Shipboard medical kit & medical care

The International Medical Guide for Ships (IMGS, WHO 3rd edition 2007), the IMO/ILO/WHO Joint Guidelines, and MLC 2006 Regulation 4.1 govern the medical equipment, medicines, and care every ship must provide. Flag states publish national annexes (UK MS Notice 1768, US 46 CFR 184.610, Norwegian Maritime Authority guidance) with country-specific items. Verification at MLC inspection.

Kit categories

• Category A. Ships on international voyages, especially deep-sea trade where shore medical attention is more than 24 hours away. Most comprehensive list — full antibiotic course, controlled analgesics, IV fluids, suture material, splints, AED.
• Category B. Ships on short-international voyages (within 24 hours of a port). Reduced list; major trauma items unchanged.
• Category C. Inland and very short coastal vessels (within a few hours of help). Basic first-aid plus a few prescription items.

Crew competence

• Medical First Aid (STCW Reg. VI/4-1). Required of every officer in charge of cargo handling on tankers and chemical tankers and many other roles.
• Medical Care (STCW Reg. VI/4-2). Required of officers nominated as the shipboard medical officer. Course includes simulated patient assessment, drug administration, suturing, splinting, telemedicine procedure.
• Crew first-aiders. Most operators ensure each watch carries a crew member trained in basic first aid plus AED operation.

Telemedicine — TMAS providers

• CIRM (Italy). Centro Internazionale Radio-Medico. Free 24/7 service to any ship at sea. Phone, fax, email, satellite. Handles >7,000 cases/year.
• CCMM (France). Centre de Consultation Médicale Maritime. 24/7, free, French- and English-speaking.
• Radio Medical Norway. Operated by Haukeland University Hospital. Free 24/7 to any vessel.
• RMC USA / Future Care / VIKAND. Commercial telemedicine services subscribed by major ship operators; richer service (case-management, follow-up, repatriation logistics) but at cost.

Controlled drugs and record-keeping

• · Controlled drugs (opioid analgesics, benzodiazepines, ketamine) kept in a separate locked compartment.
• · Master holds the controlled-drug register and signs every administration.
• · Medical Officer's daily log records all consultations, drugs given, and outcomes.
• · Disposal of expired controlled drugs requires shore-based authority — typically the destination port's environmental health office or a contracted pharmacy.

Common PSC / MLC findings

• · Expired medicines on the shelf — single most common deficiency.
• · Refrigerator temperature log not maintained.
• · Controlled-drug register entries missing or non-sequential.
• · STCW VI/4-2 certificate not held by any current crew member.
• · MFAG / EmS Guide not on board (carriage required for ships handling DG).
• · Medical Officer's log entries blank for known events recorded in the OLB.

Sources: International Medical Guide for Ships (WHO 3rd edition 2007); IMO/ILO/WHO Joint Guidelines on Maritime Medical Examinations; MLC 2006 Reg. 4.1 + Standard A4.1; STCW Reg. VI/4; MSC/Circ.857 (MFAG); ILO/WHO publication 'International Medical Guide for Ships' (free download). National variants: UK MS Notice 1768; US 46 CFR 184.610. See also injury at sea, medical help, CIRM, MFAG.