have penetrated shoes, some going thru the entire foot......and lots of wounds on and above the ankle.

BTW, I'm not trying to make a big deal about sting ray injuries.....I know they are rarely fatal. My concerns are things like anaphylactic and septic shock from exposure to a plethora of bad stuff. Years ago my ex wife would have died from the former if not for IMMEDIATE medical treatment.

So many critters, so many toxins.....
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Old 16-12-2015, 15:02   #12
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Re: Medical Emergencies at Remote Cruising Destinations

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We don't swim with crocs, but then again, driving in Baltimore scares us more. And is a higher risk activity.
Mark,

I used to live on Kent Island and drive to BWI for work....scared me too.:big grin:
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Old 16-12-2015, 15:04   #13
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Re: Medical Emergencies at Remote Cruising Destinations

[QUOTE=Guy;1989351]
Quote:
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So I gather that it's business as usual, even if hundreds of miles from a medical facility.


I've seen more carnage around docks than anywhere else.
Yes!...but aren't docks USUALLY somewhere near civilization?
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Old 16-12-2015, 15:16   #14
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Re: Medical Emergencies at Remote Cruising Destinations

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hellosailor;1989297]Step #1 would be to take a "Wilderness Medical" course, which gives you the knowledge to correctly assess a situation and act on it.
Good advice!

On my glorified bus, we have medical kits...one being an "enhanced" medical kit that we can allow access to by qualified medical personnel. We too can be many hours away from a medical facility should an emergency arise. Lives have been saved by medical staff using the contents of the enhanced medical kit and our onboard AEDs.

Issue is, most of us are not "qualified" medical personnel, nor do we have access to some potentially life saving drugs.
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Old 16-12-2015, 16:27   #15
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Re: Medical Emergencies at Remote Cruising Destinations

Quote:
Originally Posted by Saleen411 View Post
My girlfriend stepped on a stingray a few days ago and wound up in the emergency room due to a severe reaction to the venom. There she was pumped full of steroids, Benadryl and morphine. Her foot was x-rayed and bandaged and then she was given prescriptions for Cipro and pain killers upon being discharged.

..
So they didn't do anything, really, that you could not have done together in a remote location.
In fact all they really fave her was painkillers. No special anti-venine , no surgery, just shoved her in bed and self with the pain.

So if you guys were by yourself she may have had to endure a bit more, but still would have recovered.

In remote areas you need to be a bit psycologically self sufficient that's all. The others who have posted saying they have an AED could not help you, and the chance it would help them is a seriously minute chance.
Ehats the percentage of people who recover after their heart has stopped? About 10%. Doesnent matter of you are in town or remote, if its that bad the chances of recovery are slim.

So go enjoy yourself expecting the same % death rate as if you had stayed at home

Mark
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