Table of Contents
Chapter 1 Introduction to Nautical Medicine 1
Chapter 2 Patient Assessment 3
Assessment and Care 3
How to Use This Book
Initial Assessment 6
Survey the Scene
Check the Airway and Breathing
Check Circulation
Check for Severe Bleeding
Check the Cervical Spine
Focused Assessment 8
The Physical Exam
General Principles of the Focused Assessment
Vital Signs 9
Level of Responsiveness
Pulse
Respirations
Skin Signs
Blood Pressure
Temperature
Oxygen Saturation
Medical History and Physical Examination 12
Head
Neck
Chest
Abdomen
Back
Pelvis/Hip
Legs
Shoulders and Arms
Chapter 3 Stabilization Of The Patient 15
Shock 15
Difficult Respirations 17
Foreign Body Airway Obstruction
Adult One-Rescuer CPR
Adult Two-Rescuer CPR
Defibrillator
Rapid Breathing
Cardiac Evaluation and Care 23
Heart Attack-Myocardial Infarction
Rapid Heart Rate-Tachycardia
Slow Heart Rate-Bradycardia
Chapter 4 Symptom Management 29
Fever/Chills 30
Lethargy 32
Pain 33
Mild Pain
Severe Pain
Itch 35
Hives 36
Hiccups 37
Headache 37
Chapter 5 Seasickness (mat de mer) and Sopite Syndrome 39
Chapter 6 Eye 45
Eye Patch and Bandaging Techniques 46
Foreign Body Eye Injury 47
Contact Lenses 49
Eye Abrasion 52
Ultraviolet Eye Injury 53
Conjunctivitis 54
Iritis 55
Allergic Conjunctivitis 56
Sties and Chalazia 56
Spontaneous Subconjunctival Hemorrhage 57
Blunt Eye Trauma 57
Glaucoma 58
Chapter 7 Nose 61
Nasal Congestion 61
Nasal Foreign Body 61
Nosebleed-Epistaxis 62
Broken Nose 63
Chapter 8 Ear 65
Earache 66
Outer Ear Infection-Otitis Externa 66
Middle Ear Infection-Otitis Media 67
Foreign Body in Ear 69
Ruptured Eardrum 69
Temporomandibular Joint Syndrome 70
Chapter 9 Mouth and Throat 71
Sore Throat 71
Infectious Mononucleosis 72
Mouth Sores 72
Dental Care 74
Gum Pain or Swelling
Mouth Lacerations
Dental
Pain
Lost Filling
Cavity
Loose or Dislodged Tooth
Pulling a Tooth
Chapter 10 Chest 81
Bronchitis/Pneumonia 81
Pneumothorax 82
Pulmonary Embolus 83
Chapter 11 Abdomen 85
Abdominal Pain 85
Gall Bladder Problems and Appendicitis
Vomiting 90
Diarrhea 90
Constipation 93
Hemorrhoids 93
Hernia 94
Bladder Infection 95
Urinary Retention 96
How to Insert a Foley Catheter
Chapter 12 Reproductive Organs 99
Venereal Diseases 99
Vaginal Discharge and Itching 100
Menstrual Problems 101
Spontaneous Abortion 102
Ectopic Pregnancy 102
Pregnancy 103
Painful Testicle 104
Chapter 13 Poisoning 107
Plant or Food Poisoning 107
Petroleum Products 107
Ciguatera Poisoning 108
Scombroid Poisoning 108
Pufferfish Poisoning 109
Paralytic Shellfish Poisoning 109
Chapter 14 Managing Diabetes 111
Chapter 15 Water Safety, Fluid Replacement 113
Oral Fluid Replacement 113
Water Purification
Drinking Seawater 119
Chapter 16 Soft Tissue Care and Trauma Management 121
Stop the Bleeding 126
Hemostatic Dressings 127
Wound Cleaning 131
Antibiotic Guidelines
Wound Closure Techniques 135
Tape Closure Techniques
Stapling
Suturing
Special Wound Considerations 139
Shaving the Wound Area
Bleeding from Suture or Staple Use
Scalp Wounds 139
Eyebrow and Lip Closure 140
Mouth and Tongue Lacerations 140
Control of Pain
Dressings 141
Abrasions 142
Puncture Wounds 143
Splinter Removal 143
Fishhook Removal 144
Push Through, Snip Off Method
The String Jerk Method
The Dissection Method
Friction Blisters 147
Thermal Burns 148
Human Bites 152
Animal Bites 152
Finger and Toe Problems 153
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
Chapter 17 Orthopedics 163
Muscle Pain-No Acute Injury 164
Muscle Pain-Acute Injury 165
Joint Pain-No Acute Injury 167
Joint Pain-Acute Injury 168
Fractures-Broken Bones 170
Open Fracture
Diagnosis and Care Protocols
Head Fractures-Unconscious 174
Neck
Spine
Collarbone-Clavicle 179
Shoulder 181
Shoulder Blade-Scapula
Upper Arm Fractures (Near the Shoulder) 184
Upper Arm Fractures (Below the Shoulder) 185
Elbow Trauma 186
Forearm Fractures 188
Wrist Fractures and Dislocations 189
Thumb Sprains and Fractures 192
Hand Fractures and Injuries 192
Finger Fractures and Sprains
Hip Dislocation and Fracture 194
Thigh (Femur) Fractures 196
Kneecap (Patella) Dislocation 197
Knee Sprains, Dislocations, and Fractures 198
Ankle Sprains, Dislocations, and Fractures 199
Foot Injuries 200
Chest Injuries 200
Chapter 18 Bites and Stings 203
Anaphylactic Shock 203
Use of Epipen
Snake Bites
Spider Bites 210
Black Widow Spider
Brown Recluse Spider
Ticks 212
Caterpillar Reactions 213
Millipede Reactions 213
Centipede Bites 213
Mosquitoes 213
Black Flies 216
No-See-Ums and Biting Gnats 216
Scorpion Stings 217
Ants/Fire Ants 217
Aquatic Stings, Cuts, and Rash 218
Sea Urchin
Jellyfish 218
Coral Stings 219
Coral and Barnacle Cuts
Stingray
Catfish
Scorpion Fish
Sponge Rash
Chapter 19 Infectious Disease 221
Diagnosis of Infectious Diseases 221
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
Stari
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
Chapter 20 Environmental Injuries 255
Hypothermia 256
Chronic Hypothermia
Acute Hypothermia
Cold Water Submersion
Cold-Stress Injuries 260
Frostnip
Frostbite
Cold-Induced Bronchospasm
Immersion Foot (Trench Foot, Cockpit Foot)
Chilblains
Heat Stress Injuries 264
Dilutional Hyponatremia
Heat Cramps
Heat Exhaustion
Heat Stroke
Prickly Heat
Lightning 270
Ship Damage
Crew Injury
Chapter 21 The Ship's Medicine Chest 277
Alternative Improvisation 280
Lifeboat Kit versus Ship's Medicine Chest 280
Topical Medication and Bandaging Kit 281
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 oz. (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 288
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 291
Doxycycline Tablets (100 mg) (Antibiotic)
Azithromycin Tablets (500 mg) (Antibiotic)
Levofloxacin Tablets (750 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, Anti-Inflammatory)
Tetracaine Ophthalmic Solution (Drops), 0.5%, 15 ml Bottle (Eye and Ear Anesthetic)
Penciclovir (Denavir) Cream, 1%, 5 gm Tube (Antiviral, Tip 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 297
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 298
Aspirin (81 mg Chewable Tablets)
Nitroglycerin Sublingual Tablets (0.4 mg)
Clopidogrel (Plavix) Tablets (75 mg)
Atenolol (Tenormin®) Tablets (25 mg)
Clinical Reference Index 301
About the Author 315
