INTERNATIONAL NORMS OF MEDICAL CARE ABROAD SHIP AND ASHORE By DR VIJAY BADE,DG SHIPPING APPROVED MEDICAL EXAMINER

 

 

Medical Care Aboard Ship and Ashore

 

Medicine Chest Requirements, Recordkeeping, Responsibilities, and Training for Medical Care

                               For MARITIME ADMINISTRATOR

DR VIJAY BADE

MBBS,AFIH DIPLOMA IN OCCUPATIONAL HEALTH U.K

PGPN BOSTON UNIVERSITY

APPROVED BY DG SHIPPING & CIVIL AVIATION

PH+919881398048 www,drbadevshl.com

Email info@drbadevshl.com

 

Appendix 1 – Inventory Guidelines

for Medicines and Medical Supplies for Ships Without a Doctor On Board

Table I

 Quantities of Medicines for

 Ships Without a Doctor On

 BoardRec

(WHO Quantification Addendum to be used in conjunction with the International Medical Guide for Ships, 3^rd Edition)

 
Category A:    Oceangoing ships. Stock levels are based on a six months’ supply.
Category B:     Vessels engaged in coastal trade or going to nearby ports that travel no more than 24 hours from port of call. Stock levels are based on a six months’ supply.
Category C:     Fishing vessels and private craft usually traveling no more than a few hours from home port or a port of call. The assumed duration of each trip is up to three to four weeks.

 

Name	Form6	Strength	Indication7	Quantities per 10 Crew8			Notes
				A	B	C
Acetylsalicylic acid	tab	300mg	pain, fever, blood clots	50	50	-
Aciclovir	tab	400mg	herpes simples/zoster	70+	35+	-
Adrenaline	amp	1 mg/ml	anaphylaxis	10+	5+	5+
Amoxicillin + clavulanic acid	tab	875mg/125mg	infections	20	10	-
Artemether	amp	80mg/ml	malaria treatment	12+	12+	-
Artemether + Lumefantrine	tab	20mg/120mg	Malaria treatment	24+	24+	-	double if crew size > 30
Atropine	amp	1.2mg/ml	MI/organophosphate poisoning	10+	5+	-	double quantity if carrying organophosphates
Azithromycin	tab	500mg	infections	10+	5+	-
Ceftriaxone	amp	1g	Infections	15	5+	-
Cetirizine	tab	10 mg	Hay fever/hives/dermatitis	30+	30+	-
Charcoal, activated	powder		Poisoning	120g+	120g+	-
Ciprofloxacin	tab	250mg	Infections	20+	10+	-	double if crew size >30
Cloves, oil of	liq		toothache	10ml	10ml+	-
Dexamethasone	amp	4mg/ml	Severe asthma/anaphylaxis	3	1	-
Diazepam	tab	5mg	alcohol withdrawal	50+	20+	-

⁶      amp=ampoule; crm=cream; inh=inhalation; liq=liquid; lot=lotion; oint=ointment; tab=tablet

⁷      AF=atrial fibrillation; HTN=hypertension; MI=myocardial infarction

⁸      Quantities marked with a ‘+’ are suggested quantities irrespective of crew size.

Name	Form6	Strength	Indication7	Quantities per 10 Crew8			Notes
				A	B	C
Docusate with senna	tab	50mg/8mg	constipation	30+	-	-
Doxycyline	tab	100mg	infections	10	-	-
Ethanol, hand cleanser	gel	70%	hand cleaning	500ml	500ml+	100ml+
Ethanol	liq	70%	disinfect instruments	500ml	100ml	-
Fluorescein	eye strips	1%	Detect corneal damage	20+	20+	-
Frusemide	amp	40mg/4ml	Pulmonary oedema	5+	5+	-
Glucagon	amp	1mg	hypoglycaemia	1+	1+	-
Haloperidol	amp	5mg/ml	psychosis/severe agitation	5	5+	-
Hydrocortisone	crm	1%	allergy/inflammatory skin	2x30g	1x30g	-	one (1) tube per patient
Ibuprofen	tab	400 mg	inflammation/pain	100	50	50+
Isosorbide dinitrate	tab	5 mg	angina/MI	10	10	5+
Lignocaine	amp	1%, 5ml	suturing/minor surgery	5	5	-
Loperamide	tab	2mg	diarrhea	30	30	10+
Mebendazole	tab	100mg	intestinal worms	6+	6+	-
Metroprolol	tab	100mg	HTN/AF/angina/migraine	60+	-	-
Metronidazole	tab	500 mg	infections	30+	20+	-
Miconazole	crm	2%	Fungal skin infections	2x30g	1x30g	-	double quantities if females on board
Midazolam	amp	5mg/ml	epileptic fits	10+	5+	-
Misoprostol	tab	200ug	Post-partum hemorrhage	3+	3+	-	only if females on board
Morphine (Controlled Substance)	amp	10mg/ml	severe pain	10	10	-
Morphine (Controlled Substance)	liq	1mg/ml	severe pain in patients able to eat and drink	100ml+	100ml+	-	double if crew size > 30
Naloxone	amp	0.4mg/ml	Opiate overdose	10+	5+	-
Omeprazole	tab	20mg	Reflux, peptic ulcers	30+	30+		double if crew size > 30
Ondanestron	tab	4mg	vomiting, sea-sickness	10	10	10+
Oral rehydration solution	powder	sachet	Dehydration due to diarrhea	15l(75)	10l(50)	2l(10)+	quantities in brackets are number of sachets based on sachets made up to 200ml
Oxymetazoline	nasal drop	0.50%	nasal obstruction/drain sinuses	2	1	-	one (1) bottle per patient
Paracetamol	tab	500mg	pain and fever	100	50	25
Permethrin	lot	1%	lice	200ml+	100ml+	-	double if crew size > 30
Permethrin	lot	5%	scabies	300ml+	100ml+	-	100ml per patient
Povidone iodine	liq	10%	disinfect skin/wounds	100ml	100ml	100ml+
Povidone iodine	oint	10%	disinfect skin/wounds	1x25g	1x25g	-

Name	Form6	Strength	Indication7	Quantities per 10 Crew8			Notes
				A	B	C
Prednisone	tab	25mg	asthma/inflammatory conditions	30+	30+	-
Salbutamol	inh	100ug/dose	asthma/bronchitis/emphysema	1	1	-	one (1) inhaler per patient
Sodium chloride	liq	0.9%,1litre	fluid replacement	5+	1	-
Tetracaine (amethocaine)	eye drop	0.50%, 1ml	eye examination	20+	20+	-
Tetracycline	eye ointment	1%	minor eye infections	2	1	1+	one (1) tube per patient
Vitamin K	amp	10mg/ml	reverse warfarin or similar	2+	2+	-
Water for injection	amp	5ml	reconstitute injection	15	5+	-	only used to reconstitute cefriaxone
Zidovudine + lamivudine	tab	300mg/150mg	needle-stick injury prophylaxis	56+	56+	-
Zinc Oxide	Paste/ ointment	20%	irritated skin	200g+	100g+	100g+	4x25g or3X30gtubes per 100g

 

Table I (Continued) Supplies and Equipment

(International Medical Guide for Ships, 3^rd Edition)

 

Category	Recommended Item	Quantity
RESUSCITATION EQUIPMENT
Appliance for the administration of oxygen	Portable oxygen set, complete, containing:	1
	·     1 oxygen cylinder, 2 1/200 bar	1
	·     1 spare oxygen cylinder, 2 1/200 bar	1
	·     Pressure regulating unit and flow meter with tubes such that ship’s industrial oxygen can also be used	1
	·     3 disposable face masks of choice; including simple face mask and non-rebreathing mask	3
Oropharyngeal airway	Guedel airway (Mayo-tube): sizes medium and large	2
Mechanical aspirator	Manual aspirator to clear upper airways, including 2 catheters	1
Bag and mask resuscitator	Ambubag (or equivalent); supplied with large, medium and small masks	1
Cannula for mouth-to-mouth resuscitation	Brook Airway, Lifeway, pocket face mask or equivalent	1
DRESSING MATERIAL AND SUTURING EQUIPMENT
Adhesive dressings	Assorted wound-plaster or plaster strips, water-resistant	200
Eye pads	Eye pads	3
Sterile gauze compresses	Sterile gauze compresses, 5x5 cm, sterile	100
	Sterile gauze compresses, 10x10 cm, sterile	100
Gauze roll	Gauze roll, 5cm and 90cm or 60cm x 100 m, non-sterile	1
Gauze dressing with non-adherent surface	Non-adherent gauze dressing, square, 10 cm	100

Category	Recommended Item	Quantity
Vaseline gauze	Paraffin gauze dressing, 10 x 10 cm, sterile	50
Bandage	Elastic fixation bandage, 4 m x 6 cm	3
Sterile compression bandages	First-aid absorbent gauze-covered cotton pad sewn into a cotton bandage (ambulance dressing), small/medium/large	5
Tubular gauze for finger bandage	Tubular gauze bandage for finger bandage with applicator, 5 m	1
Adhesive elastic bandage	Adhesive elastic bandage, 4 m x 6 cm	10
Triangular sling	Triangular sling	5
Sterile sheet for burn victims	Sterile sheet for burn patients	1
Honey or burn kit for dressing burns	1 kg	1
Adhesive sutures or zinc oxide bandages	Adhesive tape, waterproof, skin-friendly, 5 x 1.25 cm	10
Q-tips	Q-tips (wooden)	100
Safety pins	Safety pins (stainless steel) 12 pcs	50
Butterfly sutures	Butterfly sutures, Steristrips® or Leukostrip®, sterile	20
Skin adhesive	2-octyl cyanoacrylate liquid, 0.5 ml	2
Suturing equipment	Sutures, absorbable with curved non-traumatic needs, 1-O, 3-O, & 4-O or 5-O	10 each       10
Gloves	Disposable examination gloves	50
	Surgical gloves sizes, 6.5, 7.5, 8.5, sterile, in pairs	3 of each size
INSTRUMENTS
Disposable scalpels	Scalpel, sterile, disposable	20
Stainless-steel instrument box	Instrument box (stainless steel)	1
Scissors	Operating scissors, straight (stainless steel)	1
	Bandage scissors (stainless steel)	1
Forceps	Splinter forceps, pointed (stainless steel)	3
	Teeth tissue forceps (stainless steel)	1
Needle holder	Needle holder, Mayo-Hegar, 1800 mm, straight	1
Haemostatic clamps	Haemostatic clamp, Lahlstead mosquito, 125 mm, stainless steel	3
Disposable razors	Razor, disposable	50
EXAMINATION AND MONITORING EQUIPMENT
Disposable tongue depressors	Tongue depressors, disposable	100
Reactive strips for urine analysis	Reactive strips for urine analysis: blood/glucose/protein/nitrite/leukocytes, 50 paper strips	100
Microscope slides	Microscope slides	100
Stethoscope	Stethoscope	1
Aneriod sphygmomanometer	Sphygomamanometer (blood pressure set), preferably automatic	1
Standard thermometer	Thermometer, digital if possible	1
Rectal thermometer	Thermometer, digital if possible	1
Hypothermic thermometer	Thermometer 32º-34º, digital if possible	1
Penlight	Penlight + blue cover	1

Category	Recommended Item	Quantity
Magnifying glass	a x 8 loupe	1
Marker	Waterproof indelible marker	1
EQUIPMENT FOR INJECTION, INFUSION, AND CATHETERIZATION
Equipment for injection	Syringes, Luer connection, 2 ml, sterile, disposable	50
	Syringes, Luer connection, 5 ml, sterile, disposable	50
	Hypodermic subcutaneous needle, Luer connection, 16 x 0.5 mm, sterile, disposable	20
	Hypodermic intramuscular needle, Luer connection, 40 x 08 mm, sterile, disposable	20
	Needles, 19G, blunt, “drawing up” type	20
Equipment for infusion	Intravenous infusion cannula 16G (1.2 mm) and 22G (0.8 mm), Luer-lock connection, sterile non-recap type	10 each
	Intravenous giving set, Luer-lock connection, sterile	3
	Tourniquet, blood-taking type to be used with intravenous infusion cannula	1
Bladder drainage equipment	Penile sheath set with condom catheter, tube, and bag	2
	Short-term urine catheter with soft-eye straight tip Thieman No. 12 and No. 16 or equivalent, sterile, individually packed, prelubricated or with additional lignocaine/chlorhexidine lubricant	2
	Urine collecting bag and tube	2
GENERAL MEDICAL AND NURSING EQUIPMENT
Eye protection	Plastic goggles or full-face masks	2
Plastic apron	Disposable	20
Kidney dish	Kidney dish, stainless steel, 825 ml	2
Plastic backed towels	Towels, plastic backed, absorbent 600 x 500 mm	10
Safety box	Safety box for sharps disposal, 5 l	1
Mask	Mask, duckbill type, disposable	50
Tape measure	Tape measure, vinyl coated, 1.5 m	1
Draw sheets	Draw sheet, plastic 90 x 180 cm	2
Bedpan	Bedpan, stainless steel	1
Hot-water bottle	Hot-water bag	1
Urine bottle	Urinal, male (plastic)	1
Ice bag	Cold/Hotpack Maxi	1
Aluminum foil blanker	Aluminum foil blanket	1
Condoms	Male condoms	100
Wash bottle	Plastic wash bottles, 250 ml	1
Plastic bottle	Bottle, 1 litre, plastic with screw top	3
Dressing tray	Stainless steel dressing tray, 300 x 200 x 30 mm	1
Plastic apron	Apron, protection, plastic, disposable	20
Bowl	Bowl, stainless steel, 180 ml	3
Specimen jars	Jars, plastic, with lids and labels, 100 ml	10
Plaster-of Paris bandage	Bandages, POP, 5 cm and 10 cm x 2.7m	12 each
Stockinet	Sizes for arm and leg splints, 10 m roll	1 each
Cotton wool	Cotton wool roll, 500 g	10
Alcohol swabs	70 % alcohol swabs for skin cleansing prior to injection	200

Category	Recommended Item	Quantity
Nail brush	Nail brush	1
Thermometer for refrigerator	Thermometer for refrigerator	1
Mortuary transfer bag	Mortuary transfer bag	1
IMMOBILIZATION AND TRANSPORTATION EQUIPMENT
Malleable splints	Malleable finger splint	1
	Malleable forearm/hand splint	2
	Malleable splint leg	2
Cervical ridge collar	Cervical rigid collar variable size for neck immobilization	1
Stretcher	Stretcher equipment allowing immobilization and crane or helicopter lifting	1