mcleaves

I just read with interest the ditch bag thread. Great stuff. One item obviously in the bag is a first aid kit, but that in and of itself I think is an elusive package to put together. While you can appease the CG with a 10.00 kit from West Marine, the purpose it to be able to treat someone in an emergency, so in my opinion that won't do.

So what do people put in their kits? I am particularly interested in sutures and medicines. And how do you get certain prescription medicines for a kit if you were to carry them, like for tetanus or something?

M

Scup

You are scaring the hell out of me! I do not think I will ever go fishing in your boat. You sound like the guy on TV that stayed in some hotel that is now an expert in every field including doctoring. Seriously, I always thought of a first aid kit as something to tide one over until one can get to a proper medical facility. My daughter is an EMT, and I do not believe she will even start to get into sutures, prescription medicines, or shots. I think you have to balance what your known personal medical problems are and just how isolated you plan on being from getting medical help. For example, if you are a type 1 diabetic, and prone to getting seasick, then talk it over with your doctor as to what your plan of attack should be. I think one of the most important things a fisherman can carry is a dam good American made diagonal cutter. You may be a little chicken to push a hook clean through your whatever, but at least you can clip most of the hardware off so you do not have enter the ER with rebel hanging off of your forehead. If you check out the prices for marine first aid kits, your low ball estimate of $10 is not going to get you much. I never cared for the prepackaged stuff anyway as it really appears to be more of a pile of poorly assembled junk. The tweezers supplied are useless, the scissors won't cut anything and you would get a better assortment bandages at Walmart for one tenth the price. Should you wish, I could ask my daughter what she would recommend. I almost have to laugh at her when I see her getting ready to go on call, she probably has couple of hundreds of bucks tied up in gear that is dangling from her belt, bulging from her pockets, and this is nothing compare to what the ambulance has inside of it. In addition, she is trained in how to use all this stuff.

mcleaves

I think you are making way too many presumptions here. First, an EMT's perspective on land is very different than on the water. An EMT is charged with stabilizing and transporting a person to the nearest appropriate medical facility. You wouldn't need to administer most meds or close wounds in that time frame. Out on the water, and I fish 30-40 miles out sometimes, you don't have that luxury. For instance necrosis starts to set in within an hour or two when it comes to closing a wound. I was logging in Maine one time and got a good gash. I bandaged it up and finished the job and upon further examination decided I might need a few stitches. I called the doc and and said it was about 3-4 hours old. They told me not to bother that stitching won't help after that time. Just keep it clean and covered. Cuts requiring stitches needs addressing in a timely manner. So if you are three hours out you have an option of calling the CG to transport you for a couple stitches or leaving the wound open or fudging it with a butterfly bandage. We're not talking neuro-surgery here.

I almost ALWAYS travel with medically trained personnel. My brother was field trained as a medic in the Army and is rarely not on board. He's stitched up dozens of people an administered IV's etc. My mom comes out sometimes and she's a former OR nurse and has done many small procedures. I also have a Nurse Practitioner that comes out from time to time. I hope this satisfies your training concern.

I have been personally stitched up in the field on a 4 day hike. It's not a big deal and it doesn't require much more than some advanced first aid. Of course if you can GET to a hospital for treatment that should always be your first option. Offshore that's not the case.

When I was young, maybe around 9, I was on a boat about 30 miles offshore where the captain called in for medical advice on a passenger and was instructed over the phone on administering some medicine which he had in his kit, but clearly needed direction. I don't know what it was, but the captain carried it. It wasn't the passengers insulin or anything.

I know some people probably carry portable OR on their boat. I am not interested in that. I simply asked what most people carry and, specifically, I am interested in whether or not people carry meds and kits for minor wounds, like sutures. Also do people carry IV equipment for dehydration (resulting from seasickness). Being offshore I can see all these situations arising. It' hasn't happened to me yet crossing my fingers. I don't carry a $10.00 kit, I was illustrating that they are useless and if you wanted to build your own quality kit, what would be in it. I keep a lot of bandages compresses, tourniquets ice packs cleaning agents etc. I'd like to expand it to a REASONABLE kit knowing that either someone on board could administer treatment or I could be walked through something if need be.

So maybe I should rephrase my question. What do you OFFSHORE guys carry.


M

Scup

Sorry Mecleaves,

I am no longer an off-shore type. Most of my time on the water is within a mile or two from shore. However, I did spend 37 years riding gray ships for the Navy. Why are you asking form members about what is needed in an offshore first aid kit when you go out with a field trained medic, an OR nurse, and a nurse practitioner? I hope you realized that you have more accumulated medical talent aboard than a DDG has. Really, I am sorry to make light of this subject, as it does deserve serious consideration. I sort of sense that I struck a nerve and I am really not a wise ass. I just could not miss taking a free shot at you but sincerely I apologize. This form does have a great bunch of members, many of which are charter boat captains, and routinely they head out to the canyons which is far further than 30 miles offshore. I tend to stay close to shore because I mistrust my ride, I am old, and I am a chicken. However, should I ever consider going off shore alone again, my first concern would to be able request help. Cell phones that far out are useless. If you go out during the boating season likely you will be within VHF range of a friendly contact. This time of the year, I would feel better with a Single Side Band radio. Finally, while expensive, satellite phones work.
You stated something that really struck a nerve or two in jogging my memory. Seasickness, while for most part is trivial, but add a few complications and it can be fatal. We lost an officer one evening, because our medic underestimated just how seriously ill this man had become. He heaved up while lying on his back in his rack. We found him dead the following morning. The medic said that it appeared he strangled in his own vomit. I did not think that was possible. On another occasion one of my associates was a type one diabetic. He ended up getting a bad case of seasickness. He could not figure out how much insulin he should inject since he was not sure of his food intake. Oh he knew how much he ate, but he lost count of how much came back up. He miscalculated and went into insulin shock. Our medic knew what to do but I thought we were going to lose him too. We had a serious talk to him when we got back, he had no business being on a deck of a ship. I wonder what charter boats do when a fare becomes far sicker than one would normally expect? If they head in, it might upset those who paid for the charter. If he stays out, and things go very wrong, he could end up getting sued. Would he head home and give out a rain check and lose a day's pay not to mention expenses. I think I am glad I am not a charter boat captain.

mcleaves

No harm, no foul.. Yes, I do tend to have an experienced medical professional on most of my trips. But there are two things which make me ask what people in all practicality carry.

1. Much like and EMT, their experience is in a medical facility, not on the sea. My brother comes closest with his field training.
2. If I ask them what they think I should carry I get 3 different sets of answers, and as I mentioned, I would have a portable OR on board!

So really I just want to know what the charter capts and offshore guys carry to deal with practical issues. I carry two VHF's and a Sat phone, so I can always call for help. How long before it arrives is another story.

Your suggestion about snips is a good one though.

M

mcleaves

Are Scup and I the only ones who carry First Aid kits? ;)

old mud

NO !! I carry a school buss kit on my boat. also one on my Solas raft. Along with the rest of the safety gear. Survival suits, 50 mile flair kit, Epirb, Type 3 and iv jackets etc.

don

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AlloyToy

Wife is an RN so she took care of putting together the first aid kit. It's basic but does have some things like Pedia lite, Tylenol, peroxide, butterflies............ I'm not planning on doing surgery out there however you need to be prepared with gaffs, and large hooks for anything.

More importantly I just completed a CPR course. Very important, and I believe everyone should be trained in this. It covered CPR, Choking, and AED's Great interactive course!!!

It always kills me to see someone stick a rod in the rod holder with a 3 oz. weight and a 4/0 hook swinging around as you "rock-n-roll". Very easily that hook could end up in someone............

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mcleaves

Pedialite.. Great idea! I remember using that with the kids when they were sick.. Excellent compromise over hanging a bag of saline!

This is always high on my list and I never get around to it. Shame on me. I think becasue I have this safety net of "other people" I am lazy about it, but I agree. Very important. I was on another board last year when the topic of AED's came up. I think they are a great idea, but a large group of people who were EMT's argued they are not effective on the water becasue they detect motion. I guess they emit a "Stop the vehicle" alarm if they need to fire. You can't really do that in rolling seas. My opinion was hell, if you can afford to have one and it works it works. It's better than not having one. But these guys were pretty hard nosed about them being a waste of money. If I had the extra dough I still think I'd have one. They do need annual maintenance though.

Hey, I think I have fished with those same guys!! ;). Seriously I have had more arguments, even sitting at rest, about this. The weights are either in the water, on the floor or off the pole. PERIOD!

But there will always be someone!

Good post, thanks. The pedialite is a great idea as is the reminder for CPR.

M

AlloyToy

I coach kids sports, and I see more & more AED's showing up at basketball games, hockey games ect....... kids at all levels push themselves more & more.

My three pet peeves (sp), the "swinging sinker" , "the loose fillet knife", and a gaff not properly stowed. I've been on charters where the captain got mad cause I spoke up about the placement of the gaff. I don't care though it could even be he (the cap) that it saves.

Way to easy to get caught up in the moment, and loose focus on safety

I'm gonna ask about Ada's on a boat. That's a good point. They do go through a self diagnostic cycle so I'd be interested to know that answer.

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"First The Bite Then The Fight"