Transport Publication TP 13008 E
5.1 Course Duration, Pre-requisites and Goal
- The Marine Medical Care course has a duration of 50 hours and is provided to those seafarers who are designated to provide medical care on board vessels at sea. In order to register for this course, trainees must have completed the 31-hour training course in Marine Advanced First Aid during the previous three years.
- This course may be combined with the Marine Advanced First Aid course to facilitate the training of any individual who wishes to take the Marine Medical Care course but does not have the necessary prerequisite. A combined program will include the content of both courses for a total of 75.5 hours.
- Every seafarer who is designated to provide medical care in the event of an accident or illness on board a vessel at sea is required to demonstrate competence to undertake the tasks, duties and responsibilities described in items 1 to 15.
- Teaching staff should note that this outline is offered for guidance purposes only as regards the different learning objectives and the length of time to be allocated to each objective. These factors may be adapted by instructors to suit individual groups of trainees depending on their experience and abilities as well as the equipment and staff available for training.
5.2 Number of Trainees per Instructor
The number of trainees in a course must not exceed eight when under the supervision of one accredited instructor.
5.3 Course Criteria
Marine Medical Care is required by:
The person designated to take charge of medical care on board a vessel carrying less than 100 crew members and is engaged on a voyage of a duration of more than three days that is an unlimited voyage or a near coastal voyage, class 1.
5.4 Instructor Qualification – Physician
This course must be delivered by a physician and a team whose knowledge and qualifications are recognized by a professional body.
5.5 Training Certificate
After successfully completing this training, candidates will receive a training certificate titled: Marine Medical Care in Accordance with STCW Convention, Regulation VI/4-2.
5.6 Course Outline and Duration
Section | Subject | Time (in hours) |
---|---|---|
1. | First aid – review | 6.0 |
2. | Care of casualties | 7.0 |
3. | Aspects of nursing | 3.5 |
4. | Treatment of diseases | 4.5 |
5. | Alcohol and drug abuse | 3.0 |
6. | Dental care | 1.0 |
7. | Gynecology and pregnancy | 2.0 |
8. | Medical care of rescued persons, including trauma, hypothermia and cold exposure | 3.0 |
9. | Death at sea | 1.0 |
10. | Environment control on board ship | 2.0 |
11. | Disease prevention | 1.0 |
12. | Record keeping and regulations | 0.5 |
13. | Medicines and medical equipment | 4.0 |
14. | Surgical equipment, instruments and supplies | 4.0 |
15. | External assistance | 3.0 |
TOTAL | 45.5 | |
16. | Assessment | 4.5 |
5.7 Knowledge and Competencies
Methods of demonstrating competency are by assessment of the candidate on instruction received and demonstration of the acquired skills. When available, approved practical experience at a hospital or similar establishment should be encouraged.
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
---|---|---|
1. | 1.1 First Aid – Review
1.1.1 Review the knowledge and associated practical skills contained in the Marine Basic First Aid and Marine Advanced First Aid training courses as specified in document TP 13008, emphasizing:
1.1.2 Describe and carry out simple laboratory tests for:
Explain the concepts of clinical examination and medical history tracking under seagoing conditions. |
Trainees must be able to review the basic and intermediate knowledge, as contained in the Marine Basic First Aid and the Marine Medical courses. |
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
---|---|---|
2. |
2.1 Head and spinal injuries 2.1.1 Recognize the mechanisms and symptoms of head and spinal injuries:
2.1.2 Describe how to care for an unconscious casualty and emphasize that no anesthetic or sedative should be used unless prescribed. 2.1.3 Describe and demonstrate the technique to use for a case of suspected spinal fracture:
2.2 Injuries to the ears, nose, throat and eyes 2.2.1 Recognize the mechanisms and symptoms of injuries to the ears, nose, throat and eyes:
2.2.2 Describe the appropriate treatment for such injuries:
2.2.3 For injuries to the ears, nose and throat:
2.2.4 For injuries to the eye region and external eye:
2.3 External and internal bleeding 2.3.1 For external and internal bleeding:
2.4 Burns and frostbite 2.4.1 Recognize the signs of burns and frostbite. 2.4.2 State the possible complications that can arise from such injuries:
2.4.3 Define a burn and recognize burns according to type: heat, hot liquid, electrical, chemical, radiation. 2.4.4 Explain the difference between first-degree, second-degree and third-degree burns:- determine seriousness of injury based on degree and area involved
2.4.5 For the further treatment of a burn:
2.4.6 Explain the difference between burns and frostbite. 2.4.7 Describe how tissues can be damaged by frostbite:
2.4.8 Describe and demonstrate appropriate procedures for:
2.5 Fractures, dislocations and muscular injuries 2.5.1 Describe, explain and demonstrate for fractures, dislocations and muscle injuries:
2.5.2 List and describe the types of fractures:
2.5.3 Describe and demonstrate the methods used for:
2.5.4 Describe the special requirements for the treatment of pelvic, femoral and spinal injuries. 2.5.5 Describe the mechanisms and symptoms for the treatment of:
2.6 Wounds, wound healing and infection 2.6.1 Recognize and list the different kinds and types of wounds:
2.6.2 Describe and demonstrate the different techniques for wound treatment:
2.6.3 Describe the general process of wound healing. 2.6.4 List the measures to prevent infection:
2.6.5 Describe the treatment of infected wounds:
2.6.6 Demonstrate treatment procedures to be used for infected wounds. 2.6.7 Describe the physiological state of shock and its importance in the care of persons suffering from an illness or injury:
2.7 Pain relief 2.7.1 State the general principles of pain relief and anaesthesia, and apply simple procedures. 2.7.2 Describe the simple procedures for non-medicinal relief:
2.7.3 Describe the medicinal treatment:
2.7.4 Knowledge of appropriate medications and products available on board:
2.7.5 Describe non-invasive pain assessment and list the methods used:
2.8 Suturing and clamping techniques 2.8.1 Apply simple measures to stop bleeding and close wounds. Describe and demonstrate the stoppage of bleeding by:
2.8.2 Describe and demonstrate the surgical treatment of a wound by:
2.9 Management of acute abdominal conditions 2.9.1 ecognize the signs and symptoms of acute abdominal conditions, including:
2.9.2 Describe and apply emergency treatment. 2.9.3 Recognize the need for radio medical advice and describe the procedures used. 2.10 Minor surgical treatment 2.10.1 State that, for surgical instruments:
2.10.2 Demonstrate the correct preparations for casualty and equipment before proceeding with minor surgical treatment:
2.10.3 Demonstrate how to proceed with minor surgical treatment for localized skin injuries and infections. 2.10.4 Local anesthesia 2.11 Dressings and bandages 2.11.1 Indicate that dressings are sterile gauze or cotton padding with a layer of cotton fabric to cover a wound or injury. 2.11.2 State the main functions of bandages:
2.11.3 Demonstrate the use of simple dressings and bandages for injuries to:
2.11.4 Demonstrate the use of elasticized gauze and bandages (RETELAST). |
Trainees must be able to ensure that identification of symptoms is based on the concept of clinical examination and medical history and treatment of injury is appropriate and conforms to accepted medical practice and relevant national and international medical guides. |
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
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3. |
3.1 General principles 3.1.1 Describe the general principles of nursing:
3.1.2 Ensure that clinical examination procedures are complete and comply with instructions received:
3.2 Nursing care 3.2.1 Describe and apply simple nursing care procedures for:
|
Trainees must be able to ensure that personal attitude is calm, confident and reassuring, provide medical care to the sick and injured while they remain on board and the significance of changes in patient’s condition is promptly recognized |
Table 4 - Treatment of Diseases
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
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4. |
4.1 Medical conditions and emergencies 4.1.1 Recognize medical emergencies involving:
4.1.2 Use of
O2 resuscitators:
4.1.3 Apply measures and treatments to deal with medical emergency conditions:
4.1.4 Demonstrate the use of the WHO ’s International Medical Guide for Ships ( IMGS ) or similar national guides in conjunction with radio medical advice until more expert help is available or the patient recovers. 4.2 Sexually transmitted diseases 4.2.1 Name the primary sexually-transmitted and blood-borne infections. 4.2.2 Apply basic medical treatment and counselling after receiving radio medical advice. 4.2.3 Obtain medical advice for:
4.3 Tropical and infectious diseases 4.3.1 Recognize and identify infectious diseases. 4.3.2 Define infectious diseases and describe their characteristics, including:
4.3.3 State that particular emphasis should be placed on the causes, treatment and prevention of gastrointestinal illnesses aboard ship. 4.3.4 For tropical diseases:
4.3.5 Describe prevention techniques and procedures. |
Trainees must be able to ensure that identification of symptoms is based on the concepts of clinical examination and medical history and treatment of condition is appropriate and conforms to accepted medical practice and relevant national and international medical guides. |
Table 5 - Alcohol and Drug Abuse and Psychiatric Disorders
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
---|---|---|
5. |
5.1 Recognize alcohol abuse and signs of alcohol dependence. 5.2 Describe potentially addictive drugs and narcotics. 5.3 List the most common substances that can lead to addiction and describe their effects on people. 5.4 Describe and implement treatment measures. 5.5 Describe the risks associated with withdrawal. 5.6 Recognize the importance of alcohol and drug counseling. 5.7 Indicate where such counseling can be obtained. 5.8 Demonstrate the important aspects of counseling. 5.9 Indicate that behavioral and psychiatric problems are sometimes influenced by:
5.10 Understand the concepts of civil and criminal liability in connection with suspected drug abuse. |
Trainees must be able to provide counselling and care with cases of alcohol and drug abuse. |
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
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6. |
6.1 Describe basic dental care:
6.2 Describe the principles of oral hygiene. 6.3 Apply appropriate emergency treatment, including temporary fillings. |
Trainees must be able to apply adequate emergency dental care. |
Table 7 - Gynecology, Pregnancy and Childbirth
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
---|---|---|
7. |
7.1 With respect to pregnancy, describe:
7.2 Describe miscarriage:
7.3 Identify and describe diseases specific to women. 7.4 Recognize labour and imminent delivery:
|
Trainees must be able to assist and provide gynecologic care, as indicated. |
Table 8 - Medical Care of Rescued Persons, Including Distress, Hypothermia and Cold Exposure
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
---|---|---|
8. |
8.1 Describe and apply the procedures for dealing with rescued persons. 8.2 Recognize the special problems that can affect rescued persons, and explain the causes and treatment for:
8.3 Recognize the signs and symptoms of heat-related illness:
8.4 Knowledge of casualty care in near drowning incidents, decompression illness:
|
Trainees must be able to evaluate condition of rescued persons and apply immediately medical care as appropriate. |
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
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9. |
9.1 Recognize and describe the general principles of care for the dying person. 9.2 Recognize and describe the general principles of care for the deceased:
|
Trainees must be able to follow prescribed procedures related to death on board or at sea. |
Table 10 - Enviromment Control on Board Ship
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
---|---|---|
10. |
10.1 Hygiene 10.1.1 Describe the general principles of shipboard hygiene and health education aboard ship. 10.1.2 Apply the main principles to:
10.1.3 Maintain a nursing station. |
Trainees must be able to ensure that sanitary and hygiene standards are maintained on board ship. |
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
---|---|---|
11. |
11.1 Disinfection, disinfestation, de-ratting 11.1.1 Describe the general principles and apply the procedures for protection against the transmission of disease and the control of epidemics. 11.1.2 State the regulations regarding waste and sewage disposal:
11.1.3 Define and apply methods for:
11.2 Vaccination 11.2.1 Describe the general principles regarding the protection of persons by vaccination. 11.2.2 Describe the different kinds of vaccination required for seafarers:
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Trainees must be able to ensure that protection against infection and spread of diseases is complete and effective. |
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
---|---|---|
12. |
12.1 Records of signs, symptoms and medicines given 12.1.1 Describe the general principles regarding the keeping of medical records:
12.1.2 Describe, in particular, the keeping and contents of:
12.1.3 Verification of medical history. 12.2 Inventory control of medicines (storage standards) 12.2.1 Describe expiry dates on drug packaging and the need for timely supply of replacements. 12.2.2 Knowledge of national and international regulations. 12.2.3 State that international and national health regulations apply to medicine at sea, including recommendations by WHO , IMO , and ILO :
|
Trainees must be able to maintain inventory control of medicines and keeping of medical records. |
Table 13 - Medicines and Medical Equipment
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
---|---|---|
13. |
13.1 Medicines 13.1.1 List the contents of the ship’s medicine chest. 13.1.2 State for the medicines and drugs contained in the chest:
13.2 Medical equipment 13.2.1 Knowledge of the use of medical equipment kept on board ship. 13.2.2 State procedures for destruction of date-expired medicines:
13.2.3 Describe the procedure for the disposal of hospital waste. |
Trainees must be able to ensure that the dosage and application of drugs and medication complies with manufacturers’ recommendations and acceptedmedical practice. |
Table 14 - Surgical Equiment, Instruments and Supplies
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
---|---|---|
14. |
14.1 Describe and apply appropriate measures for disinfection and sterilization. 14.2 Demonstrate the use of the surgical equipment and instruments available on board ship. |
Trainees must be able to use sterilized surgical equipment. |
Table 15 - External Assistance
Knowledge, Understanding and Proficiency | Criteria for Evaluating Competence | |
---|---|---|
15. |
15.1 Radio medical advice 15.1.1 Apply and demonstrate the general principles of radio medical advice, including:
15.1.2 Establish effective radio communication. 15.1.3 Complete appropriate verbal reports at time of patient hand-over. 15.2 Transportation of the ill and injured, including helicopter evacuation 15.2.1 Identify the problems involved in the transport of the ill and injured:
15.2.2 Ability to use approved stretchers:
15.2.3 Describe the procedures for evacuation by helicopter and by boat or lifeboat:
15.3 Medical care of the ill and injured, involving cooperation with port health authorities or out-patient wards in port 15.3.1 Describe the procedures for cooperating with port health authorities and out-patient wards in port. 15.3.2 Identify possible problems with language and cultural differences. 15.3.3 Describe the detailed medical records that must be kept and demonstrate their use. |
Trainees must be able to participate in co-ordinated schemes for medical assistance to ships and ensure that procedures for seeking radio medical advice conform to established practice and recommendations. |