Medical

Introduction

Maritime medicine addresses specific conditions: isolation at sea, distance from hospitals and medical facilities, long voyages, demanding physical environments and the need to care for a sick or injured seafarer, sometimes without a doctor on board. The “Medical” category of the Nautic Way Maritime Bookshop brings together publications and technical documents dealing with medical care on board ships, health-risk prevention, first aid, ship medicine chests and the management of medical emergencies at sea.

These publications are relevant to the merchant navy, fishing vessels, passenger ships, workboats, offshore vessels and other professional ships, and, depending on the publication, to smaller vessels operating on coastal or offshore voyages.

Medical care on board is not simply a matter of carrying a first-aid kit. It requires a medical organization adapted to the type of ship, crew size, voyage duration and distance from medical facilities. The World Health Organization's International Medical Guide for Ships is a major international reference covering seafarer health and medical care on board ships.

Medical care on board ships

On board a ship, a condition that might appear minor on shore can become significantly more serious when access to a doctor or hospital requires several hours or even days. Crew members therefore need to be able to identify an emergency, provide first aid, monitor the patient's condition and, when necessary, arrange remote medical advice or evacuation.

Possible situations include:

• injuries and trauma;

• wounds and bleeding;

• burns;

• fractures and sprains;

• fainting and loss of consciousness;

• acute pain;

• respiratory problems;

• digestive disorders;

• infections;

• allergic reactions;

• poisoning;

• hypothermia or heat-related illness;

• accidents involving machinery or cargo operations;

• enclosed-space accidents;

• dental problems;

• illnesses requiring monitoring over several days.

Maritime medical publications provide a structured approach to assessing these situations and determining appropriate action while external medical assistance is being arranged.

First aid and Medical First Aid

First aid is a fundamental part of shipboard safety. Prompt intervention can help reduce the consequences of an accident before specialist medical assistance becomes available.

Maritime training distinguishes between general first-aid knowledge and more advanced Medical First Aid competencies. These skills are particularly important for seafarers who may have to assist a sick or injured person in an isolated environment.

Medical publications may cover:

• initial patient assessment;

• monitoring of vital functions;

• resuscitation;

• management of bleeding;

• trauma;

• burns;

• fractures;

• eye injuries;

• respiratory problems;

• poisoning;

• infections;

• pain management;

• wound care;

• preparation for medical evacuation.

The purpose is not to replace a doctor but to enable trained personnel to respond in an organized and appropriate manner until specialist medical care becomes available.

International Medical Guide for Ships

The International Medical Guide for Ships published by the World Health Organization is a major reference in maritime medicine. Its third edition includes information intended to assist with the diagnosis and management of medical problems that may occur on board, together with information relating to the ship's medicine chest.

This type of guide is particularly important for vessels operating far from shore where the crew may have to provide initial medical care while awaiting remote medical advice, evacuation or arrival in port.

Shipboard medical publications should always be used in accordance with the requirements applicable to the vessel's flag, type of operation and company procedures.

Ship's medicine chest and medical stores

The ship's medicine chest is an essential part of the vessel's medical organization. Its contents depend on factors such as vessel category, crew size, voyage duration and the time normally required to reach a port.

The WHO has developed recommendations concerning medicine quantities and indications for different categories of ships. These include ocean-going ships without a doctor, coastal ships and small craft operating relatively close to medical facilities.

Management of the medicine chest includes:

• stock control;

• checking expiry dates;

• appropriate storage;

• product identification;

• replacement of used medicines;

• suitable storage conditions;

• maintenance of required records;

• inspection of medical equipment;

• checking first-aid equipment.

A properly managed medicine chest ensures that appropriate supplies are available when an emergency occurs.

Medical emergencies at sea

A medical emergency at sea must be assessed within the maritime context. Distance from the nearest port, weather conditions, sea state, helicopter evacuation possibilities and the medical resources available on board can directly influence the response.

Chest pain, severe breathing difficulties, major trauma, loss of consciousness or severe bleeding require particularly rapid action.

The response may include:

• assessing the patient's condition;

• ensuring safety;

• providing first aid;

• monitoring essential parameters;

• contacting a shore-based medical service;

• preparing for evacuation;

• transmitting medical information to rescuers.

Accurate communication of symptoms, accident circumstances, treatment already provided and changes in the patient's condition is essential to allow the shore-based doctor to make an appropriate decision.

Remote medical assistance and maritime telemedicine

When a ship is far from shore, remote medical assistance can be an important resource. Depending on the communications equipment and procedures available, radio or satellite communications may be used to transmit information to a shore-based medical service.

The crew must be able to provide structured information including the patient's identity, age, symptoms, circumstances, known medical history, observed signs, treatment already administered and changes in condition.

This ability is particularly important when deciding whether the vessel should continue its voyage, alter course, divert to a port or arrange medical evacuation.

The IMO has emphasized the importance of access to medical care for seafarers and refers to the international framework established through instruments including the MLC 2006, SOLAS and maritime search-and-rescue provisions.

Occupational accidents and risks on board

The maritime environment presents numerous occupational hazards. Cargo operations, deck work, machinery, enclosed spaces, maintenance activities and work in heavy weather can all result in accidents.

Medical documentation therefore complements the ship's safety procedures. It can help crews prepare for the medical consequences of incidents such as:

• falls from height;

• falls on deck;

• crushing injuries;

• cuts;

• burns;

• exposure to hazardous substances;

• inhalation of toxic substances;

• electrical accidents;

• cargo-handling injuries;

• enclosed or confined-space accidents.

Prevention remains the priority: personal protective equipment, work procedures, risk assessments, permits to work and training should reduce the likelihood of such accidents.

Dangerous goods and medical care

Ships carrying dangerous goods face specific medical hazards. Exposure to toxic, corrosive or irritating substances may require immediate action appropriate to the product involved.

The Medical First Aid Guide for Use in Accidents Involving Dangerous Goods, or MFAG, provides specific guidance for first aid following accidents involving dangerous goods. The IMO describes the guide as a medical supplement to the IMDG Code and states that it is reproduced in the IMDG Code Supplement.

Medical documentation must therefore be considered together with cargo information when a vessel carries hazardous substances.

Hygiene, prevention and health on board

Maritime medicine is not limited to accidents and illness. Prevention of health risks is also an important part of crew health.

Safe water, food hygiene, sanitation, accommodation areas and food-preparation facilities all contribute to reducing the risk of illness on board. The World Health Organization's Guide to Ship Sanitation addresses health risks associated with ships and preventive and control measures.

Collective health issues may include:

• drinking water;

• food hygiene;

• food storage;

• cleaning and disinfection;

• ventilation;

• vector control;

• waste management;

• accommodation hygiene;

• infection prevention;

• management of public-health events on board.

These issues are particularly important for vessels undertaking long voyages or regularly calling at international ports.

Maritime medicine and STCW

Medical competencies form part of seafarer training and certification. The STCW Convention provides the international framework for seafarer training, certification and watchkeeping.

Medical publications can therefore support training in first aid, Medical First Aid, medical care on board and emergency preparedness.

The 2026 edition of the STCW Convention and Code was published by the IMO in July 2026, with a French digital edition published in August 2026.

Publications should nevertheless be used as a complement to required training and the requirements of the relevant flag State.

Medical fitness of seafarers

Maritime medicine also covers the medical fitness of persons working on board ships. Medical examinations for seafarers assess their ability to perform their duties in a professional maritime environment.

In 2025, the IMO adopted a resolution concerning the accessibility of information relating to seafarer medical certificates and recognized medical practitioners conducting seafarer medical examinations.

This preventive dimension is particularly important because a seafarer's health must be compatible with the physical, psychological and operational demands of the position.

Maritime medicine according to vessel type

Medical requirements vary according to vessel type and operation.

On a container ship or bulk carrier undertaking an ocean voyage, the distance from shore may require substantial medical capability on board. On a passenger ship, the larger number of people on board increases the range of medical situations that may arise.

Fishing vessels present specific risks associated with deck work, fishing gear and weather conditions. Offshore and work vessels may also face particular occupational hazards.

Medical documentation should therefore be selected according to:

• vessel type;

• crew size;

• operating area;

• voyage duration;

• whether a doctor is carried;

• distance from medical facilities;

• cargo carried;

• flag State requirements.

Medical documentation adapted to the maritime environment

Shipboard medicine requires publications specifically suited to the constraints of a vessel. A medical reference designed for use ashore does not necessarily address the same needs as a guide intended for a ship isolated at sea.

Specialized documentation takes account of the absence of a doctor, evacuation delays, available communications, medicine-chest contents and maritime occupational risks.

It is therefore an important reference resource for Masters, officers, designated medical personnel, safety managers, trainers and ship operators.

Conclusion

Maritime medicine is an essential component of ship safety and seafarer protection. It combines first aid, medical care, ship medicine chests, health prevention, hygiene, remote medical assistance and preparation for medical evacuation.

Medical publications intended for the maritime sector help crews prepare for situations that may occur during coastal or ocean voyages. They complement regulatory training and shipboard procedures and should be selected according to vessel type, crew, operating area and applicable requirements.

From the International Medical Guide for Ships to references dealing with first aid, ship medicine chests, dangerous goods and maritime hygiene, medical documentation provides an essential knowledge base for improving preparedness and health safety on board.

FAQ – Maritime Medical Care

What is maritime medicine?

Maritime medicine covers the knowledge, procedures and medical resources required to prevent, assess and manage health problems that may occur on board ships.

Why is specific medical documentation required on ships?

Because a ship may be several hours or days away from medical facilities. Crew members must therefore be able to provide first aid, monitor a patient and communicate effectively with a shore-based medical service.

What is the International Medical Guide for Ships?

It is a major World Health Organization reference for medical care on board ships. It covers the management of medical conditions and includes information concerning the ship's medicine chest.

What is the MFAG?

The MFAG, or Medical First Aid Guide for Use in Accidents Involving Dangerous Goods, provides first-aid guidance for accidents involving dangerous goods. It supplements the IMDG Code.

What does a ship's medicine chest contain?

Its contents depend on vessel type, crew size, voyage duration, operating area and regulatory requirements. It may include medicines, medical supplies, first-aid equipment and emergency-care equipment.

What is Medical First Aid?

Medical First Aid refers to the competencies that enable a trained seafarer to provide initial medical assistance to a sick or injured person on board, particularly while specialist medical care is being arranged.

How should a medical emergency at sea be managed?

The situation should first be made safe, the patient's condition assessed, appropriate first aid provided, the patient monitored and, where necessary, a shore-based medical service contacted and evacuation prepared.

Why is hygiene important on board ships?

Good hygiene involving water, food, sanitation and accommodation helps prevent illness and infectious outbreaks that could affect several crew members or passengers.

Does maritime medicine only concern merchant ships?

No. It also applies to fishing vessels, passenger ships, offshore vessels, workboats and other professional vessels, with medical requirements adapted to their specific operations.

What is the role of STCW in medical training for seafarers?

The STCW Convention provides the international framework for seafarer training and certification, including competencies related to first aid and medical care on board.

Why is medical fitness important for seafarers?

It helps establish that a seafarer's health is compatible with the requirements of the position and the particular constraints of working at sea.

Who uses maritime medical publications?

They are used by Masters, officers, designated medical personnel, safety managers, shipping companies, trainers, students and other professionals involved in ship management and maritime operations.