Medical help on the sea and in desolated places

Discussion in 'All Things Boats & Boating' started by =D=, Feb 21, 2006.

  1. =D=
    Joined: Nov 2004
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    =D= Junior Member


    Does any of you was wounded or had a wounded crewman on the sea or in desolated places and had to help him/yourself ??. How did you survive that ??
  2. longliner45
    Joined: Dec 2005
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    longliner45 Senior Member

    Yes I was struck on my head,,,,(dont laugh walruss, ) by a hauling block ,pulling in gear from 70 phathoms, it got snagged and I kept the tention on it. the block ricochet off my head and busted the whellhous door ,my brother and another mate shaved my head and duct tape the 2and a half inch gap together, we stayed for 4 more days of fishing ,,,,,,,,, another time I was offshore I was runnin desperat and left out on the tail end of bad weather ,we almost sank it got much worse,just had a new transmission put in a week earlier. after bailing all night I inspected the boat and saw that all the paint was pealed and burnt off of the new tranny, I cheched the oil pressure gauge It read 0,I undogged the filler hole and hot oil sprayed on my right arm and burnt my beard and melted my sunglasses, the gauge had spun all the way around,,,,was lucky not to be blinded, put Ice on my 2nd degree burns and one small 3rd degree burn ,,,,,stayed 3 mor days , Navy cruiser Mobile bay gave me some good help also. most injurys are cuts and infection from fish poison, it good to keep strong antibiotics on board such as kelflex , when one ventures offshore he should try to be readdy for anything last but not least we caught a 1or 2 hundred lb sting ray I told the mate to cut the leader but he wanted to show me he was a man, the stingray p;ulled its tail up and jabbed him in the forarm, we had to cut the barb off and pull it trough , his arm immidiantly turned black and we gave some kelflex but had to go home lucky for him we were18 hrs out ,I could go on and on but Im sure you dont want to here about the time I stabbed myself at the fish fry eating oysters .longliner
  3. safewalrus
    Joined: Feb 2005
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    safewalrus Ancient Marriner

    Oh yes we do Longliner that's got to be a Good yarn that has! ;)

    Get on your radio is the answer, shore station will patch you through to a doctor who will talk you through any action you need to take (helps if you've done a bit of medical training they tend to get carried away at time! but are normally bloody good! Most counties have standard med kits for different areas and types of boats (and suprisingly enough training to, most good if basic)! Also if a warship is in range get on the VHF he'll drop his doc on your deck by helicopter before you know it! and those guys are even better! Most all warships of any size have doctors onboard or at least a highly qualified nurse/paramedic! Cause if you have a satphone you have even more chance. From experience Merchant ships (except passenger ships obviously) have 'highly trained' ships officers who will be only too willing to help out (having been one of these characters I stay well away! may have learned it some time back but due to lack of use it tends to get kinda rusty -and we're just looking for someone to practice on! now how was that stitching technique again!]:D :rolleyes:
  4. bilgeboy
    Joined: Dec 2005
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    bilgeboy Senior Member

    What an interesting topic.

    I've marveled that some circumnavigators get a prophylactic appendectomy before heading out. This is the most common surgical emergency, so its understandable I guess. Risk of operation is way better than trying to survive an appendicitis at sea.

    Longliner has a good point about antibiotics. Most infections after trauma are caused by bugs that live on the skin, like Staphylococcus and Streptococcus. Keflex is good at treating these Gram positive infections, but not very good at other problems. It would be smart to have a bunch of Keflex on board.

    Levofloxacin would be the next drug I would pack alot of. It will treat a urinary tract infection, pneumonia, as well as an intraabdominal infection. Levo and Flagyl could buy you alot of time if you do get an appendicitis but help is a few days out. It would beat the pants off trying to remove your own appendix.

    Thats my vote for antibiotics: Keflex, Levofloxacin, and Flagyl.

    A few liters of sterile saline solution to flush wounds and a modest suture kit with a little local anesthetic like lidocaine would take care of a big percentage of wounds.

    Also, considered by many doctors to be the most important medical discovery of all time....Morphine. Its the humane thing to do, and keeping the screams down should help ships morale significantly!

  5. Wellydeckhand

    Wellydeckhand Previous Member

    Yup....... ......... Whisky for cleaning wounds.
    Morphine well for something nice.
    Tampone for wrapped on wounds.
    clubs for strange sick friends.
    chain and old Levis for dead body cast away.
    Pretty nurse for own protection and etc...........................

    Believe it or not........ depend on countries' law

  6. JPC
    Joined: Jun 2005
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    JPC Junior Member


    Sounds like you know your way around the cabinet. Do you, or does another, have a recommendation for obtaining these drugs, and those that might be more 'controlled' and for contending with the authorities when entering a country (especially one like the US)?

    We are all familiar with the stories of sailors having to execute procedures that they aren't formally trained for, especially if they have the assistance of med by radio, but -especially in the US- "officiallly" available med kits are little more than asprin and child-safe scissors.

    btw- I had an incident racing in the West Indies where each of a doctor and a dentist backed up the myth about WD-40 and duct-tape, using the former for disinfectant and the latter for ersatz sutures until we got to shore. I don't like WD-40, but many boats will have it aboard.

  7. Wellydeckhand

    Wellydeckhand Previous Member


    Do u believe that I see my worker use preston red brake oil to tend extenal wound? I try to tell them it is not correct and later use it myself in an emergency rush........... now using it all the time in my workshop for rash and minor wounds.
    My doctor think it is not correct but dont object it if thats the fastest and nearest thing I can get.
    Did once on my broken nail wound( whole nail pluck out)....... no pain when used...... cure in a week completely dry and painless.:)
  8. bilgeboy
    Joined: Dec 2005
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    bilgeboy Senior Member

    I don't doubt that a variety of chemicals could possibly help prevent a nasty infection from setting in. In the past few years, though, the way we treat open wounds has changed a bit. Its probably just that a healthy person beat the damage caused by the toxic substance in addition to the possible infection. All of us have probably had a doc rinse a wound with a water and betadine solution. Its been shown to not be as good as straight saline solution, vigourously irrigated.

    You can clean skin with betadine, as long as its intact. You can clean around a wound with it, too, if you want to or if there is even moderate contamination of dirt or foreign matter.

    Getting these topical antibiotics into a wound, however, is bad. The reason is that they kill bacteria, but also kill human cells. They will kill the white blood cells migrating through the soft tissue, that are trying to get to the bacteria to kill them. They also kill some of the non-infection fighting cells, which makes for dead tissue. Dead tissue is bacteria food.

    You can't effectively make a wound sterile without killing some human tissue. Dead tissue will rapidly become contaminated again. But don't sweat it - its not neccessary. The only sterile wounds are those made in the operating room. The classification then becomes something like "clean wound", "clean contaminated", and "dirty contaminated". This classification is based on the colony counts of bacteria per mass of tissue. The goal is to get a "clean" wound, not a "sterile" wound.

    You want to get all foreign matter out along with the bacteria clinging to it. You can do this with a jet of sterile saline solution. Fill up a 30ml syringe and forcefully spray into the wound, and repeat this at least 500ml for a small wound, or say a liter for a larger or dirty wound. You can't get all the bacteria, but if the blood supply is good, you'll be fine. Better to add some systemic antibiotics like cephalexin (Keflex is trade) than get antiseptic into the wound.

    If you've got active bleeding into the wound, you really need to suture if direct pressure doesn't stop the flow after some time. Active arterial bleeding (aka "pumpers") can give you pretty good blood loss quick. If not alot of blood loss, you can just apply sterile dressings and it will heal with a slightly bigger scar.

    I forgot to mention the tetanus prophylaxis earlier. Get it before leaving port. You can keep some anti-tetanus toxoid in your fridge, too. That is one infection you don't need.

    Anyway, the specifics could go on all day. An epinephrine pen, for instance, would be an important thing to have on board if someone should have a severe allergic reaction.

    You raise a good point about drugs in different countries, JPC. You can't buy Keflex in this country without a prescription, but I think you can pick it up in just about any pharmacy south of the US border without the Rx. Morphine is probably an issue in any country. Tough to justify an Rx for that if you are not sick. Getting caught hiding it would be worse than openly displaying it in medical kit, I imagine.

    My brother is in his last year of law school, with a Masters in maritime law. I think I'll harass him and see what he knows-make him do the research for me. At least in the US, there would be a huge medical liability for the distribution of a real good emergency kit. I know what you mean about the standard "first aid kit". There is nothing in there to help out a wound that wouldn't heal on its own with ease anyway. What a joke.

    I'll get back to you on the "Home Medical and Surgical Kit - the One that Doesn't Suck" pheasability.

  9. safewalrus
    Joined: Feb 2005
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    Location: Cornwall, England

    safewalrus Ancient Marriner

    Don't forget rule one - a slug of something strong (drop of Grog maybe) for the medic to calm his nerves! 'specially if it's his first go at 'open heart surgery' or whatever, especially if theres only two of you, remember who he's operating on! You'll need his nerves pretty steady!

    Also 'bilgerat' remember that it's all very well having all this stuff but if (like most guys) you can't pronounce the bloody thing let alone know what it's for it ain't worth a toss! so the first and most important thing after strong nerves is either a good book! or some good knowledge or better still both!:)

  10. Wellydeckhand

    Wellydeckhand Previous Member

    Bioplaceaton isolate the wound and mediacte to cure from bacteria while speed up healing........ it dry up act like an external skin with all it need covering the wound........:)
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