First-Aid and Medical Kits

Sailing offshore is one of the last opportunities for a truly self-sufficient experience in our always-connected world, and this includes the possibility of handling medical problems. While medical support at home may only be a few minutes away, it becomes the responsibility of someone on board to administer appropriate first aid assistance. On board medical emergency requires the appropriate tools to be available, not only because a medical or first aid kit could save a life but also may avoid an expensive visit to a hospital in a remote location.

As often, preparation and planning can make all the difference between an adventure and a disaster.

First-Aid Kits vs. Medical Kits

First-Aid kits as available for basic first aid in cars, offices or public buildings are well suited for treating small injuries like abrasions, burns, minor cuts and sprains. They are small, inexpensive and contain enough material to adequately treat a small crew on a weekend cruise.

The kits mostly contain a collection of different sorts of bandages, dressings and medical plaster. Included is normally also some tools such as a scissor, tweezers and a pair of medical gloves. These kits usually contain no pharmaceuticals nor germicides of any kind. Most of the included First-Aid consumables have an expiry date. Keeping the contents up to date is the only way to ensure that the First-Aid kit is functional and ready to use.

Medical kits contain a more elaborate collection of material and can help dealing with significant illnesses or injuries at sea. Part of these kits is also a selection of pharmaceuticals and germicides. However, some basic medical knowledge and experience may be required to apply some of these medicines on an injured crew member.
If you are planning a longer offshore cruise it is probably a good idea to consult a physician to get help on a meaningful selection of medicines and to obtain some instructions on their application. Relevant medical information on each crew member such as current medication, allergic sensitivities and acute diseases should be recorded somewhere (e.g. in the logbook).

There is probably no standard medical kit that is perfect for every boat, so it will have to be selected based on the length of the journey and the number of people in the crew.
Standard basic medical kits and a reasonably-equipped first aid kit are adequate for a small crew on a two-week holiday cruise. More comprehensive marine medical kits can cover up to 10 people for a month on an offshore voyage. With many options in between, the following questions can be considered to help define the requirements.

• Boating style: What kind of boating voyage is planned? Daysailing, weekend trips, coastal sailing, long-distance off-shore voyages, ocean racing? And how long, the crew is likely going to be completely self-reliant? Hours? Days? Weeks?
• Crew: Who will be part of the crew? What are their ages and general health status? Will there be children aboard? Do members of your crew have specific health problems to consider, like heart problems or diabetes? Does anyone regularly require prescription medicines?
• Communication Gear: Which communication channels are available to organize medical advice? VHF radio, SSB, a satellite phone, just a cell phone?
• Medical Skills: Do crew members have special medical skills like first aid or CPR training or a medical/nursing background?
• Custom-made kits: Do you have the time, skills, energy and interest to custom-build your own kit from scratch, or are you looking for an “off-the-shelf” kit to meet your needs, perhaps with a little customization?

Organizing Medical Advice over Marine Radio

Medical assistance
A "PAN-PAN MEDICO" call is appropriate if someone becomes injured or in need of medical help at sea.  If the vessel is heading to shore and wants to be met by an ambulance crew, the local Coast Guard station can arrange this.  A doctor or other trained medical advisor may also be available on the radio, perhaps by patching through via telephone from ashore or from a nearby vessel.  Again, if there is immediate risk to life, then a MAYDAY call is more appropriate.  "PAN-PAN MEDICO" is no longer in official use.

Marine Rescue Organizations, such as Coastal Patrol, Coast Guard & Search and Rescue listen on marine radio frequencies for all distress calls including "PAN-PAN".  These organizations can coordinate or assist and can relay such calls to other stations that may be better able to do so.

Medical advice
One special case of "PAN-PAN" is to ask for medical advice.  This is a normal "PAN-PAN" call including a phrase such as "request medical advice" and the identification of the craft, its position and the nature of a medical problem suffered by one of the passengers or crew.  This type of call is specifically used in order to get a doctor's advice for a medical problem that does not, in the current opinion of the skipper or master of the vessel, seem to be life-threatening.

Once patched through to a medical expert either on land or in another vessel, the radio operator will most likely be asked to describe some detail of the symptoms and history of the condition and perhaps some medical history of the casualty too.  The doctor will, most likely, be able to recommend first aid treatment and give other advice to make the patient more comfortable, using whatever resources are available on board.

In some cases a decision may be made that the medical case is more urgent than the skipper assumed, and so the call will be escalated to a 'MAYDAY' and receive immediate intervention by rescuers, if at all possible.

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