HEALTHCARE

Outside the US Health Care is generally very affordable.

Throughout the area you are near local heath clinics which you can visit and with the help of google translate you will be able to communicate with doctors, pharmacists and local healthcare providers .
However if you are in an remote area or on passage you may need to seek medical evacuation – for remote evacuation consider
https://danboater.org/travel-health-and-safety/medical-evacuation-repatriation-search-rescue-explained.html

BELOW IS A SET OF TOOLS FOR REMOTE EMERGENCIES

THE FOLLOWING ARE COMPILED LIST FOR OFFSHORE MEDICINE EMERGENCIES
PRESCRIPTIONS AND OTHER ITEMS FOR MEDICAL PURPOSES
to be used by professional CAREGIVERS

PAS/BLS
SCENE

❑ Recognize and safely manage scene dangers including personal protective equipment
❑ Establish number of patients.
❑ Determine MOI.


INITIAL ASSESSMENT

❑ Rapidly assess Critical Systems status ( Circulatory, Respiratory, Neurologic ).

Basic Life Support

❑ Demonstrates ability to assess the Critical Systems and determine need for interventions.
❑ Demonstrates rapid repositioning of patients with Critical Systems problems and potential spine injury.
❑ Demonstrates proficiency in CPR and FBAO according to AHA standards.
❑ Demonstrates proficiency in NPA and OPA use.
❑ Demonstrates proficiency in BVM use and PPV. technique.
❑ Demonstrates proficiency in AED use.

Focused Assessment

❑ Accurately completes physical exam for traumatic and non-traumatic patient.
❑ Vital signs (P,R,S,C,T). B/P and lung sounds if applicable.
❑ SAMPLE History

Treatment and SOAP formatting

❑ Create an accurate problem list.
❑ Create an accurate anticipated problem list.
❑ Create a treatment plan.
❑ Fill out a SOAP note.

Spine Assessment

Assessment

❑ Verify context and obtain consent from patient.
❑ Demonstrate ability to roll patient in a spine stable manner for assessment purposes with a second rescuer.

 Demonstrate spine assessment guidelines by evaluating:

❑ patient’s mental status and reliability.
❑ spine pain and/or tenderness
❑ Motor/ sensory exam (as outlined in text)
❑ Document findings upon completion of procedure.
❑ patient’s mental status and reliability.
❑ spine pain and/or tenderness
❑ Motor/ sensory exam (as outlined in text)
❑ Document findings upon completion of procedure.
❑ Verify context and obtain consent from patient.
❑ Demonstrate ability to roll patient in a spine stable manner for assessment purposes with a second rescuer.

Demonstrate spine assessment guidelines by evaluating:
❑ patient’s mental status and reliability.
❑ spine pain and/or tenderness
❑ Motor/ sensory exam (as outlined in text)
❑ Document findings upon completion of procedure.

EXTRICATION / Immobilization

Demonstrates ability to measure and properly apply both a:
❑ manufactured cervical collar
❑ improvised cervicol collar
❑ Demonstrates ability to participate and lead in a rescue team which can properly move a potentially spine injured patient from various body positions onto backboards and litters.
❑ Demonstrates ability to participate and lead in a rescue team properly immobilizing a patient in both a backboard and litter.

Wilderness Rescue

Patient and Litter Carries

❑ Demonstrates ability to create a “piggy back” carry system using webbing, rope and other available materials.
❑ Demonstrates ability to participate in a rescue team on rough terrain using appropriate carrying and passing technique

Improvised Litters

❑ Demonstrates ability to build improvised stretchers and litters for non-spine injured patients.
❑ Demonstrates ability to build a “hypothermia wrap” in a litter or backboard.

Wounds and Burns

❑ Using BSI Technique, shows ability to expose bleeding area and apply eel aimed direct pressure (WADP)
❑ Demonstrate ability to create a pressure bandage.
❑ Identify the context and situations in which removal of impaled objects is appropriate.

Allergies/Anaphylaxis (sticks lab) 

❑ Prepares injection site
❑ Examines syringe for presence of excessive air and purges appropriately. L-3
❑ Successfully performs injection.
❑ Disposes of syringe appropriately.

 Musculoskeletal System

Stable Injuries 

❑ Assess distal CMS before beginning treatment.
❑ Assess musculoskeletal injury and correctly identify stable injuries.
❑ Appropriately and effectively treat stable injuries.
❑ Re-assess distal CMS upon completion of treatment.

UNStable Injuries 

❑ Assess distal CMS before beginning treatment.
❑ Assess musculoskeletal injury and correctly identify unstable injuries.
❑ Appropriately and effectively treat unstable injuries, including:
❑ Lower leg, ankle and knee.
❑ Upper arm, forearm, and wrist.
❑ Re-assess distal CMS upon completion of treatment.

Shoulder Dislocation Reduction

❑ Verify wilderness context and obtain consent from patient.
❑ Check distal CSM before proceeding with reduction, including sensation in deltoid region.
❑ Demonstrate ability to reduce dislocation using traction, abduction and external rotation.
❑ Demonstrate alternative method of reduction (hanging, scapula manipulation).
❑ Stabilizes area post reduction and re-assess distal CSM.

Patella Dislocation Reduction

❑ Verify wilderness context and obtain consent from patient.
❑ Check distal CSM before procedure (not critical).
❑ Demonstrate appropriate patella reduction technique.
❑ Stabilizes area post reduction and re-check CSM.
❑ Demonstrate appropriate patella reduction technique.
❑ Stabilizes area post reduction and re-check CSM.

Digit Dislocation Reduction</span class=”font-681074″>

❑ Verify wilderness context and obtain consent from patient.
❑ Check distal CSM before procedure.
❑ Demonstrate appropriate digit reduction technique.
❑ Stabilizes area post reduction and re-assess distal CSM.

TRACTION SPLINTING

❑ Demonstrates correct assessment of fractured femur that would benefit from traction splint.
❑ Assesses distal CSM
❑ Properly manages injury and applies:
❑ Manufactured traction splint ❑ Improvised traction splint
❑ Re-assess distal CSM upon completion of treatment.

SUGGESTED READING:

Merck Manual and Your Offshore Doctor books are good for quick references. Quick diagnosing is the Merck manual… brief and to the point in almost layman’s words.

SUGGESTED MATERIALS:***

 

laminated list of ailments and medicines taken and allergies for each of the crew members***

    • Blood Pressure cuff, stethoscope,otoscope (??),thermometer, and pulse oxymeter for giving vitals in case you call to shore MD
    • Gausses various sizes
    • Latex or non-latex gloves sterile and/or non sterile
    • Suture kit
    • Sutures various sizes
    • Dermabond (glue)
    • Steri-strips 10cm, 15cm and 30cm bandages
    • Antiseptic solution for would cleansing
    • Microdancyn spray
    • Syringes 3cc, 5cc, 10cc , 20cc
    • Needles
    • Insulin needle for anesthesia (freezing or numbing)
    • SAM Splints
    • Pneumo/air/inflatable splints
    • Oxygen tank (small portable) With Oxygen mask or nasal tips
    • IV solutions
    • IV starter kit
    • IV catheters
    • Tape/micropore or other for skin
    • Anesthetic
    • Topical,
      • lidocain creams
      • Local injectable 2%
      • Local spray 10

       

OINTMENTS:

Furacin cream (shrek snot) for burns
Mupirocine scrapes and cuts
Sun block FTP is up to you (depends on sun worshiping status)
Topical anesthetic (look above)
Hydrocortisone cream 1% (bites, burns solar and other) Antihistamine gel (bites, stigs etc)
Kankha soluction (kankha sores)
Pain ointment/cream Piroxicam gel Diclofenac gel Arnica cream (natural product)

 

PAIN MANAGEMENT:

 

NSAIDs Advl (Ibuprofen),
Tylenol (acetaminophen/paracetamol),
Aleve (naproxen)
*Toradol (ketorolac),
*dexketoprofen
* injectable vials available and combination sublingual available


OPIODS

Tramadol (light opiod),
Tylex CD (acetaminophen with codeine),
lertus CD (diclofenac with codeine higher dosage)

Cortisone:

oral and injectable Dexamethasone,
Betamethasone,
Hydrocortisone
prednisone

ANTIBIOTICS:

Wide spectrum antibiotics.
Amoxicillin/Clavulanic acid: upper respiratory infections, ears, sinuses
Azithromycin: Diarrhea, respiratory infections
**Ciprofloxacin: UTI, diarrhea, sinus, respiratory infections
***Sulfa drugs Bactrim/Septrim/Bactiver etc UTI, diarrhea, skin infections, Good combination drug with others
Clindamycin: skin infections, cellulitis
Ceftriaxone injectable: very wide spectrum. when you can’t swallow pills.
** makes you sun sensitive, fda and who recommend limited uses *** sun sensitivity If allergic to penicillin avoid ceftriaxone and amoxicillin

MISC. PRODUCTS:

Seasickness, dizziness, nausea/vomiting:
Difenidol , vial or oral tablets
Stugeron forte tablets
Meclizine/pyridoxine, vial or oral tablets
Ondasetron tablets
(Zofran) Anxiety/stress: Clonazepam 0.5mg tablets
Alprazolam 0.5mg tablets
NoseBleeds: Afrin or equivalent in nose spray Fungus: Lamisil cream
Yeast infections; fluconazole capsule 150mg (1 time dose)
Vaginal suppositories box with 10 Vagitrol V cream
Heartburn/acid reflux/GERD: Omeprazole, pantoprazole, nexium all oral Riopan (magaldrate) (ulcers, gerd, gastritis) Stomach cramping: Panclasa oral, butilhioscina oral and inj. vials Anti-diarrheal: Treda tabs, hidrasec caps, loperamide tab

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