open access

Vol 68, No 3 (2017)
Original article
Submitted: 2017-08-22
Accepted: 2017-08-22
Published online: 2017-09-27
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Medical emergencies on large passenger ships without doctors: the Oslo-Kiel-Oslo ferry experience

Thor-Erik Holt1, Agnar Tveten2, Eilif Dahl3
·
Pubmed: 28952660
·
IMH 2017;68(3):153-158.
Affiliations
  1. Color Line, Oslo, Norway
  2. Department of Occupational Medicine, Norwegian Centre for Maritime and Diving Medicine, Haukeland University Hospital, Bergen, Norway, Norway
  3. Department of Occupational Medicine, Norwegian Centre for Maritime and Diving Medicine, Haukeland University Hospital, Bergen, Norway

open access

Vol 68, No 3 (2017)
MARITIME MEDICINE Original article
Submitted: 2017-08-22
Accepted: 2017-08-22
Published online: 2017-09-27

Abstract

Background: The Oslo-Kiel-Oslo route is currently the only direct ferry crossing between Norway and Germany, covered by 2 cruise-and-cars ferries carrying about 2,600 passengers each and sailing every day (20 h at sea, 4 h in port). Unlike most ocean going cruise vessels, they are not required to carry a physician but an on-board paramedic handles medical emergencies. The aim of the study was to provide data on medical emergencies leading to helicopter evacuations (helivacs) or other urgent transfers to facilities ashore from the two ferries during a 3-year period.

Materials and methods: Data about the ferries, passengers, crew, helivacs and other medical transfers were collected from official company statistics and the paramedics’ transfer reports.

Results: A total of 169 persons, including 14 (8.3%) crewmembers, were transferred from the ferries to land-based facilities by ambulance while alongside (n = 80; 47.3%) or evacuated by helicopter (n = 85; 50.3%) and rescue boat (n = 4; 2.4%) during the 3-year period. Transfer destinations were Denmark (n = 53), Germany (n = 49), Norway (n = 48) and Sweden (n = 19). The passenger helivac rate was 2.4 per 100,000 passenger-days. One person was airlifted from a ferry every 2 weeks. Among helivacs, 40% were heart-related, and more cardiac cases were airlifted than transferred by ambulance in port.

Conclusions: All helivac requests were made after discussion between the ferry’s paramedic and telemedical doctors ashore and agreement that the medical challenge exceeded the ferry’s capability. This close cooperation kept the threshold for arranging helivacs from the ferries low, enabling short transport times to land-based facilities for critically ill patients. Further studies, including feedback from the receiving hospitals, are needed to determine measures that can reduce possible helicopter overutilisation without compromising patient safety and outcome.  

Abstract

Background: The Oslo-Kiel-Oslo route is currently the only direct ferry crossing between Norway and Germany, covered by 2 cruise-and-cars ferries carrying about 2,600 passengers each and sailing every day (20 h at sea, 4 h in port). Unlike most ocean going cruise vessels, they are not required to carry a physician but an on-board paramedic handles medical emergencies. The aim of the study was to provide data on medical emergencies leading to helicopter evacuations (helivacs) or other urgent transfers to facilities ashore from the two ferries during a 3-year period.

Materials and methods: Data about the ferries, passengers, crew, helivacs and other medical transfers were collected from official company statistics and the paramedics’ transfer reports.

Results: A total of 169 persons, including 14 (8.3%) crewmembers, were transferred from the ferries to land-based facilities by ambulance while alongside (n = 80; 47.3%) or evacuated by helicopter (n = 85; 50.3%) and rescue boat (n = 4; 2.4%) during the 3-year period. Transfer destinations were Denmark (n = 53), Germany (n = 49), Norway (n = 48) and Sweden (n = 19). The passenger helivac rate was 2.4 per 100,000 passenger-days. One person was airlifted from a ferry every 2 weeks. Among helivacs, 40% were heart-related, and more cardiac cases were airlifted than transferred by ambulance in port.

Conclusions: All helivac requests were made after discussion between the ferry’s paramedic and telemedical doctors ashore and agreement that the medical challenge exceeded the ferry’s capability. This close cooperation kept the threshold for arranging helivacs from the ferries low, enabling short transport times to land-based facilities for critically ill patients. Further studies, including feedback from the receiving hospitals, are needed to determine measures that can reduce possible helicopter overutilisation without compromising patient safety and outcome.  

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Keywords

cruise ferry, medical patient transfer, helicopter evacuation (helivac), paramedic, Tele-medical Maritime Assistance Service (TMAS), maritime medicine

About this article
Title

Medical emergencies on large passenger ships without doctors: the Oslo-Kiel-Oslo ferry experience

Journal

International Maritime Health

Issue

Vol 68, No 3 (2017)

Article type

Original article

Pages

153-158

Published online

2017-09-27

Page views

2261

Article views/downloads

2504

DOI

10.5603/IMH.2017.0027

Pubmed

28952660

Bibliographic record

IMH 2017;68(3):153-158.

Keywords

cruise ferry
medical patient transfer
helicopter evacuation (helivac)
paramedic
Tele-medical Maritime Assistance Service (TMAS)
maritime medicine

Authors

Thor-Erik Holt
Agnar Tveten
Eilif Dahl

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