– add new paragraph 2.7.7 after paragraph
2.7.6 as follows:
-
“2.7.7 New satellite systems are emerging
which can relay distress alerts. Many vessels are equipped with systems
that provide comprehensive online such connections to Internet, voice,
facsimile and data communications for functions as online E-mail,
Short Message System (SMS), video conferencing and medical examination
and reporting. These commercial satellite systems are not primarily
designed for alerting, but may be used for subsequent SAR communications
between ships or aircraft and RCCs or RSCs, or as a link to the On
Scene Coordinator.”
– Replace the existing paragraph 2.24.1
with the following:
-
“2.24.1 Publications which can be used to
assist in overcoming language barriers and communication difficulties
between vessel and aircraft crews, survivors and SAR personnel include
the International Code of Signals, International Regulations for Preventing
Collisions at Sea, the IMO Standard Marine Communication Phrases (SMCP)
(Assembly resolution A.918(22)),
Annex 10 to the Convention on International Civil Aviation and PANS-ATM
(ICAO Document 4444). These documents should be included in RCC libraries
and be understood by the staff who should be able to comprehend and
transmit messages using these phrases. Ships should carry these documents.
SRUs should carry the International Code of Signals. The Code of Standard
Phrases for Use between (Maritime) RCCs and RSCs is provided in Appendix
I.).”
– Replace the existing paragraph 2.24.6
with the following:
-
“2.24.6 With the decreasing use of Morse
Code, the International Code of Signals and the IMO Standard Marine
Communication Phrases (SMCP) (Assembly resolution
A.918(22)) will become increasingly important. It may be of
assistance to refer to these documents in international SAR agreements
as provisions for use during operations, training and exercises when
SAR facilities of more than one country are co-operating in response
to a distress incident.”
– Replace in paragraph 2.27.22, first sentence,
“arrangements with doctors outside the SAR organization”
with: “a TMAS”.
– Replace in paragraph 2.27.23, second sentence,
“medical advisory service” with “TMAS”.
– Add new paragraphs after paragraph 2.27.23
as follows:
-
“2.27.24
Good communications
are essential for an effective telemedical assistance service. Telemedical
communications are considered to be safety or urgency communications
and as such should have priority over routine traffic and normally
be free of charge to the mariner.
-
2.27.25
The ship’s captain,
who is responsible for treatment on board, must be able to access
the TMAS of his choice. Choice may be based on his nationality, the
ship’s flag and, especially, the language spoken.
-
2.27.26
Recording of the date and
time of all TMAS communications and archiving of secure tape will
enable essential data to be preserved should they be required in the
event of legal proceedings. All recorded information is subject to
medical privacy in the same way as the content of a medical file.
-
2.27.27
Voice communication is the
basis of telemedical advice. It allows free dialogue and contributes
to the human relationship, which is crucial to any medical consultation.
Text messages are a useful complement to the voice telemedical advice
and add the reliability of writing. Facsimile allows the exchange
of pictures or diagrams, which help to identify a symptom, describe
a lesion or the method of treatment. Digital data transmissions (photographs
or electrocardiogram) provide an objective and potentially crucial
addition to descriptive and subjective clinical data.
-
2.27.28
Given the international dimension
of maritime navigation, a medical problem may occur on board a ship
far from its country of origin. In such a case, the master will normally
call his national TMAS, which can perform a telemedical consultation
in his language. Should there be a need, following the consultation,
for an evacuation to the nearest shore, the master will normally contact
the MRCC responsible for the search and rescue region involved.
-
2.27.29
In order to facilitate and
enhance planning of the medical aspects of the evacuation, all available
medical information collected by the firstcontacted TMAS should be
transferred to the TMAS attached to the responsible MRCC. This is
to avoid any additional tele-consultation by the second TMAS. A “Medical
Assistance at Sea, TMAS – TMAS Medical Information Exchange
Form” can be used for this purpose. See Appendix R.
-
2.27.30
Communication between the
ship and TMAS can be established via coast radio stations using VHF,
MF or HF radio. Inmarsat satellite communications can be accessed
by use of special access codes (SAC) 32 for medical advice and 38
for medical assistance or MEDEVAC. Inmarsat Land Earth Stations (LES)
normally route SAC 32 direct to a TMAS and SAC 38 to the associated
RCC. Inmarsat can support voice and telex (telex only for Inmarsat-C).”