1st Aid at Sea & Important Like Items to Carry - Page 4 - SailNet Community

   Search Sailnet:

 forums  store  


Quick Menu
Forums           
Articles          
Galleries        
Boat Reviews  
Classifieds     
Search SailNet 
Boat Search (new)

Shop the
SailNet Store
Anchor Locker
Boatbuilding & Repair
Charts
Clothing
Electrical
Electronics
Engine
Hatches and Portlights
Interior And Galley
Maintenance
Marine Electronics
Navigation
Other Items
Plumbing and Pumps
Rigging
Safety
Sailing Hardware
Trailer & Watersports
Clearance Items

Advertise Here






Go Back   SailNet Community > General Interest > General Discussion (sailing related)
 Not a Member? 


Like Tree12Likes
Reply
 
LinkBack Thread Tools
  #31  
Old 11-06-2012
biology's Avatar
Member
 
Join Date: Oct 2012
Location: NC
Posts: 44
Thanks: 0
Thanked 0 Times in 0 Posts
Rep Power: 0
biology is on a distinguished road
Re: 1st Aid at Sea & Important Like Items to Carry

I'd go with a SAM splint (the longest one that comes rolled up). Pretty cheap ($10-15), easy to use, compact, and lots and lots of splinting uses.

Dunno about the BVM (ambu bag). That's a bulky (and more expensive $20) item that could be remedied with a simple pocket mask ($5). Plus the person would have to be trained for how and when to use a BVM. The pocket mask is easier to use and works fine. Current AHA guidelines support ventilationless chest compressions ("compression-only CPR") with evidence of high efficacy anyway for out-of-hospital cardiac arrest management. Isolated respiratory arrest without cardiac compromise is rare and most likely exacerbation of a pre-existing medical condition such as asthma or COPD. In that case, it takes us back to crew-specific Rx meds and a face mask.
Reply With Quote Quick reply to this message Share with Facebook
  #32  
Old 11-06-2012
hellosailor's Avatar
Senior Member
 
Join Date: Apr 2006
Posts: 10,802
Thanks: 2
Thanked 97 Times in 94 Posts
Rep Power: 10
hellosailor has a spectacular aura about hellosailor has a spectacular aura about
Re: 1st Aid at Sea & Important Like Items to Carry

smurph, I'd only argue that what you are calling a first aid kit, is what I learned is best NOT called a first aid kit. The first aid kit is a little thing in opne reach that dals with booboos.

The BIG kit that has the splints and bandage compresses and all the "damn I'm gonna faint" stuff in it? That's a "trauma kit". Honest, you'll find a lot more of the more appropriate stuff if you look for them under that name.

First aid kit? $9.99 at WallyWorld, 510 pieces including 110 bandaids, four by three packets of pain relievers, coupla sting-kills...that's what you get all the hits on.
Reply With Quote Quick reply to this message Share with Facebook
  #33  
Old 11-06-2012
msmith10's Avatar
Junior member, rest old
 
Join Date: Feb 2009
Location: Columbus Ohio
Posts: 492
Thanks: 3
Thanked 0 Times in 0 Posts
Rep Power: 6
msmith10 is on a distinguished road
Re: 1st Aid at Sea & Important Like Items to Carry

Quote:
Originally Posted by biology View Post
Isolated respiratory arrest without cardiac compromise is rare and most likely exacerbation of a pre-existing medical condition such as asthma or COPD.
While you're correct in general, in a boating environment drowning or near drowning will account for a higher incidence of primary respiratory arrest than the usual environment. It's also not true in a younger population. Anybody in a boating environment should be capable of practicing CPR with ventilations. The move toward "mouth off" CPR is not appropriate in a marine environment.
I agree, though, that a pocket mask is the way to go. I actually have an ambu bag and intubation equipment and am quite proficient at using them. I don't carry them on my boat.
__________________
Mark Smith
1977 C&C 30 Mk 1 hailing from Port Clinton, Ohio

Last edited by msmith10; 11-06-2012 at 04:35 PM.
Reply With Quote Quick reply to this message Share with Facebook
  #34  
Old 11-06-2012
tdw's Avatar
tdw tdw is offline
Super Fuzzy Moderator
 
Join Date: Oct 2006
Location: Sydney Australia
Posts: 14,754
Thanks: 5
Thanked 76 Times in 70 Posts
Rep Power: 10
tdw is a jewel in the rough tdw is a jewel in the rough tdw is a jewel in the rough
Re: 1st Aid at Sea & Important Like Items to Carry

Smith, you are probably correct that drowning or near drowning are major or the major concerns on board overall but out cruising away from immediate medical care burns, sprains/fractures and stomach/intestinal upset are probably more of an issue.

My partner , the Wombet, pulled a pot of boiling water over herself a couple of years back when we happened to be anchored within fifty miles of major settlement yet had no VHF or Mobile Phone reception. The adequacy of our first aid kit and a modicum of knowledge meant that we could treat the problem where we were and had no need to go into panic mode. Had we been five miles distant from where we were and had the problem been worse, then we could have called in a rescue helicopter or boat but had we been far from land that would not have been an option.

I don't have any statistics to back this up but I'd guess that drowning is a fairly minor concern to off shore cruisers.
__________________
Andrew B

"Do you think God gets stoned? I think so... Look at the platypus." Robin Williams.
Reply With Quote Quick reply to this message Share with Facebook
  #35  
Old 11-06-2012
msmith10's Avatar
Junior member, rest old
 
Join Date: Feb 2009
Location: Columbus Ohio
Posts: 492
Thanks: 3
Thanked 0 Times in 0 Posts
Rep Power: 6
msmith10 is on a distinguished road
Re: 1st Aid at Sea & Important Like Items to Carry

Quote:
Originally Posted by tdw View Post
Smith, you are probably correct that drowning or near drowning are major or the major concerns on board overall but out cruising away from immediate medical care burns, sprains/fractures and stomach/intestinal upset are probably more of an issue.
Of course you're right, and my post was essentially didactic. We've strayed a long way from the OP, which was a shotgun full of "I'm gonna blue water cruise, what do I need?"
I was addressing one point with which I disagreed.
I find it difficult to tell someone what they need in their "first aid kit" without knowing their capabilities and what they're going to be doing. I did, in fact, recommend a first aid kit via private message a few days ago to a man who's a pharmacist with several other qualifications, and who's going to be the medical officer on an offshore race. In that case, I know what he's capable of doing and what he may be called upon to do, and I know what he'll need to do this. In a case like that, I can make specific recommendations. In his situation, this really isn't first aid, but may become definitive treatment.
There have been a lot of subsequent posts addressing CPR, cauterizing wounds, treating shock, and a lot of suggestions that are just plain nonsense.
The best thing the OP can do is learn some first aid, decide what he's capable of handling and is likely to be treating, and prepare a kit accordingly.
tdw likes this.
__________________
Mark Smith
1977 C&C 30 Mk 1 hailing from Port Clinton, Ohio
Reply With Quote Quick reply to this message Share with Facebook
  #36  
Old 11-06-2012
biology's Avatar
Member
 
Join Date: Oct 2012
Location: NC
Posts: 44
Thanks: 0
Thanked 0 Times in 0 Posts
Rep Power: 0
biology is on a distinguished road
Re: 1st Aid at Sea & Important Like Items to Carry

@Smith; I assume you're a Paramedic, Nurse Anesthetist or Physician considering you seem to have experience intubating. The near-drowning is an interesting thing to consider. I would imagine the person went overboard and you were able to retrieve them and get them back on deck to find them in respiratory/cardiac arrest. I think the likelihood of survival would be based on a few factors: (this info is for general public and not directed at you smith since you seem to have your finger on the pulse of things)

1. water temperature. As you know (but perhaps others don't) cold water survival rates are much higher than warm water, especially in younger populations, usually due to the mammalian diving reflex that slow metabolism upon dropping into cold water. This usually means longer resuscitation times to allow for warming before determining death. Some may say, "they're not dead, until they're warm and dead." Basically year round along the coast of New England would always count as cold water, and along Florida always warm water due to consistent temperatures. Soooooo fall overboard up north?!

2. laryngeal spasms. A "dry drowning" is due to laryngeal spasms, which still causes asphyxiation by submersion (the definition of drowning); water does not enter the lung. A "wet drowning" is absent of laryngeal spasms and allows water into the trachea and thus lungs. An intubation kit with suction (a meconium aspirator works like a champ to turn your ET tube into a laryngeal suction device) come in very handy here. Usually wet drownings are associated with intoxication or head injury as normal physiological responses are hindered (assuming you got them back aboard quickly).

3. Age. The younger you are the more likely you'll survive a near-drowning. Kids tolerate transient hypoxia a bit better (especially in cold water, as mentioned above).

4. salt vs fresh. This is usually only important is the person is revived after a wet-drowning. In fresh water the surfactant is washed away and causes the alveoli to collapse (atelectasis). When you ventilate with positive pressure you're actually forcing more fluid into the capillaries causing hemodilution (decreasing the concentration of your red blood cells is the key factor here). With salt water, if the person is revived, salt stays in the alveoli and (due to osmotic pressure) draws fluid out of the capillaries back into the alveoli. So a person can wind up with pulmonary edema hours after they've been revived and still have serious respiratory compromise.

5. distance to rescue. Can't do CPR or ventilate forever. Gotta get to definitive care: hospital.

Side note: usually "drowning" is considered death by asphyxiation within 24 hours of submersion, and "near drowning" is death by asphyxiation after 24 hours of submersion. So if you fell in the water and were revived and lived... it wasn't actually a "near drowning" (it would only be called that if you died the next day!).
Reply With Quote Quick reply to this message Share with Facebook
  #37  
Old 11-06-2012
smurphny's Avatar
Over Hill Sailing Club
 
Join Date: Feb 2009
Location: Adirondacks NY
Posts: 2,862
Thanks: 55
Thanked 64 Times in 62 Posts
Rep Power: 6
smurphny is on a distinguished road
Re: 1st Aid at Sea & Important Like Items to Carry

Quote:
Originally Posted by biology View Post
I'd go with a SAM splint (the longest one that comes rolled up). Pretty cheap ($10-15), easy to use, compact, and lots and lots of splinting uses.

Dunno about the BVM (ambu bag). That's a bulky (and more expensive $20) item that could be remedied with a simple pocket mask ($5). Plus the person would have to be trained for how and when to use a BVM. The pocket mask is easier to use and works fine. Current AHA guidelines support ventilationless chest compressions ("compression-only CPR") with evidence of high efficacy anyway for out-of-hospital cardiac arrest management. Isolated respiratory arrest without cardiac compromise is rare and most likely exacerbation of a pre-existing medical condition such as asthma or COPD. In that case, it takes us back to crew-specific Rx meds and a face mask.
Yes, the pocket masks are what I have. The only reason I'd maybe choose something bigger like a bag is the yuk factor. Having been on a number of situations away from immediate help, continuing CPR for any length of time can be a messy proposition. Training is definitely needed to use an airway but they can mean the difference... I've been out of FA for a long time and am sure there are lots of things I'm not up to date on. In the 12 years I spent as a full time first-aider, I learned the common sense is the main thing needed in any FA kit. Unfortunately you can't put that in a sterile wrapper.

The ladder splint I mentioned sounds like the SAM splint. It's just a rolled-up flexible wire splint, about 4" wide and maybe 4' long when unrolled.

Sailing is not a particularly safe thing to do. There are ample opportunities for cuts, lacerations, head injuries, compound fractures, etc. A good FA kit, not just the WalMart variety of band-aids Hellosailor referred to, really should be a priority.
__________________
Alberg 35: With a philosophical flourish Cato throws himself upon his sword; I quietly take to the ship.

Last edited by smurphny; 11-06-2012 at 06:14 PM.
Reply With Quote Quick reply to this message Share with Facebook
  #38  
Old 11-06-2012
msmith10's Avatar
Junior member, rest old
 
Join Date: Feb 2009
Location: Columbus Ohio
Posts: 492
Thanks: 3
Thanked 0 Times in 0 Posts
Rep Power: 6
msmith10 is on a distinguished road
Re: 1st Aid at Sea & Important Like Items to Carry

Biology,
Yeah, I'm a residency trained and board certified Emergency Physician for 28 years in a very busy urban ER and level 1 trauma center with between 130-140,000 patients I've personally cared for in my career. I've intubated and resuscitated a few people. I won't hold myself out as an expert on law or even sailing, but I will hold my ground on emergency medical care.
Your analysis of drowning is correct, from a physiologic standpoint. Dry or wet, salt water or fresh doesn't make much difference in resuscitation, you've got to get them breathing, get their heart started, and get their tissues perfused, and once they're stabilized, then you start putting out fires.


Smurpny,
You're right about common sense, but isn't that a rare commodity- it's really the application of knowledge and experience, eh?

tdw,
You're absolutely right. Very few will ever have to resuscitate a person. But we'll all be called upon to treat a burn, a cut, seasickness, even as a coastal cruiser or day sailor, and that's what people should read up on and prepare for. I had a similar episode as yours in the BVIs when my wife sustained a nasty 2nd degree "lap" burn from spilled hot water. Knowing how to handle it turned a painful and potentially trip-ending injury into an inconvenient but tolerable nuisance. Being able to help seasick crew allowed me to finish more than one race that I otherwise would have had to scrub. I even stitched a cut to my chin using a mirror in my cabin one time so I wouldn't have to cut my sail short.
__________________
Mark Smith
1977 C&C 30 Mk 1 hailing from Port Clinton, Ohio

Last edited by msmith10; 11-06-2012 at 07:16 PM.
Reply With Quote Quick reply to this message Share with Facebook
  #39  
Old 11-06-2012
biology's Avatar
Member
 
Join Date: Oct 2012
Location: NC
Posts: 44
Thanks: 0
Thanked 0 Times in 0 Posts
Rep Power: 0
biology is on a distinguished road
Re: 1st Aid at Sea & Important Like Items to Carry

Quote:
Originally Posted by msmith10 View Post
I even stitched a cut to my chin using a mirror in my cabin one time so I wouldn't have to cut my sail short.
FRANKENSAILOR!! that would've been fun to watch... self-suturing on a (I'm assuming) rocking boat. I can only imagine you've used that since with apprehensive patients in the ED, "Don't be a baby, I had to suture my own face on a moving sailboat before. You've got it easy here..."
msmith10 likes this.
Reply With Quote Quick reply to this message Share with Facebook
  #40  
Old 11-06-2012
msmith10's Avatar
Junior member, rest old
 
Join Date: Feb 2009
Location: Columbus Ohio
Posts: 492
Thanks: 3
Thanked 0 Times in 0 Posts
Rep Power: 6
msmith10 is on a distinguished road
Re: 1st Aid at Sea & Important Like Items to Carry

Suturing myself in a mirror was kind of like that Ginger Rogers quote - backwards in heels. Upside down and backwards. I'm not brave, though; I had local anesthetic on board.
What I like best about knowing medicine is that it feeds into a strong drive I have for self-sufficiency. I think most sailors have this same goal- we like to be able to handle situations on our own, without outside help. Knowing medicine allows me to spend my time learning the stuff I don't know as well. It's also, of course, a desired skill that I can offer among a crew that are better sailors, or navigators, etc- it gives me a niche.
__________________
Mark Smith
1977 C&C 30 Mk 1 hailing from Port Clinton, Ohio
Reply With Quote Quick reply to this message Share with Facebook
Reply

Quick Reply
Message:
Options

By choosing to post the reply above you agree to the rules you agreed to when joining Sailnet.
Click Here to view those rules.

Register Now

In order to be able to post messages on the SailNet Community forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
Please note: After entering 3 characters a list of Usernames already in use will appear and the list will disappear once a valid Username is entered.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.




Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools

 
Posting Rules
You may post new threads
You may post replies
You may post attachments
You may edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is On


Similar Threads
Thread Thread Starter Forum Replies Last Post
carry-on A.C. QuickMick Gear & Maintenance 0 04-26-2010 02:01 PM
I'm looking for several items apple45jacks General Discussion (sailing related) 2 02-26-2009 08:21 PM
Carry-on AC maboyer Living Aboard 7 11-15-2007 11:08 AM


All times are GMT -4. The time now is 04:55 AM.

Add to My Yahoo!         
Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2014, vBulletin Solutions, Inc.
SEO by vBSEO 3.6.1
(c) Marine.com LLC 2000-2012

The SailNet.com store is owned and operated by a company independent of the SailNet.com forum. You are now leaving the SailNet forum. Click OK to continue or Cancel to return to the SailNet forum.