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Old 07-04-2020, 17:02   #1
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Upgrading your Boats Medical Locker

With us all focussed on health issues during this pandemic, I think it would be useful to share professional advice from doctors and nurses on what should be carried in the way of latest emergency prescription medicines for:

A LIVEABOARD COUPLE , who cruise remote areas.

Advanced first aid training and reading of "Where there is no Doctor/Dentist" assumed.

1 Does anyone have an updated list they would share?

2 Recommendations on storage and shelf life in Tropics?

3 Any updates medical software to help layman diagnose and treat when there is no help around?
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Old 07-04-2020, 19:02   #2
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Re: Upgrading your Boats Medical Locker

Look at the Cat 1 Offshore list in appendix 1 here
https://www.yachtingnz.org.nz/resour...ling-2017-2020

Depends where you are as to how easy it is to obtain these. We were able to stock our med kit in New Zealand tnrough a pharmacy with no doctor prescriptions required.
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Old 07-04-2020, 19:56   #3
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Re: Upgrading your Boats Medical Locker

Following

Current medical kit is focused on trauma with some medicine inclusions for sea sickness, NSAID for inflamation, otc for pain.
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Old 07-04-2020, 20:08   #4
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Re: Upgrading your Boats Medical Locker

Thanks Paul, that is exactly what I was hoping for which I will transcribe to my Medical Inventory Excel spreadsheet (unless someone already has this in Excel).
My GP here in Subic has offered to provide prescriptions for what I need so we can be complete when ready/allowed to leave.

I have a very old (1993) Mayo clinic interactive CD that helps correlate vitals and symptoms with internal diagnosis..
Does anyone have something more modern that can be downloaded as an interactive and graphic reference?
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Old 07-04-2020, 20:17   #5
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Re: Upgrading your Boats Medical Locker

Quote:
Originally Posted by Smokeys Kitchen View Post
Following

Current medical kit is focused on trauma with some medicine inclusions for sea sickness, NSAID for inflamation, otc for pain.
Yes, I think during this period with cruising forbidden, it is a good time to update inventories and be better prepared for forced isolation if this reoccurring issue comes up.

I do have somewhere a very extensive medical inventory for Super yachts ((18 crew-12 guests) but that included an RN crew member/ controlled drug bonded locker and dedicated shore support .

Looking for something an MD would carry on their own liveaboard.
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Old 07-04-2020, 21:17   #6
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Re: Upgrading your Boats Medical Locker

Here’s one of my medical kits, not the boat one but pretty close



As for drugs, depends on the people, if you don’t have conditions long and short I don’t carry anything. Depending some places have puritanical rules on some such matters

Fun one, for nausea a alcohol wipe under the nose does wonders.

I’d recommend a wilderness first responder course.
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Old 07-04-2020, 22:12   #7
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Re: Upgrading your Boats Medical Locker

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Here’s one of my medical kits, not the boat one but pretty close



As for drugs, depends on the people, if you don’t have conditions long and short I don’t carry anything. Depending some places have puritanical rules on some such matters

Fun one, for nausea a alcohol wipe under the nose does wonders.

I’d recommend a wilderness first responder course.
Not sure what type of situations you are planning for. I think the OP waxps planning for situations where you will not have access to onshore medical care within weeks or longer. For these situations having significant drugs onboard us important,. Antibiotics, pain management, burn management.

We clearly declare our onboard drugs as part of the ships medical kit when clearing into countries. Even tightly controlled drugs have not been a problem. Even if you don't have the expertise to use these drugs, having them onboard means you might be able to contact shoreside support that will recomend dosages and timing.
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Old 08-04-2020, 03:38   #8
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Re: Upgrading your Boats Medical Locker

Exactly correct Paul. When someone comes down with a serious viral or bacterial infection in a remote island or Atol, you are on your own.

If you do find a clinic, odds are their limited drugs are well past expiry dates and reserved for the sickest local patient.

Good chance that taking those expired local meds which have been stored too long in tropical conditions would cause our more fragile immune system to go into anaphylactic shock.... (Happened to me once in Pohnpei Micronesia )

The First Aid stuff is easy, it is the life saving prescription meds and trauma treatments that you need to consider.

Best to carry your own so you can save yourself or help.others.
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Old 08-04-2020, 09:56   #9
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Re: Upgrading your Boats Medical Locker

If you are in the USA or Canada, make sure all prescription required medications have a proper Medical Doctor authorized prescription. Your Family Doctor is where you start!
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Old 08-04-2020, 10:48   #10
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Re: Upgrading your Boats Medical Locker

What to carry depends on your skill and experience and where you expect to be. For example if I was cruising in countries with low levels of medical infrastructure and issues like AIDS such as Africa I would defiantly include an intravenous kit, IV ports etc as they may not have sterile supplies. Another issue on the same theme is time. If you are within helicopter range of an industrialized country with VHF coverage you are hours from help. If you are in drakes passage or rounding the horn you are days or even weeks from help. That makes a huge difference.
Think about what you are comfortable using. There is no point in carry supplies for procedures you would not be able to do. I carry what I need to set and splint a long bone fracture but it is not something you want to be learning from the book while at sea so unless you have experience as a first responded there would be little point.

Be realistic a bout what you can do and carry. If someone has an MI severe enough to need drug therapy is there a realistic chance of survival? If not there is little point in including the meds.
What are you crews vulnerabilities. Age, fitness and preexisting conditions need consideration. An big adventurous young crew may want to carry meds for venereal disease, if you are a retired couple do you need to? Does someone have angina etc etc.
Event though I am a nurse (ret) I still looked for advice on what to carry. best thing I found was the Ships Captains Medical book from the UK and the med chest recommendations that go with it (available as a free download). I went though it and crossed off the parts I definitely did not think relevant. The kit is what the UK coast Guard requires small commercial craft to carry and is OTT for most leisure cruisers but it is fairly easy to see what you don't need. There is also a very good course that goes with it. The other thing is that it is linked to radio support. If you are taking direction via radio and tell them you have this kit then in many places they know exactly what is available and can guide you through using it. The US coast guard may have an equivalent.
Only problem I had with it is that the dug list is somewhat dated, when I saw a doctor to get the supplies (it includes prescription only meds) they suggested some alternative that are now considered better. When that happened I added a label to say what it had replaced.
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Old 08-04-2020, 11:38   #11
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Re: Upgrading your Boats Medical Locker

While radio etc and on-line advice is available, in an emergency situation that can be time consuming, if even available. I (first responder) recommend "On-Board Medical Emergency Handbook" - First Aid at Sea. ISBN 978-0-07-154857-1, or MHID 0-07-154857-2. And should you think a crew member may need one, get an AED - Automatic External Defibrillator - and learn how to do CPR (easy to find on-line). And lots of Band Aids, various sizes-thats what are missing whenever I do a boaters emergency supplies check
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Old 08-04-2020, 12:12   #12
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Re: Upgrading your Boats Medical Locker

file:///C:/Users/HOME/Documents/TRAMA%20BOOK.pdf

Simple to read and understand. It covers trama not acute illness.
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Old 08-04-2020, 12:14   #13
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Re: Upgrading your Boats Medical Locker

Quote:
Originally Posted by joeelliott View Post
file:///C:/Users/HOME/Documents/TRAMA%20BOOK.pdf

Simple to read and understand. It covers trama not acute illness.

Link is no good. It points to a file on your PC, not anything the rest of us can access.
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Old 08-04-2020, 12:20   #14
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Re: Upgrading your Boats Medical Locker

Look up "Advanced Trama Life Support " ATLS 9th edition, It is put out by the American College of Surgeons, and was free to download when I did it about a year ago
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Old 08-04-2020, 12:37   #15
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Re: Upgrading your Boats Medical Locker

One needs an inventory of medical supplies that can last weeks, if not months, before running out. Obviously, space, money and possibly refrigeration, will limit how much one can take, but one does need a decent inventory.

If someone gets a serious burn, does a medical kit have enough dressings to last multiple changes per day for the week or two it takes to get to a hospital? How about if the are burns on different parts of the body and require multiple bandages? Does the medical kit have enough ointments to address this for weeks? How about pain meds?

One can, and should, think about what is being carried, why it would be used, how often, and for how long. Then one should ask what would we need if we had multiple casualties? How would that change the amount of stuff in the medical locker?

A lot of this stuff is pretty cheap in the industrialized world but it can be worth it's weight in gold in the middle of no where.

Later,
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