It should, however, be emphasised, that the capacity to receive communications via these two codes is not compulsory for CES, although more and more of them are now becoming equipped to do so.
Most of the time, the service is free of charge for the ship, under an agreement between the CES operator and the relevant medical authority.
4 COMMUNICATIONS BENEEN THE PARTNERS IN MEDICAL ASSISTAFNCE AT SEA
Although telemedical advice is primarily based on direct communication between the ship and the TMAS, to function well, the global system of medical assistance at sea involves exchange of information in real time between the various operational and medical partners (*=normal means;** = content):
- between the TMAS and MRCC:
* telephone, fax or telex by public network;
** operational data, confirmation or indication of the medical reasons for intervention;
- between the TMAS and the responsible medical centre (hospital) on shore:
* telephone, fax or telex by public network;
** medical information about the patient to prepare the medical intervention team, hospital transport on shore and hospital admission. In return, the TMAS should receive the hospital report necessary to evaluate the telemedical advice;
- between the MRCC and the responsible medical centre on land:
* telephone, fax or telex by public network;
** operational information essential for joint intervention by rescue and medical teams;
- between the aeronautical or nautical rescue team, the MRCC (operational contact) and the shore-based medical centre (preparation for admission of the patient):
* maritime or specialized means of radiocommunications;
** operational information essential to medical reception on land;
- if applicable, between the TMAS and a body responsible for maintaining seafarers' medical records:
* fax, telex, data transmission networks, etc.
** access by TMAS doctor to medical data contained in a computerized file of seafarers' health records, if available.
Exchange of medical information must be restricted to medical correspondents involved in medical assistance at sea, and must be subject to strict respect for medical secrecy.
