Medical kit, for long distance, remote area cruising.

[Stormboy]

Cruising folk.....We are looking for advice on ways and means to
build up a comprehensive medical kit, its no problem to buy all the bandages, scissors and tape, but how does one source a
modest supply of antibiotics, local anaesthetics and painkillers?

[HankOnthewater]

Generally things like antibiotics and strong painkillers need to be prescribed by a medical doctor, although some countries may have different (more relaxed/slack) rules.
There has been a recent thread containing information you may be interested in here: http://www.cruisersforum.com/forums/...oo-185113.html

[Papasail]

(20 year veteran nurse):

(In order):
#1. Hydrgen peroxide: my favorite for all sorts of wounds/ even very large "packed" wounds. Use as quarter strength/ 1 part hydrogen peroxide to 3 parts sterile saline.
Full strength on small boils, or fish hook type infections. All others below ate also 1/4 strength, and I would keep (all) on hand:
#2. Vinegar: great for fungal issues or scale, good preventative/ limiting expansion of small wounds.
#3. Bleach, yep, called "Dakins Solution" in hospitals (****ing bleach). Packed massive wounds with it (1/4 strength).

Be careful of providone iodine solutions: they will encourage coral growth in a wound.

Exacto knives can double as scalpels/ cheap. Keep them in a ziplock bag, wipe light coating of machine oil off with alcohol prep swabs before using.
Needle assortment for splinters, etc., from sewing shops (NOT good for true stitches!): get suture packs from medical supply houses: 22 to (bigger) 18 gauge silk sutures on a semi-circular triangle cutter needle.
Epinephrine: for (any)anaphylactic reaction: "bee sting kits".
Benadryl only as secondary follow up.
Claritin/ Zyrtec for longer relief, and to reduce chances of secondary nasal/ throat infection/ when you get the flu.

(NSAIDS)
Aspirin without caffeine.
Aleve.

These three meds can help with a lot: aspirin/ claritin/ benadryl.

Zantac for acid reflux.

Don't use bandaids/ let it dry out.

Stock Vitamins: Geritol with Iron.

Have a medical person you can contact in your arsenal.

Antibiotic ointments are (in my opinion) reasonably useless.

Erythromycin - for general (1st tier) infections. Can be obtained in Mexico without prescription.

Doxycycline for 2nd tier.

Flagyl for gut infections.

Silvadene cream for serious sunburns. Aloe vera for mild.

Read about anaphylaxis.
Have a medical contact.
Travel with others.

Hope this helps!!
Bill

[meatservo]

Check out fish mox flex for antibiotics, same stuff for humans...

meatservo

[JPA Cate]

Stormboy,

I'll take a stab at your being Australian. So, one of the guys at the yacht club WAGs races will be a GP, maybe more than one. Talk about it with him or her after the races, and take it from there.

I actually disagree about the Povidone. It is what my husband's former employers recommended for prophylaxis for boating injuries in the tropics, and the only bacterial infection Jim ever got was a wound that flies walked on about 45 minutes before he used it. In the event, a round of flucloxicilin, prescribed by a tribal tatooed woman in Vanuatu saw him right.

One thing, if you have any pre-existing conditions that require meds, local to Oz practitioners can make an indication on the scrip itself, and you can buy 6 months at a time. Look for compounding pharmacies, they can make up special stuff for you if required, and can fill foreign Rxes for ships' medicine chests. Be sure to include something really effective for seasickness, minimum of 3 day's worth for the whole crew.

If you're heading up to Qld, and get sand fly bites, I've found Paraderm Plus works well for me, and for mozzie bites, as well.

Ann

[Papasail]

In the way pf bandages, I would only carry 2" silk tape, and 4x4 sterile bandages (useful for just about everything. Anything bigger than that, and you're calling "mayday," and seeking medical evacuation.

Tweezers (several kinds)
Hemastats -they're okay, but they lock in place, and that can sometimes be an issue that you don't want... instead:
Eyelash (cosmetics isle) pluckers are very useful: (tiny pliers).
Needle nose pliers
"Fiskar" garden shears/ heavy duty scissors of any kind.

Some poisons: jellyfish and sting rays have heat labile venom: the poison will break down in the face of applied heat.

Work from the most common issues to the least common:
Jellyfish to ciguatara poisoning.
Be prepped for the common, have a plan for when the **** hits the fan.

All sea snakes are to be avoided, and avoided: swim away from the reef, and mostly they will return to their area of protection. Bites happen during mating season, or when they are mistaken for scuba lines/ handled by swatting at them.

Lionfish are everywhere now: know where the poison spikes are (sea catfish too) and avoid handling them when they're flopping about.

Know the dangerous stuff in the area you're in: box jellyfish, mantis shrimp, sting rays, blue-ringed octopus, sea-snakes, scorpion fish.

View videos on fishook removal, and treating severe sunburns; also sprains/ strains, and dehydration.

Hell...
Have fun, but have a plan

Bill

[pesarsten]

A big jar of MSG sold here as a flavor enhancer / tenderizer is a should have. Jellyfish, wasp, bee and other venoms are protein based. MSG breaks down protein kills the pain very quickly. A must have for my dive bag.

[Stormboy]

Thanks for the information everybody, all of it has gone into the back of the logbook, for future reference.
I am Australian, (live in Southern Tasmania) so will invite my GP
out for a days sailing, and see if we can talk him into providing the means to get supplies of antibiotics and other 'dangerous ' items.
Thanks again to all responders..........

[CarlF]

Most doctor are glad to help - and rather enjoy the challenge. Mine made me a kit of the same drugs and supplies he carries for himself when he travels on vacation in the 3rd world. Some very powerful. The "deal" is that I will contact him before taking any of them.

He also suggested with a smile that the best thing would be to take a personal physician on the trip

[gmsutton]

Some good ideas here. I would add that antibiotic ointments are very helpful if a minor wound becomes infected. They're often sold under the name Triple Antibiotic Ointment. I'd add an ace bandage or 2 for compression to treat sprains as well as Lomotil for diarrhea.

[mnh]

One item that I don't see listed is "liquid skin" or cyano-acrylate. Works great on abrasions. Kills bacteria in deep lacerations etc....mnh

[Triumphant]

Have a look at this link

http://www.cruisersforum.com/forums/...ml#post1722710

[toddster8]

I have to call doubt on the MSG theory. MSG is an amino acid. Protein is a bunch of amino acids. It's not going to cause any more neutralization than any other salt. Some "meat tenderizer" products contain protease enzymes, which is where the old saw about using them on stings comes from. Not from the salts that they also contain.

As for antibiotics and other common medications, if you have training and/or a good reference on how to use them, there are three common ways to get them.

1) Get a prescription from a licensed physician. This is the safest way, if crossing borders with the stuff. (i.e. USA and similar) you have documentation that you're authorized to carry them. Also the most expensive way - in the US, this may cost hundreds or thousands of times the actual value of the drugs.

2) Cruise to a country where they are available without restrictions at pharmacies, and stock up there. Cons: you don't get the documentation needed to enter more restrictive countries.

3) Get a pre-paid debit card with a low balance and order them on-line from Indian pharmacies. The same places that push the black-market viagra. Then burn the card, the number of which will have been sold to Russian and Chinese hacker kids within minutes. Even if you get ripped off a few times, it's relatively cheap and fast. Cons: also no documentation. If the shipment is intercepted, you may get a nasty letter from customs.

[hellosailor]

Stormboy-
It can take some doing but you really might want to find some "wilderness first aid" or "offshore first aid" courses and old-fashioned books. There are a number of issues to consider and there is no store-bought kit that will make everyone happy.
"Painkillers", for instance, can mean aspirin in the US, or a codeine mixture that is a controlled susbstance (narcotic) here but available over the counter or on the shelf in other places. Or maybe you mean morphine, which will require a prescription everywhere. Odds are that once you know what you want, and can explain why to someone else, that you can get your doctor to write prescriptions for a range of drugs that you might need, including antibiotics and painkillers.
Common antibiotics (like the "triple" ointments) are easily bought--but you will often find the online discount sellers are selling short-dated products, not a bargain at all.

And as some posters note, there are differences of opinion as to what is best (or even acceptable) practice now. In the US, hydrogen peroxide and betadine have been cautioned AGAINST for 20 years now. Yes, hydrogen peroxide is still good to disinfect tweezers, or a gash from a dirty axe. But it kills healthy tissue in a wound, so it also guarantees that any bacteria will find convenient dead tissue to grow on, creating a major problem. Other 'weaker' products that don't kill tissue become a better option. The trick is knowing when to use which, and how to continue ongoing treatment.
Similarly betadine hasn't been recommended for a long time. It is very effective, but the red color hides any redness from a growing infection. "White" disinfectants, which don't hide infections, don't cause that problem.
You really can't put together a GOOD kit, until you spend a lot of time learning what you personally will want in it. And then, you shop around. Commercial kits of any kind tend to be expensive, probably just because it can be such a hassle to find a case, and then find all the contents, and then fit it all together. They're a good quick-start, if you have to do it that way. They still won't have the prescription items in them, but as basic first aid classes will tell you, you don't even use the antibiotic ointments on anyone, you just use plain dressings, unless you are sure they won't be allergic (D'oh!) or they can't be gotten to proper treatment.

[oleman]

Get perscriptions from a Licensed Medical Doctor who knows you and trusts you to make good judgement calls on controlled meds. If there is a serious medical emergency you will need access to the same meds that are used in a hospital emergency room if the patient is going to survive not a boy scout first aid kit or the simplistic medical qualifications of a EMT. Most EMT's are only required to check vitals, cover the wounds and call careflite.