The onboard medical kit (published February 2016)
After a few days ashore at a new destination everyone falls ill with a terrible flu. Is there enough medication onboard to treat everyone? While cleaning the bottom you cut your hand on an oyster and now it is looking red and inflamed, do you know how to treat a marine cut? On passage a crew member slips and falls badly bumping their head, do you know the signs of a concussion and how to treat it?
Nobody wants to deal with a medical emergency, especially at sea but everyone should be prepared. Like fire extinguishers, life jackets and a working VHF a medical kit is a basic safety item for any vessel. Where you are sailing, how long you’ll be away and how many crew members will be onboard are all variables that will affect what you carry and how comprehensive your medical kit will be.
Commercial first aid kits are available, and although they can be tailored to fit your needs and your budget, they are not the only option. Putting together your own medical kit is a great off season boating activity; it is a chance to familiarize yourself with medical supplies and brush up on your first aid knowledge. And if you have junior sailors onboard you can get them involved too.
Serious injuries are not always the most dangerous and certainly not the most common. A day sailor might think they are close enough to shore to seek medical help if needed, but even a few hours can be uncomfortable with a wound that won’t stop bleeding. Packing a simple store bought first aid kit could make an unpleasant accident a little easier to bear until you get back into port. A vessel planning extended blue water passages will need a more extensive medical kit, most likely including a variety of prescription medications, so that they can deal with even a serious medical situation at sea.
Medical supplies should be stored in water tight containers and clearly labeled so that anyone can find what they a looking for, even if they are in a rush or are panicked. Instead of keeping all our onboard medical kits in one large container I prefer a few smaller boxes, and group stores together according to frequency of use. For instance one box contains everyday items, think routine drug store purchases; pain killers, decongestants, topical treatments, bug bites and allergic reactions, digital thermometer and band aids. This box is kept in a very easy to access cupboard as it is needed most often. Another box contains first aid items for more serious wounds; finger splints, triangle bandages, burn creams and bandages, splinter removal kit, sterile gauze and tape. And a third contains prescription medications, emergency dental repair items and suture kit.
To maximize space I remove all cardboard boxes and package like items in clearly labeled ziplock bags. Often directions and warnings for things such as decongestants are printed on the backs of the exterior package. It is important to keep these as chances are you won’t remember dosages and ingredients in a few months’ time. Simply cut out the needed information, place it in the ziplock bag, and discard the excess packaging.
When planning an extended voyage it is best to consult a physician. Explain your intended destinations, any health concerns you might have and possible accident scenarios that might occur onboard. Your doctor should be able to advise whether you are in need of immunizations or preventative medicine for localized health risks such as malaria, and be able to prescribe any antibiotics or other prescription medications that you’ll need for the trip. Take into account how many crew members will be onboard, making sure you stock enough to treat everyone. Also there is always a chance of a relapse or reinfection before you have a chance to restock, so to be safe make sure you have enough meds for two rounds of treatment.
No medical kit should be complete without a good reference book, or two. Although we have “gone digital” I still prefer a physical book for such applications; there is no chance of the battery being flat when you need it, everyone knows how to open a book no matter how young or old and a book stands up to being handled with wet or bloody hands. It is a good idea to have at least one first aid book that has clear, concise explanations and lots of pictures so that in a crisis situation even someone who is panicked can read and follow directions. Investing in a volume that deals with the latitudes you plan on sailing is also a good idea; medical issues in the tropical South Pacific are much different than those in colder areas such as Alaska or Argentina.
Everyone onboard should be familiar with where the medical kit is stored; this includes any temporary crew or guests. Incorporating the medical kit into your on board safety briefings will ensure that everyone knows where it is stored and its contents. It is also important for the skipper to be aware of pre-existing medical conditions of any new crew members and if they are taking regular/daily medication for them. And if daily medications are being taken it is a good idea to pack some in the ditch bag in case of an emergency.
Like all other aspects of the boat the onboard medical kit also needs routine maintenance. At the beginning of the sailing season go through your supplies and see what needs to be restocked. If you are departing on a long passage, or sailing to a more remote destination, don’t forget to inspect the medical kit before leaving the last major port.
Some first aid items begin to expire once exposed to air and things like sticky band aids and elastic bandages perish in the heat. Heat also shortens the life span of most medication, including prescription drugs, so consider storing meds in the fridge for maximum shelf life. Carrying medication for every possible accident and infection is great but they will be of little use if they are past their expiry date. It is best to err on the side of caution and replace any medication, especially prescription drugs, which are currently out of date or will expire while you’re at sea. It is tempting to keep expired medication “just in case” or because replacing them is expensive but cutting corners with your life is hardly worth it. Taking expired medication is not recommended and can sometimes lead to fatal complications.
When restocking in a foreign port taking your old prescription medication or empty packaging to the doctor or the pharmacy is the easiest way to ensure that you get what you need, even if you don’t speak the language. When filling prescriptions most modern pharmacies now provide detailed print outs about ingredients, side effects and dosages. Instead of tossing these in the trash take a few minutes to review the information and then store them with the medication for future reference.
A medical clinic or a pharmacy is also the best place to discard any unwanted or expired medication, as they should have the proper facilities to destroy them. It is never a good idea to throw unused or expired medicine overboard.
Being properly kitted out is only half of the equation of being prepared, you need to know what to do during a first aid situation and how to administer all medication you carry onboard. Taking a first aid course is knowledge every sailor should invest in; a weekend learning proper techniques could save a loved one’s life. Time well spent. Organizations like the Red Cross or St. John’s Ambulance regularly run basic to advanced first aid courses for both children and adults. And even if you are certified it is recommended that you keep your knowledge current by taking a class every couple of years.
Putting together a medical kit can be a daunting task, after all your life might depend on it. Whether you are a weekend warrior, seasonal sailor or fulltime live aboard a comprehensive medical kit should be part of your onboard safety plan. From band aids and decongestants, to prescription medications and dental tools, a little pre-departure preparation will make sure every boat sets sail confident that they will be able to address any unplanned first aid situation in port or at sea.
Heather Francis is from Nova Scotia, Canada and for over a decade has worked and lived on boats throughout the world. In 2008 she and Steve, her Aussie partner, bought Kate, a Newport 41′, and have been sailing ever since. They are planning to do a lap around the planet, albeit slowly. To follow their adventures log onto www.yachtkate.com.