All Club yachts are supplied with a small first aid outfit sufficient to deal with the treatment of minor injuries and illnesses. The following notes are given in amplification of the instructions contained in these outfits.
Medication is too late when the patient has succumbed to seasickness. Anyone susceptible to seasickness should commence a course of proprietary seasickness tablets at least four hours before going to sea. Stugeron is a highly recommended brand of tablets. If seasickness has already begun the patient must be encouraged to continue to eat some dry food such as bread or biscuits to avoid retching on an empty stomach. Some brands of tablets enhance the effects of alcohol and cause drowsiness, and this combined with lethargy brought on by seasickness may result in a lack of safety consciousness in the patient. For this reason seasick crew should be watched with special care when on deck or in the cockpit, and clipped on when heaving over the side!
Cuts and Wounds
Apply a standard dressing as directed on the package. If bleeding is severe the dressing should be applied, and a further dressing applied over the first one if bleeding does not stop. For a leg injury the patient should be laid down and the leg elevated. Always bandage from joint to joint to prevent oedema.
A suspected fracture should not be set with a splint by other than a qualified person. The broken limb should be secured to the body as firmly as possible so that the body itself acts as the splint. An arm should be secured across the chest with the hand on the opposite shoulder and padding placed in the hollows between the arm and chest. If the elbow cannot be bent, secure the arm along the side, with the palm touching the thigh and again pad the hollow places. For a leg or thigh fracture the feet and legs should be lashed together, again padding the hollow places between ankles, calves and knees.
The patient should be put into a comfortable position, that does not impede normal breathing.
Nosebleed is best treated by sitting the patient up and leaning forward, not laying them down, and by pinching the nostrils until the bleeding stops. Cold compresses may also help, by causing constriction of the blood vessels.
The patient must be kept warm and at rest, the use of alcohol as a stimulant must not be allowed. If unconscious, no form of fluids should be given and any obstructions must be removed from the mouth, eg false teeth, and make sure the tongue is forward. Place the patient in the recovery position.
These are stretched or torn ligaments, the best treatment being to keep them firmly bandaged with a standard dressing, with a pad of the dressing over the area of the injury. A cold compress assists in reducing swelling.
Burns can be treated by irrigating with cool, CLEAN water. This relieves pain, reduces shock and aids healing, if this is not possible, a standard burn dressing is the best treatment, laid on dry without any form of ointment. Blisters should not be broken. Do not remove burnt clothing, it may have adhered to the skin. If clothing is soaked in boiling water, this may be removed gently, as it will hold the heat.
Boils and Skin Eruptions
These may occur on skins not accustomed to rough clothing, limited washing facilities and the effect of sun and salt water, or through a change of diet and an excess of greasy food. Boils should be treated carefully, cutting away any hair, gently washing and drying the area and covering the boil with an Elastoplast dressing. Within a couple of days the boil will have resolved itself either by discharging completely or fading away under the dressing. It is best to allow nature to take its course rather than trying to hasten things by squeezing the boil. Once the contents of the boil have been discharged, the area should be cleaned and a new dressing applied to protect the wound.
Most stomach upsets are due to indigestion brought on by over indulgence in fried food, stews and curries, the easiest meals to cook on board a small yacht. If the pain does not respond to a dose of bicarbonate of soda, or if the patient remains feverish after two or three hours, medical attention should be obtained as soon as possible. In any case aperients such as castor oil should not be given under these circumstances. Until treatment can be obtained the patient should be kept lying down and warm, and nothing given but liquids in small quantities.
Aspirin or Codeine crushed in the mouth near the offending molar will often give some relief from pain, but nothing short of a visit to the dentist will remove the cause. Clove oil will give quick relief.
It is difficult for the layman to interpret a single reading on a thermometer. It is preferable to check a feverish condition by noting the patients apparent temperature from signs such as perspiration, trembling and breathlessness. If the feverish conditions persist medical attention should be obtained as soon as possible. Liquids such as soup or beef tea may be given if the patient feels like it, but not if he also has a stomach ache. No form of alcohol should be given.
The patient should be bent over and given up to 5 backslaps followed by 5 abdominal thrusts, continue this cycle until obstruction clears or casualty becomes unconscious then CPR. If this does not remove the obstruction the patients mouth should be held open with a cork or piece of wood and have the back of the mouth searched with fingers in order to dislodge whatever is stuck there. Dentures lodged in the back of the throat are a common cause of obstruction.
Unconsciousness and collapse due to apparent drowning and shock must be treated immediately by means of Rescue Breaths, which must be continued until the patient recovers or medical assistance arrives. Where no pulse is evident Cardio Pulmonary Resuscitation must be applied immediately.
Cardiopulmonary Resuscitation (CPR)
The current CPR cycle is 30 compressions to 2 inflations.
The patient must be on his back on a firm surface, eg cabin sole. Kneel alongside the patient's chest and place one hand over the other so that the heel of the lower hand is in the middle of the patient's chest. Push the chest down firmly about 4-5 cm 30 times; then administer 2 rescue breaths.
Rescue Breaths (Mouth to Mouth Resuscitation)
PLACE CASUALTY ON HIS BACK IMMEDIATELY
Loosen all clothing around neck and chest, QUICKLY.
QUICKLY CLEAR MOUTH AND THROAT
By removing all mucus, food dentures and any other mouth or throat obstructions to ensure a clear airway.
TILT HEAD BACK AS FAR AS POSSIBLE AND PUSH CHIN UP
The head should be in a "chin up " or "sniff" position. Placing a pad under the back of the neck may help.
LIFT LOWER JAW
Grasp the jaw by placing thumb in the corner of mouth, and pull forward. Do not hold or depress the tongue.
PINCH THE NOSE SHUT WITH THE FINGERS
This is in order to prevent air leakage during resuscitation.
OPEN YOUR OWN MOUTH WIDE AND BLOW INTO THE PATIENTS MOUTH
Take a deep breath and blow into the patient's mouth until you see their chest rise.
REMOVE YOUR MOUTH AND LISTEN FOR EXHALATION
Quickly remove your own mouth when chest rises. Lift jaw higher if gurgling or snoring sound is heard.
REPEAT THE LAST TWO STAGES TWELVE TO TWENTY TIMES A MINUTE
Resuscitation must be continued until the casualty begins to breathe normally and regularly. Beware of any relapse, and keep the patient warm.