First Aid at Sea

Douglas Justins, Colin Berry

• Publisher: Adlard Coles
• Year: 2022
• ISBN:
  9781472994073
• Edition: 1
• Topic: Médecine
• Subtopic: Premiers soins et sécurité

Fully updated 8th edition of this easy-to-access instant guide to emergency first aid for all seafarers. This essential guide to first aid afloat is an essential part of any on-board medical kit. Its colour-coded tabs and clear layout make it easy to use in an emergency. This revised new edition has been updated with latest medical practice, including information relating to Covid-19, expanded information on treating burns, new section on diving accidents, and updates to advice on certain illnesses and first aid kit contents. Clear, easy-to-follow illustrations make it ideal for crew members with limited training in first aid. Key features include: · Concise descriptions of each medical condition
· Prioritised lists of treatments
· Covers all the medical emergencies likely to be encountered at sea
· Fully updated in line with current guidelines and best practice Here is some praise for previous editions in the sailing press: 'A highly practical on-board emergency tool written by doctors who sail' – Yachting Monthly 'A handy companion not only detailing medical procedures but providing some information on emergency communications' – Sailing Today

Sudden Illness

Abdominal pain

Numerous possible causes. Important to identify the person who needs urgent medical attention. He/she will suffer more severe long-lasting pain that may be constant or occur in recurrent spasms. The pain may be localised or spread over whole abdomen. The abdomen will be tender when pressed and may be very rigid. The sufferer may also have fever, nausea and vomiting or generalised illness. He/she may develop shock. See here.

Treatment

Rest, treat shock, give pain relief, nothing to eat, sips of water only. Urgent help is needed.

◼Indigestion

Indigestion is a common cause of abdominal pain. The pain is usually restricted to the upper abdomen and may follow heavy alcohol intake and rich food. The abdomen is not tender or rigid.

Treatment

Frequent small sips of water, beware of dehydration, take antacid or omeprazole. Children are more liable to become severely dehydrated and should be encouraged to drink when ill.

Allergies

There is increased awareness about allergic reactions to foods, stings and medicines. Crew members with known allergies should alert other crew before sailing and avoid triggering agents (e.g. nuts, seafood). Known food triggers should probably be avoided for the whole crew.

Reactions can be mild (rash, redness, itchiness, wheezing, runny nose) and can be treated with antihistamine cream or tablets (e.g. chlorphenamine). Symptoms should settle once the allergic stimulus has been removed.

Anaphylaxis

Severe breathlessness, wheezing and/or collapse (anaphylaxis) is a medical emergency and requires full BLS – Basic Life Support (here–here). Crew members with known severe allergies should carry at least two epinephrine (adrenaline) auto-injectors (e.g. Epipen) and one injection should be administered immediately once severe symptoms have developed. DO NOT delay administration.

Back pain

Back pain may develop following an accident, or heavy lifting, or for no apparent reason. There may be a history of previous back problems.

Treatment

Rest and painkillers. If there is numbness and weakness in the legs, or if bladder and bowel function are disturbed, seek help urgently.

Chest pain

May be caused by heart attack (see here), indigestion, oesophagitis, chest infection, fractured ribs, torn cartilage, or muscle strain.

Treatment

Painkillers – but avoid ibuprofen if indigestion is suspected. For indigestion and oesophagitis give medications such as omeprazole and Gaviscon.

SIGNS OF POSSIBLE HEART ATTACK

+Heart rate above 100 or below 50 per minute

+Irregular heart beat or pulse

+Weak, thready pulse

+Breathing rate above 30 per minute

+Reduced consciousness

+Sweating

+Vomiting

+Pain spreading to jaw, arms or back

+Known history of heart disease

Sudden Illness

Constipation

Common problem at sea and even affects those who have no problems ashore. Poor diet, relative inactivity, dehydration and reluctance to use facilities are common causes. Crew members should be encouraged to drink water and soft drinks regularly and to eat fresh fruit and vegetables when available. Constipation lasting for a few days may contribute to the formation of piles (haemorrhoids) which may be painful and bleed. Special cream may alleviate the symptoms but will not treat the constipation.

Treatment

Rehydrate with non-alcoholic and caffeine-free drinks and take paracetamol or ibuprofen for pain. Take senna tablets if constipation persists.

Diabetes

Diabetics should not go to sea without taking adequate supplies of medication and instructing other crew in the management of potential problems. A diabetic may become unconscious if the sugar content in his blood is too high (insulin is needed) or too low (sugar is needed).

Treatment

If any doubt exists, it is advisable to give sugar first – sweets, soft drinks, pure sugar. Giving insulin inappropriately is dangerous. Urgent help is needed if recovery is not rapid.

Diarrhoea

Often follows some dietary indiscretion (food or water) but may be associated with other causes. In children in particular the amount of fluid lost from the body can be very serious.

Treatment

Encourage copious fluid intake (water with one teaspoon of salt and four teaspoons of sugar per litre); loperamide is a popular anti-diarrhoeal medication.

Rehydration solution

4 tsps sugar

1 tsp salt

1 litre water

Earache

Infection in the outer ear is common in hot climates and after swimming. The ear canal appears red and discharges.

Treatment

Painkillers. Clean the outer ear very gently and insert ear drops.

Infection in the middle ear may occur during a common cold. The pain is often severe and associated with fever and general illness. Eventually the ear drum may burst and release fluid trapped in the middle ear.

Treatment

Painkillers and antibiotics. Seek help if the pain increases. NEVER insert any object deep into the ear.

Epilepsy

Epileptics should not go to sea without taking adequate supplies of medication and informing other crew of potential problems. Most epileptic fits are self-limiting and should be treated by minimising damage to the body. The patient may fall to the deck or thrash arms and legs in an alarming manner, so try to protect him or her.

Treatment

Putting a piece of cloth between the teeth may reduce damage to the tongue. After a fit the patient may enter a deep sleep and should be placed in the recovery position while keeping a close watch on the airway. Seek help.

Eye problems

Many eye problems and injuries are potentially serious. Worrying symptoms include: pain, red eye, loss or blurring of vision, sensitivity to ...