Island Cruising Association - Medical Kits and First Aid

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Medical Kits and First Aid Advice

We wish to say a BIG THANK YOU to Dr. Nellie Steinermann of the S/Y "Rory Mhor" for her very valued assistance in compiling the following lists. nsteinemann@xtra.co.nz This is a recommended Doctors First Aid Kit only (most cruisers will require less) and you must add or delete to it as your requirements arise. It is also advisable to have in your Ship's Log where the contents of your kit are stowed aboard, so look at the following and amend as you think fit for your crew. As Captains you must make sure you know of any pre existing illness, medical condition or ailments your crew have.Advise on how to do this is on pages 20 & 21 of the "KIWI CRUISER'S LOG"

Disclaimer:

Whilst every effort is made to provide current and accurate information and advice, no liability is accepted by the Island Cruising Association for any incorrect statement or advice. The following four tropical diseases are explained on separate pages. Please click on the links below for a full explanation.

INDEX

Doxycycline	A	2,4	Steristrip	E	6
Dressings	E	6	Sunscreen		4
Drixine	B	5	Suturing gear	E	7
Duoderm	E	6	Augmentin Syrup	A	2
Earplugs	B	4	Augmentin	A	2
Elastoplast	E		Syringes	C,B
Fever Thermometer	F	7	Telfast or Claratyne	D	3
			Titralac	A	2
Flucloxacillin inj	C	2	Triazolam see Halcion
Flucloxacillin	A	2	Trichozole see Metronidazole
Fucithalmic	B	5	Tweezers	E
Gastrolyte	D	3	Vaseline	F	4
Gloves, disposable	F		Vaseline Gauze	E	6
Nitrolingual spray	B	4	Ventolin inhaler	B	3
Halcion	A	4	Voltaren Suppositories	D	2
Hypofix	E	7	Vosol	B	5
Imodium see Loperamide			Water for Injection	C	2
Insect Repellant	F	4	Wet Ones	F	5
Knee support	F		Xylocaine Injection	C	6
Locoid	B	4	Zovirax	B	4
Loperamide	D	3	Quick Eze	A	3
Melatonin	A	4	Somac	A	3
Melolin	E	6	Celebrex	A	2
Metoclopramide inj	C	2
Metronidazole	D	2,3

CHECKLIST BY BOXES

A – Tablets pain,infect,nausea	Vosol	Hypofix
Amoxyc tabs	Zovirax	Primapore squares
Co-trimox		Jelonet (Vaseline Gauze)
Doxycycline	C - Injections	Melolin (dry dressing)
Fluclox	Alcohol swabs	Saline
Halcion	Inj Adrenalin	Savlon (or Dettol)
Melatonin	Inj Amoxycillin	Scalpel Blades
Noroxin	Inj Flucloxacillin	Steristrip
NSAID (Voltaren or similar)	Inj Metoclopamide	Suturing Gear
Paracetamol	Inj Morphine	Tweezers
Paradex	Inj Pethidine	Vaseline Gauze (Jelonet)
Prednisone	Inj Prochlorperazine	Opsite
Seaband	Inj Promethazine	Tape
Sealegs	Inj Solucortef
Solprin	Inj Water	F
Stemetil(Prochlorperaz) Antinaus	Inj Xylocaine w/without Adrenaline	Aqueous cream
Augmentin syrup	Needles incl scalp vein	Bandages (crepe, gauze)
Augmentin tabs	Syringes	Cotton Wool
Quick Eze		Dimp
Somac	D - Allergy, Gut, Vagina,	Fever thermometer
Celebrex	Antihistamine (Claratyne, Telfast)	Gloves
	Canesten vaginal	Knee bandage
B – Skin, Ears, eyes, cough	Coloxyl with Senna	Knee support
Anthisan cream	Gastrolyte	Primapore Strips
Bactroban	Loperamide	Precious
Batrafen	Metronidazole	Triangular bandage
Bushman Insect Repellant	Proctosedyl	Vaseline
Cough remedy	Stemetil suppos
Drixine	Voltaren Suppos	Other places:
Earplugs		Ice pack: Freezer
Fucithalmic	E - Injuries	Sunscreen: Bathroom
Nitrolingual spray	Bandaids	Spare plastic bag with;
Local Anaesth Eyes	Disinfectant	dressings, syringe, needles,
Locoid or other steroid	Dressings	xylocaine, & scalp vein needles
Sofradex	Duoderm
Ventolin inhaler	Elastoplast

BASIC KIT

Small well marked box, kept handy, containing small amounts of:Bandaids Solprin (Disprin) for pain, don't take on empty stomach or if prone to indigestion or ulcers Paracetamol for pain Sealegs for sea sickness Crêpe bandage There is plenty more of it all in the comprehensive kit; fill up when running low.

COMPREHENSIVE KIT

Specify the location in the ship's log. In marked boxes A to F - see below for instructions: A - Tablets for pain, seasickness, infections, indigestion, malaria, allergy, sleeplessness B - Creams and drops for ears, eyes, nose, lips, skin, inhaler for asthma, thrush treatment C - Injections, syringes, needles, local anaesthetic D - Medications and things for constipation, diarrhoea, haemorrhoids, thrush Suppositories for nausea E - Injuries including suturing materials F - Spare bandages, gloves, aqueous cream, insect repellant CONTENTS OF THIS BROCHURE Infections (antibiotics), Pain, Nausea, Seasickness, Vertigo Indigestion, Diarrhoea, Constipation, Allergies, Asthma Insomnia (sleeplessness), Malaria, Skin treatments Nose, Eyes, Ears, Lips, Haemorrhoids, Thrush Injury treatment Injuries continued, Suturing, burns

Medication	Indication	Amount	Dosage	Box
INFECTIONS Antibiotics: General rule: Take until better, and then two more days
Amoxycillin 250mg (Penicillin)	Tonsillitis,Ear infections,Bronchitis	30 tabs	1-2 three times daily	A
Flucloxacillin (Penicillin)	250mg Skin infections	30 tabs	2 three times daily	A
Augmentin Amoxycillin Clavulanate (Broad Spectrum Penicillin)	Skin infections, Boils, Severe Tonsillitis, ear infections, sinusitis, bronchitis, urine infections. Don't use if allergic to Penicillin	30 tabs +Powder for syrup	one 3 times daily with meals 5ml 3x daily	A
Doxycycline (a Tetracycline) Co-trimoxazol (a Sulphur drug)	Sinusitis, ear infections, bronchitis, skinSame as Doxycyline, also used for urine infections	30 tabs20 tabs	one daily, with meal2, twice daily	A
Metronidazole Trichozole	Diarrhoea caused by Giardia only (a germ caught from water)	20 tabs	one three times daily with meals. Avoid alcohol	D
Noroxin	Urine infections (cystitis), severe diarrhoea	12 tabs	one twice daily, for 3 days	A
Injections	Flucloxacillin and Amoxycillin Mix with Water for injection		every 6 hours	C
PAIN AND SPRAINS, Painkillers and Anti-inflammatories (Tablets and injections)
Solprin, Disprin or Aspirin	good pain killer, take with food, not good if indigestion or ulcers. Can combine with Paracetamol or Paradex	40 tabs		A
Paracetamol (Acetaminophen)	Good general pain killer, does not usually affect stomach	30 tabs	2 up to every 4 hours	A
Voltaren	Anti-inflammatory painkiller, can cause indigestion, good for all pain, particularly strains/injuries, also headache. Can combine with Paracetamol. This one is dispersible, i.e. can be dissolved in water. Not for people who have had ulcers!	16 tabs (50mg)	one two to three daily, with food	A
Voltaren Supposit	Insert, if cant swallow	10, 50mg	up to 3 times daily	D
Paradex Previously Digesic	For more severe pain, some people feel a "high" with it, or get drowsy. Can combine with Voltaren, not with Paracetamol.	20 tabs	2, up to 4 times daily	A
Pethidine injection	MIX with Stemetil, same syringe, give into thigh, halfway down front, slightly to outside with a 1 " (2.5cm) needle, straight in "intramuscular"(no chance of hitting bone)	5 amp. (100mg)	up to 4-hourly into muscle	C
SEASICKNESS, NAUSEA, VERTIGO (DIZZINESS)
Antinaus 5mg tabs Prochlorperazine	For nausea and for Vertigo (the kind of dizzyness that feels like seasickness, where everything is turning round) Caused by inner ear	30 tabs	one 3 x daily	A
Stemetil Suppositories	If unable to swallow medication	10 supp (25mg)	one twice daily	D
Stemetil injection	see under Pethidine	5 amp	3 times daily	C
Sea-Legs		tabs	3 x daily	A
Sea-band	apply to arms near wrists, see instructions	2 pair		A
Scopaderm Patches	available now	2 per pack


INDIGESTION
Quick Eze	For mild indigestion, chew or suck	20 tabs	as needed	A
Somac 40mg	For more severe indigestion	15	1 daily	A

DIARRHOEA
Gastrolyte	Hydration most important for diarrhoea. Drink as much as possible, 200ml of water (no more no less) to one sachet. Amount of thirst and of urine gives an indication whether enough fluid. Even if vomiting keep on drinking. If not tolerating the salty taste, use water, or juice diluted in 4 parts of water.	20 sach	10 at least per day	D
Imodium	Supposed to stop diarrhoea by paralysing gut, not bad, but only use if quite bad diarrhoea as in theory it is better to let poison/germ get out.	16 caps	2 at onset, then one 4 times daily if needed	D
Noroxin	Antibiotic, for very severe diarrhoea. A bit hit and miss, as some germs don't respond.	6 tabs	see above, antibiotic	A
Metronidazole (Flagyl)	For diarrhoea caused by Giardia, often a prolonged diarrhoea, with pain and flatulence. Caught often from water. Avoid alcohol.	20 tabs	see above, antibiotic	D

CONSTIPATION
Coloxyl tablets	Stool softener	20	2 at night	D

ALLERGIES
Telfast or Claratyne	Antihistamine, against allergic rashes, allergies from insect bites or stings, plants, other allergies. In theory should not make one tired, sometimes still does.	10 tabs	one daily	A
Prednisone (steroid)	For severe asthma or other severe allergies, take in morning as can make you sleepless.	30 tabs (5mg)	6 tabs daily with food for about 5 days	A
Promethazine Inj	Acute allergy	5 Amp	inject 1 deep thigh	C
Steroid Injection	Solucortef	5	as needed	C
Adrenaline injection, use only in life threatening situation	Acute very severe allergy, with rash, swelling all over, difficulty breathing. Give under skin, 0.5ml (half of the small syringe) at the time, half inch (1cm) needle, at a slight angle. Repeat after 5 - 10 minutes if needed	5 amp	as needed	C
ASTHMA
Ventolin Inhaler	inhale as needed, if a puff goes into throat or mouth only rather than chest, have another one. Not dangerous. If needing more than 2 puffs every 4 hours, start course of	1 inhaler	2 puffs every 4 hours	B
Prednisone	(steroid)		see above	A
Solucortef	Steroid injection		see above

INSOMNIA (SLEEPLESSNESS)
Triazolam (=Halcion)	Advise as little as possible, don't drink with it as it knocks you out too much. Good for a night or 2 but very addictive if used too much. Short action, works for about 4 hours only.	20 tabs	1/2 to one to two at night
Melatonin	assume take 1 to 3
Earplugs		2 pair

MALARIA	Most important: Prevention. Long sleeves long trousers, don't go out in dusk, insect repellent. Don't anchor near mangroves. Fly screens around all openings. Burn a coil when haveing Pot Luck dinners in cockpit.	More on this subject together with information on Dengue Fever will appear at the end of this document
Insect Repellant	Dimp Bushman
CHEST PAIN
Nitrolingual Spray	for pain that could be angina, can cause headaches	1 spray	1 puff under tongue, rep as needed
SKIN INCLUDING INSECT BITES
Aqueous cream	A bland moisturising cream, very useful for minor rashes, eczema, minor burns, also use instead of soap for sensitive skin.	500g
Vaseline	Greasier than aqueous cream, for skin protection, minor injuries
Bactroban	Steroid ointment, for eczema and allergic rashes, NOT for infections (“feeds the germs”) use only short course(few days). Use antibiotic cream for skin infections.	30g (1 tube)	apply sparingly 3 times daily
Batrafen cream	for fungal infection, e.g. rash/cracks between toes, rash groins	1 tube	apply twice daily
Anthisan cream	antihistamine cream, for insect bites and other allergies, not for infections (pus, pain rather than itch) Can also use Locoid for bites
Bushman	Insect Repellant (melts most plastics)	1 tube or bottle
Zovirax Ointment	For coldsores lips	2 tubes
NOSE
Drixine spray	for blocked nose due to cold or allergy. For allergy use antihistamine also (Claratyne) If cold and pressure pain forehead or cheeks suggestive of sinus infection, use antibiotic	1 packet

EYES
Fucithalmic eye drops		1 packet		B
Soframycin eye drops	(both do same more or less) For conjunctivitis: Gritty eyes, with discharge, glued together in morning If severe, infection round eye as well, use Augmentin too. Sometimes conjunctivitis can also be allergy (itchy, not so much pus), then use Claratyne and Oxylin	1 packet		B
Local Anaesthetic for eyes	for removal foreign body	3 (small vials)		B

EARS
Vosol	Minor ear irritation, use after swimming to keep clean, "swimmer's ear"	1 packet		B
Sofradex ear drops	For very itchy ears, discharging or dry scaly If very painful, use Augmentin as well, could be an abscess	1 packet		B

COUGH
Cepacol Discs				B

HAEMORRHOIDS	(PILES, Bleeding with motions, pain, lumps)
Proctosedyl ointment	Comes in individual portions for hygiene purpose. Make sure constipation is attended to. Also gentleness with washing and wiping the area, use moist paper or towel, wet ones are good, don't rub, pat dry, use aqueous cream for general skin protection, or Vaseline.	1 packet of 5	insert one or two per day	D
Wet ones	also called Precious or Baby Wipes Do not put these down the head under any conditions as they will block the valves.	Several boxes		F

THRUSH
Fungizide pessaries or Canesten one vag cream	insert as instructed			B

INJURY TREATMENT

Sprains, bruises	Icepack keep in freezer, use for any sprains, bruises			Freezer
	Remember any sprains - breaks: RICE for Rest, Ice , Compression, Elevation
Crêpe bandages				E, F
Gauze bandages various sizes

Knee bandage			F
Painkillers and anti- inflammatories	see tablet section		A

Grazes
Duoderm	Excellent wound cover for clean grazes. Leave for up to a week, keeps skin moist and allows better healing. Waterproof, but tape edges down. Change if leaks. Unpleasant smell when taken off, does not mean it is infected. However do not use on infected skin	10 packets	E
Opsite	Transparent, ‘plastic skin’, watertight		E

Cuts
Bandaids		1 packet	E
Elastoplast strip	to cut to size	1 packet	E
Tape	To keep dressings in place, and to tape two fingers or toes together (piece of gauze in between them if broken or strained)	1 elastoplast, brown 3 white, can be torn	E
Gauze		10 packets of 2	E
Primapore squares	square dressings for slightly larger areas	6	E
Melolin	Dry dressing, once sutured		E
Fingertip dressings		6	E
Safety pins		12 asst sizes	E
Savlon or Dettol	Disinfectant, thin down with water. I am never quite sure how much it does	1 lge bottle	E
Sodium Chloride (Saline)	Vials, good to wash any wounds, use before suturing. Just twist top off	3 Amp x 20ml 5 amp x 5ml	E
Triangular bandage	for any injury arm/hand, important to keep it immobilised.	1	F
Steristrip (Butterfly)	Good to fix minor cuts which do not require suturing in places where there is not much tension. To help them stick, use Tinc Benz (Friar's Balsam) at the edges.	various sizes	E
Friars Balsam	as above		E
Cotton buds	do not use in ears. To apply Tinc Benz		E
Finger Bandage and applicator		1	E
Vaseline Gauze	Another wound cover, for squashed fingers, cut to strips and mould bits of skin into place, change after about 5 days, remember to keep finger still, bandage, but not too tight.		E
Xylocaine injection	Local anaesthetic before suturing or removing splinter / foreign body, inject into skin. If skin broken, inject from inside wound edges. Just twist top off	5 amp of 5ml	C

Needleholder,	Forceps(tweezers),	Scissors
Nylon (Nylene) and Dexon thread	Straight cut best to suture. If all ragged and not very deep, better dress, with Duoderm, or Jelonet. To suture; use local anaesthetic before. Make sure you make knots triple or quadruple as nylon is slippery Leave suture in for 5 days (in face), 14 days if somewhere where a lot of tension, 10 days at other places. If it gets infected use Augmentin; if bad infection it is better to take suture out and let it drain. After suturing cover with Elastoplast or similar.	Nylene thread 3.0 size where thick skin, e.g. scalp 4.0 size for most wounds 5.0 size for thin skin, e.g. face. PDS monofilament absorbable for suture under skin, ‘dissolving’	E
Syringes	1ml for Adrenaline 3ml for injections of Pethidine, Stemetil, Local anaesthetic or 5ml for injections of local anaesthetic	3 4 4	C
Needles	for syringes, also good to take splinters out. For injections use 25 or 23 gauge needle, 1 inch except for Adrenalin (1/2 inch)	12	C
Alcohol swabs	to disinfect skin before injection	12	C
Scalpel blades	To cut open an abscess (boil), gives instantaneous relief. Use some local anaesthetic if you like, but it is often difficult to put in and hurts more than the cut with the scalpel blade.	4	E

Burns
Aqueous cream	good for superficial burns, use copiously	lge pot	F
Hypofix dressing	Just a sticky dressing, can be left on for days, soak In oil before removing		E

Splinters
Needles	very good to lift splinter out, may want to use some local anaesthetic		C
Tweezers	Sometimes help; spare one on small plastic bag with some bandaids.		E

Various
Cotton wool	for padding, Don't put directly onto open wound		F
Eye pad	for eye injuries, severe conjunctivitis		B
Disposable gloves	Small, Med, Large	4 pairs each	F
Cardboard for splinting fractures,	wood for splinting, use plenty padding and PLENTY OF PETHIDINE, later Voltaren helps too.
Baumgartner's tip:	A rolled up magazine is very useful to splint broken arm.
Fever Thermometer	Perhaps it may give you an idea whether a problem is an infection, in which case an antibiotic may help.		F