I recently learned of a new provider of cruising medical kits from the cool website Three Sheets Northwest, which covers Pacific Northwest boating and is run by Marty McOmber and Deborah Bach.
The Expedition Medical Chest series is the brainchild of Kirsten Hansen and her partner, Steve Roberts (he of Technomad and Nomadness fame). Unlike the cheap kits you get from the typical marine supply house, these kits are stocked with professional-grade supplies and tools to help you deal with health emergencies while at sea.
Kirsten Hansen is a nurse with 17 years of experience (including ER). She has patched many a cut, assessed countless traumas, changed innumerable complicated dressings, given thousands of injections, started many IV’s, assisted with surgeries, sutured many incisions and generated a few trees’ worth of documentation and is teamed with Steve Roberts in this new venture.
Steve became known in the 1980′s as a “technomad,” pedaling a computerized recumbent bicycle 17,000 miles around the U.S. while freelance writing with a handlebar chord keyboard and built-in networking tools. He has written six books, and is now converting a 44-foot steel pilothouse sailboat into something akin to the Starship Enterprise, with a distributed sensor network and voice/browser user interface.
I asked Kirsten to post a version of one of her recent blogs, wherein she discusses the philosophy behind the kits and some of the specific supplies. Yes, she’s selling these. But I think they’re a great idea and I want my readers to hear about them from the people who build them.
Expedition Medical Chests
by Kirsten Hansen
One of our basic philosophies is that we must take responsibility for our own health, and this is not even optional in the cruising setting. We have to educate ourselves, stock the best tools and supplies, and take a deliberate approach to on-board health management.
The first module in our Expedition Medical Chest line is focused on wounds and burn care. Since lacerations, abrasions, punctures, and burns are common injuries on a boat, we decided to focus on those for our initial offering. Steve told me how he shopped for his boat’s expensive medical kit, and as I browsed the contents with a critical nurse’s eye, I found myself surprised at what was (and was not) included. I realized that if I were called upon to take care of someone who had just cut themselves badly at sea, I would not want to reach for that kit… which is a high-end and well-marketed product.
This brings me to the reasoning behind our first Medical Chest module, which reflects my nursing experience as well as Steve’s colorful career of adventure on land and sea. I have specific preferences in the items I reach for when I enter the hospital supply room, so here is an inventory of the contents packed in a logical sequence in our gasketed Lexan cases, along with some commentary on my rationale behind each:
Ten non-latex gloves - We chose vinyl since many people are allergic to latex (including some who are not aware of it).
Two 8” X 10” high absorbency ‘Abdominal’ pads – these dressings are extremely absorbent, versatile, and generous enough to cover a large wound.
25 4” X 4” gauze sponges – when someone is really bleeding, pressure is the first thing to think of to stop it. Gauze 4×4’s are great to just grab and hold on the fresh wound.
10 stretch fabric knuckle/fingertip bandaids
20 stretch fabric 1” X 3” bandaids- this is my favorite tape for applying and changing dressings (and I’ve tried them all). It is easy to manipulate in tight spots, the adhesive lasts a long time, and it seems to cause the least irritation.
One roll Micropore paper tape
Two 100mL bottles of sterile water – sterile water or saline is a very good thing to have on hand for flushing a fresh wound.
One 12mL syringe – when you are flushing a wound with the sterile solution, a syringe helps to get some pressure going. This can be very helpful with displacing debris and microbes.
One tube of triple antibiotic ointment – a good broad-spectrum topical antibiotic ointment can mean the difference between quick healing and a painful infection. Indispensable stuff.
One pack of 10 3M Steri-strips – To close a gash, these are my tool of choice.
5 Povidone Betadine swab sticks – iodine (betadine) is really an amazing substance. It will nearly sterilize skin around a wound and is used in surgical prep as well as complicated dressing change protocols.
20 Alcohol wipes – alcohol will also nearly sterilize skin as well as instruments (such as forceps) before use.
5 Telfa 3”x5” non-adherent pads – these dressings will help prevent ripping off a newly formed scab (your body’s natural protective layer).
Two rolls of Kerlix gauze wrap – I really like this stuff for keeping a dressing in place in a spot like an elbow or wrist where there is a lot of motion or friction, but where you don’t need moisture protection.
Two sterile eye pads- this is the wrap to use when you need to secure a dressing, further protect the area, and/or give some support to a joint. Coban is wonderful.
One roll of 3M Coban wrap
One 2”x2” 3M Acticoat burn dressing – these dressings are impregnated with a silver antimicrobial substance which is particularly effective for healing a burn.
One Instant Ice Pack – before you tape a dressing on an area, if you remove the hair it is much easier to achieve cleanliness as well as less painful dressing changes.
One disposable razor
Self-published instruction manual and starter medical log – To tie all this together, I’ve written a set of procedures for dealing with typical lacerations, presented in a logical sequence that matches the grouping of supplies within the chest.
As a nurse, maybe I am spoiled, but I know there is a huge difference in the quality and usability of these items. Lower grade bandages will fall apart as soon as they get wet or you bend your elbow to hoist a line… better ones last longer, are easier to work with, and give you a better chance to heal. The supplies in our kits are the same ones I am used to grabbing when I run into the supply room in hospitals, and the quantities reflect my experience with first aid as well as ongoing care. The gasketed polycarbonate box is completely waterproof and will keep your supplies dry… a must in the marine environment.
Upcoming modules in the series include a smaller version for local journeys (out now), a “ship’s pharmacy,” CPAP storage, and a few others. Future blog posts will look at such topics as what to stock in your onboard medicine cabinet (both over-the-counter and with a prescription from your MD), prophylactic “guerrilla” antibiotics (broad spectrum and others), to Tourniquet or not to Tourniquet, the proper way to do dressing changes and wound assessments, shock, hypothermia, aseptic technique, burns, how to wrap, how to give an injection, how to document incidents in a medical log, use of epinephrine pens and so on. I expect it to be interesting and fun… especially with the added color of your stories about medical adventures at sea!
Cheers and thanks for dropping by!
Read a more detailed version of this blog post, and find much more information at: MedicalChests.com.
Kirsten Hansen &
Nomadic Research Labs