Medical kit

[Auzzee]

I can spend a mint on a medical kit either from a kit supplier, or by tailoring my own. I am however of the opinion that carrying a complex pharmaceutical dispensiary onboard is of little true worth.

With limited practical medical knowledge, it seems a waste to carry sophisticated, expensive first aid/medical inclusions which in all probability will never be used.

Obviously dressings, pain management treatments, antibiotic ointment, and basic care items such as eye and tooth medication and a few tools such as scissors, tweezers etc. along with some form of anaesthetic cream are vital. But where do we, as offshore cruisers, draw the line.

What medical care related items do you regard as essential for offshore voyaging?

[CCBullseye]

The best medical management is prevention. My medical kit besides bandages, H2O2, and such are: aloe, probiotic capsules, the herbal antibiotic sold as Bactex, and tree tea oil. Also over the counter pain meds which are common in any household medicine cabinet and then any some strong prescription pain killers. With the above I figure it will be enough for most anything less surgery.

[Celestialsailor]

There was a thread for "cruising essential list", where everyone worked together and came up with an essential offshore list. It would be nice to see that here so we could put together our own list.

[KDH]

Sturgeron for sea sickness. Ciprofloxicin (antibiotic). Tea tree oil. Aspirin, coated. Enough of any unique prescription medicine to last at least a year (everyone will tell you that you can get medicines everywhere and generally that has been true but I have one prescription I can't get in Europe). Antifungal skin cream. A muscle relaxant and pain management meds. On the prevention side, sunscreen and insect repellent, ginger tea and honey.

[David_Old_Jersey]

My First Aid kit usually consists of:-

1) Over the counter pain killers.
2) a roll of electrical tape (although I have recently been discovering that masking tape works pretty much the same as surgical tape).
3) antiseptic cream (mostly for the "there there" factor ).
4) tweezers (for anything else - see tool kit).
5) Alcohol (for internal use only).


Aftersun cream is really useful for sunburn.

[FearfulGirl]

Living on a boat—especially in the tropics—puts you at great risk of infection, so the best way to fend off sickness is to keep wounds clean. One item that was indispensable for us was a large plastic syringe with the needle removed. You mix water with a little Betadine antiseptic, then you suck it into the syringe and then squirt that directly into the wound to flush it out. This forces quite a lot of water pressure into the wound, which is good for flushing dirt out. Repeat 2 - 3 times a day. We had some pretty deep wounds that we managed to keep infection-free this way.

My partner and I did a 10 day wilderness first responder medical course at UCLA before embarking on a two year trip. I would highly recommend this if you're planning a major voyage. It was a huge comfort to have that first-aid knowledge.

[Celestialsailor]

When I lived in Hawaii I skinned my knee on a rock while climbing out of the water. I used Hydrogen Peroxide like I use to when I lived on the mainland. It slowly became reddened. I was talking to a couple of locals, one of whom was a Pharmacist. He immediately recognized it and told me to use Betadine which I also call Iodine antiseptic. It worked great.

[micah719]

Artery forceps. Nothing else will do when you really need one. And when you really need one, you need it fast. A leaking femoral artery will drain you dry and dead in less than a minute.

Rapid Superglue. Yes, no kidding. Instant suture for when sewing someone/yourself back together might not be so easy or practical. Eg, too cold/wet, or you only have one usable hand for some reason. Or just too squeamish. Just be careful applying it....

Tampons and panty shields make good cheap sterile field dressings, and more commonly available.

Antihistamines. Anti-allergenic; allergic reactions are usually over quickly. Permanently.

Plasma kit, or at least isotonal infusion solution with kit. Know how to use it.

Also, an enema kit. You may need to rehydrate someone/yourself, and be without potable water; worst case, you can use the built-in waterfilter we all have in the toosh. Gatorade or equivalent for replacing electrolytes...for instance after dysentery or puking.

Charcoal. Eaten something dodgy? Get those toxins out of your system, fast...especially when the ER is far, far away.

[jackdale]

One additional recommendations:

Vet wrap - it is the stuff they use to wrap horse legs. It sticks to itself and replaces triangular bandages, tensor bandages, etc.. It works for splicing, etc..

[JamuJoe]

Outfit your medical kit appropriate to your training. If you have no training - start there. There are several excellent courses available in the USA, such as Wilderness First Responder. I should hope that similar are available in OZ.

[teneicm]

We used this document as a start: http://www.dft.gov.uk/mca/msn1768-annex1.pdf and then worked with a physician to pare down the items to what was really useful.

This is the drug list we came up with:

To purchase OTC:
• Ranitidine (H1 blocker) for acid reflux and severe allergic reactions
• Diphenhydramine (Benadryl) 25mg for allergies
• Ceterizine (Zyrtec) 10mg for allergies (non-sedating)
• Ibuprofen 200mg
• Aspirin 325 mg
• Acetaminophen 500mg
• Senna laxative
• Loperamide 2mg for diarrhea
• Pseudoephedrine decongestant
• Pedialyte dry powder oral rehydration packets
• Triple antibiotic ointment
• Clotrimazine anti-fungal ointment
• Finger splints (or just make something if you need one)

To pick up via prescription:
• Epipen 0.3mg (#1)
• Scopalamine patches, box of 4, apply every 3 days for motion sickness (#2 boxes)
• Prochlorperazine suppository 5mg, insert in rectum Q6 hrs PRN nausea (#6)
• Triamcinalone 0.5% ointment, PRN rash,( #1 tube)
• EMLA (lidocaine/prilocaine), topical anesthetic, (#30gm tube)
• Silvadene 1% cream, PRN for burns, (#50gm tube)
• Cyclobenzaprine 10mg every 6 hours PRN for muscle spasm (#30)
• Prednisone 20mg, as directed for allergic reaction (#30)
• Albuterol Multi-dose Inhaler, 2 puffs every 4 hours for wheezing (#1)
Antibiotics
• Bactrim DS, 1 tablet BID for infection, (#28)
• Ciprofloxacin 500mg, 1 tablet BID for infection,( #28)
• Azithromycin 250mg, 2 tabs for 1 day, then 1 tab for 4 days (#6)
• Azithromycin suspension (for kids) 200mg/5cc. 2.5 cc for 5 days (#2 bottles)
• Amoxacillin/Clavulanate, 875mg, 1 tablet BID for infection (#14)
• Doxycycline 100mg, 1 daily for infection (#14)
• Mebendazole 100mg, single dose for parasites (#5)
• Polytrim eye drops, apply to affected eye every 4 hours for infection (#1 bottle)
• Cortisporin Otic, apply to affected ear for swimmers ear (#1bottle)
Analgesics/Anxiolytics
• Hydrocodone/Acetaminophen 5/500, 1-2 tablets every 6 hours PRN pain (#30)
• Lorazepam 5mg, 1 tablet PRN every 6 hours for anxiety (#30)
• Codeine 30mg, 1 tablet every 4 hours for cough (#30)

[Kenomac]

Teneicm has it right.

My wife and I are both Registered Nurses and thought that we could get by with a rather good medical kit, but I have to tell you, really unusual and weird things happen on boats that you will probably not encounter on land; so we've added quite a few important bits to our kit, so it now looks more like the prior post.

One example of something weird that can happen:

On our last trip, I managed to smash my middle finger tip in the companionway hatch, OUCH!... no big deal we thought, I'll just splint it next to my ring finger and keep the broken fingertip still and keep the crushed nail & cut clean and bandaged. Well, it got infected and didn't heal over the next two weeks. I eventually went to a medical doctor and was given a sulfa based antibiotic. Took the antibiotic twice and on the second dose had an allergic reaction, broke out with hives and my throat began to close up. Thank goodness we had an antihistamine on board. Well a very long story made short, the infection consisted of two varieties of fungus and a bacteria... all of marine origin. Then more antibiotics including Cipro and the nail eventually needed to be removed; three months later... it's finally healed.

My advice: Get the more extensive medical kit; you need to be self-reliant out there. We've recently added a suture kit after seeing a fellow on another boat sustain a massive cut on his head during a storm.

[carstenb]

Beth Leaonards book !"The Voyagers Handbook" has a medical kit suggestion. They have been circumnavigating since sometime in the early 90's. Good list.

[jismay]

Something I haven't seen anyone recommend yet is quik clot. You can get it pretty easily these days, RED, Big, etc. If dealing with major lacerations, punctures, etc it can be a real life saver. http://www.quikclot.com

[Dsanduril]

Originally Posted by Auzzee

With limited practical medical knowledge, it seems a waste to carry sophisticated, expensive first aid/medical inclusions which in all probability will never be used.

We're in the same boat, knowledgewise, but carry a pretty extensive medical kit as outlined in some of the posts above and designed with the help of our family doctor. You/we may not know how to use everything in it, but that doesn't mean those around you don't. Frequently the hard part is getting the supplies, not the knowledge. Our medical kit gets broken out with some regularity. Sometimes for use by us on us, sometimes for us by others (a nurse or doctor in the anchorage or on shore) on us, and sometimes to assist locals. All in all we find having a well equipped kit useful and the knowledge usually turns up somewhere.