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While being careful and avoiding accidents is a natural instinct for us, doing so aboard is of even more importance as the distance in miles and hours to the nearest caregiver is always longer than ashore. What complicates matters on a boat is that the environment itself makes being careful difficult. First of all, the boat itself is constantly moving around - sometimes at extreme angles and accelerations. Secondly, the more the boat is rocking and rolling around you, the more likely it is that you are going to have to go and do something active, which increases the chances of something going awry. No matter how well-designed, a boat is a myriad of sharp corners and edges, oddly shaped object and protuberances that all seem to want to do nothing else than snag parts of your body. So far, on Zanshin I I've broken a little, a middle toe (both times while running forward during the anchoring process) and almost lost a finger (to a spring-loaded spinnaker pole attachment) and consider myself to be lucky that nothing worse happened. Since most sicknesses are bacteria/virus borne and often have human carriers, sailors are less likely to contract them - living away from densely populated urban centres. We won't catch anything offshore that we didn't already bring with us and most likely started incubating before departing the last port. While it is important to pay attention to hygiene aboard in order to avoid bacteria to get a foothold, the major concern, in my opinion, is to attempt to prevent and avoid accidents.
While I haven't found the reference, I've heard that the major cause of accidents aboard a sailboat is the galley. Be it open flames or scalding water, the galley has plenty of potential to do damage and the recommendation for galley cooks to wear thick clothing (oilskins or the like) while working in weather is understandable, but not necessarily practicable, particularly in tropical climes.
With the advent of proximate first aid in urban areas most of us have little or no knowledge of first-aid measures. Both initial and advanced first-aid courses teach measures and methods to provide initial care and patient stabilization until professionals arrive. Getting training that goes beyond this basic set of skills is difficult to find as the target audience is quite small, so far I have seen classes for sailors and for wilderness guides as both groups need to ensure that the injured person is not only given initial aid but then stabilized for a lengthy transport (or period of time) and potentially the measures need to last indefinitely. So while a first-responder course teaches how to stop a bad cut from bleeding , the advanced class needs to augment that skill with the ability to change the dressings or, if necessary, to suture the wound.
I was fortunate to get a place on an advanced first-aid course in 2014 in Germany, which had the students do hands-on training over a couple of days. I actually got to give one of ours instructors an infusion (which he fortunately survived) and also got to play around with bandages plus got to practice suturing using standard first-aid equipment on some pig's feet.
There are a number of excellent books available in both electronic and print form which I consider to be indispensable aboard any boat more then 30 minutes from primary health care. I've listed them below:
|Where There Is no Doctor (2011) (PDF)||This is the book by which all others are measured and I know of no other work which is more helpful. It is geared towards tropical and subtropical climates and is written by David Werner and issued by the Hesperian Foundation|
|Special Operations Forces Medical Handbook 1st Edition 2001 (PDF)||Contains a great store of information particularly useful when improvisation is necessary|
|Wound Closure Manual (PDF)||Issued by Johnson & Johnson, it is relatively easy to comprehend.|
|International Medical Guide for Ships (PDF)||WHO (World Health Organization) - guide for commercial ships|