Content of onboard medicine chest

[ELC]

Anybody consider a military style IFAK? Like the ones sold by Dark Angel or several other companies.

A tourniquet
Quick Clot gause
Nasal airway
Compression bandage
Chest seal
Trauma shears
Butterfly bandages

All vacuumed packed and in a belt pouch. Not only worth having onboard along with the usual supplies but worth having when exploring in out of the way places off the boat.

[basssears]

Originally Posted by ELC

Anybody consider a military style IFAK? Like the ones sold by Dark Angel or several other companies.

A tourniquet
Quick Clot gause
Nasal airway
Compression bandage
Chest seal
Trauma shears
Butterfly bandages

All vacuumed packed and in a belt pouch. Not only worth having onboard along with the usual supplies but worth having when exploring in out of the way places off the boat.

Assuming you know how to use these things, I agree that planning for trauma is a good idea... it seems most discussions of onboard medical planning cover medical emergencies only not trauma emergencies.


I would modify the above list a bit though... quick clots are notoriously fickle and can have plenty of unwanted side effects, so you have to be aware of that. But if you are then they could work for you.


A good compression bandage to go with is what they call an Israeli bandage, gauze and compression mechanism built in.


Chest seal... well, you better know what you're doing with this one... you can take a (certainly unwell, but surviving) patient and kill them by creating a tension pneumo where there wasn't one before.


Tourniquet I 100% agree with... lots learned about them (unfortunately, thanks Iraq & Afghanistan) since the dark old days of "if you put a tourniquet on expect to lose the limb", it's remarkable what can be saved even after a tourniquet has been on for hours, and you might have something to try to save because you're patient's still alive because you stopped the bleeding.


I'd be hesitant with butterflies unless you're close to regular medical care... the concern there is that when ER's butterfly / stitch / glue / staple you together they've already SERIOUSLY cleaned that wound (like to the point that they have had to give you pain meds because they're scrubbing so deeply)... without that kind of cleaning you run the risk of still having debris / pathogens in there and now you're closing it in making it harder to clean repeatedly down the line and harder to get topical antibiotic on. My backcountry take on deep wounds is to care of them as best I can with topical antibiotics and cleaning and gauze but leave them open and live with the scar.


-- Bass

[ELC]

Agree with the training! Luckily it's not hard to get. While not fully medic trained I did get some good training in the past both civilian and military.

I tend to think get them or me stable until help arrives. I've had to patch up myself in a few remote places and crawl in with some major victims and keep them going waiting for help.

I'm aware of Quick Clots potential issues including throwing a clot but consider it a tool just in case.

The butterflies I needed once for me with controlling a flap of skin while giving myself first aid for a nasty suprise.

Chest seal again, know the basics is right. The new ones these days are vented which helps. In a pinch we got trained to use a tape hinge and a flap of plastic.

Israeli bandage is a good one!

Always a good idea to think keeping someone going for 24 to 72 hours when planning I think. Most of the time we can get some kind of help by then.

[s/v Jedi]

Here’s mine. I think it’s better to configure your own rather than buy something off the shelve.

Edit: left is trauma bag, right is 24h survival.

[GordMay]

Originally Posted by PapaLulu

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.

Thanks!

Oral Rehydration Solutions (ORS) are used to treat dehydration, caused by diarrhea, a common illness in travellers. Unlike other fluids, the ratio of the ingredients in an ORS matches what the body needs to recover from a diarrheal illness. Avoid alcohol, caffeinated or sugary drinks, like coffee, energy drinks, pop, sweetened fruit juices, and tea. Alcohol and caffeine can worsen dehydration, and sugary drinks can worsen diarrhea.
An ORS contains three ingredients:
Clean water that has been boiled or disinfected or from a commercially sealed bottle.
Electrolytes (also called “salts”), which are chemicals that your body needs to function properly.
Carbohydrates, usually in the form of sugar.
➥ https://travel.gc.ca/travelling/heal...ty/rehydration

[s/v Jedi]

Originally Posted by GordMay

Thanks!

Oral Rehydration Solutions (ORS) are used to treat dehydration, caused by diarrhea, a common illness in travellers. Unlike other fluids, the ratio of the ingredients in an ORS matches what the body needs to recover from a diarrheal illness. Avoid alcohol, caffeinated or sugary drinks, like coffee, energy drinks, pop, sweetened fruit juices, and tea. Alcohol and caffeine can worsen dehydration, and sugary drinks can worsen diarrhea.
An ORS contains three ingredients:
Clean water that has been boiled or disinfected or from a commercially sealed bottle.
Electrolytes (also called “salts”), which are chemicals that your body needs to function properly.
Carbohydrates, usually in the form of sugar.
➥ https://travel.gc.ca/travelling/heal...ty/rehydration

Dehydration is one of the overlooked conditions aboard sailboats, more so in the tropics than in moderate latitudes. The article linked by Gord unfortunately does not help sailors much as it is written for shore based people.

- sailors, especially in the tropics, don’t need to have diarrhea to become dehydrated. Not understanding this has put many in hospitals. In our society there is so much attention to limiting salt intake, that people don’t understand you need to increase salt intake in the tropics. Note that farmers hang blocks of salt for cows to lick in high summer. This is for the same reason and somehow the cows know that they need to lick the salt. Humans are the same: when you feel like you really want a salty snack, listen to your body.

- we carry packets of instant ORS but only found a handful of other boats that do. You need to be able to make your own when you’re days away from the nearest farmacie, doctor etc. Here is the “water of life” recipe: 1 liter of water, 6 teaspoons of sugar, 1/2 teaspoon of salt.

- buy a Tilley hat!

[jjuliajul11]

My husband and I collected the first aid kit ourselves. We also couldn't remember what goes in there. On one site we found a list of necessary medications. When we saw it, we realized that we don't have even half of that list. So I quickly ordered everything I needed. Also, don't forget about the medications you always take (for example, I always buy rybelsus for my husband) And the funny thing that we forgot to take with us on a swim is a cure for poisoning. Fortunately, everything was fine and we didn`t need them

[s/v Jedi]

Ah, revival of old thread. I have since added the following to our on-board medical supplies:

- Ivermectin
- Vitamin C 500mg
- Vitamin D3, 1000IU
- Melatonin 5mg
- Zinc supplement 30mg

All these in the light of Covid treatment. For sailors, being outdoors I expect no vitamin D deficiency but a Vitamin C deficiency is more likely. I carry it anyway in case someone around us needs it.

All but the first item are available over the counter (I got them from Amazon). Ivermectin is now (recently) allowed to be prescribed by doctors for treatment against Covid. I bought ours before that decision change from CDC so went to Tractor Supply instead. Note that the dose is by body weight and you need to get the math right for correct dose.

Also add this info: https://covid19criticalcare.com/i-ma...-translations/

I added main info as attachment. Note that prophylaxis means preventative treatment. When you are in a high risk group, or when you are forced to be/go into a high risk area, this is a consideration.

Also, check all listed medications in the documents; I only listed our additions as we already carry others (like aspirin).

[dannc]

Originally Posted by s/v Jedi

...
All these in the light of Covid treatment. For sailors, being outdoors I expect no vitamin D deficiency but a Vitamin C deficiency is more likely. I carry it anyway in case someone around us needs it...

That is likely a wrong expectation. It really depends on latitude and season.

https://www.health.harvard.edu/stayi...more-vitamin-d

Except during the summer months, the skin makes little if any vitamin D from the sun at latitudes above 37 degrees north (in the United States, the shaded region in the map) or below 37 degrees south of the equator. People who live in these areas are at relatively greater risk for vitamin D deficiency.

37 degrees north is roughly the NC and VA border in the eastern US to the middle part of CA on the west coast.

Years ago my doctor had my vitamin D level checked during a check up. I thought I would be fine due to what I eat and the amount of time I spent out doors. We live in the middle part of NC. I was wrong.

Vitamin D levels should be between 30 an 100. Mine was in the teens. NOT GOOD. It took two years of adjusting my supplement intake to get my vitamin D level to around 70. Figured that was good enough.

To get to that level I had to take 2 pills each with 2,000 IUs. The only way to know if you have the correct level is to get the blood work done.

We suspect that my family had the virus in late Feb 2020. One person was tested and did not have Flu A or B but had flu like symptoms. I had no symptoms, was not sick, never had a cough or a sniffle, yet the rest of the family all had the flu and it took them a few weeks to get over what ever they had.

Later,
Dan

[Discovery 15797]

Originally Posted by s/v Jedi

Dehydration is one of the overlooked conditions aboard sailboats, more so in the tropics than in moderate latitudes.

Absolutely agree!

I received training to administer an IV and carry NS (normal saline) bags in my med-kit. But, administering an IV is not for everyone, and when the patient is dehydrated it becomes a real challenge for a lay-person.

IMHO, a better solution for sailors is a hypodermoclysis kit. This basically is a way to deliver NS subcutaneously rather than intravenously. It still requires some level of training. These are available from many med supply companies but require a prescription (and some companies may only sell to doctors). My doc had no problem ordering two kits for me.

If a patient is unconscious and/or cannot take fluids orally, an effective alternative method is rectal rehydration.