Emergency Medical Supplies?

[nauti kat]

My husband, myself & our 2 dogs will begin our life aboard our boat cruising & enjoying our lives soon. We are in the process of stocking supples, especially emergency medical. We will purchase an AED but were wondering how to go about stocking up on prescriptions , mostly antibiotics. Also does anyone know the shelf of medications ? We are also wondering is there somewhere we could learn suturing , and where would we get those supplies . Any other ideas of "must haves" that we will need ?.

[sailcruiser]

This thread has a lot of good info:

http://www.cruisersforum.com/forums/...it-100964.html

SC

[Teknav]

Hi! If you do a little search on here, medical supply kits were extensively discussed. Sutures/needles combo can be bought from Biological Supply houses and on Ebay. Performing sutures...it gets complicated...you need to know basic Anatomy. You'll need a few forceps to hold the curved suturing needle. You'll need to learn how to tie a suture. For small cuts, hold pressure on the cut until bleeding stops. A friendly surgical nurse can teach you how to use a suture "kit". Your personal physician can prescribe you some antibiotics, for a variety of bacterial infections. If you keep them in a fridge (not the ice box), you can extend their life. You need to take a First Aid/CPR class, like the one taught by the Red Cross. There are advanced classes for seafarers. The biggest hurdle you'll find is in obtaining Schedule II drugs; opiate based pain killers. These drugs are prescribed for major trauma; crushed bones, severe nerve pain among others. Without some medical background/training, it will be very difficult to administer much in the medical kit. Good luck!
Mauritz

[Paul Elliott]

For prescription drugs I just have a chat with my personal doctor and he prescribes them for me in quantities appropriate for my crew and plans. We discuss the crew, where we will be sailing, how long might we be out of reach of emergency assistance, etc. For a while I was seeing a doctor specifically for the boat prescriptions -- he had done a bunch of solo sailing (including the Singlehanded Transpac), so he was extremely sympathetic to our needs.

As for the kit itself, you might want to look at some kits that my friend Steve Roberts has put together and is selling. They're well thought-out: Introducing our Kits | The Expedition Medical Chest

Of course, just having the supplies is merely the beginning. You need some combination of training, experience, reference material, and access to medical advice. I'm sure we can give you some suggestions if you want -- just ask.

[Dennis.G]

Get a good reference book such as:

Amazon.com: Wilderness Medicine, 5th: Beyond First Aid (0024933704903): William W. Forgey M.D.: Books

(I think that is one we have, although cover looks different). Should have advice on stocking medical kit, plus of course what actions to take.

Good first aid training is a must, but usually falls short as they always assume that hospital is not far off and any secondary care is not your concern. I have been certified as an EMT and OMC (Outdoor Emergency Care - Ski Patrol) and neither was real helpful for situations where medical assistance is days away - that's where I found the book very informative.

[Paul Elliott]

Originally Posted by Dennis.G

Good first aid training is a must, but usually falls short as they always assume that hospital is not far off and any secondary care is not your concern.

Completely agree. I was a volunteer firefighter, and had pretty extensive first-responder medical training (short of an EMT though). We learned how to keep the victim stable for the next fifteen minutes until the pros showed up. Fortunately most boat medical incidents are minor, and first aid style training will be extremely valuable. Books and outside communications can be a lifesaver in the rare serious situations.

[MarkJ]

I have Bandaids, a defribulator, a small operating theatre, a medium one, a helicopter on the aft deck for medivac.


But I have ever only needed Bandaids.

[Paul L]

You might want to search the CF archives for AED to help decide if this makes any sense for your cruise.

[John Galt]

I would submit that you do plenty of research before considering an AED. While early defibrillation is key in patient care, there are only 2 arrhythmias that are shockable.
V-Fib and V-Tach.

Shocking a flat line or asystole only happens on TV and modern AEDs won't allow you to do it.

I've shocked or witnessed 20-30 with about a third walking out of the hospital. They don't just jump up and spring back to life. Every one I've seen go immediately to a cath lab or the morgue.

Time is key in cardiac events.

Find a set of emergency protocols or 'standing orders'. They're flow charts for most trauma or medical incidents and are carried by every ambulance crew out there.

Hope you have fun with your cruising life!
Rick

[Greg4cocokai]

Originally Posted by MarkJ

I have Bandaids, a defribulator, a small operating theatre, a medium one, a helicopter on the aft deck for medivac.


But I have ever only needed Bandaids.

+1, and maybe few antibiotics!

[goboatingnow]

From talking to paramedics I would suggest a AED at sea is useless, it typically buys or extends the " golden hour" its virtually useless if a major trauma centre isn't readily available.

Dave

[Krakato]

While I'm not a sailor yet (waiting for the pension to kick in), I am a paramedic with 24 years of experience in the field and work in an area where the "closest" hospital can be over 2 hours away by road and no helicopter service is available. So it is kind of like being at sea in such that there is no definitive care for a long time for patients.

That said, let me say first that people who go into cardiac arrest from trauma rarely if ever survive. I was in a conference with about 3000 EMS providers and the question was asked if anyone ever had a traumatic arrest patient survive and leave the hospital. Out of all of us there, none had. American Heart is considering saying don't even bother doing CPR if someone arrest from a trauma event.

AEDs are good to buy you time in heart attacks of a non-trauma nature in which the patient is in V-fib or V-tach. However with the exception of lightning strike victims, more care is needed than just an AED. They require quite a bit of pharmacological care to keep them from going back into V-fib or V-tach. And even that is still stalling therapies until they can get to a cath lab or be giving clot buster drugs. So having 'just' and AED with no other support is pretty much worthless.

Also note that AEDs have associated maintenance costs. They are not a device that you can just put in a cabinet and forget about. The pads expire about every 2 years and the batteries are good for about 5 years. Both are kind of expensive to replace. They also need to be checked on a regular basis and self test run.

Will I carry an AED when I start sailing, I don't know yet. I know I will have a medical kit stocked with a lot more than most people do, but the AED would be on the tail end of my wish list.

Cheers,
Mike

[jeremiason]

Nauti Cat

You didn't say where you were planning on cruising? That makes a huge difference on you medical supplies. For instance if you are cruising the coast of the USA, then maybe you don't need things like antibiotics or sutures, since available medical help won't be to far away, via the USCG or other emergency responders.

If you are in isolated areas then you should take some advanced first aid training and then decide what you want to carry based on your training and experience.

Both of us were working EMT's in a former life. When we cruised Mexico and Central America, we carried a couple of courses of antibiotics and lots of stuff for bleeding, burns and minor breaks.

We started our first aid kit with an off the shelf advance first aid kit and then added to it. Neither of us had training in suturing and decided against carrying them, figuring if it came to it we always had a sewing kit.

[Paul Elliott]

The doctor I used to see for my at-sea prescriptions had an extremely dim view of the desirability of AED on the boat. He thought that unless advanced help was minutes away, the probable range of outcomes would be somewhere between life as a vegetable, and death. I decided against carrying an AED.

[goboatingnow]

I carry broad spectrum antibiotics and pain relief ( fast acting and slow acting Zidol, Tramadol) on long trips over 2 weeks. I also carry skin antibiotics for various fungal attacks.

All this has yet to used.

Mostly its cuts and bruises. The fact is my direct experience of major trauma is to thank god that evacuation was nearby

Dave