The subject of the degree of preparation needed to tackle a medical emergency when sailing is very controversial; some people believes that nothing more than the same knowledge useful in everyday's domestic life is required, also in view of the generally healthy lifestyle practiced on-board.
I do not agree with this view: especially during offshore- or passage-sailing, the risk of an accident is always present, and latent diseases may become evident (especially risky when there are on board people whose medical history is not well known), while external help may be several days away and casualty evacuation may be unfeasible.
Even if nowadays it could be possible to consult a doctor via SSB radio or sat-phone, it's nevertheless essential to:
- ensure the competences and skills needed to perform first-aid and subsequent medical care (and if needed to report symptoms to a faraway doctor and perform his instructions).
- have on board the medicines and equipment suitable - within reason - to tackle any emergency.
The commonly-available "First Aid" courses are of very limited use because they are meant for situations where professional help can be available in a matter of minutes and the only objective is to make sure that immediate threats to the casualty are removed and no further damage is done through improper practices.
Courses specifically aimed at professional mariners are available in the UK; I chose "KTY Yachts", operating near Southampton, which offers special prices to Blue Water Rally members; their courses, based on the MCA syllabus, are:
Counting course-price, travelling and accomodation, it's a fairly substantial expenditure: is it worth doing? I believe so, even if these courses are obviously aimed at "getting the ticket", I still feel much more confident to be able to tackle a medical emergency and consult the manuals in a much more methodical fashion.
The International Radio-Medical Centre (CIRM) in Rome, which manages an excellent worldwide radio-medical consultation service, is providing one-day courses which normally run on Saturdays. A bit short and in Italian, but a possibility nevertheless.
On-board Medical Kit:
This is another controversial subject, because the list of "potentially useful" kit may be very long!
For offshore sailing, a good guide could be the "Table A"
which international regulation prescribe for offshore-sailing ships, taking into
account that help could be many days away and even shore-based infrastructure
may be very poorly-equipped.
The Blue Water Rally, with the aid of some sailing doctors, has defined a recommended "Medical Kit", which is in fact a subset of Table A: Medkit contents (file .pdf)
In the "MSN1768 - Ship's Medical Stores" booklet there is a section which I find very useful, where for every medicine listed in Table A main usages, dosages and side-effects are provided; for my own use, I've made an abstract with only the medicines included in the Rally Medkit: Guide to the usage of Medicines (file .pdf)
DISCLAIMER: these documents are provided merely as an example of how I organised myself concerning medical stores and their usage and should not be treated as official documents or as an alternative to professional consultation. Use at your own risk!
Getting Medical Assistance:
The Italian C.I.R.M. (Centro Internazionale Radio Medico - International Radio Medical Centre) provides since 1935 free medical assistance to vessels at sea, initially over short-wave radio and nowadays also by sat-phone or e-mail. Contact details can be found at CIRM's WEBSITE.
"Ship Captain's Medical Guide", available for download on the MCA website.
"MSN1768 - Ship's Medical Stores", document describing the internationally-required medical kit and its use, also downloadable from the MCA website. (Note: there is an error in MCA's website and the document may not be available for download. Sorry, nothing I could do about it!)
"Where there is no doctor", a manual aimed at relief-workers operating in areas without medical help; despite being markedly "rural" oriented, it can be a good source on basic medical care and is available for download from the Hesperian Foundation website.
First Aid Advice on "St.Johns Ambulance" website (text-only without illustrations - on the same site it's possible to buy the full booklet, basically containing the same info of the first day's course).
- The Captain - or Owner - of a ship is legally allowed (in
many - but not all - Countries, even without a doctor's prescription) to purchase
and store medicines for use exclusively when at sea, under the
Captain's responsibility and supervision of a qualified person ("Medical Care aboard Ship"
- A Medical-proficiency ticket would also go a long way to keep local Customs Officers happy, especially in those countries where some of the medicines are restricted (some - like codeine - must be kept in the Captain's safe). Otherwise, make sure you have a qualified Doctor's prescription for all medicaments.
- In these litigious times, the skipper is always at risk in case of a medical accident; having on-board a formally qualified person, equipped with a compliant med-kit and operating according to the "Ship Captain's Medical Manual" (or, much better, consulting with a Doctor via SSB radio) are important steps to be protected from negligence charges.
Last Update: 11/11/2014
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