FIRST AID FOR SMALL BOATERS
Introduction
Index
1. Introduction
2. Stomach Upsets
3. Cuts and Abrasions
4. Skin Problems
A. Allergic Skin Reactions
B. Jelly Fish, Man-Of-War, and Coral Stings
C. Skin Infections
D. Sunburn
E. Skin Fungus
5. Ear Care and Ear Infections
6. Seasickness
7. Pain Relief
8. Radio Communications
9. Evacuation To Shore
10. Newest Treatments (a discussion on bibliography)
11. Summary
Throughout the years numerous attempts have been made to offer
first aid instructions in written form to passengers and crew of
small boats. These range from the simple to the very complex and
sophisticated. The thoughts which follow are not so much a "how
to" text but are more intended to be a stimulus to the reader to
consider the level of responsibility he or she wants to assume in
offering of first aid to oneself or to fellow passengers as they
enjoy the great hobby of boating.The extent to which one goes in equipping and study for
medical care on small boats, commercial and noncommercial,
depends to a degree on the training and the background of the
first aid person on board. Some captains are actually physicians
or surgeons. Others are nurses with emergency room and critical
care skills. Others may be rescue paramedics. The majority of
boaters however are merely conscientious non-medical people who
earnestly want to do the right thing in an emergency, to minimize
pain and suffering, to avoid causing harm, and give a reasonable
chance for a good outcome.One consideration is the duration of the boat trip. Day
sailors generally need not make extensive first aid plans other
than for cuts, abrasions and bruises. Day sailing, by sail or by
motor, usually doesn't take one far from land and the emergency
medical services available ashore. Thought should be given to
those shore based facilities, however, regarding how to access
the care system, and how far out into the waters the local
agencies will travel to help you. Have in mind in what
situations, and in what waters you would radio or telephone for
City, County, or National Park authorities and in what situations
you would call for the Coast Guard. A little planning, even a
test call, may save precious minutes in getting medical advice or
emergency care and evacuation.Week end boaters or other short term "gunkholers"* should
consider more extensive preparations. It has been said, in the
medical field, "Common things occur commonly." The first aid
mission for trips longer than just a few hours, therefore, should
begin with a focus on common problems. These are stomach upsets,
cuts and abrasions, and skin disorders. Preparation for the major
medical and traumatic emergencies is not discussed is this paper.
Other texts will focus on these problems and they should be
studied separately.* gunkholers = live-aboards who cruise from island to island
To attempt to prepare for cardiac, neurologic, obstetric or
multiple trauma emergencies requires advanced training and
equipment planning. In dealing with these problems on a
consultative level the author has encountered the need to teach
the starting of IV solutions, and the pharmacology of cardiac
medications. The resetting of dislocated shoulders, hips or
mandibles mandates a "hands on" classroom setting to which not
everyone is motivated. Every first-aider, however, should make
general preparations for those common, minor illnesses and
accidents that all sailors encounter at one time or another. In
the present paper some of these will be discussed, more as models
for contemplation and dialogue than as comprehensive outlines for
treatment.
Stomach Upsets
Stomach upsets are like summer showers, sooner or later, they
will be encountered. Let's start by assuming that you and the
crew begin the trip healthy. That means there are no hiatus
hernias, no chronic diverticulosis, no tendencies to colitis or
recurrent intestinal obstructions. These things require tailored
preparations.Acid indigestion in an otherwise normal person is a frequent
problem for boaters. The strange food, the daring use of pepper,
and the joys of alcohol all increase the risk of heartburn and
dyspepsia. Plan for these. Alcohol, overeating and coffee all
tend to relax the gastro-esophageal junction and allow peptic
regurgitation. Alka-Seltzer is a prompt and effective remedy. It
is made up of aspirin, sodium bicarbonate, and citric acid, the
first two of which should be noted by those who are limiting
their intake of these medications.Metoclopramide HCl (ReglanR), or its new replacement,
cisapride, (PropulsidR) are pharmacologic remedies for
regurgitation, or better yet, preventatives in vulnerable
persons. Those who have past experience with heartburn, gastritis
or excess stomach acid should consult their physicians about
these and the H2 gastric acid inhibitors, as they prepare for
blue water voyages. The physician captain may well want to carry
these along with his choice of antibiotics and analgesics in the
drug box.The diarrheas are a major nuisance on boats because of the
limited bathroom facilities. There are two types, limited
attacks and prolonged diarrheas. Nature usually sorts these out
for us. After a few days the limited attacks are over with. The
chronic diarrheas continue. Initial treatment is the same. The
chronic or persistent diarrheas require specialized diagnosis and
treatment, as they may be due to persistent salmonella, giardia or amoeba.The short term diarrheas come from either intestinal flu,
dietary indiscretions, food allergy, food reactions, or food
poisoning. With few exceptions these run a short course and end.
The challenge for the first aid person is to help minimize the
discomfort and possibly shorten the course a little. The second
job is to sustain the ill person, especially if the fluid loss is
excessive and a threat to normal blood pressure and circulation.
This can be a real problem in very old or very young persons or
if the attack is severe and the climate has already produced a
state of heavy sweating and dehydration.There are several things to keep in mind. Start with a
healthy crew. Don't leave on an extended trip with one member
already suffering from diarrhea. It might be contagious! Second,
give careful thought to food selection and storage. Poultry,
notorious for carrying salmonella bacteria, should be bought only
from very reputable vendors, and kept frozen if possible. Buy dry
ice for the sea chest for short cruises. Salmonella can be
nicely prevented, even in contaminated chickens by deep and
thorough cooking. Although salmonella diarrhea generally runs a
3-5 day course, with some strains it may have a prolonged course.
Antibiotics are of limited value. Medical consultation may be
needed.Food poisoning due to staphylococcus, (staph' poisoning),
results from the growth of this bacteria in food left standing
out at room or cabin temperatures. It doesn't develop
spontaneously ! The food must first have been seeded with the
bacteria from the nose of a carrier or from the oozing of an
infected skin sore. As the bacteria grow on the food a toxin is
produced that cannot be eliminated by cooking. Typical culture
media for staphylococcus in the galley are spaghetti sauces,
moist pastries, puddings, and uncooked dough. Important items in
prevention are the health of the cook, careful hand washing and
avoidance of prolonged exposure of moist foods to galley
temperatures. Once the toxin has caused the diarrhea there is no
remedy, other than supportive care. Fortunately the attacks are
self limited, most always over in 24-36 hours. Vomiting is a
commonly associated symptom.The treatment of diarrhea is usually rather straight forward.
Loperamide (ImmodiumR), or diphyoxylate with atropine (LotomilR)
tablets are easy to store and can be given according to the
directions. PeptoBismol liquid or tablets and the new Pepto
Capsules (also a loperamide) offer companion advantage. Meanwhile
encourage the sufferer to drink liquids to prevent dehydration.
This is especially important in that rare situation, in central
or south america, in which the diarrhea is caused by cholera.
Death from cholera can generally be prevented if the patient is
kept hydrated. One can obtain small, easy to store, packets of
"Oral Rehydration Salts", Jianas Bros., Kansas City, Mo. A packet
should be added to a liter of water to help sustain the victim
from collapsing due to water and electrolyte depletion.
Constipation is a common intestinal problem on long trips.
After a few days at sea, even on the largest of ships, lack of
normal intestinal elimination is frequent. This is due to several
factors. The daily routine is thrown off by the watch, the eating
or the play schedule. The diet is different, often due to the
need for altered food preparation methods or a different cook.
Then, too, the urge to go to the head may be suppressed because
of the intimacy of the living quarters on the boat. A normal B.M.
is postponed until it becomes a problem.The best solution is prevention. Pay attention to the food
plan with plenty of roughage in the meals, plenty of exercise and
an orientation at the beginning of the cruise that all aboard are
expected to yield to the "call of nature" on a routine and non-
compromising basis. For those who encounter constipation problems
a good first step is simply to act promptly, on the urge to go,
when it occurs the next day. Failing that, milk of magnesia or
the combination of magnesia with agar or oil should be kept on
board and taken in one or two ounce doses until results are
obtained. Teaspoon doses may act as an antiacid but full doses
are needed for the laxative effect. Stronger laxatives too
frequently result in a rebound effect of renewed constipation
after they wear off. If nothing else works administer a phospho-
soda enema.Cuts and abrasions are common on boats. They invite first aid
intervention because they are visible, painful and often bloody.
Such injuries are breaks in the skin and, as such, present the
risk of infection. There is also the need to consider control of
bleeding, depending on the location and the depth of the injury.
Such injuries also raise the question of suturing.With penetrating injuries consideration must be given to the
danger of infection. The simple pouring on of alcohol,
merthiolate or even soap and water simply won't cleanse a deep
wound adequately. If you offer only local cleansing, dry dressing
and oral antibiotics you are accepting considerable risk of
gangrene (blood poisoning). With deep and dirty wounds thought
must be given to early transport to a medical facility for
advanced wound management within 6 to 12 hours, with an outside
limit of 24 hours. After 24 hours closure by suturing is
generally not acceptable, even with modern antibiotics.The more superficial wounds are the ones in which you can see
the bottom and wash it clean. Do wash it clean !! Use soap and
lots of water, rubbing, as needed, to cleanse all foreign
material out of the wound. Then apply pressure with a sterile (or
at least a good clean) gauze until bleeding is controlled. Then
put on a dry sterile dressing.Since cuts and abrasions are frequent, carry an ample supply of
these dressings. Stock surgical tape as well. At least some of
the tape should be paper type as skin allergy to standard tape is
fairly common.Wounds need to be placed at rest for them to heal. A wound
that is not properly rested often will have delayed healing or
will not heal at all. Healing takes 6 to 8 days for most "first-
aid" type wounds, longer for the deeper ones or the sutured ones.With well cleansed superficial wounds the body will generally
heal without serious infection. If infection occurs the best
treatment is local cleaning and daily dressing changes.
Applications of antiseptics or antibiotic ointments may be
helpful but the more potent healing forces are the body's own
defenses and daily wound cleansing. Oral antibiotics may also be
helpful. The common ones selected are phenoxymethyl-penicillin
(V-cillin-KR), erythromycin (Ery-TabsR), sulfa (BactrimR &
SeptraR), amoxycillin (AugmentinR), or the cephalosporin
(DuricefR). A recent popular and effective one is ciprosporin
(CiproR). Ask your personal medical consultant to help you select
which ones are recommended and which ones endure best when stored
for extended periods in the hot humid environment of a boat. Most
antibiotics have an expiration date. Look for it and discard any
expired ones. Tetracycline is seriously altered by storage at
warm temperatures and can damage the kidneys if administered
after such spoilage. It is probably not a good choice for boats.One of the major health problems for boaters who spend
extended periods on the waters is that of skin diseases. This is
due to several factors. One is the high humidity associated with
being so close to the water and the activities in water for
prolonged periods of time. Another is the absence of effective
bathing when living afloat, especially true when bath or shower
water is in short supply. Still another is the frequent custom
of wearing the same clothes several days in a row. All of these
lead to softening of the skin by moisture, and the accumulation
of dirt and disease causing bacteria. The smart boater prepares
for those misery causing and potentially serious skin itches,
rashes, blisters,
and boils.Skin allergies, also, are a special problem to boaters. These
generally result from exposure to chemicals, exotic marine
animals, or strange plants on those deserted islands so much fun
to explore. Take a soap and water shower promptly when you return
from that island.
As in most of medicine the best, and the cheapest, remedy is
prevention. Don't sit around in wet clothing. Bath as often as
reasonable. Wash off chemical and allergenic exposures promptly.
After cleansing, cover recognized allergenic exposures right away
with a thin film of cortisone type ointment or cream. There are a
number of these available, with differing costs and six grades of
potency.
Allergic Skin Reactions
Allergic skin eruptions are associated with the rather
astonishing onset of redness, itching and sometimes blisters. The
rash may resemble poison ivy but can be due to a number of
causes. If you are a good detective you will know what was the
offending agent, often within 12 to 24 hours. The area of
eruption reflects the area of contact. Often there are streaks
where you brushed against the twigs or the plastic that set off
your skin. The itch may proceed the eruption a few hours. Then
red bumps appear. Often these mature into itching blisters. In
advanced cases the blisters in these rows and clumps break and
leave a raw itching area. In the later stages the raw area
becomes infected giving a complex problem of an allergic and
infected open sore.The remedy, in the beginning, is to wash off the irritating
substance as soon as possible. During the early stages of
allergic eruption benefit can frequently be gained by applying
any type of cortisone lotion or cream. By the way cream, is water
soluble and ointment is petrolatum based. Ointment stays on the
skin longer but cream is more pleasant to use.There are a variety of such cortisone products available. They
vary in cost and potency. Some of the generic names are
triamcinolone, betamethasone, alclometasone, etc. The O.T.C.
Cort-dome, and Cortaide products are frequently effective and
don't require a prescription. All smart boaters, and in fact all
smart households, keep a tube of such "cortisone analog products"
on the shelf for those common, non-infectious allergic type skin
eruptions.
Jelly Fish and Coral Stings
Including Man-O-War stings and Seabather's Eruption
The human skin is especially vulnerable to irritations and
even painful stings from the phylum of saltwater animals called
the Cnidaria. These offenders include hydroids, corals,
jellyfish, and the Portuguese Man-O-War. The pain of their sting
ranges from mild to numbingly intense. They all do their injury
with microscopic stinging nettles, triggered to inject their
venom by the touch of the skin or dosing with certain chemicals.If the exposure is to the jelly fish tentacles, remove them from
the skin with gloved hands or instruments. Wash off the rest with
SALT water. Using fresh water activates all the stings !
Now bathe the affected skin with dilute vinegar for half an hour.
The venom may then be deactivated by papain (meat tenderizer).
Another way to remove the adherent tentacles is to use shaving
cream, mud or a paste of talcum powder or wheat flower. Let the
paste dry and gently scrape it off.Once the local area is treated, apply a light coat of the
corticosone type spray, lotion or cream. Administer an oral
antihistamine for severe cases. For the most extreme cases who
may go into allergic anaphylactic shock, one may need to rely on
the typical bee sting kits including inhaled or injected
adrenalin, and oral prednisone. Ask your consultants about the
doses.Rather common in south Florida is seabather's eruption, an
itchy hive like eruption that frequently affects swimmers and
waders. Nearly half the victims notice the stinging while still
in the water. The others notice the itch in the first night,
worse in areas covered by the bathing suit. The reddish dotted
rash may look like a typical contact dermatitis, confluent hives
or even chicken pox. The offending organism very likely is the
larve of the thimble jellyfish, Linuche Unguiculata, as described
recently by Wong, Meinking, Taplin et al. They, too, recommend
the high potency cortisone applications. They are not overly
optimistic about promising a cure but say the itch wears out in
about 12 days.The less dangerous, but still bothersome, sea nettle stings
can be managed with a paste of baking soda. Allow it to dry and
scrape it off.It is important to perceive the difference between skin
allergy and skin infection. Cortisone ointments are of no
benefit on skin infections and in fact may actually aggravate
infections. Infections require antibiotics and local antibiotic
ointments are of limited value. They should be used in
conjunction with local cleansing, washing off the pus and debris,
patting the area dry and applying the ointment at least twice a
day. When red streaks are present, or the afflicted person has a
fever, wisely selected antibiotics should be administered by
mouth or injection.The majority of bacterial infections of the skin are due to
streptococcus or staphylococcus. These often, but not always,
respond to penicillin, sulfa, erythromycin or the cephalosporins.
Boils due to penicillin resistant staphylococcus require a
special penicillin called oxacillin. Get medical advice on the
selection of antibiotics, and seek medical advice, "on line" when
a worsening condition demands it.
Sunburn is usually the result of neglect or accident. It can
usually be avoided by long shirts and pants and sun screen
creams. Chronic sun exposure increases the risk of skin cancer.
The short term damage can be lessened at times by early treatment
with two aspirins, Advils or 10 milligrams of prednisone, a
cortisone type drug. Once the sunburn has become full blown it
can be managed only by cooling sprays, cool wind and water and
pain relievers. Advanced sunburn with blistered skin is a true
second degree burn and should be managed just like any burn, to
prevent infection and scarring.
A common skin problem for boaters is that of fungus infection.
These include generally inguinal itch, athlete's foot, and under
arm and under breast yeast infection. These can be suspected by
the appearance of a red margination, central clearing and tiny
blisters. Other times it is difficult to tell the difference
between yeast infection of the skin and those due to the higher
fungi. Fortunately, in recent years selected antibiotics will
cure both types of these infections. Two examples are
ketoconazole (Nizoral 1%) and oxyconazole (Oxistat 1%). This
author doesn't use it.Apply them three times a day. Keep up the treatment two to
three weeks. Change clothes frequently. Wash the spores off the
soiled clothes before re-use. Keep the infected areas as dry as
possible.
One commonly made error in hygiene and first aid is to pour
alcohol into infected ears. The only ear that should have alcohol
put in it is a healthy ear. Even then it should be left in only
a minute or two and then carefully swabbed out.The best mode of ear care is prevention. Don't start a long
trip or even do serious swimming with a plug of wax in the ears.
Have a competent physician clean them out for you. Have that
physician also teach you how to keep you external ear canals
clean and dry with cotton tipped swabs.At the end of a session of swimming in salt water shower the
ear canals out with fresh water. Salt water left in the ears
attracts humidity, rarely dries adequately and invites infection.
Dry the canals with a soft wick of tissue paper or a cotton swab.
If the external ear canal becomes painful and infected it is best
to see a physician. If that is impossible cleanse the ear with
cool boiled water, acidified with a few drops of vinegar. Then
swab the canal with a thin film of neomycin, bacitracin or
colimycin ointment.
Any orienting survey of first aid for boaters must pay
respect to seasickness. It is a common affliction to beginning
boaters. Even the most seasoned of mariners may become queazy
when winds and waves are at their highest. It often ruins the day
for your guests, so the host captain should have some thoughts in
mind about its management.The most delightful thing about seasickness is the mystique
that is woven into it. Every captain and every navy bo'sun has
his own personal remedy. The strange part is they are all
different, and stranger still is that they frequently work. I
believe the pearls in the wrist band fall in this category.The author, however, has no particular allegiance to any of the
folk remedies. They may be tried, and many are used successfully.
Certainly there is a significant amount of psychology at play.
Belief in a particular remedy seems to enhance its effectiveness.One basic concept has been helpful to passenger and crew
alike. That is the diminishing of the stimulus of the rolling sea
by finding the lowest central point in the boat possible and
resting there until one gains ones "sea legs". This may take
minutes, hours or days. It usually take no longer than 48 to 72
hours. Comically, although one gets used to the sea on a voyage,
it may take equally long to regain one's land legs when port is
reached.A number of pharmacologic remedies have been recommended for
seasickness. Dimenhydrinate (DramamineR) and meclazine
(MerazineR) have been used for decades. They can be obtained
without pre-scription and are moderately effective. The side
effect is drowsiness. If the attack is severe they usually fail
to control the symptoms.Scopolamine became popular in the early 1970s as a result of
space science research. While scopolamine is more effective than
Dramamine it has significant side effects. It, too, causes
drowsiness. It dries the mouth, slows sweating, slows the
stomach, raises pressure in the anterior chamber of the eye,
speeds the heart and aggravates prostate symptoms with it's
atropine effects.In children and in some adults it can cause hallucinations, and
it may aggravate cerebral dysrhythmia. Mostly these less common
risks are accepted, but drowsiness can prove to be a real
problem.At one time the U.S. Navy recommended the concomitant use of
dexadrine with the scopolamine. This has worked well for the
author but after two or three days the stimulant effect of the
dexadrine leads to over fatigue and under eating, both dangerous
when one must "turn to" for a watch schedule. Scopolamine
patches, (Transderm Scop(R)) generally work well but many users
must counteract the drowsiness with coffee or colas. As a
substitute for these potent medications some have had success
with PhenerganR (promethazine) or Phenergan with caffeine. When
all else fails chlorpromazine or promethazine, tablets,
suppositories or injections may be required. The dose is 15-25
mg. oral or IM and 75 mg. suppository.
There is a natural human instinct to want to provide for pain
relief. Anthropologists tell us that members of primitive tribes
take less concern with pain levels than we more civilized types.
If one wishes to carry pain relievers on board certain factors
should be considered. Among these are the paper work possibly
required to bring narcotics into a foreign port, the possible
depression of adequate respiration in a severly injured person
and the potential some persons have for narcotics allergy.Unless one is an experienced professional, injectable narcotics
are best left ashore. Many blue water captains, however, do
carry PercodanR, PercocetR, Tylenol-IIIR or Darvocet-N-100R.
Probably the blandist of these is the Darvocet. Think about your
approach to pain relief ahead of time and discuss the selection
of type and dose with you medical consultant. The non-steroidal
anti-inflamatory drugs (NSAIDS) are slowly replacing the
narcotics for relief of minor pains. These include ibuophren,
indomethecin, oxaprozin among others, and the very new, very
potent ketorolac tromethamine (ToradolR). Mot all persons can
take this Toradol without severe stomach upset.
One aspect of first aid, often forgotten, is that of radio
communications. All boaters should maintain capability for
marine VHF. Have the equipment well installed. Utilize an
efficient antenna, have it mounted as high as practicable, and
practice with it often. Recognize that a HandiTalkie is not
potent enough for any but the shortest of trips.For travel on the high seas a reputable marine electronics
vendor can install the commercial "side band radio", an automatic
tuner with antenna, and also give instructions in the effective
use of the equipment. For extended trips, either marine SSB or
properly licensed amateur radio and operator are desired safety
features. Ham radio operators are commonly very savvy about the
use of radio aboard. Make friends with some of them and learn
about their equipment. Watch them operate and learn how they get
the most out of their systems. Many blue water sailors consider
the safety factor of taking of a "ham radio" course and obtaining
a license just as important as a Coast Guard or Power Squadron
course.If you have only marine VHF but are far out in traveled waters
there are times when your problems can be relayed in 20 mile
hops, boat to boat, back to the mainland, and the reply relayed
back the same way. This type of radio relay can be used on the HF
bands as well to help solve an emergency problem.Establish float plans and positions reports. Have companions
listen for you at scheduled places and times. Initiate requests
calls for advice, when necessary, either through friends or
through the Coast Guard or Medical Aide. Use your radio
frequently for non-emergency activities. It's use will become
second nature to you and the radio will become a meaningful
resource in medical emergencies.
There are situations in which a sick or injured person must be
evacuated to a shore facility for more accurate diagnosis or
advanced treatment. Some of the factors are the seriousness of
the problem, the worsening of the patient, the distance and/or
time to sail your boat to the shore facility. A wise move is to
discuss the decision with a third party by radio. This may be
with a medical consultant, a shore based relative, the Coast
Guard or even another nearby boater.I have personally never heard of evacuation failing to be
accomplished once the decision has been conscientiously made.
Transport agencies, both public and private are generally
accommodating.The prospect of talking to a third person, outside your boat
often helps in prioritizing and timing of the evacuation plan.
The sick or injured person generally cannot take the lead in the
transport decision. Too often they play "macho" or are in too
much distress to think clearly about evacuation. The leadership
of the first aider is commonly required.
In the equipping and study for first aid aboard the boat one
is usually led to a series of references. I have included such a
list with this paper. It should be emphasized that the
literature related to first aid, however, is significantly dated.
The old standby books of the past tend to become outdated and
their use-fullness tends to erode with time. The understanding
and management of dehydration and diarrheas improves twice a
decade. The choice of antibiotics changes just as rapidly. The
understanding of ciguatera fish poisoning is improving with the
seasons.Some truths in medicine do not change. One example is that
dehydration brings increasing risk of kidney stones but other
facts do change. Some of these are the management of pain with
the non-steroidal anti-inflammatory drugs and the oral treatment
of dehydration due to the gastroenteritides. Thus the student of
first aid is well advised to become familiar with two or three of
the more recent publications before adding to the ship's library.Most texts dealing with medical care afloat tend to be disease
or disease group specific. Examples are texts on trauma, trans-
portation, wound care, etc. Others deal more with medical
problems and infections. Still others emphasize poisonings, bites
and venoms. The author has not yet found that one text
comprehensive enough to satisfy, yet compact enough to be taken
comfortably along on the boat. The first two listings in the
bibliography come closest to being "stand alone" texts.If one is going to be isolated on the boat for long periods,
serious thought should be given to carrying a copy of Merck's
Manual, the Physician's Desk Reference, and Burt R. Meyers',
Antimicrobial Therapy Guide. The latter two are updated annually
but are quite usable for three to five years. Merck's is updated
every few years. Copies less than 5-6 years old can be very
helpful.
In summary, this paper attempts to stimulate the prospective
first aider on boats to think broadly about the level of care for
medical emergencies for which they want to provision. It presents
a discussion of a number of the more common injuries and
illnesses likely to be encountered on the boat or the nearby
shore. An inventory for the ships medical supply box and the
medicine chest is offered. Finally some suggestions are made
about the medical benefits of good ship-to-shore radio
communications.
For the day sailor the list might be shortened. For the island
cruiser the list should probably be longer.4 x 4 sterile bandages 2 dozen
2" Kerlex or Kling 1 roll
4" Kerlix or Kling 1 roll
Band-Aids, or equiv. 1 box of 50
Skin closure strips, 1/4" 20
Skin closure strips, 1/2" 20
Surgical Tape, 1" 1 roll
Paper Tape, 1" 1 roll
Tongue depressors 30-40
Surgipads, ABD, or Kotex 6-8
Q-TIPS 1-2 boxes
Liquid soap (eg. JOY) 8-12 oz.
A clean curved clamp, hemostat and forceps
Long nosed pliers and wire cutter for fish hooksIrrigating Syringe (A clean gravy syringe will do in a pinch.)
Splint material (1/4 inch plywood strips or clean, dry, light weight shoring material will do.)
Plastic zipper lock bags to keep all medical supplies clean & dry.
-----------------------------------------------------------------------------------------Transderm ScopR, diphenhydramine, meclazine for sea sickness
Silver sulfadiazine Creme One Jar, 200 gm.
+
Povidone-Iodine Solution(Betadine) 30 cc.
Lotrimin Creme, 1% 30 gm.
Immodium or Lomotil 30 tabs.
Pepto-Bismol, liquid and tablets 1 bottle, each
Tetrahydrolozine (Visine) eye soln. 1 bottle
OceanR Eye Wash 1-2 bottles
Alka-Seltzer 10-15 pkg.Antibiotics...
BactrimR or equiv. 50 tabs.
AugmentinR 250 mg. 50 tabs.Donnatal 30 tabs.
Phenergan or Thorazine Supp. 25-75 mg.
Prednisone 10 mg. 30 tabs.
Asthma Inhalors, for allergic reactions
( epinepherin ) 1-2
Sun Tan Creme or Lotion SPF 15 or more 1 bottle
Fleet's Phosphosoda Enema Kit 1-2
Tylenol c. codeine #3, and/or PercocetR 10 each
ToradolR 50 mg., for muscle or head pain 10
Advil, for minor pain 50
Bibliography: .....
Craig, Glen K., US Army Field Forces Medical Handbook, ST31-
91B,
Palidin Press, Boulder, CO., 1988
( The size of a field bible, 600 pages.)Gill, Paul G., The Water Lover's Guide to Marine Medicine,
Simon & Schuster, New York, 1993
( An easy to carry manual, 255 pages, )Auerbach, Paul S., A Medical Guide to Hazardous Marine Life,
Progressive Printing, Jacksonville, FL, 1987
( 47 pages with color pictures, and bibliography. )
( Deep diving accidents, dangerous animals, )
( first aid in illness and injury, toxicology. )Auerbach, Paul S., A Medical Guide to Hazardous Marine Life,
Second Edition,
Moseby Year Book, St. Louis, 1991
( 63 pages with bibliography )Iverson, Edwin S., How to cope with dangerous Sea Life,
a guide to animals that sting, bite and are poisonous to eat,
from the waters of the western Atlantic, Caribbean, and Gulf
of Mexico/ Edwin s. Iverson and Renate H Skinner,
Miami Windward Pub., 1977Breise, Garry L., Your First Response in the Streets,
Little, Brown, Boston, 1984.
( First Aid in Illness and Emergency, 288 pages.)
( Introduction by Nancy Caroline )Thygerson, Alton L., The First Aid Book,
Prentice Hall, Englewood Cliffs, NJ, 1982
( 314 pages with illus. and index )Hafen, Brent Q., First Aid for Health Emergencies,
West Publishing Co., St. Paul, MN, 1985
( 604 pages with illus., bibliography and index )Campbell, George R., Illustrated Guide to Some Poisonous
Plants and Animals of Florida,
Pineapple Press, Englewood, FL, 1983
( 175 pages, with bibliography )Meyers, Burt R., Antimicrobial Therapy Guide, Fourth Edition,
Antimicrobial Prescribing, Inc., Newtown, PA.Handal, Kathleen A., The Red Cross First Aid & Safety Handbook,
Little, Brown & Co., Boston, MA, 1992
"NURSING94 ," Drug Handbook, Springhouse Corp.,
Springhouse, PA (a useful compilation of most medications,
their applications and side effects)Hirschman, Jim C., Ciguitera (fish) Poisoning, Mercy Medicine
Miami, Florida, 1989, 8:2 & 3,57-59.Sams, W.M., Seabather's Eruption, Arch. Dermatology, 1949,
60:227-237.Wong, E.W., Meinking, Terri L., ... Taplin, David, et al.
Seabather's Eruption, J. Am. Acad. Derm.. 1994; 30:399-406
About the author: Jim Hirschman has participated in water sports
since childhood. He has sailed in three oceans and has guided
boats to the Bahamas countless times in recent years. He holds
the "Extra Class" license as an amateur radio operator. He is a
Senior Attending member of the medical staff of Mercy Hospital,
Division of Cardiology, presently Chairman of the Emergency,
Disaster & Trauma Committee, Board Certified in Internal
Medicine, a Fellow of both the American College of Physicians and
the American College of Emergency Physicians. He is a Clinical
Professor of Medicine, University of Miami School of Medicine.
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3-29-94This paper appeared in the Journal "Mercy Medicine" in 1995. It is for informational use
only, and not intended as specific medical advice for any unseen individual. When in doubt
ask your own doctor. Comments are invited .