Medical kit

[Cheechako]

Originally Posted by goboatingnow

I got a doctor friend who's a sailor to write me a list , some of which is prescription. Besides the usual bandages. Etc, it had broad spectrum anti biotics in both tablet and cream amd two strong painkillers. ( zydol based) I found to a good compromise.

I once took the offshore French medcal required list to a local chemist. 400 euros later I had enough stuff to handle battlefield injuries. ( I remember it had lots of stuff for women !) you can go over the top.

Dave

Yes, I had the same thing happen, my wifes Gyno was a sailor. We had a very well stocked med kit as far as prescriptions go.
Most of the time we had way too much other stuff, you dont need every possible type of bandaging item etc. Premade kits are way overpriced. They usually list their ingredients.... just go get that. Of course you wont get the fancy bag, but you wont pay dearly for it either!
I took the Bering Sea fisherman's first aid and Suturing class a couple of times. Seems like if you are going RTW, the suturing might be useful. They teach that class because they often have to sew up somebody when they are out fishing for weeks at a time.

[mcarling]

Originally Posted by Cheechako

Premade kits are way overpriced. They usually list their ingredients.... just go get that. Of course you wont get the fancy bag, but you wont pay dearly for it either!

The fancy bag may occasionally obviate trouble with customs officers. Some tend to be deferential to anything that has an aura of authority or officialdom.

[MarkJ]

Originally Posted by Chalker

What do others do about declaring their medical kit? Isthare an acceptable form of words?

Never been asked about it, never had it inspected.

There are so many countries where you can buy prescription medicines over the counter that it would be difficult for a country to enforce a prescription requirement.

But if you have the prescriptions they take little space so why not keep them. Especially for things that could be illicit drugs, or a large supply of something that could look like you are going to sell it.

[jgbrown]

Originally Posted by mcarling

The fancy bag may occasionally obviate trouble with customs officers. Some tend to be deferential to anything that has an aura of authority or officialdom.

And nobody says you can't re stock it
They often turn up on clearance at places online like sierra trading post rei outlet etc.

[Cheechako]

Originally Posted by mcarling

The fancy bag may occasionally obviate trouble with customs officers. Some tend to be deferential to anything that has an aura of authority or officialdom.

Good point. We used a red plastic box marked as medical kit. Red boxes are a little hard to find but they are around. If you put a small padlock on it, that would be even more reassuring to the officialdom.

[Nicholson58]

Plano now is selling cam-locking waterproof boxes. Not as durable as a Pelican case but much less costly. You can also find Pelican cases on E-Bay and Craig's List. We started out with everything in one box but are now dividing the common from the uncommon and special. In the US we find the over the counter medical first aid kits to be rediculously expensive and woefully inadequate. They contain little more than bandages and topical creams. Better to build your own from lists at the links in other postings. You can do well at COSCO. Taking a hands-on course is close to manditory in my opinion. Our family doctor will take care of setting us up with the items not available to the public.

Planning to rely on evacuation should be considered last resort. You may be forced to abandon your vessel. Its better to be prepared to handle emergencies well.

I didn't notice anyone mention that many drugs and durable supplies are available at Quality Farm & Fleet and other farm supply retail outlets. The cost is way lower than at a pharmacy and no prescription is needed.

[jgbrown]

Tried and failed to post from work, and then my phone crapped out for a bit. Finally bought a new laptop, sorry about the delay!

Originally Posted by DeepFrz

I don't think I remember reading that in the study. Could you provide a reference?

I found my old medical kit from traveling. It was Doxycycline that I was cautioned about, I knew it had something to do with malaria and was an antibiotic too.
The doctor I mentioned said that generally expiry only indicated a possible reduction in effectiveness, and helped me figure out a lot of the medicines etc for my kit, and also with good advice for storing some things for long term disaster/SHTF preparedness back when I had more space and money living on land.

The only exception that came up while I was preparing for my trip was that antibiotic, so I'm certain it wasn't a knee-jerk reaction to caution me about it.

He is one of the smartest men I've ever met, and with a lot of experience in medicine, and surgery, both in Africa and here. His wife(a pharmacist) also concurred. They are innovative, constantly learning, and unlikely to be just following an official line about expiry. I trust his advice, as he has proven regularly correct.

If I was still dating his daughter, I'd ask for clarification.
Since we didn't part on the best of terms owing to her poor decisions, not going to happen now.


One other thing he suggested to me for traveling that might be good to take before you go is a vaccine called Dukoral. It's an oral vaccine. Seemed effective considering the things I was eating all the way through Central America and how often I drank the water.



Other things I found in my kit that I don't remember seeing in the thread:

Quick-clot packets used for serious bleeding, supposed to do the job when nothing else will, maybe not as much of a concern on a boat as on a motorbike, where crashes are a common concern.

Steri-strips(use all the time in place of stitches, there's a bigger version as well with elastic in the middle that you can overlap, or use to keep tension off stitches, I had one packet of them when I had my hand sewn up, they worked really well).

Sealed syringe kit(to avoid disagreements at borders, it is sealed and labled clearly by the manufacturer)

aluminium mesh folded in half and rolled to use as a formable splint, takes up 1/3 the space of the foam covered splints, and forms better.

Sealed small sterile packets of saline, clip the end and irrigate wounds or eyes instantly. I use these often.

Liquid skin. The top comes off easy so I wrap it in tape to keep it on.

Second Skin band-aids for burns, blisters or cuts(I have a few of each, they are different shapes but essentially the same otherwise).
They seal on tight, so the area needs to be cleaned carefully first, but keep water, dirt, sweat etc out after. Worth their weight in gold for cuts on hands when you have to put back on dirty wet gloves.


I'm allergic to petroleum, so things like Polysporin are off limits to me unless I want to be covered in blisters.
Alternatives I use instead:

Polysporin disinfectant spray, it's ok, but not great.
The pre-treated antibiotic bandaids are fantastic, I use them whenever I have a cut that is starting to get infected or not healing up normally, they've worked every time so far.






Here are the type of kits I've seen friends use as base kits, then upgrade but keeping the official packaging and basic consumables. The bigger ones go on sale from time to time too, a Pelican hardcase takes up too much room for me.
Adventure Medical Kits 0.7 First Aid Kit - Ultralight, Watertight - Save 35%








Re: epi-pens. When taking my first Wilderness First Aid Course I was advised that epi-pens were a temporary solution, they buy you enough time to get someone to help(ideally) or to try something else. One suggestion, given with the understanding that it wasn't an official policy if I remember right was that if it can reduce the swelling enough for the victim to swallow was to use that opportunity to get them to swallow some antihistamines, in the hopes that they would kick in to reduce the reaction enough before the epi-pen wore off, as in many remote areas we might be too far to get outside help in time.
The only time that a friend of mine has had to administer one in the bush, a helicopter was on route in time, before they really had to test this suggestion about using the Epi-pen to buy time for the anti-histamines.




Also, NEVER, EVER put your thumb over the end of an epi-pen when going to use it, even in practice with no adrenaline or stress, I've seen people get them the wrong way around, as we are so conditioned to pulling the cap off the writing end of a pen, while an epi-pen cap is on the back end. holding the pen in a fist, if you poke the person with the wrong end, nothing happens flip it around and you're good to go. With a thumb over the end, you will get the shot right in your thumb which is reported to be absolutely excruciating and the victim gets nothing.

Epi-pens have a good amount of force behind the needle, I've tested an expired one on a piece of well dried wood, and the needle punched in hard enough that I could pick up the wood by the pen no problem. If you have expired ones you aren't using, an orange is a common thing to practice the injections on, that's how teachers here are trained to administer them.

[DeepFrz]

jgbrown, thanks for your informative post. It is good to know about the Doxycycline.

Some of the other things you have mentioned are essential, IMO, and I would recommend that people not go the minimalist route if at all possible. S**t happens on boats and just because it hasn't happened to some people yet is no reason for them to suggest to others that a good medical kit is not necessary. Again, IMHO.

[Sailor g]

I heard from my pharmacist that it was all the tetracycline family. They change & can be dangerous. I found this link:

http://www.drugs.com/tetracycline.html

[Jammer Six]

Oh, great. Just as I was starting to have some confidence in the advice here, it turns out that we take medical advice from a guy who used to date a physician's daughter...

[Matt Johnson]

Originally Posted by MarkJ

But now there's a different drug and a different method... A lollipop. But I have forgotten the drug.


Mark

You are thinking about a morphine lollipop. They are a military item, but now available to the general public (with prescription). The nice part is that they can be regulated... they have enough morphine, and you rewrap the lollipop for later.

Epinephrine can be injected via syringe and you don't need the pens. Also, the epinephrine vial is a lot cheaper then the pen. I have the pens in my medical bag, but would go with a vial next time.

Our medical bag and contents were purchased on eBay for about $75. It was one of the offshore medical bags that retails for $850. I removed the old expired items, but was able to replace them with new stuff from Amazon.com for an additional $50. Keep an eye out for eBay.

[jgbrown]

Originally Posted by DeepFrz

jgbrown, thanks for your informative post. It is good to know about the Doxycycline.

Some of the other things you have mentioned are essential, IMO, and I would recommend that people not go the minimalist route if at all possible. S**t happens on boats and just because it hasn't happened to some people yet is no reason for them to suggest to others that a good medical kit is not necessary. Again, IMHO.

Absolutely agree there. I regularly get to laugh at myself after I get worked about not having anywhere to put things on the boat. I've lived on a motorbike longer than I've lived on a boat, so the stressing over space is silly. On the bike, my first aid kit took up more space than all my personal stuff like clothes, and cost more than anything I owned except my camera, riding armor and helmet. It is one area NOT to skimp, regardless of cost.
Especially considering it might not just be you needing it.
I've used my kit far more on others, and always been glad to have it.


I just get concerned when I see things like expired stuff is OK to use, even though it's usually true because often people won't do their research after reading that, or replace things in a timely manner(if ever). That being said, when I had a choice between some expired antibiotic that MIGHT become toxic, and a serious health problem at the time, I took the antibiotic.
Some of the doxycycline I bought had a short expiry period(old stock), which I didn't catch on to, until I finally needed it with nowhere to buy more around. I was not pleased with myself, no fun adding extra anxiety when you're already having problems, but it worked.


Much better is replacing things prudently, and being aware that expired things can be used if replacement wasn't possible due to oversight earlier, current location, or because it's something you can't get a prescription for just because you want to have it available in future.




Jammer Six: Lol. . Guess the advice is worth what you're paying for it then

Most of what I've suggested is based on direct experience, where it wasn't I specifically pointed out that it was advice from instructors in Wilderness first aid courses I took for work, or other sources, such as a doctor I actually trust and respect, who's advice was specifically directed towards first aid kits that would be used in situations where they were unlikely to be able to be kept up to date. He was genuinely brilliant, always studying and working tirelessly for the town he cared for, at one time I was happy that he was soon going to be an in-law...

The polar opposite of several doctors I've had the misfortune to deal with, who must have been the C- students at med school, and who's advice I generally ignore and certainly don't pass on. Like the one who incorrectly set his own finger after dislocating it one trip, then ate raw ground meat he found on a trail the next trip, a stunt that was followed by crapping his guts out for the next several days(and this was a man old enough to be father!).
Or the one who refused to open up and clean out my wrist after a good puncture with a badly contaminated drill-bit, despite the explanation that it was a deep puncture not a cut, and repeated requests to irrigate it first. That one just chucked a couple stitches in. It got badly infected as expected based on the woods I was working at the time, resulting in me having to do his job a second time myself.

As always YMMV.

Epinephrine can be injected via syringe and you don't need the pens. Also, the epinephrine vial is a lot cheaper then the pen. I have the pens in my medical bag, but would go with a vial next time.

This is certainly true, I think it depends on your comfort levels with giving injections, and the situations you expect to be in at the time you're using it. In a nice, warm, calm environment, or used by someone who has lots of practice it makes total sense.


The Epi-pen is for people like me, I'm no doctor. I don't have the skills and background to feel comfortable to be giving injections like that. Most of the times I've done first aid it's been freezing cold, too hot, the person involved is moving around etc.
I know just enough to know when and how to use it, the pen reduces the potential for a mistake on my part, and is easier to handle from my point of view.

[GordMay]

Originally Posted by jgbrown

... It was Doxycycline that I was cautioned about ...
... The only exception that came up while I was preparing for my trip was that antibiotic, so I'm certain it wasn't a knee-jerk reaction to caution me about it ...

“If you have received doxycycline with an expired date on the package, FDA has authorized its use. Testing of the medicine found it is safe to use past the expiration date. “

Excerpted from ➥ http://www.fda.gov/downloads/Emergen.../UCM265824.pdf

[jgbrown]

Originally Posted by GordMay

“If you have received doxycycline with an expired date on the package, FDA has authorized its use. Testing of the medicine found it is safe to use past the expiration date. “

Excerpted from ➥ http://www.fda.gov/downloads/Emergen.../UCM265824.pdf

That appears to be for an emergency situation anthrax exposure, with doxycycline being provided to everyone exposed, with acceptable side effects. Given the choice of a potentially negative outcome vs a very negative situation, I would and have taken it too. Personally, I'd rather avoid the increase in risk or reduction in effectiveness. The 5 or 10$ savings isn't worth it, and I'm usually cheap. Not to say it cannot be used after, but if doing it then it's good to be aware of the potential issues, and that it's not an excuse to pack once and then neglect to maintain a first aid kit in a reasonable manner when it's possible to do so.

There's also a big difference in time imo. I'm more comfortable with something a bit past expiry vs a lot past expiry.
Depending on what it is too, Tylenol and an epipen have different levels of priority for replacement in my mind for example. I'll usually let things slide a while, especially if I'm not travelling, but not indefinitely.

I think of expiry like a working load. Sure you can exceed it safely in most cases but it's good to be aware of all the aspects of the decision, and where to be more cautious.