External assistance
Governing: Table A-VI/4-2 'participate in co-ordinated schemes for medical assistance'; MGN 623 (M+F); MGN 482 (M) Amendment 2; REG Yacht Code Annex J7.
The call
MGN 623: contact HM Coastguard first (MF DSC, VHF DSC, VHF 16; satellite or mobile phone as backup), who will ask for the casualty's condition, vessel type, next port or nearest port for landing, position, and if mid-ocean when you will be in helicopter range, and then connect you to a TMAS doctor. The Coastguard may arrange helicopter or lifeboat evacuation on the doctor's advice. Outside the UK, the local MRCC does the same.
Give a structured report, in this order:
| Item | Content |
|---|---|
| Patient | Age, sex, role, relevant history, allergies |
| Problem | Main complaint, when it started, how it has changed |
| Observations | Timed pulse, breathing, SpO2, BP, temperature, response level |
| Treatment | Everything given, doses and times |
| Vessel | Position, course, speed, ETA to ports, stores carried |
| Question | What you need: advice, a decision on diversion, evacuation |
Then read back the advice, write it down, and log it. REG Annex J7 requires crew with medical duties to know the medical section of the International Code of Signals for when language is a barrier.
Evacuation options
| Option | Considerations |
|---|---|
| Divert to port | Often best for stable patients; agent arranges ambulance |
| Rendezvous with lifeboat or pilot boat | Near coast; patient transfer by boat in a seaway is hazardous |
| Helicopter | Range limits; weather; winching risk to patient and crew |
| Tender to shore | Yacht-specific; only for stable, mobile patients in good conditions |
The master decides, on medical advice, with the Coastguard.
Preparing the patient
- A written summary in English: history, observations with times, treatment and medicines given, allergies.
- Passport or ID, medicines being taken, essential belongings, labelled and bagged.
- Nil by mouth if surgery is possible.
- Securely wrapped and warm; stretcher of the type the rescuers can use.
- A crew member to escort if the rescuers agree.
Preparing the deck for a helicopter
Follow the Coastguard and aircrew instructions. In general: clear and secure the area, strike awnings and antennas where possible, secure loose items, cushions and toys, keep guests below, have firefighting and rescue ready, and do not touch the winch wire until it has been earthed. Heading and speed will be given by the aircraft.
Treatment ashore
MGN 482 A2: seafarers have the right, where reasonably practicable, to go ashore for medical attention in ports; the shipowner bears costs of surgical, medical, dental or optical treatment for 16 weeks or until repatriation; the model MSF 4155 medical report form documents treatment ashore. Port health may be involved for infectious disease.
WARNING — Tender runs A night tender run with a sick crew member to a beach where 'someone will meet us' is how a medical problem becomes a SAR case. Use proper evacuation routes.
TIP — Keep a copy Copy everything you send with the patient. The next conversation will be with the owner's insurer.