Medicine at Sea

Preparing for Medical Emergencies at Sea

Step 1: Preparation

Assess your type of cruising:

  • coastal cruising and developed countries require less preparation 
  • offshore or to third world countries requires maximum self-sufficiency
  • you can stock up easily and cheaply on prescription and OTC medications in many undeveloped countries
  • determine how long you will be away
  • consider the climate and season you are sailing in (temperature, sun, insects, etc.)
  • research your destination’s medical precautions at Travel Health ONLINE and at the Centers for Disease Control and Prevention 

Assess yourself:

  • what diseases you have now
  • what ailments you are likely to come down with based on your history


Current DiseaseAllergies
Current TreatmentAntihistamine pills (ie. Claritin)
Likely emergencies1. Antihistamine eye drops (ie. Opticrom)
2. Antihistamine ointment/cream (ie. Caladryl)
3. Injectable antihistamines (IM Benadryl)
4. Ventolin inhaler
5. Prednisone tablets
6. Injectable adrenaline (ie. Ana-kit or Epi-pen)

Get Reference Materials on board:

Prepare your attitude:

  • Avoid using medicine. Most things get better with time.
  • No medicine is without a side effect
  • “At first, do no harm”
  • When in doubt, get help

Prepare your medical kit:

  • Ask for expiration dates for all prescriptions
  • Ask for expiry dates as far in the future as possible
  • Get more than you think you will need of regularly used medicine
  • Avoid medications that need refrigeration
  • Separate “trauma” from “medicines”
  • Use water-tight and air-tight plastic boxes
  • Keep an inventory log with supplies and names of medicines (generic and trade), and expiration dates. Recheck your list every 6 months
  • Avoid prepackaged kits – DIY is better

Step 2: Prepare for the mostly likely emergencies


1. Cuts, scrapes and blisters: These are caused caused by coral, boat jobs, objects on shore and shoes. This is very important because all cuts will get infected in the tropics.

Prevention:Make sure to wear gloves, wetsuits, protective clothing, socks
Avoid jewellery
Treatment:Stop the bleeding – pressure x 15 minutes
Clean the wound with hydrogen peroxide, Betadine, Savlon, saline or just fresh water
Other Supplies:Tweezers, scissors, ring cutter
Steri strips versus sutures
Bandaids – esp. fingertip, and lots of the regular size (Elastoplast) dressings
Bring telfa or sofratulle, gauze pads, cling, good tape (3M Transpore or Leukoplast waterproof tape)

2. Infection

Prevention:Antibiotic ointment prophylactically
Bactroban or Fucidin are more effective than Polysporin
Treatment:Antibiotic ointment
Oral antibiotics (ie. Cloxacillin, Keflex, or Biaxin)
Other Supplies:Scalpel, sterile packing

3. Burns (Sunburn and Thermal)

Prevention:Sunscreen, clothing, hat, sunglasses, awning or bimini
Swim with wetsuit or shirt
Get pot holders and avoid heeling or rolly anchorages (buy a catamaran)
Treatment:Aspirin for severe sunburn
Apply cold water or ice to burns immediately
Flamazine (Silver sulfadiazine) or Bactroban/Fucidin
Dressing (gauze, etc.)

4. Bug Bites

Prevention:Insect repellant (DEET 99% Muskol), clothing
Avoid shore at night
Citronella candles, coils, mosquito netting or windy anchorages
Treatment:Antihistamine ointment/cream (Caladryl)
Antihistamine pills (Claritin)


1. Seasickness: Everyone is prone. Symptoms may be mild to severe and include fatigue, apathy, irritability, nausea, hangover feeling, vomiting, diarrhea.

Prevention:Learn what you can and can’t do
Worse if tired or hungry, so eat starchy bland foods regularly
Get proper rest
Premedicate if possible, or as soon as symptoms develop
Treatment:Gravol – oral, suppositories and/or injectable
Cinnarizine (Stugeron) – not available in Canada or U.S.
Meclizine/ MarzineScopolamine – Kwells or Transderm patches

2. Dehydration: This can be a result from vomitting, diarrhea and/or sweating caused by seasickness, food intolerance/poisoning, or heat stroke.

Prevention:Drink a lot of water – intake in tropics 2L pp/day
Safe water – chlorine bleach, bottled large jugs, rain water
Treatment:Fluid replacement (Gastrolyte, Gatorade, sugar water)
IV fluids not practical
If diarrhea, “wait and see” – clear fluids for 24 hours, then bland, low fat foods
Avoid Imodium at first
Have antibiotics for traveller’s diarrhea on board (Cipro, Noroxin or Septra)
Consider having Flagyl or an anti-helmintic on board for parasites (not emergency medicine)

3. Indigestion, Constipation and Hemmorhoids: Bring Zantac and a hemmorhoid preparation.


1. Headache

Prevention:Sun – sunglasses, hat, awning, drink lots of water
Stress – good charts, good communication, being prepared
Alcohol – drink water before going to bed
Treatment:ASA, Ibuprofen, Tylenol extra strength
Codeine – Tylenol #1, Tylenol #3

2. Eyes

Infection (pink eye)Antibiotic drops (Sodium sulamyd 10 % drops)
Foreign bodyLocal anaesthetic drops, Q-tips
Antibiotic drops, anti-inflammatory drops
Contact lensesDisposable with cleaning solution/saline

3. Ears

Swimmer’s EarAntiseptic drops (Bur-o-sol)
Antibiotic drops (Garasone)
Ear WaxDon’t use Q-tips
Cerumol, mineral oil (Cerumenex)
Middle Ear InfectionAmoxil 500 mg capsules, or
Biaxin 500 mg capsules, or Zithromax


Prevention:Sail in good weather, sail on a catamaran
Know your limitations
“One hand for you, one hand for the boat”
Treatment:Muscle relaxants (Robaxisal)
Anti-inflammatories (Naprosyn)
Analgesics (Tylenol #3)
Injectable analgesics (Demerol)
Supplies:Instant cold packs
Tensor bandages – large and small splints
Triangular bandage (sling)

Step 3: Assemble your medical kit

This is what I initially packed for my three-year circumnavigation with my husband in 1992. This was a long time ago, and you should keep this in mind. There are certain new medications that would be better choices if I was leaving now. However, the CATEGORIES would remain the same. I would take more of certain things, and less of others. But one never knows what will happen out there, and it is better to err on the side of caution.

We restocked as needed along the way, as medication expired and as our destinations changed (ie. anti-malarial medication). Topical antibiotic ointment was used daily to prevent nicks and scapes from getting infected in the tropical climate. Topical steroid creams were also important due to Alec’s sensitive, eczema-prone skin. I would probably take more oral steroids too, as this has become a more recognized short-term treatment for a wide range of ailments.

This is just a sample. You must build your own list based on the first steps outlined above. You must take into account your skills as well. Please remember that I was an Emergency Room doctor and the kit reflects this. Outside assistance may help you choose the correct medication when in doubt, and in some countries it may help to take your own medicines and needles to the hospital.

AnaestheticXylocaine 1% w Epilidocaine hydrochloride90 ml
 Xylocaine 1% w/o Epilidocaine hydrochloride40 ml
Analgesics – injectableDemerol – 50 mg/mlmeperidine30 ml
 Toradolketorolac tromethamine1 x 30 mg
Analgesics – oralBayer aspirinASA (acetylsalicylic acid)100 x 325 ng
 Ponstanmefenamic acid30 x 250 mg
 Tylenol #1acetaminophen/codeine100 x 325mg/8mg
 Tylenol #3acetaminophen/codeine50 x 325mg/30mg
Analgesics – oralTylenol Extra Strengthacetaminophen100 x 500 mg
 Tylenol plainacetaminophen100 x 325 mg
Antibiotics – oralAmoxicillinamoxicillin100 x 250 mg
 Bactrim (Septra)sulfamethoxazole/trimethoprim14 x 800/160 mg
 Biaxinclarithromycin28 x 250mg
 Ceftincefuroxime28 x 250 mg
 Ciprociprofloxacin28 x 500mg
 Clavulinamoxicillin/clavulanate42 x 500mg
 Cloxacillincloxacillin40 x 500 mg
 Doryxdoxycycline14 x 100mg
 Erycerythromycin60 x 333mg
 Flagylmetronidazole4 x 500 mg
 Lariammefloquine16 x 250mg
 Noroxinnorfloxacin42 x 400mg
Antibiotics – topicalBacitracin creambacitracin60g
 Bactroban ointmentmupirocin100 g
 Fucidin creamfusidic acid15 g
 Neosporin burn creamgramicidin/neomycin/polymyxin B1 x 90 mg
 Silvadene (Flamazine)silver sulfadiazene1 x 50 g tube
Antidiarrheal – oralImodiumloperamide12 x 2 mg
Antifungals – topicalCanesten vaginal insertsclotrimazole6 x 200 mg
 Loproxciclopirox olamine30 g
 Monistat cream w applicatormiconazole1 x 85 g
 Terazol w applicatorterconazole1 x 9 g
Antihistamines – oralBenadryl capsulesdiphenhydramine40 x 25 mg
 Claritinloratadine100 x 10 mg
Antihistamines – topicalCaladryl lotioncalamine/diphenhydramine HCl
Anti-inflammatories – oralAdvilibuprofen100 x 200 mg
 Anaprox DSnaproxen30 x 550 mg
 Naprosyn SRnaproxen18 x 750 mg
 Toradolketorolac tromethamine80 x 10 mg
Anti-inflammatories – suppFeldene suppositoriespiroxicam6 x 20 mg
AntiliceKwellada shampoolindane50 ml
 NIX Creme Rinsepermethrin59 ml
AntiseasicknessGravol suppositoriesdimenhydrinate10 x 100 mg
 Gravol tabletsdimenhydrinate100 x 50 mg
 Transderm Scop. Patchesscopolamine12
AntiulcerCytotecmisoprostol20 x 200 mcg
 Zantacranitidine42 x 150 mg
AnxiolyticAtivan sublinguallorazepam12 x 0.5 mg
 Ativan tabletslorazepam50 x 1 mg
 Xanaxalprazolam9 x 0.25 mg
Asthma treatmentVentolin inhalersalbutamol (albuterol)2 inhalers
BandagesBandaid Plastic Strips10 small, 30 regular
 Elastoplast adhesive tape2.5 cm x 4.5cm – 1 roll
 Elastoplast Airstrips10 small, 30 large
 Elastoplast cont. strips1 roll of each – 1″ & 2″
 Elastoplast cont. strips6 cm x 33″
 Elastoplast plastic – pink3 x 5 cm – 3 m
 Mini/band bandaids10 small
 Tensor bandages – 2″,3″,6″1 of each
 Tensor bandages – 4″2
 Triangular bandage1
DecongestantsDristan Nasal Mistpheniramine/phenylephrine4 x 3 ml
 Sudafedpseudoephedrine60 x 30 mg
DressingsAbdo. Pads, 5″ x 9″3
 Abdo. Pads, 6″ x 8″8
 Abdo. Pads, 8″ x 10″5
 Bactigras – 10cm x 10 cmchlorhexidine acetate5
 Bactigras – 5cm x 5cmchlorhexidine acetate4
 Gauze – 4″ x 4″80
 Gauze – 5 cm x 5 cm10
 Kling, nonsterile4, 2″ rolls
 Kling, nonsterile4, 3″ rolls
 Kling, nonsterile4, 4″ rolls
 Kling, sterile4″ x 4.5 m – 4 rolls
 Large fingertip dressing10
 Sofra-Tulle – 10cm x 10 cmframycetin sulfate15
 Telfa – 3″ x 4″18
EarsGarasone ear dropsbetamethasone/gentamicin4 x 2.5 ml
EyesEye pads12
 Eye patch tape4 x 1″ roll
 Opticrom dropscromoglycate2 x 10 ml
 Sodium Sulamyd 10 % dropssulfacetamide2 x 8 ml
 Sofracort dropsframycetin/gramicidin/dexamethasone2 x 8 ml
 Tetracaine dropstetracaine5 ml
 Vasocon-Aantazoline/naphazoline10 ml
 Visine1 x 15 ml
Hemorrhoid treatmentAnusol – HC ointmenthydrocortisone/zinc sulfate15 g
Miscellaneousalcohol swabs-disposable80
 Gastrolyte sachetsdextrose/electrolytes10
 Vaselinepetroleum jelly3 x 50 g
 Vaseline nasal packing2 of 1″ x 36″
Muscle RelaxantRobaxacetacetaminophen/methacarbamol12
Muscle Relaxant – oralFlexerilcyclobenbenzaprine40 x 10 mg
 RobaxisalASA/methocarbamol28 x 325mg/400mg
NeedlesIV Quik-caths:22G & 18G2
 needles-18G, 1 1/2″6
 needles-19G, 1 1/2″2
 needles-22G, 1 1/2″2
 needles-23G, 1″5
 needles-25G, 5/8″8
 needles-25G, 5/8″2
 needles-27G, 1/2″14
 scalpels-disposable3 sterile
 syringes-1cc w 27G 1″ needle4
 syringes-20cc w/o needles2 sterile
 syringes-3 cc w 21G 1 1/2″ needle7
 syringes-3 cc w 25G 1″ needle9
 syringes-3 cc w 25G 1/2″ needle3
 syringes-3cc w 22G 1 1/2″ needle2
 syringes-3cc w 25G 5/8″ needle3
 syringes-6 cc w/o needle1 sterile
Otherabsorbent cotton balls, sterile4 balls/pk, 5 pks.
 blood pressure cuffsphygmomanometer1
 cautery – disposable1
 Gloves, latex – nonsterile1 box
 Gloves, latex – sterile4 pairs
 Gloves, vinyl – sterile1 pair
 Instant Cold Packs3
 Instrument – Coker clamp1
 Instrument – hemostat, curved1
 Instrument – hemostats, straight1 large, 1 small
 Instrument – tissue forceps1
 Instrument – towel clamp1
 Iodide tablets50
 IV Administration Set1
 magnifying glass1
 measuring tape1
 Minor Laceration Trays – sterile2
 moleskin16″ x 7″
 moleskin3″ x 2″
 pregnancy kits3
 Q-tips1 large box
 Splints for fingers2 med,1 long
 surgical scissors2 pair
 surgical tubing1 lg. piece
 tongue depressors, nonsterile40
Packing5% iodoform packing – 1 jar, sterile1.2cm x 4.5cm
 plain packing – 1 jar, sterile1.2cm x 4.5cm
Steroids – topicalHydrocortisone creamhydrocortisone 0.5 %30 g
 Hydrocortisone creamhydrocortisone 1 %30 g
 Kenacomb creamgramicidin/neomycin/nystatin/triamcinolone30 g
 Kenalog creamtriamcinolone acetonide 0.1 %120 g
 Topicort creamdesoximetasone 0.25 %30 g
 Topicort Mild120 g
 Westcort creamhydrocortisone-17-valerate 0.2 %45 g
 Prednisoneprednisone200 x 5 mg
Suturessteri-“suture”-strips40 x 1/4″x3″
 steri-strips40 x 1/8″x3″
 sutures-abs. Dexon ll2 x 4-0
 sutures-abs. plain gut1 x 2-0
 sutures-Dermalon12 x 6-0
 sutures-Dermalon4 x 4-0
 sutures-Dermalon, lg. needle8 x 5-0
 sutures-Dermalon, sm. needle7 x 5-0
 sutures-Novafil6 x 4-0
TapeCloth tape2 x 2″ rolls
 Cloth tape1 x 1″ roll
 Dressing tape – Curasilk3 x 1″ rolls
 Heavy duty stretch tape1 x 4″ roll
 Heavy duty stretch tape2 x 3″ rolls
 Leukoplast waterproof5.5 yds x 1″  – 2 rolls
 Paper tape1 x 2″ roll
 Transpore 1/2″ roll2
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