National Standard for Commercial Vessels
Thiprovides requirements for the first aid, medical supplies and associated equipment on board vessels and includes requirements relating to inventories; labelling; packaging and expiry date control of medicines and medical equipment; and the construction, location and marking of medical cabinets and first aid kits. It forms a normative (mandatory) part of this document.
OBJECTIVE
The objective of thiis to specify the medical supplies necessary to treat minor medical conditions or injuries, or to temporarily stabilise a patient until transfer to medical assistance can be arranged.
Medical supplies advice
Owners and operators should obtain medical advice from their consultant medical practitioners or pharmacists in specifying medical supplies for their vessels, especially should they wish to add to the mandatory listings.
1. The supplies and quantities specified in this Annex are based on experience of
the range of medical and surgical emergencies that can arise on board a vessel. However, they may need to be expanded in accordance with the particular risks inherent to the voyage, the length of the voyage, access to medical facilities, the cargoes carried, and the numbers of persons on board.
2. In addition to this Annex H, other requirements for first aid, medical supplies and
associated equipment, medical incident reporting procedures, storage, disposal, labelling and first aid training may be mandatory under other Commonwealth and state / territory legislation including OH&S legislation. In addition Codes of Practice and Australian Standards may exist that relate to medical supplies.
Equipment and supplies to be carried
All vessels shall carry the medical equipment and supplies specified in and/or as applicable to the vessel, dependant on its class and operating area. identifies the scales applicable to vessel class and operational area.
The scales of medical equipment and supplies specified ito are those required for single incident events involving 1 or 2 persons, and are based on the assumption that medical assistance will be achieved within the time periods specified i
NOTE: If unsure of the nature or seriousness of an illness or injury, radio medical advice should be sought and, if necessary, medical evacuation by helicopter should be initiated.
National Standard for Commercial Vessels Table H.1 – Medical assistance times CARRIAGE OF DANGEROUS GOODS
All vessels carrying as cargo, or in shipboard use, any quantity of a hazardous or dangerous chemical or goods, as defined under the International Maritime Dangerous Goods (IMDG) Code, shall have available on board the appropriate additional first aid, medicinal antidotes and other additional treatments as specified by the manufacturer, supplier or other authorised body or publication, including the material safety data sheets relating to the hazardous chemical or goods.
EXPIRY DATES
Medical supplies carried in accordance with this Subsection shall not exceed the expiry date specified by the manufacturer or supplier of the product.
All medicines have an expiry date. Expired or surplus medications should be returned to a pharmacist for appropriate disposal.
Unused controlled drugs shall not be disposed of other than by transferring them to the control of a registered pharmacist.
REPLACEMENT OF STOCKS
Antibiotics shall always be supplied in original packages or patient courses; however, other products such as analgesics and creams shall be considered adequate if an opened package contains at least 50 per cent of the original quantity, and the remaining product is uncontaminated and unaffected by any expiry date as a result of any seal being broken.
NOTE: This provision is to avoid unwarranted additional supply after a few tablets or capsules are consumed.
LABELLING AND PACKAGING
Medication should be provided in original, sealed blister or foil packs where possible.
All products shall carry instructions and directions for use in English and clearly state the adult dose where applicable to enable safe and effective use of the medication for the intended purpose(s).
Children’s doses, with weight or age criteria, can be shown if space permits on the label. It should be understood, however, that the medical inventories for vessels are designed for adult passengers and crew. If a child requires treatment, then radio medical advice should be sought.
National Standard for Commercial Vessels
All medicines and, where necessary, first aid stocks should carry cautionary and advisory labelling, as provided for in the Australian Pharmaceutical Formulary (APF) to alert Masters or patients as to issues of sedation or interaction with food or alcohol, etc. This ancillary labelling may be printed by the manufacturer on the packaging, included on a dispensing label, or by cautionary and advisory stickers.
The following details should be supplied on the label:
b) The generic or drug name (the brand name is optional unless
d) The instruction(s) for use and adult dose or directions for safe and
e) The supplying pharmacist’s name, address and telephone number on
schedule 4 and higher medicines and substances.
NOTES: Pharmacists are cautioned to avoid placing labels over the manufacturer’s expiry date or batch numbers and to provide original unopened packs, if possible. Where the choice of brands provides for blister or foil packaging, or other sealed packs, these are preferred in the harsh sea-going environment.
MEDICAL LOG BOOK
All vessels shall carry and record the use of all medicines, first aid and medical incidents in a Medical Log Book (to include the time, patient, condition and treatment) and record the stock movements for Controlled (#) Drugs in a Controlled Drugs Register. This includes the supply, use, disposal, loss or theft of such controlled (#) drugs.
FIRST AID KIT Application
All vessels covered by Scales D, E or F shall carry at least one portable first aid kit equipped as specified in Scale F. All vessels covered by Scale G shall carry either the Scale G or Scale F first aid kit.
Location
The first aid kit shall be located adjacent to the Master’s accommodation, or in the wheelhouse. In small partly open vessels, the first aid kit shall be stowed so as to protect it from incoming spray and the weather.
Construction and provisions
The first aid kit shall be stored in a weathertight, portable case of a non-corrosive material of suitable strength and size to accommodate the first aid stores.
The case should be fastened securely with quick-release closures.
National Standard for Commercial Vessels Labelling and Identification
The first aid kit case shall be labelled FIRST AID on the lid and at least two (2) sides for quick identification. The storage location of the first aid kit shall be clearly identified with an appropriate sign or sticker.
The contents shall be listed with a brief instruction for use for each item listed, along with expiry dates and the last check date. The list shall be stowed within or adjacent to the first aid kit.
Maintenance
First aid kits shall be cleaned and checked every three (3) months.
MEDICAL CABINET Application
All vessels covered by Scale D and E shall be provided with a medical cabinet of suitable size, design and construction for storing medical supplies.
NOTE: Storage of splints, neck collars, stretchers, etc may be separate from the medical cabinet; however, storage of these items should be readily accessible to the crew.
Location
The medical cabinet shall be located either—
a) in a separate compartment adjacent to the hospital accommodation;
b) where hospital accommodation is not provided, adjacent to the
vessel’s officers’ accommodation; or
in a dry and cool space accessible to the Master and a nominated crew member.
Construction and illumination
The medical cabinet shall be provided with—
a) an outer door, fitted with an efficient lock;
b) an inner cupboard, independently locked, for storing special drugs
(noted in Scales by the symbols ‘*’ or ‘#’);
a dispensing counter or table, with an impervious surface, which may be a shelf in the medical cabinet;
d) suitable storage space for medicines and measuring devices, which
facilitate identification of various items; and
e) illumination by electric light from inside or immediately outside the
Labelling and identification
The medical cabinet shall be clearly identified on the outer door with an appropriate sign or sticker.
National Standard for Commercial Vessels
The contents of the medical cabinet shall be listed with a brief instruction for use for each item listed, along with expiry dates and the last check date. The list shall be stowed within or adjacent to the medical cabinet.
Maintenance
Medical cabinets shall be cleaned and checked every three (3) months.
FIRST AID TRAINING
Persons administering first aid should possess as a minimum a current first aid qualification in accordance with NSCV Part D.
NOTE: Certain items in these Scales may require additional training to administer:
1. Persons administering first aid using Scale D should have the competency of a
Shipmasters Medical Qualification or an Advanced First Aid Certificate including training in administering injections (IMI and SCI), splinting with vacuum and air splints, and manual resuscitation.
2. Persons administering the supplies in Scale E First Aid Kits and medical supplies
should possess a current First Aid Certificate or, more preferably the Occupational level of First Aid Certificate, First Aid Oxygen therapy, Asthma management, and the use of Air Splints.
3. Where a defibrillator unit is carried, SAE Defibrillation training should be
National Standard for Commercial Vessels Table H.2—Scales applicable to vessel class and operational area Vessel use and operational area Extra specification Scale and table
Unlimited Domestic Operations (greater than 200 nm)
Restricted Offshore Operations (up to 30 nm)
Partially Smooth Water Operations (areas defined by
Smooth Water Operations (areas defined by jurisdictions) berthed passengers
Unlimited Domestic Operations (greater than 200 nm)
Restricted Offshore Operations (up to 30 nm)
Partially Smooth Water Operations (areas defined by
Smooth Water Operations (areas defined by jurisdictions)
Unlimited Domestic Operations (greater than 200 nm)
Restricted Offshore Operations (up to 30 nm)
Partially Smooth Water Operations (areas defined by
Smooth Water Operations (areas defined by jurisdictions)
National Standard for Commercial Vessels Table H.3— Scale G and F First Aid Kits Description Quantity Comments
Dressing, hydroactive (10 x 10 cm or similar)
Adhesive roll non-woven fabric 5 cm x 10 m
Gauze swabs, sterile (single use pkt of 3)
Safety pins, stainless, assorted pkt of 12
National Standard for Commercial Vessels Table H.3 cont. Description Quantity Comments
Loratadine HCl 10 mg or Fexofenadine HCl
NOTE: It is recommended that Class 1 vessels also carry a SAE Defibrillator (Laerdal First Aid unit or similar), Stretcher for helicopter evacuation / ship board use and a First Aid Oxygen Unit (Oxyport or equal) in addition to the requirements for Scale F. These items will not fit into the First Aid Kit however storage of these items should be readily accessible to the crew.
National Standard for Commercial Vessels Table H.4—Scale E and D Medication Description Quantity Comments
moderate-severe pain also cough suppression
# = Requires separate locked storage and recording in controlled drug register
National Standard for Commercial Vessels Table H.5—Scale E and D Medical Equipment Description Quantity Comments
Scissors, stainless, blunt/sharp 12.5 cm
Neck collar, multi-size, rigid, fully adjustable
Syringe with needle, sterile disposable 1 ml
Syringe with needle, sterile, disposable 2 ml
SAE Defibrillator (Laerdal First Aid unit or
Stretcher for helicopter evacuation / ship
First Aid Oxygen Unit (Oxyport or equal)
Ship Captain’s Medical Guide, current edition
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