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Medical Matters at sea.

Medical Seminar for OCC Members Messages in this topic - RSS

Simon Currin
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1/31/2016
Simon Currin
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Posts: 728
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

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Simon Currin
S/V Shimshal simon@medex.org.uk
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Daria Blackwell
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Posts: 718


1/31/2016
Daria Blackwell
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Posts: 718
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.

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Daria Blackwell - Rear Commodore, PR Officer, Editor OCC Digital Comms & Port Officer, West of Ireland s/v Aleria http://www.coastalboating.net
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Simon Currin
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1/31/2016
Simon Currin
Administrator
Posts: 728
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

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Simon Currin
S/V Shimshal simon@medex.org.uk
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Dick
Posts: 254


1/31/2016
Dick
Posts: 254
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

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Dick Stevenson, s/v Alchemy
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Simon Currin
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1/27/2016
Simon Currin
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Posts: 728
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]

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Simon Currin
S/V Shimshal simon@medex.org.uk

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Victor.Bom
Posts: 3


1/27/2016
Victor.Bom
Posts: 3
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
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Dick
Posts: 254


1/27/2016
Dick
Posts: 254
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]

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Dick Stevenson, s/v Alchemy

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aragorn
Posts: 4


1/27/2016
aragorn
Posts: 4
Simon
I would be very interested in what you though might be useful to carry
Thanks
Caroline & Robert
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Daria Blackwell
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1/27/2016
Daria Blackwell
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Posts: 718
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.

--
Daria Blackwell - Rear Commodore, PR Officer, Editor OCC Digital Comms & Port Officer, West of Ireland s/v Aleria http://www.coastalboating.net
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aragorn
Posts: 4


1/27/2016
aragorn
Posts: 4
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.
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Dick
Posts: 254


1/27/2016
Dick
Posts: 254
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

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Dick Stevenson, s/v Alchemy
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Dick
Posts: 254


1/26/2016
Dick
Posts: 254
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

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Dick Stevenson, s/v Alchemy
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Simon Currin
Administrator
Posts: 728


1/26/2016
Simon Currin
Administrator
Posts: 728
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

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Simon Currin
S/V Shimshal simon@medex.org.uk
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Daria Blackwell
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1/26/2016
Daria Blackwell
Administrator
Posts: 718
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!

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Daria Blackwell - Rear Commodore, PR Officer, Editor OCC Digital Comms & Port Officer, West of Ireland s/v Aleria http://www.coastalboating.net
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Daria Blackwell
Administrator
Posts: 718


1/26/2016
Daria Blackwell
Administrator
Posts: 718
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.

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Daria Blackwell - Rear Commodore, PR Officer, Editor OCC Digital Comms & Port Officer, West of Ireland s/v Aleria http://www.coastalboating.net
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Bill Balme
Posts: 143


1/26/2016
Bill Balme
Posts: 143
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?

--
Bill Balme
s/v Toodle-oo!
Outbound 44 #27
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Simon Currin
Administrator
Posts: 728


1/25/2016
Simon Currin
Administrator
Posts: 728
Dick and co,

So how about working toward the following plan?


  • We use our membership and their experiences to design an OCC suggested medical kit.

  • 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.

  • 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.

  • The above should give our members access to a global medical resource that few other courses, clubs or organisations could equal.

  • 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.

  • We need to be very careful about protecting the club against the risk of litigation or else this will not happen.

  • 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

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    Simon Currin
    S/V Shimshal simon@medex.org.uk
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Bill Balme
Posts: 143


1/25/2016
Bill Balme
Posts: 143
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!)

--
Bill Balme
s/v Toodle-oo!
Outbound 44 #27
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derekbreth
Posts: 4


1/25/2016
derekbreth
Posts: 4
Simon, We would most likely be interested too if we can get to wherever you plan on holding it.

Thanks.
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Dick
Posts: 254


1/24/2016
Dick
Posts: 254
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

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Dick Stevenson, s/v Alchemy
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