An exposed cotter pin puts a deep gash in your leg while you move to pick up a dock line. A crewmember spills boiling water on his hand when the boat rolls. A guest breaks his little toe on a deck cleat. Can you manage these problems?
For weekend or extended coastal cruising, the contents of your marine medical kit should enable the crew to initiate appropriate care for common medical problems encountered in the marine environment until professional care, if necessary, is available. If you are within 12 hours of medical care, as are most coastal cruisers, your requisite supplies are different than if you are headed to secluded harbors or offshore. The same medical problems may occur on a weekend cruise or weeklong trip; proximity to medical care is what determines how you stock your kit. The further you are from help, the larger the required inventory.
The goal is to increase self-reliance, prevent minor problems from becoming major ones, and avoid a high-risk medical evacuation for a low-risk medical problem. First-aid training or a wilderness/marine medicine course will increase your skill level and boost confidence. At a minimum, familiarize yourself with a good book on marine medicine and know how to use it.
It is useful to have a separate, easily accessible crew medical kit containing medications and supplies for managing common medical problems. Having a separate crew kit encourages early treatment and ensures that supplies in the ship’s primary medical kit are left intact, inventoried, organized and protected.
A partial list of the contents of the crew kit would include seasickness medications, sunscreen, lip balm (SPF 25), aloe vera gel (especially useful for sunburn), eyewash, vinegar or wipes for jellyfish stings, cortisone cream, ibuprofen, acetaminophen, aspirin, and some other commonly used non-prescription medications, such as antihistamines, antacids, drugs for diarrhea or constipation, etc. Stock wound care materials for minor cuts and scrapes, including a variety of small waterproof adhesive bandages, antiseptic (BZK) wipes, and antibiotic ointment.
If any crewmember suffers from severe life-threatening anaphylactic reactions, be sure to stock some epinephrine auto-inject pens in the crew kit, and know how to use them. Items in the crew and ship’s main kit should be stored in labeled zipper freezer bags.
Trauma supplies are the major components of any ship’s medical kit. After seasickness, wounds are the most common medical problem. While closing a wound may be considered optional, cleaning and properly dressing it is not. All oceans, bays, rivers, and lakes are contaminated by a variety of infectious microorganisms; they often cause serious infections because of improper wound treatment.
Wound-care supplies should include nitrile gloves, lidocaine anesthetic wipes, povidone-iodine for making an irrigating solution, a 20cc syringe for irrigation, tincture of benzoin swabs, and wound-closure strips. There should be a variety of waterproof adhesive bandages, assorted sterile and non-sterile gauze pads, non-adherent dressings, conforming gauze bandages, self-adhering elastic bandages, and waterproof tape. Small tweezers are helpful for splinter and tick removal and can be useful in removing debris from a wound. Burns from hot liquids are best treated with watergel burn dressings.
Fractures and sprains are common and are best stabilized with a foam-padded aluminum SAM splint, which can be molded to fit any section of an extremity. A compression elastic bandage holds the splint in place. Small splints are designed for broken fingers and toes, a common injury aboard boats. Splinting reduces pain and prevents further injury to the surrounding nerves, blood vessels and muscles.
The ship’s medical kit can be expanded, depending on specific activities during the trip. For example, if you expect to spend time snorkeling or scuba diving, consider adding some irrigating solution for swimmer’s ear and ear canal drying solution.
If you are within 12 hours of medical care, it isn’t necessary to stock oral antibiotics. It is often convenient, however, if you have some on board to begin treatment for a variety of uncomplicated infections, providing you know when to use them.
A CPR face shield belongs in every marine kit. It facilitates effective resuscitation of a drowning victim and may protect the rescuer from some contagious diseases. Be sure to take an up-to-date course in resuscitation; drowning remains the leading cause of death among boaters.
When bringing personal prescription medications, choose medications that will not increase your sensitivity to the sun, and know which ones can withstand extremes in temperature. It often makes sense to purchase a kit “off the shelf” and supplement the contents as you wish. Perhaps most importantly, know how to use the medical supplies you bring.
This story originally appeared in the January 2009 issue.