Sea Sick: by Keith Murray
It’s that time of year again. Time to buy a new calendar, make New Year’s resolutions and go through your first-aid medical kit.
The first step is to gather all of your medical equipment, first-aid kits, oxygen and automated external defibrillator (AED). This includes any small kits on the tender, in the galley and in the engine room. I suggest gathering as many crew members as possible for this exercise, especially those who are new to the boat, as this is a very good learning experience.
After everything is assembled, check all kits for missing or expired items, opened packages or things that look out of place. If you are not sure what something is, ask. If nobody knows what it does, you may not need it.
Let’s start with the simple things: medical exam gloves, eye protection such as safety goggles, and a CPR mask. Gloves have a shelf life and should be replaced annually. They are inexpensive, at about $10 for a box of 50, so when in doubt, throw them out. Does the CPR mask look cracked, dirty, discolored or melted? If so, replace it. Again, this is an inexpensive item at about $20. Safety glasses to protect your eyes from blood splatter are also cheap at about $2-$8 per pair. For those who wear prescription lenses, make certain the safety glasses fit over the prescription lenses.
Next, look at each medication. Is it current? Is it organized? What is it used for? If anything is expired, order replacements and dispose of the old medication properly. Unsure what the medication is prescribed for? Check the manual or USB drive that came with your medical kit.
This is where having an organized medical kit and quality CPR-AED-First Aid training comes into play. It is very important to understand what medications you have, how to use them, where they are located and when they expire. If I told you that a crew member was bleeding heavily from a shark bite, how long would it take you to retrieve glasses, gloves and your trauma bag with bleeding-control supplies? What if someone were having an allergic reaction and couldn’t breathe? How long would it take you to grab your Epi-Pen? Or what if someone were overdosing on Opioids? How fast could you retrieve Narcan?
Having at least one AED on board is essential. Without an AED, the chances of surviving sudden cardiac arrest outside of a hospital are small – less than 5%. However, if the AED is applied quickly, the victim’s odds increase to about 70-90%. Many of the boats I work with have two AEDs, one on the main ship and the other on the tender. Often the tender is where medical emergencies occur, and often the tender’s medical kit is overlooked.
If you have an AED, inspect it. Most manufacturers recommend a monthly inspection. If this has not been happening, create a log book or use an AED inspection tag to track inspections.
AEDs have two major parts that must be replaced periodically: the electrode pads and the battery. Most electrode pads have a two-year life and the expiration dates should be clearly marked. The battery, once installed in the unit, has a life span of 2-5 years. Write the installation date on the battery or on a sticker on the back of the AED as a reminder. Don’t wait until the AED is beeping. This is the low-battery warning. Be proactive and order a new battery before this happens.
Verify that you have a spare set of electrode pads, as well as pediatric electrodes if you have children on board. Check to see if your AED has been updated to the new American Heart Association guidelines. Check to see if your AED has been recalled or requires a software update.
How old is your AED? Look at the back; often there is a manufacture date. If your AED is more than 10 years old, you should consider replacing it. Many of my customers trade in their AEDs every 8 years. Remember, this is a life-saving medical device.
Several companies have issued recalls on their AEDs. Your AED may have been affected and may require service. If you are unsure, check with the manufacturer or email me the make, model and serial number, and I will check for you.
Look at your medical oxygen. Is the tank full? When was the last time the oxygen tank itself was inspected? Oxygen tanks generally require hydro testing every five years and should only be filled with “medical” oxygen, which is highly filtered. Turn it on to make sure the regulator and tank function properly.
What about the oxygen masks, nasal cannulas and tubing? Do you have both adult and pediatric masks? Are these in good condition? If they look old, warn or yellow, it’s time to replace them.
Learn all about your oxygen equipment and practice using it when you have time, not during an emergency. Ask one of the crew to apply the mask to another crew and see if they know how to properly work the equipment.
Please note: If you are using the oxygen for training purposes be certain to have it refilled immediately.
Much has changed in the treatment of bleeding over the past 20 years, including combat gauze, Pressure Dressing, hemostatic agents, packing the wound, chest seals and tourniquets. Does your kit have what you need?
Training for any and all emergencies is crucial. When my company teaches classes on board a boat, we talk to the captain and crew about various medical emergencies. We talk about locations that might present challenges when administering first aid. For example, someone is knocked unconscious in the bilge. How and where should we treat that person? A crew member goes into cardiac arrest in the crew quarters. Is there enough room to perform CPR or do we need to move them?
During our courses, we also pull out the ship’s AED to inspect it and show the crew what to look for. If a medical kit is available, we also review what is in the kit and explain how things work.
Be proactive. Asking questions is a good thing, and being prepared for emergencies is the key to saving lives.
Have a safe and happy new year.
EMT Keith Murray provides onboard CPR, AED and first-aid training as well as AED sales and service. His company can be found at TheCPRSchool.com. Comments are welcome below.