before you go any further with this page I am NOT
a doctor and if any doctor reads the following and thinks I am wrong or have
given bad advice please
email me Please click on the link to email me
Please click on the link to email meand tell me how to change the item
Having lived in Spain for a while I have found that virtually all medications are available from pharmacists without prescription
IT IS NOT A SUBSTITUTE FOR FINDING PROPER MEDICAL ASSISTANCE BUT IF YOU ARE DAYS OR WEEKS AWAY FROM A LANDFALL THE FOLLOWING MAY BE HELPFUL.
The most useful reference book I have found is the Ship's Captain's Medical Guide Written for laymen in simple - sensible language. It is the book carried by most UK flagged merchant ships and if you do have a problem then it may well be possible to discuss this by radio with a British ship's doctor referring to specific pages and diagrams etc.
It is not cheap at around £30 but really worth while and should last for years/ever. How to administer drugs, sew up wounds, get out fish hooks and stacks of diagnostic help. Ship's Captain's Medical Guide link will get you to the MCA Coastguard web site and the medical page. In the web site you can find all the contents of the book and use it as a method of diagnosis.
KEEPING AWAKE AT NIGHT
To help you keep awake during long lonely night watches there is a non prescription drug PROVIGIL which will help keep you alert and vigilant. It is non addictive so is pretty safe to use.
What is PROVIGIL?
PROVIGIL is a unique
wake-promoting agent that is indicated to improve wakefulness in patients with
excessive sleepiness (ES) associated with narcolepsy, obstructive sleep apnea/hypopnea
syndrome (OSAHS), or shift work sleep disorder (SWSD).6
The most serious problem, frequently encountered, are impact injuries caused by falling or getting hit by something - booms - winch handles - I have had it on my boat and met other boats that have encountered the same injury. Frequently to the head. If you have big, deep, open wounds that need fastening together you need:-
1)A good supply of surgical gloves - infection is dangerous and keeping wounds clean and sterile vital
2) A quantity of butterfly closure or Steri-Strip skin closures - in small, medium & large (really easy to use)
3) A quantity of suture needles
4) A quantity of sterile packed sutures
5) A quantity of LIDOCAINE HYDROCHLORIDE aesthetic for subcutaneous injection. PRESCRIPTION ONLY.
6) Quantity of throw away hypodermic syringes with needles attached
7) Spencer Wells forceps with serrated teeth (to hold needle and sew with)
8) Toothed dissecting forceps (for helping with sewing)
9) pack of throwaway sterile scissors to cut sutures.
10) couple of cheap throwaway scalpels
11) Bactroban - MUPIROCIN - prescription ointment to put on sutured wounds
12) Big bottle Dettol or similar to wash hands and try to keep things sterile
13) Pack(s) of Sterile gauze swabs to clean wound area
14)Pack(s) of self adhesive surgical wound dressings
15) Roll(s) of impermeable plastic surgical adhesive tape
16) Small, Medium and large sterile wound dressings.
17) Large triangular bandage
18) Assorted bandages in clean packs.
19) 1 inflatable splint for arm (I do not bother with leg because if I broke that I would not be moving or changing sail)
20) Finger splint - plastic
21) anti Malaria tablets - I carried them on board before entering possible malaria areas - it's important to do one's best to avoid getting bitten in the first place - I have known a lot of crew in yachts contract dengue fever.
22) From Army surplus stores - British Army field dressings - when the boat is bouncing around and someone has a wound - they are designed for that sort of situation.
Pain killers - Drugs etc
22) Aspirin, Paracetamol, Dihydrocodeine -
Prescription, top pain killer, is diamorphine but is a class A drug and could present problems. You could consider Oramorph which, despite being morphine sulphate, is not actually treated as a Controlled Drug in the UK - and has the benefit of not needing to be injected.
23) Oil of Cloves -tooth ache -
24) I also carry a proprietary little dental kit with mirror, spatula and cavity filling paste
25) Amoxicillin - Doxcycl hyc - Metronidazole - all prescription penicillin for tooth ulcers - talk to your dentist...for prescription. (I suffer from this when stressed or over tired so I carry the cure) * see section Tooth problems below.
26) A quantity of AMOXICILLIN which is a broad spectrum anti-biotic - Prescription only - talk to your Doctor.
27) Stugeron - anti sea sickness tablets - for crew.
28) Imodium - diarrhea treatment
29) Ceralyte or Dioralyte to prevent or correct dehydration caused by diarrhea or sea sickness
30) Senokot A laxative
31) Eye wash glass
33) Some large waterproof adhesive stick on plasters as used in hospitals. e.g. 3" X 3"
34) The normal bunch of waterproof sticking plasters - and rolls of waterproof tape - very useful for plasters and wound dressings
35) Skin healing cream like SAVLON
36) Sunburn cooling cream - Alovera - any proprietary sun burn cream - very useful....
37) Burn cream
39) I purchased a home blood pressure kit.... £25.50 I have never used it - It comes with 10 language instruction, built in stethoscope and gauge - could be useful..........
40) A lot of American boats carry a portable defibrillator designed for amateur use with on screen instructions etc - cost US$2199 if you cannot find one in the UK have a look at the West Marine catalogue - I do not have one on board.
Most of my first aid kit is designed to keep me sailing to the next port even its several days away - With the aid of the Ship Captain's Medical Book you stand a chance of keeping going - I think impact injuries are the most challenging - lots of blood, flaps of skin hanging around and bits of bone sited though the gore. These do need to be dealt with and as they will probably occur when its windy and lumpy. Big wound dressings (Army surplus?)are necessary until it all quietens down and you can start sewing. Keeping it all clean is a real problem and the antibiotics will help I guess. The next most difficult is infections that can make you very very ill - unable to operate your boat and I suspect antibiotics are the solution to this - but do try to get informed opinions about the drugs I have mentioned or suggested. Things move fast and change in the medical world.
Really Serious Tooth Problems With thanks to Sophy for her advice and input
My kit was put together with the aid and advice of a Doctor friend who had been a Cruise Liner ships doc caring for several thousand people in one big floating hotel with a high percentage of retired and unfit people... Things like a tooth ulcers have always plagued me when tired or stressed so I got my dentist to prescribe extra for me to take with me.. Remember once you are out of UK - French waters many pharmacists will sell you drugs provided you know what to ask for and normally far cheaper than at home.
I recommend you buy the book - consider your health circumstances and then make a list - the Street behind Selfridges in London has several medical supply shops that sell everything I have listed above. When you are buying medical supplies from a medical supply source it appears to be a lot cheaper than going to Boots for example. I ended up with a small holdall full of gear - can't remember how much it all cost but at a guess around £100 - £150 plus the cost of the prescription drugs.
I have never regretted the money I spent on my extensive first aid kit - I have used most items from it at some time. The only thing to remember is that the hard part is diagnosis - it is very difficult and best left to experts - Doctors - but if you must then remember that the SSB nets will nearly always have a doctor amongst the contributors and someone will have a sat phone to talk to a hospital to get you advice. Whilst I believe we go out cruising at our own risk and cannot require people to rescue us there is no harm in asking for help and if it is forthcoming accepting it. That is one of the great joys of the cruising community.
I have had some feed back from Medical people/Doctors on this page and their unedited notes are as follows
On a sailing forum the following was posted:- Do you not carry a cephalosporin drug (3rd generation) and the catch all for the moment Ciprofloxicin, both in 250mg and 500mg strengths? Might you include Conn Current Therapy International Edition, which is updated every 2 years and a concern for carrying drugs for people who are allergic to penicillin. I think these items and all my drug suggestions should be discussed with a medical doctor - your GP if he has time - You will need a prescription anyway if you buy in the UK - on the internet (but be careful!) and Spain I know they are all available off the shelf without prescription. Another route for info is to use a yachting forum like the ones at http://www.yachtingmonthly.co.uk/ym/home
From another Doctor on the sailing forum came:- your list states lidocaine for subcut AND intravenous use. intravenous use is dangerous. as as anesthetic this drug should be given sub-cutaneously - always draw back before injecting to make sure you are not in a blood vessel. Some preparations are mixed with adrenaline .this reduces bleeding and is very useful but must not be injected into an area with a limited bloods supply such as a finger because it may cause arterial spasm and dangerously reduce the blood supply to the finger. May I also suggest this lidocaine gel may be useful as a topical application. Also remember that when you inject you may occasionally produce an allergic reaction so give slowly. it might be worth having an injectible antihistamine such as piriton on board remember the article on killer bees in the Caribbean.
I would also suggest antibiotic eye-drops such as chloramphenicol, rehydration powders such as diaoralyte.last year at the Southampton Boat Show. A saline spray for irrigation [eyes wounds was demonstrated and seemed a good idea]. Many of us cruisers are getting older and perhaps a urinary catheter might be a good idea if going far heaven forbid urinary retention in mid Atlantic]. As regards dressings, sanitary towels /nappies are very useful- very absorbent and cheap also readily available. Many dressings kits are very expensive for what they are. you can easily tear up a shirt if you really need triangular bandages. Steristrips essential- I remember trying to suture my own gashed leg whilst single handing in Biscay. Finally prevention is the name of the game. plan ahead regarding immunizations. carry the appropriate malaria prophylaxis for your area don't rely on chloroquine. In the tropics you will possible come across infections outside my experience but probably worth having an antehelminthic for treating worms /larvea such as vermox
Jan & Kate:
one of the best ‘layman’s dressings’ for the
beginner is the British army’s ‘first field dressing’.
Available from army surplus stores, this is a waterproof sealed package,
about the size of a fat squidgy pack of cards…The
wrapping opens to reveal a sterile gauze dressing, a number of economy sized
safety pins, and is itself designed to be used as a means of fixing the dressing
in position, with 2 long straps that unroll.
is designed to be ripped open, stuffed on a deep, messy, bleeding wound, and
bound in place with the straps. In
extremis, the waterproof wrapping will also seal a sucking chest wound (eg
one in which a collapsing lung is venting to the air, so that when you try to
breathe in, you suck air into the useless lung through the wound).
Excellent piece of kit, well worth carrying for all
those puncture/pierce/abrasion wounds.
Best used with a sprinkle of antibiotic powder if there’s time.