Boy this site is going hi octane at the moment. We got a months worth in one
day.

I have learned so much from today's posts on crew choice and this has really
put me on guard. I have only ever had one crew member in the past that has
come on board without meeting him beforehand, for a 3000 nm journey with 5
stops. He was a young Englishman who had just graduated from University as an
engineer in England, and superlatives cannot explain how good he was to have
on board. There were four of us going from Hobart to Perth and we all got on
like a house on fire. However I'm chancing my arm in ten days time again with
strangers from Seattle to Ensenada - so will be very mindful of the advice
gone before here on PUP.

In the spirit of Georgs clear advice to put up, I would like to further
promote discussion on the subject of medical help whilst on a voyage in a
remote locale.

The following is an extract from a real passagemaker who wrote to me after
reading PUP yesterday. In fact I got a hell of a lot of private emails.

Hi Peter,

I noticed your posts about having a medico for the Pacific crossing and just
thought I would share a few thoughts with you. My wife & I did the Pacific
crossing in 2008 three months after a life threatening heart operation for me.
While I realise you have a couple of decades up on my age the reality is that
a good first aider is what you really need to have on board and the automated
defibrillators can be used by anyone these days. A medico on another boat even
10 minutes away will not be of any help in an immediate life threatening
situation. For nearly everything else a video link back to your GP in Oz will
do the trick (luckily for me many of my friends are GPs and techno savvy). You
just need a decent medical kit on board (e.g. equivalent to the RFDS ones that
they have on outback stations) and a good internet link. At a pinch the RFDS
could also assist via HF as they are very experienced in remote care but the
video link really assists in diagnosis.

I left some of our previous emails attached to let you know that we finally
decided to go with a more custom build which is closer to a N46 which I still
think is more seaworthy than any of the newer offerings - just wish they still
made it.

Good luck with the crossing - don't let anything dissuade you - the South
Pacific is a fantastic cruising ground. Our website does have a little bit of
useful info (see sv Kekada section) but is buried among the travelogue stuff.

Footnote (RFDS is the Australian Royal Doctor Flying Service that serves
people in remote outback areas)

Then another one from Rick whose advice I sought on Don's thoughts.

I tend to agree with Don, a Doctor's not a bad idea but I think maybe a little
over kill. I do like his ideas about the first aid kit and having someone to
contact back home, and maybe one other thing to add to this is an Oxygen
provider set up. The biggest killer in all traumas is shock and the best
treatment is oxygen. Lets face it people go out in the middle of Australia for
weeks on end and miles from anywhere and they don't take a Doctor with them (I
know one can always fly in but if its an emergency then its to late anyway).
I've got my Senior First Aid ticket, Defibrillator ticket and Oxygen providers
ticket as well, but if it comes down to kissing you to keep you ticking then
you had better have a lot of strong alcohol on board.

Is it March yet?

Rick

Rick is one of my crew mates crossing the Pacific. He has done over 6000 nm on
SKIE in the last 2 years.

Hell I didn't know before he could do all of this. He has been a safety
officer in movie stunts after he retired from the stunts himself, and guess
what? He is also a qualified diesel mechanic.

I hope that the above subject may be added to by some of the members. Ken
what's your view?

Peter

Peter:

With respect to medical care during long passages...

I am not an expert on this topic. Thus, I'm not sure my opinion has any
value, but with that said, a lack of knowledge has never deterred me from
having an opinion, and I have had some exposure to this topic:

• On the Nordhavn Atlantic Rally we had a doctor onboard one of the boats,
  and I had an EMT (Emergency Medical Technician) on my boat

• Prior to our Aleutian crossing, two members of our group took courses in
  wilderness medicine (and, on a few occasions, we put their knowledge to the
  test)

• I live in Mexico about half the year, and am part of a group that has been
  working on healthcare. We have a large expat community, much of which is
  older, in a country where the healthcare is of 'uneven' quality.

First off, all boats heading offshore should have a serious medical kit. Our
medical kit was bought from Lafferty's pharmacy in Ballard. If you speak to
them, ask for Mike. He specializes in putting the medical kits together for
the fishing fleets, and will help you assemble a kit based on your needs.
When you visit their place, it looks like a standard pharmacy, but don't let
the look fool you. You will be impressed.

An example of one of his kits:

http://www.kensblog.com/uploads/16765/offshore_ins.jpg

Mike's contact info is:

Lafferty's Pharmacy
(206) 783-5133
5312 17th Ave NW
Seattle 98107
mike@laffertyrx.com

As to the topic of medical attention at sea...

Having an actual Doctor along on the trip is certainly good, but usually
impractical. That said, different doctors have different skill-sets, and not
all Doctors have a relevant background. More practical, perhaps, is to have
someone aboard with EMT training, and good communications to a Doctor on
land. If your doctor won't give you his 24 hour contact info, there are
telemedicine groups that service the fishing industry, and expat
communities, including one I've spoken with that is based in Seattle (I've
forgotten their name).

In summary...

I do believe it is important to have someone along on a passage who has some
emergency response training. I assume that any captain who is crossing
oceans has done the Red Cross first aid classes, which I do think are a good
starting point, but they are only a starting point. Anyone who is serious
about safety should consider taking a course in Wilderness medicine. These
are easily found. More extensive (and, expensive) courses are available that
are specifically marine focused, as well as 'real' EMT programs. Personally,
for most uses, I think that if you have 24 hour emergency contact info for a
good doctor, a way to communicate with them (voice and internet), a top-tier
medical kit, and someone onboard with some emergency response training, then
you are in great shape.

-Ken Williams
Nordhavn 68, Sans Souci
www.kensblog.com