Med­i­cal train­ing re­quired

Yachting World - - Practical -

has led to a part­ner­ship be­tween the race and PRAXES, a telemedicine provider based in Canada but avail­able world­wide.

How­ever, as Dr John Ross, med­i­cal direc­tor for Clip­per Telemed points out, voice com­mu­ni­ca­tion is only one as­pect of how telemedicine can be utilised. “I was speak­ing to one of our small boat clients re­cently. He sus­pected one of their crew had suf­fered a stroke. Con­sid­er­ing the symp­toms and age, this sounded plau­si­ble.

“I asked the crew to email me one pic­ture of him smiling and an­other of him not smiling. With this, and some other tests, we were able to rule out a stroke. The gen­tle­man con­cerned ac­tu­ally had

Bell’s Palsy, a con­di­tion where some of the fa­cial nerves go to sleep. I think, more than any­thing, the com­bi­na­tion of voice and email com­mu­ni­ca­tion bought them all piece of mind.”

Any sailor can ac­cess ad­vice from a doc­tor 24/7 by call­ing the UK’S Ma­rine Res­cue Co­or­di­na­tion Cen­tre at Fal­mouth, from any­where in the world. How­ever, the scope to de­liver more ad­vanced lev­els of care, and so the out­come, can de­pend heav­ily on what is car­ried on board and the con­fi­dence of the crew to carry out some ba­sic med­i­cal pro­ce­dures, such as giv­ing in­jec­tions, them­selves.

Nigel Betts, an ex­pe­ri­enced am­a­teur sailor cur­rently pre­par­ing for the ARC and Oys­ter World Rally, has ob­served how far telemedicine has ad­vanced since he raced in the 1996 Global Chal­lenge. “We saw a lot of in­juries in the Southern Ocean,” he re­calls. “Pre­par­ing for this ad­ven­ture, I did the MCA’S ten-day first aid course, pur­chased a range of drugs, and also bought a de­fib­ril­la­tor. The drugs were pro­vided by ANP Pharma, a spe­cial­ist phar­macy cater­ing for the ma­rine mar­ket. I also sub­scribed to the Clip­per Telemed+ ser­vice. It was com­pet­i­tively priced and I think you’d be verg­ing on the ir­re­spon­si­ble to em­bark on a cir­cum­nav­i­ga­tion with­out it or some­thing sim­i­lar.” How­ever, a telemedicine ser­vice is no re­place­ment for train­ing. Car­ry­ing pre­scrip­tion drugs on board is some­thing any sailor can do, but the med­i­cal pro­fes­sional sign­ing the pre­scrip­tion must be con­vinced that the in­di­vid­ual the pre­scrip­tion is writ­ten for is suit­ably trained.

Susie Plume says Ad­ina’s med­i­cal set-up has evolved since Tom’s ill­ness, but they had com­pleted spe­cific train­ing well be­fore they slipped lines three years ago. “We un­der­took a two-day be­spoke med­i­cal course or­gan­ised for us by Storm­force in Ham­ble. We agreed the con­tent with the in­struc­tor in ad­vance. With our first aid train­ing al­ready cov­ered, the course was a cut-down ver­sion of the longer Med­i­cal Care Course and fo­cused on more ad­vanced train­ing in­clud­ing learn­ing how to su­ture wounds, give in­jec­tions, use sy­ringes and nee­dles, make ba­sic ex­am­i­na­tions. We also re­vis­ited CPR.

“For the drugs that were pre­scrip­tion-only in the UK we saw a pri­vate doc­tor and once he was sat­is­fied we had an ad­e­quate un­der­stand­ing of the drugs and train­ing to use them he wrote us a pri­vate pre­scrip­tion for ev­ery­thing we wanted. This in­cluded an ar­ray of an­tibi­otics, steroids, strong pain re­liev­ers, tran­quil­lis­ers, eye med­i­ca­tions and more. I then cre­ated a spread­sheet to track all of the drugs and their ex­piry dates,” ex­plains Susie.

Many sailors put to­gether their own off­shore med­i­cal kits with the help of a phar­ma­cist or doc­tor, but those pro­vided by com­pa­nies such as MSOS, Clip­per Telemed, and Medaire, prom­ise more than a sup­ply of drugs not avail­able over the counter. “As sailors and con­sul­tants work­ing in emer­gency medicine, we un­der­stand the en­vi­ron­ment that sailors are op­er­at­ing in, and make sure we un­der­stand the pro­file of the yacht to which we have sup­plied the kit,” ex­plains Dr Biggs from MSOS. “We ap­pre­ci­ate what they are ca­pa­ble of achiev­ing in an emer­gency and the kits are laid out in a way that makes them easy to use,”


Price de­pen­dent on level of telemedicine ser­vice Left: Med­i­cal train­ing is highly rec­om­mended be­fore set­ting sail for re­mote des­ti­na­tions or ocean pas­sages

Wil­liam Bru­ton, 27, grew up in Lan­cashire and learned to sail in

2012. He now works as a free­lance skip­per all over the world, spe­cial­is­ing in Oys­ter yachts. He is cur­rently based in Ja­pan.

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