In the last issue, we discussed “time to professional medical help” as the single most important variable in determining the extent of medical supplies and training needed aboard. Accordingly, we divided the theoretical “complete medical chest” into smaller kits based on boating needs. The simplest of these is the day or deck kit, where medical help is available in less than 30 minutes.
Simple and small, this kit contains commonly needed items and can serve as a minor emergency adjunct to a larger medical chest. On Raven, my 30-footer, I keep this kit accessible for the entire crew to use as needed. It gets used frequently, and I often take it on car trips and home for replenishment. To build the kit, we will use a checklist. Keep a copy with the kit and use it to replenish as needed. 
Building the day kit
Everyone’s kit will be a little different. You can use this checklist as a starting point to build a kit that suits your needs and those of your crew. Think about any special needs you or your crew members may have. Before you set sail, ask if anyone has any medical issues that may pose a problem.
Other considerations
Sun causes the most problems by far, so using sunscreen is vital. You can never have too much onboard. Offer it to the crew like water. Carry a hypoallergenic sunscreen for those with sensitive skin. Sunglasses are sunscreen for the eyes. Not only do they help reduce the incidence of cataracts and intra-ocular melanomas, sunglasses also prevent sun-exposure headaches, a more common problem than sunburn. Carry extra hats for those who forget to bring them and gloves for general protection. Eye drops and ear drops, especially if you permit swimming, will help save many a Sunday afternoon. You’ll reach for antiseptic (for cleaning and disinfecting) and analgesic (for pain relief) skin preparations often. Even if you don’t have allergies (lucky you), carry anti-allergy medications for those who are afflicted. Diphenhydramine (Benadryl) is safe and widely used. I usually carry some pseudoephedrine (Sudafed) as well. The latter can even help with seasickness. A bee sting kit or EpiPen may seem over the top, but it could easily save someone’s life. Although rare, deadly allergic reactions are one instance where every second counts, and the remedy is easy to administer. I prefer aspirin and ibuprofen (Advil) to acetaminophen (Tylenol) for pains onboard. As anti-inflammatory agents, they can relieve soreness and swelling as well as pain from minor injuries. However, you should also carry acetaminophen for those who cannot take aspirin or ibuprofen. Carry a variety of different size adhesive bandages as well as 2-inch elastic bandages, which are useful for sprains and wrapping wounds as well as prophylactically to strengthen joints. In a pinch, duct tape works great to make a second skin over a rope burn or to tape bruised or broken fingers together. If you use duct tape, wait for it to fall off with soap and water; don’t try to untape yourself. Use moleskin as a second skin covering in sensitive areas. Back pain is the number one complaint of people coming off boats after a day of fishing or sailing. Be aware of this and use preventative solutions whenever possible. This day kit isn’t meant to be all encompassing. The contents should be safe enough for anyone on board to handle, even children, though you should keep it out of their reach.
Crew-specific needs
Customize your kit by adding to each category as needed. After questioning your crew about their specific needs and medical history, inform those not familiar with sailing or fishing that the boat will be isolated and away from medical help while underway. Supplies and medications not brought on board won’t be available for some time. To meet the medical needs of your passengers and crew, especially in an emergency, you need to know their specific health problems and needs. On a day sail, help could be 30 minutes away. A diabetic may need to bring extra insulin and a testing kit. A cardiac patient may need to bring some extra meds like a nitro pill. This shouldn’t deter anyone from going out and enjoying a good sail. If you have children aboard, they always have special needs. Carry drugs appropriate for children and know the recommended dosage. When you go out on a boat, make sure you know what you’re getting into. If the boat is ill-prepared, a short day sail can turn into a life-threatening experience. Test your communication devices, leave a float plan with a loved one, and make sure you can signal for help.
Gino Bottino, M.D., has had wide experience in medical practice and emergency medical matters. A member of United States Power Squadrons First Aid Support Team (FAST) and the Safety Committee, Gino also has a background in competitive sail racing and is familiar with health-related problems afloat.
