Medical supplies for crewing

cwerhanecwerhane Portland Oregon Member

I've crewed a few swim lately, including multi day events and >24 hr solos, and thought I'd share the inventory of my Med kit. I typically include Medications and supplies not just for the swimmer but for all the crew.

Medications: Aspirin, Tylenol, Ibuprofen, Tums, Pepcid, Claritin, Zyrtec, Benadryl, Colace, Imodium, Meclazine, Maalox, Zofran, Phenergan, Scopolamine, eye drops, nasal spray, dental wax, oral gel, Aloe Vera gel, Silvadene cream, Fungal cream, Triple antibiotic ointment, Tucks cream, Hibicleanse.

Supplies: wound cleansing bottle, surgical scrub brush, suture supplies, gauze pads, abdominal pads, metaphor tape, KT tape, Ace wraps, braces for fingers, wrists, knees, back, steristrips, stethoscope, BP cuff, Pulse Ox, IV starts, IV tubing, IV Fluids, tegraderm, thermometer, surgical glue, bag valve mask, transport sheet, foil warming blanket.

I'd love to hear any suggestions about what might be missing.

JSwimIronMikeevmoKate_AlexanderSydneD

Comments

  • flystormsflystorms Memphis, TNMember
    edited May 1

    Wow, that's pretty comprehensive, thanks. Some of those medications are obvious, but several of those, what are they for? Particularly these...Colace, Meclazine, Maalox, Zofran, Phenergan, Scopolamine. Are any for sea sickness? And what about candied ginger or Papaya for seasickness as well. I've used both.

  • slknightslknight Member

    Aren't some of these (Zofran/Phenergan) prescription meds? I would be concerned about legalities dispensing them.

  • cwerhanecwerhane Portland Oregon Member

    @slknight said:
    Aren't some of these (Zofran/Phenergan) prescription meds? I would be concerned about legalities dispensing them.

    As for prescription medications like zofran, phenergan, & scopolamine, I require the swimmers and crew to obtain a prescription. I am a RN and can administer it based on symptoms. I do not though administer meds to anyone without a prescription (no sharing). On that same note, I ask my crew to divulge their Med History to me in case of emergencies.

    slknight
  • MoCoMoCo Worcester, MAMember

    Do your suture supplies include pain relief? Surgical tweezers for foreign body removal? Chemical ice packs? Chemical heat packs? Paramedic shears to get a wet suit off someone super quickly?

    Afterbite and a good bug spray. Aquaphor. :)

    cwerhaneflystormsKate_Alexander
  • Sara_WolfSara_Wolf Member

    I would also add an empty contact lens case and some contact lens solution/saline. Or, be sure that the swimmer supplies that for you.

    I also don't see gloves on your list -- unless that's a no brainer for you.

    cwerhaneKate_Alexander
  • Tracy_ClarkTracy_Clark Norwich, United Kingdom (from Auckland, New Zealand)Member

    Wow! This is a lot. I have never expected my crew to supply meds I may potentially need (the usual ibuprofen). I also leave it up to my crew to bring their own supply (including sea sick tablets). Also sounds very expensive. ...
    Not a criticism....just an observation 😎

  • cwerhanecwerhane Portland Oregon Member
    edited May 2

    @Tracy_Clark said:
    Sounds very expensive. ...

    It’s been a growing kit I built for Race Across the West, an endurance bike race. Now I simply replace the used items. Most of the over the counter meds are used by crew members in the prep days for minor discomfort... headaches, acid reflux, constipation, gas pain, upset stomachs, dental pain. They are things you would simply go to a drug store or your medicine cabinet for but in the stress of preswim logistics it’s nice to have them quickly available. It’s so nice to say “I got that in the first aid kit” vs “let’s go back to the store”.

    Tracy_ClarkKate_Alexander
  • swimrn62swimrn62 Stowe, VTMember

    I can't imagine starting an IV on a fast moving boat. Do you get a MD/PA/NP to write an open prescription/order for IV fluids? Giving fluids can also be problematic if there's pulmonary edema.

    The only thing I'd add is white vinegar and a tweezer for jellyfish tentacles.

    cwerhane
  • cwerhanecwerhane Portland Oregon Member

    @swimrn62 said:
    I can't imagine starting an IV on a fast moving boat. Do you get a MD/PA/NP to write an open prescription/order for IV fluids? Giving fluids can also be problematic if there's pulmonary edema.

    Regarding PE, exactly. IVF would be initiated based on an assessment including auscultation of the lungs.

    I’ve had my athletes obtain fluid and supplies from their MD (prescription). I typically hold conference with MD and Swimmer regarding its use. My practice is to use fluids only to treat emergency situations like severe dehydration, kidney failure, and shock not for recovery or preloading.

    Starting an IV is a 3-5 minute task at most. Depending on the person, it can be done during transport. My guess is, if you need high speed transport, maybe that IV is vital enough to slow down for placement.

  • MoCoMoCo Worcester, MAMember

    Also, note to self: Invite @cwerhane if you ever do a swim requiring crew.

    :tongue:

    lakespraycwerhanecurly
  • lakespraylakespray Senior Member

    @cwerhane would you consider some of the military style fast blood clotting solutions like Quikclot gauze impregnated with Kaolin and or Hemostatic powder's for swims in Shark waters, like the Maui or the Cook Strait etc.?

    cwerhane
  • cwerhanecwerhane Portland Oregon Member
    edited May 6

    @lakespray said:
    @cwerhane would you consider some of the military style fast blood clotting solutions like Quikclot gauze impregnated with Kaolin and or Hemostatic powder's for swims in Shark waters, like the Maui or the Cook Strait etc.?

    I like it. Little secret... I keep the solution we use for dog toe nail clipping in my kit. 🤪

  • swimrn62swimrn62 Stowe, VTMember

    I think this thread is a bit concerning. A few of these items are not appropriate for anyone but a MD or a specially trained paramedic/PA/NP to administer in an emergency, especially a hemostatic agent and IV fluids.

    I also am concerned that swimmers reading this thread may get the impression that they need a medical person on board. That would be sad as there aren't very many of us, and that impression may limit or add a fear factor to someone's swim.

    If there isn't one, maybe we can develop a manual on basic training for identification and treatment of the various problems that can affect a marathon swimmer? I know there have been several threads here, but a comprehensive (and evolving) manual would be helpful for all crew members. I just retired, so am glad to work on this with anyone who's interested.

    slknightBogdanZemkhowleyMLambycurly
  • j9swimj9swim CharlestonSenior Member

    IMHO I think this may being going to far. If the swimmer is that dehydrated then crew hasn't done their job and the swimmer has been lying about their feeds and peeing. A swimmer that needs an iv administered on the boat should have been pulled awhile ago. If a swimmer is attempting an ultra marathon lets call that over 36 hours than having a licenced medical personnel on the boat might make sense...this is maybe 1% of the swims we are all involved with. Perhaps this conversation should pivot to how do you know when to pull your swimmer, because at the end of the day its just swimming and it shouldn't get to the point of needing this kind of response.

    swimrn62emkhowleyjendut
  • j9swimj9swim CharlestonSenior Member

    @swimrn62 - I'd like to work on a crew manual with you over the summer. I think our write up from Hawaii has some good info to start with. Between the 2 of us we have crewed some epic attempts and lots of run of the mill ones too.
    @evmo - what are your thoughts on posting this somewhere in MSF land once complete?

    swimrn62evmo
  • evmoevmo San FranciscoAdmin
    edited May 7

    @j9swim said: what are your thoughts on posting [a crew manual] somewhere in MSF land once complete?

    In general, I'd love for MSF to someday host a comprehensive set of education materials for swim support and observing/documenting. There's so much collective knowledge that exists among those who crew and/or observe a lot of swims, and relatively little of it written down and publicly available.

    The videos of the SF observer training last year were a start. I plan to eventually get it posted in written form.

    I think basic CPR and First Aid training are valuable for crew and observers. Not a universal requirement - but occasionally handy. A basic first aid kit and hypothermia treatment items (emergency blankets, hand warmers) -- also useful to have on board.

    The SBCSA requires observers to have current CPR, AED, and First Aid certifications (the non-medical professional variety), and we have an AED and variety of first aid/hypothermia/etc stuff in our observer kit. This is part of the service we provide as a sanctioning association - but certainly I wouldn't expect individual swimmers or crew to own an AED.

    @ssthomas had a EMT paramedic on her 80 and 104 mile lake swims - these are the sort of extreme events where one might strongly consider bringing a trained medical professional.

    Thank you @cwerhane for starting this conversation!

    cwerhanecurlySara_Wolfj9swimIronMike
  • ssthomasssthomas DenverCharter Member
    edited May 7

    @evmo , Alex is a paramedic- higher level than an EMT (he'd want me to note the distinction). When we talked about my medical plan before Powell, he was not comfortable administering meds or IVs without a doctor's orders, in order to stay within his scope of practice. We purchased a basic medical bag for him with first aid equipment and a blood pressure cuff. He took my BP on both swims to establish my baseline so he would know if something was going wrong if I got pulled or at the end. He read up on hypothermia treatment, but otherwise our basic plan was that if something was going wrong, he was there to advise and help keep me stable until a full medical crew could arrive. He wasn't meant to be expected to save me or administer IVs or anything beyond first aid/CPR.

    evmoslknightKate_Alexanderemkhowleyjendut
  • cwerhanecwerhane Portland Oregon Member
    edited May 7

    I totally love the inquiries and concerns this thread has morphed into. When I started it I was looking for suggestions on what could be added to MY kit. It was not meant as a blanket suggestion of what others should contain. Nor did I mean to indicate a medic was a required crew member. Practicing medical care contains a high level of liability, responsibility and education. I respect these opinions and will continue my own efforts to educate myself on emergencies care in wilderness settings. A lot has changed since I was certified as a WEMT, worked Search & Rescue, and as a forest service fire fighting medic. With the advanced communications available now days, we have a lot more triage knowledge at our fingertips to support care in the field. But without supplies, that knowledge may be futile. Thanks to all who've engaged In this discussion.

    evmoj9swimKate_AlexanderSolo
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