What's the best first aid course for cruisers?

[sestina]

I've done the STCW 95 courses twice.

Medical First Aid Aboard Ship and Medical Care Aboard Ship. 3 and 5 days respectively.

This is proably the most comprehensive medical course you can do outside of medical school. Besides getting very good at CPR. You will learn serious stuff, suturing, injections, catheters, care of casualties, how to diagnose, drug administration and radio medical advice etc.

The courses were a lot of fun too; especially when we left someone strapped into a Neil Robertson stretcher and we all went for a coffee break. All our fellow pupils were professional seafarers, we were the only WAFIS, but lots of respect shown. ' You cross the Atlantic in a 9m boat! You must be bonkers!'

One of the cool benefits is you can write your own prescriptions. Admittedly the drugs allowed are based on the SOLAS requirements.

[SF Bay Dude]

There's this one too.

[UNCIVILIZED]

Originally Posted by Suijin

The Annapolis Fire Department offers the basic first aid certification with an additional section on marine emergency medicine. It's a day long seminar. Their focus is on treating trauma, since you're likely to be able to reach a doctor (won't you?) when you're offshore for diagnosis and treatment options of non-trauma issues. Last time I took it for First Aid/CPR certification for racing offshore it was $60.

Granted, the more training, the better, and the Wilderness course looks phenomenal. But as a first step, less than an hour from you, it might be worth a look.

LOL, I used to be a volunteer there, many, many years ago. Which actually isn't a bad way to pick up some knowledge... while giving back a bit to your hometown.

[Symphony]

I took a 9 week course at Orange Coast College in California, led by an MD sailor, concluded with preparing a kit and Rx based on your intended use (mine was the various races to Cabo or Ensenada, with ensuing bash northward after the race)

[Woodstock]

Originally Posted by rmarsh3309

My wife and I attended Wilderness Medical Associates Offshore Emergency Medical course in Portland Maine Bay in May. It was outstanding. Jeff Isaac is a very talented instructor and has pretty much "done it all". Dr. Dave Johnson provides medical insights as needed. They are the dream team. Their handouts and lecture enabled us to assemble a high quality medical kit. A bit of advice: don't waste money on a pre-assembled kit. You can assemble a much more applicable kit containing high quality components if you spend one day on amazon. For instance, Conterra makes high-quality medical bags that are absurdly over-priced. We bought a Lightning X First Responder bag and used the 300 we saved to fill it with name brand supplies. Another bit of cost-saving advice: www.goodrx.com.

We have scheduled two more of these for spring 2017; Herrington Harbour, MD and Paraty Brazil. Both in April. If anyone has questions, please PM me. Jeff

[wrwakefield]

Originally Posted by YellowcakeMan

We're looking for a good marine first aid course to take this winter which will prepare us for cruising. The course could be on line or bricks & mortar (we're in the D.C. area). We'd prefer something more advanced and tailored to mariners that just the basic American Red Cross course. Suggestions?

First, a brief background: we both have EMT training, and just finished the NOLS Wilderness Advanced First Aid course. [40 hrs taught in 1 week] All this for what we do as it is just the two of us. [i.e., We aren't EMTs who decided to go sailing...]

I can highly recommend the NOLS Wilderness Advanced First Aid course as a minimum. It will set you up for a lifetime of useful training both on the boat and in remote areas onshore. [The Admiral published a tongue-in-cheek post about that training recently. I am finishing up on detailed (boring) post about our 1st Aid preparations that will publish soon...]

Why these levels of training?

Our training choices [and 1st Aid kit contents] are driven by where we plan to play, and how long it might realistically take for qualified help to arrive. [4 days on our own is what we plan around. This includes emergency rescue services arriving on scene, or transiting ourselves to help.]

This is my recommend approach when asking ourselves how much training, and what level kit(s) do we need?... [i.e., How many days on your own is realistic?]

This is not unlike deciding which satellite phone to buy: select a service that offers reliable coverage where you plan to travel, and then get a phone that works with that service...

We enjoy boating, sea kayaking, and land based explorations in remote areas. [i.e, we may not see other people for weeks at a time...] Therefore we always carry various safety and communications equipment on our person [on or off the boat when remote. e.g., Marine VHF radios; Sat Phone; PLBs, etc.]

This is in addition to various levels of 1st aid kits [Lots on the boat; less kayaking; even less hiking... But the same comms equipment is always with us- even if we fall overboard- with the exception of the sat phone...]

What about rescue resources? We rely on the USCG here in SE Alaska, and we belong to DAN Boater for emergency medical/evacuation services. [Both are on speed dial on our sat and cell phones...]

Best wishes achieving your comfort level for self sufficiency.

Cheers! Bill

[wsmac]

since this is open again...
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One thing I didn't see while reading the posts is this... know your crew and their medical history and current conditions.
If you have anyone who takes regular meds, meds for infrequent needs but serious events, or carries devices for emergencies (seizures, allergies....), you should be aware of those issues and how to assist them or do the treatment for them.

Crew members who are being treated for something they expect to be over in a few days should also notify the captain. If it's an issue that can potentially blowup into a major issue... infection, blockage, loss of control (urinary or other)... you should know how to help and what to use to deal with it, as well as at what point you should stop messing with the issue and call help in.
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Having this information about all crew members can help you in determining what you want to bring along in your med chest as well.
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I would avoid books like the Merck manual. My personal experience and personal belief is that too much info... relating to medical diagnosis by amateurs... is not a good thing!
The Merck manual is just one tool a care provider uses in diagnosing a patient's issue(s).
An untrained individual might get lucky and pick the correct thing... might get lucky and what they pull out of their a... uh... manual... happens to not create more problems for the patient while the original malady goes away for other reasons, leaving the Book Doctor thinking they did a good job with their 'diagnosis'.
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Certainly people can go deep into their emergency medical training.
Commercial fishermen, rig workers, et al. might benefit from certain advanced techniques and equipment they may need for those particular environments.
You should really think long and hard about what you will realistically face on your journey, how able you and the rest of the crew are to deal with particular issues, and where - at any point - your closest TRAINED/QUALIFIED medical help is... be that by radio, sat phone, or in person.
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Nowadays, you can find medical dictionaries and phrase books that translate common communications between health providers and patients, in many languages. I have a couple for English-to-Spanish due to the high number of Spanish-speaking patients I have encountered during my years in the medical field.
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Personally... when I teach field medicine in my Wilderness Survival courses... I break it down to this...
1. Ensure the 'rescuer' is always as safe as possible. If you become another victim/patient... you ain't gonna be helping much!
2. To live... in a basic sense... we need oxygen and a means to move it around the body. That's the lungs, the heart and vascular system.
3. Keep blood in the appropriate places... control bleeding
4. Help oxygen get into the body... open airway, functioning respiratory system either patient operated or assisted by outside forces - you and any equipment specific for the job
5. Minimize aggravating any damage to the body and organs. Know how to support, when/where to apply the appropriate amount of pressure, splint, immobilize, position, the patient and their various extremities.
6. Maintain close-to-optimal body temp and hydration. Understand Hypo and Hyper thermia. Be capable of introducing and helping the patient retain fluids appropriate for their condition, be that orally or by I.V.(unless you are on long passages and have adequate training... using needles to introduce the correct type of I.V. fluid, the correct amount, at the correct rate... AND understanding your patient's medical history, as well as being able to recognize the signs and symptoms of when this method is not working correctly, can do much more harm than good!)

I know the original question was about taking classes... in my years of working in the emergency medical field (military, civilian, as well as in a commercial diving environment) and medical laboratories, my belief is that just walking into any first aid/first responder/emt course might not be the end-all. I find many instructors I've been around often train to a particular book/program and/or their personal experience. Important things may be left out because they haven't thought about the importance of adding them, weren't aware of them, restricted from teaching them. You need to be a bit proactive in determining what training is actually applicable to your particular situation.

If you are savvy enough, able to think quickly in a manner of improvisation, and can check your emotions at the door before entering into a medical emergency, then you might get by with a first aid class and some reading/practicing on your own.
I've seen folks who have gone through pretty involved medical training choke at certain things they emotionally could not handle.

Exactly what skills/equipment do you need and how thorough is the training you get for them?
Do you really need a suture kit, for example? Because if you do not understand what's going on around and inside that wound, you do not understand primary and delayed wound closure, etc etc etc... you risk sewing up something and creating an infection-prone environment that could have just been bandaged and allowed to drain as needed. But I have heard people teach folks that they should carry suture supplies, staple guns, and super glue, in order to close those horrible looking bleeding wounds. All the cool factor without the understanding on how to properly care for the wound before, during, and after.
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wish I could get paid by the word whenever I get on my rants... I'd be a gazillionaire! LOL
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If you want to do appendectomies, crack a chest and massage a heart manually, reset a broken femur, remove busted breast implants and fix those droopy eyelids... go to medical school... PA school, Nurse Practitioner school.

If you want to stop bleeding, splint an extremity injury, recognize and field-treat shock/concussion/diabetic/epileptic/cardiac/respiratory/digestive issues and simple boo-boos... take a first aid class and see how that fits the bill.
If you did good in that training... take the advanced first aid.. maybe a first responder... maybe EMT (and you can do the wilderness versions of them all too). Paramedic training... to my knowledge... is usually only available for those who are or will be working/volunteering in the profession along with the usual prereq's.

Do you want to understand a bit about nursing? Take Nursing Assistant classes or LVN (this might be a bit more involved and time/money consuming than anyone here wants). With this training... you'll have a better appreciation for patient care concerning a host of the more common medical conditions you are likely to see, basic patient care, meds, and maybe I.V. fluids.

You can enroll in any number of special private training schools around the world unless they're closed to the general public. These may be great courses... or they may be more about the REALLY COOL TITLE they have. There are no consistent regulations for opening up a 'Spec-Ops, Ninja, Uber-Survival, Medical Training School' in the U.S., other countries may do it differently. Dig through their websites/literature to try and understand if paying all that money is really getting you what you want/need. Just because the name of the course has 'Marine', or 'Advanced', in it... doesn't necessarily mean it's much more than a similar first aid course without the air of 'specialness' circulating around.
Some of these may actually provide you with boat-specific ideas and training a normal civilian first aid course wouldn't... that would be good!
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Once again... I've filled up all the alloted space for comments on this website with my lofty literature while lolling about in my lair lacking anything better to do...

And if you read this whole thing... YOU NEED MEDICAL HELP... NOT medical training!

[toddster8]

I was recently in a course in which it was suggested that crew could bring their medical history in a sealed envelope, to be opened by the captain in the event of...

I guess that helps preserve privacy, but doesn't help at all in terms of preparation. Oh well, I'm not really planning on any long trips with total strangers, anyway.

[wsmac]

Originally Posted by toddster8

I was recently in a course in which it was suggested that crew could bring their medical history in a sealed envelope, to be opened by the captain in the event of...

I guess that helps preserve privacy, but doesn't help at all in terms of preparation. Oh well, I'm not really planning on any long trips with total strangers, anyway.

You're correct... a person in charge or the actual medical personnel should know what's in the envelopes before an emergency arises!

I can tell you from my personal experience... family, friends as well as co-workers I've been partnered with for a year or more... people don't always like to divulge certain medical conditions.
For various reasons people will hide their diagnosed and possibly currently treated conditions.
They also could be apt to dismiss current signs & symptoms that should be looked into.

I had a student out on a survival trip once who had what he later described as, the flu. He wasn't showing symptoms when the class met on Friday and headed out into the woods for the weekend.

I spent some time showing the class certain edible plants along the trail, cautioning them that we were not to be picking and eating plants on this trip.

Come Sunday morning... he's now obviously sick! Throwing up while we were hiking out.
Luckily it wasn't far to the vehicles.
I learn along the way out he sampled some plant. I had no sample of what he ingested and so I couldn't know if he ate the plant he thought he did or not.

After checking his vital signs, ensuring he was stable, I went about ensuring other students were good to go and sent them on their way. While I was doing that, he proceeded to accept a beer from another student who had cracked a 6-pack open from his trunk

More vomiting.

I strongly suggested he go to the local hospital almost an hour away... I would drive him. He decided that might be a good idea.

Along the way, he fesses up to 'having the flu' and having been taking 'natural supplements like slippery elm bark' to combat it.

During the prep class before our outing... I told them NOT to go on the trip if they were on the verge of being sick (it's winter and I did not want unhealthy people adding stress to their issue by sleeping on the ground in shelters, in the cold, eating minimal food for a few days, and trying to apply what we learned in the classroom).

So... my little example... not only did the guy not follow my earlier advice... he showed up knowing he was getting sick, was attempting self-treatment all without informing me of such.

THEN... once again... ignoring my words and deciding to sample wild plants (which he did not ask me about or tell soon after about), drinking a beer after becoming sick on the way out...... well, I can tell you I really learned from THAT experience!

Yeah... for a variety of reasons... people don't always disclose something you may feel is important... even if they're loved ones!

[wsmac]

Regarding medical devices...

I was in a computer class at a local college.
One day a student collapses onto the floor.
He starts seizing.
I've dealt with patients seizing back as far as 1978 (started when I was a wee lad, of course! ) (eta: not the actual patient seizing for 40+ yrs... just want to clarify that point)

Even at that time, there was some offer to do things for him that are no longer done in the medical field for seizures.
We were able to put him into a proper position, protect his head and limbs... then one of the campus security guys shows up.

Now... I can't remember who knew this next bit of info specific to this particular patient... could have been the security guy from earlier contact with the patient.

The patient had a magnet on his belt buckle... it's for a device he has implanted for VNS... vagus nerve stimulation... for epileptic seizures.

You move the magnet near the device (in the chest) and it goes into action.
You DO NOT continue to wave it around the patient and device over and over and over again! Which is what this well-meaning security guard was doing!
Luckily I was able to get him to stop!

I can tell you that every EMT course I've been part of has never included information on this device and it's operation.
It's something you learn on the job, unless you have personal experience with it.

Now... this student doesn't need to go about wearing a sign with instructions emblazoned on it for the passerby do-gooder who stops to render aid when the guy crashes out on the streets. Like I said... I seem to recall the guard knew this student and something about his condition and the location of the magnet. What the guard did not know what the correct placement and procedure for using the magnet.

We humans get by in life when there is SO MUCH that can go wrong! Lucky I guess!

I'm not proposing people screen every person boarding their boat for medical conditions as if they are TSA agents hoping to be the one to finally catch that terrorist and be a national hero!

But if I ever make it out of the bay and take people coastal cruising or beyond... I WILL make sure I make it absolutely clear they need to tell me if they are on the verge of being sick, taking any kind of meds, carry an epi-pen or other medical device with them, are wearing a truss because, "that darn ole hernia is acting up again but it ain't no big deal really", or anything else like that!

If a guy's hernia strangulates while we're in the bay... the swim back will likely set it right again.... I'm kidding... really.... but only about the swimming

If a person is taking baby aspirin because the doctor wants them too... and they don't really appreciate the potential for a blood clot...

If that good old buddy comes aboard with his finger duct taped up good-n-tight because while working on his pickemup truck the other day... all greasy and dirty... his hand slipped and he got a pretty deep cut... but being the MAN he is... he ain't gonna cry or go to any doctor cuz they just want to take his money for a bandaid... and yet underneath that duct tape bandage is a festering lab of juicy hotness getting ready to launch up his lymphatic system (that red streak up your arm you might have always been warned about with infections), circulate all over his body, make him febrile, a deadweight onboard... not a DEAD deadweight... yet.... that needs antibiotics you cannot keep on your boat for various reasons not to mention with the appropriate means of putting them in his body!

If people don't disclose things that might seem innocuous, when preparing for a long, isolated, very self-reliant-oriented trip... just be sure you know what outfit they want to be in for their burial at sea! If they don't die... I'd probably kill them myself just for being ignorant! (not really... I'm just feeding my ego this morning)

[cveasley]

There is a company out of Atlanta GA called Deep Blue Medical. They specialize in medical training for cruisers. The course are cheap and fun. They go from basic first aid up to advance training. I have used them before for training and medical face time via computer. They have a bunch of other services also.
There contact number is 404-966-0778