Air ambulance service
Medico Cork are the HSE unit with a responsibility for providing on-line medical advice to the Irish Coast Guard. Medico Cork have agreed to assist the air ambulance service in providing similar advice. This will apply in situations where a call for an emergency helicopter transfer is received from an off-shore Island. EMC dealing with such calls will use the following procedure:
- The EMC will patch the caller through to Medico Cork at where a senior emergency care practitioner will discuss the details of the patient's condition with the caller, give appropriate medical advice and provide a direction on the category of the medical emergency.
- The EMC will respond to this advice by using the resources outlined by category in Annex I to meet the needs of the patient concerned."
Ray Bonar / Colm Megan 24/01/2008
Since August 2001 the Emergency Department in Cork University Hospital has been the Tele-Medical Assistance Service (TMAS)
- We provide 24-hour medical advice (and retrieval assistance) to ill and injured seafarers in the jurisdiction of the Irish Coast Guard (IRCG).
- Calls to the TMAS are routed through the Coast Guard stations.
- Within the Emergency Department the 'red phone' is the only telephone link from the IRCG.
- This telephone can accept calls that may originate from VHF / MHF radio, GSM or Satellite sources and Emergency Department staff are being trained for this.
- Coast Guard Stations: (see below) Valencia (Kerry): 066-947 6109, Malin Head (Donegal): 077-70103, Dublin: 01-662 0922
When a call is received
- The Medical Adviser MUST be an Emergency Department Registrar / Consultant.
- All calls must be discussed with a the Emergency Medicine on duty / call.
- If a call comes at an hour when neither of the above is available, the Coast Guard station officer should be advised to contact the Consultant on-call directly.
- This will involve giving the appropriate contact number for that Consultant to the station.
Suspected swine 'flu on board
In the event of a suspected case of swine influenza on a ship in Irish waters or in an Irish port a call will be made to Medico Cork. As well as the usual details taken, including contact details of the ship, take a detailed history of symptoms and potential contact history. - detailing location and dates and ask if any contact with a known case. Having taken a detailed history. Contact your local Director of Public Health for further advice: tel no. 9 to 5pm 021-4927601 or 087- 6486414 after 5pm.
- When the 'red phone' rings, initial contact will be with a member of the Irish Coast Guard.
- (S)He will give some preliminary details including the source of the call and the nature of the problem.
- The medical adviser will then be able to speak directly to the Captain or senior crew-member on the vessel.
- If necessary the Coast Guard station officer can intervene to improve communications or clarify questions from either side.
- Please record calls in the "Medico Cork" logbook in the prescribed format.
- The logbook is kept near the 'Red phone' at all times.
Phone : Valencia (Kerry):(066)947 6109, Malin Head (Donegal):(077)70103, Dublin (01)662 0922
In the event of IRCG requesting medical advice on behalf of a vessel the IRCG centre receiving the call will patch it through to Medico Cork. Dublin (control centre) 01- 6620922 / 6620923, VALENTIA (Kerry) 066 – 9476109, MALIN HEAD (Donegal) 077 - 70103
Dr Nora McCarthy is based in the Emergency Department at CUH and works as research registrar with Medico Cork.
History of medical advisory service
The possibility of obtaining medical advice from remote doctors became possible with the development by Marconi of radio-telegraphy in 1897 and the subsequent introduction of radio equipment on ships and the development of coastal radio stations.
Since then technology has greatly expanded the capability to communicate effectively with ships at sea, using a combination of phone, radio, telex, fax, email and satellites.
Tele-Medical assistance service (TMAS) is a very different form of medical consultation for Emergency Department doctors. Communication is particularly challenging with consultations often occurring through a third party rather than directly with the patient.
Prior to the establishment of Medico Cork requests for medical advice by the Irish Coast Guard were dealt with on an ad hoc basis by medical staff in Emergency Departments nationwide, as was the case in much of the world. The difficulties implicit in providing appropriate advice to an ill or injured seafarer were compounded by unfamiliarity with the maritime environment, inexperience with radio communications techniques and infrequency of calls to any one unit.
Origins of Medico Cork
Recommendations regulating medical assistance on board ships were issued by various agencies from 1936 to 2000. These documents were first issued by the International Labour Office (ILO) alone or in collaboration with the WHO, and more recently by the International Maritime Organisation (IMO), the United Nations agency for sea and maritime problems. Moreover, the European Commission directive no. 92/29 has regulated the problem of medical assistance to seafarers. The EU issued a directive on the minimum safety and health reqts for improved medical treatment on board vessels. Part of this directive requires that each EU country has a designated centre to provide seafarers with free medical advice by radio.
In Ireland the contract was put out to tender to the hospitals. Cork University Hospital (CUH) was judged the most suitable and favourable. ‘Medico Cork’ is Ireland’s only Radio Medical Consultation Centre.
Development of Medico Cork
CUH and Medico Cork have developed a strong awareness and knowledge of maritime matters, including:
- Appreciation of shipboard environments including space limitations
- An awareness of available drugs, equipment, personnel and their medical skills on various vessels
- Understanding of distances and weather
- The difficulties in communicating with patients via radio, poor connections and third parties
- Experience of marine environment gained through participation in Sea Survival Courses and simulator operations at NMCI, Ringaskiddy
Such awareness enables the efficient operation of Medico Cork. Additionally Medico Cork has built close links with the different seafaring communities. This has improved communication and ensures that all seafarers are kept up to date with best medical knowledge.
Links with other agencies
Medico Cork and CUH has developed a close working relationship with the Irish Naval Service – in Particular Lt. CmDr Bill O’ Brien.
Dr O’ Brien has organised courses for our doctors such as radio communication skills and sea survival skills.
We’ve also developed links with Bord Iascaigh Mhara (BIM), National Maritime College of Ireland (NMCI), Irish Sailing Association (ISA), Marine Safety Working Group, Search and Rescue (SAR) helicopters.
With the assistance of Paul Allan, who is Director of Training in Emergency Care at the Academy of Emergency Care in Sport in the C.U.H., we have helped in updating the BIM first aid manual. Medico Cork has also begun to run exercises with BIM mobile first aid units on how to gather medical information and transmit it to us. Training in the gathering and transmission of medical information is also being incorporated into NMCI’s ship captain trainees course. Ship captain trainees are also attending the emergency department to get some exposure to, and experience of, illness and injuries.
Medico Cork is also taking part in simulation exercises run by NMCI and their trainees. We are privileged to participate in the annual Sea Sunday celebrations in Kinsale. Medico Cork is a member of the International Maritime Health Association – IMHA
What is Medico Cork?
- Medico Cork’ is Ireland’s national Radio Medical Consultation Centre.
- It runs in partnership with the Irish Coast Guard service and provides a 24-hour free radio service to Irish seafarers both in Ireland’s Search & Rescue (SAR) region and worldwide.
- The Irish SAR region extends approximately 200 miles off the West Coast, 30 miles off the South Coast and across half of the Irish Sea.
How do we contact Medico Cork?
All calls must come to us through the Irish Coast Guard service.
In the event of IRCG requesting medical advice on behalf of a vessel the IRCG centre receiving the call will patch it through to Medico Cork. Dublin (control centre) 01- 6620922 / 6620923, VALENTIA (Kerry) 066 – 9476109, MALIN HEAD (Donegal) 077 – 70103
Who answers the call?
The call is answered by a registrar or consultant, so it is always a senior doctor. The IRCG stays on the line and assists as necessary with communications. Should Medico Cork advise helicopter evacuation due to a possible threatening condition the IRCG centre will be advised immediately. If non-threatening, consideration will be given to advise the vessel to proceed to port. IRCG will co-ordinate whatever action is considered necessary by Medico Cork.
Will the doctors know what medical equipment is on board?
Yes. There is a notice board at Medico Cork headquarters that has all relevant information, incl. details of what medical equipment is required by law to be carried by various vessels. This information is also available to our doctors on a website.
Where are the helicopter bases?
There are 4 SAR helicopter bases – Dublin, Waterford, Sligo and Shannon. Rescues were initially done by the Aer Corps; since January 2003 CHC Ireland have the contract. Sikorski 61-N are the helicopters used. There are 4 crew members per flight –pilot, co-pilot, winch-man and winch operator. The winch-man and winch operator are trained to emergency medical first responder level.
Is there any leaflet on medico Cork?
The Marine Safety Working Group is currently publishing a leaflet on Medico Cork to distribute to seafarers.