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by Ann Backus, MS
Ann Backus, MS is an Instructor in Occupational Health at Harvard School of Public Health, 665 Huntington Ave., Boston MA 02115, 617/432-3327, abackus@hohp.harvard.edu
First aid kits are required by documented vessels fishing beyond the Boundary Line. In actuality all vessels should carry first aid equipment. At a recent fishermen’s training held in Hull, Massachusetts, first aid trainers from Sylvester Consultants, Inc. of Centerville, MA (508-428-7262) suggested that fishermen create their own First Aid Kit. I spoke with Spanky Sylvester recently to obtain the information for this article. How is a custom-made First Aid Kit better than one off the shelf? You can include larger pads for control of bleeding, tailor the kit to your crew size and health needs, and buy in bulk to restock after each trip as necessary. Start with a medium size plastic (waterproof) tackle box with a shelf/insert and several compartments. The plastic box is basically indestructible, easily portable, and will not rust.
• 6 (at minimum) 4" x 4" abdominal pads to control bleeding and dress wounds • 2 5" x 9" abdominal pads for large wounds or to cut up for smaller wounds • 3 or 4 rolls of 4" cling gauze • 1 roll of 1" tape Add the following items • 6 pairs X-Large rubber gloves in a plastic bag • Several barrier devices for mouth to mouth resuscitation • 1 tube of Neosporin or Bacitracin (topical antibiotic) • 1 bottle of Ibuprofin or Motrin to treat inflammation • 1 pair of scissors • 1 pair of tweezers • 1 bottle of baby aspirin (81 mg chewable tablets) for possible heart attack • 4 1-quart sealable plastic bags to store an amputated finger, for example, or to bag biohazard materials such as blood-soaked compresses • several 4ft x 6 ft space blankets; they come folded up small • 1 4 oz bottle of saline for rinsing wounds • 1 bottle of contact lens fluid (small, sealed, and with spray) such as Visine for flushing eyes • several triangular bandages to make a splint • 1 digital thermometer • Several basic first aid instruction/treatment cards covering chest pain/heart attack, laceration, shock, hypothermia, airway blockage, Heimlich Maneuver, pressure points, etc. Tell the crew where the kit is stored. Next, install a carbon monoxide detector, especially if the crew is on board overnight. Spanky Sylvester also advises that the captain ask each crew member to write out a simple health history, include name, address, and phone, place it in an envelope, seal it, and sign across the seal. Conditions such as previous heart attacks or strokes, asthma, common allergies to dust and food, drug allergies and interactions, epilepsy, diabetes, etc. should be included. This envelope would be given unopened to the U.S. Coast Guard or other first responder in the event of an accident or illness. There are certain medical conditions that a crew member should tell the captain about prior to signing on for a trip. These include asthma and inhaler use, heart conditions and prescriptions for nitroglycerine, diabetes and insulin shots, and severe allergies that require an EpiPen®. Sylvester Consultants, Inc. suggests that any crew member with these conditions, bring not only their personal inhaler, nitroglycerine, insulin shot, or EpiPen®, but bring a second one of any item they bring on board and give it/them to the captain to be added to the First Aid Kit or stored in a safe place. At the discretion of the captain, crew should know that these items are onboard, where they are, and how to use them. In addition, liquid Benadryl®, an antihistamine, should be on board to use after the EpiPen® is used for those with severe allergies. What about items for splinting fractures? Fishermen are taught to use what is available when they attend safety training classes. A T-shirt, rubber hose, wooden wedge are often excellent temporary fixes for hull or hose breaches. Likewise when splinting potential fractures, the crew should take advantage of on-board items such as a wooden spoon; a rolled towel, blanket or T-shirt; a ruler, book, rolled newspaper, or magazine. Tape or triangular bandage from the First Aid Kit or duct tape can be used to hold the splint in place. In the event of an amputated finger or hand, the piece should be put in one of the plastic bags from the First Aid Kit, without ice, if emergency assistance is less than an hour away. Ice can cause frost bit and destroy the part you are trying to save. Mr. Sylvester points out, not joking, that the crew must remember to send the part with the patient when he or she transferred to first responder care. Finally, knowing signs and symptoms of conditions which can be fatal is extremely important. At the safety training in Hull, Massachusetts in October, the trainers stressed calling for emergency help right away if chest pain is present. It could be a strained muscle, but it also could be a heart attack developing. In this case, the patient should be given a baby aspirin to chew and the May Day call made. Similarly carbon monoxide exposure can be fatal if the fisherman is not removed from the source and given emergency oxygen very soon. Even if someone with CO poisoning recovers there is a potential for long term memory impairment. Early signs are confusion and often, but not always, a red face. Should hydrogen sulfide exposure be suspected (produced by decaying fish or bait), immediate emergency attention is mandatory as minute quantities of this gas are highly toxic to humans. But, don’t go into the area where someone is overcome without SCBA or oxygen. If the drill instructor or other crew member conducts medical drills frequently, the crew will know where the First Aid Kit is, what it contains, and when and how to use the various items including EpiPen®, baby aspirin, and the 4 x 4 abdominal pads. Here is the plan. Buy kit items in quantity from an on-line medical supply company to get a discount. Stock your fishing tackle box initially and take it home to restock as needed after every trip. Remember to return it to the vessel before the next trip. While you are at it, make a small kit to keep in your car this winter. Be safe and prepared. |
