Medical Kit, Medical Training for Transatlantic

[wolfgal]

Originally Posted by Dockhead

I'm the skipper, but the owner is a fine sailor (and old shipmate of mine) himself, and he likes his wine!! I am "zero absolutely zero alcohol" underway on my own boat, but the owner has overridden this policy for this voyage.



We shall see.

haven't read all input yet. great stuff though!

with someone on the boat who likes his wine, i would read up on how to determine if someone is getting severely dehydrated and what to do.

i'd also read up on detecting/determining a head concussion and know what to do about that as well

i did a course a while back and found the info in regards to these two, common situations/conditions to be most helpful.

also, do not know if anyone here listed duck tape for major wounds/bleeding

[ColIn Ferguson]

I am a surgeon and my wife is a GP so we carry far too much kit, but I would still recommend everyone getting proper first aid training, even if you think you know what you are doing. Treating injuries in the field is quite different from in an A&E department.
The NZ government have well thought out regulations for what should be carried in different circumstances and is worth looking at. For most of our needs the kit will be what is in Scale 2, Appendix 1.


https://www.maritimenz.govt.nz/rules...itime-rule.pdf


In addition to that I would recommend a set of inflatable splints - they are brilliant in the event of a suspected fracture and allow the casualty to be moved and move around without pain.
Also everyone should carry aspirin in the event of a suspected MI or TIA.

[MJH]

Originally Posted by Dockhead

All the sailing I've done more than a week or two away from civilization, I've done with a doctor on board. We'll be doing a transat in January, and none of the crew has any medical training other than some first aid courses.

I know it's been discussed before, but what do people think is an appropriate medical kit for such a voyage, large vessel with 6 to 8 people on board?

And some one of us probably needs to get first aid cert updated, no?

We will have working SSB and a robust satellite system so we will be able to do tele-medicine if, God forbid, someone gets sick or injured, but we will need to have appropriate supplies and equipment on board. Tips?

I purchased a Marine Medical Kit 2000 for my roundtrip to Hawaii...never opened it but the crew was glad it was aboard. It still has not been opened. The company makes several different models based on voyage parameters. They are not cheap.

I also keep all the unused meds that have been prescribed for me aboard...I figure that if I had it once the chances are fair I'll get it again. Many may be out of date but I have found them useful in the past on coastal cruises into the back country of British Columbia and Alaska.

I have thought that for my next voyage I would take the kit to a doctor I now know who sails and have him review it for additional supplies to supplement or replace. It would also be a good idea to have someone aboard that is knowledgeable on how to use what is inside it although the kit contains a copy of a recommended comprehensive medical guide.

~ ~ _/) ~ ~ MJH

[Jimmyhenry]

At least one. Better if two. Do a quality offshore medical first aid course. They are well worth the money. Gives you confidence in how to act in the “first hour” which in serious cases is the most important.
I have done several courses and each one has updated new learning on the best methods to treat trauma.
Very valuable. And very reassuring.
Pete

[wizoc]

In whatever training someone on the boat gets try to have starting an IV as part of the training. Be sure to include Ringers, d5w and normal saline bags in your kit.

[Jimmyhenry]

BTW. NZ has oversight and rescue responsibility for a huge chunk of the Sth Pacific so the departure rules for NZ boats is VERY strict. Apart from requiring every boat to be Category one. Each boat must have at least one experienced offshore sailor on board. And yacht inspectors will require at least one crew to have a first aid certificate.

[Jimmyhenry]

Actually the NZ requirements are TWO suitably qualified medical people.

[Icarus]

Originally Posted by goboatingnow

Note do not be hesitant in contacting the rescue authorities , if you even suspect you may have something serious then you need to get that ship diverted

Things like severe abdominal pain , significant head injuries , any sign of stroke symptoms. Do not delay. I know a friend who died mid Atlantic because the crew left in charge dithered

Sounds grim... You won't be performing surgery however, a common sense medi kit is essential.
Cuts, antibiotics, skin lotion, dressing, pain killers.
If one has a specific medical condition obviously the prescription medicine you might not able to get in a foreign country.

[DeanRussell]

As a paramedic in a big coastal city I have dealt with just about everything you an imagine, and then some.
Lots of good advice here, like take the best first aid course your time and money can afford.
There is also great advice of kits. In my view, the take as much as your money or storage allows. Even if you don’t know how to use something, someone else might.
99% of you medical needs will be cuts, scrapes and strains. Put that stuff in a separate kit as it will be used frequently, save the big complete kit for only when you need it. Then in the unlikely event you need it, it is there, fresh, clean, up to date and complete. Have an annual refresh date written on it.
Lots has been said about drugs and general supplies.
Know if you have a diabetic on board and know how to treat an episode.
There are very few live and death, seconds count medical emergencies, but a non beating heart is one. GET AN AED. Most of the newer ones are designed for use by untrained people.
We also have this drummed into the new paramedic’s heads, transport is treatment. Get help underway or get heading for it.

[CaptBobR]

Just a suggestion but you might consider an advanced STCW medical care provider course. That will teach you how to interact with medical care providers on land and give you some great suggestions as to what to carry

[MeejnDeej]

We followed SV Delos’ medical kit recommendations and cleared it with and got prescriptions from our family doctor.

https://svdelos.com/safety/


I also recommend the “israeli bandage” which does an amazing job of stopping bleeding. Lastly, we invested in an AED after being trained as a first responder and considering coronary episodes both at marina (stray voltage) and at sea.

[T. Lee]

In the emergency room for Kidney stones I had a scan and the resulting amount of great information would be very comforting for going well offshore. Get scanned. Med kits do suffer from aging so test a few items. If you like fishing, have you tried to snip your largest hook? Have a great trip!

[Hoodsail]

Originally Posted by MJH

I also keep all the unused meds that have been prescribed for me aboard...I figure that if I had it once the chances are fair I'll get it again. Many may be out of date but I have found them useful in the past on coastal cruises into the back country of British Columbia and Alaska.
~ ~ _/) ~ ~ MJH

Good idea to keep unused, "out of date", medications. Pharmacy practice is to shorten the expiration date from the original container, as we do not know what the conditions the drug maybe exposed to until used. So unless your meds are dispensed in the original container (w/ the manufacturer's exp date), then they are almost certainly potent and effective beyond the date noted on the label from your pharmacist. Prolonged, extreme heat is tough on drug potency so no leaving meds in sunny, hot windows or near routine heat sources. I am more fastidious with antibiotics than analgesics...if the former lacks potency could put you in jeopardy, the later...you take pain med more frequently. Always being mindful of labeled max doses. Interesting fact: acetaminophen/paracetamol (Tylenol in the USA), can be quite toxic, so just because its a non-prescription med, taking large amounts (5-6 grams/day) for many consecutive days can be deadly (to your liver) so again always keep a reference/review the packaging to insure you are being safe...Or hey....if heading off to the south pacific this Spring, give me a shout and I'll be your "on board" drug dude!! thnks

[Nibiruwayne]

Originally Posted by Dockhead

All the sailing I've done more than a week or two away from civilization, I've done with a doctor on board. We'll be doing a transat in January, and none of the crew has any medical training other than some first aid courses.


I know it's been discussed before, but what do people think is an appropriate medical kit for such a voyage, large vessel with 6 to 8 people on board?


And some one of us probably needs to get first aid cert updated, no?



We will have working SSB and a robust satellite system so we will be able to do tele-medicine if, God forbid, someone gets sick or injured, but we will need to have appropriate supplies and equipment on board.


Tips?

All the advice is solid. Having made several crossings and extended trips on our boat, I would say that the most common problem is infection, whether from a cut, a burn, or intestinal issues. Everyone comes aboard with a different biofilm of their own. The cross-contamination from the head to the galley is the biggest threat to good health for a long cruise. The food and water and utensils are easily contaminated. I would like to recommend you visit Biosuredental.com and review the products available. As a dentist and sailor, I use these products professionally as well as in all our recreation. They make ozone water to a concentration of 2 to 10 Ppm, depending on the unit you buy. They have personal tumbler devices that can make 5 oz. of 2 to 3 ppm ( parts per million) ozone water from plain tank or tap water in about 2 to 3 minutes.
2 to 3 ppm will kill all bacteria, fungi, molds, yeasts, parasites, amoeba ( including Giardia), and will destroy viruses, and prions in 20 seconds of contact time. This makes it the most powerful and best 'all green' solution for any infections, including oral. I recommend these for my dental patients who are battling oral disease ( periodontal), etc. of any description, as a daily tooth brushing, mouth rinse protocol.
These tumblers are re-chargeable, and work on a minimum of DC power like your phone does, and utilize a USB connection for either computer charge or 110 V AC. You can batch 5 oz. at a time per tumbler, and a single battery charge will give you from 10 to 12 batches. Each tumbler is good for about 2500 batches. All you need is tap water and a little DC electricity.
20 seconds of surface contact will give a 3 to 5 log reduction (99.9 to 99.999%) reduction of bacteria and all other microbes.
We spray all our fruits, veggies, and meats, before we cook ( chicken especially). We spray down the head and all fixtures , it's just water.
Ozone has a half life of 25 minutes. So, in an hour, it is plain water, perfectly safe to drink.
These units are not designed to work with RO water, however. They need minerals for it to work.
I suggest you look at the site and see if you're interested.
There are permanent installation units available , too. These are good to clean and maintain your tanks.
Have a blast on your cruise.

[JAFO]

Originally Posted by redhead

I recommend a book "Where There is No Doctor".

Written for missionary/peace corps people out of touch (no phone, internet etc.) and stationed in remote villages. It covers a lot of the most common medical problems, from diagnosing fever, to tooth extraction, to sutures, to fashioning a splint/cast for a broken limb.

I bought a hard copy and keep it right in the first aid bag.

To which I would add:- There is a similar book titled "Where There is No Dentist". Get it. I have both of these as ebooks.

For that matter, despite all the great advice and tips in this thread, nobody has mentioned potential dental problems. This is a serious oversight, IMO.

A good guide to a dental kit for cruisers can be found in the following video. Herb, the guy in the video, is a dentist.

https://www.youtube.com/watch?v=zg5eSh3ZqF0

I also highly recommend his video on how to suture deep wounds in emergencies.

https://www.youtube.com/watch?v=8V7zboT2N8o