# First Aid Kits



## TSOJOURNER (Dec 16, 1999)

I skimmed back and looked around. It seems that First Aid doesn't get much mention here.

I'm lucky. The Boss is a doctor, so when I gave him a copy of Advanced First Aid Afloat by Dr. Peter F. Eastman, he looked through it and said, "Okay, make a list and we'll get the stuff."

So when we go somewhere, we're set for anything short of major trauma. 

In my own boat, I have a somewhat less comprehensive kit, but I do carry normal saline and D5W (Dextrose 5% and water), a couple of IV kits, and some other heavy-duty items. When I got ready to go to the Bahamas, I took the kit to the local Customs office, along with the prescriptions for the drugs, needles, etc., and had them put their seal on it. Like most 'safety' gear sailors buy, I never expected (or wanted) to open the kit up. 

One hot day, sitting in Georgetown, I hear a panicked call from a lady over in the 'yachtie' harbor. Her husband had passed out, sweaty, cool to the touch, and was convulsing a bit.

Problem. The local doctor was in Nassau for a meeting. They didn't have anything like paramedics, and surprisingly, there were no doctors floating around out in the harbor. I threw the kit into the dinghy and made my way over. The guy was full-blown into heat stroke, dehydrated out, and in a bad way. I had his wife hold his arm down and got a butterfly needle stuck into a vein, and started him on a saline drip. Then, after re-reading Dr. Eastman's chapter on heat stroke, did the other things he recommended. 

The Doctor got back from Nassau and the local police brought him aboard, and he, fortunately, took over. The guy survived, no worse for my clumsy stick that probably saved his life. 

All of that led me to wondering what people had in their own first aid kits. The 'yachties' there in Georgetown universally seemed to have band-aids, burn ointment, bactine and that was about it. None of the boats but mine had a first aid kit that could actually handle something like heat stroke, broken arms, or a real laceration. 

I'd recommend buying Dr. Eastman's book. If you have a weak stomach, don't eat before you open it, and have a trash can handy, because the pictures are beyond graphic. That being said, that book is an absolute treasure if you're going to be someplace without nearby medical aid. 

After you've read it, decide which level of kit you need. Go and talk to your physician, and take the book with you. Get prescriptions as needed, then put everything into two boxes. One that has stuff you can get at a good pharmacy--bandages, tape, peroxide, etc., and the stuff you had to get by prescription in another box. Seal it, lock it, and have it Customs Bonded before you go offshore.

It might just save your life...or mine.


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## TSOJOURNER (Dec 16, 1999)

Post script: 

If you do have to get into your 'heavy' supplies, keep a log of what you used, why, and the empty container, etc. Take them to the local customs office, show them your log, the empty IV bags, tubing, needle, etc. Let them count the pills in your Controlled Substances. (In my case IV Valium, and IV Compazine, so it was bottles). Have them re-seal the case after noting on the table of contents (inside the case!) and US Customs won't give you a hassle at all.


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## merlin2375 (Jul 12, 2007)

http://www.sailnet.com/forums/gear-maintenance/43875-first-aid-kit-first-aid-book.html


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## TxLnghrn (Apr 22, 2008)

*Rarely mentioned Safety Items*

Gary,
I'm glad to see another post on first aid. I agree it is a topic that is greatly ignored in the sailing community, rarely is there a magazine article that isn't trying to sell you something. In the post above mentioned by Merlin, I covered my basic first aid supplies. I think prescription medical items have a role in coastal/offshore kits, some items can be generalized to all audiences and some items IMHO need to be individualized to the cruisers area/pre-existing conditions etc.... I will post later tonight or tommorrow some of my thoughts on prescription items for kits.

Congratulations on helping out in a time of need, I'm sure you did greatly assist. The hardest thing for many to do is make a decision to do something in an emergency. 

One point that is often confused by many, even many in healthcare is the difference between heat stroke and heat exhaustion...The difference has nothing to do with sweaty skin/temperature etc.... They are differentiated by altered mentation. In heat stroke the victim is altered (confused, combative, unconscious), in heat exhaustion the victim is not. Rehydration is important in both cases but in heat stroke rapid cooling takes priority to anything else other than airway/breathing concerns.

Michael


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## Boasun (Feb 10, 2007)

There are "First Aid for Mariners/sea going personnel" The one I attended was a two week course and you learned to 'stick' an IV, sew up wounds and other things. Also using the SSB for Medical assistance for anything beyond your skills. You would be guided by a doctor as you do the actual work. But it requires you having a first aid kit suitable for it. 
You can find that there are kits for day sailors, for coastal sailors and the largest and best equiped for Ocean sailors. Plus you may want to add what ever else you think you may need out there. Especially if your family history indicates the need for either heart, stroke or diabetic concerns. Or if you are the one that always getting bit by the poisonous whatevers out there.


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## tonybinTX (Feb 22, 2008)

*SAM splint - like AMEX - never leave home without it*

I used to be in Mountain Search and Rescue back in Colorado and found a ton of good uses for a SAM splint. These cheap, light weight splints are awesome. You can cut them with scissors if you need a small splint for a finger, or use them for a make shift c-collar for spine immobilization. I keep 1 on the boat, one at home, and one in the car. I've used them on both dogs and humans.

A SAM splint with some duct tape or an ace bandage will allow you to splint almost anything.

Sam® Splint from Campmor


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## TxLnghrn (Apr 22, 2008)

*Thoughts on Prescription Items*

Here are my thoughts on basic prescription items for coastal/near offshore cruising. General caveats remain as in my previous posts:

1. This is my opinion at this point in time, if you ask 3 medical people for their opinion, you are likely to get 5-6 answers.
2. I am a minimalist when I can be, I prefer objects with multiple uses.
3. This is intended for use within 12-24 hours of formal medical attention by laypersons. Things change quickly when offshore or more than a few hours from attention.
4. This is not all inclusive, but I think it provides a reasonable amount of safety and ability to respond to emergency situations.
5. As I stated above, I would be more than glad to help anyone with individual kit needs.
6. Individualizing kits to crew/area of sailing is crucial to insuring reasonable amounts of safety so I am only including items not mentioned in my previous post that I think are universal.

Antibiotics: Flagyl, Azithromycin, Silvadene (for burns, wounds, etc.... slight risk of "tattooing" so should probably be avoided on the faces of the supermodels on your boat, use neosporin or triple antibiotic ointment instead)

Pain Control: Rum or alcohol of choice  Realistically probably as useful as narcotics and in many cases easier to titrate because individuals are more likely to know there tolerance to alcohol than narcotics. (less issues with customs as well  )

Allergic Reactions: Benadryl (injectable is nice if someone onboard has been taught how to give shots), Epinephirne (Epi-Pen), Albuterol inhaler

Dehydration/Nausea: Phenergan (injectable or suppository), IV fluids/needles for severe cases. (IV's can be difficult to start even by well trained individuals so an understanding and proper needles for hypodermoclysis (subcutaneous fluid injection) should be understood.

Wound Closure: I tend to believe in not closing most wounds and relying on good irrigation and bandaging with delayed closure in a clinic/hospital after 2-3 days or closure by secondary intent (letting the body heal itself). That said staple closure is quick, convienent and in many cases has similar scarring profiles to sutured wound closure. So skin stapler and most importantly skin staple remover (in the event of infection it is crucial to reopen the wound).

Michael


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## TxLnghrn (Apr 22, 2008)

I second you on the SAM splint Toby, see my post in the article referenced by Merlin and let me know what you think of my non-prescription items list.


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## tonybinTX (Feb 22, 2008)

TxLnghrn - That's pretty much the kit we carried while in SAR as a wilderness first responder. The only things I would add is tweezers, bar of soap(hotel soap was perfect size), a tube of glucose gel for diabetic shock, and a scalpel with a few replaceable blades. 

I like the suggestion about the dish gloves. We went through our glove supply on a regular basis, but it's a great idea for infrequent use. I'm buying some the next time I'm at the store.


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## tonybinTX (Feb 22, 2008)

OH! I forgot one! Maxi Pads! I have one of the "elephant" sized ones just in case there's a large volume of liquid to control.


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## TxLnghrn (Apr 22, 2008)

*One more thing*

Forgot a cheap stethoscope. Useful for tracking down strange boat/engine vibrations as well.


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## pfbanyas (Apr 26, 2000)

Thanks for all the info. I had started putting some stuff together for a new first aid kit and this really helps. I found a First Responder catalog a couple weeks ago which sold FRE bags which you can then stock yourselves but since then misplaced it but will post if I can find it. Thanks again. Pat


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## essman (Jun 29, 2002)

The thing you learn on SailNet!!!
I didn't even know elephants used Maxi Pads!!!


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