|
Requirements for Organisation of
Medical Care on Ships and List of Medical Equipment Required on Ships Registered
in Estonia1
Regulation of
the Minister of Social Affairs of 23 October 2002
entered into
force 1 January 2003.
The
Regulation is established pursuant to subsection 28 (1) of the Seafarers Act
§ 1. Scope
of application
(1) This
Regulation applies to all vessels registered in Estonia, except warships and
border guard ships, small craft, tugs operating in harbour areas and pleasure
boats used for non-commercial purposes.
(2) For the
purposes of this Regulation, medical care for a crew member includes:
1) general
medical care provided by a doctor;
2) medical
care provided by the master, if the master has undergone appropriate training,
or by a crew member with appropriate training designated by the master;
3) first aid
provided by the master or by a crew member who has undergone appropriate
training for first aid providers;
4) the
provision of emergency care on ships or the organisation of emergency medical
care.
(3) For the purposes of this
Regulation, medical equipment includes medicines and medical devices.
§ 2.
Categories of vessels
For the
purposes of this Regulation, vessels shall be classed in the following
categories:
1) category A
vessels, with no limitation on length of trips or navigation area;
2) category B
vessels, making trips of less than 150 nautical miles from the nearest port
where health care services are provided;
3) category C
vessels, meaning vessels navigating in internal water bodies and vessels
operating on domestic voyages.
§ 3.
Organisation of medical care on ships
(1) Every
vessel with a crew of 100 or more workers and engaged on a voyage of more than
three days shall have a doctor on board.
(2) Persons
specified in clauses 1 (2) 2) and 3) (hereinafter providers of medical care)
shall provide medical care or first aid on vessels where a doctor is not
mandatory.
(3) If the
state of health of a crew member prevents the crew member from being treated on
the ship or if the illness of a crew member is putting the life or health of
other crew members or passengers in danger and it is not possible to take
measures to prevent the disease from spreading, the master shall send the crew
member who has fallen ill to a health care institution at the nearest port
within the shortest possible time.
(4) If
necessary due to the state of health of a crew member, the master shall call an
ambulance crew through the Tallinn Maritime Rescue Co-ordination Centre or the
Maritime Rescue Co-ordination Centre (MRCC) of a foreign state.
(5) If a crew
member is sent to a health care institution, an internationally recognised
report, the format of which is provided in Annex 1, shall be issued to the crew
member.
(6) A report
shall be prepared in three original copies, of which Part I shall be prepared by
the master or a person authorised thereby and Part II shall be prepared by the
doctor of the health care institution. The master shall prepare Part III if the
crew member is signed off.
(7) One copy
of the report shall be retained by the health care institution, the second copy
shall, if possible, be returned by the doctor of the health care institution to
the master or, in the absence of the master, to the agent or shipowner, and the
third copy shall be given to the crew member concerned.
(8) If a
member of an ambulance crew or a doctor who is not a crew member provides
medical care to a crew member on board a ship, the person who provides medical
care shall prepare Part II of the report specified in subsection (5).
(9) It shall
be ensured that free medical advice can be offered to providers of medical care
twenty-four hours a day from radio consultation centres located in Estonia.
(10) In the
event of providing medical care to a crew member, sending him or her to a health
care institution or receiving advice from a radio consultation centre, the
doctor or provider of medical care shall make an entry in the medical journal
specified in § 5.
§ 4.
Sick-bay
Every vessel
of more than 500 gross registered tonnes, with a crew of 15 or more workers and
engaged on a voyage of more than three days shall have a sick-bay for the
storage of medical equipment and the provision of medical care.
§ 5.
Medical journal
(1) A medical
journal maintained by a doctor or a provider of medical care is mandatory on
vessels specified in clauses 2 1) and 2).
(2) An entry
on each procurement of medical equipment shall be made in the medical journal.
The entry shall contain detailed information on the date of the procurement and
the quantities of the procured medical equipment or a reference to the delivery
note.
(3) An entry
shall be made in the medical journal on each medicine dispensed. The entry shall
contain at least the following information: the date, the given name and surname
of the person to whom the medicine, including antidotes, is dispensed, the name
and quantity of the medicine or antidote, the reason for dispensation, and the
name of the person who dispenses the medicine.
(4) The
medical journal shall be preserved for at last two years after the last entry.
§ 6.
Medical equipment
(1) Every
vessel shall carry on board medical equipment which corresponds to the
specifications for the category to which the vessel belongs. The list of medical
equipment which corresponds to the specifications for the category to which the
vessel belongs is set out in Annex 2 (Medicines) and Annex 3 (Medical Devices).
The quantities of medicines and the number of medical devices set out in the
Annexes are prescribed for a crew of up to 25 members. If the number of crew
members is greater, the amount of medical equipment shall be increased
proportionally and any quantities shall be rounded to the nearest whole number.
(2) The
medical equipment of a vessel carrying substances deemed on the basis of the
Dangerous Goods Code of the International Maritime Organisation (IMO) to be
hazardous to health shall include antidotes which are to be used to prevent or
treat the harmful effects of the substances in the event of an accident.
(3) The
medical equipment specified in subsections (1) and (2) shall be accompanied by
an exhaustive list thereof and instructions for the use of the medical devices.
The therapeutic indication of a medicine and the instructions for its use shall
be set out on the package leaflet.
(4) Medical
equipment of category C vessels, which bears the labelling “Meditsiinivarustus
/ Medical equipment”, and instructions for the provision of first aid are
mandatory on life-rafts or life-boats assembled in the Republic of Estonia. If
the medical equipment of a life-raft or life-boat is procured in a foreign port,
the equipment shall meet the requirements of the International Convention on the
Safety of Life at Sea (SOLAS).
§ 7.
Storage of medical equipment
(1) Medical
equipment shall be stored in a locked room where it is protected against
humidity, freezing and excessive heat. In the case of vessels specified in § 4,
medical equipment shall be stored in the sick-bay.
(2) Medicines
shall be stored in their original packaging. Each package shall be legibly
marked. The expiry date of the medicine shall be indicated on the packaging.
(3) Unless
the package leaflet of a medicine contains comments regarding special
conditions, the medicine shall be stored at room temperature.
(4)
Light-sensitive medicines shall be stored in tightly closed, lightproof
packaging or in a closed box or dark room. If necessary, additional lightproof
packaging shall be used.
(5) Volatile
and humidity-sensitive medicines shall be stored in a cool place and be tightly
closed. Hygroscopic medicines shall be stored in hermetically sealed glass or
plastic containers and, if necessary, the closure shall be covered with paraffin
wax. Disinfectants shall be stored in hermetically sealed packaging, in a cool
and dark place and separately from medicines.
(6) Category
A and B vessels shall have a refrigerator which ensures the necessary
temperature for the storage of thermolabile medicines. In the case of vessels
specified in § 4, the refrigerator shall be located in the sick-bay.
(7) The
medical equipment of life-rafts and life-boats shall be stored in watertight
packages.
§ 8.
Procurement, renewal and replenishment of medical equipment
(1) Before
the start of a voyage, the doctor or a provider of medical care shall check that
the medical equipment meets the requirements and, if necessary, submit an
application to the master for the renewal or replenishment of medical equipment.
(2) This
Regulation provides the legal basis for pharmacies to release prescription
medicinal products to a master or a person authorised thereby on the basis of an
application.
§ 9.
Inspection of medical equipment
(1) Checks
that the medical equipment of a vessel meets the requirements of this Regulation
shall be carried out once a year by the Maritime Administration while the vessel
is in its home port. In exceptional circumstances, this annual inspection may be
postponed for up to five months. Inspections of the medical equipment on
life-rafts and life-boats shall be carried out in the course of their annual
maintenance.
(2) In the
course of inspection, the following shall be ascertained:
1) whether
there is necessary amount of medical equipment which corresponds to the
specifications for the category to which the vessel belongs;
2) whether
the expiry dates of the medical equipment have been respected;
3) whether
the medical equipment has been labelled according to the requirements;
4) whether
the medical equipment is stored and maintained according to the requirements.
(3) A report
shall be prepared concerning the results of inspection. The person carrying out
the inspection shall also make an entry concerning the inspection in the medical
journal.
§ 10.
Entry into force of Regulation
This
Regulation enters into force on 1 January 2003.
1
The requirements of Directive 92/29/EEC (OJ L 113, 30.04.1992, pp. 19–36) of the
Council of the European Communities have been taken into account in this
Regulation.
Annex 1
to Regulation of the Minister of Social Affairs of 23 October 2002 “Requirements
for Organisation of Medical Care on Ships and List of Medical Equipment Required
on Ships Registered in Estonia”
Teatis –
Report
|
Part I
I Osa
To be
completed by Master or his Deputy
Täidab
kapten või tema pool volitatud isik |
1.
Ship's name
Laeva
nimi |
2. Port
of call
Sihtsadam |
3. Date
Kuupäev |
|
4.
Surname of crewmember
Laevapere liikme perekonnanimi |
Other
name(s)
Eesnimi |
5. Date
of birth
Sünniaeg |
|
6.
Nationality & Language(s)
Kodakondsus ja keel(ed) |
7. Job
Description
Töö
kirjeldus |
8.
Seamen's book number
Meremehe teenistusraamatu number |
|
9. Date
illness / injury occurred
Haigestumise / vigastuse kuupäev |
10.
Date work ceased on board
Töö
lõpetamise kuupäev |
11.
Date work resumed on board
Töö
jätkamise kuupäev |
|
12.
Details about the illness / injury and treatment on board
Haigestumise / vigastuse ja laeval osutatud meditsiiniabi kirjeldus |
|
14.
Ship Master's signature
Kapteni
allkiri |
13.
Ship's agent
Agent /
reeder |
|
Address
/ Aadress
Tel No
/ Telefoni nr |
|
P art
II
II Osa
To be
completed by Examining Doctor
Täidab
arst |
15. To
the doctor: please see this patient and then fill in the report.
Retain
back copy and return first copy to the master (or agent), second copy
accompanies the crewmember.
Arstile:
palun kontrollida patsienti ja täita teatis.
Säilitada
kolmas koopia, tagastada esimene koopia kaptenile (või agendile /
reederile), teine koopia anda laevapere liikmele |
|
16.
Diagnosis
Diagnoos |
|
17.
Treatment: Please specify exactly all medicines to be taken, the generic
name of the medicine, the dose, the frequency of the dose, the way it is
to be taken, and any other treatments required.
Ravi:
Palun märkida täpselt kõik ravimid, nende toimeained, doos, manustamise
viis, sagedus ning teised ravimise viisid. |
|
|
No / Ei |
Yes /
Jah |
|
|
18.
Should he / she see another doctor later?
Kas
patsient peaks edaspidi pöörduma teise arsti poole? |
|
|
When?
Millal? |
|
Contagious or infectious disease
Nakkushaigus |
|
|
Are any
precautions necessary for other crew members?
Kas on
vaja rakendada ettevaatusabinõusid teiste laevapere liikmete suhtes? |
|
|
Estimated duration of illness (days)
Haiguse
eeldatav kestus (päevades) |
|
19. Fit
for normal work now
Kõlblik
tööle |
|
|
Fit for normal work from
Kõlblik
tööle alates |
|
Date
Kuupäev |
|
Fit for
restricted work
Kõlblik
piirangutega tööle |
|
What
restrictions?
Millised piiranguid peab rakendama? |
|
|
20.
Unfit for work
Töövõimetu |
|
For how
many days?
Päevae
arv |
|
|
Bed
rest necessary
Vajalik
voodire˛iim |
|
For how
many days?
Päevade
arv |
|
|
Recommended to be signed off
Soovitus maha munsterdada |
|
|
|
|
- and
be repatriated
ja
saata koju |
|
Is air
transport recommended?
Kas on
vaja õhutransporti? |
Yes
Jah
No
Ei |
|
- and
go to hospital after repatriation
ja
saata kodumaal tervishoiuasutusse |
|
|
Yes
Jah
No
Ei |
|
|
21. The
examination took place - date
Tervisekontroll toimus - kuupäev |
|
- in
the doctor's office
tervishoiuasutuses |
|
|
|
- on
board
laeval |
|
|
|
-
elsewhere
mujal |
|
Specify
Täpsusta, kus |
|
22.
Name of health institution, doctor's name, address and Tel No
Tervishoiuasutuse nimetus, arsti nimi, aadress ja telefoni nr |
Doctor's signature
Arsti
allkiri
..... |
|
Part
III
III Osa
Master
to complete (only to be filled in if signed off)
Täidab
kapten laevapere liikme mahamunsterdamisel |
23.
Port of discharge
Sadam,
kuhu laevapere liige jäetakse |
24.
Date
Kuupäev |
25.
Domicile
Alaline
elukoht |
|
26.
Name and address of next of kin (relationship) or friend
Laevapere
liikme poolt osutatud isiku või lähisugulase nimi ja aadress |
|
27.
Name and address of health institution where crew member is staying
Tervishoiuasutuse nimi ja aadress, kuhu laevapere liige jääb |
|
28.
Disposition of effects
Korraldused laevale jäänud vara hoidmiseks |
Annex 2
to Regulation No. 128 of the Minister of Social Affairs of 23 October 2002
“Requirements for Organisation of Medical Care on Ships and List of Medical
Equipment Required on Ships Registered in Estonia”
Medicines
|
|
Minimum
quantity |
Quantity on vessel |
|
Category of vessel |
|
A |
B |
C |
|
1.
Cardiovascular |
|
|
|
|
|
Adrenaline/Epinephrine (1mg/ml 1ml injections) |
5
ampoules |
1 |
1 |
|
|
Glyceryl nitrate (0.5 mg tablets) |
30
tablets |
1 |
1 |
1 |
|
Furosemide (40 mg tablets) |
30
tablets |
1 |
1 |
|
|
Phytomenadione/Vitamin K (2 mg 0.5 ml injections) |
1
ampoule |
1 |
1 |
|
|
Oxytocin (5 U/ml 1ml injections) if there are women on board |
5
ampoules |
1 |
1 |
|
|
Metoprolole (25 mg tablets) |
30
tablets |
1 |
1 |
|
|
2.
Gastro-intestinal system |
|
Omeprazolum (20 mg capsules) |
14
tablets |
3 |
1 |
|
|
Anti-acid mucous dressing chewing tablets or suspension |
30
tablets or 250 ml |
4 |
2 |
1 |
|
Metoclopramide (10 mg tablets) |
30
tablets |
3 |
2 |
|
|
Metoclopramide (5 mg/ml injections) |
10
ampoules |
1 |
1 |
|
|
Bisacodyl (5 mg tablets) |
50
tablets |
1 |
1 |
|
|
Natrii
picosulfas (7.5 mg/ml drops) |
10 ml |
2 |
1 |
|
|
Loperamide (2 mg capsules) |
10
capsules |
6 |
3 |
2 |
|
Prednisolone in the form of ointment in combination with other haemorrhoid
preparations |
20 g |
2 |
1 |
|
|
Insulin
(100 U/ml injections) |
5 ml |
1 |
1 |
|
|
Carbo
medicinalis (250 mg tablets) |
10
tablets |
20 |
10 |
5 |
|
3.
Analgesics and anti-spasmodics |
|
Paracetamol (500 mg tablets) |
20
tablets |
5 |
3 |
1 |
|
Diclofenac (50 mg tablets) |
20
tablets |
5 |
3 |
1 |
|
Diclofenac (100 mg suppository) |
10
suppositories |
2 |
|
|
|
Diclofenac (25 mg/ml 3 ml injections) |
5
ampoules |
2 |
1 |
|
|
Morfine
(10 mg/ml 1ml injections) |
10
ampoules |
1 |
1 |
|
|
4.
Nervous system |
|
Diazepam (5 mg tablets) |
20
tablets |
2 |
1 |
|
|
Diazepam (5 mg/ml 2 ml injections) |
5
ampoules |
2 |
1 |
|
|
Diazepam (5 mg rectal tube) |
5 tubes |
1 |
|
|
|
Haloperidol (2 mg/ml drops) |
10 ml |
1 |
1 |
|
|
Seasickness remedies |
10
tablets |
6 |
6 |
3 |
|
5.
Anti-allergics and anti-anaphylactics |
|
Loratadine (10 mg tablets) |
10
tablets |
3 |
1 |
|
|
Hydrocortisone (100 mg injection and 2 ml solution) |
1
ampoule |
4 |
3 |
|
|
Prednisolone (5 mg tablets) |
20
tablets |
1 |
1 |
|
|
6.
Respiratory system |
|
Salbutamol (inh aer 100 mcg/dose) |
200
doses |
2 |
1 |
|
|
Codeine
phosphate (30 mg tablets) |
30
tablets |
3 |
2 |
|
|
Bromhexine (8 mg tablets) |
20
tablets |
3 |
2 |
|
|
Xylometazoline (1 mg/ml nose drops) |
10 ml |
2 |
1 |
|
|
7.
Anti-infection |
|
Phenoxymethylpenicillin (1 000 000 U tablets) |
20
tablets |
4 |
2 |
|
|
Doxycycline (100 mg tablets) |
10
tablets |
5 |
3 |
|
|
Ciprofloxacine (250 mg tablets) |
10
tablets |
6 |
2 |
|
|
Cefuroxime (750 mg injection) |
1
ampoule |
20 |
|
|
|
Cefadroxil (500 mg tablets) |
30
tablets |
3 |
2 |
|
|
Chloroquine (250 mg tablets) – in the event of navigation in an area at
risk of malaria |
100
tablets |
1 |
|
|
|
Mefloquine (250 mg tablets) – in the event of navigation in an area at
risk of cloroquine resistant malaria |
6
tablets |
2 |
|
|
|
Mebendazole (100 mg tablets) |
6
tablets |
2 |
|
|
|
8.
Compounds promoting rehydration, caloric intake and plasma expansion |
|
Perfusion solution 0.9% NaCl |
500 ml |
6 |
3 |
|
|
9.
Medicines for external use |
|
Skin
medicines |
|
Hydrogenii peroxydi 3% |
40 ml |
5 |
2 |
1 |
|
Chlorhexidine (desinfectant solution) |
1000 ml |
1 |
1 |
|
|
Desinfectant solution 2-propanolum, benzalkonium chloride (Cutasept) |
250 ml |
2 |
1 |
|
|
Tetracycline (ointment 3%) |
20 g |
2 |
2 |
|
|
Hydrocortisone (ointment 1%) |
30 g |
1 |
1 |
|
|
Miconazole (cream 2%) |
30 g |
3 |
2 |
|
|
Silver
Sulphadiazine (cream 1%) |
50 g |
3 |
2 |
1 |
|
Dexpanthenolum |
1
original |
3 |
1 |
|
|
Permethrin (cream 5%) |
30 g |
2 |
|
|
|
Permethrin (shampoo 5%) |
50 ml |
1 |
|
|
|
Eye
medicines |
|
Chloramphenicol (eye drops 0.5%) |
10 ml |
2 |
1 |
|
|
Tetracycline (eye ointment 1%) |
5 g |
4 |
2 |
|
|
Dexamethasone+Neomycin+Polymyxin B (eye suspension) |
5 ml |
2 |
1 |
|
|
Proxymetacaine (eye drops 0.5%) |
15 ml |
2 |
1 |
|
|
Pilocarpine (eye drops 2%) |
10 ml |
1 |
1 |
|
|
Ear
medicines |
|
Hydrocortisone+Ciprofloxacine (ear drops) |
10 ml |
2 |
1 |
|
|
Medicines for oral and throat infections |
|
Disinfectant sucking tablets |
20
tablets |
5 |
2 |
|
|
Local anaesthetics |
|
Lidocaine (injection 1%) |
20 ml |
1 |
1 |
|
|
Lidocaine (gel 2%) |
10 g |
2 |
1 |
|
Annex 3
to Regulation No. 128 of the Minister of Social Affairs of 23 October 2002
“Requirements for Organisation of Medical Care on Ships and List of Medical
Equipment Required on Ships Registered in Estonia”
Medical
Devices
|
|
Quantity on vessel |
|
Category of vessel |
|
A
|
B
|
C
|
|
1.
Resuscitation equipment |
|
|
Manual
resuscitation appliance, e.g. bag and mask |
1 |
1 |
0 |
|
|
Appliance for the administration of oxygen with pressure-reducing valve
such that ship's industrial oxygen can be used, or oxygen container |
1 |
1 |
0 |
|
|
Mechanical aspirator to clear upper respiratory passages |
1 |
1 |
0 |
|
|
Cannula
for mouth-to-mouth resuscitation (Brook airway) or Laerdal face shield |
1 |
1 |
1 |
|
2.
Dressing and suturing equipment |
|
|
Disposable suture stapler or suture kit with needles |
2 |
1 |
0 |
|
|
Adhesive elastic bandage (1.25 cm × 1 m) |
2 |
1 |
1 |
|
|
Gauze
strips (2.5 cm × 2 m) |
1 |
0 |
0 |
|
|
Tubular
gauze for finger bandages (1 m) |
1 |
0 |
0 |
|
|
Sterile
gauze compresses (90 cm × 1 m) |
2 |
2 |
1 |
|
|
Cotton
wool (15 g package) |
2 |
1 |
0 |
|
|
Sterile
sheet for burns victims |
1 |
1 |
0 |
|
|
Triangular sling (90 cm × 90 cm × 127 cm) |
1 |
1 |
0 |
|
|
Disposable polyethylene gloves |
100 |
100 |
10 |
|
|
Adhesive dressings |
20 |
10 |
5 |
|
|
Sterile
compression bandages (10 cm × 3 m) |
2 |
1 |
1 |
|
|
Adhesive sutures or zinc oxide bandages |
5 |
4 |
4 |
|
|
Non-absorbable sutures with needles |
2 |
0 |
0 |
|
|
Vaseline gauze (10 cm × 10 cm) |
10 |
5 |
0 |
|
3.
Instruments |
|
|
Stainless-steel instrument box |
1 |
1 |
0 |
|
|
Disposable scalpels |
2 |
0 |
0 |
|
|
Scissors
|
1 |
1 |
0 |
|
|
Dissecting forceps |
1 |
1 |
0 |
|
|
Haemostatic clamps |
2 |
1 |
0 |
|
|
Needle
forceps |
1 |
0 |
0 |
|
|
Disposable razors |
2 |
0 |
0 |
|
4.
Examination and monitoring equipment |
|
|
Disposable tongue depressors |
4 |
2 |
0 |
|
|
Reactive strips for urine analysis (glucose, blood, protein, ketones) |
4 |
0 |
0 |
|
|
Temperature charts |
2 |
0 |
0 |
|
|
Stethoscope |
1 |
1 |
0 |
|
|
Aneroid
sphygmomanometer |
1 |
1 |
0 |
|
|
Standard medical thermometer |
1 |
1 |
0 |
|
|
Hypothermic thermometer |
1 |
1 |
0 |
|
5.
Equipment for injection, perfusion, puncture and catheterisation |
|
|
Bladder
drainage instruments (bag, cocks, tube) |
1 |
0 |
0 |
|
|
Rectal
drip set |
1 |
0 |
0 |
|
|
Disposable filter infusor (with blood filter) |
1 |
0 |
0 |
|
|
Urine
drainage bag |
1 |
0 |
0 |
|
|
Disposable syringes (2 ml; 5 ml; 10 ml) and needles |
6 |
3 |
0 |
|
|
Catheter, e.g.
Foley type, 16.5 ml balloon |
1 |
0 |
0 |
|
|
Skin cleansing pads, with isopropyl alcohol, number of
packets
|
20 |
10 |
0 |
|
6.
General medical equipment |
|
|
Stretcher case
|
1 |
1 |
0 |
|
|
Bedpan |
1 |
0 |
0 |
|
|
Urine
bottle |
1 |
0 |
0 |
|
|
Hot-water bottle |
1 |
0 |
0 |
|
|
Ice bag |
1 |
0 |
0 |
|
7.
Immobilisation and setting equipment |
|
|
Malleable finger splint |
1 |
1 |
0 |
|
|
Malleable forearm and hand splint |
1 |
1 |
0 |
|
|
Inflatable splint |
1 |
1 |
0 |
|
|
Thigh
splint |
1 |
1 |
0 |
|
|
Collar
for neck immobilisation |
1 |
1 |
0 |
|
|
Thomas
splint or dimple mattress |
1 |
0 |
0 |
|
8.
Disinfection, disinsectisation and prophylaxis |
|
|
Water-disinfection compound (sufficient quantity for the disinfection of
50 litres of water) |
1 |
0 |
0 |
|
|
Liquid
insecticide (250 ml) |
1 |
0 |
0 |
|
|
Powder
insecticide (15 g) |
1 |
0 |
0 |
|