Comprehensive Offshore Medical Kit
The further you sail from shore, the more self-sufficient you must become. A cut hand or raging toothache that is merely inconvenient in coastal cruising can be mission-critical hundreds of nautical miles from help. The purpose of this guide is to expand our standard near-shore first-aid list into a true offshore medical locker—robust enough for passages measured in days or weeks, yet still compact and organised enough to live neatly on a performance-minded yacht.
1. Scope and Philosophy
Offshore medicine focuses on stabilisation and prolonged care rather than quick symptom relief alone. Choose medications and equipment that address:
- Trauma and haemorrhage
- Infection control
- Pain and inflammation
- Gastrointestinal disturbances and dehydration
- Allergic and anaphylactic reactions
- Respiratory emergencies
- Dental issues
- Chronic condition flares (e.g., asthma, hypertension)
Every skipper should match the kit to crew competence, underlying health issues, and the nearest realistic rescue window.
2. Medications
2.1 Analgesics & Anti-Inflammatories
| Purpose | Drug | Offshore Dose Notes |
|---|---|---|
| Mild–moderate pain, fever | Paracetamol 500 mg tablets | 1–2 tabs q4–6h; max 4g/24h |
| Anti-inflammatory, musculoskeletal pain | Ibuprofen 400 mg tabs | 1 tab q6–8h with food |
| Severe pain | Tramadol 50 mg caps (Rx) | 1 cap q6h PRN; carry antiemetic |
| Severe pain adjunct | Codeine phosphate 30 mg (Rx) | Contributes to constipation—balance with laxatives |
2.2 Antibiotics (Prescription-Only)
| Likely Condition | First-line | Alternative | Course |
|---|---|---|---|
| Cellulitis / infected cuts | Amoxicillin-clavulanate 875/125 mg | Doxycycline 100 mg / Cephalexin 500mg | 5–7 days |
| Urinary / gastro infections | Ciprofloxacin 500 mg | Trimethoprim-sulfa DS / Levofloxacin 500mg | 3–5 days |
| Respiratory infections | Levofloxacin 500mg | Azithromycin 500mg | 5-7 days |
| Dental abscess | Metronidazole 400 mg + Amox-clav | — | 5 days |
| Seasicker vomiting + aspiration risk | Azithromycin 500 mg | — | Single dose |
| Severe systemic infections | IM/IV antibiotics (advanced) | — | As directed |
Tip: Carry printed dosing sheets saved in a zip-lock inside the drug bag.
2.3 Allergies & Anaphylaxis
- Cetirizine 10 mg or loratadine 10 mg tablets
- Prednisolone 25 mg tabs (taper pack)
- Epinephrine auto-injector 0.3 mg — two per kit for redundancy
2.4 Gastrointestinal & Dehydration
- Oral Rehydration Salts (ORS) — at least 20 sachets
- Ondansetron 4 mg ODT (Rx) for refractory nausea
- Loperamide 2 mg caps
- Proton-pump inhibitor (omeprazole 20 mg) for acid control
2.5 Respiratory & ENT
- Salbutamol inhaler with spacer
- Prednisolone as above for asthma flares
- Phenylephrine nasal spray for barotrauma prophylaxis
2.6 Motion Sickness (Enhanced Coverage)
| Medication | Type | Notes |
|---|---|---|
| Scopolamine patches (Transderm Scop) | Prescription | Most effective for offshore; 3-day duration; test on shore first |
| Meclizine 25mg | OTC | Less sedating than dimenhydrinate |
| Ondansetron 4mg ODT | Prescription | Already listed above; excellent for nausea |
| Promethazine suppositories | Prescription | When oral medication can't be kept down |
| Dimenhydrinate (Dramamine) | OTC | Traditional option; shorter duration |
Note: Experts recommend having at least 3 different seasickness remedies onboard, as individual responses vary significantly.
2.7 Eye Care & Topical Antibiotics
- Ciprofloxacin 0.3% eye drops (for eye infections/injuries)
- Steroid eye drops (prednisolone acetate 1%)
- Mupirocin antibiotic ointment (for minor wounds)
- Polymyxin B/neomycin/hydrocortisone ear drops
2.8 Chronic Condition Resupply
Maintain two passage lengths of routine medications (BP meds, thyroid, insulin, etc.) plus a dated spreadsheet of crew prescriptions.
2.9 Personal Crew Medications & Allergies
This is often the most critical section - crew members without their essential medications can face life-threatening situations offshore.
Essential Documentation
- Complete medication list for each crew member (names, dosages, schedules)
- Known allergies and adverse drug reactions for each person
- Emergency contact information for each crew member's doctors
- Copies of all prescriptions (physical and digital)
- Medical history summary for each crew member
Chronic Condition Medications
| Condition Category | Typical Medications | Offshore Considerations |
|---|---|---|
| Cardiovascular | Blood pressure meds, heart medications, blood thinners | Critical - carry 3x passage length minimum |
| Diabetes | Insulin, metformin, glucose testing supplies | Refrigeration needs, extra supplies essential |
| Thyroid | Levothyroxine, methimazole | Long shelf life, but critical for function |
| Asthma/COPD | Inhalers, nebulizer medications | Carry multiple backup inhalers |
| Mental Health | Antidepressants, anxiety medications | Sudden discontinuation dangerous |
| Epilepsy | Anti-seizure medications | Extremely critical - never run short |
| Autoimmune | Immunosuppressants, steroids | May require special storage |
Example: Allergy Management by Crew Member
| Crew Member | Known Allergies | Emergency Medications | Avoidance Notes |
|---|---|---|---|
| Skipper | Penicillin, shellfish | EpiPen × 2, Benadryl | Alternative antibiotics required |
| First Mate | Bee stings | EpiPen × 2, Prednisone | Carry sting kit |
| Crew 1 | None known | Standard antihistamines | — |
| Crew 2 | Latex | Nitrile gloves only | All medical supplies latex-free |
Personal Medication Quantities
Minimum Recommended:
- Passage length × 2 for all essential medications
- Passage length × 3 for life-critical medications (insulin, heart meds, seizure meds)
- Extra 30-day supply for unexpected delays or diversions
Special Storage Requirements
| Medication Type | Storage Notes |
|---|---|
| Insulin | Requires refrigeration; carry cooling packs and backup supplies |
| EpiPens | Temperature sensitive; store in insulated case |
| Suppositories | Cool, dry storage; may melt in tropical heat |
| Liquid medications | Secure against breakage; consider powder alternatives |
| Controlled substances | Locked storage; carry prescription documentation |
Emergency Backup Plans
- Lost medication overboard: Identify which crew member can share safely
- Medication deterioration: Know signs of degraded medications
- Missed doses: Protocol for each critical medication
- Medical emergency: Which medications may interact with emergency treatments
3. Equipment & Consumables
3.1 Trauma Care
| Item | Quantity | Notes |
|---|---|---|
| CAT-style tourniquet | 1 | For severe extremity bleeding |
| Israeli pressure bandage 4 in | 2 | Can double as splint wrap |
| Haemostatic gauze (QuikClot) | 2 | Store in vacuum pouch |
| Sterile gauze pads 10×10 cm | 20 | — |
| Triangular bandage | 2 | — |
| SAM splint 36 in | 1 | — |
| Steri-Strips 6 mm × 75 mm | 4 packs | — |
| Suture kit + 1% lidocaine ampoules | 1 | Training required |
3.2 Diagnostics
| Item | Notes |
|---|---|
| Digital thermometer | Essential for diagnosis |
| Digital BP monitor | With extra batteries |
| Finger pulse oximeter | — |
| Stethoscope | For respiratory/cardiac assessment |
| Glucose meter & test strips | — |
| Pen torch/flashlight | For pupil examination, wound assessment |
| Urine dipsticks | For UTI, dehydration assessment |
| Otoscope/ophthalmoscope pocket set | Optional but useful |
3.3 IV Fluids & Advanced Hydration
| Item | Quantity | Notes |
|---|---|---|
| Aqua-C subcutaneous IV system | 1 kit | Easier than traditional IV; for severe dehydration |
| Normal saline IV bags (1000ml) | 2-4 | For severe dehydration cases |
| IV administration sets | 2 | If carrying IV fluids |
| Angiocatheters (18G, 20G) | 2 each | For IV access |
| Sterile syringes (various sizes) | 10 | 3ml, 5ml, 10ml, 20ml |
| Sterile needles (various gauges) | 10 | 18G, 22G, 25G |
Important: Only carry IV equipment if crew is trained in its use. Consider subcutaneous hydration (Aqua-C) as safer alternative.
3.4 General First-Aid Staples
- Waterproof adhesive dressings (assorted)
- Cohesive self-adhering wrap 5 cm × 4 m
- 25 mm waterproof tape
- Trauma shears and fine splinter tweezers
- CPR face shield / pocket mask
- Instant cold packs × 2
- Eye wash bottle 250 ml + eye pad dressings
- Dental temporary filling material
- Irrigation syringe 20 ml + saline ampoules 30 × 20 ml
3.5 Hypothermia & Heat Illness
- Emergency blankets (space blankets) × 2
- Chemical heat packs × 4
- Instant cold packs × 2
- Electrolyte replacement powder/tablets
3.6 Support & Reference
- Waterproof copy of Marine Medicine or Ship Captain's Medical Guide
- Satphone or HF radio with stored emergency medical numbers
- Flash drive with PDFs of drug monographs, downloaded for offline use
3.7 Advanced Emergency Equipment (Large Vessels/Extended Voyages)
- Automated External Defibrillator (AED)
- Portable oxygen cylinder with delivery masks
- Demand-valve oxygen mask (for dive operations)
- Emergency surgical airway kit (advanced training required)
4. Organisation & Storage
Two-Tier System
Day Kit: Soft pouch with basic dressings, analgesics, motion sickness tabs—lives near the companionway.
Master Locker: Hard, gasket-sealed case stored low and amidships. Inside, use colour-coded dry-bags:
- Red: trauma
- Blue: general medications
- Green: diagnostics
- Purple: personal crew medications (clearly labeled by person)
Personal Medication Organization
- Each crew member's medications in separate labeled pouches
- Waterproof medication schedule cards for each person
- Emergency medication summary sheet (allergies, critical meds, dosages)
- Store crew medications separately from general medical supplies for quick access
Inventory Control
- Attach an index card to each bag with contents and expiry date
- Log usage immediately in the maintenance notebook or app
- Re-stock at 50% depletion or before any ocean crossing
5. Training & Tele-Medical Support
A comprehensive kit is only as effective as the hands that wield it. At least two crew should hold:
- RYA/MCA Medical A or STCW Medical Person in Charge certificate
- Recent CPR/AED qualification
- Practical suturing and injection workshop
Pre-Departure Medical Planning:
- Schedule consultations with each crew member's primary care physician
- Obtain extended prescriptions for all personal medications
- Review medication interactions with emergency treatments
- Create medical summary cards for each crew member
- Ensure all crew have recent medical and dental checkups
Register your vessel with a 24/7 tele-medical provider (e.g., TMAS, MedAire). Store phone instructions and patient questionnaire forms inside the lid of the medical locker.
6. Maintenance Schedule
| Interval | Task |
|---|---|
| Before each passage | Check quantity/expiry of EpiPens, tourniquet, haemostatic gauze, prescription meds, and all personal crew medications |
| Every six months | Full inventory audit; replace sun-exposed creams, batteries; review personal medication needs with crew |
| Annually | Renew ORS, sterile saline, motion-sickness meds; run first-aid drill with crew; schedule crew medical checkups and prescription renewals |
7. Customising for Your Crew & Region
| Region/Activity | Additional Items |
|---|---|
| Tropical routes | Broad-spectrum antimalarials, high-SPF zinc-based sunscreen |
| High latitude | Additional frostbite dressings, extra chemical heat packs |
| Dive-heavy itineraries | Oxygen cylinder and demand-valve mask |
| Crew considerations | Adjust drug quantities for children or weight-based dosing |
8. Cost Analysis: Building a Comprehensive Offshore Medical Kit
Pre-Built Professional Kits
| Kit Level | Product | Price Range | What's Included |
|---|---|---|---|
| Basic Offshore | Adventure Medical Marine 600 | $220-280 | 8-person crew, 12 hours from care |
| Advanced Offshore | Adventure Medical Marine 3000 | $795 | Large crew, 24+ hours from care |
| Professional Grade | Ocean Medical International Class A | $4,840 | MCA/STCW compliant with prescriptions |
| Mid-Range Complete | Fieldtex Trans-Ocean Pak (hard case) | $1,129 | Good base requiring medication additions |
Build-Your-Own Comprehensive Kit
Essential Components Cost Breakdown:
| Category | Items | Estimated Cost |
|---|---|---|
| Storage System | Pelican waterproof case + organization bags | $150-300 |
| Basic Medical Supplies | Bandages, gauze, tape, splints, instruments | $200-350 |
| Over-the-Counter Medications | Pain relievers, antihistamines, motion sickness | $100-150 |
| Prescription Medications | Antibiotics, pain meds, emergency injections | $300-600 |
| Diagnostic Equipment | BP monitor, thermometer, stethoscope, pulse ox | $200-400 |
| Advanced Trauma Supplies | Tourniquets, hemostatic gauze, suture kits | $150-250 |
| Personal Crew Medications | Extended supplies for each crew member | $200-500 |
| IV/Hydration Equipment | Aqua-C system, IV fluids, administration sets | $100-200 |
| Reference Materials | Medical guides, emergency cards | $50-100 |
Build-Your-Own Total: $1,450-2,850
Real-World Example
Experienced offshore sailors spent $1,365 for their comprehensive DIY kit in 2023, which included most items from this enhanced guide.
Additional Costs to Consider
| Item | Cost | Notes |
|---|---|---|
| Medical Training | $300-800 | Offshore medical course for 2 crew |
| Prescription Consultations | $200-500 | Doctor visits for medication prescriptions |
| Telemedicine Service | $200-400/year | 24/7 maritime medical support |
| Annual Restocking | $200-400 | Expired medications and supplies |
Cost-Effective Recommendations
Budget Approach ($800-1,200)
- Start with Adventure Medical Marine 3000 ($795)
- Add prescription medications ($300-400)
- Enhance with personal crew medications
Comprehensive Approach ($1,400-2,000)
- Build custom kit with quality components
- Include all enhanced items from this guide
- Focus on crew-specific medical needs
Professional Approach ($2,500-5,000)
- Commercial-grade kit with full prescription coverage
- Professional medical consultation and training
- Advanced equipment for extended voyages
Money-Saving Tips
- Buy in bulk - Many items come in larger quantities than needed
- Generic medications - Significant savings over brand names
- Check insurance coverage - Some prescription costs may be covered
- Annual restocking - Replace expired items strategically
Bottom Line
For a comprehensive offshore medical kit starting from scratch, budget $1,400-2,000 for a well-equipped system covering all scenarios in this guide. This investment represents excellent value compared to other safety equipment costs and could save lives during extended offshore passages.
The key is matching your kit complexity to voyage length, crew size, distance from help, and medical training level.
9. Important Medical Notes & Warnings
Scopolamine Patches
Scopolamine patches are highly effective for seasickness but can cause serious side effects including hallucinations, confusion, blurred vision, and severe withdrawal symptoms. Test patches on shore before use, and be aware that side effects can include dry mouth, drowsiness, and disorientation. Do not consume alcohol while wearing the patch.
IV Fluids & Advanced Procedures
IV equipment should only be carried if crew members are properly trained in its use. Consider subcutaneous hydration systems (Aqua-C) as a safer alternative to traditional IV access. Intramuscular injections are recommended over IV while sailing as they're easier to administer in a moving environment.
Training Requirements
Advanced medical training is essential for anyone carrying comprehensive offshore medical equipment, especially for extended ocean voyages. At least one crew member should be competent in advanced first aid and able to stabilize serious injuries until professional help arrives.
10. Conclusion
Long-range sailing demands a mindset shift from evacuate to stabilise and treat. Investing in a well-curated offshore medical kit—and the training to match—turns minor emergencies into manageable inconveniences and buys vital time when minutes stretch into days. Equip thoroughly, review regularly, and sail beyond the horizon with confidence.
Recent Updates Based on Current Best Practices
This guide has been enhanced with additional items commonly recommended by offshore sailing experts and medical professionals:
- Personal crew medications and allergy management - often the most critical aspect of offshore medical planning
- Enhanced seasickness medications including scopolamine patches, multiple backup options
- Critical diagnostic tools including thermometer, stethoscope, pen torch, and urine dipsticks
- Advanced hydration systems including subcutaneous IV options for severe dehydration
- Expanded antibiotic coverage including broader-spectrum options
- Eye care medications for infections and injuries
- Hypothermia/heat illness supplies for extreme weather conditions
- Advanced emergency equipment for extended voyages and larger vessels
Remember: The most common medical emergencies offshore often involve crew members without access to their regular medications. Plan accordingly.
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