Emergency room afloat: Coastal first-aid kit

Gino Bottino, MD

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In the Summer 2019 issue, I discussed creating a first-aid day kit. When considering what to include in a medical kit, the most important consideration is how long it will take for professional help to arrive.

Let’s add two other considerations for creating a medical kit: developing an emergency medical plan and designating a medical officer and response team.

Develop a plan

Write down your plan in a medical log and review it with the crew. Include the location of emergency equipment and a maintenance schedule for equipment and medications. Include crew members’ medical histories and medications in the medical log. Perform medical drills, just like crew overboard drills, annually and before a big cruise. Record crew and medical officer training and drills in the log. A medical log’s primary purpose is to record all medical incidents and the equipment and medications used.

Designate a team

A response team should include a medical officer and at least one other crew member with up-to-date advanced first-aid and CPR training. If it’s just two of you, you both need training and should share the responsibilities.

The medical officer should organize and restock the medical kits and keep the log. Keeping track of all medications is essential. If a true medical emergency occurs, the medical officer and response team are the first responders. You need a kit and supplies equipped to deal with these situations.

Putting together a kit

A coastal cruise could take place over a long weekend or during a year spent cruising the Great Loop. In either case, medical help could be from a few hours to half a day away. When creating a coastal cruising medical kit, start with a deck kit as covered in the first-aid day kit and then customize as needed.

Your kit should include supplies for common medical emergencies:

Heart attackBleedingBack pain
Joint sprains and strainsDifficulty breathingLacerations
StrokeHead and neck injuriesSevere allergic reactions
FracturesChest painAcute abdominal pain
FaintingShockFalls
DislocationsSeizures
Diabetic crisisBurns

To make items easier to locate in an emergency, organize your medical kit in sections by type of emergency. Although you may end up duplicating some supplies, it’s worth it in an emergency.
As mentioned in an earlier article (Spring 2019 The Ensign), you should carry at least two medical handbooks in your shipboard library, a comprehensive one and a picture book. In a stressful emergency, you’ll have trouble following a comprehensive book. In these situations, you’ll find the “here is the problem and here is the response” picture book more helpful.

Personalize the kit

Medical kits should be personalized. This includes items only available through your doctor. Bring the lists to your doctor to review and get scripts for items that need to be carried onboard.

To cover shock from any cause, including stroke, serious head trauma, respiratory failure, and heart attacks, you’ll need a CPR kit. In these situations, survival and a favorable outcome are dependent on immediate action. First, call for help and consider medivac removal of the victim dependent on time to rescue.

A key part of a CPR kit, automated external defibrillators are safe, easy to use, and affordable, so you’d be advised to keep one on board. AEDs should have a spare set of adult and pediatric pads. Create a CPR kit attached to your AED that includes a pocket mask, scissors, razor, gloves, and a disposable towel. Keep your kit ready for immediate use by checking the unit and supplies monthly and after each use.

To put together your own coastal first-aid kit, download this comprehensive item list to use as a starting point.

Buy a custom-curated kit

While not a fan of pre-packaged medical kits, I think personalized made-to-order medical kits are great. The services that put them together are knowledgeable and can be helpful. You can easily find these companies online. Some are geared to cruise ships and large yachts, which are often expensive. However, they also will provide 24/7 telemedical services if desired.

If you’re a DAN Boater member, you can get an affordable service with travel medical insurance. America’s Boating Club members get a discount, so check your Member Benefits page. On the same page, you’ll find first-aid kits from MyMEDIC and HeartSine.

If you need help putting together or selecting a kit, contact me or Jeff McKinney, members of America’s Boating Club First Aid Support Team.

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