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Old 11-04-2014, 07:48   #46
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Re: What are the common injuries cruisers encounter?

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This should mean we can deal with most minor cases but for anything more serious I'm on the VHF making a PanPan or even a MayDay immediately.

I don't prescribe to the school of thought of having prescription controlled medications on board (including antibiotics), unless they are for you personally. As a 1st Aider I am not allowed to give any drugs but can help a person take their own medications (such as for angina or asthma). There are too many risks to go around giving antibiotics or other drugs to anyone unless you are a qualified pharmacist, paramedic or medical doctor. Better to stabilise and obtain proper medical help through a MayDay call.

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Keiron, your advice may be fine for day cruising in a developed area, but not for long passages and months spent in remote areas. In a large part of the world, there it make take 24 hours or more for help to arrive and it may be in the form of another cruiser or local whose medical equipment and knowledge is no better than yours. Then you have to deal with the backlash on the internet from asking for help.
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Old 11-04-2014, 09:12   #47
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Re: What are the common injuries cruisers encounter?

And, for us old farts, 800 mg Ibuprofen and Flexoril (Cyclobenzaprine HCL 10 mg) for the mysterious afflictions of joints and muscle that seem to accompany all of that wonderful adventure we soak up over the years.
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Old 11-04-2014, 09:24   #48
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Re: What are the common injuries cruisers encounter?

cut shin when I stepped/fell into anchor locker during a nighttime anchor reset. Never leave locker door open, especially at night. And various skin infections, a couple severe, requiring clinic visit for lancing, from coral and iron shore.
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Old 11-04-2014, 09:30   #49
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Re: What are the common injuries cruisers encounter?

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Keiron, your advice may be fine for day cruising in a developed area, but not for long passages and months spent in remote areas. In a large part of the world, there it make take 24 hours or more for help to arrive and it may be in the form of another cruiser or local whose medical equipment and knowledge is no better than yours. Then you have to deal with the backlash on the internet from asking for help.
Very true!! I ended up with a MRSA infection and luckily other cruisers in the area had better antibiotics than we had for the conditions. The doctor finally flew in after ten days waiting and ordered me back to G-Town where I could visit clinic daily for treatment. A nurse from another boat dressed and repacked wound daily until then..
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Old 11-04-2014, 10:36   #50
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Re: What are the common injuries cruisers encounter?

Honestly the ones that we tend to find scariest, although not most common are two groups of infections. Staph infections and bacterial infections such as Salmonella and Listeria. These are so easy to get and so difficult to treat and require meds that most boaters don't have with them.

As to staph, understand it occurs more in hospitals than any other place. The places that should be taking the most precautions find it hard to prevent. Professional athletes with the best surgeons and care find themselves post surgery with staph infections, sometimes even ending careers.

As to Salmonella and Listeria and E-Coli and such. The risk in groceries, in restaurants, everywhere is substantial. Even in the most professionally and more regulated food processing they are common. Let's see, the FDA recalls of just the past few days. Chiles with Salmonella, Cilantro with Salmonella, Basil with Salmonella, Dog and Cat food with Salmonella (there have been human deaths in the last couple of years from dog food with salmonella, not from eating it, but handling it to feed their pets), Peppercorns with Salmonella, Tree Tea Mouthwash with Pseudomonas Aeruginosa (a bacteria), Salted Fish with Clostridium Botulinum (life threatening bacteria), Salads with Listeria, Cheese with Listeria. Note that many here may be at even greater than normal exposure as with our efforts to eat healthy, fresh, natural, organic, our exposure to these things increases unfortunately. That is not intended to discourage anyone from trying to eat healthy, but just pointing out that we are are at some risk.

Most of the time too these things mentioned above can easily hit more than one crew member. Staph infections spread easily and exposure to bacteria like Salmonella and Listeria is often through something more than one person was in contact with. It's just that they are hardest and most dangerous for young children, seniors, and those with suppressed immune systems.

I'd say our approach to these is:

1. If within a few hours of land, get immediately to land and medical care.
2. If we're going to be beyond that reach of land, then we do carry a lot of antibiotics (a variety so choices) and we will contact our doctors and start the "patient" on antibiotics plus monitor the patient's signs. Meanwhile head to land and medical care. Now as power boaters we will probably never be more than 6 days from land (assumes a 10 day ocean crossing) but then these things can happen at the worst time. And sometimes you don't have 6 days leeway without risk of life.
3. If at any point the antibiotic isn't leading to improvement or we have concern about the person's life, call for help, wherever we must call, however we must get that help. Never let our pride or sense that we can control things overrule our concern for others.

We can think of only one thing that could quickly destroy our love of boating and that is the loss of a life as a result, direct or indirect, of boating with us.
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Old 11-04-2014, 16:02   #51
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What are the common injuries cruisers encounter?

I think sickness at sea is a rare concern and thankfully so. Most injuries are minor cuts and abrasions, fungal infections and the like. I found the STCW training very useful and I plan to refresh it again soon. On long trips I carry a range of broad spectrum anti biotics and spin killers like petidine and tramadol. I have yet to use them in anger.

I will not allow crew to walk around on deck without foot coverings unless we are stopped. I don't insist on gloves as you don't really work a lot of lines cruising. Racing is different.

Seasickness is another debate altogether

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Old 11-04-2014, 17:50   #52
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Re: What are the common injuries cruisers encounter?

Actually one not mentioned is getting beat up on Cruiser's Forum! Hmm... how to prepare....
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Old 11-04-2014, 19:20   #53
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Re: What are the common injuries cruisers encounter?

Infections are scary. They can occur from an injury - cut/scrape/scratch, and if left untreated can become a risk to life quicker than one can imagine. Some people carry antibiotics, but how can you be sure you have enough, or the right ones. Or even if a medical facility is available, it might not have the ability or resources to effectively treat an infection.

Here is a sad case of a healthy 41 year old women cruising in the south Pacific who died from an infection in a matter of days even though she received treatment. Very unfortunate and while details are limited, it highlights the need to give this substantial thought and planning depending where and for how long you might be cruising.

From the blog of Peter Bernfeld one of our CF members:
'Sarf & West mate, Sarf & West' - A terrible Tragedy
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Old 11-04-2014, 19:46   #54
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Re: What are the common injuries cruisers encounter?

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Infections are scary. They can occur from an injury - cut/scrape/scratch, and if left untreated can become a risk to life quicker than one can imagine. Some people carry antibiotics, but how can you be sure you have enough, or the right ones. Or even if a medical facility is available, it might not have the ability or resources to effectively treat an infection.

Here is a sad case of a healthy 41 year old women cruising in the south Pacific who died from an infection in a matter of days even though she received treatment. Very unfortunate and while details are limited, it highlights the need to give this substantial thought and planning depending where and for how long you might be cruising.

From the blog of Peter Bernfeld one of our CF members:
'Sarf & West mate, Sarf & West' - A terrible Tragedy

Other then telling us life can be scary, what's your point.

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Old 11-04-2014, 23:37   #55
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Re: What are the common injuries cruisers encounter?

In my post: it highlights the need to give this substantial thought and planning depending where and for how long you might be cruising.

Yeesh!
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Old 12-04-2014, 01:00   #56
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Re: What are the common injuries cruisers encounter?

Seasickness is a major danger (I recommend avoiding rich or fatty foods for at least a day ahead of departure, and start taking any anti nausea medication a similar time ahead, partly to get accustomed to it)

This is particularly important in some weather patterns and some parts of the world.

When setting off into rough weather, I was lucky to have a couple of great skippers in my youth who had no compunction about ducking into a remote cove for a sleep and sort-out even after clearing customs: it's madness to face a hard beat into a gale after all the rushing involved in a departure, with the boat not even properly secured and stowed, and the crews' stomachs in a delicate state of butterflies.

I carry injectable anti-nausea prescription drugs on offshore trips: on one trip there were only three of us, the skipper, a doctor and me, and I ended up having to inject the skipper under directions from the doctor, who wasn't feeling much better. Sub- cutaneous injections need some coaching if you don't sail with a doctor, or even if you do.

In the instance I gave, the skipper's recovery was rapid and lasted the rest of the trip. I was a convert, for this specific challenge. I'm not generally a fan of pharmacological interventions, but seasickness is one thing I take really seriously; a great many disasters on boats have been contributed to by this scourge since the first log was ever hollowed.

A potentially serious health problem which doesn't often get mentioned, and can afflict even those relatively immune to seasickness, is constipation. Particularly if rough weather sets in early on a trip, the muscular effort of holding the body steady against violent motion, added to even mild dehydration and the usually stodgy diet on a boat, can lead to increasing discomfort, turning into a full blown crisis if unaddressed.

Obviously dietary fibre is essential, along with drinking good quality water, in moderation but constantly. Too much water sloshing around can compound seasickness.

My worst case of constipation (not something I'm prone to generally) was on a boat whose skipper, while embodying almost the perfect mixture of skipperly virtues, had grown up with brackish water on his farm and had no conception of how foul the water in his tanks had become. I joined the boat in Fiji, whence we sailed straight into forty knots, and enjoyed champagne power reaching for the next three days at least, during which time my enjoyment gradually diminished while everyone else became increasingly chipper. Luckily on the fourth morning, when I joined the grinning fools in the cockpit, who were gleefully announcing "16.4 knots !!!" on a forty foot cruising boat ... I, too, was able to pass on a piece of great news ... or at least, I thought so ....

Warm salt enemas can be administered if the problem persists for more than (say) four days (which was another reason for me to rejoice!): it's dangerous to wait longer that that for a resolution. If that doesn't work a finger in a Vaseline- lubricated glove might be necessary to dislodge compacted, hardened stools at the anal sphincter.

Now that everyone's thoroughly grossed out I might as well mention urine retention. Some women, in particular (usually young women or girls), no matter how outdoorsy their life up until that time, and how uninhibited their personality, have real problems passing urine in rough conditions. I think it must be physiological as well as, sometimes rather than, psychological.

It was even more of a problem in the days when small boats relied on buckets. I can remember as an adolescent having to make a hard choice: to enter a narrow unlit inlet in the middle of the night in fairly torrid conditions, or remain hove-to and stand off until dawn, when my girlfriend was in a condition which only going ashore was ever going to resolve.

I didn't know the 'ins and outs', either of catheterisation or my girlfriend, well enough to respond to that particular challenge in any other way.
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Old 12-04-2014, 01:35   #57
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Re: What are the common injuries cruisers encounter?

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Originally Posted by JusDreaming View Post
cut shin when I stepped/fell into anchor locker during a nighttime anchor reset. Never leave locker door open, especially at night. And various skin infections, a couple severe, requiring clinic visit for lancing, from coral and iron shore.
GAWD that hurtz don't it !?!?!? Or a laz locker, or sole hatch...

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Actually one not mentioned is getting beat up on Cruiser's Forum! Hmm... how to prepare....
I don't understand???

***off to go through the past 100 cheech posts***

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Old 12-04-2014, 01:53   #58
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Re: What are the common injuries cruisers encounter?

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Keiron, your advice may be fine for day cruising in a developed area, but not for long passages and months spent in remote areas. In a large part of the world, there it make take 24 hours or more for help to arrive and it may be in the form of another cruiser or local whose medical equipment and knowledge is no better than yours. Then you have to deal with the backlash on the internet from asking for help.
Don,
As I am generally only day cruising from one place to the next I can only speak from my experience of course. And I agree with you that if you are crossing the Atlantic or sailing around the Indian Ocean then you do need to be prepared for the worst. Which should include a proper medical intervention course so you know how to deal with more serious conditions, how to administer an IV or use a hypodermic syringe properly and even include how to use broad spectrum antibiotics (obtained by prescription from a qualified doctor of course). Part of the problem of MRSA, VRE and C.Diff is people not using antibiotics properly and the bugs gaining the resistance.

I also work offshore in some pretty remote places so I know how long it can take to get emergency medical help. When the nearest hospital is a 3hr helicopter flight away and it is in Angola trust me you don't want to be getting injured. We have formally qualified medics on board and if I were to be long distance cruising I would seriously consider doing the course they take.

Keiron
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Old 12-04-2014, 02:29   #59
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Re: What are the common injuries cruisers encounter?

Both my wife and I work in the medical field and try and prepare the best that we can, but injuries still can happen. When purchasing our boat the PO stated his wife fell down the companion way and landed on the navigation table breaking several ribs. The ribs being broken though serious, are usually not life threatening, but you also have to watch out for other abdominal injuries and referred pain patterns for any blunt force trauma to the area.
Besides all the bumps and bruises, fractures, lacerations, dislocations, concussions, sunburns, seasickness, and dehydration you always have the risk of drowning. One day I'll never forget we're listening on the radio to a captain bringing one of his crew back into the docks while performing CPR for falling overboard after being struck in the head becoming unconscious and drowning. From that point on we always use one hand for the boat and one for us while being clipped in.
As for guests onboard we do have a safety meeting of where everything is located, what should happen if i get injured, and we also talk about loaded lines and where to sit. The last thing someone needs is a winch or block flying at them.
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Old 12-04-2014, 02:52   #60
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Re: What are the common injuries cruisers encounter?

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....One day I'll never forget we're listening on the radio to a captain bringing one of his crew back into the docks while performing CPR for falling overboard after being struck in the head becoming unconscious and drowning. ....
Yikes. Was that gybe related?
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