FIRST AID ON BOARD
In coming times, for the health of all merchant seamen and others at sea, the world has been changing significantly. Continual “real-time” communication, more sophisticated tele-medicine capabilities, including video and audio components, as well as internet and satellite communication have greatly expanded the immediately available knowledge base.
Although today’s shipboard health provider has new and expanded resources as compared to days past, he needs to be equipped with some specific skills to treat minor conditions independently, and also to recognize when these minor conditions are a sign of something more serious.
Approaching a sick patient at sea :
A patient on sea may have a health complaint ranging from a common head cold to appendicitis. The environment in which the patient is cared for should be a quiet spot, well-lit, safe from explosives as oxygen may be required to be given to the patient, and the ambient temperature should be comfortable. There should be availability of thermometers, BP apparatus, stethoscope, otoscope, ophthalmoscope, tongue blades, flashlight, gloves and lubricant, reflex hammer, several washbasins,(with water supply) and scale.
Managing Dehydration on Board :
Dehydration is a progressive loss of body fluids and electrolytes (body salts) from the body, which
can in some cases lead to altered mental status, weakness, cramps, fainting, convulsions, shock, coma
and even death. Common causes of dehydration include working in hot environment in ship, also
other causes include vomiting, severe diarrhea, blood loss, and others. Once a patient has become
dehydrated fluid replacement with oral or intravenous will help in rehydration.Managing seasickness :
Following is a list of several actions you can take to minimise your chances of feeling nauseous on boat ;
• Avoid alcohol & rich, greasy or spicy foods
• Keep some solid food in your stomach at all times. Crackers or bread make good choices.
• Sip small amounts of fizzy drinks such as ginger or clear soft drinks.
Commonly used drugs for seasickness include meclizine, promethazine or cinnarizine.
Wound Care :
Wound Care includes universal precautions, control of bleeding, control of infection, and preservation of function in the injured part.
The quickest and most effective way to control bleeding is to exert direct pressure and try to draw the edge of the wound together.
If the injury is to a limb, raise it to reduce the flow of blood. Cover the wound, preferably with a sterile dressing and apply pressure. If it continues to bleed simply add more dressings on top.
If you suspect internal bleeding after an injury, loosen the casualty's clothing, monitor his pulse and respiration and seek medical aid immediately. The wound should be inspected frequently for signs of infection. Wound infection will be characterized by such local signs as pain, swelling, heat, redness, and/or limitation of motion.
Steer clear of sunburn
These first aid tips can help you avoid having a painful sunburn at the end of the day:
• Put sunscreen of atleast SPF 15 several times during the day.
• Always wear a hat and polarized sunglasses.
• Drink plenty of cool fluids. If you're fair-skinned, wear a long sleeved, lightweight cotton
• For Moderate Sunburn :
Use tannic acid ointment or boric acid ointment. Use zinc oxide
ointment in cases where the skin has begun to crack and peel.
• For Severe Sunburn :
Where large blisters are present, put on boric acid ointment and cover
with sterile gauze. If boric acid ointment is not available, use vaseline. Feverish patients should be kept in bed and fluids should be plentifully given.
Some tips on First Aid for life-threatening conditions :
Initial Assessment and Treatment:
One method for evaluating a victim’s condition is known by the acronym ABCs, which stands for:
A — Airway—is it open and unobstructed?
B — Breathing—is the person breathing?
Look, listen, and feel for breathing.
C — Circulation—is there a pulse?
Is the person bleeding externally? Check skin color
and temperature for additional indications of circulation problems.
Once obvious injuries have been evaluated and no evidence exists to suggest potential skull or spinal injury, place the injured person in the Recovery Position. Position the person to
lay on one side with the head kept in a neutral position in line with the body so as the victim can vomit without choking or obstructing the airway.
How to Treat Shock :
Shock occurs when Blood Pressure drops and the organs do not receive enough blood, depriving them of oxygen and nutrients. The symptoms of shock are anxiety or restlessness; pale, cool, clammy skin; a weak but rapid pulse; shallow breathing; bluish lips; and nausea. Shock victims should be covered with blankets or warm clothes to maintain a normal body temperature, given lots of reassurance and fresh air. The victim’s feet should be elevated. Its safer not to administer anything by mouth to a shock patient.
Things You should have in a cruising boat's first aid kit :
• A cruiser's first aid kit should be waterproof.
• It should be well equipped to treat burns, minor and major cuts and lacerations as well as
• Its contents should include hospital quality tweezers to remove broken glass, scissors, items
to make splints, adhesive bandages, gauze, low grade disinfectant, regular strength pain medication, large size bottles of iodine, triple antibiotic ointment, serious painkillers, anti diarrhoea medicines, antacids, motion sickness medicines, oral antibiotics, rehydration solutions, over the counter medicines, instant cold packs, lots of bandages of all sizes for minor cuts scalpel and skin staples to close large wounds.
A good first aid kit onboard your cruising sailboat can save your life.
With advances in modern medicine, newer drugs and technology, managing medical problems at sea has become far better in today’s times. Also people with any problems are far better comforted with such available measures.
So, if you've been looking forward to a holiday and plan a sea travel, there is no cause to worry. You will have fun, stay healthy, and be safe, as long as all these safety precautions on board are there.
Zusammenstellung der fachlichen praktischen, publizistischen und wissenschaftlichen Aktivitäten von Dr. med. Armin Aeschbach Dr. med. Armin Aeschbach, Facharzt Anästhesie Intensivmedizin FMH, Schmerztherapie - Dozent/Ausbildner von Assistenten und Fachärzten in Interventioneller Schmerztherapie - Dozent an praktischen schmerzinterventionellen Workshops/Kursen - Publikationen in Fac
REHABILITATION AFTER ANTERIOR CRUCIATE LIGAMENT (ACL) SURGERY Rehabilitation following ACL reconstruction is milestone based and varies from patient to patient. One stage should be completed before moving on to the next. Timescales have been entered as a guide: RECOVERY PHASE (WEEKS 0-2) THEME: REST, PAIN CONTROL & BRUISING REDUCTION An ACL reconstruction effectively causes a new