Rx for Mariners

Medical emergencies at sea are no laughing matter. Fortunately, there’s plenty of help at hand.

By Ilene Grifen

It’s not a question of if, but rather when, a mariner will have an injury or get sick at sea. More often than not, there is no skilled medical attendant on board. Faced with these circumstances, shipowners and vessel masters need to prepare beforehand to handle medical emergencies quickly and effectively when they arise. The growing number of rapid-response providers offering emergency medical services for injured and sick crew helps ensure that they will be rescued sooner, receive treatment faster and get the proper medications quicker than ever before. 

General Care Providers
New York City- and Athens- based Future Care, Inc. is a pioneer in managed care services for sick and injured mariners with dedicated 24/7 first-response Caring for the Crew™ and Medical Advise at Sea programs. Christina DeSimone, Founder and CEO, spoke of the progress her company has made in caring for mariners: “We began in 1996 to manage our health care program for seafarers, and at that time there was no medical care manager being utilized by ship owners. Medical coordination and supervision were handled by port agents and ship operators. Since then, our program has advanced by offering medical services at sea and landside internationally.”

Future Care employs trained medical care managers and physician advisers who form an open communication with both the captain and the crew member as well as the attending physician at any port or maritime facility. This method of communication helps ensure that the captain’s medical decisions are correct. It also reassures the crew member by having a medical expert oversee his condition. Ship owners and insurance companies know that the crew member is receiving quality care.

Dr. Brian Bourgeois, Future Care’s lead physician on its 24-hour Help Line, spoke of the need for early intervention to prevent a medical issue from becoming more serious: “Our services are provided to bluewater vessels that trade internationally that don’t have infirmaries or doctors onboard. Ship owners and captains call our 24-hour hot line for primary care issues as well as medical emergencies. A primary care issue, if not attended to properly, can easily turn into something much more complicated.”

Houston-based Marine Healthcare Services was formed in 2008 by CEO Mike Chaney and COO Lloyd Schwing because they recognized the many challenges of crew medical care. “You have to be ready to handle any health issue 24/7,” noted Schwing, “and it could be anything from a cut finger to the worst case of malaria.” Schwing spoke of the company’s innovative Online Crewmember Health Record or OCHR, “The biggest challenge we faced was disseminating the information pertaining to the crew member’s treatment process. There are numerous parties over numerous time zones with ‘the need to know.’ As a result, when designing the OCHR we had to take into consideration the local steamship agent who is handling the vessel locally, the master, the owner, and the insurance group or P&I Club.”

Added CEO Chaney, “It’s what sets us apart from other companies. We give them access. When a crewmember comes into one of our clinics, he gets registered into our OCHR system and a registration email goes out to the agent and owner notifying them that we have an individual off their vessel and giving them a user name and password to log in.” The company will soon be launching a new phone app, which will function on the iPhone and Android at first, with the BlackBerry to follow, allowing the agent, owner and P&I clubs to log in. “The maritime industry is 24/7, so this will give them a tool to operate more efficiently,” explained Schwing.    

A big part of healthcare for mariners is getting the proper medicine and other medical supplies when needed. Headquartered in New York, Universal Marine Medical Supply specializes in the logistics of getting medical supplies – everything from hospital beds to morphine – to ships worldwide, including oil rigs, tankers and cruise ships. Julius Nasso, CEO and Pharmacist, explained, “Every flagged vessel is required to have its medical chest updated yearly to receive a medical chest certificate, which is issued in accordance with the regulations for that vessel’s flag state. Each flag has its own requirements.” He noted that often vendors are not familiar with the different requirements and just issue certificates, and this is a major concern: “They have to pass inspection, and the medical list is one of the categories for the ship’s hospital that is inspected. If the medical chest list is not up-to-date as per the regulations, they are fined heavy sums.”

The company has been affiliated with the George Washington University Emergency Care Unit for radio medical assistance for over 25 years. “If there is a ship at sea and someone gets hurt, the GW Emergency Center tells them what to do,” said Nasso, who added that there is an incident every day and his company services 6,500 vessels worldwide. 

Remote Providers
Houston-based InPlace Medical Solutions, a division of NuPhysicia Inc., is a remote healthcare provider that bases all of its services on physicians delivering telemedicine to remote locations. Dr. Glenn Hammack, President, said, “The purpose of the programs we bring to the maritime industry is to provide opportunities to crew members, who can be anywhere in the world, to have a virtual ‘face-to-face’ visit with the doctor.” Dr. Oscar Boultinghouse, Senior Vice President, explained, “Mariner patients are more comfortable knowing they are talking to a doctor and not just a computer, so we use a commercial two-way video phone with a color screen with the image of the doctor, who can see the patient, and vice versa.”

Boultinghouse noted that the company has doctors in both the northern and southern hemispheres: “This allows us to keep physicians ready 24/7 to take this very important video connection at any time. Typically in a 24-hour period we will get four to six calls from sites worldwide. From the time you get the first call from the ship to talking to the medic is less than 30 seconds, and the video less than two minutes.” He also spoke of the cost-effectiveness of telemedicine for ship owners, explaining, “One of the biggest benefits of these services is that, in case of a non-emergency medical situation, things can be better managed so a vessel may not have to divert to get the individual to shore. These new telemedicine services provide not only the best care for the patient but also improved decision-making.”

Operating out of the George Washington University Department of Emergency Medicine, Washington, D.C.-based Maritime Medical Access (MMA) has been delivering remote medical services to the maritime industry for over 20 years. The company delivers worldwide telemedicine advice, clinical case management, training, repatriation, plus recommendations for medical equipment and medicine chests via one centrally controlled and secure client portal. MMA’s Worldwide Emergency Communications Center (WECC) is staffed 24/7 by medically trained operators, who patch the patient through to the on-call physician from any location in the world.

George Kyle Keenan, RN, BSN, Director of Remote Medical Programs, explained: “We can pull up a ship name and know exactly what medications they have onboard. The physician can speak directly to the designated physician onboard and now that we have the ability to stream live video it is very nice, especially for the mariner feeling any chest pain. It’s like being right there in the emergency room with the doctor, which is comforting to them. There are over 550 specialty physicians covering cardiology, pediatrics, psychiatry, dermatology and other specialties." MMA, which is nonprofit, also works closely with vessel owners to ensure that their medical chests are properly stocked.

Air Rescue Services
Mariners in distress have a friend in Mesa, Arizona-based Priority 1 Air Rescue, boasting over a decade of helicopter-based SAR service. Focused specifically on oil and gas, the company does offshore search and rescue in the Gulf of Mexico. Brad Matheson, President, spoke about the potential dangers facing workers in this region: “If a mariner has a freak accident, a cardiac incident, or slips and falls while working 100 miles out at sea on a smaller vessel where you can’t land a helicopter, what are those person’s options for emergency medical evaluation?”

The company prides itself on the high level of training and expertise of its rescuers as well as its strong commitment to mariners. “The way we provide assistance is we have a trained hoist operator Emergency Medical Technician in the helicopter who hoists a rescue swimmer/EMT and a rescue paramedic down to the boat to provide medical care and rescue,” explained Matheson. “In order to provide this capability, our Search and Rescue crew complement in the helicopter is three. This allows us to provide two people to the injured or sick person on the boat, so they get the same level of care they would receive if they called 911 at home.”

Another SAR provider is MedAire. With headquarters in Arizona and Singapore, it serves the energy, mining, and oil and gas sectors as well as commercial ships, yachts, business and general aviation, and airlines. In 2010 MedAire managed more than 45,000 cases for its maritime and aviation clients and provided its own training courses that conform to STCW-95 standards for commercial vessels. With a network of Global Emergency Response Centers available 24/7/365, it handles thousands of calls a month. 

“MedAire is proud of its continual investment in the maritime sector,” said Grant Jeffery, CEO. “A significant part of this investment includes implementing our aggressive globalization plans to deliver medical care and training, as well as medical supplies and equipment, to mariners working and living throughout the world.” MedAire works closely with its partner, RDT, which provides ships with a telemedicine unit that allows vital signs transmission to emergency care doctors who formulate a diagnostic impression and provide a further course of care.

Safe Harbor
Other providers include UK-based Avia Health Informatics, which markets a line of clinical decision-support software called Odyssey, and Baptist Health Services in Miami, which primarily serves the cruise industry. No matter where you are in the world, when accidents or illness strike, help is just a call away. – MarEx

Ilene Grifen is a Fort Lauderdale-based freelance journalist.