Heard Island Expedition 1997 (Planning Documents)
MEDICAL
Mike McGirr K9AJ
I. Pre-trip canvas of each team member
1) past medical problems
2) allergies (food, meds, etc)
3) current medications
4) on-going medical problems
5) immunizations (ie: tetanus, etc)
II. Pre-trip consult w/ CDC
1) malaria concern re: Reunion Is visit
2) yellow fever concern re: " " "
3) other medical concerns re: " " "
III. Medical concerns on Reunion
1) will rely on local medical facilities (our supplies will be stowed)
2) to avoid customs problems, may have to obtain some pharmaceuticals
(ie: narcotic pain meds) on Reunion
3) be appraised of local medical capabilites & recommended physicians
through pre-trip consultations w/ FR7 locals
IV. Sea voyage
1) sea sickness
a) scopolamine patches-presently unavailable-will follow up on
this
b) oral/parenteral/rectal anti-emetics (should be available from
ship's dispensary) *
2) other on-board medical problems
a) likely will be dealt w/ by ship dispensary, w/ input from
Heard medical team (our supplies will be stowed)
V. At Heard
1) environmental concerns
a) hypothermia ---
b) frost bite |---> to be covered at SF meeting 9/96
c) trench foot ---
2) minor wound concerns
a) simple wound infections & simple skin infections
b) bumps/bruises/sprains/simple lacerations
c) animal bites & misc wounds
4) serious trauma/medical emergencies
a) stabilization
1. attempt to preserve airway
2. attempt stop hemorrhage
3. vent pneumothorax
4. splint major fractures
b) arrange for evacuation * **
1) protocol for contacting ship & Kerguelen base
5) non-traumatic problems
a) GI problems: diarrhea w, w/o constitutional symptoms
b) dehydration
c) respiratory sx: cold/cough/sore throat, etc
d) misc
6) Health maintenance
a) dietary concerns-constipation often a problem
b) hand washing
c) sufficient sleep
d) common sense in a strange environment (don't pet the sea lions,
don't walk on thin ice, etc)
e) psychological health-adequate personal/quiet time
7) Medical consultations w/ MARCO panel of physicians
a) protocol to be established w/ MARCO group
* IMPORTANT: need to know capabilities of ship's dispensary, as well
as the medical facilities at Kerguelen
** we have three physicians in our group, and we will act as a team. All
major medical decisions will be made (where feasible & appropriate) w/
input from the medical team members.
Health information for Heard Island team #1 (draft)
Each team member should have a physical exam before the Heard operation.
The member's physician should be made aware of the physical challenges
this undertaking will present, so appropriate fitness screening (ie:
stress testing) can be considered.
Each team member should have a dental exam before the Heard operation, so
any dental problems can be addressed before departure.
Those who wear glasses & have not had an eye exam in the past 2 years
should have an eye exam to be sure their current eyeglass prescription is
correct.
Personal medical kit: each team member should pack a small kit of items for
his personal use. This may include bandaids, blister
dressings, aspirin/acetaminophen or ibuprofen,
antacids, creams/ointments commonly used at home, etc.
It may also contain medications suggested by your
physician-for example for traveller's diarrhea & other
things you & your physician might deem helpful. This
kit should contain any prescription medicines &
a spare set of eyeglasses (also take sufficient
quantities of any prescription meds in your carry-on
bag on your flights). This would be a good place to
pack your mosquito repellant for our visit to Reunion
(see below).
Motion sickness: A call to CIBA-GEIGY headquarters 15 Aug 96 informs that
Trans-derm scop patches for sea sickness are still not
available, and will likely not be available before early
1997. Ask your physician for an alternative motion
sickness medication.
Conditioning: No later than 2 months prior to departure, the sedentary
amongst us (your humble health czar included) should begin
a progressive exercise program to condition us for the
arduous physical demands this expedition will place on us.
Immunizations: NONE required by law, MANY are suggested. Most are due to
our brief stop in Reunion. The Heard team medical kit will
NOT contain any of these vaccines-they must be given
prior to departure (see note at end of list). The below
information is a distillation of information obtained
from the CDC, and several medical texts. The final decision
as whether to vaccinate or not rests w/ you and your
physician.
TETANUS: boosters are usually given every 10 years, but are given
for contaminated ("tetanus prone") wounds if no booster within
previous 5 years. As we can't foresee who, if any, will sustain
such wounds, prudent to have booster if more than 5 years since
previous booster-but consult w/ your physician if any problem or
local reaction w/ past boosters. (Assumes team member has
received primary series earlier in life).
POLIO: adults should have been immunized in childhood. Ask your
physician whether you need a booster.
MALARIA: Reunion is not on the CDC's list of African malaria-infected
countries.
YELLOW FEVER: immunization only required if arriving from an infected
country (generally central Africa). If arriving in Reunion
from Mauritius, Mauritius is not considered an infected
country.
DENGUE FEVER: a mosquito-transmitted viral disease characterized by high
fever, bone & joint pains, headaches & rash. Dengue fever
occurs sparodically in Reunion. There is no vaccine
available so mosquito avoidance & repellant sprays are
suggested.
TYPHOID FEVER: occurs in East Africa & transmitted by contaminated food
or water. Vaccines are available. CDC recommends vaccine
for travellers who leave the usual tourist itineraries
(ie: visit rural areas in Reunion). CDC guideline would
not require typhoid vaccine for our brief stay in Reunion.
Note: usual advice to avoid food-born illnesses is operative
here: peel it, boil it, or toss it! Don't forget ice cubes
are frozen local water & as infectious as non-frozen water.
Drink bottled water if possible.
HEPATITIS A: viral liver infection transmitted by contaminated food
water. CDC recommends vaccination for all travelers.
HEPATITIS B: viral liver infection transmitted by blood & body fluids.
CDC recommends vaccination for all travelers who might have
need for medical or dental attention in the visited country.
Since this cannot be predicted, vaccination is advised.
CHOLERA: not reported in Reunion in latest CDC list.
MISC:
SHISTOSOMIASIS: parasitic disease transmitted by swimming/bathing in
contaminated fresh water. Avoid swimming/bathing in
non-chlorinated fresh water (especially rural lakes,
rivers & streams).
NOTE: some of the above vaccinations require a series of shots &
should be attended to well in advance of our departure.
Heard Island team medical information questionnaire (draft):
In the case of serious illness or injury where you might not be able
to tell us important information about your medical history, it is
important that the medical volunteers on Heard have your medical history
readily available:
Name:
poor fair good excellent
What is your overall health?
What is your overall physical condition?
Name & specialty of your personal physician?
Address & phone " " " " ?
Current non-prescription medicines (names/dosages/frequency):
Current prescription medicines (names/dosages/frequency):
Allergies to medications?
Other allergies (including foods, animals/insects, cosmetics, etc):
Past medical conditions/surgeries:
Past hospitalizations:
Current/on-going medical conditions:
Any surgery recommended but not done?
Are you on a special/restricted diet?
Do you wear a medical alert tag? (if so-what is the alert msg?)
Do you know your blood type?
Have you had any of the following (if so, please elaborate):
Heart disease (includes angina/coronary dis, angioplasty/bypass surgery,
leaky or replaced valves)
Vascular disease (includes cerebral vascular dis, stroke/TIA, etc)
Lung disease (includes asthma, effort or cold provoked wheezing, etc)
Cold intolerance
Seizures
Kidney stones
Diabetes
GI problems
Back/spine/joint/orthopedic problems
Sleep walking
Mike McGirr, MD
mcgirr@interaccess.com
Final list of medical supplies going to Heard Island.
-
- Final list of medical supplies going to Heard Island. This list includes the
- medical supplies packed and shipped on our two containers going to Reunion,
- as well as last minute additions to be brought to Reunion w/ Mike & Glenn.
- Note: aj/puj refers to whether Mike or Glenn has procured the item & is
- packed w/ his supplies. Note also that many items listed as trade names have
- been procured in generic.
-
-
- List of medical gear for Heard Island Jan '97:
-
- sterile surgical gloves (sizes to fit team docs)
- size 7 x 2 aj
- size 7 1/2 x 4 aj
- size 8 x 3 puj
- size 8 1/2 x 5 puj
- surgical masks x 21 puj
- non-sterile gloves x 20 puj
- SYRINGES
- 3cc 22ga x 8 puj
- 10cc - handle "
- 12cc x 5 "
- various syringes/needles aj
- irrigation syringes x 2 "
- NEEDLES
- 25ga x 2" x 3 "
- 25ga x 1.5" x 9 "
- 25ga x 1.25" x 1 "
- 25ga x 5/8" x 3 "
- 22ga x 1.5" x 8 "
- 18ga x 1/5" x 12 "
- sterile basin x 2 "
- sterile field 18" x 26" x 13 "
- aperture drapes 24" x 24" x 2 "
- Chux x 2 & x 7 " & aj
- large suture set x 1 "
- small suture set x 2 " & aj
- bone set x 1 "
- SCALPELS
- #11 x 3 "
- #15 x 3 "
- #20 x 3 "
- #15 on handle x 4 "
- #10, 11, 15 x 1 ea aj
- SUTURES
- 1 Ethibond x 3 puj
- 0 Vicryl x 4 "
- 2-0 Vicryl x 4 "
- 3-0 Vicryl x 4 "
- 4-0 Vicryl PS-2 x 2 aj
- 4-0 Vicryl PS-4 x 2 aj
- 2-0 Nylon x 3 puj
- 4-0 Nylon x 6 "
- 5-0 Nylon P3 x 4 aj
- 5-0 Nylon PS-2 x 4 "
- 6-0 Nylon x 3 puj
- Steristrips 1/2" x 4" x 5 packs "
- sterile Q tips x 9 puj
- alcohol prep packs x 36 "
- bottle isopropyl alcohol 16 oz x 1 aj
- Betadine
- swabs, single x 8 puj
- swabs, triple x 6 "
- scrub brush x 6 "
- bottle 4 oz x 1 aj
- saline for irrigation x 3 liters aj
- stethoscope aj
- BP cuff aj
- SPLINTING MATERIAL puj
- 2" Stockinette 6'
- 3" " 10'
- 4" Synthetic cast padding x 2
- 3" Webril x 4
- 2" Fiberglass roll x 1
- 3" " x 1
- 4" " x 3
- 1/2" x 9" Alumafoam splint x 2
- 1" x 6" " " x 1
- Fingertip " " x 1
- DRESSING MATERIALS puj
- Kling (6") x 1
- Kling (4") x 5
- Kling (3") x 4
- sterile 3"x3" gauze x 11
- sterile 4"x4" " x 11
- Kerlix 4" rolls x 2
- 6" Ace x 2
- 4" Ace x 3
- 1" tape (rolls) x 5
- bandage scissors x 1 aj
- liter bags of saline x 3 aj
- liter bags of D5/RL x 3 aj
- IV tubing x 3 aj
- angiocaths #18 & 20 x 5 & 7 aj
- tourniquets x 1 aj
- foley catheters 14, 16, 18f x 1 ea aj
- " " 18 30cc balloon x 1 aj
- catheterization set w/ leg bag x 2 aj
- epistaxis tray x 1 aj
- nasal/epistaxis tampon x 2 aj
- silver nitrate sticks x 100 aj
- razors (shave scalp wounds) x 4 aj
- surgical stapler x 1 aj
- stapler remover x 1 aj
- C-collars (hard & soft) puj
- oral airway puj
- tongue blades x 12 aj
- flashlight x 1 aj
- ET tubes puj
- laryngoscope puj
- ambu bag puj
- urine dipstick x 100 aj
- safety pins x 9 aj
- Tucks pads 100 x 1 aj
- "big" band aids 50 x 2 aj
- tweezers (fb) x 2 aj
- tegaderm x 4 aj
- Bandaids 1" x 3" x 100 puj
- thermometer x 1 aj
-
- MEDICATIONS (parenteral):
- xylocaine 1% w/ epi 30cc x 1 puj
- xylocaine 1% plain 20cc x 2 puj
- Marcaine 1/2% 50cc x 2 puj
- Marcaine 1/2% w/epi 50cc x 1 puj
- epinephrine 1mg/cc 1cc x 10 aj
- Benadryl 50/cc 10cc x 1 aj
- Compazine 5mg/cc 10cc x 1 aj
- Versed 2cc x 6 puj
- Romazicon x 1 puj
- Fentanyl 2cc x 6 puj
- Narcan x 2 puj
- Katalar 20cc x 10 puj
- Rocephin/ceftriaxone 1gm x24 puj
-
- MEDICATIONS (oral):
- cephalexin (Keflex) 250mg 100 x 2 aj
- acetaminophen 500mg 100 x 1 aj
- ibuprofen 600mg 100 x 1 aj
- viscous xylocaine 2% 50cc x 1 aj
- prednisone 20mg 100 x 1 aj
- Benadryl 50mg 100 x 1 aj
- nitrostat (sub-lingual) 100 x 1 aj
- tetracycline 500mg 100 x 1 aj
- Cipro 500 & 750 mg x 190 tabs puj
- Flagyl 250mg 100 x 1 aj
- sudafed 60mg 100 x 1 aj
- Imodium 2.5mg 1000 x 1 puj
- colace 250mg 100 x 1 (bo) aj
- Imitrex 25mg x 6 tabs puj
- DHC+ x 40 tabs puj
-
- MEDICATIONS (topical & other):
- nitroglycerine ointment 2% 60gm x 1 aj
- Silvadene cream 1% 50gm x 2 aj
- Bacitracin/Polymyxin ointment 1oz x 2 aj
- Miconazole 2% cream 1oz x 2 aj
- Lidex ointment 15gm x 1 aj
- Lidex cream 60gm x 2 aj
- gentamycin opth drops 15cc x 1 aj
- cyclopentolate 1% opth drops 15cc x 1 aj
- erythromicin opth ointment 1/8oz x 1 aj
- Afrin nasal spray 30cc x 1 aj
- Cortisporin otic drops 10cc x 1 aj
- annusol HC suppositories x 25 aj
- dulcolax suppositories x 12 aj
- tucks pads x 100 aj
- tigan suppositories x 10 aj
- Tobrex opth drops 5cc x 1 aj
- Alcaine " " 15cc x 2 aj
- Dacriose " " 15cc x 1 aj
- flurocein strips x 6 aj
- cobalt light x 1 aj
-
- MISC
- Dental emergency kit x 1 aj
- (supplied by ham/dentist KJ9B)
The Campsite at Atlas Cove
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Last update: 20 Dec. 1996 Robert W. Schmieder cordell@ccnet.com