First aid training, how do you prepare?

[Sea Rover]

Earlier today I had to perform the Heimlich on the captain of the towing vessel that I work on. The whole crew has been trained in basic first aid and CPR. But this incident got me thinking which tends to get me writing. So I wrote about my views in first aid training on my blog .www.searover.net/first-aid

But my question to you, how do you prepare for accidents and emergencies at sea on a small boat? What sort of training have you gone through and what does your first aid kit consist of? While it would be nice to bring a hospital's amount of supplies, when space is limited what do you feel is too important to leave out?

[Kettlewell]

It's an interesting question. Before I went cruising I worried about this, but now that I have been out there I have found it is not really an issue. Yes, first-aid training is a good idea, but no I don't think you really need the full medical chest for conducting surgery that some seem to recommend. The reason being that almost every harbor I have ever been in has doctors and nurses onboard or in the town we are anchored near. Yes, there are places we go that we are the only boat and it might be awhile before we could get some help, but the same thing applies when I go hiking in the Adirondacks and I don't stuff my backpack with a full medical chest. In fact, many routine emergencies we have encountered have been attended to faster than if we had been home, because like I said it just takes a few calls on the VHF before you have doctors and nurses onboard. We've obtained antibiotics and other medecine this way and had odd diagnoses made. The other thing is you are living a lifestyle that is so much healthier that the medical issues tend to be way less. I would suggest that bringing a satellite phone with you might be the best item of all as then you could get real medical advice if needed. The basic first aid stuff is pretty easy to learn and prepare for, but it is the odd parasite or the strange symptoms that are the problem and you will never be prepared for those no matter what you bring.

[Kettlewell]

Two things I would add. One is to make sure all your vaccinations are right up to date. Preventing a disease or illness in the first place is the best medecine. Second, medical help is always cheaper outside the USA and often of much better quality than we get here. You can have a full dental check up and cleaning with the latest equipment in Colombia for $25. Doctors in other countries are often graduates of the same medical schools as doctors in the US, and you can often get right in to see someone without waiting. Prescription drugs are also cheaper and easier to obtain, and usually made by the exact same company.

[Grime]

Other than a good first aid kit from Walgreen's I would add a blood stopper. Not sure if you can buy it in a drug store but can get it in a farm and ranch store. I've used it on myself and never had it cause a infection.

[Travelnik]

As far as training goes, EMT with emergency war surgery training.

I'm still working on the kits, one for people, and one that is dog specific.

[Captain Smollett]

As far as training goes, EMT with emergency war surgery training.

I'm still working on the kits, one for people, and one that is dog specific.

Haha. Do you find with that training that you have hard time putting together kits, or that the store-bought kits are...less than satisfying?

We have that problem.  My wife's a doc and I USED to have field training as a firefighter (my certs and such have long since expired).  But...we sort of get "paralysis" on this issue in a way.

As in other areas, we try to "keep it simple."  Some sterile bandages are perhaps the most important thing to keep on hand, I'd say.  Our First Aid kits also include over-the-counter pain meds, and due to my one and only allergy, this requires some (minor) attention to keep "accurate" for our use.

In my opinion, too many kits try to be "all things for every circumstance."  It's too easy to get focused on the corner, exceptional cases.  I'd argue that like other things, it's the know-how that is more important than the "Stuff."

This is a great idea for a thread, and one I don't think we've really discussed much on here in the past.

So, what's in YOUR first aid kit?  (Question to everyone...not just Travelnik).

[Cyric30]

While I'm not on the water, i will give my little input for what its worth. it seems the type of sailing your doing would have a bearing in what you need, for day tripping or weekends along the coast where you can get back to land and medical facilities reasonably quick a standard type first aid kit would seem to serfice, while if you crossing oceans or out to sea without land in any direction for days you would probably want a much better equipped bag, at least a first responders type kit or better IMHO, i keep a first responders bag at home in case of disaster, Tornado, Earthquake Etc. because if something like that happened the local service wouldn't be able to get here quickly or would be overwhelmed i try to work under the assumption that its better to have it and not need it than to need it and not have it.

[Captain Smollett]

i try to work under the assumption that its better to have it and not need it than to need it and not have it.

An excellent point, and one we here in the family emphasize routinely.

The only problem is...where do you draw the line?  At what point do you say, "enough"?  We can't all carry MRI machines and fully stocked ER's all the time, even if we had the knowledge and skill to use them.

I like to make this same point with those folks that claim "spares" are an important part of the sailors on-board inventory.  Spare what?

If you read some of the magazine articles, they essentially would have you carrying around a spare boat.  It really does get ridiculous.  Jury rigging is a thing, and it has worked time out of mind in dire circumstances. I made a similar point to a friend a couple of weeks ago on the topic of "spares" for a backpack on a back country trip.  Do I REALLY need to carry a bunch of spare parts for my back...when I can make stuff on the fly out of available materials or even just ditch the pack and go "light"?

Seems the same would apply to a First Aid kit.  To read the magazines, we should have x, y and z in our "kit" for offshore.  Much of what they claim we "need" is not really necessary at all even in an emergency.  It's "convenience."

That's the hard part, though.  I don't have to carry spares for my backpack because I know (yes, from experience) that I can somehow solve a "broken part problem" in other ways (even if that means ditching the pack). 

To me, the thing boils down to the following considerations:

-- What is most likely to be of beneficial use AND cannot be improvised from other sources.

-- If things have gotten "that bad" that I too-specific med gear is REALLY needed to save a life...will I get to a proper medical facility in time anyway?  We could easily be days from help, even in the case of 'rescue.'

-- The basics are ABC; 'gear' is not generally needed for those at least in short term.  Keeping someone from bleeding out and lowering risk of infection seem close seconds.

I guess part of my point is that no matter what you DO bring, there's always a chance that the one thing you NEED is not part of the kit anyway...whether first aid, rig components, engine stuff, etc.

So, where's the line?  No right answer, but it for sure is a tricky line to walk.

[Tim]

My kit is typically pretty simple, a commercial group bag with extra gauze, bandages and tape. The most important thing I take is experience, in the form of wilderness medicine training and good reference material. One book that I always have onboard is "Advanced First Aid Afloat" by Eastman and Levinson. It covers in detail just about anything you will run into.

I will also take along some prescription pharmaceuticals (antibiotics and pain relievers mostly)

[Cyric30]

So, where's the line?  No right answer, but it for sure is a tricky line to walk.

Hay Smollett

I guess we go back to the type of sailing your doing, and the most probable injuries you are likely to get on that journey, and that will be diffrent for everyone. As i have no practical experience, i would preferably defer to a longtime sailor who's done the same type of sailing i was wanting to do and has seen the common injuries sustained, or someone in the medical field who also has dealt with sailors injuries. or best of all someone who's both :) and and use that as a base and add in things i know personally i need ( bandaids Lots and Lots of bandaids :D) or injuries i am personaly prone to (sprained ankles is one that comes to mind) and try to kit for that. no kit will be the same for everone or every boat but you can plan for the most common things. but your right there is a line at some point you have to stop...say a DIY home appendectomy kit :D

[Captain Smollett]

Going purely by my memory of reading accounts for some SWAG style anecdotal evidence, I'd say the most common injuries / medical problems on long, open water voyages are (in no particular order):

-- broken bones, often relatively minor
-- infections
-- heart attack (with or without known pre-existing condition)
-- flare-up of existing disease
-- lacerations, mostly relatively minor

By far, I think the most common issue is sea sickness.  And that can be seriously debilitating or downright dangerous.

Another consideration that has nothing to do with first aid kit specifically, though, is fatigue.  Having the boat set up for crew rest is important for day-to-day operations, but also for recovery in the event of serious illness or injury.

[CharlieJ]

add toothache and or a broken tooth.

And yes, I've pulled two of my own jaw teeth, with channel locks. Wasn't fun, but had to be.

[Travelnik]

Haha. Do you find with that training that you have hard time putting together kits, or that the store-bought kits are...less than satisfying?

I used to be much worse about kits. I wanted to be prepared for everything, so my car was almost as stocked as an ambulance!  ;D

I've gotten better over the years, but I still consider most store-bought kits as a starter base to add to, just like adding to a boat, car or motorcycle.

I'll agree that the knowledge is the most important part. If you know what to do, you can MacGyver most solutions!  ;)

Knowing how to sew myself up sure has saved a lot on ER bills that I would have had to pay!  :P
(Never had to do teeth though!)

[Godot]

Here is my kit, for the way I currently sail (that is, mostly Chesapeake or coastal within 50-60 miles of shore):

• Bandages. Lots of them. Also a couple gauze pads and tape.
• Alcohol, Bacitracin (or equivalent), Hydrogen peroxide, hand sanitizing wipes (avoid infection, live a long life), hydrocorizone cream.
• One of those self grippy athletic bandages (for sprains and strains).
• Chemical ice packs.
• Surgical Tubing (actually part of my sheet to tiller gear I have yet to play with; but it's there if I need a tourniquet or something).
• Ibuprofen, acetaminophen, Aleve, Excedrin, aspirin (I'm prone to migraines and perhaps go a bit overboard on pain killers...).
• Benadryl, Bonine (non-drowsy-ish seasickness med)
• Tweezers, thermometer
• Scotch...you know, for medicinal purposes. :)

This kit has served me well, doesn't take up much space (it mostly fits in a Gladware container although I have a separate box of bandages since I carry so many), and is all I've really ever needed. I'm on the boat now and looking through the kit I really need to replace a lot of it as it is getting old, or used up.

If I were to venture way off the beaten path and outside of access to medical care maybe I'd add some burn lotion (silvadene?), antibiotics, and perhaps a more powerful pain drug (Tylenol 3?), but probably not. I'd have to talk to a doc about that. Maybe a sterile eye flush would be a good idea. And probably an anti-malarial if traveling where that might be a problem. I can't really think of anything else I'd really want, although perhaps I'd boost the quantity of some of the things I generally keep aboard anyhow.

I'm prepared for the most likely things I think. I can handle sprains, cuts, aches, pains, minor burns, common breaks. I can apply a tourniquet, I can perform CPR and the Heimlich.  I can't do much about internal injuries, or sickness/disease except try to make the victim comfortable.

If I am in over my head, I will do what I can to get medical care including calling for evacuation if necessary.

[CharlieJ]

Speaking of gauze pads.

One of the easiest, most sterile packs you can find for use as a compress is a couple of women's sanitary napkins. After all, that's how they got started- gauze wound compresses during one of the wars.

We even had them on the fire truck when I was a volunteer.

[Captain Smollett]

A neighbor of mine when I lived in SC was fond of going boating to remote areas by himself.  So, he bought one of those skin staplers.

Yes.  He got to use it on himself one time.

The dude was pretty hard core in more ways than one...such as the home built forge in his back yard.  Awesome guy, actually...nuclear engineer and had some 'way up there' responsibilities at a nuke power plant.

I'm not sure I could staple myself...but I guess if it's that or die...I'd find a way.  He sure did.

[CharlieJ]

Sure you could. I also have (had) suture materials aboard, and could use them if I had too. As you say- when  the caca hits the rotator, you do what ya gotta ;D

[Captain Smollett]

Sure you could. I also have (had) suture materials aboard, and could use them if I had too. As you say- when  the caca hits the rotator, you do what ya gotta ;D

Well, I have had to do field "surgery" on myself in the form of cutting out an ingrown toenail while on a climbing trip in the Cascades.  It was bad enough so as to get a little 'shocky' through the procedure...

But, that's still not staples.   ;D

[Godot]

Maybe I should add Superglue to the medical kit. It is my understanding that it can be used in a pinch to close up many wounds in lieu of stitches, and that some hospitals actually do this on a regular basis (although I'm guessing they aren't using the hardware variety Superglue).

[CharlieJ]

Maybe I should add Superglue to the medical kit. It is my understanding that it can be used in a pinch to close up many wounds in lieu of stitches, and that some hospitals actually do this on a regular basis (although I'm guessing they aren't using the hardware variety Superglue).

From what I understand, they have a spray that is used in battlefield conditions to close wounds while transporting to rear line hospitals. Stops bleeding. And yes, it's different

I use superglue in the shop for little nicks and cuts- keeps me from bleeding on unfinished wood

For those interested, here's a link to a brief history-

http://www.straightdope.com/columns/read/2187/was-super-glue-invented-to-seal-battle-wounds-in-vietnam