
General Principles
This course covers immediate care to be given in life threatening situations involving sudden illness or injury at sea, including techniques for adult CPR. This component fulfills the requirements of STCW Section A-VI, Table A-VI/1-3.
First aid is the provision of initial care for an illness or injury. It is usually performed by a lay person to a sick or injured casualty until definitive medical treatment can be accessed. Certain self-limiting illnesses or minor injuries may not require further medical care past the first aid intervention. It generally consists of a series of simple and, in some cases, potentially life-saving techniques that an individual can be trained to perform with minimal equipment.
The person giving first aid, deals with the whole situation, the injured person, and the injury or illness. He/she know what should to do as well as what should not to do in the emergency situation. And he knows, too, that his first aid knowledge and skill can mean the difference between life and death, between temporary and permanent disability, and between rapid recovery and long hospitalisation.
First Aid is the immediate and temporary basic medical care provided to an ill or injured victim, until more advanced care arrives or the person recovers. It is a life-saving medical technique that a non-medical person or a lay person can be trained to perform with minimal equipment.
between temporary and permanent disability, and between rapid recovery and long hospitalisation.
Aim of First Aid
The key aim of first aid can be summarized in three key points.
Preserve life
The overriding aim of all medical care, including first aid, is to save lives.
Prevent Further Harm
To prevent the condition from worsening. This covers both external factors, such as moving a patient away from any cause of harm, and applying first aid techniques to prevent worsening of the condition, e.g. applying pressure to stop bleeding from becoming excessive and dangerous.
Promote Recovery
First Aid encompasses DRABCD. That is:
IMGS (International Medical Guide for Ships)
All ships should carry medical instruments, a medical chest and a copy of medical guide, as required by the International Labour Organisation's Maritime Labour Convention 2006.
The International Medical Guide for Ships gives guidelines on how to diagnose, treat and prevent health problems in seafarers, mainly focusing on the first 48 hours after injury.
In addition to giving guidelines to diagnose and treat a patient onboard, the Medical Guide also gives guidelines on preventing various health problems those may be faced by the seafarers. Illustrations in the book make it easier for the medical officer onboard to get the information for treatment.
It covers from simple injury to many types of diseases, pregnancy, child birth, death and caring of rescued persons
It endeavours to give the seafarer the treatment and health protection that is available ashore.
World Health Organisation 2007
According to the specifications of the International Labour Organisation (ILO) Maritime Labour Convention 2006, all ships must have a medicine chest, medical kit and medical guidelines. The main principles of International Medical Guide for Ships are to make sure that:
The ILO Maritime Labour Convention states that ships engaged on international journey for duration of more than three days and having 100 persons or more must have a well-qualified medical doctor to provide medical care. Ships without a medical doctor can have any of the following:
Mariners who are not medical doctors but take in-charge of medical care on board must have finished training in medical care meeting all the needs of the International Convention on Standards of Training, Certification and Watch keeping for Seafarers. The International Medical Guide for Ships acts as a standard guide for such training courses. The ILO Maritime Labour Convention 2006 specifies that the skilled authority must make sure that the medical advice given (via radio and satellites) to ships travelling in sea is available for 24 hours a day.
IMGS explains when it is necessary to seek such medical advice. By having IMGS on board ships and following the given instructions, the countries can do the following:
IMGS (International Medical Guide for ships) contains the following:
Training of Seafarers
As per IMO requirements, there are three levels of first aid training for seafarers.
A ship's owner is obliged as per Merchant Shipping laws to provide care to a seaman who becomes ill or injured while "in service". Every ship owner needs to pay for care of its seaman.
The Duty to Provide Cure
Maintenance and care is a contractual form of compensation given by general maritime law to a seaman who becomes ill while in service to his vessel. The ship owner's obligation is deep-rooted in maritime law and is an incident or implied term of a contract for maritime employment.
Care is a Contractual Obligation
The obligation of the ship owner to provide for the maintenance and care of seamen becoming ill or injured during the period of their service is an implied contractual obligation imposed by general maritime law as one annex to the employment.
Who is Entitled to Care
All persons who are members of the ship's company are entitled to maintenance and care when ill or injured in the ship's service and without culpable misconduct on their part. A Master, although not coming within the many protective wage statutes covering seamen, is regarded as a seaman for purposes of the Jones Act and is also entitled to maintenance and care. Any member of the crew, including the Captain of a vessel, is entitled to maintenance and care and therefore entitled to have the ship owner pay for all reasonable and necessary medical expenses.
In the Service of the Ship
The phrase "in the service of the ship" has had a liberal interpretation throughout history. Presently, it encompasses virtually all of the seaman's activities from the time he first boards the vessel to the time he departs from her after signing off, and perhaps, for a reasonable time thereafter, till his repatriation to hometown, should any illness manifest itself traceable to his activities while in the ship's service.A ship's owner is obliged as per Merchant Shipping laws to provide care to a seaman who becomes ill or injured while "in service". Every ship owner needs to pay for care of its seaman.
Methods to Raise a Medical Emergency Alarm
PA System Announcement: Call for medical assistance using a clear and loud announcement (e.g., "Medical Emergency in Engine Room, immediate assistance required!").
General Alarm (if required): Some ships may use the General Alarm (continuous ringing of the bell/buzzer) followed by an announcement. On a ship, the General Alarm Button is strategically placed in multiple key locations to ensure quick access in case of emergencies. The exact locations may vary depending on the ship type and design, but the most common places include:
Radio Communication: Contact the bridge using VHF/UHF radio or the internal telephone system.
Emergency Call Points: Some ships have designated emergency call buttons or telephones to notify the duty officer.
Raising an alarm
To raise the general alarm on a ship if you find someone injured, immediately activate the nearest alarm station, which typically involves pulling a lever or pressing a button, and then announce over the ship's PA system that there is a medical emergency, stating the location of the injured person and the nature of the injury; the standard general alarm signal is usually seven short blasts followed by one long blast on the ship's whistle and internal alarm system.
Raising an alarm in case of a medical emergency on a ship is a critical and systematic process to ensure the situation is promptly addressed. The following steps outline how to raise an alarm for medical emergencies onboard:
1. Assess the Situation:
Check the severity of the medical emergency. Is it life-threatening (e.g., heart attack, severe bleeding, unconsciousness), or is it a less critical issue (e.g., injury, fainting)?
Ensure safety by checking the environment. Make sure there is no further danger to the patient, such as fire, chemicals, or moving machinery.
2. Alert the Bridge (Captain and Crew):
Use the ship's internal communication system (intercom, radio, or phone) to contact the bridge.
Say: “Medical Emergency on (location of the ship), [specific area]. Immediate assistance required.”
Give clear details about the patient's condition, location, and the type of emergency.
Alternatively, you can use the emergency alarm button, if the ship is equipped with such systems, which automatically alerts the captain and crew.
3. Activate the Ship's Emergency Medical Response:
Call for assistance from the ship's medical officer or the nearest qualified crew member.
Utilize the onboard medical team (doctor or trained medical personnel) to attend to the injured or ill person. In many ships, this is a designated role such as the "ship's doctor" or a nurse.
Depending on the severity, ask for assistance to prepare medical equipment, stretchers, or first aid kits.
4. Use the Ship’s Public Address (PA) System if Needed:
Announce the emergency using the ship’s PA system if necessary.
Example announcement: "Attention, medical emergency on Deck 3, near the cafeteria. Medical team, please report immediately to the scene."
Make sure that the alarm or announcement is loud enough to alert all personnel in the vicinity.
5. Inform Nearby Crew Members:
Inform crew members in the immediate vicinity, including those responsible for specific areas like engine rooms, decks, or cabins, so they can be prepared to assist or clear the area if needed.
Notify security or safety officers for coordination, especially if there is a need to help manage the situation with crowd control or evacuations.
6. Follow Emergency Procedures:
Activate any available emergency procedures such as contacting nearby ports for medical support or arranging evacuation if required. Many ships have established protocols to deal with medical emergencies, including contacting medical professionals via radio or satellite communication.
7. Provide Medical Aid:
Until help arrives, provide first aid or basic medical care to the patient if you're trained to do so.
Monitor the patient and provide reassurance. Administer CPR, control bleeding, or perform other emergency medical interventions based on your training.
8. Coordinate Medical Evacuation if Needed:
If the emergency is severe and requires evacuation to a hospital, arrange for a helicopter or boat evacuation. This typically requires coordination with the coast guard or medical evacuation services.
9. Document the Incident:
Record the details of the medical emergency, including time, nature of the emergency, actions taken, and outcomes. This documentation is essential for both medical and legal purposes.
Own safety
In an emergency aboard a ship, the first consideration must always be for your own safety. This includes ensuring you follow established safety protocols and procedures. Secure your personal safety by wearing the necessary protective equipment, assessing your environment, and moving to a safe location. Once your own safety is ensured, you can then assist others and take appropriate action in line with the ship's emergency protocols. Adhering to these protocols is critical to maintaining order and ensuring the effective handling of the emergency situation.
Personal safety measures when the general alarm is sounded on a ship, here are key steps to ensure your own safety:
1. Acknowledge the Alarm:
2. Wear Proper Safety Gear:
3. Secure Work Area:
4. Follow Muster Instructions:
5. Account for Others:
6. Stay Informed:
7. Emergency Duties:
8. Stay Calm and Alert:
Sequence of immediate actions to be taken in emergency
In the event of a medical emergency aboard a ship, the sequence of immediate actions should be as follows:
Ensure Personal Safety: Before taking any action, make sure you are in a safe position and assess the surrounding environment for any potential hazards. Your safety is the top priority.
Alert the Crew: Immediately notify the ship's medical team or the designated first aid responder. Use the ship's communication system to inform the captain and other crew members about the situation.
Assess the Situation: Quickly assess the condition of the injured or ill person. Check for signs of breathing, consciousness, and any visible injuries. Determine the severity of the situation to decide the urgency of medical assistance needed.
Provide First Aid: Administer basic first aid according to the nature of the medical emergency. This may include CPR, controlling bleeding, treating shock, or providing any other necessary immediate interventions.
Stabilize the Patient: Keep the patient calm and still, and provide comfort to reduce stress. Ensure that their airway is clear, and monitor vital signs (breathing, pulse) if possible.
Prepare for Evacuation (if necessary): If the situation requires evacuation (e.g., for a more serious condition), prepare the patient for transfer to medical facilities on land or arrange for helicopter or boat evacuation.
Maintain Communication: Keep the captain and medical team informed about the condition of the patient and any actions taken. Coordinate with the medical team on board for further guidance.
Record the Incident: Document all actions taken, the patient’s condition, and any medications or treatments administered. This will be vital for any future medical care or investigation.
By following these steps, you can help ensure that the medical emergency is handled promptly and efficiently while maintaining the safety and well-being of the affected individual.
OWN SAFETY WHILE ENTERING TANKS OR ENCLOSED SPACES ON A SHIP
Entering tanks or enclosed spaces on a ship is one of the most dangerous tasks due to risks like oxygen deficiency, toxic gases, and explosion hazards. Always follow proper safety procedures to prevent accidents.
1. PRE-ENTRY PREPARATION
Obtain a Permit-to-Work (PTW):
Conduct Risk Assessment:
Check Gas Levels Using a Gas Detector:
Ensure Proper Ventilation:
Wear the Correct Personal Protective Equipment (PPE):
2. ENTRY PROCEDURE
Never Enter Alone (Always Follow the Buddy System)
Use a Lifeline & Communication Equipment
Avoid Naked Flames or Electrical Sparks
Monitor Gas Levels Continuously
3. EMERGENCY PROCEDURE
If You Feel Dizzy or Breathless, EXIT IMMEDIATELY!
Rescue Procedure (DO NOT Enter Immediately!)
First Aid & Medical Help
4. POST-EXIT SAFETY CHECKS
KEY SAFETY RULES
If someone falls ill during tank cleaning on a ship, it could be due to toxic gas exposure, lack of oxygen, chemical fumes, or physical exhaustion. Immediate action is critical to prevent a fatal incident.
IMMEDIATE ACTION SEQUENCE:
1. Raise the Alarm
2. Do NOT Enter the Tank Alone
3. Stop Tank Cleaning Operations
4. Assess the Situation
5. Ventilate the Tank
6. Follow Safe Rescue Procedures
7. Administer First Aid
8. Inform the Master and Shore Authorities
9. Conduct an Investigation
Key Preventive Measures for Tank Cleaning: