open access
Medical emergency announcements on cruise ships: an audit of outcome
open access
Abstract
Background: Public address announcements are an effective way of alerting staff on cruise ships to life -threatening medical emergencies on-board, but should only be used when truly necessary. An audit to investigate the outcome following this method of activating the medical emergency response team (MERT) suggested system flaws. A new elementary first aid training programme for the crew was then developed, emphasising patient assessment and the correct determination of appropriate levels of response. Following fleet-wide implementation, post-intervention audits were performed on two other company ships to evaluate the impact of the new approach.
Materials and methods: Data from all MERT activations initiated by public address announcement were prospectively collected during the audit periods, including subsequent means of transfer to the ship’s medical centre and duration of medical intervention as indicators of clinical severity.
Results: After changing the training programme the overall rate of public announcements for medical emergencies fell by 43%. The proportion of patients requiring transfer by stretcher increased from 5% to 33%, whilst the proportion of patients requiring ≥ 4 h of medical intervention increased from 5% to 44%.
Conclusions: The audits suggest that the new training programme may have improved the first aid responders’ decision-making as there were fewer inappropriate emergency announcements over the public address system. However, two-thirds of all MERT activations were still for patients either well enough to walk or only needing a wheelchair for subsequent transfer, indicating ongoing opportunity for improvement.
Abstract
Background: Public address announcements are an effective way of alerting staff on cruise ships to life -threatening medical emergencies on-board, but should only be used when truly necessary. An audit to investigate the outcome following this method of activating the medical emergency response team (MERT) suggested system flaws. A new elementary first aid training programme for the crew was then developed, emphasising patient assessment and the correct determination of appropriate levels of response. Following fleet-wide implementation, post-intervention audits were performed on two other company ships to evaluate the impact of the new approach.
Materials and methods: Data from all MERT activations initiated by public address announcement were prospectively collected during the audit periods, including subsequent means of transfer to the ship’s medical centre and duration of medical intervention as indicators of clinical severity.
Results: After changing the training programme the overall rate of public announcements for medical emergencies fell by 43%. The proportion of patients requiring transfer by stretcher increased from 5% to 33%, whilst the proportion of patients requiring ≥ 4 h of medical intervention increased from 5% to 44%.
Conclusions: The audits suggest that the new training programme may have improved the first aid responders’ decision-making as there were fewer inappropriate emergency announcements over the public address system. However, two-thirds of all MERT activations were still for patients either well enough to walk or only needing a wheelchair for subsequent transfer, indicating ongoing opportunity for improvement.
Keywords
seafarer, first aid training, education, medical emergency response team, code, passenger ship, STCW 1978
Title
Medical emergency announcements on cruise ships: an audit of outcome
Journal
Issue
Article type
Original article
Pages
203-206
Published online
2015-12-22
Page views
1157
Article views/downloads
1694
DOI
10.5603/IMH.2015.0040
Pubmed
Bibliographic record
IMH 2015;66(4):203-206.
Keywords
seafarer
first aid training
education
medical emergency response team
code
passenger ship
STCW 1978
Authors
Christopher James Taylor