First Aid Kit Essentials for Recreational Vessels

By Annie Feyereisen  RN

Let me ask you this, would you buy a live cow if you lived in a studio apartment, were vegetarian and didn’t even drink milk? Hopefully not, unless you are just crazy like that or are trying to start the next indoor pet trend.  It’s the same concept with marine first aid kits. Why buy what you either already have, can have for free, won’t need or will never use?

There are literally hundreds of marine first aid kits on the market. It’s hard to know which one is right for you. The purpose of this article is to identify the contents of a first aid kit that match your comfort level, medical knowledge, cruising destinations and the overall health of your crew and passengers.

This article will provide a list of essentials for the recreational boater along with a few household items that can suffice in a pinch. You will be amazed at how versatile some of these items can be! Who knew a turkey baster could do that!

We have all seen the standard  first aid kits- dozens of bandages of all the sizes you don’t need, scissors that don’t cut, tweezers that don’t tweeze, the worst tape ever that only gets stuck to your hair but not to anything else and one package of baby aspirin that got wet and stuck to the inside of the packaging! We frantically rummage through it, don’t find what we need, cram it all back in, pinching our fingers when we close that flimsy latch and end up grabbing a paper towel and scotch tape instead!

Let’s stop the madness! It is imperative that your kit contain the right supplies that you feel able to confidently apply.  Keep in mind how critical your first aid kit can be. At sea, in many locations, especially in the remote areas of the Inside Passage, your first aid kit and your first aid knowledge can be critical to the life and safety of your cruising friends and crew to bridge the time until you can get someone into the care of medical professionals.

The average marine first aid kit has basic standard supplies. I have listed all that boring stuff at the end of this article. The items below deviate from the standard supplies and are my additional recommendations:

  • Latex free gloves– most kits come with one pair of gloves. I think you should have a full box of gloves aboard at all times as they can be used for numerous things besides wound care. Fill one with water and freeze for an ice pack or add food coloring and create an interesting ice float for your Sangria! They make really cool jello molds and are most definitely required for manual removal of the object that fell out of your pocket into the head just before you flushed. You can just barely see the tip of said object, it hasn’t gone down yet but you know your hand is going in! I wear them at all times when working in the engine room to keep my hands clean of oil and grease.
  • 2 Tincture of Benzoin Topical Adhesive Swabs. Some kits have this but it is not intuitive just what to do with it. I love this product as it helps protect wounds and makes the skin tacky so dressings can adhere better. It does make your skin pretty sticky and requires alcohol to remove the residue. No, don’t use your vodka…just plain rubbing alcohol works. Add rubbing alcohol to the kit also.
  • 2 Rolls of Medical Tape, 1”x10 yards. Yes, yards of tape. Not scotch or electrical. I prefer fabric tape. You can purchase perforated rolls for ease of separation without having to find the scissors. I don’t really advise using your teeth to pull it off…but whatever.
  • 1 EMT Shears, 4”- make sure they actually cut and your fingers fit in the handles. EMT shears have one flat side and are angled.
  • Skin Glue– well…to glue skin together. Works for small wounds once the majority of bleeding stops. There are many different brands available. I don’t recommend using the all purpose super glue if you have a choice, but I also don’t recommend spit baths for cleaning your grandkids face, but let’s be honest, in a pinch we are capable of some gross things.

It is important to have “how to” guides for CPR, Wound Care, Burns, Bleeding/Shock, Fractures/Sprains and Stings in your kit as in the moment of injury, I can almost guarantee that you will temporarily forget what you thought you knew or you will at least question yourself. Eliminate that by pulling out the appropriate guide.  Most kits are organized based on these topics and will come with instructions.

The Survival Medicine Handbook: THE essential guide for when medical help is NOT on the way
by Joseph Alton MD and Amy Alton ARNP | Jun 7 2016

SAS Survival Guide: How to Survive in the Wild, on Land or Sea (Collins Gem)
by John ‘Lofty’ Wiseman

The Complete First Aid Pocket Guide: Step-by-Step Treatment for All of Your Medical Emergencies Including • Heart Attack • Stroke • Food Poisoning • Choking • Head Injuries • Shock • Anaphylaxis • Minor Wounds • Burns
by John Furst | Nov 13 2018

The following medications are great to have but will require that you make an appointment with your primary care provider and request the following for “ship stores”, explaining that you are putting together a kit for your boat, will be taking people out, potentially without access to immediate medical care. These medications all require a prescription.

  1. Meclizine- anti emetic (anti-nausea). This is the active ingredient in over the counter motion sickness medication. You are asking for 2-3 tabs of the prescription strength.
  2. Scopolamine patch (anti-emetic transdermal patch, lasts three days) 1-2 patches. Be sure to wash your hands after applying this patch. These are great for longer cruises.
  3. Zofran sub lingual- anti emetic that dissolves under the tongue, in case there is no way your drinking anything in order to get a pill down.
  4. Epi pen- for severe allergic reaction (anaphylaxis). You would need to be comfortable injecting this medication rather forcibly into someone’s muscle and be positive that you were dealing with an allergic reaction. Most people who have had an anaphylactic reaction in the past carry their own pen with them. Your doctor may not be comfortable with giving this to you but if you don’t ask, you don’t get.
  5. People often ask about carrying narcotics and antibiotics. This is a conversation to have with your physician. Some providers may be amenable to prescribing a broad spectrum antibiotic to have on hand and well as possibly 2-3 tablets of a pain medication, but this should not be expected as if you need something that strong, you should likely be going to an urgent care anyway.

The following medications are available over the counter and are must haves, especially in confined spaces! These are not listed in any order of importance as that is a personal decision based on your tolerance for various offensive bodily functions:

  1. Benadryl- intended purpose is for allergic reactions, be careful with this one as the potential drowsiness side effect is amplified exponentially if used with any pain medication or alcohol. This amplified effect could cause your patient to speak in tongues.
  2. Orajel or any mouth pain gel- for gum/mouth pain… because there is nothing worse, no matter where you are.
  3. Loperamide- for diarrhea, well duh! A couple of adult diapers aren’t a bad idea so you don’t have to throw any clothes away. These also make great photos for the monthly yacht club newsletter!
  4. Ibuprofen- This anti-inflammatory is a very effective pain killer if dosed appropriately. Prescription strength is 800 mg every 8 hours. Typically comes in 200 mg tabs, so for the math majors out there, that’s 4 tabs every 8 hours.
  5. Claritin or Sudafed for congestion – because drunk, nasal singing is the worst combo ever!
  6. Acetaminophen (Tylenol)- 325 mg 1-2 tabs, for fever reduction and headaches. This works great but not even Tylenol can combat the ole “sorry honey, not tonight, I have a headache” excuse.
  7. Simethicone- for flatulence (farting), for the obvious need to avoid human gas release in a confined space. “ No that is not propane, its methane and I’m sure we left the damn cow at home”. I knew a Mariner once that had a sewage spill into the bilge that was setting the CO2 detector off, it took them a day to figure out what it was. We know it burns a hole in the ozone, imagine locked in the v-berth with that, No Bueno!
  8. Aspirin- 325 mg tablets. If you suspect a heart attack, chew the tablet if able. While it tastes nasty, chewing is the quickest way to get the medication into the bloodstream`
  9. Metamucil- Laxative for constipation. This takes a while to take effect, usually overnight. Just don’t accidently give this to the guy with diarrhea! Mag Citrate liquid is another option, there can be a pretty intense response to this one so it should be second line approach if Metamucil does not work. Make sure to stay close to the head, this is not the time for a dock stroll.
  10. Antacid- extra strength Tums, because acid reflux just sucks.
  11. Oral rehydration salts- for dehydration. These are pre-packaged electrolyte replacement salts that are mixed with water. Super effective for hangovers as well.

In addition, I recommend you add the following as appropriate… well truthfully some of it is super inappropriate but oh so much fun, and 100% functional!

  1. Women’s products: Tampons and Pads. These items come in sterile packaging and are super versatile, with a daisy fresh smell!  I have seen tampons used for nosebleeds, puncture wounds and once for a wine cork, although I personally can’t quite go there.  I guess no one would drink from your bottle!  Equally, women’s pads are sterile, super absorbent and have a built-in adhesive. They are effective for larger wounds and if needed, they will stick to the Swifter and you can mop the floor!
  2. A Mini Flashlight or headlamp, nothing more challenging than trying to hold your cellphone up for a light and use your hands to dress a wound only to drop the damn phone on top of your patient’s forehead and cause a hematoma. I say a small flashlight that you can hold in your mouth or a headlamp is the way to go all day.
  3. Turkey baster. This works great as an irrigation syringe for larger wounds that need a higher flow rate to clean out debris that may have entered the wound at the time of injury. This object may terrify a female patient when you first pull it out so be sure to always use your calm, inside voice, and probably should not have the headlamp on at the same time.
  4. Duct tape, well because you can do everything with this stuff. Temporarily close a wound, make a sling, tape your patients mouth shut if needed, all while constructing a splint out of a beer carton and saran wrap!
  5. Lubricating jelly. Well, where I can go with this…clinically it is great for burns, chapped lips, it provides a protective barrier that promotes wound healing and is quite satisfying to present with the statement, “Bend over, you won’t feel a thing”.
  6. Aside from the intended emergent use of these little gems, they can be used as tourniquets, gloves, waterproof protection over a foot wound, tupperware lid and water containers. They come in sterile packaging and make great balloon animals at your next dock party!
  7. Electrolyte replacement-pedialyte/gatorade packets. These can replace the pre-packaged rehydrating salts mentioned previously and definitely taste better.
  8. 1oz , well maybe 2oz Vodka, Rum, Gin or Tequila. As tempting as it may be, do not give this to your patient as it increases bleeding time and will worsen every medical condition. No, this item is just for you…but only when you are done patching up your patient!

Many people ask about having defibrillators (AEDs) and oxygen aboard. These items are great to have and the ones you would want are pretty spendy.  Clearly commercial vessels and charter boats have these aboard and I say if you can afford it and are comfortable using it, go for it. As a nurse, I would love to carry one around with me everywhere but that would look rather ridiculous and is not practical at all. Just remember that if you don’t know how to use it, are prone to panic in emergent situations or allow people to smoke on your vessel (I know what you’re thinking but I promise it happens) or if you don’t plan on routinely checking the power source and pads, review the process or check the oxygen tank level, then you may want to rethink this.  It would be far worse to have it there and not remember how to use it or even worse have it not work due to your lack of maintenance.  The regret that comes with failing your maintenance and execution responsibility should not be taken lightly and is the single biggest factor when making the decision regarding having this equipment aboard. It’s like the life ring that is hanging on the side of my vessel right now that doesn’t even have a line tied to it. Won’t be very effective in an emergency, huh? I will feel terrible if I need it and I just hadn’t set it up. I have to take care of that tonight.

I do recommend that all Mariners, well really all adults should take a basic first aid/CPR course. It will boost your confidence in emergent situations.

 Before you leave the dock, it is best practice to have knowledge of any passenger’s chronic health conditions, including diabetes, heart problems, severe allergies, coagulation issues (taking a blood thinner) or seizure disorders.  This will allow you to respond timely and effectively, instead of running around in the moment trying to figure out what the hell is going on. This includes ensuring that your passengers have all prescription medication they require and if cruising alone, obtaining an emergency contact number.

You should never hesitate to contact the Coast Guard or first responders immediately when an emergency occurs on your vessel, even if you feel like you have it under control. This call should include patients age, gender, medical condition, your vessels position, the time of onset and what actions have been taken so far. Assign someone aboard to record information. The first responders will provide additional medical advice and determine if personnel will be deployed to your location or if they plan to meet you at the dock. Equally, they may just tell you to load the patient into a dock cart and schlep them to the urgent care when you return to shore.

Disclaimer

*Disclaimer, this article is aimed at recreational boaters.  I have a much more extensive health questionnaire and first aid requirements for commercial and charter businesses.

A thorough first aid kit along with some practical household items at your disposal can make you feel and look like a pro while providing confident, appropriate first aid aboard your vessel.

This article is directed at the recreational boater and is not intended for charters, commercial vessels or long, deep sea journeys.

Feel free to email me at waggonercruisingguide@gmail.com with any questions or comments. Place in subject line – KnottyNurse911.

Okay, now for the boring part. The items below are standard in most basic first aid kits and should be included in yours as well:

  • 1 Oronasal mask- to protect yourself or your patient
  • 1 Ammonia inhalants- to be used if your patient has a syncopal event (fainting)
  • 1 Tourniquet- to tie off an extremity from uncontrolled bleeding. Only for use in extreme situations as it will cut off blood supply and detrimentally affect tissue viability
  • 1 CPR Face Shield- to protect during resuscitation
  • 2 Trauma Pad, 5”x9”- super absorbent for large wounds.
  • 3 packages blood clotting powder- to pour in large wounds to stop bleeding
  • 3 Dressing, Gauze, Sterile, 4”x4”, Pkg/2 – to cover and protect wounds. Can be used over trauma pads or alone for wounds that are not saturating through. Allows air flow.
  • 2 Thermometer strips- thin, plastic with color temperature indicators
  • 4 Antiseptic Wound Wipes
  • 1 Heat Sheet Reflective Blanket, 56”x84”
  • 1 Wound Closure Strips, ¼”x4”, Pkg/10- also called butterfly strips or steri strips
  • 1 Syringe, Irrigation, 20cc, 18 gauge tip- not as big as a turkey baster but works for irrigating smaller wounds
  • 2 Povidone Iodine, ¾ oz.
  • 10 After Cuts & Scrapes Wipe
  • 4 Triple Antibiotic Ointment, 1/32 oz.
  • 7 Dressing, Gauze, Sterile, 4”x4”, Pkg/2
  • 4 Dressing, Non-Adherent, Sterile, 3”x4”
  • 2 Eye Pad, Sterile
  • 2 Bandage, Conforming Gauze Roll, Sterile, 3”, can be used over another dressing and is applied by wrapping and finishing with tape
  • 25 Bandage, Adhesive, Fabric 1”x3”
  • 15 Bandage, Adhesive, Fabric, Fingertip
  • 15 Bandage, Adhesive, Fabric, Knuckle
  • 2 Bandage, Adhesive, Fabric, 2”x4.5”
  • 2 Cotton Tip Applicator, Pkg/2-
  • 1 Splinter Picker / Hook Remover Forceps
  • 1 Eye Wash, 2/3 oz, (20 ml)
  • 4 After Bite Sting and Itch Relief Wipe
  • 1 Splint, 4”x36”- moldable.
  • 1 Bandage, Triangular
  • 2 Bandage, Elastic with Velcro Closure, 3”
  • 2 Cold/Heat packs
  • 2 Safety Pins
  • 1 Dressing, Burn, 2”x6”
  • 3 Dressing, Burn, 4”x4”
  • 4 clear occlusive dressings
  • 12 Pre-Cut and Shaped Moleskin- for blister prevention
  • Sunscreen
  • 2 Aloe Vera Gel with Lidocaine, 6 ml
  • 1 Bandage, Stockinette Tubular, 1”x4”
  • Splint 4” x 36”
  • Cotton balls
  • ACE bandage