Radio Medical Advice Research Articles

Public health events in the maritime transport sector

Abstract Introduction A literature review to describe evidence on communicable diseases affecting people on ships or at ports, from 1990 to 2013 was carried out. Also, a literature review on radiological and chemical events of public health relevance associated with ships or at ports, from 1940 to 2013 was performed. Methodology Databases reviewed were: Medline, Scopus, Web of Science, Spanish Society of Maritime Medicine, and WebPages of WHO, The International Radio Medical Advice Centre, International Atomic Energy Agency, European Maritime Safety Agency, Marine Accident Investigation Branch, Spanish Nuclear Safety Council and the Major Accident Reporting System. Results From 1990 to 2013, 196 outbreaks relating to ships or ports with more than 24,000 cases and 19 deaths were published. 59% of outbreaks (n = 116) were food- and waterborne, causing 82% (n = 19741) of cases and 12 deaths (11 deaths due to Legionella, case fatality ratio of 7%); almost a third was caused by norovirus. Respiratory diseases, mainly Influenza, caused 18% of outbreaks and 2 deaths. Thirteen radiological events were published that affected 500 persons and caused 47 deaths, 24 due to exposure to elevated levels of radiation. During the study period 94 chemical events were published, of which 69 events affected people and in the remaining events only a public health risk was present. These 69 chemical events generated almost 12,000 cases and more than 2,000 deaths. Thirty countries, including all EU Member States, Norway and Iceland, were requested to complete the questionnaires regarding identification of authorities and practices for management of radiological and chemical events. Conclusions Food- and waterborne diseases are most reported; followed by respiratory diseases. Legionellosis accounted for the highest case fatality ratio. Tuberculosis was reported only on seafarers from cargo or fishing vessels and vaccine preventable diseases was mainly reported on crew members from cruise ships.

Request for professional medical aid on board ocean-going ships in the Republic of Croatia.

Despite modern ship technologies, high-quality crew accommodation and exceptional communications, the absence of a doctor on board presents an issue in terms of the timely, adequate and efficient response to acute health disorders and life-threatening injuries. A serious health condition of an injured or sick person, insufficient medical knowledge of the on-board officers, inadequately equipped ship's infirmary, or scarce supply of medicines are among the typical reasons for requesting professional shore-based medical assistance. This can be achieved by requesting Radio Medical Advice or by activating air-borne medical assistance, i.e. bringing a doctor by helicopter or by Medical Evacuation, i.e. transferring the ill or injured person to the shore medical institution. The Maritime Telemedical Assistance Services are available across the world. They use all the technical possibilities available, including e-mails and very widely used photo and video attachments as well as the emergency real-time live videos. In on-board practice, the most common solution is to use medical advice over the radio (through terrestrial or satellite networks). This paper discusses the ways of requesting professional medical advice or aid on board ocean-going merchant ships in the Republic of Croatia.

Progression of the attended morbidity in the Spanish radiomedical advice centre from 2009 to 2012

Progression of the attended morbidity in the Spanish radiomedical advice centre from 2009 to 2012

Characteristics of radio medical advice to fishing vessels in Scottish coastal waters

We examined the emergencies arising on fishing vessels in Scottish Coastal Waters which required ship-to-shore radio medical advice. All calls to the service were identified for the 12-month period from August 2005. A total of 186 calls were received; 38% of calls were from fishing vessels. During the study period 53% of the calls were trauma-related, while 47% were medical emergencies. Our data suggest that there are many fishermen working offshore with chronic medical conditions. Overall, 85% of calls from fishing vessels resulted in evacuation as the outcome. Improved occupational health screening, compliance with health and safety legislation, and an evidence-based approach to remote medical care may improve seafarer self-care and reduce emergency evacuations.

Rationalizing radio medical advice for maritime emergencies.

The provision of radio medical advice by the National Health Service for British coastal waters has developed in an ad hoc fashion. In 1999, the closure of one of the two centres providing such advice led to unexpected problems. The demographic characteristics of the offshore population covered by each centre were markedly different and this resulted in a different spectrum of medical emergencies presenting to the sole remaining centre. Subsequent data collection of the details of medical emergencies presenting from offshore allowed an audit to inform the development of training packages for both base and remote practitioners. This has led to an ongoing national rationalization of ship-to-shore radio medical advice for the UK.

Maritime radio-medical services: The Singapore General Hospital experience

Medical care for the sick and injured on a variety of sea-faring vessels throughout the world represents a challenging area of medical care. The scope is extremely broad and unique in terms of the problems encountered at sea, logistical difficulties in assessment and treatment of patients, as well as the provision of definitive care. The problems of sparse resources availability, great distances, isolation, communications, accessibility, and weather are also very real. In Singapore, radio-medical advice was first coordinated by the Port Health Authority. In 1980, the accident and emergency department at Singapore General Hospital took over this responsibility. This report analyzes 2,320 calls received over a period of 21 years (January 1980 to December 2000). It highlights the common consultations, modes of communications, treatment and management prescribed, training requirements, as well as the challenges for the future. (Am J Emerg Med 2002;20:349-351. Copyright 2002, Elsevier Science (USA). All rights reserved.)

Radio Medical Advice – the Danish experience

From 1980 to 1993, the Danish Radio Medical Advice Service (RMAS) had 1136 contacts from overseas Danish merchant ships and 213 contacts from Danish territorial waters. The diagnoses were almost always of acute conditions. The distribution of the diagnoses in the overseas contacts were; diseases in the digestive and genitourinary system 30%, traumatic lesions 23%, infectious diseases 14% and diseases in the cardiovascular and respiratory system 9%. The only trend over the years was a significant (P = 0.01) decrease in psychiatric diagnosis. Evacuation from the ship was recommended in 53% and medicine was prescribed in 61% of the contacts. The medicine was antibiotics in 40% and analgesics in 29% of the contacts. Intravenous infusion was evaluated as relevant in 5% of the cases and this procedure will be included in the new education of officers on the ships. In the contacts from Danish territorial waters, where many ships are recreational yachts, evacuation was recommended in 79% and medicine was prescribed in 28% of the contacts. This was probably due to the short distance to the nearest harbour and the variation in medical equipment and knowledge. The medical speciality for doctors participating in RMAS should be general surgery or orthopaedic surgery but access to advice from all other medical specialities should be available. Experience as a naval medical officer would be beneficial. The education of the officers on the ships should be more comprehensive including e.g. intravenous infusion. Communication should be by telephone and television would be an advantage.