What goes in a superyacht first-aid or marine medical kit?

With thanks to Pharmacy Progrès

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As superyachts begin to travel further offshore to more remote regions, and with guests engaging in increasingly adventurous activities, the chances of encountering a serious medical emergency on board are higher than ever.

Even under usual service it’s vital to have a fully stocked medical kit to hand at all times to ensure crew and guest safety at sea; but which first-aid kit does your boat require, where should it be kept and how should it be organised?

Which first-aid kit? Medical kits for boats and yachts

There isn't question that all boats and yachts require a first-aid or medical kit on board, but the type and contents required will all depend on the flag the yacht is registered under; the type and activities of the boat; the amount of passengers on board; the ports of call; and the distance or length of time spent away from the shore.

The UK Maritime and Coastguard Agency (MCA) sets three categories of medical kit for commercial vessels, to be tailored to the ships activities with the help of a medical professional:

MCA Category C: Inshore First-Aid Kit

A Category C First-Aid Kit is intended for small boats undertaking inshore boating, no further than 60 nautical miles from shore, or six hours from medical care. Category-C kits generally include plasters, dressings and bandages, Paracetamol and other basic first-aid supplies.

MCA Category B: Coastal First-Aid Kit

A Category B First-Aid Kit is required for boats staying within 150 nautical miles of the coast, or 12 to 24 hours from medical care, allowing crew to take care of most minor medical scenarios on board before help arrives. Category-B kits will include additional tools for resuscitation, allergies and digestive issues.

MCA Category A: Offshore and Ocean First-Aid Kit

The further offshore you go, the longer it will take for medical help to get to you. An MCA Category A First-Aid Kit complying with MSN 1768 requirements for ocean-going vessels is therefore mandatory on commercial boats, lifeboats and life rafts operating further than 150 nautical miles offshore, beyond helicopter range or prompt reach of other offshore-rescue services.

Category-A kits will include a full oxygen kit and supplies to treat fractures, wounds and burns. At least two separate bags are recommended for a Category-A medical kit: One for everyday medical care and one for emergencies, leaving the latter fully stocked in case of an incident.

1. Daily-use first-aid kit or grab bag

A small bag equipped to handle small cuts and minor incidents, stocked with medicines such as Almagate, Dimenhydrinate and Paracetamol. Typical medical supplies should include antiseptics such as alcohol, Povidone-Iodine, Chlorhexidine, antibacterial hand gel and saline solution; creams with cortisol and antibiotics; and supplies for skin repair, such as sterile gauze pads, adhesive plastic dressings, adhesive sutures, gloves, scissors and forceps.

2. Incident kit or main medical bag

A separate incident kit is then reserved for emergencies. Medicines included should treat emergency-shock and anaphylaxis; problems with the digestive system, sickness and allergies; analgesics and anti-inflammatories; anxiety and neuroleptics; and problems with the eyes. Emergency supplies will include resuscitation equipment; bands, dressings and bandages; orthopaedics; needles and syringes; digital-measuring devices and emergency blankets.

MCA Notice MSN 1768 details the items vessels are required to carry.

What makes a great marine first-aid kit?

Specialist marine-medical supplies company Pharmacy Progrès explained, "A nautical first-aid kit is an essential tool for safety at sea. With conditions at sea being highly changeable, there are many potential risks when navigating the oceans. Suddenly, a normal situation might turn into a dangerous one due to a variety of factors that may coincide."

It advises that a medical kit must therefore meet many basic requirements to make it an efficient tool for your safety. This includes, in part, a high-quality case, equipment and current medicines.

1. A high quality first-aid case and contents

A medicine is a substance that has properties to prevent and/or treat illnesses and wounds. In order to maintain these properties and ensure their effectiveness, medicines must be stored safely, in the suggested conditions. We therefore recommend a waterproof, hermetic, light and robust box. It should protect the contents from humidity, dust, salt residue, and it should be impact-resistant. Meeting these requirements guarantees that medicines and medical supplies are stored in appropriate conditions.

The quality of medical supplies is also crucial, since they have to resist tough sea conditions. Good-quality materials ensure effective first aid. If we take all these factors into consideration, we will have a kit that lasts for a long time, in perfect condition until its expiry date. The initial investment in a high-quality case and medical supplies will save money and injuries in the long term.

2. Regular checks and replenishment

With this in mind, it’s vital to ensure that the age and condition of on-board supplies are checked regularly throughout the year; at least once every six months. Many medical suppliers and services – Pharmacy Progrés included – offer an additional service to keep on top of these checks, ensuring first-aid kits are always ready to use. If the medical requirements of the yacht change, it’s vital to revisit your medical kit to be in complete control.

Once used or expired, medical products and sharps should always be disposed of responsibly. Many medical suppliers and pharmacies offer a service to get rid of expired, used and unwanted medical products in a safe way.

3. Accessibility and ease of use

Pharmacy Progrès continued, “Crewmembers need to react quickly and efficiently in case of emergencies; they must know what to do and what to use as soon as they open the kit. A good yacht first-aid kit should therefore be organised in a practical way and its contents labelled correctly, clearly and briefly. We suggest using transparent, compartmentalised pouches for fast product selection. They should be grouped together according to their therapeutic functions.

In a Category-A First-Aid Kit, we think it’s a good idea to have two boxes or bags; the smaller could contain items used on a daily basis.

It's typically down to the captain or person in charge to organise the yacht’s medical kits for the eventualities in hand, however Dr Spike Briggs from Medical Support Offshore Ltd advises on some tried-and-tested ways of going about this.

He said, “A good systematic way of designing a comprehensive medical kit is to go through each body system – head, heart, stomach, skin, etc. – thinking about the common problems that occur on board, making sure that appropriate drugs, dressings and hardware are included. All the medicines and supplies should then be arranged into transparent sealable bags or boxes, each with a laminated contents list.

In addition, there should also be separate bags that don’t fit into the ‘body-system’ scheme, containing resuscitation drugs, hardware such as defibrillators, intravenous and intramuscular drugs, needles, syringes, and fluids, if carried. All this can generally fit into one bag or box, especially for the Offshore and Ocean kits.

4. Legal compliance

Of course, there are certain legal requirements that boats have to comply with when it comes to first aid and medical care.

Pharmacy Progrès explained, “Legal requirements for marine-medical kits depend on the vessel’s flag. It’s important to bear in mind that your first-aid kit may save someone’s life before getting into the nearest port. The idea of having it just to pass inspection or to comply with a law is wrong. This tool is crucial for the safety of everyone on board. Once the kit has the basic contents required by law, it can be complemented according to your needs. A health professional can guide you on how to make up your kit.

The Royal Yachting Association (RYA) explains that a vessel operating commercially is required to carry certain drugs on board by the Merchant Shipping (Medical Stores) Regulations 1995. Commercial yachts are therefore able to obtain certain controlled drugs without a prescription. A private yachtsman is, however, recognised as a private individual ashore, meaning controlled drugs can only be obtained with a prescription from a qualified medical practitioner, with illegal possession resulting in potential prosecution.

5. Basic medical training

Of course, no first-aid kit is complete without a crew that knows how to make best use of it. As knowing what’s wrong with someone is the first step towards helping, the captain or another crewmember must hold an MCA STCW Medical First-Aid Aboard Ships or Medical Care Aboard Ships certificate. Find out more about STCW medical-training courses.

The RYA advises that chapter one of the MCA Ship’s Captain’s Medical Guide supports these courses.

General first-aid advice for yacht crew

Before setting off on any journey, crew should ensure that they, and their guests, are fully stocked with the routine medicines they will require during the trip, and that they are knowledgeable about any allergies or special requirements of guests on board.

While most crew will be required to hold a valid ENG1 Seafarer Medical Certificate or equivalent, recognising them as being safe to work at sea, accidents and incidents can and do happen. A full brief should therefore also be given on the potential dangers on board.

A first-aid manual is also invaluable to your marine medical kit. The RYA offers its own first-aid manuals as tailored resources for mariners, while alternatives are available from St John’s, St Andrew’s or Red Cross.

When setting off to any new country, current international travel advice should always be followed, with necessary inoculations and preventative treatments obtained if recommended. For some countries, where disposable syringes and needles are not generally used, carrying a personal sharps kit is advisable, in case of hospital treatment.

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