The Offshore Voyaging Reference Site

A Good First Aid Kit

Our new-to-us J/109 came with pretty much zero safety equipment. A couple of old, out of date, and under-recall, dry-powder fire extinguishers; an old horseshoe life ring, with no line or dan buoy; and a box of dried-out bandaids.

That was pretty much it, so we are faced with starting from scratch on safety equipment. No bad thing since other people’s safety equipment buy decisions can be, shall we say, interesting.

One of the first things I dug into was selecting and sourcing a good first aid kit, since I have hurt myself enough times (yeah, I’m clumsy) to know that even inshore and close to help having the right gear (along with training) is vital.

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Alan Sexton

Hi John,
once again in NZ the safety rules are prescriptive on the minimum medical stores to be carried. You can see the lists in Appendix 1 Medical Stores, page 106 here
I expect in general the packs offered by Adventure are very similar. Of special note in the NZ Regs is the list of prescription drugs to be carried for Cat 1.
A couple of other thoughts, I attended a first aid course run by and ER Doctor/Sailor. He strongly advocated carrying a couple of the Israeli Army all purpose bandages, along with a skin stapler.
Another experience offshore sailor said to make sure you have a packet of drinking straws, he had an experience where a crew member copped a mouthful of boom and could only take liquids through clenched teeth!

René Bornmann

Just as an addition to the Adventure Medical Kits, a German supplier who offers kits very much like you presented. Site unfortunately only in German.
Their kits have a great reputation amongst sailors in Germany.

Jo Blach


Thank you for the link. I was about to ask for a continental European alternative. Not everyone is coming from a place where opiates is sold like sweets in family-packs. Seadoc looks like what I was looking for. Does anyone know how their training is.

Michael Lambert

I can recommend the WFR course at SOLO in NH, USA. Also, I recently took my 8yo into the er for stitches but instead they used 3M steri strips. They’re like narrow fiber-enforced packing tape but with a porous membrane, so glue (super or otherwise) can go through and bond everything together, and his gaping wound was healed before it wore out. The doc gave me the remains of the package and it went straight into my kit, but it’s actually easy to find despite not having seen it before.

Arne Mogstad

Hi, yes strips are great, they’re easy and pretty painless to put on. “Normal” wound/dressing tape or sports tape also work and I regularly use it myself at work (I’m an anesthetic nurse and paramedic on air and car ambulances). The issue with tape and strips is the fact that they don’t adhere do the skin always. If it’s very cold or hot, bloody, wet, greasy skin… all often present in a pre-hospital setting. Also if they don’t close the wound up properly and it open up again after some hours, you’re almost back to square one in the healing process.

In conclusion, they are great as an addition when possible to use them, but sutures and/or staples should definitely be part of the tools.

Richard Camp

a couple of the you tube channels did sessions on this – o’kelly, happy together, and Sophie or Ryan and Sophie got a major burn from a coffee pot and you see the after math. The summary from all if you need to be able to do major first aid on your own. Help is usually days away!
There’s usually first aid courses for major injuries available if you look.
A sobering stat is that 95+% of patients with heart attacks die when there’s no defib around/ Mouth to mouth and chest massage barely help

Arne Mogstad

Great article, and I would just like to reinforce the importance of training! For non-professionals it’s almost impossible to get any experience in first aid (luckily?). And not all training is the same! Training on the level using live actors with makeup and actual exercises is highly preferable! And going through some medical conditions as well, and not only trauma, even though trauma is the “sexiest” and highly emphasized on those courses.

Further, the more of learn and know, the less equipment you need. Or put another way, more equipment is NOT a substitute for training. You’d be surprised to learn how little we actually have with us in the ambulances and helicopters.

The ready kits can be great, but personally I prefer to kit them out myself, as I then get items that I know, and can easily supplement and replace as they expire. Just mentioning as a viable alternative.

And a last note, don’t let the first aid kit be one of those special things you never use unless there’s a disaster! Take it out and open it regularly, open items and look at and use them (just replace them as nescessary). Keep items you’re likely to need often in the medical kit, so you don’t get “afraid” of it.

Blake Redding

An essential tool for medical emergencies is communication equipment and knowing how to use it to get in touch with doctors. If you are going out of cell phone and VHF range a satellite phone is a necessity.

Morgan Henry

We worked with a pharmacy in Seattle before we went cruising. They have serviced the commercial fishing industry for decades and based their kits on their feedback, but then tailored a kit to our needs – size of crew, where we intended to cruise and for how long. We also took a maritime first aid course that is set up for the maritime industry. It was focused on the sorts of injuries experienced at sea on commercial vessels. From the kit, antibiotics were the most used item. This was the group in Seattle: I like the approach of the kit you recommend – having categories, clearly labeled would help get the right supplies for the situation at hand.

William Murdoch

A doctor sailing with us in the Bahamas suggested QuikClot for uncontrolled bleeding.

We added it to our kit

Rob Thompson

Being clumsy from time to time affords me the opportunity to check on my wound healing abilities, and over the years it’s become obvious things are slowing down a bit.

Last year I sustained yet another self inflicted “accident” wound of concerning proportions on my left arm. Took a good chunk out of it, and pretty deep through the skin and into muscle.

The wound nurse put me onto a wound healing gel product called Solosite, marketed in Australia.

What marvellous stuff! The relevance for cruisers is it does several things at once to promote wound healing without frequent dressing changes.

After stopping the bleeding with local compression, you flush the wound with clean water, and/or antiseptic liquid if there is suspected contamination that could lead to infection, then put a generous amount of Solosite gel into the wound, cover it with a waterproof bandage….and leave it alone. For quite a long time, ie several days to a week. Monitor for infection, redness around the wound etc etc.

I was astonished at the rapid healing that this stuff promotes, in comparison to my previous wound experiences. It earned a spot in our medkit, especially for cruising tropical waters where wound infection seems to occur so easily. Hope that helps.

Rob Thompson

Hi John,

Yes I hope so. It’s a good addition to a kit for any wound greater than a bandaid type cut or scrape.

Michael Feiertag

For anything longer than a day trip, each person on board should provide a written health summary to be held by the skipper in a place known to all crew. The medical kit would be a good location. Each person’s record can be in a sealed envelope to be opened in case of emergency, in order to provide some measure of privacy. Especially if the kit contains medicines, non-prescription or prescription, particularly antibiotics or pain relievers, you should have at a minimum a record of allergies to medicines and a list of current medicines (prescription and non-prescription) for each person. It is easy to compound a problem or add new ones with medicines. Even if crew does not fully appreciate the information in the medical record, health providers on scene or in communication may find it invaluable.

I think the record should be on a form created by the skipper; it will then be identical in format and familiar to the skipper for each crew. Ideally it would be reviewed by skipper with each person before sealing, although it could be submitted already sealed for privacy. Skipper and crew should consider how much safety they are willing to risk in the name of privacy, in the context of small vessel offshore sailing. The record should include: date created, name, date of birth, allergies to medicine and reaction, other allergies, current prescription medicines, current non-prescription medicines, current medical conditions; optionally list past medical conditions and past surgeries; contact info for relevant doctors; contact info for family or friend.

Michael Feiertag

I’m with you regarding personal responsibility and not parenting crew, and delegating health officer work if possible. However, an ill or injured person may not be able to communicate their current meds, allergies to meds, or medical conditions; if they can, you must remember or record it, and share it with any co-treaters. A prior record serves these purposes. And if the medical kit contains medicines, you should at least know allergies and current meds before administering meds. And adminstering meds raises the importance of having epinephrine available.

Also, some crew might take unwise risks with their personal health related to a voyage (or not appreciate the demands of the voyage), and as skipper I may not be willing to share that risk. I suspect that compared to you, some of us are more likely to have crew prospects that do not appreciate the rigors of the trip, the remoteness, the limitations on communication, and the associated amplification of health risks. Personally, as skipper, I am ok with a known health risk in a crew member, providing I have a health record and a mutually informed decision.

I think a health record can reduce the likelihood of a medical incident and improve the safety of treating one.

Please believe that I have tried to not belabor this issue.

Eric Klem

Hi John,

Good but also tricky subject. I did land based volunteer search and rescue for several years and I can confirm that there are widely differing opinions on what to carry. Since the most training I ever had was the very good 72 hour Wilderness First Responder cert, I never did more than very basic first aid as there was always a paramedic, ER doc or someone like that around. As a result, the gear I carried was mainly targeted at life and limb injuries as we did a lot of miles carrying stuff. I still keep a relatively basic kit but it has definitely grown over the years.

Your post got me thinking about the various first aid that I have rendered over the years and most of it was actually part of my own adventures and not associated with SAR work. I was surprised at how many serious incidents requiring first aid I could think of off the top of my head. I don’t have nearly enough experience to draw any real conclusions on what is common but my own experience has included a really broad range of issues. I do know that for me, I am much more comfortable with the obvious diagnosis type injuries like a dislocated shoulder rather than the tricky ones which need medicine to treat.

When I worked on boats commercially, the thing that stood out to me was how important medical history is and how poorly many spouses know it. I can remember 3 distinct instances of having an unconscious patient where there was no obvious cause but I suspected the person was on serious meds. In 2 cases, the spouses stated that they were on no meds and in the other case, the person was alone. In all cases, I sent a crew member to go through the person’s belonging which is not popular and in all cases, we found quite the array of pretty serious meds. All 3 people turned out okay but we nearly lost one who had double dosed themselves on blood pressure meds and another got medevaced but in all cases, I lost a lot of time trying to figure out what I was dealing with. I have also run into multiple occasions of people not having meds with them, in the 3 instances where I have administered epinephrine, only once was it with the persons own epipen, in 2 other cases I got to try my hand at our med kit’s syringes. I did notice that the kit you link to has diphenhydramine which is an important part of anaphylaxis treatment but not epinephrine so this is something that people would need to think about whether they need to add. Now, whenever doing more extended trips with guests, we write down all meds and any important medical history and put it with the first aid kit, I would also recommend this if you have a spouse or immediate family who is on anything more than something like a generic allergy med. Maybe not strictly part of a med kit but I have come to think of it as part of it.

One very cool experience I had in grad school was that the SAR team got invited to a talk by a doc at the local hospital and then got to meet with him afterwards. As he was giving the talk, he started to describe sending instructions to a solo Russian sailor with an infected elbow. Of course, I immediately recognized this as being from the 1998 Around Alone and it was very neat to hear his side of the story. Learning a bit more about Dr. Daniel Carlin, he runs an organization called World Clinic ( that I believe really is intended to provide fairly comprehensive medical care remotely including providing the supplies. When this sort of thing makes sense to get involved with, I don’t know but depending on the cost, I can see this sort of thing making a lot of sense for voyagers.


Eric Klem

Hi John,

Interesting, I didn’t know the EpiPens were only good for a year as we have always used syringes and vials as Paul recommends below. I do remember plenty of debate among the doctors doing SAR about how long epinephrine was good for and opinions ranged from the people who won’t even let items go to the expiration date to as long as it hadn’t turned cloudy.

I don’t know what the solution to the history and meds question is, especially in a case where there are paying guests. I think in the context of a friends trip your suggestion of a health officer could make sense although you would likely need to provide a written list of responsibilities for the position. It may also be a good time to try to get another crew member up to some level of first aid like WFA so it isn’t another one of those things that only the skipper can do.


Charles Starke MD

Hi John
I was ship’s physician on 44 commercial cruises (my vacations) around the world in addition to my medical practice and sailing my own boat. I hold a USCG captain’s license with all safety, STCW ‘95 and Medical Person in Charge endorsements so I looked official.
I recommend several things to my friends. A good course with some experience is the best teacher. There are several texts that are downloadable from the web and easy to keep stored on a computer. Notably:

The Ship’s Medicine Chest and Medical Aid at Sea
The US Navy diving manual is also downloadable and has an excellent appendix on marine poisoning and envenomation.

Stugeron is frequently mentioned for sea sickness but many people get headache and nauseous on this. The US Navy studied common medications (like Bonine, etc.) and compared them to Phenergan (promethazine) by doing loops with a volunteer on a plane. Most common meds got the volunteer to 15-20 loops before a “whooops”. With Phenergan, the volunteer made it to over 100 loops, and that’s what the astronauts use. Common side
effect is sleepiness so I recommend starting it the night before and then switching to the Trans-Derm scopolamine patch. Both are only by prescription.
Injectable epinephrine is always a good idea for serious allergic reactions. This could be life saving.
I also recommend super glue for small cuts, a skin stapler and remover, and Steristrips and clozex medical strips, all for simple wounds. A friend called me by sat phone from the middle of the Atlantic when a crew almost cut a finger off. I told him to use super glue and a splint and bandage. It healed.
I fell down the stairs sailing out of Bora Bora and used the stapler myself for a wound on my leg. Luckily I had the help of a veterinarian. When I got home, I started to grow a grey coat and a tail and everyone called me a complete ass. But the laceration healed.

Best wishes,
Charles L Starke
s/v Dawnpiper

Paul Padyk

Hi John,
30 years an ED doc and more adventuring in the backcountry. My backcountry kit covers things that are life threatening but readily treatable. I agree with Charles that epinephrine is a life saving drug for someone with anaphylaxis and is the only drug that reverses anaphylaxis. Worth carrying if there are folks on the boat who have had anaphylaxis. I carry a tourniquet because sometimes direct pressure and elevation of a wound won’t stop bleeding, especially when an artery in the arm or leg is cut. Tourniquet use requires some education but it’s not hard. It is useful even several hours out at sea and will make a difference for the unlucky person with an arterial bleed. For coastal sailing, antibiotics are a waste of space in my opinion but off shore could be useful. Opioids are very effective for painful injuries as you know and whether to use them depends on the situation. For those folks with an isolated limb injury without a head injury, opioids are compassionate and safe when used as directed. There is only one use for the pocket rescue breathing mask I can think of and that is to support someone struck by lightning. In that case, because lightning is DC current, the heart usually restarts on its own but the respiratory center in the brain gets stunned and can take some time to start spontaneous breathing again. Rescue breathing until the brain wakes up can be life saving assuming there aren’t other severe injuries from the strike or associated trauma. Regarding the defibrillator, it could be useful to fix ventricular fibrillation from an AC electric shock, or for certain causes of sudden cardiac arrest but as your friend suggested, such patients then need to be moved rapidly to higher level care. Performing chest compressions for any extended period of time is ineffective. It would certainly be a reasonable choice to say that when such a catastrophic event as cardiac arrest occurs for any reason, the unfortunate person has found a beautiful place on the ocean to begin his/her next adventure.

Arne Mogstad

No, a torniquet can be used for a short amount of time (minutes, to hours) while stuffing, compressing and whatever else techniques you use to control the bleeding. And then you release the torniquet. If you did a good enough job controlling the bleeding, then all is fine. If not, you just tighten and stuff more into the laceration, release and see if it hold thus time. Are you still unsuccessful, you can still leave the torniquet on for as long as possible, giving the wound time to heal itself as much as possible to stop the bleeding, and by the time you release the torniquet, the body (in combination with your dressings) may have stopped the bleeding.

If everything fail, you can leave the torniquet on indefinitely, although after a good hour or two the pain from the distal ischemia is so severe that even patients under deep anesthesia get elevated blood pressure. To buy time you can release the torniquet a bit every hour or so, giving some circulation.

This is worst case scenarios, but some imagination and a practical/pragmatic approach can go a long way.

In summary, a torniquet is a great tool that dies in no way imply sacrificing a limb. It gives you time to stop the bleeding and deal with other pressing issues (like the mast that came down and cut the leg open?)

Paul Padyk

Another point about epinephrine: yes, the epipen is very expensive but for those people who carry epinephrine because they have had a severe allergic reaction, it is far cheaper to get a multi-dose vial of 1 mg/ml or 1:1000 epinephrine. For example, a quick review on a common professional drug information site shows that an average epipen with likely 2 doses costs $78 – $156, while epinephrine 30 ml costs $9 – $17 before pharmacy mark up. 30 ml is equal to 60 – 100 doses of epinephrine for allergic reactions. Just like an epipen, a multi dose vial requires a prescription. It also requires some knowledge, again easy to learn, about how to draw up the correct amount of epinephrine. This is a skill I believe anyone who fastidiously manages a sailboat on the ocean can learn.

Arne Mogstad

A lot of talk about the epinephrine. I work with anesthesia as well as prehospital (ambulances, heli rescue etc), and it’s a drug we ALWAYS have, but use incredibly rarely. So rarely in fact that I have to look up the dosing etc every time! And I pop and mix 20-50 ampoules of various drugs every day…. I have more cardiac arrests than I have the need for epinephrine.

This tells me two things:

– The likelihood you’ll need this drug is very slim (without prior history). So do you really need it? Calculated risk etc.

– Bring something that’s easy to use and dose! Mixing this up is not life saving, it’s deadly.

In a stressful situation for people not drilled on drug dosing, dilution, and administration, it is a high risk game to play to save some cash. For comparison, we’re ALWAYS two highly proficient personnel to double check this before administering.

Sorry to be a party-pooper. Epinephrine is a VERY potent drug.

Arne Mogstad

Sorry for being a bit vague. The Epi-pens are indeed for easy administration, but I was referring to the use of vials/ampoules and measuring (and even diluting) the correct amount yourself “manually” as advocated earlier.

I have nothing against Epi-pens as long as they are used on the correct indication, apart from them being expensive, and personally I can think of many much better ways to spent that money to improve safety. Namely, an airway suction device, refresher first aid courses, a sat phone plan…

I’m not throwing dirt at people who choose to bring epinephrine, but I’m a firm believer in spending the effort where it’s most useful, and there is a limited use, high price, and it’s got the potential to make a bad day worse if used incorrectly. I’m merely balancing the scale a little. Arguments for these things often get thrown around and are “smart to have” items and people spend money on it when in reality it’ll give little benefit. Again, I give drugs on a daily basis that are known to “frequently” cause allergic reactions, and epinephrine is a drug we rarely need.

So I’m probably not helping this topic anymore, and I’m afraid of dragging this out: it’s very okay to bring epinephrine, but it’s also okay not to, and frankly, if you spend that money elsewhere on something safety/prevention related, you’re most likely getting more safety for your cash. Buy that electric heated blanket so we sleep better, making better judgements, and don’t hurt ourself in the first place… ;p

Eric Klem

Hi Arne and John,

I find this discussion putting it in the big picture quite helpful. For those of us who are not professional healthcare providers, we don’t have enough data points to really understand what is common and what is not. Similarly, John made a very good point when talking about getting a health history in that the skipper tends to be very overloaded with other tasks already. Seeing these in the big picture, we can look at options for mitigation and decide what to do. Of course, all of this takes time and time is often one of the most scarce resources. If we actually followed all the safety advice out there, none of us would ever go sailing and we would all be broke with boats floating 6″ below their lines.


Paul Padyk

Hi John,

It’s too bad your instructor saddled you with the guilt of potentially causing limb loss if you applied a tourniquet to prevent someone from bleeding out. That kind of emotional burden slows a person from accurately assessing a situation and doing what is required. First step is to stop the bleeding, then figure out how to reduce downstream badness from the tourniquet. In general, the probability of secondary limb injury increases as tourniquet time increases. Much of the information on tourniquet duration comes from orthopedic surgical experience with 2 hours considered the upper limit of safe use but literature from the military includes data on field tourniquet time out to 5 hours. My point is a tourniquet is a tool with benefits and risks which are learnable. Having the tool and the knowledge could make all the difference for someone with an arterial injury to a limb.
Best, Paul

Paul Padyk

Hi John,
Sounds like you had a great instructor. Sorry for the editorial digression. Should have stayed to the point of your question regarding tourniquet time.

Richard Phillips

IMPORTANT: if you are going to carry opiates make sure that you check the legal position of *every* country you intend to visit. Laws vary a great deal and prescribed opiates that are legal in your country of origin might be a drugs offence in another country. Other medications might be *entirely* banned as well – such as various stimulant based medications in Japan.

This is an excellent resource:

Emile Cantin

Hi John,

I went to Adventure Medical’s website, and it seems like the 1000 kit has been discontinued, and replaced by the 1500 kit. The latter looks very similar, but comes in a yellow Pelican case instead of a bag. It still contains smaller bags organized by injury type, and is only $10 more expensive.

That seemed like a good deal, so I ordered one. I’ll report back when I receive it (might take a while, though, it was backordered).

Arne Mogstad

Hi, I saw the same thing. Generally I hugely prefer soft cases for a multitude of reasons, one being they are not dangerous if it moves, and for storage it can often be more beneficial. I would also be very interested to know what the box is like if you remember to write a few words on it! I normally prefer to build my own kits, but I’m in need of a new one since I just got a boat, and those seem pretty good!

Emile Cantin

So, I just received it. Backorder delay was only about a month, so don’t let that keep you from ordering. Cost me $150 more than expected (thanks, UPS), but the kit itself seems good. The case is very sturdy, and they used a type of clasp I haven’t seen before, that opens in one single move (smart!).

The smaller bags don’t fit that well in it, though, and the clear plastic is all bunched up. Makes it a bit hard to close back again. In theory, the rush is when you open it, when you close it back up the emergency has passed, but I can see it becoming annoying. Maybe I’ll consolidate a few sub-bags; that should help.

Also, my “burns” bag only contains a few pairs of nitrile gloves, that’s it. Not sure if that’s normal? I’ll double-check on Adventure’s website if I have everything, but I suspect it’s just a matter of stuff being in other bags (I saw after-burn cream in the “medications” bag, for example).

Bill Arbaugh

I think the ‘000 series is in the process of being discontinued. We were only able to find a 3000 available. So far, we like the kit. Some of the meds expire in less than a year which is annoying, and we were missing a trauma item. Calling them tomorrow to get the missing item hopefully.

We inventoried each bag and placed a print out of the inventory and expiration dates at the top of each bag. If we use something, we mark it off. That makes it easy to resupply when needed. We do the same for spare parts and food stores.