YACHTING NEWS

Dealing with Onboard Medical Emergencies

How to ensure the best medical support for your yacht with Franc Jansen, Head of YPI Management

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Recent events in Italy are a timely and very public reminder that accidents happen at sea. Every year thousands of medical emergencies and accidents from breaking arms to falling overboard to serious medical illnesses occur on board yachts. But how prepared can captains and crew be for such eventualities and what options are open to owners and crew in finding the best solutions. Franc Jansen, Head of YPI Management, talks to Tony Nicholson of MedAire/Yacht Lifeline to find out more.
 

The most common cases are gastrointestinal, ENT (ear, nose and throat), dermatological, trauma, and orthopedic/ musculoskeletal. Interestingly, in over 70% of cases we supported, the yacht was in port or at anchor.

 

Tony Nicholson
MedAire/Yacht Lifeline

FJ.

Are the mandatory legal requirements yachts must abide by in respect of onboard medical provisions and crew training levels enough?

TN.

The statutory requirements are the minimum standard established in legislation. These alone may not leave you fully prepared to deal with medical incidents onboard and there are a number of reasons for this:
  • the level of competence and confidence to deal with a medical event will vary
  • the types of activity commonplace on board many yachts e.g. diving / water sports and planned destinations, may not be catered for by the legislation that was originally drafted for commercial shipping activities
  • current legislation may not reflect ‘best medical practice’, particularly with regards to newly available treatments
  • cost is a significant deciding factor in statutory legislation – it may not be such a restrictive issue where the safety of owners, guests and crew is paramount
     
FJ.In your experience what are the most common medical situations onboard private yachts?
TN.The majority of medical events we assist with are non-emergency in nature. The ideal is that medical advice is sought early and quickly, thereby hopefully preventing an emergency from developing. As part of our ongoing research we maintain detailed case data, this allows us to identify not only potential problem areas but also to ensure Medical Kit and training issues that require specific focus are addressed.
FJ.What makes the Medical Kits provided by you, and companies like yours, different from what the law requires?
TN.

The legislation provides guidance and recommendations for when the captain and/or owner do not seek medical advice. One of the benefits of consulting with a professional organisation is having a cohesive solution between skill level, available equipment and medicines (specific to the yachts activities) as well as the availability of accurate information and fast access to appropriate medical advice. To give you an example, here are some standard recommendations that are not required today by current legislation:

  • Defibrillation / resuscitation equipment
  • Advanced oxygen systems – including being suitable for diving operations
  • Diagnostic additions (blood tests / telemedicine equipment) to aid both remote physicians and onboard crew
  • Emergency fluid resuscitation options
  • Fracture and spinal management capability suited to the yacht’s activities
  • More accurate scaling of medicine quantities to minimize wastage and give the best balanced approach to available treatments
  • Guest specific medications – e.g. children and pre-existing conditions
FJ.Is the minimum crew training required by law enough when it comes to medical emergencies on board?
TN.We do not believe so. Let me give you some comparisons. Legislation in the Maritime Industry calls for medical training to be conducted every 5 years - the commercial aviation industry calls for training every year as a minimum. The longest time frame on an aircraft without assistance being available is 8 hours. As we all know, it can sometimes be up to 5 days before a patient can be taken off a yacht to get proper medical assistance - this is hugely significant from a medical point of view.

We recently added a very popular training option for the Yachting Industry which is a short, customised, onboard, knowledge based and practical “Tune Up Training”. It can be conducted over a one-day period and can cover any aspects the captain/crew/owner wish to cover (provided it is safe for us to do so). We recommend all yachts conduct this once a year. The programs are very flexible and putting it quite simply - having all the gear and advice available is going to do you no good if the patient bleeds out because immediate action is not carried out effectively through lack of training or practice.
 

FJ.Kits can include Shore-side Assistance: how does that work?
TN.It gives immediate access to a full range of physicians - we employ 970 physicians worldwide - and operational experts. As part of the International SOS Group we now handle over 1.3 million cases per annum and conduct over 21,000 evacuations and repatriations.

The concept is simple – call early and call often. Access is based on an annual fee (with no cost, or disincentive, to call). There are two Service Level Options both provided on a “Worldwide for Yachts” basis: MedLink Medical and MedLink Comprehensive.

The new MedLink Comprehensive service allows us to provide a greater range of services for crew and guests both in port and whilst in transit to and from the yacht. This includes many elements of personal safety and security (they often have associated medical issues). Let me give you an example of how this service would be used:

Imagine your stewardess is in transit to the yacht and is in an unknown town. She has been mugged and has lost her handbag. She can’t contact anyone on the yacht and is not feeling safe. So she calls the MedLink Comprehensive service, secure transport will be arranged - and if needed, prepaid - her documents will be arranged to be replaced and onwards transportation will be coordinated if needed. Consular assistance and translation services are available 24/7. If she also requires medical assistance, initial advice and any coordination for this will be arranged at a pre-screened facility. Ongoing management will continue until the case is fully resolved. There is no cost to access the service on a call-per-call basis.
 

 FJ.So what cost range are we looking at for the most basic to the most advanced kits?
 TN.Costs vary considerably and depend on the activities the yacht is undertaking. Likely “worst case” delay in medical evacuation and space onboard are just some of the possible considerations. We normally suggest a direct consultation and review which can be provided free of charge by one of our consultants and it can be carried out during tune-up training onboard. The price range for a basic kit can be anything between €895.00 and €5500.00.
 
 FJ.Finally, with all the items an owner has to pay for or buy, why should an owner invest in a Medical Kit?
 TN.Clinically, a delay in medical treatment is significant and can have life altering effects. Of course due to the nature of the industry we may not be able to prevent a delay in seeing a physician face-to-face and, as such, the industry as a whole has a responsibility to provide the best possible medical care without delay. We all want owners, guests and crew to return from any voyage healthy and happy. Our focus is on ensuring that happens – to do that the right tools and knowledge must be available – we provide them.