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Old 02-10-2018, 08:54   #46
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Re: Content of onboard medicine chest

As a doctor, I am a little embarrassed to say that my medical kit is not nearly as extensive as any mentioned on this thread. I work in urgent care and before that was a paramedic for many years. As such, I have a fairly good idea as to what the more common injuries and ailments are and what to do about them. This has informed the medicines that I carry. Here is a partial list:

Vinegar = For stingray and jellyfish injuries. Can also be used for otitis externa "swimmer's" or "tropo" ear.
Amoxicillin/clavulinic acid "Augmentin" =For the rare chance of intra-abdominal infections such as appendicitis or diverticulitis, dog or cat bites, dental infections.
Doxycycline = There are a lot of nasties living in salt water, including Vibrio sp. Doxy will cover these and can be used for other skin infections and pneumonia as well. It is one of the few medications active against MRSA.
Nitrofurantoin "Macrobid" = For uncomplicated UTI. Not for kidney infection.
Ciprofloxacin = Can be used for complicated UTI, Pseudomonas infection. I use it in conjunction with Doxycycline for salt water injuries where I am concerned about infection. Can be used for bloody diarrhea.
Tobramycin ophthalmic drops = I wear contacts and carry this for corneal infection
Naproxen = For pain, body aches. Any available NSAID will do
Ondansetron ODT= For nausea. Suppositories such as Ann mentioned are a good alternative.
Seasickness medication = These are usually antihistamines and just about anything works. We carry Stugeron. A caution about scopolamine patches. A small percentage of people can develop "scopolamine withdrawal syndrome" which can cause nausea, headache and blurred vision for up to several weeks after using the patch.
Antibiotic ointment = My preference is for bacitracin or bacitracin/polymyxin B. "Neosporin" or "triple antibiotic" contains neomycin may cause a contact dermatitis. This affects about 20% of the population.

That's pretty much it for medication. I also carry a suture kit with several different sutures as well as lidocaine/epinephrine and syringes with needles. Crazy glue is a good alternative or some small cuts. A scalpel for draining abscesses or removing fish hooks.

Last but not least, don't forget the duct tape.
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Old 09-10-2018, 09:34   #47
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Re: Content of onboard medicine chest

Don't forget some basic tools for serious trauma... a few triangular bandages and a bunch of gauze pads and tape and Coban can go a long way to patching up pretty significant bleeding, and for the really scary stuff carry a combat tourniquet and an Israeli bandage or two.
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Old 09-10-2018, 09:43   #48
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Re: Content of onboard medicine chest

How about sterile eye wash? The stuff use with contacts and such. Though one might have that on the boat already.



What about treatment for eye infections? Pink eye and such.


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Old 09-10-2018, 10:10   #49
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Re: Content of onboard medicine chest

Paramedics typically only need to provide triage for 10s of minutes. Your kit needs greater quantities of consumables like liquids, dressings, sunscreen, etc. You also want good fracture stabilization kit, easily digestible energy, etc

The US Army publish their combat medical guide online.
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Old 16-12-2018, 18:20   #50
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Re: Content of onboard medicine chest

Quote:
Originally Posted by mikereed100 View Post
As a doctor, I am a little embarrassed to say that my medical kit is not nearly as extensive as any mentioned on this thread. I work in urgent care and before that was a paramedic for many years. As such, I have a fairly good idea as to what the more common injuries and ailments are and what to do about them. This has informed the medicines that I carry. Here is a partial list:

Vinegar = For stingray and jellyfish injuries. Can also be used for otitis externa "swimmer's" or "tropo" ear.
Amoxicillin/clavulinic acid "Augmentin" =For the rare chance of intra-abdominal infections such as appendicitis or diverticulitis, dog or cat bites, dental infections.
Doxycycline = There are a lot of nasties living in salt water, including Vibrio sp. Doxy will cover these and can be used for other skin infections and pneumonia as well. It is one of the few medications active against MRSA.
Nitrofurantoin "Macrobid" = For uncomplicated UTI. Not for kidney infection.
Ciprofloxacin = Can be used for complicated UTI, Pseudomonas infection. I use it in conjunction with Doxycycline for salt water injuries where I am concerned about infection. Can be used for bloody diarrhea.
Tobramycin ophthalmic drops = I wear contacts and carry this for corneal infection
Naproxen = For pain, body aches. Any available NSAID will do
Ondansetron ODT= For nausea. Suppositories such as Ann mentioned are a good alternative.
Seasickness medication = These are usually antihistamines and just about anything works. We carry Stugeron. A caution about scopolamine patches. A small percentage of people can develop "scopolamine withdrawal syndrome" which can cause nausea, headache and blurred vision for up to several weeks after using the patch.
Antibiotic ointment = My preference is for bacitracin or bacitracin/polymyxin B. "Neosporin" or "triple antibiotic" contains neomycin may cause a contact dermatitis. This affects about 20% of the population.

That's pretty much it for medication. I also carry a suture kit with several different sutures as well as lidocaine/epinephrine and syringes with needles. Crazy glue is a good alternative or some small cuts. A scalpel for draining abscesses or removing fish hooks.

Last but not least, don't forget the duct tape.
Thanks Mike. Have several rolls of duct tape on board already! Vinegar, in the galley. Ammonia, in the heads!

I managed to get a week's supply of doxycycline, which I had used before for a pulmonary infection. Not easy to come by; my GP in the UK would not prescribe it to me, adducing it is "toxic". To bugs... yeah, I do hope so!

I also got a 2-week supply of Malarone (atovaquone + proguanil) as an anti-malarial compound. This was not in my original list. Evidently to start with, as length of treatment depends on length of exposure. But does not seem problematic to get hold of in most places.

Only later, I learned that doxycycline is also prescribed as an anti-malarial.
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Old 16-12-2018, 18:41   #51
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Re: Content of onboard medicine chest

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Old 16-12-2018, 19:59   #52
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Re: Content of onboard medicine chest

For years I have used the Mayo Clinic Symptom Checker to help guide me on diagnosis

https://www.mayoclinic.org/symptom-c...m/itt-20009075
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Old 17-12-2018, 01:51   #53
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Re: Content of onboard medicine chest

A couple things missed in this thread.

The liquid Benadryl is the most important part of fighting an allergic reaction. More important than the epi pen. So have plenty of it.

And one if the most common emergencies on a boat are burns.

Have large liquid gel burn pads on hand. Like these.

https://www.webstaurantstore.com/med...iABEgIMXvD_BwE
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Old 17-12-2018, 10:09   #54
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Re: Content of onboard medicine chest

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Originally Posted by JPA Cate View Post
You should have an anti-emetic in suppository form. Discuss it with the doctor. (Ours are compazine suppositories, kept in the fridge, to keep them firm enough for insertion.) We've only needed such a thing once, and did not have it, and lived to tell the story. The problem is getting de-hydrated from repeated throwing up, and being unable to keep even a sip of water down. By the 3rd day, it's scary.

Ann

PS. Consider that both of you might come down with the flu at the same time!


Drinking 2-3 tablespoons every 5” is an effective way to orally hydrate. The oral rehydration solution (ORS) technique is used to augment treatment of cholera patients and applies to pediatric and adult dehydration and diarrhea illnesses as well. The relative volume of stomach contents expelled when vomiting is about 60% so the remainder is absorbed, and rapidly so if appropriately proportioned electrolytes and carbs are included. WHO has formulated oral rehydration powder that can be purchased in sealed bags and reconstituted with tap water but there are diy formulas. One such is 6 teaspoons sugar + 1/2 teaspoon salt (NaCl) in 1 liter of water. Using ORS is more effective than using anti-diarrheal’s (e.g. Lomotil) when confronted with typical ‘travelers’ diarrhea or other contagion-causes diarrhea which can prolong illnesses in many cases. Also very effective during prolonged motion sickness episodes when dehydration is a risk.
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Old 17-12-2018, 10:42   #55
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Re: Content of onboard medicine chest

Glad to see the OP is now packing Dettol.
Something to note is that the traditional betadine (US) povidine (UK) or simply red iodine should be THROWN OUT if anyone still has it. For something like a decade now it has been frowned upon in the US, because the red coloring hides infection, allowing that to get a dangerous start. Products that do not color the skin are a little more expensive sometimes, but since red iodine "lasts forever" the stuff stays on shelves and keeps turning up.
It is also worth remembering that simply having meds on board does not mean you should give them to anyone. When at all possible, get a consult from a real physician by any possible means (radio) before passing out anything that someone might have an adverse drug reaction to. That's why ordinary "first aid" in the US consists of mainly bandaging and cleaning. Not even antiseptic creams or soothing (benzocaine, etc.) washes and rinses, just plain saline wash and clean dressings. Compression bandages and tourniquets if necessary--but no clotting agents in general, some are made from chitin and shellfish allergies can occur.
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Old 17-12-2018, 11:18   #56
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Re: Content of onboard medicine chest

Not the nicest to talk about, but since dehydration is mentioned so often a great alternative is rectal rehydration.
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Old 19-12-2018, 11:12   #57
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Re: Content of onboard medicine chest

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Originally Posted by PapaLulu View Post
Drinking 2-3 tablespoons every 5” is an effective way to orally hydrate.
thanks for the ORS - is 5" meaning 5 seconds, 5 minutes, or ...?
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Old 13-04-2020, 09:49   #58
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Re: Content of onboard medicine chest

Five minutes. ORS is is simpler to initiate and, at many times, as or more effective than IV solutions when in remote or healthcare unsupported areas. Doesn’t matter if the patient is throwing up or has severe diarrhea. The idea is to keep administering ORS frequently in small amounts- preferably enough to replace fluids lost in vomiting or diarrhea and then extra to account for insensible losses (sweating, breathing, fever, etc.). IVs are difficult for laypersons to start in the best of circumstances and expired IV fluids & equipment are another worry you just don’t need to bother with. Even if you used IV fluids to rehydrate, you would still need to initiate oral rehydration at some point.

BTW, clean tap water under pressure is equally effective as saline for cleaning out wounds. An easy hack: poke a hole in the end of a plastic water bottle and squeeze to irrigate a wound. Use a good deal of hand pressure and irrigate more than you think you should, ensuring you’re controlling any significant blood loss before irrigating with direct pressure, etc.
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Old 13-04-2020, 12:41   #59
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Re: Content of onboard medicine chest

Doing any IV administration on a boat is dangerous. Heck its dangerous in a hospital. Great way to get blood poisoning and then death. Unless everything is sterile, including the site and your paws, giving some poor soul an iv runs a high risk of injecting directly into their blood stream all sorts of toxins.
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Old 13-04-2020, 12:44   #60
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Re: Content of onboard medicine chest

Quote:
Originally Posted by seadago View Post
Thanks Mike. Have several rolls of duct tape on board already! Vinegar, in the galley. Ammonia, in the heads!

I managed to get a week's supply of doxycycline, which I had used before for a pulmonary infection. Not easy to come by; my GP in the UK would not prescribe it to me, adducing it is "toxic". To bugs... yeah, I do hope so!

I also got a 2-week supply of Malarone (atovaquone + proguanil) as an anti-malarial compound. This was not in my original list. Evidently to start with, as length of treatment depends on length of exposure. But does not seem problematic to get hold of in most places.

Only later, I learned that doxycycline is also prescribed as an anti-malarial.
Doxycycline is perhaps one of your best all purpose antibiotics that has a range of uses beyond killing rampaging bacteria.
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