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Medical Matters at sea.

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

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Simon Currin
S/V Shimshal simon@medex.org.uk
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Daria Blackwell
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18 days ago
Daria Blackwell
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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

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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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WilliamStrassberg
Posts: 2


23 days ago
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
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Simon Currin
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Posts: 792


1/1/2019
Simon Currin
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Posts: 792
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

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Simon Currin
S/V Shimshal simon@medex.org.uk
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Simon Currin
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8/12/2018
Simon Currin
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Posts: 792
Maria
It was very good to talk about your plans yesterday and I am very much looking forward to seeing the outcomes. It will be fascinating to see if there are differences between ARC participants and OCC members when it comes to designing medical stores. Please use the OCC events at the start and finish of the ARC to promote your survey. Augustin Martin (our Gran Canaria P.O.) will, I am sure, be only too pleased to assist.
Simon

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Simon Currin
S/V Shimshal simon@medex.org.uk
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Simon Currin
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8/8/2018
Simon Currin
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Posts: 792
Maria,
That’s great news. I have been getting a significant number of enquiries through this thread and a more structured approach is probably long overdue. Can we talk it over? I can make anytime this weekend for a call if that’s of any use.
Simon

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Simon Currin
S/V Shimshal simon@medex.org.uk
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Dick
Posts: 361


8/6/2018
Dick
Posts: 361
Hi Maria,
There are a number of good ideas embedded in your comment and much worth pursuing.
In addition to the training that you correctly pointed out was necessary for the use of certain procedures (suturing for ex.), there is another piece of the challenge to a crew being prepared for medical emergencies. That is to find the compromise between choosing the skills to learn while also being aware that anything complicated needs to be practiced with some degree of regularity to be useful in an emergency. It has been my observation that many crews are gung ho for training in the year prior to their departure, but that, as the cruise goes on, few cruisers push themselves to any semblance of “continuing ed” or even a review of their training.
My best, Dick Stevenson, s/v Alchemy

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Dick Stevenson, s/v Alchemy
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Maria.Forbes
Posts: 1


8/6/2018
Maria.Forbes
Posts: 1
I am interested in taking part in the OCC Medical Project.
A few general thoughts about medical kit:
Suture/catheter/rectal infusion kit is useless/dangerous unless one has had some training. The STCW course is the minimum needed to use this equipment. This is an internationally certified course.
I recommend downloading the full Cat A kit list and then working backwards deleting the drugs which will almost certainly not be needed e.g. Ergometrine with Oxytocin for post-delivery/miscarriage bleeding if no child-bearing age women are part of the crew, or Phytomenadione if no new-born babies expected.This way there is less chance of overlooking something useful.
The International Radio Medical Advice Centre (C.I.R.M.) provides a free radio medical advice service to ships of any nationality navigating on all seas of the world. Its HQ is in Rome. They also include arrangements for the transfer, if necessary of a patient to a ship with a doctor on board. Doctors are continuously on duty at the CIRM. Email telesoccorso@cirm.it or telephone +39 06592 90263.
This subject is of interest to me because I am a retired doctor who has recently (2017-18) completed an Atlantic circuit and whose co-skipper did the STCW MCAS course. I am just starting doing research on this subject for a Masters in Medical Education and I could incorporate FAQs into the research.
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Simon Currin
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7/20/2018
Simon Currin
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Posts: 792
James,
Finally found some Wi-fi!

Below is a link to an earlier thread on medical kits. Others have posted their kits as have I. As you know I am happy to help with the prescription only stuff if you need it when back in the UK from 31st July.
Simon

https://forum.oceancruisingclub.org/topic1531-medical-seminar-for-occ-members.aspx?Page=1

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Simon Currin
S/V Shimshal simon@medex.org.uk
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james.fiske
Posts: 2


7/17/2018
james.fiske
Posts: 2
Hi Simon,
Much appreciated. in my professional capacity we use Medaire but i dont have teh funds nor the space to purchase everything they suggest!!
Where on the forum will i find your list please?
I'll take a look and get in touch. We depart August 11/15th from Plymouth UK for the Islands
James.
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Simon Currin
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7/14/2018
Simon Currin
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Posts: 792
James ours is listed on the Forum and I am happy to help with access to prescription only items when back in the UK early August. Pick what you want.

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Simon Currin
S/V Shimshal simon@medex.org.uk
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james.fiske
Posts: 2


7/10/2018
james.fiske
Posts: 2
I am getting the final items together before our departure from the UK in August '18.
We are off to Canaries and then ARC to St Lucia in November. A winter around the Islands and then maybe Pacific bound or back to work.....

Ive researched med kits online and they range from the sublime to the ridiculous in size, value, contents etc.
I am trained to a reasonably high standard (MCA/STCW '10 Advanced medical Care Aboard ship) but still require doctors advice from ashore.
Does anyone have a sensible medical kit list that has worked for them. Most off the shelf ones seem to have items i don't need and are missing items i do want to carry.
Many thanks in advance.
James
S/Y Gitana
edited by james.fiske on 7/10/2018
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