Training

The Role of the Medical Person on Board

1 May 2020 By Ted Morley
technician holding tube labeled coronavirus
iStock/Samara Heisz

Capt. Ted Morley was raised aboard a schooner and has made a career working on board vessels ranging from superyachts to super tankers. During his tenure at sea, he worked his way up from seaman to master. He currently holds a USCG Master’s License, Unlimited Tonnage as well as several foreign certificates. Capt. Morley actively participates in maritime advisory committees in the U.S. as well as overseas and is involved in regulatory policy review in the U.S.. 

The coronavirus pandemic has changed the world and how many of us look at our policies and protocols on board. I recently had a captain ask me what they should do on board their yacht to control the spread, and what the Med PiC (Medical Person in Charge) could do treatment-wise while on board. We discussed CDC guidelines — more specifically about hygiene and cleaning — but then the topic shifted to the role of the Med PiC.

The Med PiC training requirements are outlined in 46 CFR 11.305(a)(3)(ix); 11.307(a)(3)(ix); 11.311(a)(3)(vi); 11.313(a)(3)(vi); 11.315(a) (3)(ii); and 46 CFR 12.621(a)(1) and (2); and Table A-VI/4-2 of the STCW Code, as amended in 2010 for an STCW endorsement as Person in Charge of Medical Care; and the competence of Table A-II/2 to organize and manage the provision of medical care on board, hence satisfying the STCW requirement for a medical certification at the management level.

The question is, what is your capability to actually manage and treat the case on board while waiting for medevac or treatment ashore? Some yachts have ventilators and oxygen on board to assist in breathing when there is reduced lung function, but the majority don’t.

Telemedicine and shoreside assistance are musts in any acute medical emergency response. They’ll also play a vital role as expert advice is most certainly needed for highly infectious diseases. The question is, what is your capability to actually manage and treat the case on board while waiting for medevac or treatment ashore? Some yachts have ventilators and oxygen on board to assist in breathing when there is reduced lung function, but the majority don’t.

Your ability to treat the patient on board relies on your equipment and training. The Med PiC class, or Proficiency in Medical Care in MCA parlance, discusses infectious diseases and respiratory emergencies among many other medical conditions. While it covers a tremendous amount of information and provides a high level of training, it doesn’t make you an expert.

Your job as the Med PiC is to manage care, document it, and do your best to prevent the spread. Consider how and where you could isolate a crewmember or passenger; how long you could provide emergency care for; and how far away help is. Take a hard look at the equipment you have and get some expert assistance to ensure you have the right equipment to go along with your training.

The worldwide coronavirus outbreak demonstrates how quickly a disease can spread in our “socially connected” world, but there are many other highly contagious and deadly diseases/viruses out there. Part of being prepared is having a well thought-out plan, the right equipment, right training, and right mindset. Preventative measures are also important to consider — there are UV sterilizers that can be used in HVAC systems, disinfectant foggers, proper hygiene, and other measures that will greatly limit the likelihood of a virus taking hold.

Think about what steps can be taken to avoid it in the first place, as that’s far easier than managing it once it happens.

This column is taken from the May 2020 issue of Dockwalk.

 

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