ANNEX 2
Draft [COMSAR circular]
MEDICAL ASSISTANCE AT SEA AND MARITIME RADIOCOMMUNICATIONS
1 COMMUNICATIONS ARE ESSENTIAL TO TELEMEDECINE AT SEA
The global system of medical assistance at sea relies heavily on the use of telemedical advice. The various systems of maritime communications must allow access which is:
- permanent
- priority
- free of charge
to the TeleMedical Assistance Service - TMAS
Telemedical advice is one of the emergency procedures in maritime radiocommunications, in the same way as a call to an MRCC.
The ship's captain, who is responsible for treatment on board, must be able to access the TMAS of his choice, based on his nationality, the ship's flag and especially the language spoken.
Communications used for telemedical advice must be subject to the strictest confidentiality and are subject to medical secrecy.
Recording of the date and time of all TMAS communications and archiving on secure tape will enable essential data to be preserved should they be required in the case of legal proceedings into responsibility. All recorded information is subject to medical secrecy in the same way as the content of a medical file.
2 MEANS OF COMMUNICATION
2.1 Voice communication is the basis of telemedical advice. It allows free dialogue between the doctor and the person responsible for treatment on board or between doctor and patient, and contribute to the human relationship which is crucial to any medical consultation.
2.2 Text messages exchanged between the ship and the TMAS by telex are a useful complement to the voice telemedical advice and add the reliability of writing. Capacity for dialogue, however, is limited, and the gain in precision is obtained at the expense of the human relationship which remains essential in an isolated environment.
Communication by telex is the only one available on some systems such as Inmarsat-C.
2.3 Fax allows the exchange of pictures or diagrams which can help to identify a symptom, describe a lesion or the method of treatment.
2.4 Digital data transmission (photograph or electrocardiogram) provides an objective and potentially critical addition to descriptive and subjective clinical data. This method should be developed in the future1.
1 Devices for recording and transmitting electrocardiograms, at a relatively low cost and for use by people who are not doctors are now available on the market and some ships are already equipped with them.
