This level of training may be presented supplementary to the Marine Advanced
program, or as a combined program facilitating the training of any individual to
the level of Marine Medical Care without prerequisite requirements. A combined
program will include content of both courses for a total of 66 hours.
The number of trainees in a course must not exceed 12 when under the
supervision of one accredited instructor.
Every seafarer who is designated to apply medical care in the event of an
accident or illness on board to demonstrate competence to undertake the tasks,
duties and responsibilities described in the subjects listed below.
Note: Program content for this level of training will be structured to
facilitate flexibility in program delivery (e.g. the 50 hour program may be
delivered in two separate but related teaching blocks).
Competence |
Knowledge, Understanding And Proficiency |
Methods Of Demonstrating Competence |
Criteria For Evaluating Competence |
Apply medical care to the sick and injured while they remain on board. |
3.1 CARE OF CASUALTY, involving:
3.1.1 HEAD/SPINAL INJURIES
Ability to:
- Assess the casualty’s level of responsiveness
- Describe the significance of casualty’s level of consciousness in
assessing the seriousness of the casualty’s condition
- Assess seriousness of head or spinal injury based on mechanism of
injury and signs and symptoms
- Select, size and position commercial cervical collar
- Determine the most appropriate means of transportation according to
the situation, the casualty’s condition and resources available
- Package and prepare casualty for transport according to established
protocols
|
Assessment of evidence obtained from practical instruction and
demonstration.
Where practicable, approved practical experience at a hospital or
similar establishment |
Identification of symptoms is based on the concept of clinical
examination and medical history.
Protection against infection and spread of diseases is complete and
effective.
Treatment of injury or condition is appropriate and conforms to
accepted medical practice and relevant national and international medical
guides.
The dosage and application of drugs and medication complies with
manufacturer’s recommendations and accepted medical practice.
The significance of changes in patient’s condition is promptly
recognized.
Personal attitude is calm, confident and reassuring. |
Competence |
Knowledge, Understanding And Proficiency |
Methods Of Demonstrating Competence |
Criteria For Evaluating Competence |
Apply medical care to the sick and injured while they remain on board
|
3.1.2 INJURIES TO EARS, NOSE, THROAT AND EYES
Ability to:
- Assess injuries to ears, nose and throat and determine the
seriousness of each according to signs and symptoms
- Determine care appropriate to common injuries to ear, nose and
throat
- Assess types of eye injury and related dangers of same
- Assess situations where removal of foreign objects in the eye (or
area around the eye) should not be attempted
- Provide appropriate care for removal of foreign objects from the eye
- Provide appropriate care for injury to the eye or the immediate area
around the eye
- Provide appropriate care for burns to the eye(s)
|
Assessment of evidence obtained from practical instruction and
demonstration.
Where practicable,
approved practical
experience at a
hospital or similar
establishment
|
Identification of symptoms is based on the concept of clinical
examination and medical history.
Protection against infection and spread of diseases is complete and
effective.
Treatment of injury or condition is appropriate and conforms to
accepted medical practice and relevant national and international medical
guides.
The dosage and application of drugs and medication complies with
manufacturer’s recommendations and accepted medical practice.
The significance of changes in patient’s condition is promptly
recognized.
Personal attitude is calm, confident and reassuring.
|
Competence |
Knowledge, Understanding And Proficiency |
Methods Of Demonstrating Competence |
Criteria For Evaluating Competence |
Apply medical care to the sick and injured while they remain on board
|
3.1.3 EXTERNAL AND INTERNAL BLEEDING
Ability to:
- Recognize external bleeding and provide appropriate care
- Recognize internal bleeding and provide appropriate care
3.1.4 BURNS, SCALDS and FROSTBITE
Ability to:
- Recognize burns according to type heat, electrical, chemical,
radiation
- Classify burns by degree first, second or third
- Assess burned area and determine seriousness of injury based on
degree and area involved
- Recognize special considerations and types of burns. Provide
appropriate care for burns according to type. Recognize frostbite and
determine seriousness of the casualty’s condition based on signs and
symptoms
- Provide care appropriate to the nature of the frostbite
|
Assessment of evidence obtained from practical instruction and
demonstration.
Where practicable,
approved practical
experience at a
hospital or similar
establishment
|
Identification of symptoms is based on the concept of clinical
examination and medical history.
Protection against infection and spread of diseases is complete and
effective.
Treatment of injury or condition is appropriate and conforms to
accepted medical practice and relevant national and international medical
guides.
The dosage and application of drugs and medication complies with
manufacturer’s recommendations and accepted medical practice.
The significance of changes in patient’s condition is promptly
recognized.
Personal attitude is calm, confident and reassuring.
|
Competence |
Knowledge, Understanding And Proficiency |
Methods Of Demonstrating Competence |
Criteria For Evaluating Competence |
Apply medical care to the sick and injured while they remain on board
|
3.1.5 FRACTURES, DISLOCATIONS AND MUSCULAR INJURIES
Ability to:
- Identify types of fractures (open/closed, simple/ compound)
- Control bleeding from an open fracture
- Provide appropriate care for suspected sprains and fractures by
preventing movement and providing support to the injured area during
transportation
- Provide appropriate care for suspected dislocations by preventing
movement and providing support to the injured area during
transportation
- Identify muscle strain
- Provide appropriate care for muscle strain
3.1.6 WOUNDS, WOUND HEALING AND INFECTION
Ability to:
- Use commercial and improvised materials as effective dressings and
bandages
- Provide care for wounds and bleeding including eyes, ears, nose,
mouth, knocked out teeth, and crush injury.
|
Assessment of evidence obtained from practical instruction and demonstration.
Where practicable, approved practical experience at a hospital or similar establishment |
Identification of symptoms is based on the concept of clinical
examination and medical history.
Protection against infection and spread of diseases is complete and
effective.
Treatment of injury or condition is appropriate and conforms to
accepted medical practice and relevant national and international medical
guides.
The dosage and application of drugs and medication complies with
manufacturer’s recommendations and accepted medical practice.
The significance of changes in patient’s condition is promptly
recognized.
Personal attitude is calm, confident and reassuring.
|
Competence |
Knowledge, Understanding And Proficiency |
Methods Of Demonstrating Competence |
Criteria For Evaluating Competence |
Apply medical care to the sick and injured while they remain on board
|
3.1.7 PAIN RELIEF
Knowledge of:
- Medications available on board and qualifications required for
administration of each in the case of on board emergencies
- Appropriate symptom relief available on board (e.g. administration
of ASA, glucose, nitroglycerin) including pain relief
- Appropriate medications and procedures for administration of same by
subcutaneous injection
- Appropriate medications and procedures for administration of same by
intramuscular injection
- Appropriate medications and procedures for administration of same by
intravenous injection
- Appropriate medications and procedures for administration of
vaccinations
|
Assessment of evidence obtained from practical instruction and demonstration.
Where practicable, approved practical experience at a hospital or similar establishment |
Identification of symptoms is based on the concept of clinical
examination and medical history.
Protection against infection and spread of diseases is complete and
effective.
Treatment of injury or condition is appropriate and conforms to
accepted medical practice and relevant national and international medical
guides.
The dosage and application of drugs and medication complies with
manufacturer’s recommendations and accepted medical practice.
The significance of changes in patient’s condition is promptly
recognized.
Personal attitude is calm, confident and reassuring.
|
Competence |
Knowledge, Understanding And Proficiency |
Methods Of Demonstrating Competence |
Criteria For Evaluating Competence |
Apply medical care to the sick and injured while they remain on board
|
3.1.8 TECHNIQUES OF SEWING AND CLAMPING
Knowledge of:
- Basic sewing and clamping techniques
3.1.9 MANAGEMENT OF ACUTE ABDOMINAL CONDITIONS
Ability to:
- Recognize acute abdominal distress
- Possible causes of acute abdominal distress including signs and
symptoms
- Appropriate care for acute abdominal distress
3.1.10 MINOR SURGICAL TREATMENT
Knowledge of:
- Importance of cleanliness and sterilization
- Procedures for ensuring cleanliness and sterilization of equipment
and materials
- Surgical equipment available on board and proper use of same
3.1.11 DRESSINGS AND BANDAGING
Ability to:
- Use specialized dressings and bandages in appropriate situations
|
Assessment of evidence obtained from practical instruction and demonstration.
Where practicable, approved practical experience at a hospital or similar establishment |
Identification of symptoms is based on the concept of clinical
examination and medical history.
Protection against infection and spread of diseases is complete and
effective.
Treatment of injury or condition is appropriate and conforms to
accepted medical practice and relevant national and international medical
guides.
The dosage and application of drugs and medication complies with
manufacturer’s recommendations and accepted medical practice.
The significance of changes in patient’s condition is promptly
recognized.
Personal attitude is calm, confident and reassuring.
|
Competence |
Knowledge, Understanding And Proficiency |
Methods Of Demonstrating Competence |
Criteria For Evaluating Competence |
Apply medical care to the sick and injured while they remain on board
|
3.2 ASPECTS OF NURSING
Knowledge of procedures and protocols relating to:
3.2.1 GENERAL PRINCIPLES
- Maintain a nursing station
3.2.2 NURSING CARE
- Recognize feigning illness. Traumatic incident stress
- Responsibilities regarding care for existing medical conditions
- Ongoing care for injury/illness
3.3 DISEASES, including:
3.3.1 MEDICAL CONDITIONS AND EMERGENCIES
- Knowledge of conditions and appropriate care for emergencies
involving:
- Diabetes
- Epilepsy
- Respiratory conditions (e.g. asthma, emphysema)
- Motion sickness (seasickness)
- Contagious diseases (e.g.
- German measles, chicken pox, scarlet fever, TB, yellow fever)
- Hepatitis
- Resources outlining appropriate care for various other conditions
|
Assessment of evidence obtained from practical instruction and
demonstration.
Where practicable,
approvedpractical
experience at ahospital or similar
establishment
|
Identification of symptoms is based on the concept of clinical
examination and medical history.
Protection against infection and spread of diseases is complete and
effective.
Treatment of injury or condition is appropriate and conforms to
accepted medical practice and relevant national and international medical
guides.
The dosage and application of drugs and medication complies with
manufacturer’s recommendations and accepted medical practice.
The significance of changes in patient’s condition is promptly
recognized.
Personal attitude is calm, confident and reassuring. |
Competence |
Knowledge, Understanding And Proficiency |
Methods Of Demonstrating Competence |
Criteria For Evaluating Competence |
Apply medical care to the sick and injured while they remain on board
|
3.3.2 SEXUALLY TRANSMITTED DISEASES
Knowledge of conditions and appropriate care for emergencies involving:
- Sexually transmitted diseases
3.3.3 TROPICAL AND INFECTIOUS DISEASES
Knowledge of conditions and appropriate care for emergencies involving:
- Tropical diseases including:
- Identify types of poisons based routes of entry
- Identify potentially serious sources of insect and animal
bites/stings
- Provide appropriate care for suspected exposure to insect and animal
bites and stings
3.4 ALCOHOL AND DRUG ABUSE
Ability to:
- Recognize drug abuse
- Understand responsibility and liability with respect to suspected
drug abuse
- Identify and access appropriate resources to assist with cases of
suspected drug abuse
|
Assessment of evidence obtained from practical instruction and demonstration.
Where practicable, approved practical experience at a hospital or similar establishment |
Identification of symptoms is based on the concept of clinical
examination and medical history.
Protection against infection and spread of diseases is complete and
effective.
Treatment of injury or condition is appropriate and conforms to
accepted medical practice and relevant national and international
medicalguides.
The dosage and application of drugs and medication complies with
manufacturer’s recommendations and accepted medical practice.
The significance of changes in patient’s condition is promptly
recognized.
Personal attitude is calm, confident and reassuring.
|
Competence |
Knowledge, Understanding And Proficiency |
Methods Of Demonstrating Competence |
Criteria For Evaluating Competence |
Apply medical care to the sick and injured while they remain on board
|
3.5 DENTAL CARE
Ability to:
- Recognize dental emergencies
3.6 GYNAECOLOGY, PREGNANCY AND CHILDBIRTH
Ability to:
- Recognize labour and imminent delivery
- Assist the mother in the delivery of the new-born
- Provide care for the new-born child
- Provide care for the mother
- Provide care for the placenta
- Recognize signs of miscarriage
- Provide first aid and care for the mother in cases of miscarriage
|
Assessment of evidence obtained from practical instruction and demonstration.
Where practicable, approved practical experience at a hospital or similar establishment |
Identification of symptoms is based on the concept of clinical
examination and medical history.
Protection against infection and spread of disease is complete and
effective.
Treatment of injury or condition is appropriate and conforms to
accepted medical practice and relevant national and international medical
guides.
The dosage and application of drugs and medication complies with
manufacturer’s recommendations and accepted medical practice.
The significance of changes in patient’s condition is promptly
recognized.
Personal attitude is calm, confident and reassuring.
|
Competence |
Knowledge, Understanding And Proficiency |
Methods Of Demonstrating Competence |
Criteria For Evaluating Competence |
Apply medical care to the sick and injured while they remain on board
|
3.7 MEDICAL CARE OF RESCUED PERSONS
Ability to:
- Recognize signs and symptoms of heat related illnesses
- cramps
- heat stroke
- heat exhaustion
- Provide care for heat related illness
- Recognize signs and symptoms various stages of hypothermia
- Provide care for hypothermia
- Recognize signs and symptoms of frostbite
- Provide care for frostbite
Knowledge of:
- Near drowning
- Care for the casualty involved in a near drowning incident
- Decompression illness
- Resources available and access to same when dealing with
decompression illness
|
Assessment of evidence obtained from practical instruction and demonstration.
Where practicable, approved practical experience at a hospital or similar establishment |
Identification of symptoms is based on the concept of clinical
examination and medical history.
Protection against infection and spread of diseases is complete and
effective.
Treatment of injury or condition is appropriate and conforms to
accepted medical practice and relevant national and international medical
guides.
The dosage and application of drugs and medication complies with
manufacturer’s recommendations and accepted medical practice.
The significance of changes in patient’s condition is promptly
recognized.
Personal attitude is calm, confident and reassuring. |
Competence |
Knowledge, Understanding And Proficiency |
Methods Of Demonstrating Competence |
Criteria For Evaluating Competence |
Apply medical care to the sick and injured while they remain on board
|
3.8 DEATH AT SEA
Knowledge of procedures and protocols relating to:
3.9 HYGIENE
Knowledge of procedures and protocols relating to:
- Maintain a nursing station
- Water and food storage
3.10 DISEASE PREVENTION, including:
3.10.1 DISINFECTION, DISINFESTATION, DERATTING
Knowledge of procedures and protocols relating to:
- Disinfection, disinfestation and de-ratting
3.10.2 VACCINATIONS
Knowledge of procedures and protocols relating to:
|
Assessment of evidence obtained from practical instruction and
demonstration.
Where practicable, approved practical experience at a hospital or
similar establishment
|
Identification of symptoms is based on the concept of clinical
examination and medical history.
Protection against infection and spread of diseases is complete and
effective.
Treatment of injury or condition is appropriate and conforms to
accepted medical practice and relevant national and international medical
guides.
The dosage and application of drugs and medication complies with
manufacturer’s recommendations and accepted medical practice.
The significance of changes in patient’s condition is promptly
recognized.
Personal attitude is calm, confident and reassuring.
|
Column 1 |
Column 2 |
Column 3 |
Column |
Competence |
Knowledge, Understanding And Proficiency |
Methods Of Demonstrating Competence |
Criteria For Evaluating Competence |
Apply medical care to the sick and injured while they remain on board
|
3.11 KEEPING RECORDS AND COPIES OF APPLICABLE REGULATIONS
3.11.1 KEEPING MEDICAL RECORDS
Knowledge of:
- Applicable record keeping procedures
- Responsibilities for completion of medical records and appropriate
filing of same
Ability to:
- Complete appropriate written record keeping
3.11.2 INTERNATIONAL AND NATIONAL MARITIME MEDICAL REGULATIONS
Knowledge of:
- Applicable national and international maritime medical regulations
- Location of relevant documents on board
|
Assessment of evidence obtained from practical instruction and demonstration.
Where practicable, approved practical experience at a hospital or similar establishment |
Identification of symptoms is based on the concept of clinical
examination and medical history.
Protection against infection and spread of diseases is complete and
effective.
Treatment of injury or condition is appropriate and conforms to
accepted medical practice and relevant national and international medical
guides.
The dosage and application of drugs and medication complies with
manufacturer’s recommendations and accepted medical practice.
The significance of changes in patient’s condition is promptly
recognized.
Personal attitude is calm, confident and reassuring.
|
Column 1
|
Column 2 |
Column 3 |
Column |
Competence |
Knowledge, Understanding And Proficiency |
Methods Of Demonstrating Competence |
Criteria For Evaluating Competence |
Apply medical care to the sick and injured while they remain on board
|
3.12 EXTERNAL ASSISTANCE, including:
Ability to:
3.12.1 RADIO MEDICAL ADVICE
- Establish effective radio communication
- Complete appropriate verbal reports at hand-over
3.12.2 TRANSPORTATION OF THE ILL AND INJURED,including
helicopter evacuation
Ability to demonstrate urgent removal of the casualty:
- From the area of the incident
- From confined spaces
- From vehicles
Ability to perform effective carries involving:
- One rescuer
- Two rescuers
- Multiple rescuers
- Stretcher carries
- Other equipment (e.g. stokes basket)
|
Assessment of evidence obtained from practical instruction and demonstration.
Where practicable, approved practical experience at a hospital or similar establishment |
Identification of symptoms is based on the concept of clinical
examination and medical history.
Protection against infection and spread of diseases is complete and
effective.
Treatment of injury or condition is appropriate and conforms to
accepted medical practice and relevant national and international medical
guides.
The dosage and application of drugs and medication complies with
manufacturer’s recommendations and accepted medical practice.
The significance of changes in patient’s condition is promptly
recognized.
Personal attitude is calm, confident and reassuring. |
Competence |
Knowledge, Understanding And Proficiency |
Methods Of Demonstrating Competence |
Criteria For Evaluating Competence |
Apply medical care to the sick and injured while they remain on board
|
Knowledge of:
- Equipment available on board
- Other resources (e.g. Coast Guard, International assistance) and the
requirements and procedures for gaining assistance from same
3.12.3 MEDICAL CARE OF SICK SEAFARERS involving co-operation
with port health authorities or outpatient ward in port
Ability to:
- Establish an effective incident command system
- Establish a systematic allocation and prioritization of resources
- Deal effectively with rescuers injured or otherwise affected in the
line of duty
- Communicate effectively with identified resources
- Responsibilities for castaways and rescued persons
- Legal and ethical responsibilities
- Appropriate cultural and behavioural considerations
3.13 EXAMINATION
|
Assessment of evidence obtained from practical instruction and
demonstration.
Where practicable, approved practical experience at a hospital or
similar establishment
|
Identification of symptoms is based on the concept of clinical
examination and medical history.
Protection against infection and spread of diseases is complete and
effective.
Treatment of injury or condition is appropriate and conforms to
accepted medical practice and relevant national and international medical
guides.
The dosage and application of drugs and medication complies with
manufacturer’s recommendations and accepted medical practice.
The significance of changes in patient’s condition is promptly
recognized.
Personal attitude is calm, confident and reassuring. |