Medical at sea

Your first call in a medical emergency is your Master. Onboard medical decisions are supported by telemedicine providers — the ship's flag or owner usually contracts one (CIRM, Radio Medical, Medlink are common). TMAS (Telemedical Maritime Assistance Service) is free under SOLAS for any ship in distress.

Step-by-step

1. Alert the Master immediately; Master contacts TMAS via the flag state's channel (often MF/HF or INMARSAT-C).
2. Provide the patient's age, sex, vital signs, and the ship's full medical kit contents (Cat A/B/C per STCW).
3. Follow TMAS instructions to the letter — the medical log becomes a legal document.
4. If disembarkation is needed, Master requests medevac via the nearest MRCC (Maritime Rescue Coordination Centre).

Evidence to save

• Patient vitals log (BP, pulse, temperature, oxygen sats) at 15-min intervals
• TMAS consultation transcript (master writes verbatim + the time)
• Medication administered with dose, time, and route
• Photographs of the injury / condition if visible (with consent)
• Original PEME (Pre-Employment Medical Examination) certificate

What NOT to sign

• Any waiver of further medical care to expedite discharge
• Release of liability presented by the owner before P&I cover engages

Legal basis

SOLAS V/4.1 (SAR), ILO C164 (medical care onboard), MLC 2006 Regulation 4.1.

Primary sources

• SOLAS V/4.1 — Search and rescue
• MLC 2006 Reg 4.1 + Std A4.1 — Medical care onboard + ashore
• IMO MFAG (Medical First Aid Guide for use in accidents involving dangerous goods)
• Rights pillar: medical care

Organisations that can help

• ISWAN SeafarerHelp
  Global · 24/7
  📞 +44 800 012 1004
  💬 WhatsApp +44 7909 470732
• CIRM — Centro Internazionale Radio Medico (Rome)
  Global · 24/7
  📞 +39 06 5923331
• Centre de Consultation Médicale Maritime (Toulouse)
  Global · 24/7
  📞 +33 5 34 39 33 33
• Radio Medico Norway (Haukeland Universitetssjukehus)
  Global · 24/7
  📞 +47 55 97 50 00
• Sailors' Society
  Global · 24/7 crisis line
  📞 +44 23 8051 5950
• Headway — Brain Injury Support (relevant to seafarers post-incident)
  Europe · Mon-Fri 9-17 GMT
  📞 +44 808 800 2244
• Stella Maris (Apostleship of the Sea)
  Global · 24/7 emergency line
  📞 +44 207 901 1931
  💬 WhatsApp +44 7732 469783
• AMOSUP (Philippines)
  Asia-Pacific · Office hours
  📞 +63 2 8527 8491

Disclaimer. General information only — not medical or legal advice. In a real medical emergency at sea, contact TMAS via the flag-state channel and follow the medical professional's instructions. Onboard medical decisions are the master's responsibility under SOLAS V/4.1.