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  #21  
Old 01-12-2007
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Mick,
Most EMT course are predicated on the assumption the more advanced life support is near by either in the form of a hospital or paramedics. The Wilderness EMT module is additional training on top of a regular EMT training. The traditional focus of the wilderness module is training for backcountry accidents and is geared usually toward the needs of backcountry guides, rafting guides, NOLS instructors, and the like. If you search you might be able to find one more in line with the specific needs of the lond distance voyager. The main advantage of the course is in teaching one how to improvise and think when help is a not just a few minutes away. I took a course years ago form these guys and would reccomend them: Wilderness Medical Institute . But would think if you go this route you should try to find an EMT course geared towards long distance voyaging and/or the issues regarding third world medical care which can range from excellent to nonexistant. Let me also recommend the following, as it has replaced the included (and excellent) guide that came with my Adventure Medical Kits Family II fak: Wilderness Medical Associates Field Guide (Spiral-bound) . As far as additions to a fak I would recommend the following: SAM splints, vet wrap, and large triangular banadages

I would second the idea that someone else posted that illness rather than acute trauma is a far more likely situation. Although both should be prepared for. Your doctor and/or a travel clinic given your your medical history and travel plans would be able offer more specific advice regarding potential illnesses.

A doctor should also be able help flesh out a fak with needed prescriptions for antibiotics and pain killers. This is especially important if your allergies to, say, penicillin, codine, or any of the popular antibiotics or pain killers or have a significant preexisting conditions such as a heart condition.

Sam

P.S. Another class, if you will, of books to consider, primarily as a supplemental reference, are those geared toward combat and special forces medics. Ditch Medicine and U.S. Army Special Forces Medical Handbook come immediately to mind but I have no experience them so cannot comment on thier quality or utility.

Last edited by svs3; 01-12-2007 at 10:29 AM.
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  #22  
Old 01-12-2007
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All,

Sorry to sound like I am about to go on a rant and rave, but this is a little pet-peave of mine and a common missconception among sailors.

First, let me throw in a point and observation: I have NEVER had to call the USCG for an emergency onboard. There you go, I set the stage. However, I think it should be stated on a sailboat you have to be INFINITELY more prepared and ready to hold your own for a longer period of time than if you were land based or on a motor vessel.

If you are moored off of Nassau, hell, jump in the dink. But for most of us, we are some hours (or many hours, at hull speed) to the nearest medical help. It is not as if you can run up to shore and you are at a hospital. You have no car there. You can call the USCG, but the time between the call and them actually ARRIVING can be considerable even if you are only a few miles away from their station (which is never the case, it seems).

Remember, you are on a sailboat. You can only go hull speed, even in an emergency. You cannot exactly call an ambulance service and tell them to meet you at this island near the beach since most of them would not have a clue what you are talking about (and many are unaccesible by motor vehicle). Air Evac (chopper, outside of USCG) has to have a place to land (you cannot land in mangroves). What I am trying to say is that everyone better be prepared for a long-haul to medical help. This is ESPECIALLY true if you sail with kids. I don't care if it is coastal... sailboats can be accident prone and you can go from fine to critical in one Jibe. Be prepared for trauma. That is another reason to make sure you can BOTH (Spouse, for example) single the boat in and out of the slip...not just sit behind the wheel and trim a sail as needed. And remember too, if there are only two of you, the boat cannot sail itself. One is hurt, the other is rendering aid, so who now is driving the boat? Calling the CGuard? Getting you closer to medical assistance? That's right, no one. Use your imagination for a moment and really think about all the steps that are required for you to get medical assistance. Just 20 miles offshore, you are WAYYYY out.

I said upfront that I am ultra conservative about this stuff, so please take the comments as such. I don't know that anyone sailing down a major US coastline will be waiting for 24 hours for an evac/medical assistance, but don't fool yourself into thinking you can dial 911 and you will have someone there within minutes... not to mention hour(s). Head trauma, cardiac, you have only minutes to stabilize. Cut a major artery. Minutes to stabilize. A band-aid and aspiring won't cut it.

If you approach even coastal cruising with the demeanor that "I am 24 hours from help and have to hold my own" you will stock accordingly and prep accordingly. You are not 24 hours, but get you mindset correct. Listen to Cruising Dad as he preaches the Boy Scout motto: BE PREPARED. Otherwise, you are no better than Ken Barnes (who everyone seems to feel showed very poor semanship).

Be responsible for yourself. It will save your life.

- CD
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  #23  
Old 01-12-2007
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I'd have to agree with most of what CD said. It is very much the case, that even though, by high-speed powerboat or helo you are just minutes from help, it is very likely that help will not arrive in just minutes. A good example, though not of a sailboat, is the fishing boat that Giulietta mentions that was just 50 yards off the beach... yet people on the boat still died.

Just because you're in sight of help, doesn't necessarily mean that help can get to you. Being prepared as if you don't have timely access to help is the only way to go.

Head trauma, heatstroke, cardiac arrest, hypothermia, severe lacerations are all very possible injuries on a sailboat... head trauma during an accidental gybe, heatstroke from the sun, cardiac arrest and hypothermia from a man-overboard in cold waters, severe lacerations from falling or being hit by something. All of them have fairly good basic measures that you can take to try and help stabilize the person, but you have to have the knowledge and the equipment do so on board.

His point about what happens if it is just two of you.... or what if you're single-handing and get injured... Having a well-stocked medical kit... one that goes beyond basic first aid, is probably a good idea.
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  #24  
Old 01-12-2007
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I both agree and disagree with CD and sailingdog. As I mentioned in last post, you HAVE to know your cruising grounds. I don't consider 20mi to be waaay out. At 6mph you are 3 hours and 20 minutes from help. (Roughly equivalent to an emergency room wait time. )In my previous post I was careful to say 20mi from port. Yes in most cases you could call 911 and have aid waiting for you at the dock when you got there. No one has mentioned equiping the boat as an ambulance. Even the best of the fak discussed didn't mention having an AED. If someone goes into cardiac arrest, lets be honest, there isn't much you are going to do beyond CPR and your not going to use too much out of a big fak while doing it. You can do CPR if you have enough people on board, or you can call Coasties, or they are going to die. Heat stroke, the best aid there is the thing you have the most of, water, and getting them out of the hot environment. Things like severe lacerations you have to be prepared for and know how to treat. Most of what you are going to do while at sea doesn't take a ton of gear, but a few well used items while you go like hell for shore. The reality is unless there is trauma surgeon on your crew your ability to treat is more like treading water.
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  #25  
Old 01-12-2007
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Giulietta is just really nice Giulietta is just really nice Giulietta is just really nice Giulietta is just really nice Giulietta is just really nice
T, did you forget me??? The bag????
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  #26  
Old 01-12-2007
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Sorry G- Some where along the way I missed your request.
http://www.basspro.com/servlet/catal...rTarget=browse
This one is pretty close to what I use and comes in various sizes. The "ziplock" type bags are really good to keep everything organized.
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  #27  
Old 01-12-2007
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Giulietta is just really nice Giulietta is just really nice Giulietta is just really nice Giulietta is just really nice Giulietta is just really nice
Thnak you T. I will get one for sure. If they were red, or white that would be perfect.
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  #28  
Old 01-12-2007
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G- Not sure on the color options. Various mfgs make similar models that may fit your needs better.
http://www.cabelas.com/cabelas/en/te...036&hasJS=true

http://www.tacklewarehouse.com/descpage-SHBTBJ.html

Last edited by T34C; 01-12-2007 at 12:10 PM.
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  #29  
Old 01-12-2007
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T34,

I dissagree, but that is fine. Even 5 miles can be wayyy out. 1 mile can be wayyy out.

Using the 20 miles, you are not 3 20 minutes to help, period. Now, let's really make this unrealistic and pretend you are a 30 year ER phsician that teaches at Harvard medical. You are the most prepared and equipped boat on the planet to handle an emergency.

The accident happens. A brief moment of panic sets in. You were motoring at the time and not sailing so all you have to do is kill the engine. You have to get the person to lay down, find out all of what is wrong. You know exactly what is in your medical kit (and where it is... not buried under a thousand pounds of other gear) and are prepared to handle anything. You pull it out, quickly sort through what you need, and prepare to stabilize. You stabilize. You call the coast guard and authorities to alert them to your situation. You put the patient on the cockpit floor, start the motor and motor back to port as quickly as possible. Only now does your 3 hour 20 minute clock start. You have absolutely no waves, no traffic, and no Sea Rays between you and the dock on this perfectly calm day, sun shinning, visibility 1000 nm. You pull straight into the marina on the slip you have had for 20 years and the medical staff is sitting there ready to grab your lines. They grab your patient and in one fell swoop throw them into the ambulance. Job done.

You think that is 3 hours and 20 minutes? Foogetaboutit.

Here is reality: You are not the 30 year physician. You were likely sailing at the time (as we are sailors). You have to drop your sails, etc before you can realistaically render any real aid. Your First aid bag is buried under crap (we keep the majors available immediately but our bag is stashed in a closet). You don't know what you are doing or exactly which stuff you need - so you are uncertain about everything and are probably referring to the book you read a thousand times but suddenly cannot remember due to panic. Your time just to stabilize is significant. The call is made to the USCG. THat is assuming everyone else on 16 shuts up (which never happens) when you pan-pan. The seas were probably not perfect, or the sun probably was not shining, or the visibility probably was not perfect. These are not your cruising grounds and you probably were not raised there. You won't know the marina you are going into, much less the slip, and there will be a million people in your way between here and there. THis is also assuming you do not have to render ANY more aid to the patient. And let's not forget the most important thing: this person is probably a loved one or at the very least a very close acquintance as we do not sail with strangers... we are not commercial ships. You really think everything is going to go smooth on a loved one?

That is the missconception I am talking about. You are not 3 1/3 hours from aid (which is still a long time, incidentally). Ever called an ambulance? 5 minutes can seem like an eternity. Now consider the above example... and think about how you are going to have to handle it.

I totally concede that you can over-do it. You are not an ambulance and cannot logically equip as one. You are not a physician and cannot render aid like one. But you better start thinking that you have to stabilizde this person (Assuming there was only one) long term and care for yourself long term or even 20 miles out you are in the middle of the Pacific.
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  #30  
Old 01-12-2007
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CD- Some excellent points. You are assuming a few things that might very well be true, but may not. Namely that there are only 2 on the boat and one is hurt, or there are several on the boat and all are hurt but you. (absolutly possible, but may not be) Yes, on top of the 3.5 hrs you have to travel to port, is any treatment time. However in most cases the best aid you can give is to start eating into that 3.5 hrs as fast as you can. (The 3.5 assumes top speed of 6 which may or may not be the case.) FYI, I'm not going to take the time to pull into my slip and make all secure before off-loading the injured person. More likely will be going straight to gas dock or first empty space I see at hull speed. In a true emergency I may be headed to the beach.

You're right about the 5 min feeling like 5 hours. I have been there both with family members and strangers. Not pleasant anytime.

Please remember all of my ideas are based on the short cruise premis near shore or inland. Offshore, all bets are off.

Last edited by T34C; 01-12-2007 at 12:39 PM.
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