For a yacht preparing for the Pacific Cup being able to cope with a medical emergency at sea will be a significant factor in contributing to a favorable outcome. The potential exposure due to the distance, the availability of direct professional medical assistance and the level of care that might be available should be taken into account in assembling the components of a suitable medical kit and the training of individuals onboard.
Statistics indicate that for medical situations encountered by boaters 40% are due to injury while a startling 60% are due to illness. Yes, there will be the stubbed or broken toe, sprain, dislocated shoulder, laceration, fishhook incident or head trauma, yet it is more likely that the issue will be sickness, dehydration, severe sunburn, an infection, or an aggravated existing medical condition. A great many of these if properly addressed at the onset can be dealt with and, as often as not, thwart the escalation into a true medical emergency and the possible need for outside assistance.
The specific medical requirements for the Pacific Cup - 2016 are set forth in the Notice of Race (NOR) with reference to the 2013-2016 Racing Rule of Sailing (RRS), including the US Sailing Prescriptions, and the Safety Equipment Requirements (SER) published by US Sailing effective as of January 1st, 2015 as amended by addition and modification by Appendix II to the NOR as adopted by the Pacific Cup Yacht Club for Pacific Cup - 2016.
The governing section of the Safety Equipment Requirements under Section 3.25 - Gear: Medical Kits, states “A boat shall carry a first aid kit and first aid manual suitable for the likely conditions of the passage and the number of crew aboard.”
There are two highly regarded first aid manuals that should be considered. Marine Medicine, A Comprehensive Guide, written by Dr. Eric Weiss and Dr. Michael Jacobs, now in its second edition, and Advanced First Aid Afloat, written by Dr. Peter F. Eastman. This manual, first published in 1972, has become widely accepted and is now in its fifth edition. Both of these manuals address injuries and illnesses, and include information about first aid kits, prescription medications and medical support. Each is written in plain language complete with diagrams and photographs to aid in the evaluation and treatment of a patient onboard.
There are two well designed, organized and stocked lines of first aid kit developed specifically for the offshore sailor. These are the Medical Sea Pak product line by Fieldtex Products, Inc. and the Marine Series Medical Kits developed by Adventure Medical Kits in consultation with Dr. Michael Jacobs, the noted sailor and marine medical authority.
These two product lines do vary somewhat with regard to the specific items; yet, each comes in a full range of kit sizes, with the contents organized by category and contained in clearly market pouches. The Medical Sea Paks are available either in a rugged nylon soft case or in a hard case, while the Marine Series are available in a padded foam case with a water-resistant zipper. The parameters for the selection of a specific kit are based on the number of persons onboard, the duration offshore, and the anticipated time and distance away from direct professional medical assistance.
A suitable first aid kit can be assembled from scratch; and, although a worthwhile task, can be expensive and difficult as many items may not be readily available, or in the appropriate size or quantity desired. In addition, one must consider the many contingencies and organize and package all of the items in such a way that they are secure and readily available when needed.
An additional choice is to have a custom medical kit assembled in the event of any special needs, or the advanced medical qualifications of a crew member. A number of vendors provide this service including OceanMedix, Remote Medical International and World Clinic.
Prescription medications are a necessary component of any vessel’s medical inventory; and, are carried in anticipation of a wide range of illnesses and injuries that might be encountered when direct access to professional medical assistance is not an option. Developing an appropriate list of prescription medications can be done in consultation with a physician, or by referring to one of the lists found in the appendices of the manuals noted above.
An alternative is the product line of Prescription Medical Kits developed by OceanMedix. These kits are base on a comprehensive list of medications configured in three sizes from small to large, configured for a vessel with a crew size ranging from 1 - 12 people embarking on voyages of up to 28 days. Each kit is assembled to order, with medications and supplies selected and provided in adequate quantities, and then organized in a custom fabricated, rugged nylon case with internal removable pouches, complete with a Physician's Prescription Order and Instructions for Use.
A complete supply of over-the-counter products should not be overlooked. In addition to those used on a regular basis, one should consider everything from sunscreen to Imodium, from Milk of Magnesia to Meclizine, from Q-tips to lip balm.
Each crew member should know their own susceptibility to seasickness, be aware of their own early signs and symptoms, and know which remedy works best for them. In addition, a compliment of sea sick remedies ranging from ginger root, the aromatics, over-the-counter tablets, Relief Band©, and prescription options should also be carried onboard.
In the event of a severe bleeding incident where direct pressure does not work, a selection of QuikClot® Advanced Clotting Sponges or similar haemostatic product should be considered. The self contained pouch, originally developed for the military, packed into an open wound followed by direct pressure will stop bleeding rapidly. For larger wounds, more than one pouch can be used. The pouch(s) will conform to the shape of the wound, are to be bandaged in place, and can be easily removed at the time of treatment in a hospital setting.
For an open ocean event like the Pacific Cup at least two members of the crew should have valid Basic First Aid and CPR certificates. These certified crew members should be completely familiar with the first aid manual and the contents of the medical kit being carried onboard. They also must be able to address
the existing medical conditions of any crew member as well as any others that might arise, and to communicate any situation to an outside professional medical provider by radio or sat-phone if necessary.
Each crew member onboard should be confident of their health and conditioning to avert a potential medical incident while underway. If in doubt, a physician should be consulted. Any and all medical conditions of consequence should be addressed, and should be called to the attention of the skipper of the boat prior to participation.
Being as self reliant as possible should be the goal. Prior planning, proper training and the preparation of a suitable medical kit will allow you to best cope with a wide range of medical emergencies at sea.