By Oceancare Mediclinic · DGMA Approved Centre, Navi Mumbai · 7 min read
On most merchant ships there is no doctor. When a crew member falls ill or is injured mid-ocean, medical responsibility falls on the master and the designated medical officer — usually the Chief Officer. Their principal companion in that moment is The Ship Captain's Medical Guide, the standard reference (published by the UK Maritime & Coastguard Agency and carried under MLC 2006 medical-care requirements) for treating illness and injury at sea without professional medical staff.
What the Guide Is Designed To Do
The Guide assumes three things: the reader is not a doctor, the ship is hours or days from help, and the medicine chest is limited. Every chapter is therefore written as a decision pathway — recognise, assess, treat with what is aboard, and know when to call for help or divert.
How the Guide Is Organised
- Emergency chapters first — resuscitation, choking, severe bleeding, shock and burns are placed for instant access, because in these minutes count.
- Symptom-based chapters — chest pain, abdominal pain, fever, breathlessness: the Guide works from what you can see and measure, not from diagnoses you cannot make.
- Body-system chapters — detailed sections on injuries, infections, skin, eyes, ears and mental health.
- The medicine chest annex — every recommended drug cross-referenced by number to the treatments in the text, matching the statutory medical stores your flag requires.
- External assistance — how to structure a radio medical consultation and prepare for medevac or port diversion.
Using It in a Real Situation — Step by Step
- Stabilise first. Go straight to the emergency section: airway, breathing, circulation, bleeding control. Do not research while a casualty deteriorates.
- Record vital data. Temperature, pulse, respiration rate, blood pressure, consciousness level — the same vital data framework your pre-sea medical documents. Write times against every reading; trends matter more than single values.
- Work through the symptom chapter. Answer the Guide's structured questions honestly — location, onset, severity, history. The pathway will lead to a working assessment and a treatment plan from the medicine chest.
- Seek Radio Medical Advice early. Services such as CIRM Roma and coastal TMAS stations provide free 24/7 physician support to ships. Have your recorded observations ready — a structured handover gets better advice, faster. India's own arrangements route through the DG Shipping framework.
- Document everything. Treatment given, times, doses and responses — for the ship's medical log, the receiving hospital, and any P&I or flag state review that follows.
- Escalate decisively. The Guide is explicit about red flags that justify diversion or evacuation. A master who diverts on the Guide's criteria is on defensible ground, medically and commercially.
CIRM Roma — The World's Radio Medical Lifeline
The Guide's chapter on external assistance leads to one institution above all: CIRM — Centro Internazionale Radio Medico, the International Radio Medical Centre in Rome. Founded in 1935, it is the oldest radio-medical assistance organisation in existence and today serves as Italy's Telemedical Maritime Assistance Service (TMAS), with duty physicians available 24 hours a day, 365 days a year — completely free of charge to ships of any flag, anywhere on earth.
How to Contact CIRM
- Email: telesoccorso@cirm.it (the primary channel for structured case reports and follow-ups)
- Telephone: +39 06 5929 0263 / +39 329 723 2798 (24-hour duty physician)
- Via any Italian coastal radio station or your flag's designated TMAS, which can relay to CIRM
What CIRM Will Ask You — Prepare Before You Call
A radio medical consultation is only as good as the information the ship provides. Have this ready, in writing:
- Vessel name, call sign, position, ports of departure and destination, ETA
- Patient's rank, age, nationality — and his last medical fitness certificate details
- Vital signs with times: temperature, pulse, blood pressure, respiration rate, consciousness
- Symptom onset, progression and anything already administered from the medicine chest
- Known history, allergies and current medications
- Your medicine chest inventory — the doctor prescribes only from what you actually carry
Notice how much of that list traces straight back to shore: the vital-data baseline, the declared history, the medications on record — all documented at the seafarer's pre-sea medical examination. A thorough examination file ashore becomes clinical gold when a CIRM physician is treating your crewman blind from 4,000 miles away.
Where we fit in: the best onboard emergency is the one that never happens. A rigorous
pre-sea medical screens out the silent cardiac disease, uncontrolled diabetes and untreated infection that become mid-ocean crises — and as DGMA-approved examiners we also inspect shipboard medical stores under DGS Order 02 of 2017, so the chest the Guide refers to is actually stocked, in date and complete.
Advice for Masters and Chief Officers
Read the emergency chapters before you need them — familiarity under calm conditions is what makes the Guide usable under stress. Run medicine-chest checks against the annex at each handover. And insist on crew joining with genuine, thorough medical certificates: the Guide is a safety net, not a substitute for a fit crew.
Book a Seafarer Medical Ask About Medical Stores Inspection
