Cruise ship doctor: demands and challenges versus qualifications and training

Abstract

Background. The objective was to register and analyze data from all passenger injuries reported to the medical centre of a cruise ship with a median passenger load of 719 per day during a three-year period, and to determine high risk areas, equipment, and behaviour.
Methods. All reported passenger injuries were registered at first visit. An injury was “serious” if it led to hospitalization ashore or if full recovery was not expected within two weeks.
Results. During 3 years, 663 injuries (62.7% women) were reported aboard; 12.5% were classified as serious. The victims” median age was 72 (range: 1–97) years. The incidence rate was 0.8 injuries per 1000 passenger-days. Most victims (65.3%) suffered injuries aboard, 3.6% on tenders, and 31.1% ashore. The most common accident locations aboard were cabins (20.1%) and bathrooms (13.4), and ashore, streets (29.6%) and buses (16.1%). Slips/trips/falls caused 44.8% of injuries aboard and 69.4% ashore (p < 0.001). The most frequently injured body part was the lower extremity (43.0%), and open wounds the most common injury type (41.6%). More wounds and fractures/dislocations occurred ashore than aboard (p < 0.05). Only 2% were hospitalized in port, while 5% were referred to specialists in local ports and returned to the ship. There were no helicopter evacuations or ship diversions.
Conclusions. Passenger injuries contribute considerably to the workload of the medical team aboard. A well-equipped, competent medical staff will effectively treat most injuries aboard and thus reduce the number of costly and inconvenient helicopter evacuations, ship diversions, port referrals, and medical disembarkations.