Medical supplies for cat 1

[Guest]

Hi everyone

Wondering if anyone has some good tips on getting a medical kit for a few months away to Tonga/Fiji at a reasonable price.

Cheers Steve.

[Guest]

For a one off trip it might pay to find a cruising boat that isn't doing the run this year and borrow/rent theirs. Offer to update expired stuff etc. ICA might be a good place to start as many of their members don't come up every year.

[Guest]

It would be good to find a business that rents these kits or at least the serious accident part.

[Fusion 0]

yacht lifeline will rent, supply, give you options.

 

http://www.yachtlifeline.com

+64 21 023 21605

 

Auckland, New Zealand

 

Tel: +64 21 023 21605

 

Unit 20, Orams Marine Village

144 Beaumont Street

Westhaven

Auckland, 1010, New Zealand

Tel: +64 9 302 5222

[Guest]

I must say that I have grave reserves about what is being offered/touted around WRT medical kits.

 

Firstly one only needs a kit that has stuff in that one knows how to use. Sure you can get advice on SSB - but it does not really change things that much.

 

So what can happen to you or your crew?

- heart attack (WTMB). If you have an coronary infarct all you really need is aspirin. If it leads on to an arrythmia (cardiac arrest) even if you have a defibrillator your survival either out of or in a hospital is not great. Ten days from a landfall…………..

- Major injury. Well this really depends on what kind of injury. If there is massive blood loss/lung injury/massive tissue trauma/damaged bowel/head trauma/fracture of a major long bone (femur)/significant burn/etc…..well without immediate and competant medical help you're pretty stuffed. Pressure bandages/splints/IV fluids/airways/etc only if you have done a first aid course

- Minor injury. Things like a damaged hand (caught in a winch)/fractured forearm/broken rib/fractured ankle/etc./small area burn/foreign body in the eye/boils/toothache/sore back/small laceration (without major blood loss)/etc….you'll survive but will need pain killers/splinting of the fracture/antibiotic/etc. This is not a major medical adventure…..just a simple broad-spectrum antibiotic, simple analgesics (paracetamol/ibuprofen) and possibly a more powerful analgesic for a fracture (effective splinting works very well). Simple dressing for a burn and larger tissue trauma, steri-strips (even simple old bandaid works). You might end up with some funtional loss but you'll live.

- infective illnesses - pneumonia/tonsillitis/gastroenteritis/meningitis/cellulitis/or any other kind of 'itis. Treatment always starts with simple broad-spectrum antibiotics, analgesia/antipyretics (paracetamol)/fluids and bed rest. Immodium and Zofran make the D&V more bearable. Arthropod bourne ilnesses (Dengue/malaria/etc)…know the illnesses in the areas you are going to and then carry your chloroquin, etc.

- other things like renal stones/gall stones/cancers of any description/Alzheimers/diabetes/etc….they usually are not immediately life-threatening and it really is all about the great big lotto wheel in the sky. You just take your chance whether on a boat or in cotton wool.

 

Simple really. One does not need huge expensive medical kits. Do a sensible first aid course, talk to your friendly doctor, have someone contactable on satphone/ssb, etc.

 

For coastal cruising - if you can get to a place with medical help within 24 hours, you need very little - no more than in your bathroom cabinet at home.

 

(I await the deluge of disagreement).

[Guest]

No disagreement anttay, but out of interest are you a medic of some sort, or just an interested sailor?

 

Must say that in some 150,000 miles I have had to deal with two moderate burns (one thanks to a powerboat wake during cooking), and one foreign object in eye (flushed it 400 times), and a bunged up ear (flush with warm water).

 

Plus coral cuts etc - carried antibiotics and thought it was great in Central America to be able to get them over the counter, plus they were a powder with a huge shelf life.

[Bimini Babe 0]

You present a very compelling argument anttay, and one that I'm inclined to agree with. I'm currently going through the motions of putting an offshore med kit together, and wouldn't have a clue what to do with most of the items in the med kit from the company mentioned above. I readily admit that I would like more medical training, and I'd prefer to carry too many meds than too little, but time and budget are getting tighter and if it's a choice between going 'under-prepared' (by YNZ/MNZ standards, not by mine), and putting it off (again.......) until everything is in order and my boat is full to gunwales with things I'll probably never use, I unreservedly choose the former.

[Guest]

There used to be a downloadable thingo on the web something like "Barefoot Doctor" which was very useful med info that did not need the huge kit to perform first aid. I think I have it onboard stashed away in a safe place so it will probably show up when I've given up looking for it. If i can find it I'll post a copy because it really is good. May still be online but all I come up with is Taoism stuff.

[Megwyn 2]

Some people are allergic to aspirin, and ibuprofen is another drug that many people cannot tolerate as it can cause gastric bleeding. You would need to carry epinephrine in case someone reacted to something you gave them, or that they otherwise ingested. I believe this comes in your offshore kit as an epipen that is ready to use and has instructions written on it.

 

Broad spectrum antibiotics - penicilin too can be allergenic. And someone may not know that they are, as you can become allergic. So you need to carry an antibiotic that does not have a tendency to be allergenic (non penicillin), as well as your penicillin. The 4th generation cephalosporins seem to be a safe option.

 

A suture kit is a waste of money if you do not know how to use it - although in reality, if you can push a needle through tough leather and do an ok blanket stitch, it would suffice until real help was available. (Human skin is very tough).

Steristrips are fantastic, but limited in their application.

 

If someone has a heart attack - the most important thing to give them is oxygen - but I don't think you get that in your Cat 1 kit? The thing is, do you know what a heart attack looks like? Can you be sure that is what someone is having or has had? Do you know the symptoms? MI does not always present with heart pain, or the typical numbness and tingling down the arm.

 

IV administration requires good access to a vein, and although it is relatively simple to do, if you have never canulated someone before then it can be a tricky exercise. This is not something they teach you in a first aid course, as on land you call the ambulance, and they do it.

 

When offshore, if a serious accident occurred, you may want to keep someone in a reduced state of consciousness to keep them stable and prevent further injury/damage until landfall - ie a serious fracture etc. For this you would need to know how much opiate you can give them (it is a bodyweight formula) without killing them. And if you have opiates on board, you need Naloxone (or Narcan) and need to know how to monitor for narcosis if you wish to consider using morphine.

 

Looking through an offshore kit a couple of years back, I did feel that some of it was redundant, and that it was missing some things I felt should be there. But that is only my opinion, and my memory is not what it once was .

 

LOL - truely - I would recommend a medics course, not just first aid, but at least the coastal medics.

I think I just talked myself into it!

[Farrari 4]

LOL - truely - I would recommend a medics course, not just first aid, but at least the coastal medics.

I think I just talked myself into it!

 

I'd second that. I attended the Coastal Medics course that Sally G arranged and found it very good. If anything it showed me how little I knew and how much more there was to learn. If I was going offshore I would definetly want to attend an offshore medics course.

[Guest]

I did a medic course years ago before heading off into the wild blue yonder. At the time there was nothing aimed at sailors so this was more for outback Aus. In nearly every situation the advice was "make the patient stable and wait for help to arrive" Pretty useless really.

But the last thing we did was childbirth. After going through all the gory details they said "then tie a knot in the cord and cut it". I was confused - every knot I knew involved passing the bight through a loop somewhere - so what do you do, shove the baby or the afterbirth through the loop in the umbilical? They laughed at me (OK I was 22 yo)

[Farrari 4]

I did a medic course years ago before heading off into the wild blue yonder. At the time there was nothing aimed at sailors so this was more for outback Aus. In nearly every situation the advice was "make the patient stable and wait for help to arrive" Pretty useless really.

 

Quite the opposite to the yacht lifeline one I attended. It was 100% focused on yachting and full of practical examples. There was a bit of "If this happens do your best but don't expect a good outcome" type thing. What it really showed was that the cheap (and some of the more expensive) medical kits sold over the counter are really only any good for scratches and grazes. Any serious trauma and you just don't have enough bulky contents to deal with it.

 

The other interesting thing they raised was the benefit of oxygen. It seems daft that the general public can't buy or refill oxygen bottles for medical use.

[PaulR 3]

A clean packet of baby nappies has great bulk blood absorbing properties, and leak proof, for a while. Cheap but effective for big wounds. Luckily I've knot need to use one and don't want to either, being a sensitive caring type and disliking the sight of blood, especially my own

 

Have a supply of towels, freshly launded and shrink / vacuumed packed for emergency use only. It's a good use of the worn large bath towels, cut out the worn patches and one ends up overlocking the frayed edges and you have 3 smaller but reasonably sized towels about 3ft / 900mm square.

 

We have a domestic food vacuum sealer and I have packed a "dry" set of clothes for my offshore kit bag as well.

[Guest]

When we were kids my Dad hit his bald head on a hatch, wouldn't stop bleeding and no normal bandage or plaster would stick. Ended up with a sanitary napkin on his head with the loops around his ears - much to the amusement of the rest of the family.

[Megwyn 2]

Nappies and/or incontinence pads are fantastic absorbers. I have used them for dressings before when someone has a 'leaky' wound.

 

But if you have a bleeder - someone who has cut an artery, towels hold their form better. ie a nappy as it fills with liquid becomes mushy, and you need something firm to hold against a damaged artery. It can take more than 20 minutes for a clot to form to stop an artery bleeding too, so you have to hold the pressure on for at least 20 minutes. It is not easy to apply adequate pressure for that long. Your muscles become fatigued.

 

I had a gentleman who took a tumble when he was AWOL one day. He cut his head. Unfortunately he clipped an artery. Lucky (or unlucky depending on how you see it) a passing motorist saw him fall, and applied pressure immediately. By the time we found him the ambo's were there, it was 15-20 minutes later, and he was still bleeding - lots.

 

So yes, you need stuff to soak up the blood, but it is better to try to keep the blood in the body, if you can .

 

There are some things that you just hope never happen, as some injuries are extremely difficult to manage, even in Hospital. And for those, you really cannot be prepared. . .

[Farrari 4]

Nappies and/or incontinence pads are fantastic absorbers. I have used them for dressings before when someone has a 'leaky' wound.

 

But if you have a bleeder - someone who has cut an artery, towels hold their form better. ie a nappy as it fills with liquid becomes mushy, and you need something firm to hold against a damaged artery. It can take more than 20 minutes for a clot to form to stop an artery bleeding too, so you have to hold the pressure on for at least 20 minutes. It is not easy to apply adequate pressure for that long. Your muscles become fatigued.

 

I had a gentleman who took a tumble when he was AWOL one day. He cut his head. Unfortunately he clipped an artery. Lucky (or unlucky depending on how you see it) a passing motorist saw him fall, and applied pressure immediately. By the time we found him the ambo's were there, it was 15-20 minutes later, and he was still bleeding - lots.

 

So yes, you need stuff to soak up the blood, but it is better to try to keep the blood in the body, if you can .

 

There are some things that you just hope never happen, as some injuries are extremely difficult to manage, even in Hospital. And for those, you really cannot be prepared. . .

 

On the medic course they talked about a product called CELOX that was mean't to help with arterial bleeds. Something about acting as a fast cloting agent. It came in a guaze that you could shove in an open wound, cover with plastic and then wrap a pressure bandage around keep the blood in. Again it was quite expensive but I'm not sure you would be thinking about money if you had a major trauma on your hands.

[Grinna 2]

I did a passage to fiji on a boat that had a Dr onboard. He was real good value and a neat guy to chat with. His take on first aid procedures was very common sense.

 

I was under the impression that I'd need to learn suturing techniques and stuff and he said "Nah, just use butterflys or even just tape to close lacerations". I asked what happens with head injuries and his response was "tie clumps of hair together to keep things closed(ish), direct pressure and rest ... and monitor for consussion, etc". Basically just patch things up enough until you get to land and/or medical assistance. He carried some pethadene for serious horsepower pain relief but other than that it was all pretty run of the mill stuff in the first aid kit he had prepared.

 

When it came to something like heart attack we basically just agreed that in all probability you were dead meat. Heart attacks occuring outside a hospital have something like an 8% chance of survival ... and that's in the best of circumstances. Having attended a heart attack victim and having spoken with others who have attanded similar events, my experience is that you're pretty much knackered if you have a myocardial infarction. The heart stopped for a reason and its usually because its so badly damaged that it can't function. It ain't gonna miraculously fix itself. Drowning or eletrocution resulting in defibrillation is a different thing though ... there may actually be a chance of getting things going again.

[Fogg 427]

I did an offshore passage on a boat with an elderly co-owner aboard, which carried a defibrilator just-in-case. The crew were trained to use it but I was relieved to end the trip without incident, wouldn't have been much fun.

[Bimini Babe 0]

Those new defibs for public places like shopping malls are great. Totally idiot proof. They talk you through the whole process, and only shock if an arythmia(???) is detected. You can stick the pads on your own skin and push the big red button and nothing happens. Although no-one seemed to really want to test it themselves...

[Guest]

but out of interest are you a medic of some sort

Yes