The paper byte OCC’s Maria Forbes, “Comparing Recommendations to Reality: First Aid Training and Equipment for Amateur Yacht Crews on Ocean Passages” has been published on-line by Elsevier for Wilderness and Environmental Medicine. It will be in print in September’s edition. This is the link https://www.sciencedirect.com/science/article/pii/S1080603220300648

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Dick - 6/29/2020

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Simon Currin - 6/28/2020

Here is the link to the excellent article in Flying Fish written by Dr Maria Forbes based on her original research and with contributors drawn from this Forum Thread. Great job Maria. https://liveicomgrshot.blob.core.windows.net/occfiles/ffarticles/69_75-82_FORBES.pdfSimon

Hi Simon and all,
I have written in these pages about the kind of medical preparedness training that I consider most pertinent for ocean passage makers and those who wander areas where there are no facilities. The danger in choosing training, as I see it, is to choose training where the mind-set is that the goal is stabilization prior to professional intervention in a hospital or clinic. These are often the local first-aid courses and those aimed towards EMTs and the like. The other course offering that some cruisers gravitate toward are those for commercial mariners. The training is often good, but there can be a skewing of training towards having a wide range of diagnostic/treatment opportunities and comm with shore professionals ready-at-hand that a small sailboat does can’t (or usually doesn’t) match.
I favor wilderness training courses as they are designed for off-the-grid intervention with minimal medical tools (in other words, what can fit in a backpack in addition to the everyday personal items) and no expectation of easy or expedient assistance. Of course, if assistance can be called in, all the better, but the training is focused on first evaluating whether outside assistance is warranted (life or death kind of evaluation) and whether one needs to call in a chopper and put SAR personnel into action and/or possibly in danger.
In the US, I believe that NOLS (National Outdoor Leadership School) offers the best courses for the offshore sailor (https://www.nols.edu/en/wilderness-medicine/why-nols/). They have a few levels of training, that can cover the coastal cruiser up to ambitious expedition cruising. Other courses to consider are Wilderness Medical Associates International (https://www.wildmed.com/contact-us/) and SOLO (https://www.google.com/search?q=solo+wilderness+medical+school+conway+nh&oq=solo+wilderness+medic&aqs=chrome.5.0j69i57j0l6.32512j0j7&sourceid=chrome&ie=UTF-8) both of which I am less familiar.
In the UK, I have yet to hear of a wilderness medical training even though I was based in the Uk for 5 years, but I am sure that there must be the equivalent. Outward Bound administration in the UK might be a good place to start research.
My best, Dick Stevenson, s/v Alchemy

Hi all,
It has come to my attention that there is on-line wilderness medical training by one of the organizations I referred to earlier (https://www.solowfa.com/). Casual research on-line appears to give it good ratings. They seem to have a number of levels of training. One of the drawbacks of on-line is the lack of hands-on practice under the eyes of an instructor and conjointly with classmates: not a small drawback. But the SOLO course may have suggestions as to how to deal with this.
As said, I do not believe that the above is optimal, but it checks a number of the boxes that I consider important and is likely worth considering.
My best, Dick Stevenson, s/v Alchemy

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Simon Currin - 6/28/2020

Here is the link to the excellent article in Flying Fish written by Dr Maria Forbes based on her original research and with contributors drawn from this Forum Thread. Great job Maria. https://liveicomgrshot.blob.core.windows.net/occfiles/ffarticles/69_75-82_FORBES.pdfSimon

Hi Simon and all,
I have written in these pages about the kind of medical preparedness training that I consider most pertinent for ocean passage makers and those who wander areas where there are no facilities. The danger in choosing training, as I see it, is to choose training where the mind-set is that the goal is stabilization prior to professional intervention in a hospital or clinic. These are often the local first-aid courses and those aimed towards EMTs and the like. The other course offering that some cruisers gravitate toward are those for commercial mariners. The training is often good, but there can be a skewing of training towards having a wide range of diagnostic/treatment opportunities and comm with shore professionals ready-at-hand that a small sailboat does can’t (or usually doesn’t) match.
I favor wilderness training courses as they are designed for off-the-grid intervention with minimal medical tools (in other words, what can fit in a backpack in addition to the everyday personal items) and no expectation of easy or expedient assistance. Of course, if assistance can be called in, all the better, but the training is focused on first evaluating whether outside assistance is warranted (life or death kind of evaluation) and whether one needs to call in a chopper and put SAR personnel into action and/or possibly in danger.
In the US, I believe that NOLS (National Outdoor Leadership School) offers the best courses for the offshore sailor (https://www.nols.edu/en/wilderness-medicine/why-nols/). They have a few levels of training, that can cover the coastal cruiser up to ambitious expedition cruising. Other courses to consider are Wilderness Medical Associates International (https://www.wildmed.com/contact-us/) and SOLO (https://www.google.com/search?q=solo+wilderness+medical+school+conway+nh&oq=solo+wilderness+medic&aqs=chrome.5.0j69i57j0l6.32512j0j7&sourceid=chrome&ie=UTF-8) both of which I am less familiar.
In the UK, I have yet to hear of a wilderness medical training even though I was based in the Uk for 5 years, but I am sure that there must be the equivalent. Outward Bound administration in the UK might be a good place to start research.
My best, Dick Stevenson, s/v Alchemy

Here is the link to the excellent article in Flying Fish written by Dr Maria Forbes based on her original research and with contributors drawn from this Forum Thread. Great job Maria. https://liveicomgrshot.blob.core.windows.net/occfiles/ffarticles/69_75-82_FORBES.pdf
Simon

When we decided to come across the Atlantic back in 2018 we both did our STCW parts 1 and 2 with a company called Red Square Medical, who then sourced our medical kit and necessary drugs etc our contact there was Liz Baugh, https://www.redsquaremedical.com please mention us and I'm sure shell give you discount as OCC members.



Life isn't about waiting for the storm to pass … it's about learning to dance in the rain!

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Simon Currin - 1/1/2019

A brief update on this thread. Maria has now completed the survey looking at the medical preparedness of trans Atlantic crews. It seems to show that crews are rather less prepared than was expected. She is going to go on to write this up as part of a Master’s research project. In addition she will be using research methodology to compile a recommended kit. Maria is keen enlist experienced oceangoing medics to assist in this project so do please respond here if you are interested. It is really pleasing that such a positive piece of work has come out of this thread.Simon

How is this research progressing - the recommended kit in particular?

Daria,
Useful piece of research. I think one of the exceptions should be adrenaline (injections) which have quite a short shelf life.
Simon

I've often heard cruisers ask the question about what to do with expired medications. Having been in the pharma industry for many years, I have often explained that the expiration date is based on the extent of stability testing prior to drug approval. The stability tests are long enough to support required pharmacy shelf life. They do not necessarily test for longevity. A new study conducted on several drugs returned from the Antarctic research station showed that these drugs remained effective despite being exposed to harsh conditions aboard ships. https://www.wemjournal.org/article/S1080-6032(18)30209-6/fulltext

That does not mean that all drugs would remain effective, but it does suggest that many drugs will remain active long past their expiration dates. They may lose some potency. Aspirin for example remains fully effective for at least ten years. The US military tested drugs commonly kept in their stockpile for troops. They found that aside from injectable products, nitroglycerin, insulin and liquid antibiotics, most medications are as long-lasting as the ones tested by the military.
https://www.health.harvard.edu/staying-healthy/drug-expiration-dates-do-they-mean-anything

Vice Commodore, OCC 

Good day. Great and useful topic. For what it's worth, I can add this ca. 2009 list to the mix - if helpful.

It should be noted that I am a physician so this might not translate well to all. Additionally, parenteral narcotic medications such as morphine are no longer available in the USA to mere mortals like me.

Rx            Chemical name   Instructions   Dosing and Number   
            
Oral Medications            
Keflex 500 mg         Cephalexin      1 po 4x/day #40   
Levaquin 750 mg      Levofloxacin      1 po daily # 14   
Cipro 750 mg         Ciproflaxacin      1 po 2x/day #20   
Bactrim DS                     1 po 2x/day #20   
Augmentin XR 1000mg               2 tabs Q12h #28   
Prednisone 5 mg   #20   
Hydrocodone 5/500                  1-2 po 4x/day #40   
Oxycodone 5/500                  1 po 4x/day #40   
Dulcolax supp       Biscodyl         #4   
NTG S/L 1/150                  #6   
Ativan 1 mg         Lorazapam      1-2 po 3x/day #12   
Protonix 40 mg            
Pseudofed 60 mg      With phenergan 25 mg every 6 hrs is NASA cocktail      
Stugeron/cinnarzine    15 mg         1 po Q 6-12 hrs   
            
Parenteral Medications   
Chemical name   Instructions   Dosing and Number   
Marcaine          .25% plain         2 bottles   
Lidocaine 2% with epi                  2 bottles   
Ancef 1 gm         Cefazolin   1 gm Q8hrs   7 days = 21 bottles   
Rocephin 2 gm      ceftrioxone NA      1-2 gm once daily   10 bottles   
Solumedrol 125 mg                  2 bottles   
Kenalog 40mg/cc      Tramcinolone         4 2cc vials   
Atropine 1 mg                     2 vials   
MorphineSO4 10 mg/ml               8 1ml vials   
Epinephrine 1:1000 mg/ml            4 vials   
Phenergan sol'n 25mg/ml   promethazine-HCl      8 ampules   
Zofran 2mg/ml 4 mg vial   Ondansetrin      4 vials   
Toradol/Ketorolac 30 mg vials   Tromethamnie      12 vials   
            
Sea Sickness Rx Overview      
Instructions   Dosing and Number   
Phenergan 25-50 mg IM,   see parenteral    ideal before sleep/theraputic      
Scopolamine patch 0.5 mg   see topical   prophylactic      
Stugeron/cinnarzine 15 mg   see oral      1 po Q 6-12 hrs   
Pseudofed 60 mg po plus Phenergan 25 mg IM   see oral   Pseudofed 60mg with Phenergan 25 mg every 6 hrs is NASA cocktail      
Phenergan Suppository      see topical      5   
            
Sea Sickness OTC   
Chemical name   Instructions   Dosing and Number   
Dramamine/dyminhydrinate 50 mg         1 po Q4-6 hrs #36   
Bonine/meclazine 25 mg         1 po Q6-12 hrs #60   
            
OTC   
Chemical name   Instructions   Dosing and Number   
Immodium 2 mg      anti-diarrheal    2 tabs 1st dose #24   
Ibuprophen 200 mg      NSAID      
Kaopectate 12 oz      anti-diarrheal    1 bottle   
MOM 8 oz         laxative   1 bottle   
Ipecap syrup 2 oz         1 bottle   
Pseudofed decong 30 mgantihistamine   100   
Benadryl 25 mg      antihistamine   50   
Loratidine 10mg       antihistamine      antihstamine      
Senna laxitive         laxative      
Pepcid 20 mg         famotodine   A   cid reflux      
Desitin Cream                     Rash      
            
Topical/Eyes/Otic   
Chemical name   Instructions   Dosing and Number   
Silvadene cream 1%         50 gm   
HO cortisone oint. 1%         28 gm   
Erythromycin opthalmic oint.         1/2 oz   
Aurulgan otic sol'n            15 ml   
Miconizol cream 2%         15 gm   
Neomycin polymixin B   Ac-OH/HO Cort otic susp      10 ml   
Desitin Cream            
Flonase 50mcg per spray   Fluticasone propionate         
Albuterol Inhaler 17 gm            
Phenergan Suppository   Promethazine      #5   
Scopolamine patch 0.5 mg      prophylactic   4 boxes   

Best regards,

Bill Strassberg
Visions of Johanna

A brief update on this thread.

Maria has now completed the survey looking at the medical preparedness of trans Atlantic crews. It seems to show that crews are rather less prepared than was expected. She is going to go on to write this up as part of a Master’s research project. In addition she will be using research methodology to compile a recommended kit. Maria is keen enlist experienced oceangoing medics to assist in this project so do please respond here if you are interested. It is really pleasing that such a positive piece of work has come out of this thread.
Simon