So, you are the Doctor on Board!

Assessment and Care How to Use This Book Initial Assessment Survey the Scene • Check the Airway and Breathing • Check Circulation • Check Severe • Bleeding • Check the Cervical Spine Focused Assessment The Physical Exam • General Principles of the Focused Assessment Vital Signs Level of Responsiveness • Pulse • Respirations • Skin Signs • Blood Pressure • Temperature • Oxygen Saturation Medical History and Physical Examination Head • Neck • Chest • Abdomen • Back • Pelvis/Hip • Legs • Shoulders and Arms

ShockDifficult Respirations Foreign Body Airway Obstruction • Adult One-Rescuer CPR • Adult Two-Rescuer CPR • Defibrillator • Rapid Breathing Cardiac Evaluation and Care Heart Attack—Myocardial Infarction • Rapid Heart • Rate—Tachycardia • Slow Heart Rate—Bradycardia

Fever/Chills Lethargy Pain Mild Pain • Severe Pain Itch Hiccups Headache

Not all motion sickness is created equal.

Eye Patch and Bandaging TechniquesForeign Body Eye InjuryContact LensesEye AbrasionUltraviolet Eye InjuryConjunctivitisIritisAllergic ConjunctivitisSties and ChalaziaSpontaneous Subconjunctival HemorrhageBlunt Eye TraumaGlaucoma

Nasal CongestionNasal Foreign BodyNosebleed—EpistaxisBroken Nose

EaracheOuter Ear Infection—Otitis ExternaMiddle Ear Infection—Otitis MediaForeign Body in EarRuptured EardrumTemporomandibular Joint Syndrome

Sore Throat Infections Mononucleosis Mouth Sores Dental Care Gum Pain or Swelling • Mouth Lacerations • Dental Pain • Lost Filling • Cavity • Loose or Dislodged Tooth • Pulling a Tooth

Bronchitis/PneumoniaPneumothoraxPulmonary Embolus

Abdominal Pain Gall Bladder Problems and Appendicitis VomitingDiarrheaConstipationHemorrhoidsHerniaBladder InfectionUrinary Retention How to Insert a Foley Catheter

Venereal DiseasesVaginal Discharge and ItchingMenstrual ProblemsSpontaneous AbortionEctopic PregnancyPregnancyPainful Testicle

Plant or Food Poisoning Petroleum Products Ciguatera Poisoning Scombroid Poisoning Pufferfish Poisoning Paralytic Shellfish Poisoning

Diabetic children or adults can have an active sailing life but learning to control their diabetes must first be worked on with their physicians.

Oral Fluid Replacement Water Purification Drinking Seawater

Stop the BleedingHemostatic DressingsWound Cleaning Antibiotic Guidelines Wound Closure Techniques Tape Closure Techniques • Stapling • Suturing Special Wound Considerations Shaving the Wound Area • Bleeding from Suture or Staple Use Scalp WoundsEyebrow and Lip ClosureMouth and Tongue LacerationsControl of PainDressingsAbrasionsPuncture WoundsSplinter RemovalFishhook Removal Push Through, Snip Off Method • The String Jerk Method • The Dissection Method Friction BlistersThermal BurnsHuman BitesAnimal BitesFinger and Toe Problems Ingrown Nail • Paronychia (Nail Base Infection) • Felon • Blood Under Nail (Subungual Hematoma) • Wound Infection and Inflammation • Abscess • Cellulitis • Skin Rash • Fungal Infection • Allergic Dermatitis • Bacterial Skin Rash • Seabather’s Eruption

Muscle Pain—No Acute InjuryMuscle Pain—Acute InjuryJoint Pain—No Acute InjuryJoint Pain—Acute InjuryFractures—Broken Bones Open Fracture • Diagnosis and Care Protocols Head Fractures—Unconscious Neck • Spine Collarbone—ClavicleShoulder Shoulder Blade—Scapula Upper Arm Fractures (Near the Shoulder)Upper Arm Fractures (Below the Shoulder)Elbow TraumaForearm FracturesWrist Fractures and Dislocations Thumb Sprains and FracturesHand Fractures and Injuries Finger Fractures and Sprains Hip Dislocation and FractureThigh (Femur) FracturesKneecap (Patella) DislocationKnee Sprains, Dislocations, and FractureAnkle Sprains,Dislocations,and FracturesFoot InjuriesChest Injuries

Anaphylactic Shock Use of Epipen • Snake Bites Spider Bites Black Widow Spider • Brown Recluse Spider TicksCaterpillar ReactionsMillipede ReactionsCentipede BitesMosquitoesBlack FliesNo-See-Ums and Biting Gnats Scorpion StingsAnts/Fire Ants Aquatic Stings, Cuts, and Rash Sea Urchin Jellyfish Coral Stings Coral and Barnacle Cuts • Stingray • Catfish • Scorpion Fish • Sponge Rash

Diagnosis of Infectious Diseases So, What is the Approach to Infectious Disease? • Anaplasmosis • Babesiosis • Blastomycosis • Chikungunya Fever • Cholera • Coccidioidomycosis • Colorado Tick Fever • Coronavirus • Dengue • Echinococcus • Ehrlichiosis • Encephalitis • Giardiasis • Hantavirus • Hepatitis A • Hepatitis B • Hepatitis C • Hepatitis D • Hepatitis E • Hepatitis G • Leptospirosis • Lyme Disease • Malaria • Measles (Rubeola) • Meningococcal Meningitis • Mumps • Plague • Rabies • Relapsing Fever • Rocky Mountain Spotted Fever • Rubella (German Measles, 3-Day Measles) • Schistosomiasis • Tapeworms • Tetanus • Tick Paralysis • Trichinosis • Trypanosomiasis, African (African Sleeping Sickness) • Trypanosomiasis, American (Chagas Disease) • Tuberculosis • Tularemia • Typhoid Fever • Endemic Typhus, Flea-Borne • Epidemic Typhus, Louse-Borne • West Nile Virus • Yellow Fever • Zika Virus

Hypothermia Chronic Hypothermia • Acute Hypothermia • Cold Water Submersion Cold-Stress Injuries Frostnip • Frostbite • Cold-Induced Bronchospasm • Immersion Foot (Trench Foot, Cockpit Foot) • Chilblains Heat Stress Injuries Dilutional Hyponatremia • Heat Cramps • Heat Exhaustion • Heat Stroke • Prickly Heat Lightning Ship Damage • Crew Injury

Alternative ImprovisationLifeboat Kit Versus Ship’s Medicine ChestTopical Medication and Bandaging Kit Coverlet Bandage Strips • Spenco 2nd Skin • Hemostatic Dressings • Nu-Gauze Pads • Silverlon Bandage • Waterproof Tape • Sam Splint • Elastic Bandages • Maximum Strength Triple Antibiotic Ointment With Pramoxine, 1 oz Tube • Lanacane Cream 1 ounce (30 g) Tube • Chlorhexidine Surgical Scrub • Opcon-A Eye Drops • Hydrocortisone Cream 1%, 1 oz Tube • Clotrimazole Cream 2%, 1⁄2 oz Tube • Cavit Dental Filling Paste • Protective Gloves • Irrigation Syringe • Surgical Kit • Foley Catheter Kit • Automatic External Defibrillator Non-Rx Oral Medication Kit Percogesic Tablets (Pain, Fever, Muscle Spasm, Sleep Aid, Anxiety, Congestion, Cough, And Nausea) • Ibuprofen Tablets (200 mg) (Pain, Fever, Bursitis, Tendonitis, Menstrual Cramps) • Diphenhydramine Tablets (25 mg) (Antihistamine, Antianxiety, Cough, Muscle Cramps, Nausea, Motion Sickness Prevention) • Bisacodyl Tablets (5 mg) (Constipation) • Loperamide Tablets (2 mg) (Diarrhea) • Famotidine (20 mg) (Heartburn, Certain Allergic Reactions) Rx Oral/Topical Medication Kit Doxycycline Tablets (100 mg) (Antibiotic) • Azithromycin Tablets (500 mg) (Antibiotic) • Levofloxacin Tablets (500 mg) (Antibiotic) • Diflucan Tablets (150 mg) (Antifungal) • Norco-10/325 Tablets (Pain, Cough) • Hydroxyzine Tablets (25 mg) (Nausea, Anxiety, Antihistamine, Pain Medication Augmentation) • Meloxicam (Mobic) 15 mg Tablets (Pain Medication, Anti- Inflammatory, Fever) • Desoximetasone (Topicort) Ointment (0.25%, 0.5 oz Tube) (Skin Allergy) • Tobradex Ophthalmic Drops (2.5 ml) (Eye And Ear Antibiotic, AntiInflammatory) • Tetracaine Ophthalmic Solution (Drops), 0.5%, 15 ml Bottle (Eye And Ear Anesthetic) • Penciclovir (Denavir) Cream, 1%, 5 gm Tube (Antiviral, Lip And Mouth Sores) • Butorphanol (Nubain) Nasal Spray (Severe Pain) • Dexamethasone (Decadron) Tablets (4 mg) (Allergy, Specific Trauma Situations) • Metronidazole (Flagyl) Capsules (250 mg) (Trichomonas or Giardia Infection) • Famciclovir Capsules (250 or 500 mg) (Cold Sores, Herpes Viral Infections) • Atovaquone And Proguanil (Malarone) (250 mg/100mg For Adult; 62.5 mg/25 mg Pediatric) Rx Injectable Medication Kit Nalbuphine (Nubain) (20 mg/ml, 10 ml Vial) • Lidocaine 1% (10 ml Vial) • Dexamethasone (Decadron) (4 mg/ml, 5 ml Vial) • Ceftriaxone (Rocephin) (500 mg Vial) • Hydroxyzine (Vistaril) (50 mg/ml, 10 ml Vial) • Epinephrine Auto Inject Pens (Epipen, Epipen Jr. and Symjepi®) Cardiac Medication Kit Aspirin (81 mg Chewable Tablets) • Nitroglycerin Sublingual Tablets (0.4 mg) • Clopidogrel (Plavix) Tablets (75 mg) • Atenolol (Tenormin®) Tablets (25 mg)

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