Annex - Medical Considerations for the Use of the “Emergency Medical Kit/Bag” on Ro-Ro Passenger Ships, Not Normally Carrying a Medical Doctor
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Annex - Medical Considerations for the Use of the “Emergency Medical Kit/Bag” on Ro-Ro Passenger Ships, Not Normally Carrying a Medical Doctor

  1 Apart from the list of contents for an “ Emergency Medical Kit/Bag “ to be used by a medical doctor on board certain ro-ro passenger ships, the following medical considerations should be taken into account for its use on board:

  • .1 there is a high risk of a medical emergency occurring aboard any passenger ship even those cruising for a few hours only, particularly ro-ro ships and similar ferries carrying large numbers of passengers, because of the large scale of ages and possible previous illness of passengers;

  • .2 many of these medical emergencies require treatment by a medical doctor either on board among the passengers or in the nearest hospital ashore;

  • .3 evacuation of a person in medical emergency, even by helicopter, will be unduly time consuming and be associated with avoidable risks for the person to be evacuated;

  • .4 the IMO/ILO/WHO current regulations do not fully address this risk of medical emergencies aboard passenger ships as they only regard health and safety of the seafarers considered as workers;

  • .5 when there is no medical doctor among the crew (if not “100 or more seafarers and ordinarily engaged on international voyages of more than three days” - ILO Convention No.164 - Art. 8), the master is responsible for medical care on board the ship (as he/she is on board any merchant or fishing vessel - ILO Convention No.164 - Art.9);

  • .6 according to the 1978 STCW Convention, as amended, “the personnel designated to ensure the responsibility of medical care onboard” must follow and validate a medical training to be able to perform a medical examination or a teleconsultation with a TeleMedical Advice Service (TMAS), and to provide medical and nursing care under medical advice;

  • .7 MSC/Circular.960 on Medical assistance at sea recommends MRCCs to co-operate with TMASs to facilitate and to improve medical assistance at sea and SAR services;

  • .8 whenever the master facing a medical emergency onboard can do it, he might call for a doctor possibly present among the passengers. Such a medical competency and action will improve the efficiency of the medical care rendered to the injured/ill passenger, provided that:

    • .1 calling for a doctor should not delay the first-aid care to be rendered by the ship personnel while waiting for the doctor arrival; and

    • .2 the master should take all reasonable steps to check the qualification of an individual who presents him/herself as a physician before allowing him/her rendering medical care to the patient;

  • .9 the need for an “ Emergency Medical Kit/Bag “ is evident to facilitate the doctor's action in an emergency because the patient must be treated “ on the spot “ before being transferred to the ship hospital for further medical care;

  • .10 such an “Emergency Medical Kit/Bag” should:

    • .1 be portable;

    • .2 include any essential medicine and medical equipment to cope with a medical emergency on the spot, and guidance on their use;

    • .3 be kept securely;

    • .4 be labelled as follows: “The medicines in this bag are to be used by a qualified medical practitioner or a registered general nurse, a qualified paramedic or a ship personnel in charge of the medical care on board under the direct supervision of a medical practitioner on board the ship or under telemedical advice/prescription by a TeleMedical Advice Service (TMAS)”; and

    • .5 be maintained by the master or under his responsibility with a regular accounting of its content; any drugs or piece of equipment used in an emergency should be accounted for and replaced, and appropriate records should be kept, as required by national laws; and

  • .11 in any case, regarding the IMO (STCW)/ILO regulations, the master remains the only person responsible for the final decision (care on board, diversion of the ship, medical evacuation). However, at any time, he/she can get telemedical advice from a TMAS either to confirm the passenger - doctor action or to help the nurse, paramedic or ship personnel in rendering the best possible medical care. An official TMAS teleconsultation provides protection for the patient, the ship's master and the passenger physician.

  2 The list of contents for the “Emergency Medical Kit/Bag” for the use on certain ro-ro passenger ships without a medical doctor on board is set out in the appendix.

Parent topic: MSC/Circular.1042 – List of Contents of the “Emergency Medical Kit/Bag” and Medical Consideration for its Use on Ro-Ro Passenger Ships Not Normally Carrying a Medical Doctor – (Adopted on 28 May 2002)
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