Circular Letter MSC/Circ.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 21 May 2002)

 

1. The Maritime Safety Committee (MSC), at its seventy-fifth session (15 to 24 May 2002), that in paragraph 1.3.3 of chapter

 

1. of the Annex to the International Convention on Maritime Search and Rescue (SAR), 1979, as amended, the term Search and Rescue is defined as "the performance of distress monitor­ing, communication, co-ordination and search and rescue func­tions, including provision of medical advice, initial medical as­sistance, or medical evacuation, through the use of public and private resources including co-operating aircraft, vessels and other craft and installations".

 

2. Having considered the recommendations of the Sub-Com­mittee on Radiocommunications and Search and Rescue (COMSAR), at its sixth session (18 to 22 February 2002), MSC 75 approved the List of contents of the "Emergency Medi­cal Kit/Bag" and medical considerations for its use on ro-ro passenger ships not normally carrying a medical doctor, as set out at Annex.

 

3. Member Governments are invited to bring the annexed med­ical considerations and list to the attention of SAR service pro­viders, shipowners, ship operators, ship masters and others con­cerned.

 

4. Member Governments are invited to report on their experi­ence gained in the use of the "emergency medical kit/bag".

 

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 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 IMCMLO/WHO current regulations do not fully address this risk of medical emergencies aboard passen­ger vessels 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 n° l64 - Art. 8), the master is responsible for medical care on board the ship (as he is on board any merchant or fishing vessel - ILO Convention n° l64 -Art.9).

 

.6 According to the STCW Convention "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 Tele Medical Advice Service (TMAS), and to provide medical and nursing care under medical advice.

 

.7 The MSC Circular 960 recommends MRCCs to cooper­ate 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;

 

.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 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 follow: "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;

 

.6 appropriate records should be kept, as required by national laws.

 

.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 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 doctor on board is set out in the Appendix.

 

Appendix.
LIST OF CONTENTS OF AN "EMERGENCY MEDICAL BAG" FOR RO-RO PASSENGER VESSELS NOT NORMALLY CARRYING A MEDICAL DOCTOR