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Daria Blackwell - 12/1/2020

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Dick - 9/5/2020

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Dick - 2/7/2019

Hi OCC community, I believe that the development of medical kits suggestions should not be very hard as the wheel has already been invented. Every few years there is an article to this end in the slicks, there are also commercial outfits who list their contents and some YC’s have suggestions. The details should clearly be vetted as to their content by those among us who are experienced in medicine and experienced in cruising and they should be vetted for the changes in wilderness medical responses that are accruing. But to come up with a contents list for widely wandering cruising boats should not be a challenge (and pare it down for those who are coastal cruising etc.). In addition, too few kit lists address the specific needs of children and the largely unknown (for most cruisers) dangers of tropical mishaps while snorkeling, hiking etc. In most ways, the cruising families we have shared anchorages with over the years were the best prepared and trained: they carried a heightened anxiety with regards to their responsibility to their children and acted on that anxiety by getting training. In contrast, to my casual observation over the years, the cruising couples were far less well prepared. Many had not taken courses comprehensive enough to enable them to use the contents of a reasonably sized medical kit effectively in an emergency. When there was training, it was in the realm of basic first aid or the type of courses where the content of the course presumes that first responders are on their way and a hospital an ambulance ride away.. The above is a long route to suggesting that hand-in-hand with developing suggestions for a kit (and perhaps even prior to developing a kit), especially a kit with prescription medicines ready-at-hand, we should be looking at the various training opportunities in our respective countries and urging OCC members to get the training necessary to use the kits effectively. I would want to suggest, that once one gets adequately trained, that the kit choices will largely fall into place and that it is the un-trained who will be confused and bewildered and looking to others for help: in other words, if you are confused about what your kit should contain, then you probably need training (or more training in depth). My best, Dick Stevenson, s/v Alchemy

In another part of the forum, I posted this as it was a follow up of a Thought on Safety. I think it also fits here. Dick
Hi all,
I said a while back that I was taking a refresher course in medical training: below is my report.
Comments on the course;
1.    Medical training has come up upon occasion. There is very little for the offshore recreational sailor and is more easily found among wilderness support programs. In these covid period with time on our hands, my wife and decided to do an on-line course labeled “Wilderness First Aid” (solowfa.com). It is a self-paced training that takes about 16 hours, I think matching the 2-day in house training of the same name and you have a month to complete the course. It is presented under the umbrella organization of SOLO Schools, one of three well known and well thought of wilderness training organizations in the US. It comes with a handbook.
2.    All will benefit, but those sailors who do a lot of hiking will particularly benefit from the emphasis on trail injuries.
3.    This is an on-line course that was cobbled together for this covid time, and should be viewed as an impressive effort. There is definitely a loss from missing class participation where hands-on skills are practiced, but some, or most, of that can be covered by diligent students on their own.
4.    We got a lot out of the course and felt we had renewed some, perhaps much, of the skill-and-thinking set acquired in previous training that is the basis for wilderness intervention.
5.    We certainly noticed that this was a “low budget” locally produced production, but did not feel that this interfered with the training nor did it impact adversely our ability to learn the content. That said some of the whiteboard hand writing and organization could have been improved; additionally, not all is covered in the accompanying text. A lower fee for couples training together would be appreciated.
6.    It is not a wilderness course by my definition: being completely on one’s own. Most interventions are predicated on the thought that there could be an ambulance called to the trailhead. That said, it did cover the essentials of making a determination of the nature and severity of a medical emergency. An offshore sailor would do well to continue training using this course as a beginning.
7.    This not a course that teaches initial and follow-up treatment of moderately serious injuries/illness that do not meet the level to bring rescue hundreds of miles to seas: perhaps the loss of a finger tip in a winch might be an example. Painful, gruesome, worrisome, but within the treatment capacities of a crew with an adequate medical kit and reasonable prescription pain medications and meds for infection.
8.    In summary, I would very much recommend this course for those who have had no prior training or for those whose training has consisted of CPR and a few hours of first aid. This course is far more substantial and might be best described as and “Adventurer’s First Aid” course rather than a “Wilderness First Aid” which should do nothing to diminish its usefulness.
Come back with questions,
My best to all, Dick Stevenson, s/v Alchemy

I made Alex take an advanced first aid course because his typical response to injury was 'soak it in salt water'. In self-preservation, I signed him up for certification.

I had studied and have onboard Auerbach's Wilderness Medicine manual. It's now a 2-volume set.  I would have loved this online course you suggest, Dick. I will check it out. Thanks. 
I also had onboard a comprehensive personalised medical kit that my sister put together for me  - she was an Infectious Disease specialist. And I had a complete surgical kit with some instruction in how to use it. If I had to get advice via SSB, at least I'd have all the tools necessary to follow instructions. Thankfully, the only thing I had to use was the antibiotic when I developed strep throat after swimming in Martinique. We never made it into the Pacific after a family member had a heart attack and then a stroke and we had to return home, so we were never really that remote. 

Alex broke ribs on a delivery from the Azores to Ireland. There's not much one can do about this. Fortunately, I had sent him off with a good supply of painkillers and instructions about how to use them.

I wonder if there's a way for us to compile a list of injuries/illness our members have experienced while cruising. Perhaps a survey on the Forum? The results analysed could make an excellent Best Practices paper.

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Simon Currin - 12/2/2020

Daria
I’d be happy to put a link to such a survey in my December email to all members and follow it up with a webinar in the Spring. It looks like the next series of webinars will be more technical in nature so a mediaeval one would fit nicely.
Simon

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Daria Blackwell - 12/1/2020

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Dick - 9/5/2020

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Dick - 2/7/2019

Hi OCC community, I believe that the development of medical kits suggestions should not be very hard as the wheel has already been invented. Every few years there is an article to this end in the slicks, there are also commercial outfits who list their contents and some YC’s have suggestions. The details should clearly be vetted as to their content by those among us who are experienced in medicine and experienced in cruising and they should be vetted for the changes in wilderness medical responses that are accruing. But to come up with a contents list for widely wandering cruising boats should not be a challenge (and pare it down for those who are coastal cruising etc.). In addition, too few kit lists address the specific needs of children and the largely unknown (for most cruisers) dangers of tropical mishaps while snorkeling, hiking etc. In most ways, the cruising families we have shared anchorages with over the years were the best prepared and trained: they carried a heightened anxiety with regards to their responsibility to their children and acted on that anxiety by getting training. In contrast, to my casual observation over the years, the cruising couples were far less well prepared. Many had not taken courses comprehensive enough to enable them to use the contents of a reasonably sized medical kit effectively in an emergency. When there was training, it was in the realm of basic first aid or the type of courses where the content of the course presumes that first responders are on their way and a hospital an ambulance ride away.. The above is a long route to suggesting that hand-in-hand with developing suggestions for a kit (and perhaps even prior to developing a kit), especially a kit with prescription medicines ready-at-hand, we should be looking at the various training opportunities in our respective countries and urging OCC members to get the training necessary to use the kits effectively. I would want to suggest, that once one gets adequately trained, that the kit choices will largely fall into place and that it is the un-trained who will be confused and bewildered and looking to others for help: in other words, if you are confused about what your kit should contain, then you probably need training (or more training in depth). My best, Dick Stevenson, s/v Alchemy

In another part of the forum, I posted this as it was a follow up of a Thought on Safety. I think it also fits here. Dick
Hi all,
I said a while back that I was taking a refresher course in medical training: below is my report.
Comments on the course;
1.    Medical training has come up upon occasion. There is very little for the offshore recreational sailor and is more easily found among wilderness support programs. In these covid period with time on our hands, my wife and decided to do an on-line course labeled “Wilderness First Aid” (solowfa.com). It is a self-paced training that takes about 16 hours, I think matching the 2-day in house training of the same name and you have a month to complete the course. It is presented under the umbrella organization of SOLO Schools, one of three well known and well thought of wilderness training organizations in the US. It comes with a handbook.
2.    All will benefit, but those sailors who do a lot of hiking will particularly benefit from the emphasis on trail injuries.
3.    This is an on-line course that was cobbled together for this covid time, and should be viewed as an impressive effort. There is definitely a loss from missing class participation where hands-on skills are practiced, but some, or most, of that can be covered by diligent students on their own.
4.    We got a lot out of the course and felt we had renewed some, perhaps much, of the skill-and-thinking set acquired in previous training that is the basis for wilderness intervention.
5.    We certainly noticed that this was a “low budget” locally produced production, but did not feel that this interfered with the training nor did it impact adversely our ability to learn the content. That said some of the whiteboard hand writing and organization could have been improved; additionally, not all is covered in the accompanying text. A lower fee for couples training together would be appreciated.
6.    It is not a wilderness course by my definition: being completely on one’s own. Most interventions are predicated on the thought that there could be an ambulance called to the trailhead. That said, it did cover the essentials of making a determination of the nature and severity of a medical emergency. An offshore sailor would do well to continue training using this course as a beginning.
7.    This not a course that teaches initial and follow-up treatment of moderately serious injuries/illness that do not meet the level to bring rescue hundreds of miles to seas: perhaps the loss of a finger tip in a winch might be an example. Painful, gruesome, worrisome, but within the treatment capacities of a crew with an adequate medical kit and reasonable prescription pain medications and meds for infection.
8.    In summary, I would very much recommend this course for those who have had no prior training or for those whose training has consisted of CPR and a few hours of first aid. This course is far more substantial and might be best described as and “Adventurer’s First Aid” course rather than a “Wilderness First Aid” which should do nothing to diminish its usefulness.
Come back with questions,
My best to all, Dick Stevenson, s/v Alchemy

I made Alex take an advanced first aid course because his typical response to injury was 'soak it in salt water'. In self-preservation, I signed him up for certification.

I had studied and have onboard Auerbach's Wilderness Medicine manual. It's now a 2-volume set.  I would have loved this online course you suggest, Dick. I will check it out. Thanks. 
I also had onboard a comprehensive personalised medical kit that my sister put together for me  - she was an Infectious Disease specialist. And I had a complete surgical kit with some instruction in how to use it. If I had to get advice via SSB, at least I'd have all the tools necessary to follow instructions. Thankfully, the only thing I had to use was the antibiotic when I developed strep throat after swimming in Martinique. We never made it into the Pacific after a family member had a heart attack and then a stroke and we had to return home, so we were never really that remote. 

Alex broke ribs on a delivery from the Azores to Ireland. There's not much one can do about this. Fortunately, I had sent him off with a good supply of painkillers and instructions about how to use them.

I wonder if there's a way for us to compile a list of injuries/illness our members have experienced while cruising. Perhaps a survey on the Forum? The results analysed could make an excellent Best Practices paper.