Regulations for Ship's Hospital

What type of medical equipment is required to have on board. What does Coast Guard require you to carry. or for Solas requirements.or
is it up to the company or client or medical personnel you have on board.

This is a very good question! Where indeed are the requirements for what a hospital is to be equipped with? I have never seen any and have always just relied on firms to supply the tackleboxes filled with the meds they thought I should have but I have always wondered if there ever was a standard anywhere?

I’m sure it can be found in the CFR’s somewhere.

[QUOTE=Capnklump;62505]I’m sure it can be found in the CFR’s somewhere.[/QUOTE]

Don’t know about that…been through them a bunch of times looking for these regulations and nothing plus the USCG has nothing in their inspection booklets or other guidance publications.

I guess maybe not then. When all else fails… Google it!

I am not sure if this is what you are looking for , but it may help.

46 CFR 92.20 Cargo Ships
46 CFR 108.209 MODU
46 CFR 167.50 and 168.15 Nautical School Ships
46 CFR 190.20 Research Vessels

It’s in the World Health Organization’s Medical Guide For Ships. Here’s a link to an older copy but an updated version should be in you hospital:
http://www.seasidemarinedrugs.com/pdf/WHO%203rd%20Book.pdf

I’m afraid I don’t have references to regs - but my understanding is that only requirement for hospitals is that 1- the bed be accessible from three sides (not against a bulkhead) and 2-it have head facilities segregated from other personnel on board. Good luck finding any difinitive requirements for pharmaceuticals to be carried- been down that road and never got a conclusive answer. I think the Ship Captain’s Medical Guide provides guidance - but nothing regulatory.

[QUOTE=todd.harter;62539]I’m afraid I don’t have references to regs - but my understanding is that only requirement for hospitals is that 1- the bed be accessible from three sides (not against a bulkhead) and 2-it have head facilities segregated from other personnel on board. Good luck finding any difinitive requirements for pharmaceuticals to be carried- been down that road and never got a conclusive answer. I think the Ship Captain’s Medical Guide provides guidance - but nothing regulatory.[/QUOTE]

I think there is also a list in “Ship’s Medicine Chest and First Aid at Sea” which was one of the standard medical publications found on US ships but that is so antiquated now. Myself, I have always wanted to have all the basics but also to have the equipment and meds to treat major trauma long enough to get the person in range of transport to some facility ashore. Of course, crossings of the southern Indian Ocean is one of the lonliest you can make with regards to sources of aid but my drillship did have a medic and well equipped hospital aboard yet we did not have what I felt was an adequate qauntity of serious pain relieving and shock reducing narcotics if we had someone suffer an major trauma injury. There is also the issue of very acute illnesses such as heart attack or stroke to be able to contend with as well.

I’ve been very fortunate to have never faced a major medical emergency at sea (although I once had a very strange one which I won’t go in to details about here) and am not glad for my ship to be only a helicopter ride to the nearest trauma center.

ILO convention (No. 164) offers a little information

The CFRs offer design and little equipment information, but nothing specific

46 CFR 108.209 MODUs
46 CFR 190.20-35 Research Vessels
46 CFR 92.20-35 Cargo
46 CFR 167.50 and 168.15-35 Nautical School Vessels

I think that information can also be obtained from the New International Medical Guide for Ships (Third Edition), which is a joint communication from the ILO, IMO and WHO

[QUOTE=captamericas;62549]ILO convention (No. 164) offers a little information

I think that information can also be obtained from the New International Medical Guide for Ships (Third Edition), which is a joint communication from the ILO, IMO and WHO[/QUOTE]

I was wondering if there might be something from the ILO but have not seen this guide yet. WIll order it for my vessel to see what it recommends.

Gents,

I have never seen a surveyor, USCG or any other entity perform an extensive audit of Medical Supplies other than checking dates and the proper securing of controlled substances/prescription meds. Here is a good link with a general comprehensive list of items for a ships medicine chest:

http://www.fas.org/irp/doddir/milmed/ships.pdf

There are different standards which are all difficult to find specifics on and they vary whether you are calling the area an actual Hospital or Treatment Area. A hospital should have a full assortment of medical supplies and equipment vs. a Captains Medicine Chest with the bare necessities. A hospital must have an exit to the exterior of the vessel large enough for egress of a stretcher etc. as well as the bed w/a call button accessible from 3 sides…yada, yada, yada. Every Master should have his MPIC and be familiar with the basics. The DPA should be able to define exactly what is required onboard by Flag, Surveyor, Insurer or Contractor. These days everyone should have an AED. As far as the requirement of an actual Paramedic onboard they must still operate underneath the supervision of a Licensed Physician same as a Nurse. Paramedics have much more advanced emergency lifesaving training and are more experienced operating independently on trauma related/severe medical situations. Stocking Narcotics (Morphine, Valium, Vicodin or Codeine) can be tricky as they are considered a DEA controlled substance and from what I understand not readily permissible in all countries. They also must be purchased and maintained under a Physicians license and logged and documented as far as use and storage. Other than a bottle of Vicodin and prefilled Morphine syringes I would not want to carry narcotics without a Medic. Once again your DPA should be able to define exactly what should be happening onboard the vessel as this should be part of your SMS/ISM documentation. Good sense applies here, you should have enough supplies for your crew and be well trained to use your lifesaving tools or they are useless. And make sure you have more than one person trained, if the medical care provider is injured who will take care of him? And be sure to regularly inventory and maintain your medical equipment/supplies. They are the items that you may never need in your career but if you do need them you must be able to count on them not to fail. Keep in mind even USCG flight rescue medics are only trained at a Basic Level so they are pretty much just giving you a ride to the closest hospital. Be prepared.If you have deep pockets hire a consultant. Do not rely on CFR’s, SOLAS or other resources if you are not well versed with the subject. It could be your life on the line. I hope this helps… if you have specific questions I’d be glad to offer what little help I can. Cheers.

anyone that has a question on this send me a PM

See also a good presentation on this item:
http://www.helse-bergen.no/omoss/avdelinger/norsk-senter-for-maritim-medisin/Documents/Recommendations%20for%20Ship%20Medical%20facilities.pdf