Medical Page

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There is an excellent web site - mail order' from where you can order all diagnostic equipment, bandages and everything else except drugs at  http://www.spservices.co.uk All at professional prices - almost wholesale.

Really Serious Tooth Problems  With thanks to Sophy for her advice and input 'teeth abscesses' These are either lateral periodontal abscesses, or periapical abscesses. Lateral perio. abscess:  It is an infection up the side of the tooth, with the microbes invading from the mouth up the side of the root. Diagnosis:   Pain described as throbbing, sore, can be associated with bad taste in mouth. Pain tends to be around the side of the tooth.  Can be around a couple of teeth next to each other.  Comes and goes over weeks and months.  Can appear when you are immunosuppressed and run-down. Treatment:  Local:  Scaling around teeth, regular hygiene treatment with hygienist, Corsodyl(0.2% chlorhexidine gluconate mouthwash daily),  in severe cases antibiotics, usually combined broad spectrum penicillin based and an antibiotic suitable from anaerobic bacteria such as metronidazole. Periapical abscess:   Is an infection of the inside of the tooth, the pulp chamber, usually caused by decay in the tooth, which spreads microbes down the nerve channel in the tooth and causes pain and infection around the end of the root in the jaw. Diagnosis:   throbbing, pain with heat and hot drinks etc. , pain with biting, sometimes facial swelling next to infected tooth. Patient can feel very unwell, and get raised temperature. Treatment : drain abscess surgically if possible, extract tooth, or as a temporary measure, antibiotics to control the infection until the former two treatments may be carried out. (tooth can sometimes be kept by having the nerve channel disinfected and filled up: called root canal treatment)

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

From 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.

It 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.

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