EMERGENCIES AT SEA
TIPS FOR EMERGENCIES AT SEARobert E. Rakel, M.D.
Professor
Department of Family and Community Medicine
Baylor College of Medicine
Houston, Texas
ANTISEPTICS
Betadine ˆ no prescription needed
Hydrogen peroxide ˆ a good all around cleanser of wounds
ANTIBIOTICS
Cipro (ciprofloxacin), 500 mg capsules, one twice a day for five days for most cases of diarrhea or urinary, respiratory, or skin infections.
Biaxin (clarithromycin), 500 mg tablets, one twice a day for respiratory infections (pharyngitis, bronchitis, sinusitis, pneumonia).
Bactrim (trimethoprim-sulfamethoxazole), DS (double strength) tablets, one twice a day for urinary tract infection, otitis media, traveler‚s diarrhea.
Flagyl (metronidazole), 250 mg three times daily for 7-10 days for Giardia and some vaginal infections.
PAIN MANAGEMENT
Acetominophen (Tylenol), 500 mg every 4 to 6 hrs.
Naproxen (Aleve, Naprosyn), 250 to 500 mg twice a day
Ibuprofen (Advil, Motrin), 400 mg every 4 to 6 hrs.
ANTIHISTAMINE
Diphenhydramine (Benadryl) ˆ 25 or 50 mg tablets, 1 every 6 to 8 hrs
Chlorpheniramine (Chlor-Trimeton) ˆ 4 mg tablets, 1 every 4 to 6 hrs
DIARRHEA
Prevention: Pepto-Bismol - Two tablets four times a day when in Mexico or other high-risk areas.
Treatment: Cipro, (ciprofloxacin), 500 mg twice daily for 3 days or
Bactrim DS (trimethoprim-sulfamethoxazole), one twice daily for 3 d.
Imodium (loperamide), 2 mg tablets. Two after first loose bowel movement then one each subsequent one but no more than 4 tablets per 24 hrs.
SEASICKNESS
Ginger ale, ginger snaps or ginger tea.
Acupressure ˆ wristbands
Meclizine ˆ Bonine, Dramamine II, Dizmiss ˆ 25mg, 50mg tablets
Transderm Scop (scopolamine transdermal patch), apply behind the ear 4 hrs. before needed.
Scopace (scopolamine hydrobromide), 0.4 mg., 1 to 2 tablets every 8 hrs. as needed.
Zofran (ondansetron) ˆ 4mg or 8mg tablet every 12 hours - prescription only - very expensive.
STONY CORAL CUTS (coral poisoning)
Wash promptly and vigorously with salt water.
Apply hydrogen peroxide to bubble out „coral dust.‰
Rinse with vinegar (dilute acetic acid).
Apply bacitracin or neosporin ointment.
Take an antihistamine and immobilize the injured part.
JELLYFISH, FIRE CORAL, SEA ANEMONE
Rinse with seawater (not freshwater)
Flood the area with vinegar (5% acetic acid) for 30 min.
Shave area using shaving cream or a paste of baking soda
Apply anesthetic ointment (Solarcaine) or hydrocortisone cream
SEA URCHINS, STINGRAY, SCORPIONFISH
Immerse in hot water for 1 hour (this detoxifies the protein venom)
Remove any embedded spines
Cleanse wound thoroughly with hydrogen peroxide or other antiseptic
Cipro (antibiotic) twice daily for two days
SPLINTERS
If exposed end cannot be grasped with tweezers, unroof an area near
the end to expose enough to grasp.
Wash with soap and water then apply antibiotic ointment.
BURNS
Wash gently with soap and water.
Remove loose skin, leave intact blisters alone.
Apply Silvadene cream (prescription) and cover with dressing
SUNBURN PREVENTION
Sunscreens with SPF (sun protection factor) >15 to 30.
For kids, Baby Faces provides SPF 50 or use Banana Boat Active Sports Sunblock Spray Lotion SPF 48. Solarveil clothing blocks 75% of ultraviolet light and the double-layer protection blocks 95%.
HEAT EXHAUSTION
Rest with feet elevated
Cool the skin
Drink plenty of fluids (with salt - not plain water)
Heat stroke is more serious ˆ no sweating, confusion, shock.
LACERATION, BLEEDING
Use pressure to control bleeding
Wash with soap and water
Apply butterfly bandage or steristrips to approximate edges
Super Glue can be used to close superficial lacerations
FISH HOOKS
Push the barb through the skin, use ice to numb area first
Use wire cutter to snip off the barb
Back the hook out
FRACTURE, SEVERE SPRAIN
IMMOBILIZE
BIBLIOGRAPHY
Gill, Paul G. Jr., M.D. The Onboard Medical Handbook: First Aid and Emergency Medicine Afloat. International Marine, Camden, Maine, 1997. $17.95.
Gould, Robert S. M.D. The Boater's Medical Companion. Centreville, Maryland, Cornell Maritime Press, 1989. $6.26.
The American Medical Association Handbook of First Aid and Emergency Care. New York, Random House, 1990. $10.00.
Eastman, Peter F. Advanced First Aid Afloat. Centreville, Maryland, Cornell Maritime Press, 4th edition, 1995. $13.46.
Breyfogle, Newell D. Commonsense Outdoor Medicine and Emergency Companion.
Camden, Maine, Ragged Mountain Press, 3rd edition, 1993. $14.36.
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