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Old 30-03-2013, 15:10   #1
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Our Medical Kit

I just completed our offshore medical kit. This is what we, as a family of four, feel is right for us to take care of most foreseeable accidents living on a boat with children and heading offshore. It is not perfect, but neither are we, so take this as a list of suggestions, or maybe ideas that can help you answer a few questions you might have on the subject.

I took an intensive wilderness medicine course which was tailored to offshore sailors. Using that new found knowledge gave me the confidence to assemble our own kit - and more importantly - knowledge of how to use everything.

For those contemplating a shipboard medical kit, you can read about what we have determined should go in ours on my blog, which I have just updated (see signature).

.

Sail safe.

Dhillen
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Old 30-03-2013, 15:22   #2
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Re: Our Medical Kit

I would like to discuss this if you agree. I find you have some items we lack but also we carry some items that you don't have but we find crucial. I could take some pictures and join into this.
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Old 30-03-2013, 15:27   #3
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Re: Our Medical Kit

Excellent idea. I am keen to see what you find crucial and readily admit what we have is not 100% complete.

Thanks.

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Old 30-03-2013, 18:16   #4
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Can you please post the link.....it appears that the CF apps do not show signatures. The Admiral is a nurse so I feel confident we will make it to a port okay .....but I would like to see what others carry.

Thanks!
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Old 30-03-2013, 18:19   #5
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Re: Our Medical Kit

Link to blog post from Dhillen: Our Medical Kit |
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Old 30-03-2013, 20:02   #6
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Re: Our Medical Kit

I just lost my post here when somebody closed my browser

So, I'll just list some points and will probably add more later. First a picture of the Pelican EMS (Emergency Services) case we use; this keeps it air tight so that the contents keep longer and better:


- Ciprofloxacin broad spectrum anti-biotic for infections (reef cuts etc.)
- GlacierGel for burns treatment
- Celox to survive arterial bleeding
- Stingkill ampules for biting/stinging insects & jellyfish
- Klinitule waxed gauze
- wound closure kit (the stitching kind)
- wound stapler plus the tool to remove the staples again
- blood pressure monitor (the new wrist-types with position-sensor are small and good; practice!)
- more battle dressings; they exist in multiple sizes but may be called different then plus are not packed military grade.
- big SAM splint for arm or leg
- survival blanket (to add to anti-shock measures)
- Iodine and hydrogen-peroxide.
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Old 30-03-2013, 20:22   #7
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Re: Our Medical Kit

Jedi,

Be careful with the Ciprofloxacin. The FDA has given it a "Black Box" rating. It can cause spontaneous tendon ruptures in older persons.

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Old 30-03-2013, 20:44   #8
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Re: Our Medical Kit

Quote:
Be careful with the Ciprofloxacin. The FDA has given it a "Black Box" rating. It can cause spontaneous tendon ruptures in older persons.
Erythromycin or cephalexin might be better substitutes for ciprofloxacin.
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Old 30-03-2013, 20:45   #9
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Re: Our Medical Kit

Quote:
Originally Posted by Gelfling View Post
Can you please post the link.....it appears that the CF apps do not show signatures. The Admiral is a nurse so I feel confident we will make it to a port okay .....but I would like to see what others carry.

Thanks!

Here you go: Our Medical Kit |

Cheers.

Dhillen
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Old 30-03-2013, 20:57   #10
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Re: Our Medical Kit

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Originally Posted by Viking Sailor View Post
Jedi,

Be careful with the Ciprofloxacin. The FDA has given it a "Black Box" rating. It can cause spontaneous tendon ruptures in older persons.

Yes it can; people who had trouble do exist. But we're talking out in the middle of nowhere emergencies; cipro is *the* anti-biotic to bring along for that and can save limbs or even life.

The Vicodin is another drug listed in the medical kit that we also carry and also has risks; it is a narcotic so can lead to addiction and trouble with customs officers because it is a controlled substance. Still, not having it when it's needed is a big problem.
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Old 30-03-2013, 21:03   #11
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Re: Our Medical Kit

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Erythromycin or cephalexin might be better substitutes for ciprofloxacin.
Are those broad spectrum replacements? A doctor I asked told me cipro is the best choice if taking one anti-biotic but it was a couple of years ago...
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Old 30-03-2013, 21:59   #12
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Re: Our Medical Kit

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Originally Posted by s/v Jedi View Post
Are those broad spectrum replacements? A doctor I asked told me cipro is the best choice if taking one anti-biotic but it was a couple of years ago...
Cipro is best for gram negative and Augmentin is better for gram positive--we carry both.
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Old 30-03-2013, 22:08   #13
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Re: Our Medical Kit

When I took my wilderness first responder vlass (WFR) Cipro was the recommended drug of choice as a GI antibiotic; Augmentin for everything else.

Some other stuff I carry:

- Quick-clot. Designed for the military, use in large open wounds to prevent blood loss.
- Flagyl or equivalent for giardia
- an anti-emetic
- a muscle relaxant (for dislocations)
- super glue
- a big assortment of cough/cold/decongestant/antihistamines
- clear, waterproof bandages (forget the name). These have stayed on for a week of rafting in the grand canyon, and you can see through to see how the wound is healing.

I go light on bandages, but heavy on meds, since cotton clothingcan substitute for bandages.

I think the single most important skill I learned in the WFR class was how to do a focused spinal exam.
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Old 30-03-2013, 22:09   #14
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Re: Our Medical Kit

Cephalexin is a good substitute in cases where penicillin allergies are suspected or present and is a good broad spectrum antibiotic which can treat sinus infections, inner ear infections, respiratory tract infection, UTIs and skin infections.

Erythromycin is slightly more broad spectrum than penicillin, but can be hard on the flora of the digestive tract. If I were chosing between erythromycin and cephalexin, the latter might be a better one to have on hand.
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Old 30-03-2013, 22:28   #15
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Re: Our Medical Kit

Quote:
Originally Posted by s/v Jedi View Post
I just lost my post here when somebody closed my browser

So, I'll just list some points and will probably add more later. First a picture of the Pelican EMS (Emergency Services) case we use; this keeps it air tight so that the contents keep longer and better:


- Ciprofloxacin broad spectrum anti-biotic for infections (reef cuts etc.)
- GlacierGel for burns treatment
- Celox to survive arterial bleeding
- Stingkill ampules for biting/stinging insects & jellyfish
- Klinitule waxed gauze
- wound closure kit (the stitching kind)
- wound stapler plus the tool to remove the staples again
- blood pressure monitor (the new wrist-types with position-sensor are small and good; practice!)
- more battle dressings; they exist in multiple sizes but may be called different then plus are not packed military grade.
- big SAM splint for arm or leg
- survival blanket (to add to anti-shock measures)
- Iodine and hydrogen-peroxide.
Jedi,

Thanks for the list. I am not familiar with some of these items. "Klinitule" sounds like it might be similar to hydrocolloid dressings which keep the wound moist and facilitate healing.

For jellyfish and other stings the research shows that there is no one "cure," and what works on one kind of sting may aggravate another. We carry a great book on oceanic stings and the different treatments, "All Stings Considered." It was written by two doctors based in Hawaii and has a Pacific Ocean bias but is extremely useful.

For wound closure, it seems the thinking now has changed and closure via stitching or staples is discouraged. Wounds need to "exude," or drain to heal properly. Closing a wound in the field (on a boat) raises the risk of infection which is why we are going with Xeroform (petrolatum dressing) and hydrocolloids.

We also learned that hyrogen peroxide use is now discouraged due to the fact that it kills everything it touches - including the tissue you are trying to save. Povidone Iodine solution is what we carry as a substitute.

Lastly, the blood pressure monitor is a good idea and I will look at adding it to our kit. The space blanket is also good but we are putting those in the ditch bag. In our kit I have a separate section for hypothermia which includes a hot water bottle and packets of Gu Gel - instant energy used by marathoners.

We also carry Vicodin and I asked for hydrocodone or fentanyl and was told in no uncertain terms by my physician, "NO." The druggies have hijacked that market and doctors are under extreme scrutiny if they prescribe these restricted medications.

Thanks for sharing and starting this discussion.

Cheers.

Dhillen
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