What's in your First Aid Kit?

[jacob30]

So I just received my Pelican 1500 EMS kit and am going to begin stocking. My list thus far is:

Bandages ( various)
scissors
Tourniquet
Butterfly bandages
Splint
Sutures
quickclot sponge
Saline wash
Eye drops
Neosporin
Super glue gel
IV kit with lactated ringer's solution
Eye patch
Gauze
Tape
Tweezers
Forceps
Antibiotics (cypro ??)
Pain meds ( Tylenol, Motrin, codein)
Imodium
Sea sickness meds ( Dramamine )??
Epi pen
Aspirin
Valium??
Iodine tincture
Alcohol prep pads
Neosporin

So just a start. If you have a medical background chime in on what you would bring.

Thanks,
Jacob


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[JPA Cate]

Suggestions:
1) compazine suppositories for when the person is vomiting too much [you'll find it in the PDR under anti-emetic]

2) meclizine HCL ("Bonine" is somewhat less soporific than dramamine], but for me, Stugeron (cinnarizine HCL) works best of all and will be obtainable in Mexico.

3) Betadine for wound cleansing, especially effective for preventing coral growth in the bloodstream from a coral cut, and which can cause medical emergency when the organisms try to build a reef in your joint -- and it will prevent bacterial infection as well. Do not use tincture of iodine, it is too strong, and hard on the injured tissues.

4) metronidazole against bacterial infections of the gut

5) don't know what you want the valium for....there are more effective muscle relaxants

6) A comment about the EpiPen: they don't stay good for very long. Unless the anaphylactic reaction is really fast, you may be better served with phenergan or benadryl. [Jim's allergic to peanuts, but the speed of his response has slowed over the years, and the phenergan works for him now, but he used to have to carry an Epi Pen.]

I am not a physician. These items come out of our cruising experience and what has been prescribed for us, which so far, is 28 yrs duration.

Ann

[Red Sky]

Ann, +1 on the Compazine. My wife had a bit of a time on her first passage. She gave it a good try at toughing it out, but after a couple of days it was time for the "Magic bullet".

[Jehoshaphat]

Originally Posted by jacob30

So I just received my Pelican 1500 EMS kit and am going to begin stocking. My list thus far is: Bandages ( various) scissors Tourniquet Butterfly bandages Splint Sutures quickclot sponge Saline wash Eye drops Neosporin Super glue gel IV kit with lactated ringer's solution Eye patch Gauze Tape Tweezers Forceps Antibiotics (cypro ??) Pain meds ( Tylenol, Motrin, codein) Imodium Sea sickness meds ( Dramamine )?? Epi pen Aspirin Valium?? Iodine tincture Alcohol prep pads Neosporin So just a start. If you have a medical background chime in on what you would bring. Thanks, Jacob Sent from my iPad using Cruisers Sailing Forum

Jacob

Good on ya for putting the kit together rather than buying one of those pre-made kits they flog at the boat shows. However, I think you have overlooked your best source of advice (and materials) and if you are still a SAR Pilot, he's probably sitting right behind you. Your Medic/Corpsman! That guy will tell you just what you need and probably be able to get it for you.

That said, and as I meet your criteria (8 yrs Hospital Corpsman USN Fleet Marine Force Trained, EMT/Paramedic, 8 years Physician Assistant-Certified practicing Internal Medicine, Emergency Medicine and Primary Care), I'll chime in if only to give you my best advice and steer you clear of some of the frankly more laughable advice.

First, don't include anything you don't already know how to use, it'll only get you in trouble. Sutures and IV's are great but only if you can use them. Oral hydration is always the best option when possible. "Butterfly" sutures are easy and all the average person can manage. Forget carrying sterile water, fresh water and a mild soap are all you need. If you really want a good cleaning product, trade the water weight for Hibicleanse. It is easy on tissues and a better choice than betadine of any kind for an open wound. Betadine is really only for a skin prep BEFORE an incision or procedure and to be effective, it has to dry completely.

You should be able to get your hands on some G.I. Battle Dressings. They are highly absorbent and have gauze already attached to secure them. I LOVE quickclot and carry it myself. NEVER EVER use superglue on a wound, it's a myth and will cause infection and necrosis. Get Dermabond which is a surgical adhesive if you must, but it's useless but for the smallest lacerations in my opinion. SAM splints are gold, they are versatile and you should carry about 4 to make good use of them they are light and when used properly, better than anything else. ( Remember though, that casting/splinting material is no longer plaster but, yep... Fiberglass! And the advantage here is that it can heal your boat too!)

Second, don't include anything considered a controlled substance unless it is prescribed, more trouble. Any narcotics are hard to explain and too great a temptation for some to pass up, so have a copy of the original Rx and keep both locked up. Tylenol/Ibuprofen and Aspirin are all good. Neosporin is garbage, carry Bactroban or silver sulfadiazine for abrasions and superficial burns respectively. Ciprofloxacin and Imodium together are a good treatment for the trots, metronidazole has a relatively narrow spectrum of application and isn't worth carrying. Plain ol' penicillin goes a long way, Ceftriaxone is good too. The trouble is, unless you know what you are trying to treat, you could make things worse. I like Valium, it's good for pain, anxiety, seizures, as a muscle relaxer and it can be used for sedation or treating alcohol withdrawal when the rum runs out on a crossing!

Sea water is apt'ly described as bacteria soup. Other than superficial abrasions, wounds related to contact with coral are a concern, but coral CAN NOT reproduce in the body under any circumstances. Just care for the usual injuries the usual way and 99 of 100 will be just fine.

You can't plan for every eventuality, but you can practice prevention. Know the medical history of any crew and any medications. Life jackets, harness and even helmets for bad weather. Preventing seasickness is easier than treating it, same goes for sunburn, dehydration, sleep deprivation and piss poor planning.

So, having given my advice, I say take it with a grain of salt (also a good antibacterial agent) and go talk to the guy behind you. This forum has a very few people with good knowledge who will rarely part with it so search them out. Try not to be blown off course by those who think the sheer volume of the advice they spew gives them credibility.

[boatman61]

Paracetamol
Duct tape
Vodka
Tissues
Sailmakers repair kit

[jacob30]

Thanks for the advice so far. Yes I will be going over everything with our SMT's.


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[SVJennie]

Great question! Thanks for asking it.

Just noticed that cinnarizine HCL or Stugeron is available on eBay. Worked great for my wife who was allergic to the Scopolamine Transdermal patch.

[CarstenWL]

... what you take on board should also heavily depend on where and for long you sail ...

Carsten

[polaris2.11]

Having just popped a crown, I suggest some temporary adhesive to glue the crown back in place. Available at the pharmacy e.g., 'Dentemp'.

[Sailor647]

Hi Jacob,
We published our list on CF a while back. Search "List of items for medical care and first aid kit" and look for our post.

We built our kit with the help of Jeff Issac, PA and Suzanne Gwilliam, MD. Mr. Issac teaches Offshore Emergency Medicine and works as a PA in Colorodo in an ER close to a ski slope and is an avid offshore sailor. Having climbed Mt. Killimanjaro, Dr. Gwilliam understand the seriousness of outdoor wildness environments. Mr. Issac educated us on what we needed, trained us how to use it, and how to store it onboard. Dr. Gwilliam provided the prescriptions and will be our Ship-to-Shore doc if/when we can reach her.

I completely agree with only having stuff on board you are trained to use - and have the presence of mind to use it when things are going sideways and the boat is pitching wildly. Mr. Issac pointed out the dehydration is probably the number one issue with sailors, but inserting an IV in a rolling ocean will be impossible for us, AND if a person is dehydrated, try finding a vein. (Won't happen.) He agrees with "prevent it in the first place!" But if all else has failed (illness or seasickness that causes prolonged vomiting), Mr. Issac recommended hypodermoclysis, sub-q rehydration. (Look it up if you're interested.)

Dr. Gwilliam agreed with Neosporin being ineffective. I'll remove that from our list.
Cheers.

[DefinitelyMe]

Gravol (or equivalent) suppositories are invaluable if someone is so sick that they can't keep anything down.

I also consider serious pain meds (i carry injectible morphine) to be invaluable if someone is seriously injured (read: broken leg half way to the Caribbean from Bermuda) at sea. But, of course, prescription narcotics come with their own set of problems with customs in some places.

I can second the Imodium - Ciprofloxacin combo for chronic trots. Worked a charm for me.

Not a physician. Medical first responder. Put my kit together with advice from a doctor who is also a friend and an offshore sailor.

[Kenomac]

We have a fully automatic AED onboard, plus just about everything on your list. We're close enough to civilization to handle the stuff that can wait a few hours or a day. But we're too far away due to logistics to be able to count on emergency medical assistance. Also, there's usually a language barrier which can also contribute to a delay.

So, we have an emergency defibrillator and pacer onboard.

[Tessellate]

Originally Posted by polaris2.11

Having just popped a crown, I suggest some temporary adhesive to glue the crown back in place. Available at the pharmacy e.g., 'Dentemp'.

Great point. I had a crown pop off once, and I wouldn't have liked having to go a few days on a boat like that. The root of your tooth is exposed and cold water or hard foods can bother it, plus I hate the thought of germs and sugar collecting in there.

Temporary crown glue is pretty cheap and will usually hold for a few days till you can get to a dentist. And there aren't really any great alternatives - I wouldn't want to think about using superglue inside the mouth.

[wrwakefield]

I put together my first off-shore kit in the early '80s after achieving an EMT2 certification at the time, and with advice of physician friends. I'm on my 7th generation kit now, and the advice you are receiving here and from your compatriots will suffice.

I'm writing to remind us all who travel to remote areas to include a back-up second responder in your 1st Aid Kit: Consider a remote medical evacuation service.

We are all trained to treat, stabilize, and hand-off to professional medical staff. That is our typical way of thinking of first aid. [first responder...]

When remote, we could be in a situation where we endanger the patient(s) by delaying transport to professional help when it is some distance away. In that case a cost effective service such as Divers Alert Network (DAN) TravelAssist service [think medivac] could make all the difference. [This is a medical evac service [NOT insurance] for anyone [i.e., not just SCUBA divers...] 50 or more miles from home anywhere in the world... They separately offer Diver's and Travel Insurance plans; don't confuse these separate offerings...]

What are the caveats? DAN must arrange the transport, so they must be the contact for medical transport. They do not reimburse for transport they didn't arrange... [This is a service, not insurance...]

At $55/year for a family of 5 this service is difficult to ignore...

How do we include them in our medical kits? The emergency phone number is written inside and out. (+1-919-684-9111)

From the DAN website:

DAN TravelAssist®
As a DAN Member, you automatically receive DAN TravelAssist and up to $100,000 of evacuation assistance coverage. This benefit is effective for both diving and nondiving medical emergencies. Evacuation coverage begins when you travel on a trip at least 50 miles (80 km) from home and call the DAN Emergency Hotline (+1-919-684-9111) for assistance or evacuation.

It is worth noting DAN also offers some very robust first aid kits which can also include oxygen and AED.

Here's hoping none of us ever need our kits nor medivac services...

[TrinitySeas]

BETADINE solution, a topical antiseptic is great for any type of wound care and for treating skin infection of any kind. Cleaning with BETADINE is routine pre-surgery. For sore throat as an early stage and/or primary symptom of most ear/nose/throat/"cold"/"flu" maladies, I have had grteat success with gargling: warm salt water, dilute (5:1) hydrogen peroxide and good ol' LISTERINE. (the alcohol, camphor and menthol are a triple whammy on bacteria and the biofilm these bugs require and produce).