OCC Forums

Medical Seminar for OCC Members

https://forum.oceancruisingclub.org/Topic2684.aspx

By simoncurrin - 3 Jan 2016

We were wondering if there might be a demand for a weekend medical seminar specifically for cruisers far from shore let alone home? I would be happy to facilitate this being a UK GP, an active cruiser and with 25 years of experience in remote mountain medical matters. I wouldn 't propose a rigid course but rather shape it to fit the experience and concerns of those attending. The aim would be to share experiences and skills in an informal environment.

What are your thoughts? Is there a need? What subjects should be tackled? Formal or informal?

Simon
By bbalme - 4 Jan 2016

Hi Simon, sounds like a good idea - wonder if you 'd be able to do it over the web?
By Dick - 11 Jan 2016

Hi Simon,
There certainly should be a demand.
For me, a good medical course such as you are describing is essential preparation to wandering at sea. There are skills one expects to use: piloting and navigation. And there are skills one hopes never to exercise: MOB and medical skills for two. My observation from 40 years of cruising 13 of them full time live aboard, is that the skills one hopes never to use get woefully neglected.
An abbreviated course might be considered for those whose intentions are local sailing (coastal cruising) where help is generally ready at hand and the necessary skills are of the First Responder/EMS variety.
Those venturing on passages, have an obligation to themselves and their crew (at least to my mind) to have significant skills in this area of medical evaluation and intervention, regularly updated.
And I would go a step further than wondering whether there is demand by pushing a little harder and suggesting that those skippers (and crew) venturing on passages do a two-day course and that coastal cruisers have a one-day course in the medical skills necessary for evaluation and intervention commensurate with the availability of land based medical facilities. This (and refresher activities) I consider minimum levels for skippers to go to sea.
I have watched (and read a number) of the books generated for sailors and none check the boxes better (for me) than Jeff Isaac’s book(s). His particular approach seems well suited to the practical issues faced by those with a medical emergency at sea. He also is a superb instructor which I know first-hand as he gives a 2/3 day course under the umbrella on Offshore Navigator magazine.
My best, Dick Stevenson, s/v Alchemy
By aragorn - 23 Jan 2016

Simon, for us it 's the issue of being offshore and say a week or so from land. We have done the Rya first aid course and know that the next step probably is ships medical but other than signing up for the arc or paying around £1000 to do the course, it 's what we could do practically in the interim and what drugs etc we could get from a friendly gp in our local surgery if we explained the situation.
Any form of remote joining a session would help - or written guidelines or a session ... we would be interested
Caroline & Robert - Yacht Aragorn
By Dick - 23 Jan 2016

Hi Caroline & Robert,
When I researched medical courses my memory (it was 15 years ago and this was in the US) was that the Ship’s Medical Officer courses were not well designed for the kinds of issues that cruisers might face: as you put it “a week or so from land”. I do not remember the details however, but I believe they had to do with the Ship’s far better availability of communications/medical consult expertise and the amount of available supplies/equipment. Things may have changed and/or be different in the UK. The expense was also an issue as individuals did not pay, the companies did, and prices reflected this commercial aspect.
I believe wilderness emergency medical training comes closest to the emergency medical needs of the offshore sailor, but I am not sure what the UK has to offer in this realm. If interested in remote, you might try the book I mentioned in an earlier email.
Please let us know what you find that seems to work in getting educated/trained in this area.
My best, Dick Stevenson, s/v Alchemy
By simoncurrin - 23 Jan 2016

Caroline
I am wondering how most cruisers source their drugs and what they carry? I would be happy to share what we left the UK with this summer to start our circumnavigation but it might not be so appropriate as we oviously have a medic on board.

I would be very happy to host a weekend meeting to share experiencesanxieties and knowledge and provide some practical skills training. Don 't want to compete head on with the RYA but I am firmly of the belief that we all have much to learn from each other in the OCC.
By Dick - 24 Jan 2016

Hi Simon and Caroline,
Of the dozens of cruisers I know who are passage makers and in need of a (hopefully never used) supply of prescription meds, there are two major methods: if your Dr. is aware of passage making preparedness needs and is willing to work with you, then he/she might accommodate. Most do not have the time/interest. More often there is a friend/acquaintance who is a Dr. and is willing to cut scrips. If you do not have a Dr. friend willing, you might explore your club/association etc. where there may be a Dr. familiar with passage making needs who would work with you.
With access to a Dr. (maybe also a pharmacist, Physician’s Assistant or nurse), it is worth the effort to spend an afternoon going over the various antibiotics/painkillers etc. and making notes on dosage, different properties (which is good for what), expiry (often a longer span than written on the bottle, especially if stored properly) etc. Keep these notes in a central location and an individual copy with each med. Do not expect you will remember.
Some thoughts on dealing with officials: Always keep the original prescription/paperwork for each med. Have a spread sheet which lists the prescription drugs carried with space to document usage/dates/diagnosis etc. (For US boats, separate out the “Controlled Substances” and highlight: not sure how the UK manages those meds with addictive potential). I also drafted a letter from my Dr. where he signed off on: prescribing the meds, the reason (days or weeks from help), that he had trained us in their use, and that we would report to him their use when/if this occurred.
Finally, we have had dozens of officials ask us whether we have drugs on board. We chose to consider the question as referring to illegal/recreational type drugs and always answered “no”, but I was suspecting the question covered prescription drugs as well, but was loath to open up our substantial medical chest for review. This suspicion was confirmed when we were in St. Petersburg a few years back (before the club cruise so some might have heard this report already) and a boat reported no drugs and dogs found his med chest with a big no-no substance in Russia (codeine in the Tylenol I think). In any case, the officials were most concerned that they felt they were lied to. He was briefly arrested, but, with help, things were straightened out, but it could have gotten more difficult.
I hope this helps.
My best, Dick Stevenson, s/v Alchemy
By simoncurrin - 24 Jan 2016

So one tangible benefit of an OCC could be an afternoon spent on therapeutics in order to acquire the basic information to inform the use of commonly carried drugs. I would them be happy to issue prescriptions and paperwork to support member 's confronted by difficult customs officials. Would that be helpful? This could only help uk residents source drugs but perhaps we could persuade other occ doctors in other countries to join in?
Simon
By Dick - 24 Jan 2016

Hi Simon,
I would see that offer as, indeed, being very helpful and generous on your part.
It might be useful to generate a base line list of meds for the membership (for those on their own either offshore or a “Patagonia” level coastal cruising) that require scrips with some indications of general dosage, indications, etc. I am sure this has already been done by other organizations, so we might not have to re-invent the wheel. Individuals could then add on the meds they need for their personal and ongoing support or massage the list to reflect unusual cruising grounds, extended voyages etc.
The above list could be used to approach other OCC Drs. (in country or out) who may appreciate a pre-thought through list and the idea that this list had been previously vetted in some manner.
Good thoughts, Dick Stevenson, s/v Alchemy
By derekbreth - 25 Jan 2016

Simon, We would most likely be interested too if we can get to wherever you plan on holding it.

Thanks.
By bbalme - 25 Jan 2016

I 'd be interested... How about doing it in conjunction with the AGM - on the Sunday morning?

I was thinking about having a short Patagonian Cruise discussion on the Sunday morning - perhaps you could do a medical thing too?

(Now I just have to justify a transatlantic flight with the Admiral!)
By simoncurrin - 25 Jan 2016

Dick and co,

So how about working toward the following plan?

[ul]
[li]We use our membership and their experiences to design an OCC suggested medical kit.[/li]
[li]We pilot in the UK a course to provide members with the minimum knowledge required to safely use this kit and help them with appropriate papers and access to these drugs and equipment.[/li]
[li]We build on this pilot by seeking the cooperation of our international medical members to provide a similar service in their own countries giving all members, resident and roving, access to the equipment, training and drugs that they require. Providing we can find that network then this will be a tremendous benefit for our long distance cruisers seeking re-supply that conforms with the laws of the countries they are visiting.[/li]
[li]The above should give our members access to a global medical resource that few other courses, clubs or organisations could equal.[/li]
[li]Perhaps we might develop an international consensus amongst OCC medics as to what such equipment and training would be appropriate? The aim being to protect all parties against potential litigation. I am very well aware that my medical negligence cover would not cover me outside the UK so an agreed consensus would be very helpful in mitigating this risk.[/li]
[li]We need to be very careful about protecting the club against the risk of litigation or else this will not happen.[/li]
All of the above should be specifically designed to cater for the needs of short handed crew in remote waters on modest boats.

Thoughts, comments, ideas?

Simon
By bbalme - 26 Jan 2016

Simon,

This sort of initiative will certainly set the OCC apart from other organizations - and in my mind will be totally in keeping with the OCC 's premise. Would be interesting to hear the candidates for commodore weigh in on the idea.

With long distance in mind, getting the non UK doctor members on board will be key - I don 't suppose we have any way of sorting the membership database for Dr. or MD do we?
By DariaBlackwell - 26 Jan 2016

Simon, you may have a medic on board, but what happens when something happens to you?

I am highly experienced with pharmaceuticals and took an wilderness medicine training course. I insisted that Alex take a serious first aid course so that someone could help me if I needed it. :) Wilderness medicine done by sailors is the ticket. Jeff Isaac is really good. https://www.wildmed.com/wilderness-medical-courses/first-aid/offshore-emergency-medicine/

As to drugs and medical supplies, I happened to have a sister who was an ID. She loved putting together everything I might need. She did the saline solutions and drips, syringes and needles, every kind of bandage, all kind of surgical tools, etc. She also put together all the prophylactic drugs and antibiotics for us: antiemetics, antimalarials, etc.

My primary care doc took it on herself to give me a years ' worth of prescriptions and called the pharmacy to okay advance dispensing. She also gave me her personal contact information so that I could reach her if we had medical problems underway. She had also told me that she had delivered Rxs to people all over the world who traveled on business and forgot their meds or ran out. She just happened to be in tune with people traveling.

We also went to Traveller 's Vaccination Clinics in the US and had the full series of adult vaccinations for the world because we weren 't sure where we would end up.

Then, I happened on a sale at the Annapolis Boat Show. A company who did portable surgical kits for cruisers was closing out their line -- not enough market. So I bought one for a song and thankfully never needed to open it after the initial inspection.
By DariaBlackwell - 26 Jan 2016

Bill, a web based course via webinar is certainly doable. SSCA does many courses, although none medical that I recall, via webinars. It 's a great way to share information worldwide as they can be recorded and downloaded at leisure. Alex and I do an anchoring webinar. We are in Ireland with participants stretched across the US, Canada, Mexico and occasionally farther afield. It works great!
By simoncurrin - 26 Jan 2016

Daria & Bill,

The trouble is with webinars is that it is, by definition, difficult to demonstrate practical skills. Wound care and closure, subcutaneous fluids, catheterisation, injections etc would be difficult to teach online in a way that would give folk the confidence they require.

I agree courses can be great and there would be no intention to compete with them but there is a wealth of experience amongst our members that could be utilised to educate us all.

Access to medicines and medical kit will always be problematic for some and certainly NHS doctors would struggle to match the service you received from your physician so I suspect a lot of our members rely on friends and family.

Simon
By Dick - 26 Jan 2016

Hi Simon,
Sorry, I have been on the road or I would have responded earlier.
Your suggestions sounds like the makings of a plan, a good plan.
It might be helpful to think about generating a generic offshore medical kit at first (apparatus, bandaging and pharmaceuticals etc.). I would suggest the parameters for the kit be designed for a base crew of 2 healthy adults who sail (as you so nicely put it) remote waters in a modest boat with occasional 1-2 additional people on board for passages. It might be helpful to initially think of the generic kit as reflecting the above parameters and then later move on to suggest additions to the generic kit for say: older crew (catheters for ex), tropical sailing (snorkeling ear/eye infection drops , high latitudes, children, etc. In this way we can start at a reasonable task and work our way to specifics.
Training seems to me to be another issue, best addressed after one is clear the resources that the boat might have to work with.
My best, Dick Stevenson s/v Alchemy
By Dick - 27 Jan 2016

Hi Simon and all,
In reviewing my notes etc on medical kits, I believe that every sailor can come up with the generic kit on their own. There are a number of well thought through commercial kits that can cost some major money, but it is also easy to determine their contents and duplicate their offerings for about ½ the price and forego their elegant packaging.
I think our efforts would be best spent on coming up with a generic package of meds and maybe make specific suggestions for diagnostic apparatus, (such as an automated blood pressure cuff), then some specific suggestions for crews with older persons, children, specific locations etc. and then move on to the training aspect.
It would be interesting to get a list, from our experienced members of the meds carried on their journeys, how they might change the list based on their experiences, and what meds were actually used.
My best, Dick
By aragorn - 27 Jan 2016

Thanks Dick - we will look into the wilderness stuff you suggested and Simon, at the moment all we carry is paracetamol and sterry strips (skin closures) and a satellite phone.
By DariaBlackwell - 27 Jan 2016

Simon,
True about webinars, you can 't sew up a pig 's foot, but you can reach a whole lot more people with the basics.

Realistically, in the UK people can travel to a webinar as it 's not that far to get anywhere in the UK. But in North America and Australia, holding practical sessions would prove impractical. With our membership spread around the world, certainly a combination of the two options would be a winner.
By aragorn - 27 Jan 2016

Simon
I would be very interested in what you though might be useful to carry
Thanks
Caroline & Robert
By Dick - 27 Jan 2016

Hi everyone,
Attached is a bit outdated list of meds we had on board for our out of the way cruising and longer passages.
Dick Stevenson, s/v Alchemy
Alchemy Medication List

[attachment=324]AlchemyMedicationList.pdf[/attachment]
By Victor.Bom - 27 Jan 2016

Hi everyone,
I would certainly welcome a medical webinar. Also we have anti-biotics and painkillers on board, supplied through our friendly GP.

As I understand several meds-lists are floating around. It would be helpful to have one 'really good ' thought through list, without the less useful items.

Also useful might be a list of 'equivalents ' as many substances exist under different names made by various companies.

Victor Bom, sy Mamira Fenna
By simoncurrin - 27 Jan 2016

Caroline, Bill & Dick,

Attached is a pdf of the kit we put on board our boat when we left the UK last summer destined for very remote waters. I am sure it is not perfect and is designed for a cruising couple joined, from time to time by a up to 2 crew. Some of our destinations (NE Greenland) are very remote too so this isn 't all about mid ocean requirements. This is the spreadsheet we actually used to order from our wholesaler so the prices are UK list prices but it does give you and idea of cost.

I have, of course, to add a disclaimer in that this list contains UK "prescription only" items for use by appropriately qualified and experienced medical personnel. It does not contain any UK controlled drugs but I am aware that some countries that we may visit will have differing rules and regulations.

Hope it helps.

Simon

[attachment=317]SailingMedicalkit.pdf[/attachment]
By Dick - 31 Jan 2016

Hi Simon and all,
Your list of meds etc is very helpful. I notice that there is not a nice box in my post of my meds which, I am suspecting, means that I did something wrong in the "adding of the file". If someone confirms this, I will try again. Dick
By simoncurrin - 31 Jan 2016

Dick,
That 's correct there is no attachment. If you are struggling email it to simon@medex.org.uk and I will attach it to your original post.
Simon
By DariaBlackwell - 31 Jan 2016

Simon, great list of meds.

Someone had asked what cruisers had used out of their kits while underway. In more than a year of cruising around the Atlantic, we used very little. I used up our supply of amoxicillin/clavulanic acid when I got strep throat in a remote anchorage. I replaced the antibiotic with plain amoxicillin in Dominica without a prescription via a sympathetic pharmacist who did not have Augmentin in stock. I also used topical antibiotics and topical steroids in the Caribbean to combat prickly rash.

When crossing oceans we found we didn 't get sick because there is little exposure to infectious diseases. Then it was mostly a matter of minor injuries and so topical antibiotics and painkillers were helpful.

When Alex broke four ribs on a delivery, having an adequate supply of ibuprofen for the pain was essential; it took four days to get to shore and a hospital.
By simoncurrin - 31 Jan 2016

Daria,
I agree it is over the top for most cruising couples.

We initially put this kit together for a 6 week Antarctic cruise for 6 people on Pelagic where we were doing lots of other activities including kayaking, diving and ski mountaineering. We sailed this summer with this on board knowing that we were going into some similarly remote waters with shoreside activities planned.

Also, when other boats sniff a medic, then things can turn into a busman 's holiday sometimes and it is nice to be able to help out.

So really this kit is probably not appropriate for ordinary use but it does illustrate how cheap generic drugs are these days so cost need not limit the scope of the kit. It all fits into a 55 litre Ortleib duffle bag so size and weight aren 't really an obstacle either.
Simon
By DariaBlackwell - 31 Jan 2016

I just googled medical injuries at sea and came up with this very useful presentation. Although much relates to racing rather than cruising, it may be helpful to see the stats on the most common types of injuries on sailboats.

http://www.ucdenver.edu/academics/colleges/medicine/sportsmed/cusm_events/2014-Extreme-Sports-Medicine-Congress/Documents/Presentations/Extreme%20Sailing%20Injuries.pdf
By DariaBlackwell - 31 Jan 2016

Simon, I wasn 't implying it was OTT. Ours probably had almost as much in it.

One thing I don 't see on your list is antivirals. Can you please comment on your thoughts there?
By simoncurrin - 31 Jan 2016

Daria,
Anti-virals are not much used in the UK with the exception of acyclovir for Herpes Zoster and recurrent Herpes Simplex. Flu is only treated when epidemic levels of virus are circulating in the community and evidence for its effectiveness is limited. I am aware that other health systems place more emphasis on these drugs.
Simon
By Dick - 31 Jan 2016

Trying again to get my Alchemy 's meds list to attach. Dick
[attachment=323]AlchemyMedicationList.pdf[/attachment]
Alchemy medication list
By dcaukill - 1 Feb 2016

I think this would be a good service if we could support it AND find a way for our members to buy the necessary drugs. I have found that latter quite a challenge.

There are many commercial courses available for sailors. In my experience, they tend to seek to cover all eventualities - including remote contingencies. We did do a course before we began our circumnavigation which the instructor tailored to our needs (because all of the participants were owners about to go ocean sailing). So in addition to basic first aid, the instructor concentrated on the things that were most likely to happen - cuts, bruises, breakages; how to treat them, suturing, and immobilisation of fractures for extended periods etc. together with the administration of various drugs and anesthetics. We also dealt with procdures that older people might require including catheterisation etc., what to do if a crewman had a heart attack etc.

I dont know any friendly doctors. My crew 's GPs were all prepared to provide scripts for ongoing treatments (e.g. hypertension) for extended periods but were not prepared to prescribe drugs "just in case" - not even on a private prescription.

There are a number of organisations that will supply such drugs; initially mine came from a pharmacist in Jersey. He had retired by the time I needed replacements and so I contacted Medical Support Offshore (https://www.msos.org.uk/home.html) who replaced them for me - at a price. Once they have supplied the drugs they will support you at sea - (call a their doctor 24/7 via sat phone) - he knows exactly what kit you have and can advise you what to do. Theirs is a comprehensive service which you can pick and choose from but it is aimed at SuperYachts so they are not shy about billings!

OthersI am aware that Vortec Marine (https://www.vortecmarine.com/medicalkits) will arrange the supply of non-controlled drugs. As to ongoing advice, they refreshingly point out that FREE emergency medical advice is available 365 days a year 24/7 by contacting a UK Maritime Rescue Co-ordination Centre (MRCC) (HF radio or Sat Phone) and being linked to the duty doctor with whom you can agree a care plan for a casualty on board.
By simoncurrin - 1 Feb 2016

David,
The suggestion (buried way back in this topic) is designed to provide OCC members with global access to these drugs. I am happy to lead on this in the UK but we will need the international cooperation of OCC medics as I can only prescribe within the UK. Clearly, until we ask, we don 't know our international OCC medics would be prepared to take part.
Simon
By DariaBlackwell - 1 Feb 2016

Simon, have you thought of reaching out to potential OCC MDs around the world via the Facebook page as a start? Would you like to post a note on the website?

Might even consider a poll for interest on the FB page.
By dcaukill - 1 Feb 2016

Sorry Simon - I understood you were circumnavigating. If you can handle it for the UK that would be a great service. And if we managed to replicate it elsewhere that would be a real USP for the OCC!
By simoncurrin - 1 Feb 2016

David,
Our circumnavigation is in chunks so keeping one foot in the work place.
Simon

Daria,
I would prefer not to put anything on Facebook for now as I think this needs to be discussed in Committee first. I have a draft paper to circulate in time for the February Committee Meeting.
Simon
By mrsannelloyd - 25 Feb 2016

This is a really first rate initiative. When preparing for our circumnavigation we spent some tim eon this but as if we were inventing th ewheel

We used some other peoples lists and modified according to our understanding of risk/cost

Evan Starzinger has a good list, our mentors gave us theirs and we found the contents list for Ocean Safety big kit. Plus lots of ideas bout hardware, sam splints etc

We did get our GP to prescribe about 10 items, but in small quantities and with little interest on his part, Even as private prescriptions they were surprisingly inexpensive. Of course now we cannot remember expiry information on the drugs.

So far incidents have been broken ribs [twice] and crush injuries to fingers. ie pain killers and bleeding.

I look forward to developments.

I would suggest any course be run near Christmas, as many of us long distance types return for that occasionally!



But an OCC kit list: Drugs/equipment etc would be grand, plus a course [too late for us]

The RYA first aid course- every incident finished with a defibrillator it seemed!

I have added our prescription drugs list. I do worry about the co codomol but so far no reactions by officialdom.

[Attachment will not attach}

Anne
By simoncurrin - 25 Feb 2016

Anne,
Your attachment is not included in you post. This may be because the forum does not accept Word/Excel documents but prefers PDF 's. If you are struggling then please send to me and I will attach. My email is simon@medex.org.uk.
Simon
By Bethbone - 7 Mar 2016

Hi Simon,

Happy to help in any way. I have now retired as a GP but still cruising. I seem to have spent a lot of time over the past 20 years cruising holding impromptu surgeries in exotic surroundings. Fellow cruisers are often anxious regarding the contents of their medical kits and the difficulties in obtaining replacements.

Beth
By simoncurrin - 7 Mar 2016

Beth,
That 's great I will add you to our growing list of volunteer medics for this project and will be in touch.
Simon
By archive - 27 Mar 2017

Wow what a wonderful thread!
I have just joined and would love to know what happened about this idea?

I managed to get prescription drugs with an prescription at Boots in Falmouth before we left.
I took along ships papers, a letter explaining that we would be offshore cruising and they ordered nearly everything on the list.
The things they did not order where because they could not get them.

I was very surprised but please as my doctor was not going to help in any way.

I would love to do an in-depth course, weekend course.
I found the RYA course to be very basic.

JoJO
By Dick - 27 Mar 2017

Hi JoJO,
Good report on the course and your success with the Pharmacy. I am pleased and a bit surprised that a big chain like Boots was so flexible. Were you familiar with them as a person/family? I do not know of a greater depth course in UK, just US. I would also try climbing/backpacker/back country sites. The skills are very similar. Let us know what you find.
My best, Dick Stevenson, s/v Alchemy
By archive - 27 Mar 2017

Hi Dick,
I did not know anyone at the store.
I found a regulation that stated that a ships captain, that will be sailing more than 150NM offshore, can order prescription drugs without a prescription.
This was three years ago, but I will check on the boat tomorrow for more information.
They checked and confirmed that this was possible, and I ordered everything I wanted.
It was easy and straightforward. But I don 't know if this regulation has been changed.

What happened about the idea of a OCC seminar and medical supply list?
I would love to do some more training in this very important area.

JoJo
s/v Island Swift
By simoncurrin - 27 Mar 2017

JoJo
No the idea did not die and infact it went ahead. I got Committee approval and we did a Skype tutorial as time and geography conspired to make face to face impossible on that occasion. Having satisfied myself that the drugs were to be appropriately used I has happy to provide the prescriptions for most of the drugs on the list I posted some months ago. I just never got around to writing up the happy ending.

Better still though is this projects knits very well with the Telemedicine project Susie Plume (s/v Adina) has been working for occ members as it provides boats with the tools required for a successful telemedicine consultation.

If there is demand I 'd be happy to make this into a proper webinar which I think would be the only way of overcoming geographical constraints. Of course I can only prescribe for those in the U.K.

I had no idea about your Ship 's Captain clause. That 's brilliant.
Simon
By derekbreth - 27 Mar 2017

Hi, As the recipient of Simon 's advice I can testify that it was first rate and very reassuring. We learned a lot, became confident in what we should and shouldn 't do and equipped ourselves with a number of useful meds. Thankfully 6 months and some 6,000 miles cruising later we haven 't had to use any but I would recommend that anyone who is not medically trained takes advantage of this type of seminar. This type of initiative is exactly where the OCC benefits cruisers and volunteers like Simon make it happen. Thanks all round.
By Dick - 17 Jul 2017

Hi all,
In a series of emails with our fellow OCC member, Charles Starke, I have gleaned the following information from his writing for those who might be preparing/designing their medical kit.
Dick Stevenson, s/v Alchemy

Hi:
I've tried these (http://www.clozex.com/) out and recommend that we add this article as a safety addition to the OCC website. They are excellent to carry aboard for lacerations, and can save time and cut risk. I had to staple myself up in 15 foot seas off Bora Bora without anesthesia and wish I had these instead.

Best wishes,
Charles
Charles L Starke MD FACP

The product is just coming out and I haven't found it yet online. Searches seem to lead to the old product, Steristrips. Steristrips are worth having too but the Clozex is a new development.

" Clozex will be available in one to two months on their website (http://www.clozex.com/) and probably on Amazon. I have no economic relationship to Clozex.
By Dick - 17 Jul 2017

Hi Simon & Daria,
It might be a good idea to garner all the posts pertaining to developing a medical kit for offshore boats in a separate topic. When I went to post the one pertaining to Clozex, I was not sure where to put it. It seems a topic worthy of its own stream. Dick
By DariaBlackwell - 5 Feb 2019

Dick,

There is a new thread on medical kits already started. We should definitely cross reference the different threads.

This Clozex product is fantastic for cruisers. I think a Best Practices article would be a really good way to summarise some of this information in a useful downloadable format. As a former medical writer, I'll talk to Simon about getting that done later this year.
By simoncurrin - 6 Feb 2019

Daria
A Best Practices Document would be an excellent outcome and it would be great if you could undertake this when you have time. Maria is currently running her Delphi study having surveyed ARC kits in 2018. Her original research will do a great deal to add authority to the Best Practices Document when it is drafted. A great outcome for this Forum thread.
Simon
By Dick - 7 Feb 2019

Hi OCC community,
I believe that the development of medical kits suggestions should not be very hard as the wheel has already been invented. Every few years there is an article to this end in the slicks, there are also commercial outfits who list their contents and some YC’s have suggestions. The details should clearly be vetted as to their content by those among us who are experienced in medicine and experienced in cruising and they should be vetted for the changes in wilderness medical responses that are accruing. But to come up with a contents list for widely wandering cruising boats should not be a challenge (and pare it down for those who are coastal cruising etc.).
In addition, too few kit lists address the specific needs of children and the largely unknown (for most cruisers) dangers of tropical mishaps while snorkeling, hiking etc.
In most ways, the cruising families we have shared anchorages with over the years were the best prepared and trained: they carried a heightened anxiety with regards to their responsibility to their children and acted on that anxiety by getting training.
In contrast, to my casual observation over the years, the cruising couples were far less well prepared. Many had not taken courses comprehensive enough to enable them to use the contents of a reasonably sized medical kit effectively in an emergency. When there was training, it was in the realm of basic first aid or the type of courses where the content of the course presumes that first responders are on their way and a hospital an ambulance ride away..
The above is a long route to suggesting that hand-in-hand with developing suggestions for a kit (and perhaps even prior to developing a kit), especially a kit with prescription medicines ready-at-hand, we should be looking at the various training opportunities in our respective countries and urging OCC members to get the training necessary to use the kits effectively.
I would want to suggest, that once one gets adequately trained, that the kit choices will largely fall into place and that it is the un-trained who will be confused and bewildered and looking to others for help: in other words, if you are confused about what your kit should contain, then you probably need training (or more training in depth).
My best, Dick Stevenson, s/v Alchemy
By Dick - 5 Sep 2020

Dick - 2/7/2019
Hi OCC community, I believe that the development of medical kits suggestions should not be very hard as the wheel has already been invented. Every few years there is an article to this end in the slicks, there are also commercial outfits who list their contents and some YC’s have suggestions. The details should clearly be vetted as to their content by those among us who are experienced in medicine and experienced in cruising and they should be vetted for the changes in wilderness medical responses that are accruing. But to come up with a contents list for widely wandering cruising boats should not be a challenge (and pare it down for those who are coastal cruising etc.). In addition, too few kit lists address the specific needs of children and the largely unknown (for most cruisers) dangers of tropical mishaps while snorkeling, hiking etc. In most ways, the cruising families we have shared anchorages with over the years were the best prepared and trained: they carried a heightened anxiety with regards to their responsibility to their children and acted on that anxiety by getting training. In contrast, to my casual observation over the years, the cruising couples were far less well prepared. Many had not taken courses comprehensive enough to enable them to use the contents of a reasonably sized medical kit effectively in an emergency. When there was training, it was in the realm of basic first aid or the type of courses where the content of the course presumes that first responders are on their way and a hospital an ambulance ride away.. The above is a long route to suggesting that hand-in-hand with developing suggestions for a kit (and perhaps even prior to developing a kit), especially a kit with prescription medicines ready-at-hand, we should be looking at the various training opportunities in our respective countries and urging OCC members to get the training necessary to use the kits effectively. I would want to suggest, that once one gets adequately trained, that the kit choices will largely fall into place and that it is the un-trained who will be confused and bewildered and looking to others for help: in other words, if you are confused about what your kit should contain, then you probably need training (or more training in depth). My best, Dick Stevenson, s/v Alchemy

In another part of the forum, I posted this as it was a follow up of a Thought on Safety. I think it also fits here. Dick
Hi all,
I said a while back that I was taking a refresher course in medical training: below is my report.
Comments on the course;
1.    Medical training has come up upon occasion. There is very little for the offshore recreational sailor and is more easily found among wilderness support programs. In these covid period with time on our hands, my wife and decided to do an on-line course labeled “Wilderness First Aid” (solowfa.com). It is a self-paced training that takes about 16 hours, I think matching the 2-day in house training of the same name and you have a month to complete the course. It is presented under the umbrella organization of SOLO Schools, one of three well known and well thought of wilderness training organizations in the US. It comes with a handbook.
2.    All will benefit, but those sailors who do a lot of hiking will particularly benefit from the emphasis on trail injuries.
3.    This is an on-line course that was cobbled together for this covid time, and should be viewed as an impressive effort. There is definitely a loss from missing class participation where hands-on skills are practiced, but some, or most, of that can be covered by diligent students on their own.
4.    We got a lot out of the course and felt we had renewed some, perhaps much, of the skill-and-thinking set acquired in previous training that is the basis for wilderness intervention.
5.    We certainly noticed that this was a “low budget” locally produced production, but did not feel that this interfered with the training nor did it impact adversely our ability to learn the content. That said some of the whiteboard hand writing and organization could have been improved; additionally, not all is covered in the accompanying text. A lower fee for couples training together would be appreciated.
6.    It is not a wilderness course by my definition: being completely on one’s own. Most interventions are predicated on the thought that there could be an ambulance called to the trailhead. That said, it did cover the essentials of making a determination of the nature and severity of a medical emergency. An offshore sailor would do well to continue training using this course as a beginning.
7.    This not a course that teaches initial and follow-up treatment of moderately serious injuries/illness that do not meet the level to bring rescue hundreds of miles to seas: perhaps the loss of a finger tip in a winch might be an example. Painful, gruesome, worrisome, but within the treatment capacities of a crew with an adequate medical kit and reasonable prescription pain medications and meds for infection.
8.    In summary, I would very much recommend this course for those who have had no prior training or for those whose training has consisted of CPR and a few hours of first aid. This course is far more substantial and might be best described as and “Adventurer’s First Aid” course rather than a “Wilderness First Aid” which should do nothing to diminish its usefulness.
Come back with questions,
My best to all, Dick Stevenson, s/v Alchemy
By simoncurrin - 5 Sep 2020

Dick
That sounds good. I wonder if I might steer Sally in that direction?

Simon
By Dick - 5 Sep 2020

Simon Currin - 9/5/2020
Dick
That sounds good. I wonder if I might steer Sally in that direction?

Simon

Hi Simon,
I think anyone who is a sailor or hiker would benefit, especially if starting from the minimal training that most bump into in their land based life.
With your and Sally's wide ranging outdoor interests and adventurous undertakings, I can only imagine that Sally would benefit and would feel more secure in having some skills training to take care of you if bad luck comes your way.
It would be great to have another set of eyes giving a review as well
Come back with any questions, My best, Dick
By DariaBlackwell - 1 Dec 2020

Dick - 9/5/2020
Dick - 2/7/2019
Hi OCC community, I believe that the development of medical kits suggestions should not be very hard as the wheel has already been invented. Every few years there is an article to this end in the slicks, there are also commercial outfits who list their contents and some YC’s have suggestions. The details should clearly be vetted as to their content by those among us who are experienced in medicine and experienced in cruising and they should be vetted for the changes in wilderness medical responses that are accruing. But to come up with a contents list for widely wandering cruising boats should not be a challenge (and pare it down for those who are coastal cruising etc.). In addition, too few kit lists address the specific needs of children and the largely unknown (for most cruisers) dangers of tropical mishaps while snorkeling, hiking etc. In most ways, the cruising families we have shared anchorages with over the years were the best prepared and trained: they carried a heightened anxiety with regards to their responsibility to their children and acted on that anxiety by getting training. In contrast, to my casual observation over the years, the cruising couples were far less well prepared. Many had not taken courses comprehensive enough to enable them to use the contents of a reasonably sized medical kit effectively in an emergency. When there was training, it was in the realm of basic first aid or the type of courses where the content of the course presumes that first responders are on their way and a hospital an ambulance ride away.. The above is a long route to suggesting that hand-in-hand with developing suggestions for a kit (and perhaps even prior to developing a kit), especially a kit with prescription medicines ready-at-hand, we should be looking at the various training opportunities in our respective countries and urging OCC members to get the training necessary to use the kits effectively. I would want to suggest, that once one gets adequately trained, that the kit choices will largely fall into place and that it is the un-trained who will be confused and bewildered and looking to others for help: in other words, if you are confused about what your kit should contain, then you probably need training (or more training in depth). My best, Dick Stevenson, s/v Alchemy

In another part of the forum, I posted this as it was a follow up of a Thought on Safety. I think it also fits here. Dick
Hi all,
I said a while back that I was taking a refresher course in medical training: below is my report.
Comments on the course;
1.    Medical training has come up upon occasion. There is very little for the offshore recreational sailor and is more easily found among wilderness support programs. In these covid period with time on our hands, my wife and decided to do an on-line course labeled “Wilderness First Aid” (solowfa.com). It is a self-paced training that takes about 16 hours, I think matching the 2-day in house training of the same name and you have a month to complete the course. It is presented under the umbrella organization of SOLO Schools, one of three well known and well thought of wilderness training organizations in the US. It comes with a handbook.
2.    All will benefit, but those sailors who do a lot of hiking will particularly benefit from the emphasis on trail injuries.
3.    This is an on-line course that was cobbled together for this covid time, and should be viewed as an impressive effort. There is definitely a loss from missing class participation where hands-on skills are practiced, but some, or most, of that can be covered by diligent students on their own.
4.    We got a lot out of the course and felt we had renewed some, perhaps much, of the skill-and-thinking set acquired in previous training that is the basis for wilderness intervention.
5.    We certainly noticed that this was a “low budget” locally produced production, but did not feel that this interfered with the training nor did it impact adversely our ability to learn the content. That said some of the whiteboard hand writing and organization could have been improved; additionally, not all is covered in the accompanying text. A lower fee for couples training together would be appreciated.
6.    It is not a wilderness course by my definition: being completely on one’s own. Most interventions are predicated on the thought that there could be an ambulance called to the trailhead. That said, it did cover the essentials of making a determination of the nature and severity of a medical emergency. An offshore sailor would do well to continue training using this course as a beginning.
7.    This not a course that teaches initial and follow-up treatment of moderately serious injuries/illness that do not meet the level to bring rescue hundreds of miles to seas: perhaps the loss of a finger tip in a winch might be an example. Painful, gruesome, worrisome, but within the treatment capacities of a crew with an adequate medical kit and reasonable prescription pain medications and meds for infection.
8.    In summary, I would very much recommend this course for those who have had no prior training or for those whose training has consisted of CPR and a few hours of first aid. This course is far more substantial and might be best described as and “Adventurer’s First Aid” course rather than a “Wilderness First Aid” which should do nothing to diminish its usefulness.
Come back with questions,
My best to all, Dick Stevenson, s/v Alchemy

I made Alex take an advanced first aid course because his typical response to injury was 'soak it in salt water'. In self-preservation, I signed him up for certification.

I had studied and have onboard Auerbach's Wilderness Medicine manual. It's now a 2-volume set.  I would have loved this online course you suggest, Dick. I will check it out. Thanks. 
I also had onboard a comprehensive personalised medical kit that my sister put together for me  - she was an Infectious Disease specialist. And I had a complete surgical kit with some instruction in how to use it. If I had to get advice via SSB, at least I'd have all the tools necessary to follow instructions. Thankfully, the only thing I had to use was the antibiotic when I developed strep throat after swimming in Martinique. We never made it into the Pacific after a family member had a heart attack and then a stroke and we had to return home, so we were never really that remote. 

Alex broke ribs on a delivery from the Azores to Ireland. There's not much one can do about this. Fortunately, I had sent him off with a good supply of painkillers and instructions about how to use them.

I wonder if there's a way for us to compile a list of injuries/illness our members have experienced while cruising. Perhaps a survey on the Forum? The results analysed could make an excellent Best Practices paper.
By Dick - 1 Dec 2020

Daria Blackwell - 12/1/2020
Dick - 9/5/2020
Dick - 2/7/2019
Hi OCC community, I believe that the development of medical kits suggestions should not be very hard as the wheel has already been invented. Every few years there is an article to this end in the slicks, there are also commercial outfits who list their contents and some YC’s have suggestions. The details should clearly be vetted as to their content by those among us who are experienced in medicine and experienced in cruising and they should be vetted for the changes in wilderness medical responses that are accruing. But to come up with a contents list for widely wandering cruising boats should not be a challenge (and pare it down for those who are coastal cruising etc.). In addition, too few kit lists address the specific needs of children and the largely unknown (for most cruisers) dangers of tropical mishaps while snorkeling, hiking etc. In most ways, the cruising families we have shared anchorages with over the years were the best prepared and trained: they carried a heightened anxiety with regards to their responsibility to their children and acted on that anxiety by getting training. In contrast, to my casual observation over the years, the cruising couples were far less well prepared. Many had not taken courses comprehensive enough to enable them to use the contents of a reasonably sized medical kit effectively in an emergency. When there was training, it was in the realm of basic first aid or the type of courses where the content of the course presumes that first responders are on their way and a hospital an ambulance ride away.. The above is a long route to suggesting that hand-in-hand with developing suggestions for a kit (and perhaps even prior to developing a kit), especially a kit with prescription medicines ready-at-hand, we should be looking at the various training opportunities in our respective countries and urging OCC members to get the training necessary to use the kits effectively. I would want to suggest, that once one gets adequately trained, that the kit choices will largely fall into place and that it is the un-trained who will be confused and bewildered and looking to others for help: in other words, if you are confused about what your kit should contain, then you probably need training (or more training in depth). My best, Dick Stevenson, s/v Alchemy

In another part of the forum, I posted this as it was a follow up of a Thought on Safety. I think it also fits here. Dick
Hi all,
I said a while back that I was taking a refresher course in medical training: below is my report.
Comments on the course;
1.    Medical training has come up upon occasion. There is very little for the offshore recreational sailor and is more easily found among wilderness support programs. In these covid period with time on our hands, my wife and decided to do an on-line course labeled “Wilderness First Aid” (solowfa.com). It is a self-paced training that takes about 16 hours, I think matching the 2-day in house training of the same name and you have a month to complete the course. It is presented under the umbrella organization of SOLO Schools, one of three well known and well thought of wilderness training organizations in the US. It comes with a handbook.
2.    All will benefit, but those sailors who do a lot of hiking will particularly benefit from the emphasis on trail injuries.
3.    This is an on-line course that was cobbled together for this covid time, and should be viewed as an impressive effort. There is definitely a loss from missing class participation where hands-on skills are practiced, but some, or most, of that can be covered by diligent students on their own.
4.    We got a lot out of the course and felt we had renewed some, perhaps much, of the skill-and-thinking set acquired in previous training that is the basis for wilderness intervention.
5.    We certainly noticed that this was a “low budget” locally produced production, but did not feel that this interfered with the training nor did it impact adversely our ability to learn the content. That said some of the whiteboard hand writing and organization could have been improved; additionally, not all is covered in the accompanying text. A lower fee for couples training together would be appreciated.
6.    It is not a wilderness course by my definition: being completely on one’s own. Most interventions are predicated on the thought that there could be an ambulance called to the trailhead. That said, it did cover the essentials of making a determination of the nature and severity of a medical emergency. An offshore sailor would do well to continue training using this course as a beginning.
7.    This not a course that teaches initial and follow-up treatment of moderately serious injuries/illness that do not meet the level to bring rescue hundreds of miles to seas: perhaps the loss of a finger tip in a winch might be an example. Painful, gruesome, worrisome, but within the treatment capacities of a crew with an adequate medical kit and reasonable prescription pain medications and meds for infection.
8.    In summary, I would very much recommend this course for those who have had no prior training or for those whose training has consisted of CPR and a few hours of first aid. This course is far more substantial and might be best described as and “Adventurer’s First Aid” course rather than a “Wilderness First Aid” which should do nothing to diminish its usefulness.
Come back with questions,
My best to all, Dick Stevenson, s/v Alchemy

I made Alex take an advanced first aid course because his typical response to injury was 'soak it in salt water'. In self-preservation, I signed him up for certification.

I had studied and have onboard Auerbach's Wilderness Medicine manual. It's now a 2-volume set.  I would have loved this online course you suggest, Dick. I will check it out. Thanks. 
I also had onboard a comprehensive personalised medical kit that my sister put together for me  - she was an Infectious Disease specialist. And I had a complete surgical kit with some instruction in how to use it. If I had to get advice via SSB, at least I'd have all the tools necessary to follow instructions. Thankfully, the only thing I had to use was the antibiotic when I developed strep throat after swimming in Martinique. We never made it into the Pacific after a family member had a heart attack and then a stroke and we had to return home, so we were never really that remote. 

Alex broke ribs on a delivery from the Azores to Ireland. There's not much one can do about this. Fortunately, I had sent him off with a good supply of painkillers and instructions about how to use them.

I wonder if there's a way for us to compile a list of injuries/illness our members have experienced while cruising. Perhaps a survey on the Forum? The results analysed could make an excellent Best Practices paper.
Hi Daria,
Good for you for pulling Alex away from salt water on wounds if that salt water is from the ocean. Ocean water is not sterile and is not recommended for cleaning wounds. Sterile saline solution can be used for irrigation of wounds. On the boat, I make a point of quickly covering even small cuts with an anti-biotic cream and a bandaid or it will impressively quickly get infected. And especially if I get it in salt water.
I believe a recent Forum addition (by Dr. Forbes if memory serves) did some compiling of data, but I forget whether injuries were part of the questionnaire. It is a good question.
The following is my un-professional understanding but based on training in wilderness emergency medicine and reading: please do your own research.
If your surgical kit was in the service of doing stitching, my research and training indicates that it is best (out cruising) to not close up the wound with stitching. Firstly, it is hard to have a sterile theater in which to do the work on a boat, especially a moving boat and a wound requiring stitching is likely to be hard to clean effectively by us amateurs in those circumstances. It is therefore likely with stitching, that bacteria will get closed into the wound where it will blossom in not-so-good ways. Better to use butterfly bandages or gauze and tape bandages.
Stitching is also best done by someone who does it regularly. It can and has been done in the field by amateurs, but the above alternatives are likely to work out better for the patient.
My best, Dick Stevenson, s/v Alchemy


By neilm - 2 Dec 2020

A seminar as you suggest would be worthwhile
Particularly with Covid restrictions, doing it on Zoom is probably best

I agree with the virtually all the other poster's points
By simoncurrin - 2 Dec 2020

Daria
I’d be happy to put a link to such a survey in my December email to all members and follow it up with a webinar in the Spring. It looks like the next series of webinars will be more technical in nature so a medical one would fit nicely.
Simon

Daria Blackwell - 12/1/2020
Dick - 9/5/2020
Dick - 2/7/2019
Hi OCC community, I believe that the development of medical kits suggestions should not be very hard as the wheel has already been invented. Every few years there is an article to this end in the slicks, there are also commercial outfits who list their contents and some YC’s have suggestions. The details should clearly be vetted as to their content by those among us who are experienced in medicine and experienced in cruising and they should be vetted for the changes in wilderness medical responses that are accruing. But to come up with a contents list for widely wandering cruising boats should not be a challenge (and pare it down for those who are coastal cruising etc.). In addition, too few kit lists address the specific needs of children and the largely unknown (for most cruisers) dangers of tropical mishaps while snorkeling, hiking etc. In most ways, the cruising families we have shared anchorages with over the years were the best prepared and trained: they carried a heightened anxiety with regards to their responsibility to their children and acted on that anxiety by getting training. In contrast, to my casual observation over the years, the cruising couples were far less well prepared. Many had not taken courses comprehensive enough to enable them to use the contents of a reasonably sized medical kit effectively in an emergency. When there was training, it was in the realm of basic first aid or the type of courses where the content of the course presumes that first responders are on their way and a hospital an ambulance ride away.. The above is a long route to suggesting that hand-in-hand with developing suggestions for a kit (and perhaps even prior to developing a kit), especially a kit with prescription medicines ready-at-hand, we should be looking at the various training opportunities in our respective countries and urging OCC members to get the training necessary to use the kits effectively. I would want to suggest, that once one gets adequately trained, that the kit choices will largely fall into place and that it is the un-trained who will be confused and bewildered and looking to others for help: in other words, if you are confused about what your kit should contain, then you probably need training (or more training in depth). My best, Dick Stevenson, s/v Alchemy

In another part of the forum, I posted this as it was a follow up of a Thought on Safety. I think it also fits here. Dick
Hi all,
I said a while back that I was taking a refresher course in medical training: below is my report.
Comments on the course;
1.    Medical training has come up upon occasion. There is very little for the offshore recreational sailor and is more easily found among wilderness support programs. In these covid period with time on our hands, my wife and decided to do an on-line course labeled “Wilderness First Aid” (solowfa.com). It is a self-paced training that takes about 16 hours, I think matching the 2-day in house training of the same name and you have a month to complete the course. It is presented under the umbrella organization of SOLO Schools, one of three well known and well thought of wilderness training organizations in the US. It comes with a handbook.
2.    All will benefit, but those sailors who do a lot of hiking will particularly benefit from the emphasis on trail injuries.
3.    This is an on-line course that was cobbled together for this covid time, and should be viewed as an impressive effort. There is definitely a loss from missing class participation where hands-on skills are practiced, but some, or most, of that can be covered by diligent students on their own.
4.    We got a lot out of the course and felt we had renewed some, perhaps much, of the skill-and-thinking set acquired in previous training that is the basis for wilderness intervention.
5.    We certainly noticed that this was a “low budget” locally produced production, but did not feel that this interfered with the training nor did it impact adversely our ability to learn the content. That said some of the whiteboard hand writing and organization could have been improved; additionally, not all is covered in the accompanying text. A lower fee for couples training together would be appreciated.
6.    It is not a wilderness course by my definition: being completely on one’s own. Most interventions are predicated on the thought that there could be an ambulance called to the trailhead. That said, it did cover the essentials of making a determination of the nature and severity of a medical emergency. An offshore sailor would do well to continue training using this course as a beginning.
7.    This not a course that teaches initial and follow-up treatment of moderately serious injuries/illness that do not meet the level to bring rescue hundreds of miles to seas: perhaps the loss of a finger tip in a winch might be an example. Painful, gruesome, worrisome, but within the treatment capacities of a crew with an adequate medical kit and reasonable prescription pain medications and meds for infection.
8.    In summary, I would very much recommend this course for those who have had no prior training or for those whose training has consisted of CPR and a few hours of first aid. This course is far more substantial and might be best described as and “Adventurer’s First Aid” course rather than a “Wilderness First Aid” which should do nothing to diminish its usefulness.
Come back with questions,
My best to all, Dick Stevenson, s/v Alchemy

I made Alex take an advanced first aid course because his typical response to injury was 'soak it in salt water'. In self-preservation, I signed him up for certification.

I had studied and have onboard Auerbach's Wilderness Medicine manual. It's now a 2-volume set.  I would have loved this online course you suggest, Dick. I will check it out. Thanks. 
I also had onboard a comprehensive personalised medical kit that my sister put together for me  - she was an Infectious Disease specialist. And I had a complete surgical kit with some instruction in how to use it. If I had to get advice via SSB, at least I'd have all the tools necessary to follow instructions. Thankfully, the only thing I had to use was the antibiotic when I developed strep throat after swimming in Martinique. We never made it into the Pacific after a family member had a heart attack and then a stroke and we had to return home, so we were never really that remote. 

Alex broke ribs on a delivery from the Azores to Ireland. There's not much one can do about this. Fortunately, I had sent him off with a good supply of painkillers and instructions about how to use them.

I wonder if there's a way for us to compile a list of injuries/illness our members have experienced while cruising. Perhaps a survey on the Forum? The results analysed could make an excellent Best Practices paper.


By DariaBlackwell - 2 Dec 2020

Simon Currin - 12/2/2020
Daria
I’d be happy to put a link to such a survey in my December email to all members and follow it up with a webinar in the Spring. It looks like the next series of webinars will be more technical in nature so a mediaeval one would fit nicely.
Simon

Daria Blackwell - 12/1/2020
Dick - 9/5/2020
Dick - 2/7/2019
Hi OCC community, I believe that the development of medical kits suggestions should not be very hard as the wheel has already been invented. Every few years there is an article to this end in the slicks, there are also commercial outfits who list their contents and some YC’s have suggestions. The details should clearly be vetted as to their content by those among us who are experienced in medicine and experienced in cruising and they should be vetted for the changes in wilderness medical responses that are accruing. But to come up with a contents list for widely wandering cruising boats should not be a challenge (and pare it down for those who are coastal cruising etc.). In addition, too few kit lists address the specific needs of children and the largely unknown (for most cruisers) dangers of tropical mishaps while snorkeling, hiking etc. In most ways, the cruising families we have shared anchorages with over the years were the best prepared and trained: they carried a heightened anxiety with regards to their responsibility to their children and acted on that anxiety by getting training. In contrast, to my casual observation over the years, the cruising couples were far less well prepared. Many had not taken courses comprehensive enough to enable them to use the contents of a reasonably sized medical kit effectively in an emergency. When there was training, it was in the realm of basic first aid or the type of courses where the content of the course presumes that first responders are on their way and a hospital an ambulance ride away.. The above is a long route to suggesting that hand-in-hand with developing suggestions for a kit (and perhaps even prior to developing a kit), especially a kit with prescription medicines ready-at-hand, we should be looking at the various training opportunities in our respective countries and urging OCC members to get the training necessary to use the kits effectively. I would want to suggest, that once one gets adequately trained, that the kit choices will largely fall into place and that it is the un-trained who will be confused and bewildered and looking to others for help: in other words, if you are confused about what your kit should contain, then you probably need training (or more training in depth). My best, Dick Stevenson, s/v Alchemy

In another part of the forum, I posted this as it was a follow up of a Thought on Safety. I think it also fits here. Dick
Hi all,
I said a while back that I was taking a refresher course in medical training: below is my report.
Comments on the course;
1.    Medical training has come up upon occasion. There is very little for the offshore recreational sailor and is more easily found among wilderness support programs. In these covid period with time on our hands, my wife and decided to do an on-line course labeled “Wilderness First Aid” (solowfa.com). It is a self-paced training that takes about 16 hours, I think matching the 2-day in house training of the same name and you have a month to complete the course. It is presented under the umbrella organization of SOLO Schools, one of three well known and well thought of wilderness training organizations in the US. It comes with a handbook.
2.    All will benefit, but those sailors who do a lot of hiking will particularly benefit from the emphasis on trail injuries.
3.    This is an on-line course that was cobbled together for this covid time, and should be viewed as an impressive effort. There is definitely a loss from missing class participation where hands-on skills are practiced, but some, or most, of that can be covered by diligent students on their own.
4.    We got a lot out of the course and felt we had renewed some, perhaps much, of the skill-and-thinking set acquired in previous training that is the basis for wilderness intervention.
5.    We certainly noticed that this was a “low budget” locally produced production, but did not feel that this interfered with the training nor did it impact adversely our ability to learn the content. That said some of the whiteboard hand writing and organization could have been improved; additionally, not all is covered in the accompanying text. A lower fee for couples training together would be appreciated.
6.    It is not a wilderness course by my definition: being completely on one’s own. Most interventions are predicated on the thought that there could be an ambulance called to the trailhead. That said, it did cover the essentials of making a determination of the nature and severity of a medical emergency. An offshore sailor would do well to continue training using this course as a beginning.
7.    This not a course that teaches initial and follow-up treatment of moderately serious injuries/illness that do not meet the level to bring rescue hundreds of miles to seas: perhaps the loss of a finger tip in a winch might be an example. Painful, gruesome, worrisome, but within the treatment capacities of a crew with an adequate medical kit and reasonable prescription pain medications and meds for infection.
8.    In summary, I would very much recommend this course for those who have had no prior training or for those whose training has consisted of CPR and a few hours of first aid. This course is far more substantial and might be best described as and “Adventurer’s First Aid” course rather than a “Wilderness First Aid” which should do nothing to diminish its usefulness.
Come back with questions,
My best to all, Dick Stevenson, s/v Alchemy

I made Alex take an advanced first aid course because his typical response to injury was 'soak it in salt water'. In self-preservation, I signed him up for certification.

I had studied and have onboard Auerbach's Wilderness Medicine manual. It's now a 2-volume set.  I would have loved this online course you suggest, Dick. I will check it out. Thanks. 
I also had onboard a comprehensive personalised medical kit that my sister put together for me  - she was an Infectious Disease specialist. And I had a complete surgical kit with some instruction in how to use it. If I had to get advice via SSB, at least I'd have all the tools necessary to follow instructions. Thankfully, the only thing I had to use was the antibiotic when I developed strep throat after swimming in Martinique. We never made it into the Pacific after a family member had a heart attack and then a stroke and we had to return home, so we were never really that remote. 

Alex broke ribs on a delivery from the Azores to Ireland. There's not much one can do about this. Fortunately, I had sent him off with a good supply of painkillers and instructions about how to use them.

I wonder if there's a way for us to compile a list of injuries/illness our members have experienced while cruising. Perhaps a survey on the Forum? The results analysed could make an excellent Best Practices paper.



Great! I'd love a 'mediaeval' topic! :)  Let's work on a survey.
Daria
By simoncurrin - 2 Dec 2020

Daria
Let me know what questions you would like to ask and I will format the survey.
Simon