General Principles
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 also involves attempt to start the recovery process from the illness or injury, and in some cases might involve completing a treatment, such as in the case of applying a plaster to a small wound or a tourniquet to prevent bleeding or a splint to immobilize a fracture.
- First aid training also involves the prevention of initial injury and responder safety, and the treatment phases.
First Aid encompasses DRABCD. That is:
- Danger
- Response
- Airway
- Breathing
- Compressions/Circulation
- Defibrillation
First Aid Procedures
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 mariners are given proper health protection and medical care.
- The mariners are given necessary medicines without any delay.
- Medical equipment and facilities for analysing and for doing treatment are available.
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:
- At least one mariner on board taking charge of all the medical care and administering medicine as part of their usual duties
- At least one mariner skilled in providing medical first aid on board.
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:
- Fulfil their responsibilities under the sections of the Maritime Labour Convention 2006
- Make sure the finest possible health outcomes for their maritime population.
IMGS (International Medical Guide for ships) contains the following:
- First aid treatment
- Shock
- Pain management
- Head injuries
- Eye injuries and illness
- Injuries in bone, joint, and muscle
- Injuries in abdominal and chest
- Wounds
- Burns, chemical splashes, smoke inhalation, and electrocution
- Heat disorders like heat stroke
- Poisoning
- Examination of the sick person
- Paralysis, weird behaviour and unconsciousness
- Heart disorders like chest pain, circulation problem etc
- Respiratory problems
- Gastrointestinal and liver illness
- Kidney disorders and other urinary infections
- Pregnancy and childbirth
- Infections transmitted by sexually activities
- Skin diseases
- Disorders in bone, joint and muscle
- Usage of tobacco, alcohol and drugs
- Transmittable diseases
- Dental problems
- External aid
- Nursing care and medical actions
- Fatality at sea
- Medical care for mariners at sea
- Environmental control and cleanliness
- Preventing illness and promoting health in mariners
- Anatomy and physiology
- International Health Regulations (abbreviated as IHR)
- Medicine chest of ship
- Annex A: Forms for case reporting, referral and clearance
Training of Seafarers
As per IMO requirements, there are three levels of first aid training for seafarers.
- Before starting work at sea, all seafarers are required to undertake elementary first aid training, which is a short course designed to provide a basic knowledge of what to do when faced with an accident or medical emergency.
- Ships’ officers are required to complete proficiency in medical first aid training, covering the provision of immediate first aid in the event of an accident or illness on board.
- The ship’s Master and anyone who is designated to be responsible for the medical stores on board is required to complete proficiency in medical care training, covering provision of medical care to the sick and injured while they remain on board.
- Each of the courses includes the use of the medical stores which are required to be carried on board. Organizations providing the training have to be approved by the flag state administration and details of approved training providers can be obtained from them. Syllabus of these courses is as per the STCW Code.
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.
