Marco Flamingo has asked about a first aid kit in the thread on EPRIB.
None of the below should be considered to be specific medical advice, and is only for first response and emergency treatment, until an injury or illness can be evaluated at a medical facility. I have intentionally avoiding some issues, but welcome questions.
I have made several hundred offshore custom first aid kits (Including RX and Narcotics) for offshore sailors and voyagers during my over 30 years of practicing medicine (Mostly in Long Beach CA). What is needed for a day trip, will be different from a trip in a remote area, such as Alaska for a month, and that is different to what you will carry if crossing an ocean.
My philosophy is that anyone who is smart enough to afford a boat to voyage, is smart enough to handle medical crisis, as long as they have supplies at hand, some basic knowledge and have a good communication system (Ham Radio, Satellite phone, or text message via satellite) to contact a shore side physician. I used to offer this aid thru ham radio and Winlink. We shut this down because of potential liability. There used to be several coastal hospitals who had a ham set, with a patch to the ER and could give this advice, and there are currently services which give this for a fee, but you have to subscribe before you leave on the voyage. This includes vetting the skipper/and being sure that they have adequate basic training and gear.I
One wonders how much room this takes up? For 7 years I was director of Athletic Medicine at a large Division I university, and carried all emergency gear I needed in a large fanny pack--this included gear not on this list, including laryngoscope, endotracheal tubes, 3 suiture kits, and several injectables including a 50 CC syringe with dextrose solution. A cardiac monitor, AED, Oxygen and extra dressings were carried by one of the trainers--all of this gear was personally carried on aircraft.
What I present here would be for a C Dory on a week end to several week coastal trip where they could get to a hospital setting in 12 hours if necessary.
Training. I highly recommend that at least 2 people aboard have CPR certification, have at least basic first aid knowledge, and training as given by the American Red Cross. For ocean voyages, I recommend that a paramedic course be taken--at least for the basic level.
Books
I recommend a basic first aid book aboard--such as the AMA, or Red Cross First aid and Safety book.
Marine Medicine, by Dr. Eric Weiss (there is also a Kindle Edition)
"Doctor on Board" by Dr. Hauert
A PDR or "The pill book" are also handy.
American Wilderness Society has an excellent book on Wilderness medicine:
Wilderness Medicine beyond first aid.
Kits
The basic kid can be obtained in the Walmart Johnson and Johnson $7 first aid kit for day trips. We keep a number of these in cars, RV, Boat etc, all with supplements.
If you want something very organized, then the kits from Adventure Medicine: There are lists of the kit contents--if you want you can assemble for less.
https://www.adventuremedicalkits.com
Medication:
No medication, including Generic should be taken without a doctors's advice. Be sure that a person is not allergic to a medication before giving it.
Bonnie (Meclizine 25 mg) chewable for motion sickness can be chewed or dissolved under the tongue after a person has motion sickness--also mild anti histamine.
Benadryl; (25 mg anti histamine.)
Advil / ( Ibuprofen ) ( 200 mg x 2 Tablets )
Tylenol / ( Acetaminophen ) ( 500 mg x 2 Tablets )
Aspirin ( 325 mg x 2 Tablets )
EpiPen (Epinephrine, for severe allergic reactions--injected RX)
Medrol Dose Pac (for severe allergy, oral, tapering decrease dose of steroids RX)
Peptobismol
IMODIUM®(loperamide hydrochloride)
Metamucil
Ducolax tab
Antacids
Cleaning
It is extremely important to clean well any wound which has been in the water, or from beach/coral sand/marine life, or rock.
Scrub brush It sounds harsh, but scrub out a wound, to get any debris out.
hexachlorophene or solution.
Betadine, or Povidine (can be in swabs--or pads)
Benzalkonium Chloride Antiseptic pads
Saline rinse (in bottles or pressure cans) to irrigate the wound
There is some controversy about using potential toxic chemicals on wound edges. Our experience is that one time initial application doe snot delay healing, and gives far less infection. We do not use alcohol. But alcohol can be used to sterilize instruments.
Instruments:
Head lamp (several times I had to suiture folks when no lights available)
Splinter forceps--we often use those on the handle of our Swiss Army knife, but we also have small dental picks, and larger sharp pointed forceps
#11 Knife blade (X-acto) and handle
Scissors--bandage, and small cuticle type
Gloves, Nitrile Gloves extra thick, disposable --I keep a box of 50 aboard.
Sterile gloves, for suiture and exam--this is elective.
Diagonal wire cutters for fish hooks.
Wound closure:
Most wounds will do well with just pressure, and not suiture, but when it is necessary:
Also this is a point to mention "quick Clot" It is life saving--but rarely necessary, unless massive trauma. If you want it or not--is elective.
For the most part, we used steri strips (CVS) or butterfly bandages: You can make your own, if necessary, here is some technique on use of skin closure strips:
http://www.firstaidguide.net/skin-closure-strips/
Suiture sets--not recommended for short near shore--clean, dress and use pressure dressing, until you get to medical care.
I carried several sterile packets with 4 different types of suitures, and needles, hemostats, scissors, probe, suiture holder, etc. You can buy sets from "Duluth Trading co".
Small suitures, and needles hurt less than injection of Xylocaine for a small wound.
If you want to know all of the suiture types and stitches:
http://www.uphs.upenn.edu/surgery/Educa ... Manual.pdf
Bandages and dressings:
An assortment of Band aids: I prefer the cloth "Tough Strips" by J & J.
Get: everything from small spots, to the 3 x 3" pad for knees and elbows.
At least several dozen assorted.
Telfa pads (non stick dressingsI). 2 x3 up to 3 x 6 inches. You can cut if you need smaller
Gauze pads: At least a dozen 2 x 2, 2 x 3, on up to 4 x 4 size.
Roller Gauze--several rolls of 1" and 2".
Eye bandage: several pads
Kerlex dressing: 4.5" x 4 yards (at least one)
Muslin 36" square--washed and clean. This can be cut for a sling, head dressing etc--basic "bandage"
Israel war dressing: 4 x 6"-- not necessary, but something that more are carrying for massive trauma. Can make one out of telfa pads, 4 x 4 and Kerlex. But handy for compression dressing.
Tape:
1" cloth x 6 yards min.
1" micro pore clear tape x 3 yards
Athletic wrap (4" is most handy size), self adhering, elastic
"Ace" bandage: 2" 3" and 4"
ointment and skin
I am an advocate of using antibiotic ointment if a wound can be contaminated, after the cleaning and irrigation But this is also controversial.
I carry at least one tube of triple antibiotic ointment.
Cortisone 1% ointment.
Air way
Although the most recent CRP does not require rescue breathing, I feel that establishing a good airway is essential, and at times the only way is to have an airway device.
Fractures or dislocations:
If compound keep wound sterile and cover with a dressing--immobalize until you obtain medical care.
SAM splint, along with Ace bandage. (4.25" x 36")
Inflatable splint
Casting material--only on longer voyages
fingers and toes are more common, and taping to adjacent digit often is all that is necessary. There is also a SAM finger splint--excellent.
Burns
Minor burns, cool water may help--do not use ice, or put butter etc on the burn.
A 3rd degree burn, cover with sterile material (if you have sterile saline, you can put this on the first layer of dressing material, avoid pressure, put no ointment on the burn, and get medical attention.
Be safe, and avoid injury and illness.
None of the below should be considered to be specific medical advice, and is only for first response and emergency treatment, until an injury or illness can be evaluated at a medical facility. I have intentionally avoiding some issues, but welcome questions.
I have made several hundred offshore custom first aid kits (Including RX and Narcotics) for offshore sailors and voyagers during my over 30 years of practicing medicine (Mostly in Long Beach CA). What is needed for a day trip, will be different from a trip in a remote area, such as Alaska for a month, and that is different to what you will carry if crossing an ocean.
My philosophy is that anyone who is smart enough to afford a boat to voyage, is smart enough to handle medical crisis, as long as they have supplies at hand, some basic knowledge and have a good communication system (Ham Radio, Satellite phone, or text message via satellite) to contact a shore side physician. I used to offer this aid thru ham radio and Winlink. We shut this down because of potential liability. There used to be several coastal hospitals who had a ham set, with a patch to the ER and could give this advice, and there are currently services which give this for a fee, but you have to subscribe before you leave on the voyage. This includes vetting the skipper/and being sure that they have adequate basic training and gear.I
One wonders how much room this takes up? For 7 years I was director of Athletic Medicine at a large Division I university, and carried all emergency gear I needed in a large fanny pack--this included gear not on this list, including laryngoscope, endotracheal tubes, 3 suiture kits, and several injectables including a 50 CC syringe with dextrose solution. A cardiac monitor, AED, Oxygen and extra dressings were carried by one of the trainers--all of this gear was personally carried on aircraft.
What I present here would be for a C Dory on a week end to several week coastal trip where they could get to a hospital setting in 12 hours if necessary.
Training. I highly recommend that at least 2 people aboard have CPR certification, have at least basic first aid knowledge, and training as given by the American Red Cross. For ocean voyages, I recommend that a paramedic course be taken--at least for the basic level.
Books
I recommend a basic first aid book aboard--such as the AMA, or Red Cross First aid and Safety book.
Marine Medicine, by Dr. Eric Weiss (there is also a Kindle Edition)
"Doctor on Board" by Dr. Hauert
A PDR or "The pill book" are also handy.
American Wilderness Society has an excellent book on Wilderness medicine:
Wilderness Medicine beyond first aid.
Kits
The basic kid can be obtained in the Walmart Johnson and Johnson $7 first aid kit for day trips. We keep a number of these in cars, RV, Boat etc, all with supplements.
If you want something very organized, then the kits from Adventure Medicine: There are lists of the kit contents--if you want you can assemble for less.
https://www.adventuremedicalkits.com
Medication:
No medication, including Generic should be taken without a doctors's advice. Be sure that a person is not allergic to a medication before giving it.
Bonnie (Meclizine 25 mg) chewable for motion sickness can be chewed or dissolved under the tongue after a person has motion sickness--also mild anti histamine.
Benadryl; (25 mg anti histamine.)
Advil / ( Ibuprofen ) ( 200 mg x 2 Tablets )
Tylenol / ( Acetaminophen ) ( 500 mg x 2 Tablets )
Aspirin ( 325 mg x 2 Tablets )
EpiPen (Epinephrine, for severe allergic reactions--injected RX)
Medrol Dose Pac (for severe allergy, oral, tapering decrease dose of steroids RX)
Peptobismol
IMODIUM®(loperamide hydrochloride)
Metamucil
Ducolax tab
Antacids
Cleaning
It is extremely important to clean well any wound which has been in the water, or from beach/coral sand/marine life, or rock.
Scrub brush It sounds harsh, but scrub out a wound, to get any debris out.
hexachlorophene or solution.
Betadine, or Povidine (can be in swabs--or pads)
Benzalkonium Chloride Antiseptic pads
Saline rinse (in bottles or pressure cans) to irrigate the wound
There is some controversy about using potential toxic chemicals on wound edges. Our experience is that one time initial application doe snot delay healing, and gives far less infection. We do not use alcohol. But alcohol can be used to sterilize instruments.
Instruments:
Head lamp (several times I had to suiture folks when no lights available)
Splinter forceps--we often use those on the handle of our Swiss Army knife, but we also have small dental picks, and larger sharp pointed forceps
#11 Knife blade (X-acto) and handle
Scissors--bandage, and small cuticle type
Gloves, Nitrile Gloves extra thick, disposable --I keep a box of 50 aboard.
Sterile gloves, for suiture and exam--this is elective.
Diagonal wire cutters for fish hooks.
Wound closure:
Most wounds will do well with just pressure, and not suiture, but when it is necessary:
Also this is a point to mention "quick Clot" It is life saving--but rarely necessary, unless massive trauma. If you want it or not--is elective.
For the most part, we used steri strips (CVS) or butterfly bandages: You can make your own, if necessary, here is some technique on use of skin closure strips:
http://www.firstaidguide.net/skin-closure-strips/
Suiture sets--not recommended for short near shore--clean, dress and use pressure dressing, until you get to medical care.
I carried several sterile packets with 4 different types of suitures, and needles, hemostats, scissors, probe, suiture holder, etc. You can buy sets from "Duluth Trading co".
Small suitures, and needles hurt less than injection of Xylocaine for a small wound.
If you want to know all of the suiture types and stitches:
http://www.uphs.upenn.edu/surgery/Educa ... Manual.pdf
Bandages and dressings:
An assortment of Band aids: I prefer the cloth "Tough Strips" by J & J.
Get: everything from small spots, to the 3 x 3" pad for knees and elbows.
At least several dozen assorted.
Telfa pads (non stick dressingsI). 2 x3 up to 3 x 6 inches. You can cut if you need smaller
Gauze pads: At least a dozen 2 x 2, 2 x 3, on up to 4 x 4 size.
Roller Gauze--several rolls of 1" and 2".
Eye bandage: several pads
Kerlex dressing: 4.5" x 4 yards (at least one)
Muslin 36" square--washed and clean. This can be cut for a sling, head dressing etc--basic "bandage"
Israel war dressing: 4 x 6"-- not necessary, but something that more are carrying for massive trauma. Can make one out of telfa pads, 4 x 4 and Kerlex. But handy for compression dressing.
Tape:
1" cloth x 6 yards min.
1" micro pore clear tape x 3 yards
Athletic wrap (4" is most handy size), self adhering, elastic
"Ace" bandage: 2" 3" and 4"
ointment and skin
I am an advocate of using antibiotic ointment if a wound can be contaminated, after the cleaning and irrigation But this is also controversial.
I carry at least one tube of triple antibiotic ointment.
Cortisone 1% ointment.
Air way
Although the most recent CRP does not require rescue breathing, I feel that establishing a good airway is essential, and at times the only way is to have an airway device.
Fractures or dislocations:
If compound keep wound sterile and cover with a dressing--immobalize until you obtain medical care.
SAM splint, along with Ace bandage. (4.25" x 36")
Inflatable splint
Casting material--only on longer voyages
fingers and toes are more common, and taping to adjacent digit often is all that is necessary. There is also a SAM finger splint--excellent.
Burns
Minor burns, cool water may help--do not use ice, or put butter etc on the burn.
A 3rd degree burn, cover with sterile material (if you have sterile saline, you can put this on the first layer of dressing material, avoid pressure, put no ointment on the burn, and get medical attention.
Be safe, and avoid injury and illness.
