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It is a scary thought to be all alone on a vast ocean, have an accident or become ill without the possibility to reach help. And that could very well prove the case.

The RORC is the name of a friendly race, every year enabling small boats to sail off together when crossing the oceans. This provides some security. VHF and SSB contacts between boats, some even carrying satellite phones, make it easier to get help or perhaps even get picked up by a nearby freighter if an emergency.

If you sail outside of the RORC time schedule though - as we did - it will be another story. You´ll be alone. Totally.

We met in all two boats on our passage, one that we could chat to on VHF - the other silent. We brought a satellite phone, but the chance of a nearby freighter was obviously nil. Rescue flights won´t reach far out on the ocean. A Satellite phone or a single side-band radio is still helpful though - if only for professional medical assistance.

Fortunately it is rare with sudden illnesses like heart attacks on the ocean. The risk of such seems greater in urban environments.

The medical dangers on the Atlantic will rather be such as man overboard, head injury caused by an unsecured boom perhaps, traumas or sprains, wounds, burns and heatstroke. The minor illnesses and accidents will be sunburn, seasickness, toothaches, cuts and bruises. Common colds and influenza’s don´t exist. There is nobody there to catch it from.

Before departure
Start with getting the right immunizations for your destination. Visit your doctor, tell him of your crossing and get the right drugs. Be sure to understand their dosages and administrations. There are great medical books out there, even specifically on cruising, get at least one and compare your doctor’s advice. You should be able to find one specified for your country, which is great for drug prescription advice. Basically, you'll need a variety of antibiotics, wound care products, painkillers and seasickness drugs. Look especially for books describing trauma procedures, splinting and bandaging, head injury aid, emergency childbirth if pregnant person aboard, poison treatment and lifesaving procedures.

Sometimes, people remove their appendix prior to a passage - but today there are antibiotics that greatly lessen - although not entirely eliminate - the risk of a burst appendix at sea. We kept ours but brought the drugs.

Pay a visit to your dentist - let him/her know of your sailing plans for a complete x-ray and checkup. Toothaches could spoil the whole journey.

A first aid course is also always very valuable - check with your local Red Cross organization before departure. Learn CPR, choking procedures, Anaphylactic shock and general shock treatment.

Check if you are allergic to medicines, insects or foods. Check especially your penicillin tolerance - get its equivalents otherwise and let your friends or spouse know of this allergy. Epinephrine could be brought for Anaphylactic shock, since sometimes reactions can occur to products previously tolerated. Antihistamines such as Benadryl help for lighter allergies. Bee-sting kit (Ana-kit) could also be brought.

Antacids for heartburn could also be handy especially if you are prone to it. Aspirin is mild preventive for heart attacks. Bring multi-vitamins and sunscreens.

On board
Prevent seasickness by staying away from alcohol the day prior to the passage and have a hearty meal with carbohydrates. Eat bread or bananas and take a seasickness drug upon leaving. Ginger is also said to help.

If you do get seasick, stay where the boat is moving least, outside in fresh air, preferably watching the horizon. Get rests and sleep if possible. Seasickness at the Atlantic usually goes away after 1-3 days.

Constipation is best avoided by eating fiber, fruit, veggies and drinking lots of water.

Diarrhea requires high fluid intake, possibly a salt and mineral replacement powder and drugs such as Imodium (the latter as a late resort only - you need to get rid of the evil after all). Store foods well - especially if catching a lot of fresh fish (we consumed ours immediately and dispose of the leftovers). Dispose of everything smelly or otherwise suspected.

Prevent heatstroke by drinking a lot of fluid at all times. (Booze doesn´t count and could even bring it on.) Vigorous exercise and high humidity is sometimes enough for a heatstroke, even at lower temperatures.

Pale and clammy skin, muscle cramps, nausea and headache with weak pulse indicates heat exhaustion. High temperature, hot and dry, reddish skin and rapid breathing, dizziness and nausea all signal a possible oncoming or existent heatstroke. Drink fluid, have salt tablets, sponge or bucket with cold water and cover with cold, wet towels. Fan. Treat this condition with care, it is dangerous.

Prevent heat problems by drinking plenty fluids, eat some salt and check your urine at times - it should be frequent and light.

Burns are a possible threat at sea. Boiling water, strong chemicals and the sun can cause burns of various degrees. First, remember that a major burn; blisters, tissue turning white, gray or black - over a large part of the body or face, is a serious condition and requires professional care swiftly if possible.

Always flush with lots of water - seawater if no fresh is available - after applying cold compresses for not more than 10 minutes. Flush for around 30 minutes - especially chemical burns of the eye. Take a painkiller such as strong Tylenol. Cover the burn with antibiotic cream and apply a sterile dressing. Change once daily and don´t puncture the blisters. The danger is infections and dehydration. Drink plenty.

Note: Never use butter, Vaseline, baking soda or vinegar on burns.

Wound care means stopping the blood flow, cleaning, perhaps pulling tissue ends together and then applying a bandage. Stop all blood flow by applying pressure to the area with a sterile dressing preferably and then a pressure bandage or tape/strip bandages.

Clean with soapy water and treat with antibiotic cream. Change bandage daily and check for infections. If infected (swollen, red, pus, fever) continue to clean, apply the antibiotic cream and take oral antibiotics.

A loose tooth on board should be repositioned or just left alone if not necessary, kept clean by frequent rinses of the mouth and prevented from chewing at hard foods.

If a tooth is broken but only sensitive to cold and hot, just leave it alone. If the fracture is severe, exposing the pulp, it will cause a toothache. Take painkillers such as Tylenol 3, and toothache drops (oil of cloves). If swelling occurs, take antibiotics. Sometimes people cut up the swelled area to empty it. That is dangerous and should only be attempted if the victim is getting a high fever and deteriorating. In this case, make sure to cut only the swelling (soft and moving), with puss coming out. Don´t cut several times where blood flows.

A knocked out tooth can be replanted within 20 minutes. If the tooth needs cleaning - do this very gently in plain water or you will destroy protective substances. Place the tooth in position and hold it there for 30-45 minutes. Take immediately a broad spectrum antibiotics for 10-14 days.

General treatment for sprains and bruises is cold water or ice applied to the area, perhaps a painkiller and rest.

Fractures are a different story. Usually not life threatening, they are painful and not easily diagnosed or treated by an amateur. Usually you will see an obvious deformity, swelling, blackish color and feel severe pain around the area.

There are open fractures and closed fractures. Open fracture meaning an open wound over the broken bone - perhaps with the bone sticking out.

A closed fracture should be relocated back into position (or approximate position) by pulling gently, and then splinted. Various fractures require various splints, check your medical book. Take a painkiller.

An open fracture should first get cleaned with sterile water (water boiled for 20 minutes and cooled), covered with antibiotic cream right into the wound area and then covered with sterile gauze. There after you can try relocation of the bone. Painkiller will be needed and oral antibiotic treatment for 10 days. Dislocations usually occur around a joint as opposed to fractures, even though both can be present at the same time. Try to relocate ("pop" back) gently though, mate! A dislocated shoulder can "hang out" if the person lays face down on a berth, with the arm hanging down and 10-15 pounds of weight in a bucket attached to the wrist. Pad the wrist and the armpit. The muscles in the shoulder will gradually tire out and the spasm decrease, correcting the dislocation.