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wind_magic 07-07-2007 09:52 AM

Medical training
 
What medical training is recommended for long distance cruisers ?

Certification is not necessary, I am just interested in a good education so that I can avoid dying, losing a leg, and other unpleasant experiences. The more I could study at home the better, but I realize that some formal training might be a good idea. But what training ? And what should I read to prepare in advance of the training ? I am good at learning things on my own so I do not want to tie up time and resources participating in training if it is unnecessary, that is to say if I could have just learned the same thing on my own through reading and practice here at home. Some kind of an on-line course might be good.

Look forward to your thoughts.

chris_gee 07-07-2007 12:13 PM

NZ has a requirement that one has done an advanced first aid cert. There are courses tailored to sailors. The ocean one covers 2 weekends and is good but in practice one would need to refer back to the course material or a reference book.
It might seem overkill but if you are out of helicopter range and say four or more days from land, and perhaps more so in an older age group there is the possibility of some intervention being required.
Book learning is all very well but it requires testing to see if you pick up the key things. Also hands on teaching is desirable for say CPR to see just how much pressure is required and how hard it is to sustain. Similarly doing stitches and giving injections requires some practical experience.
In a marine environment issues such as keeping a MOB flat on recovery and getting someone into a safe position first come into it. You also need a decent medical kit and gain the right to have and dispense drugs.
Older people incidentally may find that a thousand on a portable defibrillator may save a life if not theirs someone in a neighbouring boat.
Such a course is required for many marine qualifications so is likely to be found in most countries.
It is first aid, rather than selfcare or safety which are important but different areas.
I suppose some would see all this as overkill, indeed and hopefully one may not need it but apart from being at sea in many islands for instance medical supplies or care would not be available. A SSB and VHF radio would also be helpful, there may be a dr or nurse in the next bay.

Valiente 07-07-2007 12:19 PM

My wife is a degreed biologist, and works as a wildlife rehabilitator...think "vet tech" without the dog and cat orientation. She knows how to administer a variety of drugs (although not to humans) and probably has the wild animal equivalent of a paramedic's knowledge. Consequently, she is the designated "medical officer" aboard.

I will take St. John's Ambulance courses before we set off, and we will have a general first-aid book plus a "marine" first-aid book along, as well as an extensive medicine chest that includes splints, a BP cuff and an array of suture equipment.

Most boat injuries are of the impact and/or burn variety, with a lot of sprains and hand injuries included. We have already decided to forego boat insurance in favour of extended medical insurance, but we have yet to figure out whether flying "home" to keep our provincial health plan coverage active (the purchased insurance would extend this, not replace it) is cheaper than buying a whole "offshore" package, as would an American, for instance.

knotaloud 07-07-2007 12:44 PM

You might contact your local Red Cross, I've taken a few classes from them and the training is quite good. One first aid class I recommend is called "Wilderness First Aid" it's 16 hours of instruction, mainly designed for hikers and backpackers; but the course covers everything you need for accidents occurring away from immediate assistance and in areas where "normal" basic first aid and life saving techniques are not feasible.

ianbass 07-07-2007 12:52 PM

if i was you i would go to a community college book store and get a emt text book. you dont even have to take the class but if you read the book you should bea able to handle some of the smaller things. but remimber you need the equipment to be able to do any thing so make a good first aid kit.

bestfriend 07-07-2007 01:00 PM

Wind - There should be a book or two somewhere about first aid on the high seas. Depending on your age, and where you live, my advice would differ. If you and yours are over 40 and have any family history of heart attack, high blood pressure, or stroke, I would suggest getting an AED, Automatic External Defibrillator. If you are over 50, history doesn't matter, just get one. Getting an initial quick shock to a cardiac arrest victim is crucial in saving a life. If standard cpr, without shock, does not work within the first few minutes, its not going to. Remember that you can't shock traumatic arrest, meaning that if you get hit in the head with the boom and your heart stops because you are bleeding to death, the shock won't work. Anyway, I would also recommend that you take First Aid/CPR from somewhere. You will need hands on to learn how to do it right. Red Cross or American Heart Association is the best here in the States. You can really go overboard with stuff here, blood pressure cuffs, stethoscope, trauma dressings, ice packs, heat packs, thermometer, all kinds of things.
Off the top of my head, heres what I would bring:
AED
Gauze rolls
4x4 pads
bandaides
splints, maybe a traction splint
instant hot and cold packs
tape
needle and thread for stitches
antiseptics
thermometer
BP cuff
aspirin
ibuprofen
also if you know anyone that can get you antibiotics like penicillin, get it.

If you are bleeding, apply pressure and elevate the wound above the heart.
If its a sprain or similar, elevate, immobilize, and ice for at least an hour. Then alternate ice and hot. Take ibuprofen to reduce swelling.
Basics
Edit - I would second knotaloud's suggestion of survival classes, I have taken them and they are great. The premise is the same, you are in the middle of nowhere with no help, use whats around you.

Sapperwhite 07-07-2007 01:31 PM

Not so much training related, but.... Here is a link to Seaside Marine Drug Co. out of Ca. I have not used their service, but have heard and read good things about them. They apparently build some pretty good medical kits for cruisers. They also can fill prescriptions and have them waiting at your next port of call.
Seaside Marine International Drug Company Inc

Missionary 07-07-2007 01:32 PM

There is a book my wife and I used a lot to help with medical problems. While serving as missionaries in the jungles of Panama is "where there is no doctor" It is available on line and can be downloaded for free. We delivered babies, treated wounds, even broken arms till we could get the person to a clinic. Sometimes several days because of the transportation problems there.
HealthWrights: Workgroup for People's Health and Rights Check it out and see how it could be a help for you on your boat.
Tom

Tynwald 07-17-2007 02:37 PM

Be aware that first aid offshore is pretty different from onshore. If you serious about it, start with downloading the pdf files from here:
Ships Captain's Medical Guide

Its not sufficient, but you will find how to continue.
Some useful reading: Ditch medicine by Hugh L. Coffee, looks heavy, but you might find the situations which you will (hopefully never) experience.

Know how to reach Medical Advice/Assistance (VHF/HF), think about with whom the MRCC should connect you (Singapore, Rome, etc. might be better than others, collect this information before you need it)

Have the proper form filled out BEFORE you call the doctor (you might download one before you start) otherwise you might run up and down the a lot before you are able to answer the questions.

If you just want to do some coastal cruising, forget about the above, except the useful frequenices, maybe. -)

wildcard 07-17-2007 05:42 PM

Im going to second the wilderness first aid as the best single class you can take for offshore sailing. EMT is good but the training does not focus on long term care like the WFA class will. Wilderness EMT, which is an add on to the basic EMT class 120-160 hours is outstanding but you still dont have the training to administer injectable drugs. It's not hard but you do have to know what your doing. Get a few hours of IV traing from someone, Paramedic, RN PA, whoever you can find and have them give you a letter stating you have recieved a few hours of basic informal iinstruction. Take that to you private doc and get him to sign off on a Rx off shore med kit for you, then you will be able to do a lot of good.


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