I wake up confused, not as I first think in my pilot berth, but a bunk on a London bound sleeper train from the Scottish Highlands. Emerging from the kind of vivid dream that’s familiar on ocean passages. A product of interrupted sleep and unusual motion.
After conducting several minor operations on a piece of pork belly over the weekend I am pretty confident that I could staple my bosses gashed leg back together, something the dream entailed, but less so that I could get the associated blood out of the teak. It’s the latter that doesn’t bear thinking about.
I’ve spent a busy four days getting a shock dose of emergency medicine knowledge with Wilderness Medical Training a company that runs advanced first aid courses for travel and adventure. My head is full of drug names I can’t pronounce properly, mnemonics, and a now very solid knowledge of The Bristol Stool Scale. A useful diagnostic indicator.
Whilst a long way from the UK’s sailing grounds, Glenmore Lodge in Aviemoor is a very appropriate venue for this sort of course. The majority of our training is classroom based, but avalanche rescue practice going on outside the window hints at the remote dangers of this area of beguiling beauty. The parallels with ocean sailing are obvious.
My course mates’ backgrounds include an expedition organiser from Kate Middleton’s former school Marlborough College, soon taking a group to Greenland; a recently retired couple planning to circumnavigate by Land Rover, and another Yachting Monthly reader getting ready for one on her yacht. All 24 of us will in the near future be a long way from an A&E department or out of range of the helicopter to get us there.
The objective of the training is to empower us to do much more than we otherwise could for those in our care or, quite possibly, ourselves. It is an exercise in needs must and throughout the course there are minor epiphanies of understanding that make me realise that far more ￼is possible than I first thought, even far offshore. There is measured enthusiasm from the instructors for getting stuck in and doing something, in a medical situation far from help, things are often worth trying.
Dr Harvey Pynn, WMT’s Training Director is someone that expounds pragmatism. He is a veteran of expeditions to far flung places as well as A&E departments so imparts acquired experience and the latest thinking in equal measure. The course and accompanying manual, he explains, are constantly evolving. Techniques included are a carefully considered skill set, designed to be grasped in four intensive days. The material comes thick and fast. I fill a small notebook.
Intravenous (needle into vein) giving of fluids isn’t covered as it’s challenging to master without regular practice, but subcutaneous giving (a small needle under the skin) is. The simplicity of the latter technique, which I’d never heard of before, becomes obvious when it’s demonstrated. A butterfly needle feeds fluid under the first layer of soft skin to rehydrate the patient. It could be a lifesaver that I would feel surprisingly comfortable putting into practice if I had to. Intra-muscular injections, a personal dislike, are also taught.
Venturing into highland snow outside the classroom, we practice putting traction on broken legs, and a couple of techniques to put dislocated shoulders back where they belong. There is a mix of practical trauma exercises, medical techniques, and theory. The latter is a surprising proportion of the course content. Far from help, we learn it will often be drugs that make the difference, and are taught the basics of a broad range of them.
Technology and medicine go hand in hand, so the discussion about the equipment at our disposal is almost constant. I asked Harvey how much his own medical kit weighed on expeditions, the answer was revealing, ‘not more than a kilogram, most of that is drugs.’ Whilst on an offshore cruising yacht weight is not such a concern, the adage knowledge weighs nothing appears to hold a lot of truth in far from help medicine.
￼The satellite phone is a game changing addition to a yachts medical arsenal. For sailors, the Coastguard should be the first port of call for help as they will put you through to a duty doctor. We are reminded though that satellite email also gives the capability to send pictures, enormously useful in aiding diagnosis and treatment with professional help. To join a course like this and leave with a Heath Robinson view of fixing people up by hook or crook is to have got the wrong end of the stick. It is a course that combined with the right drugs and equipment, revolutionises the level of medical safety on board a yacht venturing far from home waters. The addition of a satellite phone can further enhance this capability.
The course ends with a discussion on the limits on what we have been taught. Access is given on completion to a range of prescription drugs for use on trips abroad far from help. For me this is crucial. I can now equip the boats I skipper with appropriate drugs and equipment, with the support of people who understand the environment I might have to use them in. What’s more, I’ve gone a long way to curing my phobia of needles, though not the Bristol Stool Scale, the nine stages of which are etched on my mind like Beaufort’s. It’s something you only have to see once.