Radio medical advice
Governing: STCW Table A-VI/1-3; UK Telemedical Advice Service (TMAS) arrangements via HM Coastguard. Builds on: L1.2.
Ashore, first aid buys minutes until an ambulance. At sea, it may need to buy hours or days. The link that closes the gap is radio medical advice: a doctor, on the radio or phone, advising the master and the designated medical person.
The UK system
The UK provides a Telemedical Advice Service (TMAS) through HM Coastguard:
| Element | Arrangement (as summarised) |
|---|---|
| How to call | Contact HM Coastguard by MF DSC, VHF DSC, VHF Channel 16, or by telephone |
| Who advises | Doctors at the designated TMAS hospitals: Queen Alexandra Hospital, Portsmouth and Aberdeen Royal Infirmary |
| Cost | Free of charge |
| Other means | Satellite voice or mobile phones can be used, but should not be the only means of contact |
Outside UK waters, other states' coastguards and TMAS centres provide the same service. On a Red Ensign yacht abroad, the local Maritime Rescue Coordination Centre will connect you.
CAUTION — Verify the numbers Keep the current Coastguard numbers on the bridge and in the medical log, taken from current MCA guidance rather than from this course.
Who makes the call
On most yachts, the master or the officer holding Medical Care makes the call. Your job, as EFA-trained crew, is often to gather the information, take observations, and carry out the treatment advised.
What to have ready
The Coastguard will ask for:
- brief details of the casualty's illness or injury;
- vessel type;
- position;
- next port of call or nearest landing port;
- if far offshore, estimated time to helicopter range.
The doctor will want a structured picture. The Ship Captain's Medical Guide has a proforma. At minimum:
| Item | Detail |
|---|---|
| Casualty | Name, age, sex, role |
| Problem | What happened, when, symptoms |
| Observations | Pulse, breathing rate, level of response, temperature, skin colour; with times |
| History | Past illness, medications, allergies (L1.2) |
| Treatment | What first aid has been given, when, and the effect |
| Resources | What medical stores and trained people are aboard |
Photographs of injuries can help.
TIP — Observations every 15 minutes Write pulse, breathing and response every 15 minutes on a sheet with times. Trends tell the doctor more than any single reading.
After the call
- Follow the advice; record it, with times, in the medical log.
- Re-contact if the casualty changes.
- If evacuation is advised, the Coastguard coordinates it: diversion to port, a lifeboat, or a helicopter.
Preparing for evacuation
- Casualty packaged: warm, secured to a stretcher if needed, with the medical notes and a copy of the log attached.
- Documents: passport, ENG1 details, list of medications given.
- Personal items: minimal; phone, charger.
- Helicopter: see the helicopter rescue section of Personal Survival Techniques.
- Handover: brief summary to the paramedic or winchman: who, what, what was done, current state.
Beyond EFA
If you are designated to give first aid on board, you need Medical First Aid. The officer in charge of medical care needs Medical Care. Both build on what this course covers.
WARNING — Do not guess If you are unsure, call. The TMAS doctor would rather take an unnecessary call than hear about a casualty too late.