Friday, 19 May 2017

What we carry in our boat's First Aid Kit



It's important to have a well-stocked first aid kit in your home, but on a boat you should be carrying a comprehensive kit so you can deal with minor accidents and injuries, away from immediate medical help.

While kits may be any physical size, they should be large enough to contain all necessary items, and be immediately identifiable which means ideally marked with a white cross against a green background. Kits should also contain a list of the contents inside, and be made of material that protects against dust and moisture. Having a well organised kit will help you to identify items of need quickly and items that need replenishing when next in port. Your first aid kit should be ready for action at all times but kept locked in a cool, dry place out of the reach of children. 

On Our Dreamtime we use 5 individual boxes (similar to tool boxes) that have individual areas for each item. Each box has a clear lid where each item is visible, labelled and easily identified. Our First Aid items are kept in 4 of the boxes and medication separately in the fifth. With each medication instructions provided. Crew should be fully briefed on the first aid kit, location and use prior to leaving the dock. If you are the one injured you need them to be fully aware of your supplies and usage.

We have delved into our kit on many occasions in response to minor bumps, scrapes and maladies. But we were very thankful we were well prepared when Karen had the misfortune to suffer a stingray strike. You can read that story HERE. 



On Our Dreamtime we have 5 boxes with clear lids with everything clearly labelled
Many people also keep a small first aid kit in the dinghy for emergencies ashore. We have one that is similar to a bum-bag, it is easily worn whilst hiking. We also have one in the fully equipped life-raft and a separate one in the ditch-bag. (See separate article) 



This style of first aid kit is handy for going ashore and hiking
A basic first aid kit may contain:
  • plasters in a variety of different sizes and shapes 
  • small, medium and large sterile gauze dressings 
  • Blood Pressure bandages large and small
  • at least two sterile eye dressings 
  • triangular bandages 
  • Splint
  • crêpe rolled bandages 
  • safety pins 
  • 5 pairs disposable sterile gloves 
  • tweezers 
  • scissors 
  • alcohol-free cleansing wipes 
  • sticky tape 
  • thermometer (preferably digital) 
  • skin rash cream, such as hydrocortisone or calendula 
  • cream or spray to relieve insect bites and stings 
  • antiseptic cream or spray
  • painkillers such as paracetamol (or infant paracetamol for children), aspirin (not to be given to children under 16), or ibuprofen 
  • cough medicine 
  • antihistamine tablets 
  • distilled water for cleaning wounds 
  • eye wash and eye bath 
  • Resuscitation mask
  • Saline Solution 5 bottles 15 ml
  • Waterproof Bandaids 
  • Hypothermia blanket
  • Burn Cream
  • Burn Plastic wrap
  • Burn bandage
  • Rehydrate powder or dissoluble tables with electrolytes. Sports drinks are also suitable.
It's also be useful to keep a comprehensive first aid manual or instruction booklet with your first aid kit. 

Medicines and consumables should be checked regularly to make sure they are within their use-by dates. Letters from your Doctor should be held for any prescription medication in case authorities require proof of requirements on board.


Emergency treatment Medication Plans for particular illness.


If a family member or crew member has any particular ailments such as Allergies, Asthma, Diabetes or High Blood Pressure, you should prepare an emergency response plan with the help of your doctor. All crew on board should be aware of these plans.




Additional medical items you may need.
  • Adrenaline autoinjector (EpiPen®) to treat a severe allergic reaction
  • Asthma preventative and treatment medication 
  • Diabetes medications or insulin
  • Antihistamine 
  • Pain relief 




Do you know how to use your first aid equipment?

First aid is essentially a practical skill, and your confidence and effectiveness will be greatly enhanced by expert training in a practical setting. There are a number of first aid courses that specialise in yachting. The RYA's (Royal Yachting Association) one-day course covers all the usual first aid subjects, but from a boating perspective. It is aimed at anyone who goes afloat, whether on inland waters, rivers, estuaries or on cross passages.


In a medical emergency a little first aid knowledge and immediate action can save lives, especially in remote locations. This one-day course is designed to provide a working knowledge of first aid for people on the water.


First aid equipment explained


The various gauzes, dressings and bandages found in a first aid kit have different uses. Some of these include:


Adhesive strip dressings – small strips of gauze attached to a sticky backing. These dressings are used for minor cuts and skin injuries. In Australia, they are commonly called bandaids. It is important to be aware that some people are allergic to the adhesive on bandaids.

  • Non-adhesive dressings – best used for covering burnt or abraded (scraped or grazed) skin. Never use adhesive dressings on burnt or abraded skin.
  • Wound dressings – these thick pads are used to help control bleeding and reduce the risk of infection. Different sizes are needed for different-sized wounds.
  • Crepe or conforming bandages – these elastic bandages are used to create pressure, hold dressings in place, reduce swelling and provide some support.
  • Triangular bandages – these non-elastic bandages are used for slings, to hold splints in place and to restrict movement.
  • Sterile eyewash solution – used to flush eyelashes, insects, dust, sand or similar particles from the eye. Never attempt to remove an object that is embedded in or has penetrated an eye – in such an instance, seek urgent medical attention.

Traveling overseas with prescribed medication. 

If you are planning a trip overseas, organising your medicine is one of the most important things you can do. If you require prescription medicine, it is important you have this medicine with you so you remain in good health while you are away.

It is illegal to take PSB medicines out of Australia unless the medicine is for your personal use, or the personal use of someone travelling with you. 

If you are planning to take prescription medicines overseas for your own personal use or the personal use of someone in your care who is travelling with you:
  • read the the relevant travel advice and check with the embassies of the countries you will be traveling to make sure your medicine is legal there 
  • carry a letter from your doctor detailing what the medicine is, how much you'll be taking and stating the medicine is for your personal use or the personal use of someone with you (for example, a child) 
  • leave the medicine in its original packaging so it can be easily identified. 
More information on travelling with medicines & medical devices: this is the link to Smart Traveller

Knowing the medication you have on board.

Safe Medication Care Starts With You! Do you know the best medications to take and how you take them. Out in the ocean when we have no Doctor down the road, we need to know what we have onboard and how to use it.

If you take medications, you play a role in your healthcare when it comes to medication safety. Keep an up-to-date list of all the medications you take and carry it with you. (See below medication record list). Medication, or medicine, doesn’t just mean t he prescriptions you take. Your medication list speaks for you in case you can’t, or if you don’t always remember all the medications you take. 

Sharing your updated list every time you see your doctor helps them give you the best care possible. It could even prevent a dangerous medication situation.

A medicines list is a useful way to keep all the information about your medicines together. We use alphabetical dividers in a folder. It will assist you in understanding the medication you are carrying onboard, assist crew to use the correct medications in an emergency and provide authorities to asses what you are carrying onboard.

You can use a medicines list to record:
  • all the medicines you use, including prescription, non-prescription, over-the-counter, minerals, herbal and natural medicines
  • what each medicine is for
  • how much of each medicine to use
  • when and how to use each medicine
  • Keeping a medicines list will:
  • help you to know more about your medicines
  • remind you how and when to take your medicines
  • ensure everyone involved in your health care knows which medicines you use
  • help your doctor and pharmacist check and review your medicines
  • provide vital information about your medicines in an emergency.
  • Knowing as much as you can about your medicines will help you to:
  • get better results from the medicines you use
  • get the most out of a consultation with your doctor or pharmacist
  • help to prevent side effect and interactions
  • enjoy better health.
  • The List can be as simple or as detailed as you want.


    Here is a link to a great site that can assist you in making your own "medicine list". 

    Keeping a medicines list


    Medicenet
Here is a few common situations where first aid may be required on the water.


Sunburn

We know, you didn’t mean to get sunburned. You lost track of time, or nodded off, and now you can tell you’re going to be lobster-red and miserable. It can take several hours for the full damage to show itself. So at the first sign, get out of the sun and follow this expert advice from dermatologist Jeffrey Brackeen, MD, a member of The Skin Cancer Foundation.
  • Act fast to cool the skin, treat with cool water or cold compress. 
  • Moisturise while the skin is damp.
  • Decrease the Inflammation by taking an anti inflammatory drug such as ibuprofen, naproxen or aspirin. 
  • Replenish your fluids with water and electrolytes 
  • See a doctor if you are showing signs of blistering or concerned about anything.
If in doubt call for medical assistance by phoning 13HEALTH or for emergency 000 (in Australia)

Dehydration 

If a person becomes mildly to moderately dehydrated. 
  • Stop their activity and make them rest. 
  • Get them out of direct sunlight and lie down in a cool spot, such as in the shade. 
  • Prop up feet. 
  • Take off any extra clothes. 
  • Drink a rehydration drink, water, juice, or sports drink to replace fluids and minerals. Drink 2 litres of cool liquids over the next 2 to 4 hours. 
  • You should drink at least 10 glasses of liquid a day to replace lost fluids. 

You can make an inexpensive rehydration drink. But do not give this homemade drink to children younger than 12. Measure all ingredients precisely. Small variations can make the drink less effective or even harmful. Mix the following:

1 litre water
½ teaspoon table salt
6 teaspoons sugar

If in doubt call for medical assistance by phoning 13HEALTH or for emergency 000 (in Australia)

Allergic reactions 

Person may develop a rash, itchiness or swelling on their hands, feet or face. Their breathing may slow down. Vomiting and diarrhoea can also occur. Common causes of allergic reactions are pollen, stings, latex and some food items.

A severe allergic reaction (anaphylaxis) is life threatening and requires urgent action.
Emergency responses for severe allergic reaction (anaphylaxis) are:
administer adrenaline with an autoinjector (EpiPen®)


If you or a crew member are at risk of a severe allergic reactions, you should:
  • have a severe allergic reaction action plan
  • carry an adrenaline autoinjector (EpiPen®) to treat a severe allergic reaction
  • Member wear medical identification jewellery – this increases the likelihood that adrenaline will be administered in an emergency 
  • avoid medication (where possible) that may increase the severity of an allergic reaction or complicate its treatment – such as beta blockers.
Heavy Bleeding

Put pressure on the wound with whatever is available to stop or slow down the flow of blood. You are acting as a 'plug' to stop the blood escaping. The pressure you provide will help the blood clot and slow the bleeding until a dressing can be applied. 



Sprains and Strains
  • Get the person to rest. 
  • Apply an ice pack to the injury. An ice pack can be simply ice or frozen vegetables wrapped in something such as a tea towel. Applying it to the injury will reduce the swelling and pain. 
Broken Bones

Good first-aid care of fractures is always important. Moving the broken bones can increase pain and bleeding and can damage tissues around the injury. This can lead to complications in the repair and healing of the injury later on. 
  • Encourage the person to support the injury with their hand, or use a cushion or items of clothing to prevent unnecessary movement. 
  • Supporting the injury may give pain relief and prevent further damage. 
  • Fractures of the head or body such as skull, ribs and pelvis are all serious and should be managed by paramedics. 
Burns
  • Cool the burn under cold running water for at least ten minutes. Cooling the burn will reduce pain, swelling and the risk of scarring. The faster and longer a burn is cooled, the less the impact of the injury. 
  • After the burn has been cooled, cover it with cling film or a clean plastic bag. This helps prevent infection by keeping the area clean. It’s an ideal covering because it doesn’t stick to the burn and reduces pain by keeping air from the skin’s surface. 

Poisoning 
  • Establish what they have taken. When? And how much? Emergency services will require this information.  
  • Do not make the person sick. By making them sick, you can cause further damage to their throat or block their airway. 


Hypothermia


The person may be shivering, pale and cold to touch. They may also be disorientated. 


Warm the person, giving constant reassurance until help arrives. You can warm them by wrapping them in a blanket and giving warm drinks and high-energy foods, such as chocolate. 

Asthma Attack


Severe asthma attacks need emergency first aid.

Help the person sit in a comfortable position and take their medication. When someone has an asthma attack, the muscles in the airways narrow, making it difficult for them to breathe. Using an inhaler relaxes the muscles, allowing the air passages to expand and ease the person’s breathing. A mild attack should ease within a few minutes.

If it doesn’t, or the inhaler has no effect, call for medical assistance immediately by using your VHF, phoning 13HEALTH or for emergency 000 (in Australia)


Where to get help
  • In an emergency, always call triple zero (000)
  • St John Ambulance Australia Tel. 1300 360 455
  • Australian Red Cross Tel. 1300 367 428
  • 13HEALTH for non life threatening injuries or sickness.
  • Betterhealth - search

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