We’ve got one diabetic, three rambunctious kids, a lifestyle that we intend to be “safely adventurous” (but realistically more injury prone than average), and a plan to be far enough away from our beloved Canadian health care system that a trip to the family doctor just won’t be practical or possible. Now to keep everything in perspective, except for the <1% time we’re on multi-day ocean passage we won’t be so far away from a clinic or hospital that professional help is out of reach in a real emergency; however, the big-time hassle of taking a dinghy ride to shore, finding a ride to the nearest clinic/hospital, and figuring out the system in a foreign country is something we’d really rather avoid. So for the vast majority of our time living on the boat, our real need is to handle anything up-to and including what a visit to our family doctor might warrant back at home.

In addition to that, when we do happen to be away from land for days at a time we want to be confident we can (a) identify which injuries/ailments can be safely managed until we can get back to land (b) identify which injuries/ailments warrant the extremely serious and risky step of a medical evacuation at sea and (c) treat any injuries/ailments until either they are resolved, we get back to land and can get professional help, or (god forbid) help has time to come to us.

Offshore Emergency Medicine Training

The first thing we did to tackle this somewhat daunting aspect of boat living was to go out and enrol in some training to upgrade our skillsets. While medical training specific to cruising sailors is pretty hard to come by, we do live in Canada where medical training for backcountry camping, skiing, and kyaking/canoeing is pretty commonplace. Since the curriculum required for certifying guides, ski patrol, and other professionals working in the backcountry covers all the material we wanted before taking the boat to a remote location, we started by finding the best provider of such training and ended up settling on programs by Wilderness Medical Associates. As it turns out, a couple times a year they offer an Offshore Emergency Medicine course designed for voyaging sailors as well as professional mariners. This spring it was being offered in Annapolis, Maryland, pretty close to where Matriarch was being stored on land at the time, so we pulled the trigger and booked ourselves a spot.

We’re so glad we did! The course instructors, Jeffrey Isaac, PA-C and David Johnson, MD, were experienced and practical and wove in many real world scenarios to illustrate how the course content is applied in actual situations. We came away with a lot of new tools and skills, but most importantly the confidence to identify whether an issue can be managed on board until a medical facility can be reached and, if so, how do going about doing it.

Health Issues We Endeavour to Handle Ourselves

One of the big takeaways from our training was a recommendation to get specific about what types of health issues we wanted to take responsibility for and equip ourselves accordingly. There’s no sense carrying a bunch of specialized medical equipment if you’re fully prepared to use it and take responsibility for the outcome! So Megan and I went through as many scenarios as we could think of to come up with a list of the things we were going to take on, including:

• motion sickness

• common infections (skin, eye, respiratory, gastrointestinal)

• dehydration

• wounds (cleaning, dressing, closing)

• fractures

• simple dislocations (finger, shoulder)

• head injuries (if no concussion or confirmed stable with concussion)

• mild hypothermia

• allergies / allergic reactions

• minor burns

We’ve developed the contents of our ship’s med kit to enable treatment of all of the above to at least the point where the patient has been stabilized without relying on outside assistance. Depending on our location and the severity of the issue this may not end up being to the point of full resolution, but at least to the point where emergency evacuation off the boat won’t be needed.

Health Issues We Will NOT Handle Ourselves

On the other hand, we’ve tried to be realistic about what our surroundings, level of training, and equipment will allow us to handle on board versus what will require immediate evacuation to the nearest medical facility. These are the things that would have us finding a way to get the injured person off the boat and to the nearest hospital as quickly as possible, even justifying the risk of a high-stakes evacuation at sea from a bouncing vessel:

• head injuries with suspected or confirmed intracranial bleeding

• complex dislocations (elbow, wrist, ankle, hip)

• significant cardiovascular issues (heart attack, stroke)

• moderate to severe hypothermia

• major burns

Putting It All Together

Bringing all this together and assembling all the tools, medications, bandages, and other miscellaneous items needed was a pretty big job and frankly a little overwhelming. We started by gathering lists of med kit contents from as many cruisers as we could find, then consolidating them all into one massive master list that was clearly overkill unless you were planning on operating your own emergency room from the salon of your boat. From there we rapidly narrowed it down via a conversation with the instructors of our Offshore Emergency Medicine course who were extremely helpful identifying which items would be useful in a real world scenario. The caveat with our narrowed list is that it had a largely American perspective and a number of items either weren’t available in Canada or could be substituted with a much more cost effective Canadian-based alternative.

To solve this disconnect, we consulted with our pharmacist and family doctor in Milton. I want to send out a special thanks to Anca from Loblaws Pharmacy and Dr. Chung from the Prime Care Family Health Team who were both incredibly helpful and open to listening and responding to our out-of-the-ordinary needs. Their recommendations were extremely helpful and enabled us to finalize our ultimate med kit shopping list.

At the end of the process we ended up with a list of 140 items ranging from bandaids to painkillers to various antibiotics to a stethoscope and otiscope to splints to a dental kit to various creams, drops, and ointments to epi-pens and not to forget the all-important multiple versions of sea sickness drugs. We got almost all the medications from our local pharmacy, most of the tools (stethoscope etc.) from Amazon, and filled in the various bandages, splints, etc. from a local home care supply store. In total, we spent approximately $1000CAD to put the entire kit together even including the bag which I believe is pretty economical given the breadth of contents.

NOTE: If you have any questions or comments about the specifics of our med kit contents feel free to reach out in the comments below, via instagram, or twitter!

The Bottom Line

Do we think we’re well equipped given our particular circumstances? Yes.

Do we feel comfortable using absolutely everything in the med kit if the time comes when it’s needed? Yes.

Have we found the contents of our med kit useful so far? Yes and yes.

Do we expect to use even a fraction of what we’re carrying overall? Absolutely not.

Like most things with this transition to boat living, we’ve done our best to prepare for the worst and expect the best. We’ve spent a lot of time and energy on things like the med kit with full knowledge that if things go well it will just sit and collect dust, but then again the moment you don’t have something is when you’ll probably need it…