Abstract

Abstract In many places, Medevac is either technically challenging due to length (5 days in our experience in Arctic conditions), lack of quality medical support ashore, or hostile environment. To mitigate medical risks in these extreme environments, the authors implemented an innovative integrated medical support solution onboard seismic vessels since 2013. To limit unnecessary Medevac, we emphasized on the upgrade of diagnostic tools, through rapidly deployable mobile digital X-ray, ultrasound, and point of care laboratory automates. These equipment were used by a specifically trained medical team including an emergency physician and a registered nurse backed up by an adapted top side support. Therapeutic tools were also upgraded and the most dramatic improvement was the implementation of Fresh Whole Blood Transfusion (FWBT) and Lyophilized Plasma to address trauma induced life threatening hemorrhages and slow uncontrolled bleedings from medical origin (mostly gastro intestinal). The authors are presenting the different steps (most of them conducted onboard at sea) involved in the complex process of FWBT, from blood donors' qualifications and management to actual transfusions. The pros and cons of blood transfusion in extreme remote environment are discussed, including, health care professionals training, equipment requirements, legal and ethical issues, decision making in complex blood group matching, medical benefits and risks. Some clinical examples will be provided to illustrate the medical context in the oil & gas industry working environment in remote area and how this fully integrated onboard hospital address them. Finally based on experience in Arctic and other extreme environment the authors developed others medical solutions, more agile to support scouting surveys. This whole range of medical services aims to make oil and gas operations safer in the most extreme environments.

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