Marine EMS Transport/Paramedicine

[ministermedic]

Hello all,

I'm doing some research on Marine Transport for my CE and am wondering if anyone can point me to some good online resources on Marine EMS Transport and Marine Paramedicine.

Thanks,

Ministermedic

EMT-P

[Dustdevil]

I transported a lot of Marines in Iraq, if that is helpful to you.

[scubanurse]

define marine? USMC? or like aquatic and boats?

[ministermedic]

define marine? USMC? or like aquatic and boats?

Sorry Dustdevil and Scoobykate, I should have been clearer in my first post. I am referring to the use of a "Marine Ambulance" for the transportation of patients similar to the "Flying Christine III" http://www.seawardboat.com/A_Rescue.html

The specific CE competency is to "Demonstrate the knowledge and ability to determine appropriateness of marine transport." I certainly have ideas on when it is appropriate to use marine transport but am looking for material I can read and reference.

Thank,

MinisterMedic

EMT-P

[scubanurse]

Sorry, can't help ya much there. I know a bit about off-shore medicine for Sailing and trans-atlantic/pacific passages but not so much what you're looking for. Good luck!

[Dustdevil]

Well, I don't think I know of any specific resources for you. Sorry about that.

It's an interesting question though. I've been involved in marine transportation at jet boat events, as well as in the role of a lake patrolman years ago, and military SAR. Of course, those were all scene response EMS events, not long distance transportation.

I'm kind of confused by the question though. The above examples are obviously absolute indications for marine transport. But what other indications might there be? As a flight nurse, I have had patients that absolutely did not want to fly, yet needed to travel a long -- sometimes intercontinental -- distance for repatriation. I suppose it might be appropriate to stick them on a cruise ship with a nurse, under those conditions.

I'm interested in what other information you come up with, as well as your preconceptions on the matter.

Good luck!

[FredG]

Well, from the Merchant Mariner side of things, there may be some resources online. All Merchant Marine Officers are required to take Basic First Aid and maintain a Medical care Provider certification (24-hour class) and 2nd Mates on up are required to maintain a Medical Care Person In Charge certification, which is a 60 hour course. The requirements fall under STCW 95 (Standards of Training, Certification, and watchkeeping 1995 - see www.stcw.org). STCW certifications are required and managed in the US by the US Coast Guard for civilian Merchant Mariners. There are also SOLAS (International Convention for the Safety Of Life At Sea) regulations that may apply.

Try to do a search for STCW Medical at http://www.uscg.mil/global/search/default.asp

You can also look for information at http://www.imo.org/ which is the International Maritime Organization and serves as the repository for many STCW and SOLAS documentation.

You can probably find some hits using some creative Google searching with the regulation terms and "medical" or "injury", etc.

My experience as a Merchat Mariner is somewhat limited, I went to a State Maritime College and had to sail on a Training Ship for 3 summers. Because of the number of cadets, we had a full sickbay staffed with a MD, a Nurse, and 12 cadet hospital corpsman (who were mostly cadets that had CFR or EMT certs). My wife sailed as an officer for 10 years (but I decided that sailing was not for me), but I can tell you that based on her "sea stories", along with my experience from the few medical evacs we had from the Training ship, most medical responses are either Coast guard or local law enforcement responses. Depending on the condition of the patient and the distance from shore, the evac may be done via helo by dropping a basket via cable to the deck (or some larger tankers have helipads) and closer in, the patient may be transferer to a fast response vessel. In rare cases, if there is sufficient resources on the vessel itself or if the patient has been stabilized (usually with the aid of shore based doctors via Sat Phone or Radio) AND dock space is available at the desitnation terminal, the vessel may be reprioritized to enter port and dock...but the cargo ops have to start as if it were normal procedure.

For smaller recreational boats, most responses are handled by the Coast Guard and local law enforcement. In NYC and some other localities, there are also FDNY fire boats that can be utilized.

Hope this helps.

[scubanurse]

Fred, thank you for those resources. I recently outfitted my parents medic kit for a 3-year circumnavigation on a small sail craft. They will be traveling in countries with very limited medical resources and on waters between land for several weeks. They both have CPR and First Aid training, but as you are aware, that will only get them so far. They have quick-clot, KingLT, burn kits, and plenty of small bandages. It's hard to prepare them for everything, but they have a Wilderness Medicine book from NOLS and I made a little quick reference book for them. The big things they will run into are fractures and head injuries from falling from the mast, lacerations, and burns from engine fires. They have the silverlon burn kits and such. They also have several Epi-pens in case they encounter some funky marine life in their adventures.

Anyone interested they have a blog about their adventures.

http://sv-grace.blogspot.com