Being Prepared –
Recently I sailed to Southeast Asia aboard The Celebrity Millennium cruise ship. Once on board, you are greeted with a glass of mimosa, a welcoming smile and a sense that your journey has begun. The drinks start to flow, the inhibitions, of most fellow passengers, start to relax and the stresses of the day to day, are all but forgotten. From this moment on, age is not really a factor. Everyone has signed up to enjoy and explore wherever and whatever this expedition has to offer.
I on the other hand, start to see things a little bit differently. Like a parent always looking out for their young child, I can already visualize the potential harmful situations that these delighted passengers may encounter throughout their trip. Those who drink too much may be faced with any number of unexpected situations. You have the sunbathers, who just can’t seem to get enough sun. Then there are those who eat foods they may not be accustomed to eating, or eat excessively and end up with a very uncomfortable gastro situation. The elderly or disabled also have their own challenges to overcome. High rises in bathrooms, shower stalls, uneven walkways, hallways not to mention the occasional swaying of the ship, all could be a recipe for potential falls, followed by fractures. Yes! As I look around the ship I’m starting to wonder about the fate of my fellow passengers.
The Medical Team on a cruise ship play a critical, ever changing, fast paced, multi-faceted role in treating crew and passengers for any number of diseases, injuries and simple first aid matters.
“When seeing a patient or emergency case, the critical thought at that point in time, is to prioritize that imminent situation.”
They never know what is going to walk through their doors or when they will need to respond to an emergency on deck. On average the medical team is made up of, 2-3 doctors and 3-5 nurses, working a 24 hour schedule. In those hours, they may encounter as little as 10 patients per day to as many as 50 patients. Regardless of the number of casualties that walk through their doors, the staffing quota does not change. They have to deal with each and every individual emergency situation.
Margarita Lever Senior Medical Doctor, MD on the Celebrity Millennium, a member of the Royal Caribbean Cruise Line stated “when seeing a patient or emergency case, the critical thought at that moment, is to prioritize the immediate situation.” There are numerous challenges that this team may have to face at any given time. They may be dealing with a language barrier, cultural differences, certain ethnic groups, and/or respecting the many religions practiced by the crew and passengers.
They also have to take into account the immigration laws and regulations necessary to get a patients and the family through customs. Situations have occurred whereby a passenger may use a medical situation to gain access into a country or smuggle illegal objects. So it makes sense that this is the necessary practice needed to be carried out. Margarita stated it would be easy to get caught up in all these barriers, but you have to remain and maintain a focus on the patient and providing the best medical treatment according to the Medical Operations Division stationed in Miami. In other words, each party has their own jobs to carry out and to make sure that it is done with the highest degree of professionalism and integrity.
Other necessary responsibilities of the Medical doctor are to make sure that the ship maintains and carries out a high level of safety and prevention in their practices. Like hand washing, providing sanitizing stations and by regulating the staff to make sure that these practices are carried out by the crew and passengers, especially in food areas. The physician on-board may need to isolate passengers who are potentially suspect to, or who may have contracted any type of communicable disease. In some cases a ship-wide quarantine may be necessary, all which must be reported to the Medical Operations Division for the Cruise Centre. They may have to confine and assess an individual’s state of mind if they become abusive or aggressive. In this situation they are usually placed in a room with minimal furniture and a security guard posted outside the room until the necessary law enforcement can take over. Imminent and necessary blood transfusions can also be carried out by the team with the aid of a very sophisticated laboratory they have onboard and the ability to screen the blood for HIV, Hepatitis and blood type. Man overboard is a very common occurrence on a cruise ship, most times witnessed either through camera or person. Either way the medical team is an integral part of the search and rescue attempt.
Then of course, there are the common day to day occurrences of setting bones, suturing wounds, providing medications, physical assessments and performing minor operations. When it comes to the more extensive operations, most times the person can be helicopter lifted to the nearest land medical centre, since most cruises are within 100 miles of shore even when out at sea. However the trans-ocean cruises can prove to be a bit more challenging, but these are the cruises when you will see staffing at its maximum and the greater coverage.
Cruise ships are often referred to as a “floating hotel,” so it’s no surprise that these cruise ships are now furnished with state of the art and modern “floating hospitals.” They have an ICU, Operating Room, X-ray machine, Laboratory as well as a highly qualified and specialized medical team.
It can be a great comfort to know that a cruise ship is so well equipped and has the ability to deal with the various medical scenarios that can occur while out at sea and away from the traditional health care centers. But here are some precautions that can be practiced to decrease your chances of a trip to the lower level of the cruise ship.
- Minimize time in the sun
- Apply sun block and insect repellent as necessary
- Hydrate yourself with plenty of water
- Drink responsibly
- Don’t overdo anything or start something that you are not accustomed to doing.
- Don’t engage in dangerous activities if you are not physically prepared.
- Wear the proper clothing to suit the excursion you are going on
The medical team is there and prepared to take on any and most medical situations should the need arise. But it is also important to emphasize the need for doing whatever is within your power to eliminate, minimize or prepare yourself and avoid having visit the medical centre.