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Old 15-01-2009, 14:31   #1
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Medical/First Aid Training for the Cruiser

Searched all the threads and came up with just a couple on this subject but nothing that had what I was looking for. Specifically what training and by whom is offered where for the medical training for cruisers getting ready to leave.

Available to just about everyone everywhere is some kind of CPR/ First aid class. Typically taught by the Red Cross or it's local equivalent. (Personally, I think this ought to be taught in all schools, once a year for every grade! it's so important for the general populous to know.)

Along the more medical route, people here in the states can take Emergency Medical Training and become an EMT (better known as the strange folks who come pick you after a car accident or when you call 911 and take you to the nearest hospital.) This is excellent training in many respects but is limited to some degree by the 'scoop and scoot' philosophy that is common here in the states in an effort to get you to the Emergency Room and better conditions. (For the record I was an NREMT-B, lapsed.) This does not provided some of the more basic knowledge like how to suture a wound closed, but does teach you how to apply advanced first aid to stabilize an injury for the short term and keep someone alive.

I understand that along the east and west coast of the US folks can find Search and Rescue classes that teach more advanced wilderness first aid, where more advanced help may be 24-48 hours plus away and more than a band-aid is need.

Also mentioned specifically is the 'Medical Care for Long Distance Sailors and Wilderness First Aid' hosted by Seattle Yacht Club in 2008. Open to anyone who was available to be there and pay the $160 US entry fee until the class was full.

Can folks post schools / training locations and roughly what the fees and class material are as a reference for those who are looking for training regardless of the their location in the world.

Thanks
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Old 15-01-2009, 15:50   #2
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I find standard first aid does not provide me with the knowledge and skills I need my advanced courses. I have Adventure Medic certification from the University of Calgary. It is a 40 hour program with a two day field trip.

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Old 15-01-2009, 16:05   #3
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Old 15-01-2009, 19:07   #4
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Almost any first aid class is better than total ignorance, but most ordinary FA classes, such as most Red Cross ones, assume you can hand the injured person off to an ambulance in a short while. I think the best classes are those that emphasize "Wilderness Medicine". Wilderness oriented classes assume you have to treat them for many hours or days until they get to a hospital. Some things are done differently in that situation. Also, wilderness oriented classes emphasize evacuation descision making...in other words, do I need to call for a helicopter even though it's dark and the weather sucks?...or is this person stable enough to wait until a rescue would be easier? We don't want to put the Coast Guard at risk for injuries that aren't as serious as they might first appear.

As someone else pointed out, even regular EMT training is mostly oriented to urban situations where a hospital is close by. In my opinion, the "Wilderness First Responder", also called WFR or "woofer", is the best all around training. It has become more or less the standard required training for professional whitewater river guides, climbing guides, etc. I'm certified in Alaska as an EMT-1 (the same as an EMT-B in most states) and also as a WFR. If I had to pick one or the other, I would go with WFR. However, woofer is a week long class and costs around $500. The time and expense makes it tough for many people to take it. Shorter (and cheaper), 1 or 2 day Wilderness First Aid classes are also available.

There are three big outfits that teach wilderness medicine classes around the country. While there may be minor differences, I think their classes are all more or less similar and I’ve heard generally good things about all of them. There are also smaller schools that are affiliated with or certified through the big three:

Wilderness Medical Associates (WMA)
Wilderness Medical Associates
They are based in Maine, and seem to have a close relationship with Outward Bound

Wilderness Medicine Institute (WMI)
NOLS - WMI : Wilderness Medicine Institute
This is a branch of NOLS (National Outdoor Leadership School)

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Old 16-01-2009, 13:01   #5
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For Australians the couse we did is Remote First Aid which can be combined with a Senior First Aid ticket.


HLTFA302A - Provide first aid in a remote situation


<LI hasbox="2">Prepare to respond to emergency in a remote situation <LI hasbox="2">Provide first aid in a remote situation <LI hasbox="2">Work in conjunction with medical and emergency services support <LI hasbox="2">Evaluate the incident

During our course (Nic and I did it together to get the Kiss of Life a bit of a fling!) the instructors still loved to be able to tell you: Ring the ambulance - wait for the ambulance - let the ambulance officers - etc. LOLOL

Listen you dill: We will be 3,000 miles from land and only have an EPIRB now tell me how to set a broken bone!!



We finally got the message through and were given some great instruction!

Also there is a defribulator course (we don't need one) for those with heart problems - get the fit person to do the course, then buy a portable defribulator....


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Old 16-01-2009, 13:08   #6
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I took several combat/Self-aid/Buddy aid courses - but, I don't like the idea of setting bones. LOL

On the other hand, I don't think that saving lives is something to take for granted nor are ANY courses you take going to be an all-inclusive course.

I think someone above said, the courses pretty much assume you can hand off to a medical agency, ambulance or a well-trained rescue crew.

If you're on the water, with no one close at hand, it might be hours, or days before you can do that.

So, I personally don't think any course will help THAT much - but, ALL are better than NOTHING.

(I've taken one Red Cross course in my time. Wife has taken several courses on the subject, required when she was a girl scout leader... my training was all from the military and I hope I don't have to use it ever these days)
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Old 16-01-2009, 13:08   #7
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cpr

A tip of the hat to the bee gees. Apparently while administering cpr you should use the beat of "Stayin Alive by the B Gs Do they get royalties for for this?
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Old 16-01-2009, 13:17   #8
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A tip of the hat to the bee gees. Apparently while administering cpr you should use the beat of "Stayin Alive by the B Gs Do they get royalties for for this?
I dont think many were able to stay alive...
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Old 16-01-2009, 14:00   #9
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I've been looking around forever, did a red cross first responder training and fortunately I was in class with the Port of Baltimore's chief medical officer. The problem with even a course like "wilderness EMT" is they will not be showing you how to do critical items you will need in care conditions where you could be several days or even weeks from medical care. They won't cover how to do even very basic items like administering fluids or stitches as this wouldn't be something typically carried by a hiker. They will go into resetting limbs and other critical skills, but it's definitely geared more to a hiker who gets in trouble in the wilderness than someone who is onboard a boat and has an elaborate medical kit with them. EMT training is great, but again, they aren't going to reset bones as it's transitive care meant to provide intermediate care to stabilize a person to where they can get to a hospital the hospital is only an hour or two away at max. They would cover splits, inline stabilization, controlling bleeding, resuscitation, etc.

The type of medical care training we need is this "Shipboard Medical Care" Med-SMC.
This is training for a merchant marine onboard medical officer and it's specifically for our situation, days to weeks away from medical care but you have a well equipped medical station. They will cover administration of fluids, stitches, short and LONG term care. It's 20 days of training and has 2 days of clinical hospital training included. You get the EMT certification at the end. I haven't had a chance to take this course myself, but it does come highly recommended and sounds like exactly what we need.

MITAGS.org

When I get closer to leaving I will definitely be taking this class.
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Old 16-01-2009, 14:16   #10
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If you look up the treatment it covers, it includes things like techniques of sewing and clamping and minor surgical treatment.
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Old 16-01-2009, 14:22   #11
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Got you all beat!

My lady is a critical care certified RN. I'm set but I feel sorry for her if something happens to her with only me around.

Actually, she's been teaching and going through the kit to make sure I know what to use, when to use it, and how.

She's really kind of upset at most of the "offshore medical" books. Much of what they discuss and/or recommend is rather wortheless, or worse dangerous. They often recommend courses of action that a trained person would hesitate to perform. Additionally, she feels the guilt trip on someone trying to follow their advice and watching their partner die is unwarranted.

Face it, we don't live forever. Why leave the survivor in misery thinking that if they had performed a bit better, their partner would have survived? Despite the fact that a full ER would have had difficulty, to say the least. It's like O2. For anyone offshore it's virtually impossible to carry enough to make a difference if help is even 24 hours away.

What my lady is trying to do is to put together a new type of medical/ first-aid book for the offshore traveler. Amongst other things she is soliciting info on any old family remedies, for example a shot of vinegar to help an upset stomach. For several year she ran clinics in the Appalachians and found that not all folklore was off the wall. This doesn't mean that more modern aspects will be ignored. For example, we use benadryl for allergies, sleeping med, and in a sufficient dosage, an anasthetic. If any of you have some old saw remedy we'd be interested in hearing about it and checking it out.

It's a difficult topic, good luck to all of us.

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Old 16-01-2009, 18:28   #12
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Originally Posted by schoonerdog View Post
includes things like techniques of sewing and clamping and minor surgical treatment.
Kewl! Can help with sail repairs too!


Or

Perhaps I could just use sail repair tape on a laceration???


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Old 11-02-2009, 13:06   #13
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One thing to keep in mind is that in my First Responder training there were several nurses. I asked them why they were there and they mentioned that nurses don't get training in evac procedures, how to make a splint so a person can be mobile and dragged, etc. And there are many techniques such as subcutaneous administration of fluids which can be safely and effectively done with minimal training and have very little risk of adverse effects that aren't done in todays hospitals because IVs are quicker at getting patients in and out of the emergency room. Every bit helps, and yes, if a person has fractured a femur, or has a collapsed lung, or is bleeding profusely, there are things that can be done with training to ensure that the person will survive several days to get to help and if you have no training, the victem will quickly fall into shock. CPR is something where it has very little chance of success on it's own, but rescue breathing, how to save a choking infant, etc are extremely useful. I would suggest everyone start with a first responder course. I'd also recommend the shipboard medical officer meets stringent coast guard requirements and goes beyond EMT training.
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Old 11-02-2009, 15:22   #14
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Having worked in EMS for 6 years I can tell you that an EMT course and Paramedic for that matter is fantastic only if backed by real experience and the care enroute many times is the difference between life and death. These providers start long term care before you even reach the hospital. My wife is an ICU RN. That being said we teach First Aid and CPR and package custom medical kits for companies and cruisers. As already mentioned First Aid only goes so far. Knowing how to prevent/manage infection, fractures, and worse, is not provided in many classes. Working with MD's we are in the final stages of developing a specialized course that will concentrate on long term treatment until port or evacuation. First Aid is the backbone. Blood goes round and round, Air in and out. Any deviation fix it.
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Old 12-02-2009, 05:55   #15
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I think the Wilderness FA courses are Wilderness First Responder courses are much better suited for cruising than equivalent levels of typical red cross or other typical courses that assume professional treatment is close by. Its true, these courses don't get into extremely advanced care like administering IVs, minor surgery, etc. but they simply are not at this level. It's not fair to compare any basic course to any extremely advanced course, wilderness oriented or not. (Though the wilderness EMT goes into IVs, etc.)

I think for the time spent, any "wilderness" course will offer more applicable ongoing care instruction compared to the same city equivalent course. It's always better to learn more, but I think when one gets into the need for minor surgery and very advanced equipment, the typical cruising sailor will be hitting the eprib rather than attempt that themselves. This is the difference between first aid and advanced care.

I've been teaching Red Cross classes for over 20 years and been certified in WFA or WFFR almost as long. The direction the red cross has been going, is to place a greater emphasis on getting the professionals there as quickly as possible, and placing less emphasis on extended care training. This is logical for typical city accidents, but I think it means the wilderness courses are an even better option that before for people venturing farther from these services.

While "wilderness" courses do tend to be oriented to those who are able to carry less than cruisers, I think these differences are of minor consequence. What these courses do it teach you what changes when your "first aid" must be extended, how to make greater assessments of the victims condition and need for advanced care and how to be adaptable to use what ever you may have at hand as an aid in your treatment. For example, whether you have a tent ground cloth, tarp or storm jib available really doesn't change anything. From the point of view of improvising a rescue or problem solving an accident, there is probably little difference between a climbing rope and a nylon anchor rode or dock line.

I agree with those who have said hands-on experience such as professional nursing experience or actual ambulance experience is much preferred to just taking a course. However, for those not in these fields, the time and expense of getting such experience is hard to justify. A course, while not perfect, can with a fairly small financial or time investment give one greater skills and abilities to deal with accidents.

As someone who works full time in the outdoor field, another point I'll make is that while I think its good for people away from help to have appropriate first aid training, many people spend much more time and effort on this than accident prevention. It's better to have jacklines set up, wear a harness and prevent someone from going over in the first place than it is to have more knowledge in how to treat a half drown, hypothermic person, it took you forever to recover, (or maybe can't even find.) I'm aware of very few wilderness or sailing accidents where the level beyond basic first aid made a huge difference in the ultimate outcome. I'm aware of many where more attention to safety would have made all the difference in the world.

AK Sailor above mentioned some of the most reputable organizations teaching these courses in the U.S.
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