What should I pack in the medical box on my small boat?

Written by Professor Hugh Grantham

Big boats must carry certain medical gear as laid out in the regulations, but smaller ones usually go with commercial first aid kits. Here’s a blog to start a discussion about handy items to have on smaller boats that don’t need strict regulations.

Firstly, the box, a plastic sealable food box keeps out the moisture and dirt, smaller containers within this box can keep it organised like a commercial first aid kit.

Cuts and scrapes happen pretty often when you're out on the water or exploring on land. Regular Band-Aids don’t hold up well in damp conditions, so it’s handy to have some gauze swabs and adhesive tape to keep dressings in place. If you’re going to be away from medical help for a while and need to deal with a larger cut, Steri-Strips can help close it up. You can even add a touch of superglue on the ends of the strips to make sure they stay put—simple but effective!

Elastic compression bandages are simple and can be used for sprains and strains as well as being in the snake bite kit for a bit of remote shore-based exploring.

A triangular bandage has so many uses; as a sling, to tie the good leg to the one with the break in it, and to put round an ankle when applying a bit of traction.

The most commonly used medications are sea sickness tablets, over-the-counter chemist brand sea sickness prevention tablets (not ginger) backed up with prescription ondansetron as a second line which will work even if the sea sickness has started.

Pain is another common issue, whether it's from an injury, a headache, or something else. Basic painkillers like paracetamol (Panadol) and ibuprofen (Nurofen) are great to have on hand. They work differently, so you can use them together for a stronger effect. Ibuprofen is especially useful for muscle pain and swelling, but don't forget to be cautious—even though these are easy to find, ibuprofen can cause kidney problems if you're dehydrated or taking certain blood pressure meds, and too much paracetamol can seriously harm your liver.

For short bursts of more intense pain, you might want to look into the green whistle (methoxyflurane). It's popular with ambulance crews and in emergencies, and it's a nice extra to carry if you can get your hands on one.

Allergy is a common problem, and many people carry a simple antihistamine, one of the modern ones, (not the old-fashioned sedating Phenergan) with an adrenaline EpiPen being a must if there is a possibility of having someone who suffers from anaphylaxis on board.

Some hydrocortisone (steroid) cream to be used for a short time to control severe allergic / inflammation of the skin is useful.

There are lots of other things that people put in medical boxes, some of them just nice to have and some of them an unnecessary waste of space. In the waste of space category are irrigation kits for eyes and wounds, creams and ointments for burns, hot and cold packs, inflatable splints and plastic neck braces. There is no shortage of cool water for irrigation and cooling burns at sea (It does not have to be sterile). A hot water bottle can be improvised for comfort and ice and cold packs for sprains lack scientific backing despite being taught for years. Most of the commercially available splints are not as good as the supports that can be improvised from clothing, rolled up paper/cardboard on board. Neck braces are no longer recommended for first aid providers.

Have a look at your current first aid kit with a critical eye, although there may be some things that you could add there will probably be a lot that you could remove. Saving space and simplicity are important principles, particularly on small boats.

If you think there is an item that is a definite ‘must have’ share your thoughts here, likewise if you wish to add to the ‘waste of space’ list.

More detailed information on First aid & basic medical problems can be found in Chapter 19 of the Australian Boating Manual, which includes First Aid, CPR Guidelines, Marine Animal Bites & Stings, Terrestrial Animals Bites and Stings, Seasickness, First Aid Kits and Equipment, Working with Remote Medical Advice.

Professor Grantham is currently Chair of Emergency Medicine Foundation - Australasia (EMF), Chair of One and All tall ship board and Professor adjunct QUT (Queensland University of Technology) and Curtin University.

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