*Survival at Sea Part 1*
By: Savoy6
30 July 2007

This short article was written to provide some tips and insight into how to prepare for the healthcare needs of a small group of folks during a 1 to 2 week offshore ocean trip that involves very limited access to outside medical resources.

We've packed our aid bag for the type of situations that we might anticipate the most obvious being.. aches and pains, scrapes and minor lacerations, possible nasal/dental trauma (the boom or falls), sea sickness and skin irritations, just to name a few. I've included some common broad spectrum antibiotics to cover a possible wide range of GI/GU or upper respiratory problems. I've also included some narcotic pain meds should the worst situation befall one of the crew.

For our offshore aid bad, we had considered including advanced airway equipment and ALS situations, but decided that the likelihood of needing ET intubation or advanced life support interventions and the extremely limited likelihood of survival, so far from advanced resources (coast guard). it was not worth the weight and space. If you are as far away from help as we think we will be, and are so sick or injured that this aid bag can't help you...you are a dead man. It's that simple. We all know that.

In packing this bag, I had to prepare for the possible needs of 7 men, myself included, for an offshore sailing trip lasting approximately 2 weeks (women, of course, add another dimension that should be considered for an additional article). Also, two of the crew are older guys (56+) and attention should be paid to the special needs of an older crew, as I have tried to do.

Let's not forget the key point in any medical preparation; be responsible for yourself, first and foremost. If you require medication or special medical needs, prepare accordingly, pack your own small kit. Let your compatriots and medical personnel know, but do not count on others. Here is a look at an offshore aidbag.

This type of aid bag should be comprehensive but does not necessarily need the weight and size considerations that a tactical aid bag like Witchdoc6s' does.

The primary pack I use is a recycled EMS jump bag. It's large enough to hold the amount of supplies I'll need and it is bright orange so no one can miss it. The down side to this particular bag is a lack of divided pocket space. I overcame this by packing group supplies in large heavy duty Ziploc bags, both for convenience and moisture reduction. Two large side pockets and the inner cover flap attachments are the only intrinsic equipment supply dividers. I separated all PO, PR, IV, topical medications and syringes into a separate smaller back-backers aid bag and keep my supply of IV antibiotics with the IV fluid bags. (The actual packing numbers are what I've put in the bag, the following photos are only a representation of what the supplies and equipment actually were.) I also had the crew include a personal info-medic alert sheet.

In the main body of the bag;

  • Each side pocket contains; a bag of IV fluids, one Lactated Ringers and one Normal Saline. Each with an attached IV starter kit, 3 angio caths, sizes 18, 20 and 22 gauge, and IV Tubing.

  • 1 Quick-Cath Foley kit with attached Viscous Lidocaine lubrication. We'll be a long way from shore and if you can't urinate, you are in trouble. (for the old guys mostly, but you never know..)

  • 1 Sterile suture removal kit
  • 1 Sterile suture kit with attached suture material.

    In separate Ziploc bags;

    Dental/ Nasal Kit:

  • 2 Nasal packing tampons
  • 1 Neosynephrine (vasoconstrictor)
  • Dent Temp Filling material
  • Oral Mirror

    Dressing/ splinting Material:

  • 2 large Kerlix gauze wraps
  • 1 box sterile 4x4s
  • 2 sterile 4x8s
  • 8 sterile 2x2s
  • 2 large Abd pads
  • 4 2" kerlix
  • 1 lrg box of band aids (reduced into a Ziploc)
  • 4 small xeroform gauze dressings
  • 4 medium xeroform gauze dressings
  • 1 packet ea of Casting Tape 4" and 5" (quick cast)
  • 1 cotton gauze under wrap (for a 'Jones wrap')
  • 2 ace wraps 4"
  • 2 ace wraps 6"
  • 1 arm sling
  • 1 triangular dsg
  • 1 2 ft length of aluminum finger splint

    Airway kit:

  • 2 nasal trumpets sz 7.0 and 6.0
  • 3 oral airways sz 10, 9 and 8cm
  • 1 bite stick
  • 1 16g angio cath
  • 1 CPR Oral facial shield

    Med Bag (in no particular order):

  • 4 surgicell absorbable hemostat dressings
  • 1pair Trauma shears
  • 1 sm bottle Provodone Iodine
  • 4 packets of surgilube
  • 1 Epinepherine auto injector
  • 3 dermabond pens
  • 1 Foley catheter with 5 cc balloon
  • 1 sheet of 'foot felt'
  • 1 penlight
  • 1 Ziploc containing; 2 22g needles, 2 18g needles, 2 25g needle w/ 3cc syringe, 2 22g needle w/ 3cc syringe.
  • 3 disposable scalpels, #15, #11 and #10
  • 1 5cc btl of 1% lidocaine
  • 1 btl of 0.25% Bupivicaine (long lasting)
  • 25 tabs of Zofran 4mg
  • 1 tweezers
  • 1 small scissors

    Actual Meds (based on a single adult):

  • 1 weeks supply of PO levofloxacin
  • 1 weeks supply of PO azithromycin
  • 1 Albuteral inhaler
  • 1 btl of Maalox-Benadryl-Lidocaine
  • 20 tabs Ibuprophen 600 mg
  • 20 tabs Diphenhydramine 25mg
  • 10 tabs Famaotadine 20 mg
  • 10 tabs Omeprazole 20 mg

    Anti emetics;

  • 20 tabs of Zofran PO
  • 20 tabs of compazine PO
  • 20 tabs of phenergan PO
  • 8 tabs of dramamine PO
  • 8 tabs of meclazine PO
  • 4 compazine suppositories
  • 4 phenergan suppositories
  • 2 4mg Zofran IV
  • 2 10 mg Compazine IV/IM
  • 2 30 mg Toradol IV/IM

    Creams/Ointments;

  • Desitin (saltwater, wet clothes and human skin. desitin!)
  • Neosporin
  • Cortisone

    Gloves and miscellanea:

  • 2 pair sterile gloves
  • 2 pair non sterile gloves on a Film container
  • 4 Benzoin swap packets
  • 2 self contained scrub brushes
  • 1 EMS Field Guide, ALS version
  • 1 Petz headlamp with red and blue filters.
  • 2 rolls of Med tape
  • 2 large sheets of Tegaderm dsg
  • 3 dermabond pens
  • 4 aluminum/ poly pro emergency blankets
  • 1 sheet of 'foot felt'
  • 1 flask of Goslings Rum. 8 oz.

    Don't laugh or blow this off. Think of it like this. when your finger just got snipped off, or your ankle was just broken and is lying at a 45 degree angle. booze... It works mostly for psychological reasons anyway...and Black Rum is the best.

    Fair Winds.

    Stay tuned for the next edition of Safety at Sea.
    Savoy6



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