You have to have prescriptions for any drug which you would need a prescription in your home country (not just narcotics), by law in the US. Every voyaging vessel has the right to have a full medical kit aboard. Keep an copy of the written prescription from the physician who wrote it. The only place (we have been to over 40 countries) where we were asked about hour medical kit was in Prince Rupert BC, Canada. No other inspections (and we had some very rigorous inspections for weapons and illegeal drugs) were concerned with the ship's medicine chest. The material that Phillip is thinking of is probably "QuicClot". Another product, slightly different is "Trauma Dex". There have been various clotting foams and products on the market for some time. One has to balance, the priority of stopping bleeding, vs the potential of a foreign substance in the wound. Certainly the clotting substances have a place on the battle field, where the combatant today will have a reasonable chance of being air evaced out to a primary medical care facility in short time, and a massive wound with heavy blood loss is life threatening, vs the average trauma on a voyaging boat. The foreign object in a wound is likely to act as a nidus for infection. There is a very slight chance of such a wound on a voyaging vessel, but if going offshore, it would be a product I would include today. On a boat, it is important to throughly clean a wound. Despite some minor disadvantages, I like to use hydrogen peroxide. I carried several plastic bags of sterile saline and lactated ringer's solution aboard (which can be used for IV use, but I had a far more comprehensive medical kit than the average vessel would have) to irrigate a wound and then would suiture it under sterile circumstances (sometimes not ideal). If you get a wound of any sort on the beach, or when swimming, you need to clean it perticularly well. I recommend a scrub brush, betadine surgical soap and then peroxide, followed by Tripple antibiotic ointment. 99% of bleeding will stop with direct pressure. The other 1% will probably require some extensive surgery. As far as pain medication, I always made sure that there was injectable narcotic--usually morphine sulfate--or demerol aboard. For lesser pain there are a number of alternatives, but the synthetic codine deritatives are often used. Equally as important is some way to get medical advice. Phillip was lucky that he was only 250 miles from some help (and maybe even a chopper ride being closer than powering that distance). What if it had been 1500 miles? I am not certain what emergency medical advice is currently available via satellite phone or radio. In the past there have been subscription services so that you could contact a physican at any hour of the day for advice. If the voyager has the medical materials on board, and the emergency is beyond his scope of training, then advice may be necessary. At times the Navy or Coast Guard has also handled such medical emergencies. At one time I was working with WinLink to provide advice for voyages, and others in remote areas. Due to potential medical liability we discontinued this service. Also several hospitals in the past have had Amateur radio links to the emergency room physicians for similar contacts. My advice today, is to establish a relationship with a physican or group who has experience in emergency medicine or marine medicine. Make arrangements so that you can contact them by satellite phone or E-mail for advice in an emergency. Phillip is correct that people get medical care in the most primative of circumstances and survive. My wife had to have a sail maker's needle which had broken off inside of a joint in her foot, removed in a small hospital in Mexico. They would not agree to anthesia until I said I would scrub and standby in case of a cardiac emergency (Marie has had a pacemaker since age 32). Sometimes you get good care, and sometimes not. Consider some form of traveler's insurance (some come with a physican contact like Medex--not necessarilly an endorsement), which would fly you back to the US. Also consider that Medicare may not cover your medical expenses if you are of that age group, out side of the US. Bob Austin MD