What is in your first aid kits?

Fun Under Pressure

Is Veterano suitable too???
I hope because i don´t like Jack.

Cheers Markku

Tom Rose

After a nasty cut offshore during my college years sewn up with fishing line, I have always carried sterile sutures.

tom

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Explorer

And a frickin' helicopter with a range of 200 miles.

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kybrt

aed and a sat phone.

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Fidelis Ad Mortem
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whoizrob

I understand the idea of having a tool "just in case" and the hope that "someone knows how to use it". The reality is that a lot of ALS (advanced life support) can cause a whole lot of bad just as easily as good. Example: trying to decompress a pneumo you can penetrate vital organs if not placed properly, you can also slash a artery pretty darn easy. If you don't know how they work you are simply adding another hole which can worsen the situation further.

I am a paramedic and my medical kit is pretty simple really and came about from a simple realization: if you are critically ill and require ALS right now you are probably going to die before the cavalry comes or I run out of supplies. As a corollary, if you aren't critically ill chances are you can wait until the cavalry arrives and short of drugs I cannot possess outside of my job there is not much I can do to alleviate your discomfort. Therefore my kit is reduced to addressing things that can LEAD to your dying if left unchecked.

Mostly speaking this involves staunching bleeding from trauma and my tool of choice comes in many flavors but ultimately do the same job: coagulation aids (do a search for "quickclot" for more info). Adjuncts include a few SAM splints, some curlex rolls, Asprin (the best over the counter med for cardiac events, no really), Epi-pen if you can get ahold of one, Benadryl, gloves, safety glasses, BLS airway adjunts, a Combitube, silver rescue blankets, stethoscope, rescue shears, adjustable c-collar, flashlight, Adult BVM with 3 different sized masks, steristrips, and a whole bunch of other little things. The O2 I leave to the boat operator as you realistically need a bit more than I can carry in a neat little bag =).

In any case the best thing you can bring with you is training not gear. A lot of things you can improvise in the field but if you dont know the first thing to do well... then you are pretty much hosed and first aid training is so quick and easy to get why not? I mean even if you want to become an EMT all it takes is a semester of night classes.

Just my .02

Rob

jsevland

Thank you for all your replies!

I can see that I started this thread, sort of backwards; with the specifics rather than the general first-aid questions. I'm not a great forum-poster, so I tend to forget that you can't see my line of thought leading up to my post ;-)

Like all of you, I agree that CPR is probably the single most efficient way of saving someones life. As I have posted earlier;
learn to do it right - start immediately - and never stop!

Normally I dive OC off a boat, which carrying a massive O2 tank, which I truly appreciate.

If you were shore-diving CCR with a buddy, would you consider harvesting O2 from the units - or do you carry extra O2 tanks?

Regarding the cannulae, I may still carry one - but I register your concerns ...

Tom, you mention sterile sutures - but as far as I can tell, it is far from easy or safe to use them.

It seems easier (safer) to follow Robs suggestion to use coagulation aids. The CELOX (off Amazon ) is approved over-the-counter in the US. Can anyone recommend this product?

I think Rob (being a paramedic) puts things into perspective (for me); if the patient requires immediate ALS - there is probably little I can do to save him/her.

I still have a few less intrusive things on my whishlist:
- Asprin (as an alternatively to Jack :-)
- rescue shears (alternatively the OMS Titanium Line Cutter - which I want anyway)
- Otoscope mostly for comforting; "no, your ear looks OK - but if it hurts don't dive"
- Stethoscope mostly for the gadget freak in me ;-)

jsevland

Dave Sutton

I think it all depends on the environment, and how long you plan to be gone. On EXPLORER we carry enough stuff to do minor surgery... as we often have a physician aboard. At the very least I'm personally able to do suturing, something that might save a 3 day offshore trip. We have sufficient drugs to render a victim of a broken arm or dislocated shouder or similar injury pain free for a 15 hour evacuation by sea. We carry catheters to relieve the bladder of someone who cannot urinate. We carry a defibrulator. We have a basic ships medicine cabinet of antibiotics, etc., as someone suffering from tonsilitis, etc., can cause the need for an evacuation off site on a multi-day offshore trip. Is this first aid gear? I'm not sure... it straddles the line between first aid and definitive treatment. We've also got a satphone and a MD who will answer and offer advice 24/7 (the same one who developed the medical kit).

So: Are you planning a 2 hour time for definitive treatment? 20 hours? 2 days? 2 weeks?


You might consider reading thru this information:

Ocean Medical International -Medical Kits for Yachts & Medical Training for Crews


Although EXPLORER in the end used a local physician for our needs, the service provided by the above cited firm as well as several others is something to consider.


Dave

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babar

If I'm traveling abroad, I always carry a suture kit, which has sterile scissors and forceps, which are useful for all sorts of other things, a scalpel or 2, lidocaine, and a few syringes, and iodine. and sutures of various type/size.

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Evolution Plus
Sport kiss

Fun Under Pressure

Look´s good and very expensive. (but how much is a life worth??) Thanks for the link.

Cheers Markku

Dave Sutton

There is no cost too high to save a life. I saw your post and did an informal addition in my head... EXPLORER carries about US$10K in medical supplies. It's broken down into sub-kits, which might be germane to the discussion as each sub-kit is really a stand alone kit that might be suitable *by itself* for the needs of a shorter or longer trip.

First, there's the "drawer on the forward end of the wardroom table" which is an area where everyone is encouraged to "help themselves". It contains what we need on a routine basis for "comfort afloat". Small bandages, surgical tape, gauze pads, asprin, seasickness pills, sunscreen, lip balm, insect repellent, antacids, etc. Basically, if you can "get something yourself to make you more comfortable" it's in there. Cuts, scrapes, etc., are all handled there on an ad-hoc basis. Thankfully, we have solved *every* issue to date right there. We use it daily. If I took the contents of this drawer and put them into a small pelican case, I'd be pretty happy for a one day shore-diving trip where we could drive to a hospital if we needed to.

Second, in terms of size, is the kit contained in the "Ditch Bag", which is the emergency equipment bag that is stowed next to the raft, and which comes with us if we need to abandon ship. In addition to GPS, satphone, VHR radio, reverse osmosis watermaker, and another $5K of survival crap, there's a waterproof "6 people for 10 days" kit there as well. Inflatable splints, etc... what we would need in a raft at sea for 10 days. The raft itself has a small kit deemed to be 'acceptable' by the Coast Guard... it's a joke and is only there to meet the regulations. The "Ditch Bag" kit is a medium sized kit. If I took it out of the ditch bag, I'd be happy with it for the prime medical kit for a day-trip out on a boat under routine conditions.

Lastly, in terms of capability, is the trauma kit carried down below in my cabin. The trauma kit is not exactly under lock and key, but it's in my private space so it's not likely to be used casually. This is the non-narcotic drug kit, surgical kit, intubation kit, and has all of the bulk dressings, coagulant kits, etc., needed to deal with a serious emergency afloat. It's in a waterproof pelican case, and we would 'try' to get it in the event of a sinking offshore but would not need it. This kit *added to the other two kits* makes up a "expedition" grade kit that can support fairly definitive treatments for a long period of time. The limit at that point really is the medical *expertise* aboard, not the equipment. This is the box I would hand a Physician or Paramedic to use. Narcotic drugs are kept in the Captains Safe accessable only to me.

Medical library consists of "Emergency War Surgery" by the US Army, "The Physicians Handbook", "Medicine for Mountaneering", and "The Ships Medicine Chest and First Aid at Sea" (which is available free as a download... I posted the link elsewhere here a while back).

In addition, we carry a quick-grab 02 kit with both rebreather and demand/pressure regulator system and a 4 litre 02 bottle, a second 7 litre 02 bottle dedicated to that system, (2) J bottles of 02, and whatever other 02 we might have aboard. Complementing that is a AED defibrillator. This is the "near drowning kit" and is stowed in it's own spot in the cabin. For the day-trip beach diving or on the boat, I'd also toss this into the back of the truck.


Basically, if you look at the modules above, you can pick and choose the right gear for the right environment. On EXPLORER we carry it all.... because we need it all. Shit, even the under-seat waterproof bag of the Avon RIB boat has a small kit too.... you never know.


Maybe $10K was optimistic... If I added up *all* of the safety gear aboard EXPLORER (raft, satphone, SSB radio, EPIRB's, etc.,) it would be well over $25K. I know for a fact that we're the best equipped expedition boat on the East Coast of the USA..... and people wonder why they need to pay to go diving offshore...


Here's another excellent link to study:

Medical Kits




Dave

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