Unpopular opinion: Standard marine first aid kits are basically just expensive security theater
Posted by TightPublic3143@reddit | sailing | View on Reddit | 98 comments
I was talking to a skipper friend recently about an incident where a crew member took a bad spill while totally out of cell range. They had the giant, expensive offshore medical kit, but when the panic set in and blood was flowing, everyone just froze. Nobody knew what to actually do with half the trauma supplies inside, and they couldn't just Google it.
It got me thinking: a box of supplies is completely useless if your brain freezes during an emergency and you have zero connection to the outside world to guide you.
Am I overthinking this, or has anyone else had that terrifying "we have the tools but no idea how to use them under pressure" moment offshore? How did you handle the isolation?
Glenbard@reddit
No amount of equipment can compensate for training and experience. This goes far beyond sailing.
FalseRegister@reddit
What is a good training for this? Becoming a paramedic?
mcm87@reddit
Stop-the-bleed courses are pretty readily available. Wilderness first aid is good too.
retirement_savings@reddit
Wilderness first aid or wilderness first responder course. I took a WFR this year and it was awesome.
IndyBananaJones2@reddit
I teach wilderness medicine, and it's definitely the way to go for someone going offshore. Some programs have marine specific teaching (Back country Medical Guides comes to mind if you're west coast or willing to travel).
retirement_savings@reddit
I live in Seattle and was looking at some the sailing WFRs but they were way more expensive. Sounded awesome though.
IndyBananaJones2@reddit
I think the prices are more even if you're not actually sailing during the course. We taught a maritime course but just used the sailing clubs boats at the dock.
IndyBananaJones2@reddit
I would recommend any basic wilderness medicine course, but there are also maritime specific courses if you look online.
Usually a combination of online coursework and in person training that will get you ready to handle most immediate needs in an emergency. These are 1-3 day courses.
Quint87@reddit
We had a ton of medical training in military, super useful as a civilian day to day.
Moonsnail8@reddit
There are maritime first aid courses and wilderness first responder anybody can take.
Glenbard@reddit
Not sure why you’re downvoted…. It’s a valid question.
There are a number of courses and most are fairly inexpensive. My grandfather made me do the RYA First Aid Course when I was 15. He was getting older and usually it was just the two of us sailing to Port Royal.
When I was working in Germany and charting in Greece with my own wife and children I decided to take the STCW Medical First Aid offered in Amsterdam. It was not cheap (~€650 at the time). But, it was a significantly more advanced course and I got a ton out of it.
I used that course (and about $50 of supplies I bought on the internet) to teach my kids…. Even a practice suture kit with a “fake arm segment” so we could all practice. It’s a ton of fun actually. The kids love it…. Especially when I used fake blood. Kids 🤷🏻♂️….
Bottom line is you find a course in your budget, learn what you can… and then practice it. Practicing while underway is also helpful because it’s a little different when you’re in motion. I always get a little seasick when doing practice sutures underway…. Probably because you have to concentrate on a small area so hard.
FalseRegister@reddit
As someone living in Germany and sailing in Greece, thank you, big time. I will look into STCW Medical First Aid. Very valuable!
Glenbard@reddit
This is the one I did: https://fmtcsafety.com/courses/stcw-medical-first-aid/ Looks like the price went up slightly but not too bad. It was certainly worth it for my peace of mind sailing with my family.
Ace-of-Spades88@reddit
You don't have to go that far. Basic First Aid training can go a long way, and there are more advanced courses/certs you can get.
I'm fortunate in that my work covers some basic first-aid/safety trainings, and keeps me up to date; but I would think those trainings are fairly accessible to most people, in some form.
FalseRegister@reddit
I've taken the basic first aid offered/required for driving, and honestly I didn't find it any valuable, other than practicing the CPR with a dummy. But for most other things, a 6 hour training didn't teach much.
redluchador@reddit
EMT-B. Basic EMT. You won't learn all the stuff that paramedics lesrn like starting IVs and intubating people, but it would make you pretty solid for emergencies at sea
sgwennog@reddit
I've been watching The Pitt so it will all be fine as long as the patient is tachy at 105 with good bilateral sounds.
Flogge@reddit
That's why you should do a first aid course every now and then, and do a proper offshore emergency medicine course before going blue water sailing...
caeru1ean@reddit
I just did a one day FirstAid/CPR course as part of STCW and feel completely unprepared for emergencies still, the class was a joke.
OberonsGhost@reddit
That is why I took a first responder course besides the STCW when I got it.
MissingGravitas@reddit
It's hard to cover much in a one day class. The longer STCW Medical Care course (5 days?) has a bit more space.
For those with the time/money a 10 day WFR course is also good (especially when you don't have a well-stocked sickbay), and should include a decent amount of scenario practice. 10 days isn't that much either, but it's much better than a day or two.
pqjcjdjwkkc@reddit
To be fair the basic safety course is only interned for pure basics. On a stcw vessel you have trainings and better trained persons and equipment on board, often times real doctors and if not real time assistance by real doctors.
user685@reddit
Literally just did a two day offshore medical course not even a week ago. Although I can’t tell if I’d freeze in an emergency situation, I can say that I feel a little more equipped, though not as much as of like! With the big kit they’re designed to call someone for advice on what to use and how to use it. So yeah, if you have no internet or sat phone then there are parts of that kit that are essentially useless
sailbrew@reddit
This is the right answer here. A course, or even practice with old, expired supplies over and over again. Know exactly where everything is in your kit.
Turns into muscle memory when something bad does happen. I hate blood and gore but a switch flips and it just feels like a practice run (not that I've dealt with anything too bad other than a nasty deep cut with a lot of blood. Steri strips saved the day but there's even better wound closing devices now).
cplforlife@reddit
We dont rise to the occasion, we fall to the level of our training.
The fault is with the training, not the supplies.
fasttalkerslowwalker@reddit
Totally. “Medical supplies are worthless” is a weird reaction to “I heard about a situation where nobody knew how to use the supplies they had on hand.”
roger_cw@reddit
I think they were saying that the supplies are worthless because you don't have the training to use them on the spot. Which in itself is a true statement but a little misleading because it makes it sound like you're blaming it on the supplies.
The_Nepenthe@reddit
A lot of kits are loaded up with garbage that gets in your way.
I keep meaning to make a serious cuts kit with quickclot, butterflies and some other things and the plan is for it to be streamlined to be just what you need at hand for cuts that could use medical attention but could be tended to with first aid.
Monkeystache_HH@reddit
Yes and no. Absolutely the issue here was lack of training and practice rather than a failure of the kit. But i do think the situation the OP highlighted is way more common than it aught to be. Criticising the crew involved does not help; rather what does is taking the wake up call and realising that many of us could benefit from more medical training.
For example I’ve taken STCW basic first aid classes, as well as the RYA and St John’s equivalents over the years. These are solid classes but if you just take a class once every few years and don’t practice in between that’s not going to go very far. More practice is always going to be better!
It’s worth remembering that you can make a pan pan medico call over VHF16 to get patched through to a doc without cellphone; and if you’re going out of VHF range then the cost of an iridium or Starlink mini is a no brainer. Also you can download a pdf copy of The Ship’s Captain’s Medical Guide for free, or buy a hard copy to keep onboard.
On a commercial blue water passage under U.K. flag you’re required to have a crew member who holds two advanced MCA medical courses, each a week long; this seems like a better standard for heading offshore.
severalsmallducks@reddit
You're right, but you can also run into a double whammy.
I've been midly into prepping and have seen tons of first aid kits that are little more than expensive band aid packets. If you don't know what you might need in an emergency, you can very well run into the trap of cheaping out and buying something that will not work when you absolutely need it to.
J4pes@reddit
Having the knowledge but no kit isn’t exactly helping much either. This post reads like the kits are useless or not worth money.
This is a bad take because both the kit AND knowledge are very important to anyone responsible for the lives on board their vessel.
Arguably should be among the most important skills you carry if you consider yourself a leader at sea.
jttv@reddit
Your title had me thinking this was gonna go a different way.
IndyBananaJones2@reddit
In New Zealand you're required to take a first aid course prior to heading offshore. It's a really good point.
Any tool you take into a remote / offshore situation is useless unless you also take the knowledge (or a way to reach someone with that knowledge immediately) along with you.
joesquatchnow@reddit
Or take a scuba diver medic course, I only suggest that because it covers emergencies in the water too, gushers are usually pressure and wraps, where is your vhf radio ? Coast guard is monitoring channel 16 and may direct you to channel 9 or others …
Rubes2525@reddit
Well, yea. If nobody actually uses something, then it is worthless. Hell, the entire boat would be worthless if nobody knows how to use it and just sits and stares at it in the harbor.
Android_slag@reddit
Your kit will have expiry dates. Use the old stuff to practice. Take it with you on your annual fist aid refresher course and sometimes you'll get free refills or advice on missing stuff
Wierd657@reddit
Dates are only for the drugs contained in the kit. Newer kits being sold has the drugs removed for longer shelf life. BYOD
Zealousideal-Ad-7618@reddit
Anything sterile will have an expiry date too
RikkiLostMyNumber@reddit
What expires besides medicines and topical preparations?
Android_slag@reddit
Couple of my wound dressings have expiry dates on. Guess it's no longer guaranteed sterile after a few years /= more sales ???
Inevitable_Pride1925@reddit
First aid is a lot different than standard medical care in a hospital or ER. Most people also struggle with basic medical knowledge with no time pressure or stress. Add an emergency situation to the mix is a recipe for disaster for most people without training even if they are a nurse or physician working outside their specialty, for a regular person it’s completely expected.
First aid kits do nothing unless you also have the knowledge to use it and are able to keep equanimity in an emergency.
theheadslacker@reddit
That's a problem with the crew, not the kit
Golywobblerer@reddit
Always good to have a medical professional on your crew. I pick mine up in the parking lot of the hospital just like skilled craftsman at home depot.
Pattern_Is_Movement@reddit
Blaming the tool instead of the person behind it is certainly one way to ensure they never do better. Emergency medical training is on them to do.
Sh0ckValu3@reddit
Yeah putting a kit on board is better than nothing, but unless you have people on board who know whats in there and how to use it - you're right. It's a feel-good prop.
I'm always so thankful that one of the regulars on our boat is an RN who is squeamish about seemingly nothing.
Eltrits@reddit
Like everything,the material without the knowledge to use it is useless.
porttackapproach2@reddit
I have a printed copy of the international shipboard guide to medicine. Hope to never need it but I turn the pages and read it from time to time when things are quiet aboard.
Blarghnog@reddit
I keep a local AI trained in medicine on a usb key and also on my laptop.
On the same usb key I keep medical advice books. There are lots of training guides and cheat sheets.
I suggest this one:
https://www.pantaenius.com/fr-en/insights/journal/article/emergencies-cheat-sheet-8/
There are also fantastic resources with cut sheets of emergency protocols:
https://www.empoweredpas.com/wp-content/uploads/2020/01/Physician-Assistant-Emergency-Medicine-Cheat-Sheet-EmpoweredPAs.pdf
We also train in first aid.
It takes only thinking ahead and perhaps only a few hours a month tops to save someone’s life.
More sailors should be asking skippers about this kind of prep before heading offshore and we sailors should encourage the conversations.
davedavebobave13@reddit
In an emergency, you sink to the level of your training. Executive function goes away when adrenaline is in charge, so you need to be familiar with how to use everything, or you will stall out like that
aosmith@reddit
Quick clot and chest seals, some bandages... That's enough to triage most coastal cruising. Maybe vetabond if you want to be really prepared.
mikemerriman@reddit
all premade first aids are. build your own.
kor0na@reddit
Is "taking a bad spill" American slang for bleeding, or was this a typo that I can't figure out.
Lobomite@reddit
It means they fell.
kor0na@reddit
Thanks! Never heard the expression.
The_Big_Lie@reddit
You have to practice emergency response procedures for them to be effective
bill9896@reddit
There are two issues here that the OP brings up. First, is his lack of training. Anybody who goes offshore and is days (at least) from in-person medial assistance who has not gotten at LEAST basic first aid training is just irresponsible. A professional Captain or a Wilderness Guide has training, so should you because you are responsible for the crew on your vessel. If you don't know what to do, the best medical kit on the planet is just a pile of expensive ballast.
But... most first aid kits sold to consumers are pretty worthless for vessels that are not within hours of land. Some of them have good bones, but still lack a lot of necessary stuff, and have a lot of filling you pay for that isn't really much help.
Any serious offshore boat should have contact with a marine or wilderness medicine expert. At least one person onboard should have a minimum of training, and your expert should prescribe you the basic medications to keep onboard that you might need to stabilize an emergency. And you need to have a PLAN. In the case of a serious health emergency or trauma, who are you going to call? What are you going to do? Not having a plan is the equivalent of just throwing up your hands and saying, "You''re gonna die! So sorry!"
Finally, these days there is simply no excuse for having "zero connection to the outside world". Not having basic emergancy communications is putting a very limited value on your and your crew's health and safety. I certainly would never be on a boat crossing an ocean that had zero communications once out of sight of land. If you want to be a crazy historical re-enactor I guess you might do that, but no rational person would.
barefootviking@reddit
Take a wilderness medic course. They teach you how to improvise and they have hands-on drills goes through all the scenarios you might encounter. If your boss can’t afford it, try to get one of the instructors to teach the class on your yacht
mifter123@reddit
Sounds like these people were not properly prepared for blue water sailing and hadn't taken the time to educate themselves on how to use their equipment.
Are there first aid kits and trauma med kits that are poorly constructed and over priced, sure, but that doesn't sound like that's the issue here.
Quint87@reddit
Yes. Any tool is only as useful as the person using it.
You can do a ton of (human) repairs with super glue, some medical gauze & tape, and knowledge.
QuellishQuellish@reddit
Your observation is true of all medical kits. It's not just Marine. Medical supplies are not helpful unless you know how to use them. Ideally, everyone should have at least basic first aid training and preferably advanced.
In any dangerous endeavor where you're far enough off the couch preclude outside help, there should be at least one crew member with first responder training. The basic first aid and CPR that comes with being a Captain isn't really sufficient. Any Captain would be well served with at least the next level up.
LitlThisLitlThat@reddit
This is why everyone should have first aid training and practice full-out regularly. It’s not enough to have a stop-the-bleed tourniquet if you don’t know how and when to apply it.
brttf3@reddit
I am a NOLS wilderness medicine instructor and while courses like the WFA or WFR aren't aimed specifically at sailors I see a lot of them on courses. Take some sort of remote location medicine course.
sailingtroy@reddit
I keep a first aid book on board. If one person reads from the book, another can try to work the casualty. Being trained and knowing what you know is better but we're not doctors, so this is second best.
SomewhereInNB@reddit
Sailing or not, first aid courses should be mandatory until college.
DUIRduje@reddit
Theatre is wearing life jacket solo sailing in winter in Norway. Nevertheless... I do it. Perhaps to prolong suffering by giving some stupid hope.
sleeping-geologist@reddit
you should totally know how to use every piece of your kit, you’re right it’s useless otherwise. If you have a med kit that goes beyond first aid, you should do a medical course that goes beyond first aid. Proficiency in Medical First Aid is a good one, i’m sure there are some cheaper options out there.
if actually going well offshore, consider getting a MSOS medical package where you have a doctor on standby that you can contact with a sat phone or something. That’s what all the commercial offshore boats have.
Immediate_Matter9139@reddit
If it's theatre then your friends are the clowns. No point blaming the gear when it's the crew that failed to train for going offshore
depaaz@reddit
Every incident initiates a “fight, flight or freeze”. Training can make you more capable of “fighting” the incident but it’s not uncommon for medical professionals to freeze. That’s where training, leadership and teamwork kick in.
When I’m stressed out in a medical emergency training takes over and I go what I call “machine mode”, doing what I was thought without thinking too much. Can’t imagine what would happen without those countless hours of practicing.
Exciting_Vast7739@reddit
There's an excellent book that I recommend to anyone doing fun things in the wild: "Deep Survival" by Lawrence Gonzales.
It's a really good series of stories and observations about how the brain works under stress. There's a breakdown of the Trashman disaster in there that is quite good, but he also pulls from mountaineering, piloting fighter jets, and whitewater rafting.
0FO6@reddit
Well, There is an awesome free resource that should be kept on board printed out that is available from:
https://iris.who.int/items/ad0b59ae-daf9-44a5-b161-e78dfdcc9490
This is also a good paid for resource: Doctor on Board: Ship's Medicine Chest and Care on the Water https://www.amazon.com/dp/1493056638
Something to consider with a lot of first aid training is that it is meant to get a person in a reasonable situation before help can arrive. But they all consider professional emergency services to be a short time away for the most part. There is some additional consideration on a boat, even if sitting at anchor near a town. It can take a considerable amount of time to get emergency services to a person who needs help. Not saying to not take first aid class or even EMT training if possible. Just that the situations on a boat need to be handled a lot differently most of the time. But training is still helpful and a good idea, tends to not be terribly expensive. Having a couple of resources on board is also important.
Capri2256@reddit
100% agree. Supplies w/o training are near useless. I told a friend that I was taking a celestial navigation course and they said, "Why do you need that with GPS?"
hrtlssromantic@reddit
Take a course. Keep a book on board. Practice.
Dawn_Venture@reddit
Definitely have hardcopy references if you know you won't be able to use the internet.
Most of the larger (non marine) first aid kits I've seen have a pamphlet or booklet showing either the basics or the applications of the available supplies.
Most people don't open the kit until they have to use it. Even then, it's just to grab a bandaid.
fgorina@reddit
If you work in any ship, even as let’s say a waiter or a performer, you must have the basic stcw course that includes first aids. Why your boat should be different?
Coreantes@reddit
Very much not true in my situation. Marine first aid kits (in Europe?) have numbers and their contents are standarized. Additionally, out of cell range, at least in the Netherlands you can call the coastguard by VHF and request help. There is a doctor on standby to take your call 24/7. If you tell them your kitnumber and your emergency, they know exactly what you have onboard and how to best help you.
Preparing/practise/keeping knowledge up to date is obviously much better, so you don't have to make that call, but I find it very reassuring that when some medical emergency happens that I'm not trained for, this option is always available to me and everyone else with a VHF radio and a medical kit.
FairSeafarer@reddit
Well, I say it’s a them problem that they froze and it would be bad to assume that most offshore sailors would. For the sailors I know, most are built for embarking on serious adventures and dealing with the pressures it brings. Most have taken 1st aid classes at some point.
Going offshore is a lot of responsibility and knowing what to do in various situations and your way around the med kit is a prime responsibility.
Yesterday, I just had a call with a Dr to renew some of the meds in the kit and make a couple useful additions, just in case. From UTI, difficulty breathing, extreme pain or bleeding, suture kit, broad spectrum antibiotics injections for whatever infection, we’re covered… Gosh, we even have surgery theatre meds for seasickness should the sea state become that terrible (we’re not seasick for starters, but heck, they say everyone can meet a sea that will make you so).
I think, the med kit is one place where you definitely cannot overthink. And the more you will have thought about it, the more prepared you will be.
I’ve had to shoot myself because of a weird allergy offshore last year. I could only see from one eye at that point. I sure was glad to have a big medical kit with injectable meds and a choice from a wide array of seringues 💉So no, they are not expensive security theatre.
hudsoncress@reddit
Having a tournequet, practicing putting it on yourself and someone else, and storing it somewhere instantly accessible is probably the only thing I've added to my kit since boy scouts. I also added a box of cold compresses and a wide ace bandaage for my son's soccer injuries. Med kit needs to match the likely injuries first, but adding depth over time is good. I have stethesccope, one of those ear inspection things, two pair of EMT shears, even a geiger counter and range finder, maps compass, emergency ponchos, and mylar sheet.
vanatteveldt@reddit
I took my employer's first aid kit specifically for this scenario, and have the national first aid organization's first aid book next to it.
RockHead-MA@reddit
Most first aid kits are worthless for a serious bleed. Online Red Cross FAST training (in the US). Clotting pads, some proper "Israeli" pressure bandages, and a good tourniquet should be mandatory in any worthwhile kit.
u399566@reddit
Yea, then maybe you'all simply should not be off shore.
This is borderline reckless, just be happy that the fellow with the spill didn't accidentally delete himself.
FairSeafarer@reddit
Right?! Gosh. Being offshore is a lot of responsibility. One should know what to do in case of an emergency.
CaptainMcSmoky@reddit
You could say the same of a toolbox, the trick is to learn to use the tools provided before you need them in an emergency.
FairSeafarer@reddit
Exactly, closest analogy relatable to sailor. Came here to say that.
Brokenbowman@reddit
As a former Scouter, I keep the BSA handbook on board and build my own first aid kit from adhesive bandages to roll bandages & splints
Visual-Plant-4814@reddit
A quality First Aid course is a good start but if going offshore a Sea Survival Course prepares you better. The material usually includes fatal accidents reports which are difficult to read but critical in understand risk and implementing better safety practices onboard.
Ace-of-Spades88@reddit
You're right, supplies mean little without some form of basic training. Take a first aid course, get certified to the level you deem comfortable. You may not go to the lengths of becoming an EMT, but even a little knowledge or training can go a long way in an emergency situation.
I'm fortunate in that my work pays to keep me updated on safety/first-aid trainings, but I'd bet it's fairly accessible to everyone.
Icy_Respect_9077@reddit
I had an office job. We had mandatory annual first aid training. What's with the sloppy training requirements for offshore work. Sounds like it's a "nice to have" rather than a requirement.
TXOgre09@reddit
Tools aren’t inherently useless just because you didn’t train properly. Blame the lack of training, not the tools themselves.
Potential4752@reddit
Most store bought first aid kits are junk anyway. They are better equipped to deal with paper cuts than blood loss.
Read Marine Medicine: A Comprehensive Guide and build your own kit. Building your own will not only give you the correct gear, but will force you to think through what you have and how to use it.
Crazyfoot13@reddit
‘in a stressful situation, we sink to the level of our training’ is what my old professor used to tell me. We may react okay or adequately in a stressful situation, but we’ll probably just freeze. This is why those first aid in medical courses of sea are so important!
djrstar@reddit
I know 1st hand from injuries, fires, and other incidents on board that walking through safety equipment with the crew before departing is a life saver. The less someone has to think about and decide in an emergency, the better.
opticalminefield@reddit
Anyone who owns a boat should at least do a basic first aid course. Those going offshore should do a marine/offshore oriented course that is more advanced.
Offshore you should have Starlink and/or iridium to be able to phone a doctor for advice when you hit the limits of your training.
Likewise Advanced Sea Survival training should be on your list if you are going offshore.
wkavinsky@reddit
In New Zealand, as part of the Category A offshore requirements for NZ owned and registered boats, the skipper (and I think first mate) are required to have a current pass certificate for the offshore medical course, where they actually teach you about how to deal with most major sailing injuries away from help.
It’s not a super expensive course (a few hundo NZD), but it makes so much sense, like most of their offshore rules.
Doesn’t stop the occasional post from pissed off Americans about it here though.
UrbanRoadie@reddit
In addition to keeping my first aid up to date I have one of these on board, sadly out of print now I think.
Emergency First Aid Step by Step Guide by Dah-Di-Dah
paddleyay@reddit
Did a lot of first aid training over the years for adventure and wilderness sports, backcountry, sailing, diving, etc. I remember the simple advice of a paramedic. Basically, in a street, someone falls down, maybe a heart attack, 90% of people will stand and look, someone with first aid training will step in, assist, and if the only thing they do is give compressions until help arrives that person has a massively increased chance of survival. This was demonstrated with studies in Scandinavia, where first aid is taught in schools, and UK, where it isn't. Steet incidents showed a marked improvement in survival in Scandi countries. Wilderness training, similar to sailing, reinforced the same approach, knowledge greatly reduces the freeze or flight, and moves into anything is better than nothing approach. More training, more reinforcement, increased likelihood of better outcomes.
Rino-feroce@reddit
There are courses you should do to learn what to do in an emergency (not your average fisrt aid courses) and there are services (private and/or public depending on the country) that allow you to call a medic (or video-call if you have starlink) while you are offshore and be directed on the proper course of action.
RedPh0enix@reddit
Many kits in Australia have a small booklet included that covers a reasonable proportion of the situations you're likely to encounter when using the kit.
They're easy to read, have plenty of illustrations, and are reasonably quick to consult and understand in anything but extremely urgent circumstances.
Not ideal, and not a replacement for good first aid course, but not a bad option when you are out of comms range.
Discopathe@reddit
Les formations de skipper incluent des modules de secourisme normalement