First Aid Kits
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First Aid Kits
Whether boating on inland waters, near shore or offshore, every boat should have a medical kit onboard with in-date supplies. In addition, every boat should carry a good first aid book that suits the boating style, a basic first aid book is fine for inland waters, but an advanced book is absolutely critical for offshore work.
As with other safety gear on your boat, your medical kit needs to be geared to the kind of boating you do. Do you or any of your crew currently have specific medical or prescription needs? Is there a heart condition that may warrant carrying nitro tablets onboard? Do you boat in waters with fire coral or stinging jellyfish? Are you spear diving or carrying other weapons that could cause injury? There are many considerations to properly preparing your onboard medical kit.
Marine medical kits fall into three categories: inland, near-shore and offshore (also called voyaging).
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Offshore medical kits
Offshore medical kits are designed to render aid immediately and to stabilize a person where assistance may not be available for prolonged periods, if ever. For the more adventurous boater, these kits become a bit more complicated in order to deal with medical emergencies in remote areas or on the ocean where limited help is available or will be a long time coming. When venturing far offshore, you’ll need to have training and supplies to deal with major trauma, illnesses and infections.
There should be more surgical supplies, trauma dressings, roller gauze, sterile eye pads, cast material and padding added to the supplies you would find in the near-shore medical kit. In addition to augmented surgical supplies, a continuous draining catheter such as a Foley, gauze drains, osmotic and loop diuretics, additional prescription pain relievers, anti-inflammatory steroids, eardrops, and topical antibiotics for skin infections.
An inhaler to open breathing passages whether or not any of the crew is asthmatic should be included in the offshore kit, along with specific medications for nausea and vomiting, anaphylaxis and cardiac arrest, as well as antibiotics for ear infections, periodontal, urinary tract and ophthalmic bacterial infections.
The supplies in the offshore kit require EMT training to use as well as a familiarity with drugs. A good drug interaction book should be onboard to assist in making decisions about dispensing medications. As with the near-shore kit, consult with your physician for recommendations of specific types of medications and any items that should be included specific to you or your crew’s medical needs.
The Inland Medical Kits
Inland first aid kits are designed to give minor treatment to a patient when medical attention is not far away. Kits for day sailing on inland lakes and waterways should contain supplies to treat minor injuries such as burns, cuts and abrasions that require little first aid knowledge. Any personal medications or prescriptions you’ll need while you’re out should be included in the kit. For instance, if you’re diabetic and take insulin, be sure to carry what you’ll need for the time you’re out on the boat plus a little extra in case your return to shore is delayed.
Most basic kits should contain bandages and dressings, nonstick petrolatum gauze, regular gauze, tape and an elastic ACE bandage for sprains. ( )Isopropyl alcohol, an antimicrobial agent such as Betadine, hydrogen peroxide, sterile saline for irrigation, and burn dressings should also be included. Tweezers, sterile gloves, bandage and trauma scissors, cold packs, eye wash solution, antibiotic ointment packets, and a hydrocortisone cream should also be in the kit.
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Medications should include aspirin (coated) and nonaspirin pain relievers, an antacid, anti-diarrheal, an allergy relief medication, an external analgesic lotion, decongestants, sunscreen, aloe gel for sunburn and throat lozenges.
Aspirin is tough on most stomachs and nonaspirin products like Tylenol don’t reduce swelling. Ibuprofen is the best choice for reducing swelling, relieving pain, muscle strain and headaches. It should be taken with plenty of water to prevent possible kidney damage if taken in quantities other than as directed on the label.
An essential item to add to your kit, if not included, would be a full-size SAM Splint. This is a thin, flexible aluminum frame covered with soft, shapeable foam. For sprains or broken bones, this is a great item to have on board no matter where you boat. Add 1-inch tape to your kit to secure the splint.
Near-shore medical kits are designed to render aid immediately and to stabilize a person while waiting for assistance. These kits contain supplies that require you to have some advanced first aid knowledge to use them properly. Look for a kit with splints, such as finger splints, padded arm boards and ladder splints. Additional supplies should include an emergency dental kit, tongue depressors, petrolatum gauze, Insta-glucose, butterfly bandages, Steri-strips, large trauma dressings, lubricating jelly, a space blanket and a naso-gastric tube.
In addition to the medications included in the inland medical kits, the near-shore kits should include a stimulant laxative, glycerin suppositories, antifungal creams, second degree burn cream, broad spectrum oral antibiotics and prescription pain killers. Also important in this kit is antinausea medication such as Scopolamine or Compazine.
Consult your physician for recommendations of specific types of medications.
For emergency surgery, the kit should have an intravenous IV start kit with catheters and suturing supplies such as a needle driver, sutures, disposable scalpels, syringes, needles, a surgical scrub brush, and a surgical instrument tray with sterile scissors, hemostats and clamps and a local topical anesthetic.
For the most part, the use of these supplies will require something more than advanced first aid classes. EMT training will give you a comfort level for using this type of kit.
Mal de mer, or seasickness, can be just as debilitating as any physical injury and, unfortunately, mal de mer strikes during rough weather when extra crew is required, especially on a short-handed boat. This physiological illness also needs attention when preparing the medical kit.
There are some preventive measures that can be taken for the crew with potential motion sickness: keep the crewmember above decks, minimize any work that needs to be done below decks like charting, writing or cooking, and eliminate any reading both above and below decks. Acclimation to the boat’s motion normally takes 48 to 72 hours and if prevention doesn't work, there are remedies such as drugs, herbal and acupuncture. Not any one remedy will work with all people, so a variety of medications should be carried in the medical kit.
Any prescription or nonprescription drugs for any crewmember, other than yourself, should be obtained by that crewmember prior to boarding.
The Transderm-Scop, also known as the patch is prescription-only. If any member of your crew has a propensity towards seasickness and wishes to use the patch, he/she should procure it.
The patch, a combination of scopolamine and amphetamine, works by releasing one milligram of scopolamine over a three-day period, which is the point at which most people become acclimated to the motion of the boat and the patch is no longer needed. There are some noted side effects such as dizziness, drowsiness, blurred vision and skin rash, among others.
Over-the-counter drugs such as Dramamine, Marezine, Bonine and Benadryl are antihistamines and can cause drowsiness in some people, especially Dramamine, while Marezine lessens symptoms of drowsiness. These are all less effective than “the patch," but have fewer side effects.
Ginger root, available in liquid, tablet or naturally, has been used for decreasing nausea after surgery and reduces symptoms of motion sickness.
Wristbands, which stimulate the acupuncture point P6 - Neiguan, are known to be effective on motion sickness on some people.
A medical kit, like a liferaft, is an important part of the ship's safety gear inventory that you hope you never need. Having the kit well stocked with supplies and readily available, and the training necessary for the type of boating you do, gives you and your crew the peace of mind to enjoy your boating experience.