Medical Kits

[Guest]

From Short talk:

 

Hi,

I was asked by Jon Henry off Danaide for some advice regarding the Med kit for RNZ race

My reply is below for anyone interested. I have previously offered to look at the Med kit contents for YNZ as I am frequently asked for advice on what to take offshore.

 

 

Each boat should take all the Cat 2 gear that is on the list

My personal recommendation to add to that is as follows:

 

-"Field Dressings" Med and large - 2 of each (they are a military style bandage that you open, slap on and tie around the limb in one shot) - very good for big wounds or when its rough/wet and hard to things to stick. Here is one type to get an idea (http://www.tridentpharm.com.sg/speciali ... ssings.htm) , but many types are available

 

-"Sleek" 2 inch tape - it is plastic and the only one that sticks to wet skin

 

-Large steristrips ( to close a wound without suturing it) and Friars Balsam ( a sort of glue to make the strips stick) - 1 packet

 

-Voltaren tablets - 50, better than Ibuprofen in my opinion

 

-Loperamide (Imodium) tabs - are only recommended in Cat kit, I would definitely include

 

-Chloromycetin ointment (chlorsig) - 2 tubes. For eye infections or skin infections

 

-Sofradex ear drops - 1 bottle - for Ear infections

 

-Silver Sulphur Diazine (SSD) cream - 1 tube for burns

 

-Augmentin tablets 5 days worth

 

-Doxycycline tablets - 5 days worth - useful broad spectrum if allergic to Penicillin

 

-Aspirin - 1 box

 

-Dulcolax tablets (1 bottle) - for constipation

 

-Hydrocortisone cream - 1 tube for skin irritation

 

-Oil of cloves - for tooth ache

 

-Dental repair kit

I personally would take a suture kit ( 2 syringes/2 needles/ lignocaine/needle holder and some sutures) - HOWEVER many people would not be keen to suture so would leave up to personal discretion

 

Cheers

Dr Dave

[Dr Dave 5]

Hi Guys,

Antibiotic shelf life for orals is variable but generally the companys state Augmentin is 3 years and Doxycycline 4 years if dry and stored below 25C.

On M1 for us dry is hard to do....

As I said I am happy to redo the Cat Med lits for YNZ if you know anyone there who wanted me to do so

Happy to help

Cheers

Dr Dave

[Guest]

Very helpful! Thanks very much!!

[wheels 543]

I suggest to be very careful using Voltarin. Many people get serious Stumouch problems with the stuff. I react badly to it and I have a friend that ended up in Hospital due to using it. There is now an alternative to it that is not hard on the tummy(advertised on TV), but I can't remember the name. I asked the Chemist about it and they directed me to Nuromol, which I said no that's not it, tried it and it isn't powerful enough.

[Guest]

I would hang a question mark beside the doxycycline and try to find another broad spectrum anti biotic that doesn't give problems with sun exposure.

I had to take some on a very remote island, working at the end of a 60m pontoon jetty in the blazing sun and no shade. MAJOR pain involved, blisters etc.

[Steve Pope 243]

Voltaren / ibuprofen destroy the kidneys over time as well as buggering up the stomach. They do their work well as anti inflamatories though, short term, Voltaren being more effective, inmho.

[rigger 47]

When I was having chemo I was told take no drugs that contain ibuprofen as it interferes with white cell production - rather important when you have practically no white cells anyway and you need them for your immune system to function

[Dr Dave 5]

Guys,

Before this degenerates into chaos with various anecdotes regarding allergies or side effects of the drugs that I have recommended, a few points:

 

I was asked by SSANZ for some advice regarding the Medical kit for the Two Man Round NZ race

 

I posted my reply on crew.org because I thought that I may help other people however these are my personal recommendations - take them or leave them!

 

EVERY drug, including simple ones such as Aspirin have side effects.

 

It is neither possible to create a Medical kit that is 100% free of side effects nor to not include a drug that someone has had a bad reaction to in the past

 

I base my recommendations on my experience both as a doctor who has significant experience in the outdoors and as a yachtsman

I have sailed 35000 miles including NZ circumnavigation, 6 Island races, Fastnet race, and two 2 man Round North Island races.

I have been a doctor for 28 years, have specialised in Anaesthesia and then Intensive Care and am Director of an Intensive Care Unit

 

To answer some of your anecdotes

1. All Non steroidal agents MAY cause renal failure and Ulcers. However Ibruprofen is now available in Chemists and Supermarkets WITHOUT a prescription. My Opinion is that Voltaren has greater efficacy ( works better) but has the same side effect profile

 

2.Doxycycline can cause photosensitivity in some people, however you need a 2nd agent for people who are penicillin allergic, that covers MOST of the likely organisms, gives Malaria cover in the Tropics and is cheap to purchase. Doxycycline is the only agent that does this. If you develop photosensitivity -wear a hat and long sleeved shirt

 

I am happy to answer other queries , but not enter a debate on which drugs are best

These are my recommendations

 

Cheers

Dr Dave

[Jon 360]

Well said Doc

This is why I was hesitant to post this

 

But guys you have to start somewhere and if you or any of your crew don't agree with something on the list then take an alternative .

And Doc knows more than most about this stuff.

 

As for antibiotics that are passed there best date I get this in my line of work, at our annual audit we have to dispose of anything the's getting close, but they still work.

 

If I bumped my knee getting onto a boat the was leaving for the Islands and three days out it was the size of a rugby ball,then I wouldn't think twice about using antibiotics that are beyond some date stamp.

[Cameron 74]

On Surreal we will be following the good Doc's recommendations plus adding a few extra's as well after doing the marine medic course. One product that impressed us was Celox. It's brilliant at stopping bleeds but expensive. It's probably not necessary as there are other ways to stop bleeding but I haven't seen anything as quick or effective (but I'm no Doctor) and in a 2 Handed Race I'd like the fastest option avilable as inevitably the sh*t has hit the fan and you have numerous other issues to attend at the same time. Also Murphy's law applies...ie if you have it you won't need it !

The other addition we are seriously considering is a defibrillator.

[Guest]

 

I am happy to answer other queries , but not enter a debate on which drugs are best

These are my recommendations

 

Cheers

Dr Dave

Perhaps you shouldn't participate in a forum if you are not open to debate or discussion. A forum is a by definition a place to discuss and debate ideas etc. I too have impressive qualifications in my field but I certainly hope I do not come across as arrogant as you have. FWIW, my "anecdotal" experience has led me to believe that doxycycline is very bad stuff indeed in the tropics and there are better alternatives.

Want to know anything about how to fix your engine?

[Guest]

I too have impressive qualifications in my field but I certainly hope I do not come across as arrogant as you have.

 

You were blatantly unsuccessful on that front.

 

Thanks Doc, good post.

[Guest]

If you are prepared to accept everything posted on a forum by someone that is not prepared to enter into discussion regarding their opinions then good luck to you. I think you will find that my posts regarding my field of expertise are a little more open minded. (IE, I know I still have more to learn)

[Cameron 74]

Perhaps you shouldn't participate in a forum if you are not open to debate or discussion.

 

The sad thing is alot of very knowledgeable people are taking your advice.

 

Some people are happy to provide their expert advice but don't have the time or inclination to then have to justify everything. You may think we are better off without these people pacticipating in a forum but I'd suggest it's a great loss...

 

I personally find I am using crew.org less and less as the information quality degrades due to the most knowledgable people no longer contributing due to negative comments and criticisium.

[Guest]

I don't expect people to justify everything they say but I do object to my experiences being dismissed in an offhand manner because I'm not an expert. I work with under qualified islanders every day and learn things from them all the time.

[wheels 543]

I work with under qualified islanders every day and learn things from them all the time.

 

Arrr, then you are truely wise Grasshopper.

As I said above, there is supposed to be an alternative to Voltarin now. But my Chemist did not seem to know of it. I have bad problems with it and I know of others. So hence my advice. I was hoping someone might have piped up with, "Oh that's blah blah" but..

So if I did not know about Voltarin and I read someone making my comment, I would be looking into what else maybe available.

I learn't to ask about meds years ago when in charge of a group tramping. We had a girl break her anckle. We had a Nurse with us, but she had gone off with a small group to look at something..can't remember what..waterfall maybe. I gave the broken ankle person Ibuprofin. When the Nurse returned, she asked me, "Did you ask the person if they suffer from Asthma?" Huh????? "Ibruprophin can cause severe asthma in those that suffer from it. I imdediatly realised I had made a potentialy huge mistake and yes she did suffere from Asthma, but thankfully nothing happened. Made me read all the info on anything from then on. It simply never ever occured to me a simple pain relief could cause a possible major incident.

[Guest]

The sad thing is alot of very knowledgeable people are taking your advice.

 

Some people are happy to provide their expert advice but don't have the time or inclination to then have to justify everything. You may think we are better off without these people pacticipating in a forum but I'd suggest it's a great loss...

 

I personally find I am using crew.org less and less as the information quality degrades due to the most knowledgable people no longer contributing due to negative comments and criticisium.

 

 

You are not the first to say a similar thing. I have just read another post here expressing very similar sentiments.

I am here to learn as much as I can, and in amongst the 'bullshit and bravado' there is some damn good stuff. I cringed when I read the attack on Dr Dave...mostly because I thought...well that's the last post we're gonna see from him! And who could blame him? Did it really need saying? What did it achieve? We were all the richer for his input and we will be surely all the poorer for the absence of it now. Good one!

[Guest]

Guys,

Before this degenerates into chaos with various anecdotes regarding allergies or side effects of the drugs that I have recommended, a few points:

 

I posted my reply on crew.org because I thought that I may help other people however these are my personal recommendations - take them or leave them!

 

I am happy to answer other queries , but not enter a debate on which drugs are best

These are my recommendations

 

Cheers

Dr Dave

I am sorry if I have upset a few people here, but if this sort of response had been offered by a sailmaker, shipwright, marine engineer, circumnavigator or any other specialty then I believe that quite a few people's noses would have out of joint. Doctors are not gods and if they post an opinion/recommendation on a forum then they should be prepared to enter into discussion/debate about it. I feel that myself and a couple of others have been royally dismissed as not being worthy of talking to because we dared challenge the almighty medical profession.

[Guest]

Guys,

Before this degenerates into chaos with various anecdotes regarding allergies or side effects of the drugs that I have recommended, a few points:

 

I posted my reply on crew.org because I thought that I may help other people however these are my personal recommendations - take them or leave them!

 

I am happy to answer other queries , but not enter a debate on which drugs are best

These are my recommendations

 

Cheers

Dr Dave

I am sorry if I have upset a few people here, but if this sort of response had been offered by a sailmaker, shipwright, marine engineer, circumnavigator or any other specialty then I believe that quite a few people's noses would have out of joint. Doctors are not gods and if they post an opinion/recommendation on a forum then they should be prepared to enter into discussion/debate about it. I feel that myself and a couple of others have been royally dismissed as not being worthy of talking to because we dared challenge the almighty medical profession.

 

 

Hell, I'd be happy to listen respectfully to anyone at all in their area of specialty. Dr Dave wasn't knocking anyone or arguing with anyone. He merely stated his qualifications so that we were able to choose to take his recomendations with a grain of salt or otherwise, and then made it clear that he didn't want to enter into a debate about it. I can't see anything wrong with that. I prefer that than not having his input at all.

 

There has to be only one way forward.......be nice, or there wont be a crew.org (that is of any value to yachties) around to be nasty on!

[Guest]

Hell, I'd be happy to listen respectfully to anyone at all in their area of specialty. Dr Dave wasn't knocking anyone or arguing with anyone. He merely stated his qualifications so that we were able to choose to take his recomendations with a grain of salt or otherwise, and then made it clear that he didn't want to enter into a debate about it. I can't see anything wrong with that. I prefer that than not having his input at all.

 

There has to be only one way forward.......be nice, or there wont be a crew.org (that is of any value to yachties) around to be nasty on!

I don't believe I was being nasty, I was simply expressing my displeasure at the tenor of his reply. I will "listen respectfully" to anyone as long as they do me the same courtesy.

As for his qualifications -- "I have been a doctor for 28 years, have specialised in Anaesthesia and then Intensive Care and am Director of an Intensive Care Unit"-- what relevance do these qualifications have to musculatory inflammation and infections? Would you believe the advice of a rigger if he was telling you what was wrong with your engine? Again, I apologise if my posts have pissed people off but why are some people so unquestioning when it comes to the medical profession?

I have no intention of dissing Dr Dave but he must be able to stand up to his assertions.