U.S. Navy medical communications and evacuations at sea.

Abstract

Abstract : A 9-month study of all U.S. Navy surface ships (N = 354), Pacific Fleet submarines (N = 42), and all ships of the Military Sealift Command (N = 54) was conducted to: (1) document the frequency of, and diagnostic factors precipitating, medical communications and evacuations; and (2) determine the potential need for telemedicine capabilities aboard ship. Supplementary analyses were conducted to identify operational and medical staffing factors associated with patient visit rate at sea. The principal diagnostic categories associated with both Medevacs and medical communications included injuries, primarily fractures and lacerations; and digestive problems, primarily teeth and supporting structures and suspected appendicitis. On a case-by-case basis, senior medical department representatives indicated that 46% of the medical communications could have been improved significantly and 28% of the Medevacs probably could have been prevented if they had had the ability to transmit data through medical telecommunications technologies. The ability to transmit X-ray images, TV image of body part, and voice communications from sick bay were the technologies most frequently identified as potentially positive adjuncts. Because most ships do not have an X-ray capability on board, these data indicate a perceived need for both X-ray equipment and the ability to transmit X-ray images during a remote consultation. This report provides an important point of departure toward a more complete understanding of shipboard health care delivery and medical decision-making.