Emergency Medical Training for Cruisers ?

[GeoGoddess]

Hi all, In anticipation of beginning a cruising lifestyle, I'd like to know what emergency medical training would be sufficient, or possibly, over-preparation for two adults, one of whom is a 54 yy female and the other is a 61 yy male. Both of us are in good health, exercise regularly (including weekends snow-skiing throughout the season and everyday exercise), eat healthful diets and have no health-threatening habits (aside from chocoholism). I'd be willing to get an EMT certificate in addition to keeping my CPR cdertificate current. Would that be sufficient or are there other trainings that experienced cruisers have found useful (and reassuring)? I thank you all for your generosity in sharing the benefits of your knowledge and experience.

[AK_sailor]

GeoGoddess,

This has been discussed on a number of threads, you should be able to find those using search. However, I will give you my own thoughts here. First off, almost any formal emergency medical training is better than none, in my opinion. How much is appropriate depends on your plans.

Regarding EMT training, keep in mind that it is primarily oriented towards urban settings where the patient will be quickly transported to a hospital. In my opinion, a better option for most cruisers is one of the "Wilderness" oriented classes. The reason being that these classes assume you might not be able to reach definitive care for many hours or days. They also stress improvisation, how to make do with what you have, not what might be found in a well equipped ambulance or clinic. Finally (and very important in my opinion) they usually give some guidelines about when to seek rapid evacuation, and when you might consider postponing a call for a helicopter (until the weather improves or until daylight, etc etc).

Within this context there are several options. There are various Wilderness First Aid classes that run about 16 hours, which are OK. A better choice for those making longer cruises or traveing to remote areas would be a Wilderness First Responder (aka "WFR" or "woofer"). These run about 70-80 hours and cost $500-$600. Two good outfits offering excellent WFR classes that I can vouch for from personal experience are Wilderness Medical Associates and WMI of NOLS

There are also nautical specific classes offered by various vendors. They may be good, but since I don't have any personal experience with those, I won't comment on them.

Whatever option you take, you and your sailing partner should both consider getting the training. You can't predict which of you may become sick or injured. Also, after getting training, you should both consult with your physician. Discuss your health needs in regards to your planned trip. Depending on where you plan to travel to, get any vacinations and prescription medications that might be appropriate.

If making a voyage, to a remote area, you might also consider subscribing to one of the "telemed" outfits, where you can get consultation with a physician via radio or sat phone, should the need arise

Have a great voyage!

[swagman]

GeoGoddess,
I'd agree with everything AK says, and if you plan to cruise further afield, suggest you consider getting a big book titled 'Ships Captains Medical Guide'. It's a well written manual, and will back up any training you get. More importantly, this publication is also carried by every British Merchant Ship and an accordingly, a lot of British cruisers. It means if you have a real emergency and use the radio to contact a Brit boat with a doctor, then you and he/she can refer you to the same specific pages amd diagrams, and better guide one another.
Cheers
JOHN

[GordMay]

The Ship Captain's Medical Guide is available for download in 15 parts using Acrobat PDF format:
Here ➥ Ships Captain's Medical Guide

Or here ➥ http://www.dieselduck.ca/machine/06%...022nd%20Ed.pdf

See also:

“Where There Is No Doctor” ~ by David Werner
➥ Hesperian Foundation

“Where There Is No Dentist” ~ by Murray Dickson
➥ Hesperian Foundation

Where Women Have No Doctor - A health guide for women
➥ Hesperian Books: Where Women Have No Doctor - 2010 printing!

[GeoGoddess]

Thank you all for your responses. I did search the forums before I posted, but apparently didn't search in the right time/spaces. I appreciate your patience and support. I'll start with the SCMG and look for "wilderness" emergency trainings in my region and make sure we both get trained.

[Woodstock]

Thanks to the AK sailor who recommended WFR training. I teach wilderness medicine and have had a number of cruisers in my WFR courses over the years. It is always fun to give the class an offshore case study with an evacuation time measured in weeks. The hikers and kayakers become very quiet and the cruisers really start thinking.

WFR is excellent training, especially for coastal cruising, but if you are long distance voyaging you will need some additional skills like the use of antibiotics, pain meds, and long term nursing care like urinary catheters, wound management, etc.

Any course will be very instructor dependent. If you can, find a course taught by a sailor. Even if the course is focused on land based activity, the instructor should be able to apply it to the marine environment.

If you are new to the subject, there is nothing wrong with a basic first aid course with the Red Cross as a place to begin. The emergency response to severe bleeding or respiratory arrest is the same on the street as on the foredeck. It is what you do afterward that makes wilderness and offshore medicine different.

EMT training generally does a great job of what it is designed for; training ambulance attendants. Beyond the management of the immediate emergency, it is not useful for the offshore setting.

Thanks for being concerned about your medical skills. This is often overlooked by voyaging sailors in the rush to learn everything else. Remember, too, that medical training is as much about taking care of yourself as responding to someone else's emergency.

[sck5]

Here is a vote for the Wilderness medical associates WFR training. It is really great and the instructors were happy to talk about offshore issues. Immobilizing someone on a ship at sea would puzzle anyone ...

[TheCruisinKitty]

Is there such a thing as 'Emergency Veterinary Medical Training for Cruisers - with pets'?

Would be interested in any courses that fit...

Thanks in advance.

[Astrid]

Actually yes there are such programs, but they might be difficult to find or unavailable locally. A good many techniques which work on humans will work on your pet as well. Typically, an EAMT (Emergency Animal Medical Technician) course will run you about $500 in tuition and are offered through state or major city humane societies. The certificates are not accredited though. To be an accedited, certified EAMT usually requires a 2 year associates degree and is, naturally quite expensive.

If the price is too high or you are pressed for time, a good working knowledge of first aid would be helpful:

01 First Aid: Emergency Care for Dogs and Cats - VeterinaryPartner.com - a VIN company!

Oh, by the way, I love your blog page.

[rebel heart]

Consider an STCW-95 course. Most of them are one week, cost $500-$1000, and cover:

- life rafts
- first aid / cpr
- firefighting
- rescue
- watch standing principles

Generally all of it is practical. Firefighter trainers, jumping onto a liferaft in a pool from an elevated surface, etc. The only bummer is that it's primarily catered towards larger ships, but if you have someone onboard who's never actually used a fire extinguisher on an oil fire, you can bypass the burn management and teach them how to deal with the emergency first.

[Charon]

Hi GeoGoddess

This is an interesting issue and I can agree with other posts that most first aid training is designed for the urban setting and the cruising fraternity have a need for extended medical care - not just for life and death (cardiac arrest, crocodile and shark bites etc) - but for the little annoyances that may require curtailing a cruise to remote areas - or even abandoning your vessel to get medical care. Such things can include chest infections, salty wounds that don't heal, bites and stings, food poisoning, dysentery, conjunctivitis, tooth ache etc.

I live aboard a 37 foot Ketch (currently in Bundaberg, Oz) and work as an offshore Medic (about to mobilise to Barrow Island, WA) and there are a few things that I do for both work - more principles than hard and fast rules.

First - be real! For example - a defibrillator may be great - but in a two person vessel the chances of a successful reversion from a cardiac arrest and survival is extremely unlikely. Cost - several $1000. benefit, dubious! On the other hand an aspirin will decrease the chances of dying from a heart attach by up to 30% (decreases blood clotting after a heart attach). Cost - less than $1.00. Benefit - great!

Second - assess your resources. We cruise with a medic, a midwife and nurse and a maritime risk manager - sometimes others. Not because we are paranoid - its just what we do (or did!) for a living. So use your VHF radio and ask around. In most instances you will find help and advice within the 40NM radius. Retired brain surgeons, medics, firefighters, physicians - you may have to beat them away with a stick. My fellow Medic mate discovered that the First Officer on his last vessel was also a registered nurse! If concerned, put out a PAN PAN MEDICAL.

Third - have a source of Radio Medical Advice. Not your GP (who you will never find at midnight or hundreds of miles away) - but make contact with the best source of quality medical advice available. In Australia, this may be the Royal Flying Doctor Service (RFDS), a remote rural hospital (I used the Broome Hospital last year in the remote Kimberley's), a commercial medical advice service (I know they are available in the US). Commercial airlines have an international medical advice centre in Phoenix (Arizona) as it is a time and money issue. Make this contact BEFORE you go into a remote area and confirm communication arrangements. You will be dealing with a different doctor in the event of an emergency - but at least your lines of communication are established.

Fourth - have the equipment that relates to your needs and your skills. We are fortunate and can deliver a baby or set up an IV. The Medics in World War 1 used a Murphy Drip (Rectal Drip) which infused clean water into the rectum to replace fluid lost through haemorrhage and dehydration in unconscious patients. This is still taught in many Maritime Medical courses where IV techniques are impractical. The gear and procedure is easy. Check this out on Wikipaedia or:
http://vincetremayne.com/resources/E...2Binfusion.pdf

Finally - most people die ashore from heart attacks, strokes and cancer. So keep fit, eat well, love lots and enjoy the cruising life.

[rebel heart]

A good book as well; there's one more I have that I like equally but I'm not onboard at the moment and can't remember it off the top of my head.

Amazon.com: Advanced First Aid Afloat (9780870335242): Peter F., M.D. Eastman, John M. Levinson: Books

[TheCruisinKitty]

Originally Posted by Astrid

Actually yes there are such programs, but they might be difficult to find or unavailable locally. A good many techniques which work on humans will work on your pet as well. Typically, an EAMT (Emergency Animal Medical Technician) course will run you about $500 in tuition and are offered through state or major city humane societies. The certificates are not accredited though. To be an accedited, certified EAMT usually requires a 2 year associates degree and is, naturally quite expensive.

If the price is too high or you are pressed for time, a good working knowledge of first aid would be helpful:

01 First Aid: Emergency Care for Dogs and Cats - VeterinaryPartner.com - a VIN company!

Oh, by the way, I love your blog page.

Dear Astrid,

Thanks for the advice - and the much appreciated compliment on my blog!

I am off now for a much needed snooze... while the Can Opener types up my most recently dictated pearls of wisdom. I have noticed his motivation levels have fallen slightly with unvaried application of the smoked oysters.

Perhaps a change to smoked kippers will rejuvenate him. To be applied after the Hour of Snooze, of course.

[foolishsailor]

My wife and I were advised to get the following ertification - and did. Our GP, and personal friend, was trained in expedition medicine. He advised this level training as it enabled us to address most incidents ourselves and for more serious events it gave us the proper terminology and skill sets to act as the eyes and hands of a GP on our sattelite phone.

However as with all news skills - if you dont keep the skills up-to -date they dissappear. I am embarassd to admit that it has been two years since we took the class and much of the details of what we covered I would be hard pressed to remember. I do clearly remember the physical tasks however such as administering an IV, sutures, injections, rectal rehydration and rectally administiring medication (actually quite important for severe seasickness), etc...

Ship Captain’s Medical Training
STCW Code A-VI/4-2

This classification should be used for all Navigational Ship’s Officers from Second Mate and higher, as well as all Grade One Fishing Officers.

Course Objectives
The Ship Captain’s Medical course has been designed to ensure the appointed medical Officer meets the First Aid requirements for rendering medical assistance to any crew member in the event of a traumatic accident or medical emergency on board. The objective is to train the learner to a level that he, or she is the extension of the Marine Doctor ashore. They should firstly be able to communicate with Radio medical Advice in such a way that both parties understand each other. He must be able to respond appropriately to the emergency and then assist in making a diagnosis and prognosis of the casualty’s condition. Know how to treat the casualty according to the advice given via Radio Medical Advice, and then monitor and nurse the casualty and report back on the progress regularly.



Course Duration
The course is 40 Hours duration, including practical evaluation, oral examination and a written examination. And a compulsory hospital shift in a casualty, performing the learn skills under supervision.

Certification

Certificate is valid for 5 years

[Hirophant]

Originally Posted by GordMay

The Ship Captain's Medical Guide is available for download in 15 parts using Acrobat PDF format:
Here ➥ Ships Captain's Medical Guide

I've just been looking at that and even just the first chapter forms an extremely useful First Aid guide whether on or offshore. This kind of stuff should be taught in schools as a life skill. The only question mark is that recently there has been a focus on heart massage over artificial respiration in the UK first aid awareness campaigns, whereas the Captain's Guide puts the emphasis the other way round.