The medical kits that many boaters take away from the dock are often good for just one thing: leaving you frustrated in a true emergency.

"Have you ever seen these so-called medical kits that they give you when you charter a bareboat in the Virgin Islands?" said Dr. Eric Johnson, a Staff Physician at Teton Valley Hospital, in Driggs, Idaho; past president of the Wilderness Medical Society; a NAUI diving instructor; and a Mount Everest base camp physician. "It's a Mickey Mouse kit with a Scooby-Doo Band-Aid and these tiny little scissors. What are they for? A dollhouse?"

Actually, the most important item you can have onboard in a medical emergency has nothing to do with the medical supplies at all. It is a VHF radio or satellite telephone. No medical kit can be an entire emergency room, and there's no way, even if you're a doctor, that you can anticipate and know how to treat every conceivable injury and illness.

Every boater needs a lot of the same basic items in the crew's medical kit – seasickness pills, antibacterial wipes, bandages and other common materials.Your goals should be to have enough supplies onboard to prevent minor problems from becoming major problems, and to be able to treat low-risk medical problems so that they don't turn into high-risk evacuations. Nine times out of ten, some basic medical knowledge, skills, and supplies, plus a way to contact help, will get the job done.

TWO MEDICAL KITS

Dr. Michael Jacobs, an internal medicine physician on Martha's Vineyard and co-author of "A Comprehensive Guide to Marine Medicine," recommends leaving the dock with not one, but two medical kits: a crew's medical kit for everyday needs to treat common minor medical problems such as scrapes, seasickness, and headaches, and then a ship's medical kit for more serious emergencies that require supplies you don't want the crew rummaging through frequently. Every boater needs a lot of the same basic items in the crew's medical kit – seasickness pills, antibacterial wipes, and bandages – but the contents of your ship's medical kit should be determined by the range of your cruising and communication devices. If you're coastal cruising, you will have a far easier time getting to medical help within 12-24 hours, than if you're offshore – and therefore you don't need to stock the kinds of medical supplies to treat someone onboard beyond 24 hours. This is the major distinction between the "coastal" and "offshore" medical kit. Offshore kits should have supplies for extended comprehensive care.

"When you fit out your ship's medical kit, you have to make selections and decisions," said Jacobs, who spoke at the week-long "Medicine for Mariners and Safety at Sea" conference at The Bitter End Yacht Club on Virgin Gorda in January. "Try to anticipate what's likely to happen where you're going, and who is going to be onboard when those problems might occur."

Common ailments such as sunburn should be accountred for when assembling a kit. Common ailments such as sunburn would dictate including aloe, for example. Common injuries such as bumps and bruises should make you consider ice packs and anti-inflammatory pain medications such as Advil. The number of crew you expect to have with you will determine the quantity of basic supplies, while the preexisting conditions your crew bring aboard with them will dictate specialty needs, such as insulin for diabetics.

INSIDE YOUR KITS

As a guide to start your thought process, Jacobs recommends the following for your crew medical kit:

• Seasickness medication such as Bonine or Dramamine
• Anti-inflammatories and analgesics such as Advil and Tylenol
• Sunburn relief agents such as aloe and hydrocortisone cream
• Materials for care of minor wounds, such as waterproof bandages, antiseptic wipes, and antibacterial ointment
• Nonprescription pharmaceuticals for common ailments, such as antacids for indigestion, Metamucil for constipation, Pepto-Bismol for diarrhea, Sudafed for congestion, and drops for swimmer's ear
• Rubbing alcohol and white vinegar for treating stings by jellyfish and other sea creatures
• For your ship's medical kit, Jacobs recommends thinking about (and talking with your doctor about) the following items. The medications come as pills, drops, and shots that you can learn to administer:
• Prescription antibiotics to help a range of issues, such as Keflex for skin infections, Levaquin for abdominal and other infections, Zithromax for bronchitis and pneumonia, and Ciloxan drops for eye and ear infections.
• Phenergan suppositories for seasickness and vomiting
• Acetaminophen or Oxycodone for pain relief
• Ativan for insomnia and severe anxiety
• Full-size and finger-size Sam Splints

Offshore kits should have supplies for extended comprehensive care.

• High-compression elastic bandages
• Instant cold packs (if you don't carry ice)
• An eye pad for cornea abrasions
• Sterile gloves
• Bandage scissors and waterproof adhesive tape
• Cotton-tipped sterile applicators
• Tweezers and a magnifier to remove shards from open wounds
• Scalpel blade and handle for draining abscesses
• Disposable skin stapler for closing wounds that have been cleaned out
• New-Skin liquid bandages for abrasions and shallow cuts that have been cleaned out
• Silvadene burn cream
• A 20-cc syringe for irrigating wounds, plus safety glasses to prevent irrigation solution (even if it is water) from splashing into your eyes
• Hibiclens germicide to clean superficial wounds
• Sterile gauze dressing pads, and trauma pads, in multiple sizes
• Epinephrine "auto-injector pen" for anaphylactic shock
• Prednisone for severe allergic reactions
• Zyrtec as a non-sedating antihistamine
• Proventil inhaler for wheezing and asthma
• Pregnancy test (to rule out potentially fatal ectopic pregnancies when a woman complains of lower belly pain)
• Wound closure materials such as Dermabond, which is sort of a Super Glue for closing cuts, and wound closure strips, are also on Jacobs' consideration list, but he and Johnson warn that closing a wound can do more harm than good if you don't know how to properly irrigate and clean a wound. You could trap bacteria inside, setting the stage for a severe infection.

One item that has received a lot of attention in the boating press – but that both Jacobs and Johnson frown on including – is a portable defibrillator. As Jacobs explains it, using an AED (Automatic External Defibrillator) is just the first of many steps in the chain of care that has to occur for a patient suffering a cardiac arrest to survive. By itself, an AED is unlikely to save a life on a small boat out at sea, he says.

"I'd rather a boater take that money and make sure all his crew's immunizations are up to date," Johnson says. "Hepatitis A is everywhere, whether you're in the Caribbean or Southeast Asia. You don't know who is going to be cooking your food onshore. And that's something you can do something about."