question about medical emergencies at sea

[MariaW]

My apologies if this was covered somewhere else. Even completely healthy people are sometimes struck by an unforeseeable medical emergency that requires immediate surgery, for example, appendicitis, or a retinal detachment. What usually happens if this occurs on a commercial vessel on a long voyage at sea? What's the longest transit time between ports? What if you're in the middle of the Pacific? I'm not worried about this in any way, I was just curious. Thanks.

[HawsePiper]

Most vessels on international route, I think, have a book published Pre-WWII that gives basic instructions and crude drawings to help the medical officer perform any surgery required. And if the vessel doesn't have a medical officer on board, which is very unlikely, the captain will appoint one if needed. If that doesn't work out then you can be put in the freezer until the ship is able to put you ashore.

Best of luck!

[CoastalDPO]

Way to scare somebody Hawspipe! MariaW, there is always at minimum a "medical care provider" onboard,

[MariaW]

I was talking about emergencies that can't be taken care of by the person on board, like the two examples I gave. A retinal detachment can result from hitting your head on something, and there's no way to predict who will get it. If it's not treated within a few days, you will irreversibly lose your eyesight. I have two friends who had this condition, so it's not that uncommon. Treatment consists of a delicate operation with lasers done by an eye specialist. If you don't treat appendicitis right away, you could die.

[CoastalDPO]

Well in that case, a medivac by the closest coast guard or navy or other authority of that type, if you are in range, if that is not possible hope for the best or like previously posted they would have to clean the freezer out to store you until they can put you off at the next port. On the ship that I am on now on it's maiden voyage to the Gulf of Mexico they had to clean out the freezer. Just part of the job.

[jdcavo]

Way to scare somebody Hawspipe! MariaW, there is always at minimum a "medical care provider" onboard,

If it's a "seagoing" vessel on an international voyage, there should be a person qualified as person in charge of medical care. This requires approx. 80 hours of training (medical care provider is 24 hours). The training is comparable to intermediate level EMT training, with emphasis on the longer periods the patent will be in your care (hence training in pharmacology, nursing, etc.). It also includes training on obtaining and acting on medical advice from ashore.

[Tom_Tugboat]

Many vessels subscribe to an onshore medical contact service, such as provided by Johns Hopkins University, or MMA from George Washington University.

They can provide "on-the-scene" walk-thru for many emergencies offshore via radio link or satphone link.

[PMC]

I took the medical-person in charge course about five years ago. Like anything else, its use it or lose it. I imagine very few people "use it".

Example, l learned how to suture but I never used it. How many people can remember a knot they learned five years ago but have never made it since?

[MariaW]

I took the medical-person in charge course about five years ago. Like anything else, its use it or lose it. I imagine very few people "use it".

Example, l learned how to suture but I never used it. How many people can remember a knot they learned five years ago but have never made it since?

I was reading that some ships have a "medical officer" - how much training does that require, is it the same as the "medical person in charge"? Does it help when you're looking for a job?

[PMC]

Medical person in charge is not going to hurt you but it probably will not help you. Various STCW courses can "expire" if you do not have an appropriate mariner document to endorse a particular STCW certification.

You can find a lot of answers to your questions using google.com

[jdcavo]

I was reading that some ships have a "medical officer" - how much training does that require, is it the same as the "medical person in charge"? Does it help when you're looking for a job?

Medical officer is not an endorsement or license, it's more of a position title for a specific company or vessel. So the qualifications and training required would depend on the policies of that company or vessel. On most commercial vessel, being the medical person in charge is not a position title, it's an extra duty for one of the "regular" crew of the vessel. On many, it's a duty of the Chief Mate or Captain. I beleive very few commercial ships other than those that carry a lot of passengers or persons not in the crew have a dedicated "medical officer." So while it might be aplus to hold a medical PIC endorsement, it's probably not a big positive if you're not applying for the position who has the designated duty of being the medical PIC.

[KennyW1983]

When I worked for TECO Ocean Shipping I was on one of the big ocean tugs. Our captain had taken lots of medical classes, beyond what the CG required. I think he was the lowest grade of EMT, the company had all of their captains and a lot of their mates certified. The boat had a large medical bag in the captains room with lots of different medicines, minor surgical stuff, and of course we had the sat link to call a real hospital. We were on the Tampa-NOLA route so we were always in range of the chopper but some of their boats went to Africa and South America so they were prepared. But if the worse happens you clean out the freezer, its part of the job.

[drkblram]

Most ships today have basic medical care, as described above. Most like onboard care is limited to the EMT-Basic equivalent level (with CNA -certified nursing assistant- skills thrown in for good measure). Medical PIC (person in charge) is more like an EMT-Advanced (IV tech, Intermediate, or Intermediate Tech in the EMS nomenclature that is being discontinued). There are also some one off skills like suturing. However, as someone already said, these "advanced skills" like suturing or IV sticks are perishable skills, and most officers/captains probably have lost the skills (this is all assuming they got sufficient training to start with). But there are some EMS basic procedures that we don't have at sea. The big one I can think of is non-visualized airways. A medic and above can intubate a patient (aka a "visualized" airway, since they observe where they insert it) but in some states, a basic or advanced EMT can insert a non-visualized airway such as a combi-tube or King LT airway. The reason we don't have that skill afloat is they can only be left in a Pt for 24hours, unlike an ET tube. Unlike ashore where most Pt's get to an ER within an hour, care at the medic level or above who can replace a combi-tube with an ET may be more than 24hrs out.

There are three basic ways to get more advanced care to a Pt at sea. 1) If near the coast, the USCG can medivac them, also the USAF PJ's can parachute in and provide paramedic level care while the ship closes with helo range or options 2 or 3. 2) Naval or CG asset intercept. Whether it is one of "ours" or another naval power, most will render care. With helo's common aboard warships and auxiliaries, you don't have to be THAT close. 3) intercept with one of the few ships out there with a doctor on board. Cruise ships, large research vessels, academy training ships and some other specialty vessels have docs onboard. Using a system call AMVER, or any of the other regional services, rescue coordination centers ashore can facilitate such intercepts. The problem here often is safe transfer of the Pt or the doctor at sea.

We all know the risk when we go to sea that we are operating outside the scope of the "standard" medical care system. Its a risk we accept, just like the firefighter accepts the risks associated with their job.

[MariaW]

Thanks for the serious answer. I guess I wasn't aware that merchant ships had so many options.