By Bob Currie, Vessel Examiner
U. S. Coast Guard Auxiliary Station Galveston Flotilla
Getting home safely is the most important consideration of recreational boating. Everyone knows they should be wearing a life jacket when boating, and we have also talked about visual distress signals such as flares and rockets. This column is dedicated to discussion of the first aid kit, and how we can tailor its contents.

The Station Galveston Flotilla of the US Coast Guard Auxiliary operates out of the USCG Station Galveston base on Galveston Island. They aid the Coast Guard by providing maritime observation patrols in Galveston Bay; by providing recreational boating vessel safety checks; and by working alongside Coast Guard members in maritime accident investigation, small boat training, watch standing, and procurement.

Homemade versus Commercial First Aid Kits
Truthfully, there are commercial first aid kits on the market that can fit just about any type of recreational activity, including the various recreational boating activities such as fishing, swimming, skiing, and scuba diving. The trick is to match the types of activities in which you would most likely participate to the types of injuries most commonly seen with those activities. The next step is to find the first aid kit that contains items associated with treating those injuries. This is where a list of proposed first aid items comes in handy. There is a very good chance you will find a commercial kit that matches your needs. However, some people find it satisfying to come up with their own homemade first aid kit. Sometimes making your own kit will save you some money, but not necessarily so. You can always add to the items in a commercial kit, though.

Types of Injuries
When building your first aid kit, you should first consider the types of injuries you are most likely to encounter on the water. Here is a list of the common types of problems you may encounter on the water:

1. Sunburn (probably number 1)
2. Seasickness
3. Headache
4. Skin burns
5. Lacerations, cuts, and abrasions (3 different things)
6. Broken bones and sprains
7. Embedded hooks
8. Diarrhea
9. Allergic reactions (hives, anaphylaxis)
10. Immersion in cold water, leading to hypothermia
11. Hyperthermia (over-heating can lead to death just like hypothermia can)
12. Something in your eye (open boats make you especially subject to this)

The list above is far from complete, but keeping these types of injuries in mind will help you find or build a pretty good first aid kit. Here are some recommended items to help deal with the listed injuries.

Sunburn
Prevention is much easier than treatment of sunburn. Remind your guests to lather up before the trip. That said, sunscreen doesn’t last forever, especially if there is a chance it will be washed off by a dip in the water. So, your first aid kit should include some extra sunscreen. If someone does suffer from sunburn, there are some good sprays that contain lidocaine for pain relief, and there are some aloe gels that help as well. A good first aid medical guide will tell you to soothe the burned skin with cool, wet towels.

Seasickness
It happens to the most seasoned sailors occasionally, and preventive measures are much better than treatment measures. There are several different over the counter medications you can take to help prevent motion sickness, the other name for seasickness. Dramamine is the one we most often hear mentioned, and you should have some in your first aid kit. Although such medications are most effective when taken well in advance of the trip, they can help if someone becomes seasick on board your boat.

Headache/Stomachache
Sometimes that pounding on the water in rough seas can give you a headache. Likewise, that big greasy breakfast could be working on your digestive tract. It doesn’t take up much room to include the usual headache and stomachache remedies (aspirin, ibuprofen, acetaminophen, and antacids).

Skin Burns
We all know that skin burns are classified by degrees: first degree, second degree, and third degree. Each of these categories can happen on your boat. You should carry a variety of gauze pad skin dressings (small, medium, and large), as well as various sizes of Band-Aids, to cover skin burns. Include different types of tape to help keep bandages in place. Follow your first aid medical guide’s recommendations.

Lacerations, Cuts, Abrasions
Lacerations are tears to the skin. Cuts are clean breaks in the skin which can be superficial or very deep. Abrasions are injuries due to the skin being worn away due to contact with an object. All such injuries need cleaning and bandaging. When dealing with another person’s open wounds, you should wear nitrile gloves for your protection. You will need antibiotic ointment, shears for cutting bandages, various bandage sizes, Coban wrap to hold the bandages in place, antiseptic wipes, Band-aids for small injuries, tweezers for splinters and debris from abrasions, a bulb suction device, sterile scrub brush, tourniquets for deep cuts involving an artery, wound closure strips (Steri-strips), moleskin for blister care, a scalpel or razor, antiseptic solution (Betadine), safety pins for gauze bandages, and transparent film dressings. Many commercial kits include these items. Another useful item is a miniature LED headlamp to help you see the extent of the injury in poor lighting. Tincture of benzoin is useful for helping bandages stick.

Broken Bones and Sprains
When the water gets rough, a passenger could be tossed about and incur a broken bone or serious sprain. Your first aid kit should include methods of immobilizing the injured body part. To assist in that treatment, you should include triangular bandages for slings, parachute cord for splint building (duct tape works well too), and hot and cold pads for pain treatment. Towels can be rolled to help make splints.

Embedded Hooks
I was flounder fishing the other day and had hooked onto a big one. I finally fought him close to the boat, and just before I could reach for the net, the big fish turned loose of the lure and the lure went sailing past my right ear at near the speed of sound. My first thought was there goes supper, and my second thought was to mentally review the contents of my first aid kit to see if I had a hook cutter in it. No fisherman should be without a hook cutter. It’s bad enough having to make a trip to the ER to get a hook removed. It’s worse if you have to go with that 5-inch lure hanging from your face. Although most fishing pliers will cut through a hook, their design prevents them from getting in close enough to cut a hook away from a lure. There are cutting tools designed especially for cutting hooks away from lures.

Diarrhea
It happens. Remember that greasy breakfast you had before the trip? A good first aid kit contains an anti-diarrheal medication such as Imodium or Pepto-Bismol (which also is a good antacid). As with any medication, ask about any allergies before administering.

Allergic Reactions
Allergic reactions range in severity from simple hives to an acute anaphylactic reaction. Benadryl is an antihistamine that is useful for simple allergic reactions resulting in hives. Another useful remedy is hydrocortisone cream. Anaphylaxis is a life-threatening reaction to an allergen that requires the administration of an epinephrine autoinjector. Epinephrine autoinjectors (EpiPen for example) are expensive and may be beyond the average first aid kit. However, if you have a passenger who has an allergy that subjects them to anaphylactic reactions, they may have their own autoinjector. I recommend asking your passengers about any allergies and if they carry an epinephrine autoinjector. If they do, then I recommend that you ask about its use in case they have a reaction.

Immersion in Cold Water
The risk of hypothermia is quite high when a passenger is immersed in cold water, which often happens when a person falls overboard. An emergency warming blanket should be kept on board whenever the water temperatures begin lowering seasonally. Emergency warming blankets fold up quite small and easily fit in the average first aid kit. You should have a thermometer in your kit to help determine if the passenger needs emergency medical help. Follow the instructions in your first aid guide. If you contact the Coast Guard for assistance, you will need to give them some vital signs. A stopwatch is a good addition to your kit to meet that purpose.

Hyperthermia
Hyperthermia occurs when a person becomes severely overheated. It, like hypothermia, is a life-threatening condition. Include cloths that can be used to cool the skin in your kit. Both conditions can lead to shock, and a stopwatch can be useful in measuring vital signs such as respirations and heartbeats per minute.

Something in Your Eye
Everyone on board should wear eye protection. Their glasses should protect against UV rays as well as foreign objects. Riding in a boat is like riding a motorcycle. You are at high risk for getting a foreign object in your eye. If that happens, you should stop the boat and attend to the injured person. Consider carrying a bottle of sterile eyewash in your first aid kit. Often the foreign object can be removed by gentle irrigation of the eye. Cover the injured eye with an eye pad until the injured person can seek medical help.

Summary
First aid kits are not required by law, but the prudent boater has one that is suited to the types of injuries that can be expected from the types of activities in which they participate. You can build a first aid kit from scratch or you can buy a commercial kit. Either way, you should be prepared for the possibility of treating an injury on the water.

For more information on boating safety, please visit the Official Website of the U.S. Coast Guard’s Boating Safety Division at www.uscgboating.org. Questions about the US Coast Guard Auxiliary or our free Vessel Safety Check program may be directed to me at [email protected]. I am available to perform free Vessel Safety Checks, and I will come to your location to perform them. SAFE BOATING!

[10-28-2019]