Our Medical Kit

[hellosailor]

Lass,
I never said crew who were prone to hemorrhoids. I said in case of hemorrhoids. Which have always been a most unpleasant surprise to anyone getting one for the first time, and if your crew are middle-aged sooner or later one of them may get one for the first time.

Or perhaps you also make your crew carry their own aspirin and bandaids, because they have been known to have aches and cuts before they crewed, as well?

Nick-
Considering that Klinitulle (which sounds like a clever play on "clinical tuille cotton") is simply plain gauze pre-impregnated with with vaseline, or something very similar to that, I can't see how you are happy to use that, but think you'd get a different result from smoothing some vaseline into plain gauze. They will stick to a wound the same way, they are the same product.
Or would you eat applesauce from a jar, but reject the homemade stuff as being somehow vastly different?
Somewhere in a factory, someone is taking gauze, spreading on grease, and sealing it into Klinitulle packets. It doesn't matter if you do that, or they do that, the product will be the same if you're using the same grease.
And greased compresses are generally frowned on here, in any case. If I recall, for 2nd and 3rd degree burns only?

[s/v Jedi]

Originally Posted by hellosailor

Somewhere in a factory, someone is taking gauze, spreading on grease, and sealing it into Klinitulle packets. It doesn't matter if you do that, or they do that, the product will be the same if you're using the same grease.
And greased compresses are generally frowned on here, in any case. If I recall, for 2nd and 3rd degree burns only?

No. You assume too much the product is very different and not for burns at all.

[Seaworthy Lass]

Originally Posted by Dhillen

Or you can download my ebook on Offshore Medicine for free at this link to get you started.

Cheers.
Dhillen

I have skimmed through it - interesting read in a very palatable form .

Lots of supplies and drugs you suggest that you haven't included in your kit. Any reason for excluding them?

By the way, I am running to get a glass of water if I ever see you come near me with a funnel .

[Seaworthy Lass]

Originally Posted by s/v Jedi

Which one, there are many?

I have a very old guide for boats in Dutch which is probably obsolete, plus I have the guide that came with my original kit for the boat.

I have the idea there is a better book... the OP also had one listed...

EDIT: how about this, also available as ebook: Wilderness First Responder, 3rd: How to Recognize, Treat, and Prevent Emergencies in the Backcountry (Wilderness First Responder: How to Recognize, Treat, &): Buck Tilton: Amazon.com: Books

There is a general manual simply named The Merck Manual (up to the 19th edition now). It covers just about everything (with sections on signs and symptoms, diagnosis, treatment). It is not simply a first aid book, although trauma is covered. Thinking about it, without any prior medical knowledge it is hard to navigate.

Downloads ot texts on wilderness/offshore first aid would be better, although I don't have a specific one to recommend.

[Katiusha]

Dhillen, you mentioned that you have two small children. How small? For our daughter (8 months) our paed recommended carrying meds and nebulizer for crup and tight chest and adrenaline in case of anaphylactic reaction. And as Jedi mentioned in his list Epipens, while expensive, might be a good addition so that it's easy to give a shot of adrenaline while you're stressed a in shock from something bad happening to your kid.

Also, both our paed and our kid sister who deal with a lot of travelling families (British and South African ed in Cape Town) strongly recommended carrying Oxford Handbook of Paediatrics: Oxford Handbook of Paediatrics: Robert C Tasker, Rob McClure, Carlo L Acerini: 9780198565734: Amazon.com: Books The book, while designed for doctors, has a very useful symptom checker and a medicine dosage reference. Our paed told us that a few kids were saved by their parents from being administered adult (!) dosages of meds at hospitals that they went in for an emergency treatment to.

We also carry three different paed pain/fever management meds in case one doesn't work for the full 8 hours: empaped, ponstan, voltaren (in increasing order).

[Seaworthy Lass]

Originally Posted by hellosailor

Lass,
I never said crew who were prone to hemorrhoids. I said in case of hemorrhoids. Which have always been a most unpleasant surprise to anyone getting one for the first time, and if your crew are middle-aged sooner or later one of them may get one for the first time.

Or perhaps you also make your crew carry their own aspirin and bandaids, because they have been known to have aches and cuts before they crewed, as well?

Actually, when travelling I do carry my own tiny package of bandaids, betadine, alcohol wipes, needle for splinter removal and paracetamol. But then again I would have made an ideal girl scout .

Sure, you can try and cover just about everything in a medical kit, although then you would call it medical "suitcases" and it would include suppositories for haemorrhoids. Dhillen in his ebook even suggested carrying treatment for vaginitis, so you would throw that in too.

Carry excess if you are uncomfortable not doing so, but the expense and space occupied may be better allocated elsewhere.

[sailcruiser]

I would recommend dextrose gel and a glucose monitor. When a person becomes very seasick these can be helpful. (Not just for diabetics.)

I also agree with anti emetic suppository or a dissolving form like ondanstron/zofran (brand name).

I'm surprised more haven't mentioned corticosteroids. They are helpful in a number of ways from injury to breathing issues and allergic reactions.

Personally I use hydrogen peroxide but flush with sterile saline to minimize good tissue damage. I'm not a fan of neosporin but use bacitracin instead.

In addition to ibuprofen,acetomenophin, and aspirin I also have naproxen sodium (Aleve). It seems to be a good choice for joint injuries.

Has anyone considered something like Tramadol for pain control if necessary?

Another good ebook:
http://www.adventuremedicalkits.com/...Wilderness.pdf
SC

[hellosailor]

Nick, I'm not assuming, I'm guessing. And apparently my guess was right on the money, what you have is properly called an "occlusive dressing" in the US, and they are in fact available under the Vaseline brand name, made with Vaseline brand Petrolatum jelly, as it is properly called.

"Indicated for use on minor burns, skin donor sites, tunneling wounds, staple/suture lines, lacerations, abrasions, skin grafts, skin tears, circumcisions, umbilical bandage, and lightly exudating wounds." according to the maker.

And not mentioned at all, in standard first aid training in the US. Mentioned more in military first aid, for sucking chest wounds and eviscerations but for the rest of us? There's time to treat the more common problems by simply using a plain compress and adding the Vaseline to it.

Why have you packed it? What else do you intend to use them for, or what have you been trained to use them for?

[dan360]

Originally Posted by s/v Jedi

Get the stapler and wound closure kits. Do not use these until last resort but you really need to have them when is wound is bad enough and a hospital is more than a day or so away. This is not about properly healing; it is about surviving...

One comment on this - when we did our course we practiced with wound closure with stitches and stapler. The advice we were given was that closing a wound is in the vast majority of cases more dangerous than leaving it open. Even very major wounds should be packed with wet dressings and covered, then opened and flushed and cleaned on a regular basis until you reach proper medical care.

A deep wound is most likely to be a penetrating wound from some piece of the boat you fall on or get hit by, the worst case is remote unpopulated island where you fall on a sharp branch etc and have contaminated wound.

In either case if you sew or staple up a wound you can be trapping in the potential for infection. Hence the advice being injected antibiotics immediately and then cleaning regularly.

The one exception is scalp injuries where the bleeding can be severe from the scalp and closing that up can help staunch the bleeding.

Deep injuries to a leg or arm typically do not bleed much once the initial trauma is over unless there is major vascular damage in particular to an artery.

Arterial damage is a whole different area and quite likely to be fatal if you are far from help.

[s/v Jedi]

Originally Posted by hellosailor

Nick, I'm not assuming, I'm guessing. And apparently my guess was right on the money, what you have is properly called an "occlusive dressing" in the US, and they are in fact available under the Vaseline brand name, made with Vaseline brand Petrolatum jelly, as it is properly called.

"Indicated for use on minor burns, skin donor sites, tunneling wounds, staple/suture lines, lacerations, abrasions, skin grafts, skin tears, circumcisions, umbilical bandage, and lightly exudating wounds." according to the maker.

And not mentioned at all, in standard first aid training in the US. Mentioned more in military first aid, for sucking chest wounds and eviscerations but for the rest of us? There's time to treat the more common problems by simply using a plain compress and adding the Vaseline to it.

Why have you packed it? What else do you intend to use them for, or what have you been trained to use them for?

You guessed wrong again. To end this, I went and found it for you; it is called "non-adhering dressing":

Less Stick, Less Pain
Helps prevent dressing adherence
Helps protect regenerating tissue and minimise patient pain at dressing changes
Helps prevent pooling of fluid at the wound site

Amazon.com: Johnson&Johnson (Systagenix) ADAPTIC Non-Adhering Dressing - 3" x 3" - 50/Bx: Health & Personal Care

You better pack it too

[s/v Jedi]

Yes, following a course is a requirement for anybody who brings more than a standard pack from West Marine. Probably the super glue is better, but upon checking, ours is all expired while the old fashioned suture packs are still good. For some things it helps to bring a little choice so that when one falls off there is still another option.

This thread is not about what novices can bring to fix things; it is only for those who have followed courses and studied the diagnoses and treatments. And even then, we would try to call a doctor to assist over the phone or radio if at all possible.

About arterial damage: Celox; repeat: Celox
Celox V12090-35 Blood Clotting Solution, 35g Pouch: Amazon.com: Industrial & Scientific

Originally Posted by dan360

One comment on this - when we did our course we practiced with wound closure with stitches and stapler. The advice we were given was that closing a wound is in the vast majority of cases more dangerous than leaving it open. Even very major wounds should be packed with wet dressings and covered, then opened and flushed and cleaned on a regular basis until you reach proper medical care.

A deep wound is most likely to be a penetrating wound from some piece of the boat you fall on or get hit by, the worst case is remote unpopulated island where you fall on a sharp branch etc and have contaminated wound.

In either case if you sew or staple up a wound you can be trapping in the potential for infection. Hence the advice being injected antibiotics immediately and then cleaning regularly.

The one exception is scalp injuries where the bleeding can be severe from the scalp and closing that up can help staunch the bleeding.

Deep injuries to a leg or arm typically do not bleed much once the initial trauma is over unless there is major vascular damage in particular to an artery.

Arterial damage is a whole different area and quite likely to be fatal if you are far from help.

[hellosailor]

Check again, Nick. What you "found" on Amazon is a Telfa pad. A non-stick pad. It is not at all the same as the vaseline-impregnated Klinitulle pads you were talking about.

Make up your mind. Klinitulle, or Telfa. They are two very different products.

And you still haven't indicated why you'd want to carry the Klinitulle products at all. If you were expecting Telfa pads, you'd be rather upset to find you've packed occlusive dressings instead.

[s/v Jedi]

Originally Posted by hellosailor

Check again, Nick. What you "found" on Amazon is a Telfa pad. A non-stick pad. It is not at all the same as the vaseline-impregnated Klinitulle pads you were talking about.

Make up your mind. Klinitulle, or Telfa. They are two very different products.

And you still haven't indicated why you'd want to carry the Klinitulle products at all. If you were expecting Telfa pads, you'd be rather upset to find you've packed occlusive dressings instead.

Pls stop, you never even had Klinitulle in your hands, you never even heard of it before, you have no clue. What are you trying to accomplish? I don't need to make up my mind, I carry the good stuff, you the basic stuff, that's it, no more.

[Dhillen]

Originally Posted by Seaworthy Lass

I have skimmed through it - interesting read in a very palatable form .

Lots of supplies and drugs you suggest that you haven't included in your kit. Any reason for excluding them?

By the way, I am running to get a glass of water if I ever see you come near me with a funnel .

Thanks for the kind words about the ebook. To answer your question about why I haven't included everything I mention in the ebook into our medical kit now is actually quite simple.

We are planning a trip up to Alaska this summer which means we will be within four or five days of first world medical facilities no matter where we go. The water and food are clean, there is no malaria and the locals (for the most part) are friendly.

Our plans for two years from now include a trip down to NZ and back and that will mean we need to beef up the medical kit again and add some more things.

To those who question why all of this is necessary I can only speak to my own motivations and there are two:

1) I am not a singlehander. We have small children on board (ages 4 and 7) which requires a more responsible attitude toward possible medical emergencies.

2) I want to be in the position to help others, if the need arises, whether they are local people in a remote setting - or other sailors who don't believe in medical kits and now need something they laughed at previously and don't carry....!

Cheers.

Dhillen

[Dhillen]

Originally Posted by Katiusha

Dhillen, you mentioned that you have two small children. How small? For our daughter (8 months) our paed recommended carrying meds and nebulizer for crup and tight chest and adrenaline in case of anaphylactic reaction. And as Jedi mentioned in his list Epipens, while expensive, might be a good addition so that it's easy to give a shot of adrenaline while you're stressed a in shock from something bad happening to your kid.

Also, both our paed and our kid sister who deal with a lot of travelling families (British and South African ed in Cape Town) strongly recommended carrying Oxford Handbook of Paediatrics: Oxford Handbook of Paediatrics: Robert C Tasker, Rob McClure, Carlo L Acerini: 9780198565734: Amazon.com: Books The book, while designed for doctors, has a very useful symptom checker and a medicine dosage reference. Our paed told us that a few kids were saved by their parents from being administered adult (!) dosages of meds at hospitals that they went in for an emergency treatment to.

We also carry three different paed pain/fever management meds in case one doesn't work for the full 8 hours: empaped, ponstan, voltaren (in increasing order).

Katiusha,

Our children are ages 4 and 7 and we are carrying two epi-pens.

Thanks for the ideas, I will look into this; especially the pediatric manual on dosages. It sounds like a great idea.

Dhillen