Today i am going to continue the first aid series with some talk about the boat’s minor repairs kit aka the first aid kit. Also, because i like doing practical things i am going to empty out 2 of my existing kits and set one of them up as a temporary kit for Inanda. The reason that i’m not making up her long term kit right now is that i haven’t decided where and how to store her main first aid/medical box and if for example i decide to stow it under a bunk it might be best in a totally watertight container.
Just to recap, i tend to carry 2 first aid kits on my boats, the first which i call the ‘ready’ kit often travels with me, can be carried in a sea-bag or rucksack and is one of the things that i used to have with me when i sailed on other people’s boats. The same kit is also the one that i used to carry in my river-bag as a canoe instructor and my woods kit when i used to teach bushcraft. In each of those situations i also carried stuff that might be considered as first aid extras or adjuncts….on the river i always used to carry a flask of hot drink, bags of sweets or mini choc-bars as treats, spare beannies and a group bothy bag and of course not forgetting the roll of gaffer tape.
The blue kit hasn’t been out for a while and it’s the one that will initially go aboard Inanda so that’s the one i am going to empty out today, talk about the contents and what they relate to and then do a re-pack ready to go again. This kit was actually last set up for a canoe trip a few years back so it will be fun to see what’s in there.
It was no great surprise to immediately find that most things in there that are dated are a long way out of date. Looking at that kit today and i can see that it was set up with a specific trip or course in mind where i had most likely been pre-warned about some of the clients medical problems which is why there is aspirin, glucojel and a salbutamol inhaler for dealing with asthma.
While i am that this stage i will briefly talk about carrying and using medicines in a first aid context. Briefly put i’m a nurse and not a GP so i have no normal responsibility or medical insurance to prescribe medicines and the only one that i could feasibly get away with ‘prescribing’ is the aspirin and only in the context of a suspected heart attack. I was almost certainly carrying the salbutamol inhaler in the event of a client not carrying his own and having an asthma attack. The glucojel is slightly different in that it used to be a fairly standard acceptable practice to consider administering that to someone having a hypoglycaemic (low sugar) episode. As of today they are all out of date and irrelevant so they are all being chucked out. It’s generally frowned upon to carry medicines in purely first aid kits except for some exceptions….aspirin being one. The other one that comes to mind is when i have carried an epi-pen (adrenaline in the uk) for a younger teen who might need it. Because the kit is purely for my own use or my partner i do consider it ok to carry medicines for our own use so at the end what you will see going back in are some painkillers for our various joint and back-pain problems. Once again our main medicines pack will be in the medical kit but we shouldn’t need that until we do the longer trip home with the boat , at which time i consider the boat and its crew to be in full offshore mode. When i get to that stage i will do a similar re-pack of the main medical kit.
With that pile of stuff pushed to one now for disposal its time to look at the other kit in the bag and see what is useful and what is missing..it looks to me as though i have raided this bag for some of the tools that should be there. I can immediately see that there are several things missing for example no torch or head-torch, no fine scissors, no tick removal forceps and no phone.
With a new list of stuff to add getting longer lets look at and talk about some of the stuff that is there….lets talk rubber and latex first…..ooh
Don’t worry its only gloves.
In one of the first posts i wrote about first aid i mentioned my teaching aide-memoire technique of keeping a very visible running list of topics and skills that we had covered and the kit that we used for each problem. For quite a bit of the first day the only things that got used a lot were procedure gloves (non-sterile gloves). We use these by the thousand at work and i use loads of them at home especially when i am painting or handling epoxy resin. It’s a really good practice to ‘glove-up’ when doing anything ‘hands-on’ with people, body parts or bodily fluids and learning to de-glove competently. The first thing that you should find in my first aid kit is a couple of pairs of very large nitrile (non latex) procedure gloves and that is almost a reminder that i should put a pair on whenever there is anything messy to do. It’s not at all that i am squeamish…i haven’t ‘squeamed’ for years as the nurse saying goes but it does really help to have a small amount of protection or, vice-versa, to protect the casualty/injury in the field where it might be impossible to have very clean hands to start with.
Purple nitrile gloves and some older clear/buff gloves which don’t last as well.
In this pack the tough purple nitrile gloves are in good order, they didn’t split when i pulled a pair on, but the clear/buff ones tore through immediately so they do degrade over time and they are dirt cheap to replace. I do keep more gloves in the main medical pack and usually have a ziploc bag stuffed full of them either in my toolbag or bosun’s store. While i am thinking about hand hygiene its also worth saying that what should be in the bag is a small pack of wet-wipes as i use those for a clean-up if i have got to do something that needs a cleaner approach….getting splinters out comes to mind. Once again the first aid hand wipes are backed-up on the boat with a drum of industrial hand-wipes and lots of rolls of kitchen tissue. In the final re-pack of this kit there will be 2 pairs of XL nitrile gloves in the left side immediately visible and then several loose gloves packing out the contents in the closed section.
The re-packed bag.
From the bottom layer up : waterproof notebook, pencil and sharpie marker, nitrile gloves x 4. Top layer : large sterile trauma dressing, large and medium bandage, shears, tweezers, scissors, 2 different rolls of tape.
Bottom layer i zipped compartment : pocket face mask, spare medium/small bandage, sterile gauze (small), spare gloves, torch, headtorch. In front layer : mobile phone, adhesive dressings, medi-wipes and alcohol wipes. Mini medicines pack containing paracetamol, ibuprofen, diclofenac and anti-histamines.
I have a few things to add when i next go shopping : some very fine tweezers/forceps would be good,aspirin, some new sticky-plasters and a couple of plastic ampoules of sterile saline for eye-wash. This pack will probably make more sense when you also see the main medical pack which starts out by having more of the specific tools, wire cutters for example, a far larger selection of wound dressings, bandages, a sphygmomanometer and stethoscope, all the wound cleaning and suturing kit and so on.
I will cover the main medical pack in a future post, at the moment i have another 2 or 3 medical posts planned : one definitely about pain management as that used to be my specialty, medical communication is another. As i feel this is one area where i can uniquely contribute from my own knowledge base please feel free to request any other first-aid/boat-medical topics.