onboard first aid cpr eqipment

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gonfishin

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Are there any lists/kits recommended for fitting out the boat with emergency equipment?
 
Welcome aboard. We carry several bought kits and supplement them with our specific needs, like our medicine. You can go all the way up to an AED but they are pricey. Ask your doctor what he/she thinks would be good to have aboard.
 
Length of time away from "civilization" is one factor to consider. Day trips vs distance cruising vs passagemaking, and the area you are in.

Many places you are only ever a couple hours away or less from a urgent care and a pharmacy. Other places require a helicopter ride or a long passage just to get to population.

Something that many people don't know is that if you are voyaging in circumstances more like the latter than the former, above, you can ask for a Rx from your provider for some common medications to keep on hand that with some reasonable instruction might extend your time away from definitive medical care. For me that was a broad spectrum oral antibiotic, an antiemetic, a stronger oral painkiller with hydrocodone and some sort of epinephrine injectable. (If I were putting something together again, I might adjust, for example study shows that acetaminophen combined with a NSAID is pretty good for pain without an opioid having to be used, and I've had wilderness docs poopoo the need for oral antibiotics, at least for trauma, so long as the patient will eventually be seen at a definitive care center.)

Even without that, some consideration should be put into thought about OTC medications to treat common ailments that aren't often carried in standard first aid kits. Sour stomach/reflux? Diarrhea? Bad head cold? Motion sickness (of course)? Fever? Bad cough? Allergic reaction? All just as likely as a cut, burn or a broken bone.
 
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AED always on board

An AED for sure!
When minutes count they can save a life with a 90% success rate only if used in the first couple of minutes. By time the EMTs get there, even on land, it is usually too late. CPR on sudden cardiac arrest is not very successful.
Finally know that SCA can happen to anyone of any age. Child and adult athletes are often victims. No one can tell you will are free of risk of having a SCA because no one is.
They can be found for 500 to 700 dollars.
I know of young and older people lost for want of an AED. But none of my boat buddies can say an EPRIP, ASC, radar or life vest actually ever saved their life although those pieces of safety equipment are good to have also.
Know that you will likely never need to use your AED but like a parachute, better to have it and not need it when on the water when you only have 10 minutes till your buddy or family member is gone.
 
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The American Red Cross has excellent CPR and first aid classes, and will recommend exactly what you should have for both. Take the classes, then you'll know what you need and more importantly, how to use it. In our opinion, you can't have too much first aid gear and supplies on board, especially if you are going to spend any time away from the dock and an hour or more way from assistance.
 
I am sure there will be lots of good advice and suggestions regarding your question. Having presented numerous "first aid afloat" programs at safety at sea seminars, I offer the following:

--first, as mentioned the size and complexity of your first aid kit will depend on the size, complexity and use of your vessel. What a long distance cruiser needs is very different then a day sailor. To some extent it will depend on how far you are away from getting someone medical care.

--consider that you may need more then one first aid kit. You may not want to dig into a large medical kit when you just need a band aid. You may want a small first aid kit for your dinghy when you step on that glass bottle as you beach your boat.

--store-bought vs. homemade depends a lot on how much you want to spend and how comfortable you are putting together your own kit. Not a big deal if you just are looking at a basic kit, but gets more complicated for offshore medical kits.

--training: yes. Like your kit, the extent of training depends on how much time and $$ you have and how long you need to care for an injured or sick crew member. I have suggested: Day sailing= basic red cross or similar first aid course; coastal cruiser= wilderness first aid; offshore/long distance cruiser= wilderness first responder, offshore medical officer courses.

Couple of other thoughts:

CPR- definitely take the class (if nothing else you might save someone ashore), but understand that with few exceptions if someone has a sudden cardiac arrest offshore the likelihood of getting them back is pretty low.

WILDERNESS FIRST AID: I am a huge proponent of boaters taking a WFA class. The general definition of "wilderness" for first aid/medical purposes is more then 1 hour from definitive medical care. It doesn't take much water to fit that definition! If nothing else, the WFA courses teach that mindset. There are lots of organizations that offer it (at least in the pre-COVID world), and there are even some WFA-afloat programs.

AED: As anyone who has taken a CPR course knows, an AED is part of the survival chain for cardiac arrests. Unlike on TV, it won't save everyone, but can help to save some. It however, is a pretty pricey piece of medical gear (least expensive I found tonight was about $1200) and one that even if it works on someone in cardiac arrest you may still be too far away for the final link in the survival chain- advanced medical care! One of those personal decisions as to whether you get one.


MEDICATIONS: Tread carefully. Not a big deal when you are dealing with simple OTC meds like tylenol, ibuprophen, benedryl. Things get more complivcated with prescription drugs and then even more so if you look towards controlled pain meds. If the prescription is current and yours and you take it yourself as prescribed you are fine, problems come in if you give the med to someone it is not prescribed for. (against US law) Despite some comments I have seen, there is no general exception to prescription rules and regulations for recreational vessels (in the US; different rules apply to commercial vessels with designated medical officers). And if you go international, you need to consider and comply with the laws of the country (s) you visit.

FINALLY... many of us are cruising couples, just 2 onboard, maybe with the occasional guests. If you get trained, train your crew as well (spouse, partner, son, daughter, whatever) because what if it is you that needs the help???!!

Just my 2 cents....
 
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As a retired medic, + 1 on having an AED. They can be had for about $2000 or less. Remember you have only 4 to 6 minutes in the case of sudden cardiac arrest. The American Heart Association can teach you how ( and when ) to use it.
 
In addition to everything above, A bunch of "Wound Seal" Old people on blood thinners bleed like water out of a spigot. That stuff really works. Yes, I am a satisfied user of it.
Butterfly bandaids etc
AED +1 The automatic AEDs only shock, if necessary.
The miracle drug called aspirin.
Learn how to immobilize a broken bone. Learn the difference between a 'simple fracture' and a 'compound fracture' and how to treat each.
 
I am a retired R.N. so I built my own first aid kit with top quality equipment and drugs. A couple Vicodin and a few Penicillin tabs can be very important if you are a number of hours or days out.

An A.E.D.... big question. A lot of people have a huge misconception about what an AED can and can not do. Television is probably to blame. An AED will occasionally restart a heart which has stopped. But it will not make an old, worn out, diseased heart any better than it was at the exact second it stopped beating. It may just keep that old ticker ticking for while but the underlying causes of the heart stopping will remain unchanged. That includes bad kidneys, plugged arteries, advanced liver failure, dementia, and a host of other causes of death.

I know there are often other people on my boat with different goals in life than mine (or the Admiral) , however, to die from a heart attack on my boat is probably the perfect ending for me.

No heroics for the Admiral and I, please

pete
 
We are fortunate that one of the guys who fishes with us is a trauma surgeon who equipped my boat with an emergency surgery package, and oxygen, as well as the normal first aid stuff.
 
I have a good Marine kit, then I added wound seal, splint material, staple type sutures, emergency dental stuff, and a few basic prescription meds. I am boating solo most of the time, so a AED is probably useless for me, but I could theoretically use the rest of the stuff even if alone.
 
I think I'd choose an Oxygen tank over an AED if I couldn't have both. CPR with Oxygen is much more effective, and its vital in near drownings. Also, depending on the type of boating you do, you could just rent an AED if you were going over the horizon occaisionally.
 
I would second the inclusion of an AED. They are expensive but how does one value the life of a loved one? I suffered Cardiac Arrest last March, at home not on our boat. My wife of 47 years made her 2nd mistake (her 1st was marrying me) and performed CPR; she has never taken a certification class. She continued CPR for about 9 minutes; several lifetimes if you've ever tried it, until a rescue squad arrived and employed their AED. Six weeks and a quad bypass later, I was back home, no worse for the experience but sporting a tracheostomy tube from an unfortunate run-in with a ventilator. Somehow, I beat the odds but I know that had we been on the boat I would not be here, we do not have an AED on the boat.
 
I made a first aid kit. I bought a Pelican style box large enough for what I wanted. I then looked at a number of expensive 'expedition' class medical kits. I made a master list from their components and then headed out to the Pharmacies.

You can build a "$300-$400" medical kit for much cheaper than you can buy it.
 
Regarding AEDS, people are correct, hard to put a $$ on a life if the $1500 AED can help save someone, but if you do get one for your boat, just keep in mind, like other equipment, they require periodic maintenance and servicing (they run on a battery), it's something else to add to your list of "annual" (or more frequent) checks. Also remember that it is rare just the AED will save the person, you need a plan to get them to advanced medical care.
 
AEDs have to be certified like life rafts. I believe the AED is annually. Expensive and time-consuming. If one of your guests has heart issues, they should bring one. If you have heart issues, maybe boating is not a reasonable activity for you, rving might make more sense for proximity. We are all getting older.

An epi-pen would be useful too, but they expire every year and are expensive and I'm told, by my friend the paramedic, are in short supply.

There is a practical limit. Oxygen bottle? Backboard?
 
I'll chip in...I'm a nurse who works in the Emergency Department and ICU, formerly did fire and ambulance for 25 years, taught EMTs, wilderness courses, industrial courses, combat first aid (SABC) for the Air Force, and others.

A lot of what you might need is dependent upon where, when, and with whom you'll be boating. Inland boating, coastal cruising, or blue water voyaging? Solo, with family and/or friends, with anyone with special medical needs or certain medical histories?

For example, an AED is, indeed, a potentially life saving device, but its application is extremely limited in the backcountry...or far at sea. I was once the naturalist guide on a trawler yacht with 16 tourists aboard, 600 miles at sea, when a passenger had a heart attack. If he had suffered cardiac arrest, no amount of CPR or defibrillation would have saved him as we were days away from rescue, with no helicopters available (in the Pacific off Ecuador). On the other hand, were we in coastal waters of the US, with possibility of timely helo medevac, it would make more sense to have these capabilities.

Will you have a passenger with brittle diabetes aboard? Glucose would rise to the top of the list of medications to have aboard. Do you have a crew member with a seizure disorder? Suddenly, you wish you had a Diastat injector...rectal Valium. Family member with a history of coronary disease? Chewable aspirin, sublingual nitroglycerin, MAYBE an AED. Severe allergies? Definitely two EpiPens...or, for far less money, a couple of vials of epinephrine and a couple of syringes, if you want to get trained to do it manually. I would add Benadryl and Pepcid/Zantac as lifesaving meds for those with severe allergies, to augment the epi. Cruising in areas where encounters with jellyfish might be likely? Keep vinegar, antihistamine, and a source of hot water aboard. By the way, the only possible..and it's a stretch...circumstance in which I'd consider having oxygen aboard might be if a lot of SCUBA diving were being done. Speaking of which, if you have a dive compressor on board, do you know how to treat barotrauma?

So a lot of what you need may be anticipated, depending upon where you'll be and with whom.

A mistake I've seen over and over is folks building a kit...trying to be comprehensive, anticipating any possible disaster...but not building their knowledge or skills. Don't bring equipment for emergency needle thoracentesis if you have no way to use it! What we always emphasized in our wilderness courses was improvisation...how to make and apply bandages and splints rather than how to use a lot of specialized equipment. For example, if your head-injured patient can't maintain his airway while awaiting rescue, you could perform endotracheal intubation (not), insert a nasopharyngeal or oropharyngeal airway (only if you have them and know how to use them), or you could safety pin his tongue to his lower lip and position him in the recovery position. Caring for a blistering burn? Please learn how. Hint: no butter!

It comes down to training, training, training. With thoughtful training, you're better off with some homemade triangular bandages, sanitary napkins and Gorilla tape than the untrained person is with the EMT's kit off the ambulance. Resources for first aid training for boaters that come quickly to mind include your local Power Squadron, Propeller Club, Coast Guard Auxiliary, DANBoater, the Cruising Club of America, Sea Scouts, and local community or technical college. If you add wilderness first aid training, which is the same stuff in a different venue, the options grow. Finally, one course can't cover everything, and you can't remember everything forever. It's important to have a good reference aboard, a text book that addresses your needs. There are little pamphlets and flip books, paperback books, and large hardbound texts. Select one based upon all the above considerations. For example, the lay public seems to have no idea how to effectively care for a nosebleed. Here's how: pinch the nostrils tightly and tilt the head slightly forward. Wait a long time. If this doesn't work, blow out the clots and spray heavily with Afrin. Pinch and wait. If that doesn't work, repeat with more Afrin, pinching and waiting. If that fails, blow out the clots, saturate gauze in Afrin and pack the nostril. Pinch and wait. Keep pinching and waiting. Of course, you could always Google this stuff...oh, wait...no cell service? Bummer. There are lots of books that address everything from simple first aid to complicated diagnosis and treatment.

I like to assemble supplies and equipment for several basic purposes.

1. Routine care: treatment for boo boos such as cuts and scrapes, sprains and strains, sunburn and seasickness, fevers, simple allergies, rashes and itching, headaches and belly aches including heartburn, diarrhea and constipation, etc. Throw in stuff as needed for specific crewmembers, such as migraine meds, rescue inhalers, glucose gel/tablets, cream/suppositories for hemorrhoid flare ups, etc.

2. Outpatient care: treatment for things that ordinarily might require a walk-in clinic, such as laceration repair, severe sprains & simple fractures, draining an abscess, repairing a broken tooth or lost filling, foreign objects in the eye, deep puncture wounds/impaled objects, etc.

3. Oh **** care: this depends upon a lot of those factors mentioned above. I don't need a heavy trauma kit and morphine if I'm within 911 coverage, but would include these on a blue water passage.

Over the years I've had as much opportunity to help others with my knowledge and supplies as I have myself and my family. For this reason I carry naloxone (Narcan) on board, as well as epinephrine and a few syringes. These are highly personal choices not suited for everyone. More likely, you can be the hero with some bandages, antibiotic ointment, cortisone cream or Tylenol.

A good friend of mine who is a CT tech at the hospital, an EMT and the medical officer for our fire department, is an avid boater. Unfortunately, he's also somewhat accident prone. He once received bad burns while using a heat gun to speed the evaporation of cleaning solvents from his diesel tank. He couldn't really help care for his injury, but had the stuff aboard to make it work and could guide others in using it. Another time, using a dinghy lift, he amputated a finger at the middle knuckle. This time his wife, a nurse, was aboard and could quickly control the bleeding, apply a secure dressing, give him some appropriate pain meds, and care for him when he grew faint. He got great care from her; his chief worry during that adventure wasn't losing his finger but the way that she slammed the transmissions in and out of gear without reducing throttles!

Lastly, have the appropriate communications gear and know how to use it. If you're on the ICW, you can't necessarily count on your cell phone. If you're taking the inside passage in British Columbia or Alaska, you can't necessarily count on your cell or your VHF. Is your MMSI current and correct, i.e., not registered with a previous owner? Is your PLB/EPIRB properly registered, service plan active, and/or battery charged?

The main philosophy I use when anticipating such needs is something said over 100 years ago by Louis Pasteur: "chance favors only the prepared mind."
 
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I have an AED and a good comprehensive First Aid Kit.

Used to fish 200 miles offshore and this was how I felt comfortable being hours away from any emergency assistance.
 

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Hey thanks for all of your comments! It had not yet occurred to me that I would need to (or could) request extra prescription med’s as I begin to take longer sea trips. Also, as a retired teacher who was required to train in first aid to keep groups of students safe and alive, the idea of purchasing an AED for the sake of keeping everyone safe (including the captain) makes a lot of sense. Yes they are relatively expensive and we hope an AED is never required, but “call 911 and go get me the AED” should be a doable request when groups of people are out to sea.

Though I was not the one to attach the pads and push the start button, I was one of the responders in an emergency situation years ago at our school gym and watched someone brought back to life. This experience convinced me that AED’s need to be available whenever possible.

Here's a few that caught my eye:

Defibtech Lifeline AED
Cardiac Science Powerheart G3 AED
Philips Heartstart Onsite AED
 
Can't go wrong with the Phillips, my division maintained over 100 of them in my last posting, with little problem. Know less about the other brands.
 
Anson
Thanks so much for sharing your knowledge. A couple of years ago my wife suffered a heart attack while we were sleeping on the boat. Fortunately we were in a marina in a town (Powell River) with a hospital. Ambulance was called and got her to Emergency. Once there she went into cardiac arrest. She was then heli evac’d to Vancouver and received 3 stents. Thankfully she is fine now.
Watching the docs bring her back with CPR and AED I knew the result would have been completely different had the incident happened anytime during the previous few weeks when we were in a remote anchorages with only myself to assist her. My CPR training was years old I did not remember much. Cell phone reception was marginal and help was at least an hour away if contact could be made.
I have since retaken first aid and CPR training. Your point that it’s a good idea to have instruction documentation as part of emergency supply kits is a good one. The training is a one time event. Unless you’re performing them all the time, remembering procedures is difficult especially in the heat of the battle. At least for me yearly refreshers are likely a good idea.
Thanks again for your detailed advice
 
If I were shopping for an AED I would select the one with the longest battery life. The actual user experience is essentially the same for all of them. There are also more than just the three mentioned above, so shop around. They're all FDA approved, including the factory reconditioned ones.
 
I’m a physician. Have been internationally cruising for the last 7 years. Huge variance in quality of medical care. So did up several medical bags
Skin
Bites and stings
Trauma (large bag)- burns, fractures, cuts, lacerations, puncture wounds etc.
Infections/sepsis
Anaphylaxis
CV events -codes, MI/stroke, PE etc.
Most injuries and deaths aren’t from codes. Having paddles is great to have but without training/knowledge it’s just having one bucket of water for a housefire. We’re all set. I’m a doc. Wife’s an RN. We’re always appropriately stocked but more importantly have the skill set.

Strongly recommend
DO A WILDERNESS MED COURSE. or equivalent.

Supplement this with knowledge about local toxic plants, wild and marine life. Also learn about local diseases (dengue fever, etc.)
 
There are three categories of stuff I have. 1) deal with boo boos - this is for things you wouldn't be going to an ER for. Bandaids, creams, etc... Usually this is the limit of most kits. 2) stuff that will keep someone semi-alive until the cavalry comes - AEDs, pressure bandages, tourniquets, epipen, immobilization, hypothermia treatment. This is 30% equipment and 70% training - maybe even more training 3) stuff to get the cavalry here - EPIRB, PLB, DSC, InReach.

Chartering boats, it's scary how many don't have an MMSI, have an MMSI but it's not programmed, don't have the VHF hooked up to a GPS, etc... I've heard that less than 1 in 10 emergency calls on VHF have working DSC. Letting the computer send the coordinates is better than a misheard, misformatted (decimal degrees, decimal minutes, or degrees minutes seconds??), or mis-transcribed location. Couple that with similar sounding places-Blake Island, Blakely Island, Blakely Rock, Port Blakely are separated by ~70 nautical miles in Puget Sound - and Blakely Rock and Port are closer to Blake Island than Blakely Island, but actually on Bainbridge -- clear?

As others mentioned, location and use of this equipment should be briefed and practiced. Dealing with closed head injury, breaks, and hypothermia integrated in your MOB rehearsals. Even if it isn't you that needs help, having some folks that can work on getting the cavalry while you work on the patient will be helpful.
 
Speaking of the above, do emergency services and the USCG a favor and make decimal minutes your default coordinate format on all devices. Yes, people can convert it but that takes unnecessary seconds.
 
A comment about prescription meds on a pleasure boat;

I admit that I don't know all the laws regarding prescription meds on a boat but just to be safe we wrote up a Ship's Formulary and had it signed by a physician. It basically lists all the prescription meds, their doses, and amounts. I think this is especially important for prescription narcotics. We sailed to the Bahamas several years ago and carried a couple of doses of injectable morphine in our first aid kit. (I am a Nurse Anesthetist and my wife is a Nurse). We declared the drugs when going through customs and they respected the Formulary without question.

I'm not advocating having injectable narcotics- probably overkill unless you're going trans-ocean. We were a bit overzealous back in the day. :)
 
In the UK they have done something so intelligent it will never happen here (Canada/USA). Their medical kit class "C" is designed for the marine environment. The idea is you don't use it until instructed to do so. So the call goes to the Coast Guard or whomever and they bring a doctor in to consult. The doctor is then given a list of Class C items and he/she works with these items at hand in the kit. Obviously if you go into the kit many times before the above emergency, items will be depleted or absent altogether. So another kit is recommended to be brought along as the actual on the scene kit until the C kit is required. Below is a copy and paste I did, pretty standard stuff:

Category "C" First Aid Kit

UK MCA and Lloyds Register of Shipping Type Approved for Category "C" Vessels which includes lifeboats and liferafts. Maximum certificated drop height 36 metres. Additional Approvals held for Norway,Poland and Greece. This kit complies fully with EC Directive 92/29 and is CE marked.

ADEC Marine hold their MHRA WDA (H) Licence Number 43533 for the authorised and approved distribution of Category C First Aid Kits

Contents:

30 x Anti-Diarrhoea tablets
60 x Anti-Sea Sickness tablets
1 x Anti-Angina Preparation
50 x Analgesic tablets
50 x Ibuproven
2 x Standard Medium Dressings
2 x Standard Large Dressings
1 x Extra Large Standard Dressing
10 x Sterile Paraffin Gauze Dressings
4 x Calico Triangular Bandages
1 x Sterile Absorbant Cotton Gauze
1 x Adhesive Elastic Bandage
20 x Adhesive Plasters Assorted Sterile
6 x Adhesive Sutures 75mm
1 x Pocket Mask Mouth to Mouth Resuscitation
1 x Antiseptic Cream
5 x pairs of Disposable Polythene Gloves (Large)
1 x Burn Bag
1 x Scissors
6 x Rustless Medium Safety Pins
6 x Antiseptic Wipes
The above kit comes complete with a St. John's Ambulance manual and all in green plastic stowage box. Green stowage box will be as per either images shown, if you have a preference please.

Alternative Option - Medical Stores as above in soft pack, but without Manual or stowage box.

When ordering, please advise us of the name of vessel/boat that the first aid kit will be placed on.
 
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