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At Large: Seafaring medicine
September 29, 2005
By Doug Cabral
What if you are seasick?
"When symptoms progress, lie down and try to sleep. Take small amounts of fluid, crackers, and hard candy. Phenergan taken as a pill, but preferably as suppository or injection, will prevent additional vomiting and dehydration. Repeat every six hours as needed and treat for dehydration."
Dr. Michael Jacobs might have added, "Get off that boat as soon as you can."
How about sunburn?
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"Apply cool, wet compresses for 15-20 minutes throughout the day… Anesthetic sprays or ointments are effective but can produce significant allergic reactions. Take frequent cool showers or dowse the affected areas with cold seawater. Administer ibuprofen 400 mg or aspirin 650 mg, three to four times a day with meals, to reduce inflammation and control pain…"
And, Dr. Jacobs adds, use preventative treatments, i.e. sunblocks, and you might have avoided the discomfort.
No groundbreaking medicine in this. But how about skull fractures, scalp wounds, eye injuries, penetrating injuries, styes or abscesses? And how about treating these conditions at sea, with your small boat or large cruiser rolling wildly in a big sea driven by a big wind, and you are the one responsible?
Dr. Jacobs and Eric A. Weiss, co-authors of A Comprehensive Guide to Marine Medicine (Adventure Medical Kits, Oakland, 2005. $16.95), have the answers, delivered in handy form, with straightforward descriptions of treatment techniques and medicines. This is a small book that ought to have an important, and easy to reach, place in every mariner's or yachtsman's seagoing bookshelf.
Dr. Jacobs is a longtime Vineyard physician who practices through his Vineyard Medical Services clinic on State Road in Vineyard Haven. He is also a sailor with years of experience at the helm of offshore passagemakers, racers, multi-hulls, daysailers, and kayaks. He was the author in 2001 of Survival at Sea, a textbook of Wilderness Medicine. He is the founder and program director of MedSail, Medicine for Mariners and Safety at Sea Conferences; and a Coast Guard licensed captain. If you are unable to take a seagoing surgical officer along for your sail to Tarpaulin Cove on Sunday, be sure to take Dr. Jacobs's sea-med care primer. Dr. Weiss is assistant professor of emergency medicine and associate director of trauma at Stanford University Medical Center, a past director of the Wilderness Medical Society, and a climber, kayaker, and professional raft guide.
This marine medicine guide is designed to be helpful when physicians and other professional care is unavailable. The authors explain that grabbing their meticulously researched and clearly written volume off that bookshelf when the medical emergency occurs will not replace some forethought, practice, and practical preparations. This is a book with which sailors and yachtsmen must familiarize themselves when the sailing is pleasant and all is well aboard ship. When the accident or illness occurs, this volume will be of immense help, but its utility will depend on the responsible person on board, or as Dr. Jacobs puts it, "Remember, the value of any first-aid book or medical kit is both enhanced and limited by the ability of the owner to use the information and contents effectively and creatively. Taking a course in wilderness first aid, wilderness first responder or emergency medical technician, and practicing your skills before you leave home, will better prepare you to manage an emergency when it occurs."
By the way, although Marine Medicine is focused on the emergency needs of sailors, it will fit nicely in the glove compartment of the car or the utility drawer in the kitchen at home, and serve very well the first-aid needs of non-sailors.
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