Content of onboard medicine chest

[mikereed100]

seadago,

You have got a lot of advice on this thread ranging from excellent to dangerous. How do you know which is which? You don't, of course, that is why getting medical advice from the internet is rarely a good idea. My suggestion would be to check out a few of the many books available on the subject. They will have at least been written by doctors or other medical professional with some knowledge of what medical issues cruisers are likely to encounter. Then, get together with your own doctor and get some prescriptions for the medications that you may need and set up a system whereby you can contact the doctor by email while you are sailing so you don't take the wrong medication or take an antibiotic needlessly.

You don't need to go overboard on the medical kit. I was a paramedic for 11 years and have been a doctor for 16, but my kit is pretty basic. A few antibiotics for common infections, vinegar for ear infections, an antihistamine and an antibiotic ointment. Blue masking tape makes great bandages, toilet paper makes a good substitute for gauze, crazy glue for small lacerations, duct tape for just about anything. Naproxen and acetaminophen for pain. We have a handful of ancient hydrocodone/APAP tablets for the serious stuff.

[Symphony]

I think the EpiPen is over-prescribed now. People here carry them around in prep for minor stings or food allergy.
Unless you have an allergy that will result in sudden and severe anaphylaxis - avoid EpiPens. After using an epinephrine injection, the Rx directive is to go directly to Emergency Room. They are somewhat fool proof now, but if used wrongly can trigger a heart attack.

Plus they expire rather quickly.

[Symphony]

i just thought of a novel use for EpiPen: legal self defense weapon.

If you have a bad guy onboard and you can manage to quickly stab a vein directly, he will suffer an instant heart attack. the injector easily penetrates most clothing. aim for the carotid vein in the neck. even an indirect hit will give him serious palpitations.

The official autopsy will report he had an overdose of speed.

[Victorinox]

Originally Posted by seadago

Do I need a prescription for these?

Available from your favorite drug dealer. never heard of drug dealer taking credit cards.

[MarkJ]

Originally Posted by Symphony

i just thought of a novel use for EpiPen: legal self defense weapon.

If you have a bad guy onboard and you can manage to quickly stab a vein directly, he will suffer an instant heart attack. the injector easily penetrates most clothing. aim for the carotid vein in the neck. even an indirect hit will give him serious palpitations.

The official autopsy will report he had an overdose of speed.

You haven't priced an Epi Pen, nor a... oh what do they call them, the the analgesic whistle... anyway both are $500+

[s/v Jedi]

Check out my post here: http://www.cruisersforum.com/forums/...ml#post2088019

[HankOnthewater]

Epipen has been mentioned in previous posts, and the price of these. Check out this (today's) news report:
Mylan EpiPen US prices hikes unlikely to be experienced in Australia, experts say - ABC News (Australian Broadcasting Corporation)

Addit: Maybe I could start a business sending Epipens to USA........

Jedi, I liked your link and your posts there, but the (brand) names are not all familiar to me.
And for those who really (meaning: over the top) want to read about medication names, check this:
https://www.tga.gov.au/updating-medi...edients#active

[barnaclejim]

Getting refills for all the expensive expiring meds we had in our kit represcribed in the states from my cute 14 something year old Kaiser
doctor brought terror into her heart that we might either practice drunken sailor medicine or sell our codine on the black market. We took an offshore medical course some years back in Virginia and it was very worthwhile. Also usually helps when asking for opiates, medical marajuana, and anything else that might make your dislocated shoulder a little more tolerable. The third world is the place to get drugs that most of us are not responsible enough to dispense. But imagining a USCG rescue is another can of worms. I recommend books like " where there is no doctor" and wilderness medicine. Ita all about triage. comfort, hydrate, treat for infection ad reaction, and dump them off at the closest beach.

[seadago]

Update on this topic

First of all, many thanks to all contributors. Much info available. I also went through previous threads I could find on th same/similar topic.

Attached (.XLS) is an attempt to synthesise and structure the list of drugs for a medicine chest by condition. It follows roughly the categories I identified in opening the thread.

A few observations:

Commercial names refer to the name the drug is marketed by. Different laboratories offer exactly the same drug under different names in different countries, or for very slightly different presentations. Not all names I came cross are included!! The ones that are, correspond to popular brands mostly in Europe and LatAm respectively. There are others in other parts of the world.

I included the name of the active principle(s) for each drug. Many market names to one active principle. This, IMO, is a critical bit of info. I have received commentary to the effect that it is best practice NOT to use anything we are not already familiar with. Whilst I wholeheartedly agree with this, it does not help if we are in a foreign country looking for a brand name the pharmacist or clinic nurse is not familiar with. Knowing the active principle helps a lot. It will also allow us to identify generics, which may work just as well.

Mind everyone! this is only a list of medicines, and what pathology the are normally used (or intended) for. How you use them however, is evidently your own affair.

Finally, there is a wealth of advise on medicines and drugs on the web (grugs.com, ndrugs.com, medicine.net, etc, etc) with more info that be readily digested. Also of great help in compiling the list was the British Medical Association "New Guide to Medicines and Drugs". ISBN0-7513-0444-1. Dorling Kindersley Ed. Worthwhile having this book in any household, let alone a cruising boat.

Any further contribution to the list with your own experience and insight (or corrections to list contents!), much appreciated. Thanks.

Rafa

[seadago]

Hi everyone. I owed an update on this topic, if only, to stop boring folks with it!

To make my life simpler, I though I would look around for commercially available first aid kits (for cars, caravans, etc) which I could augment with some specifics to suit my needs. Disappointing exercise. What I found online was either far too restricted for my needs, or, at the upper end of sophistication, of a price tag far exceeding my budget. So, I decided o start at the beginning. Pics below.

The container is a plastic toolbox, 40X16X18 cm bought over the internet for a few quid.

Inside, I placed a waterproof tupperware container to keep pills and capsules all in one place and away from moisture. Everything else comes already sealed in aseptic containers/wrapping. Contents as follows:

Medicines:

Ibuprofen 500 mg (anti-inflammatory)
Bactrim 400 mg (Sulfamethoxazole/Trimethoprim: wide spectrum antibiotic)
Amoxiline 500 mg (wide spectrum antibiotic)
Icaden ointment (skin fungal infections)
Bromazepam 6 mg (anxiolytic)
Diphenhydramine (anti-histamine)
Loperamide hydrochloride 5 mg (anti-diarrhoeal)
Lysine chlonixinate 300 mg (muscle relaxant, analgesic, cramps/spasms)
Paracetamol 500 mg (analgesic, anti-inflammatory, anti-pyretic)
Codeine phosphate 30 mg (analgesic)
Dyphenhydramine (anti-histamine)
Epinephrine 1 mg (adrenaline: anaphylaxis)
Xylometazoline Hydrochloride (rhinitis, sinusitis)
Pirinase nasal spray (hay fever)

Generic:

Benzocaine solution (topical anaesthetic, mouth ulcers, toothache)
Germoloid ointment (Lidocaine: haemorrhoids)
Germolene cream (topical antiseptic, 2nd/3rd degree skin burns)
Insect repellent spray
Lactulose solution (constipation)
Sulphamide salts (topical antiseptic)
Dettol (disinfectant)
Hydration salts sachets (dehydration treatment)

First aid stuff

sterile cotton dressing
cotton eye pads
fabric adhesive strapping
elastic bandage (tubular)
superglue tube
space blankets
surgical scalpel and blades
dental probe
surgical scissor, tweezers, forceps
artificial skin spay

The only drug that a doctor may be reluctant o prescribe without an immediate need is the Codeine, as it is an opiate. In my case, it was prescribed to me for post-op pain control. I never felt the need o use it then, so have it.

Total cost, GBP 126.60

There is lots of room for improvement of the contents, and still some room inside he box, so suggestions most welcome.

[JPA Cate]

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!

[seadago]

Good point. Severe nausea is a thing I had not considered, but it's frequent enough! Added to the list!

Thanks Ann

[JPA Cate]

No worries, mate.

Ann

[Mike Banks]

Include a dozen field kits of Nelaton catheters, 12 FG and 10 FG, and the kit includes some examination gloves and lubricating gel. The 30 cm length suits either male or female.

[JPA Cate]

Originally Posted by Mike Banks

Include a dozen field kits of Nelaton catheters, 12 FG and 10 FG, and the kit includes some examination gloves and lubricating gel. The 30 cm length suits either male or female.

Yes! catheters can save lives. Our kit includes a length long enough for a male, and KY jelly, to lubricate it on its way to the bladder. The run is a lot shorter for the female. Hopefully, we don't have to deal with this, but failure to urinate is an emergency, and one doesn't have a whole lot of time to consider options.

Ann

PS. There is no cure that I know of for a ruptured bladder.