1.3.4 The system of medical assistance at sea, as described in this circular, does not apply to maritime accidents involving a large number of shipwrecked people or where the rescue proper involves the assistance of medical teams. However, the various elements of the system are normally involved in the case of a serious accident, subject to special procedures.
1.4 Sections 2 to 6 below cover the various elements that constitute a global system of medical assistance at sea.
2 RCCs
As medical assistance at sea is an integral part of rescue, RCCs are a key element in the system, because captains "naturally" call on the RCC when they have a problem that might jeopardize the lives of people on board.
That is why all RCCs should be able:
- to provide the captain with information to allow him to contact a TMAS;
- then, if medically necessary, to organize an evacuation, to the extent of its capacities;
- failing that where the TMAS suggests diverting the voyage, to advise the captain of the most suitable port, bearing in mind the condition of the sick or injured person;
- lastly, to transmit the alert, together with any relevant information, to the shore-based reception facility.
RCCs should therefore be provided with the necessary instructions and documentation and, in particular, operational procedures for medical assistance at sea, setting out the roles and responsibilities of each partner.
3 The Maritime Telemedical Assistance Service (TMAS)
3.1 The existence of such a service in a system of medical assistance at sea is essential for the following reasons:
- to alleviate the isolation at sea of both the victim (the sick or injured person on board) and the captain responsible for giving treatment;
- to avoid, as far as possible, the need for evacuation, which, although sometimes essential, is by its nature dangerous and expensive;
- to assist RCCs, which are often the first contact with the captain in difficulty, to take an appropriate decision.
3.2 A TMAS should be officially designated as such by the competent authority in the State concerned so as to:
- appear in official documentation (especially that of the IMO);
- provide a guarantee of competence and quality to potential users.
The designation should also indicate effective links with one or more RCCs, so that the latter are quite clear as to which RCC they should turn in any particular instance. For the telemedical service, it involves taking medical responsibility for the advice given by its doctors.
