What is International Medical Guide for ships and its contents?

• World Health Organization (WHO) – including the WHO Collaborating Centres on Maritime Health network
• International Maritime Organization (IMO)
• International Labour Organization (ILO)
• International Transport Workers Federation (ITF)
• International Shipping Federation (ISF)

Objective of the WGMC is to:

1. Revise of the Medical Chest on Board.
2. create an expert advisory panel on maritime health for close cooperation with the different international UN bodies concerned with maritime health.
3. requirements for medical care on board ships
4. emergency communications procedures
5. radio medical advice

Note:-

• International medical guide( IMGS) for ships is jointly published by world health organisation( WHO) as well as international maritime health association( IMHA)
• The “Ship Medicine Chest” is not really a chest any more, but the name is still there, although it would have been more appropriate today to talk about ship medical facilities and ship medicine, as it comprises both medicines and equipment.
• International Maritime Health Association (IMHA)  members and members of the WHO network of collaboration centres for seafarers health was published in the International Maritime Health in 2010 as the direct result of the Athens meeting of IMHA.

1. First aid
   • First aid on board
   • A basic life support sequence
   • Choking
   • Bleeding
2. Shock
3. Pain management
4. Head injuries
   • Anatomical note
   • General note on head injuries
   • Skull fractures
   • Traumatic brain injury (brain damage)
   • Post-concussion syndrome
5. Eye injuries and diseases
   • Eye injuries
   • Red flags
   • A blow on or near the eye
   • Corneal abrasion
   • Loose foreign bodies
   • Foreign bodies embedded in the eye
   • Wounds of the eyelids and eyeball
   • Chemical burns
   • Arc eyes (“welder’s flash”)
   • Noninfectious eye diseases
   • Subconjunctival haemorrhage
   • Cataract
   • Glaucoma
   • Infectious eye diseases
   • Blepharitis
   • Conjunctivitis
   • Keratitis
   • Hordeolum
   • Sudden painless loss of vision
6. Bone, joint, and muscle injuries
   • General treatment of injuries
   • Specific injuries
   • Strains and sprains .
   • Compound fractures
   • Skull fractures
   • Nose, jaw, and face fractures
   • Neck (cervical spine) injuries
   • Collar bone (clavicle) injury
   • Shoulder injury
   • Injury to the upper arm (humerus) and elbow
   • Wrist and forearm fractures
   • Hand and finger injuries
   •  Rib fractures
   • Fractures of the pelvis, hip, and femur
   • Knee injuries
   • Shin (tibia and fibula) fractures
   • Ankle injuries
   • Fractures of the foot and toes
   • Splints and slings
7. Abdominal and chest injuries
   • Abdominal injuries
   • Blunt abdominal injuries
   • Penetrating abdominal injuries
   • Chest injuries
   • Simple rib fracture
   • Flail chest
   • Pneumothorax
   • Spontaneous pneumothorax
   • Tension pneumothorax
   • Penetrating chest wounds
8. Wounds
   • Wound healing
   • Red flag wounds
   • How to close a wound
   • Using adhesive skin closures
   • Using skin adhesive (liquid stitches)
   • Suturing a wound
   • Local anaesthesia
   • Special wounds
   • Lips
   • Tongue
   • Ears and nose
   • Eyelids
   • Puncture wounds of the soles of the feet
   • Wound infection
   • Dressing wounds that cannot be closed
9. Burns, chemical splashes, smoke inhalation, and electrocution .
   • Clothing on fire
   • Heat burns and scalds
   • Infection of a burn
   • Respiratory tract burns
   • Electrical burns and electrocution
   • Chemical splashes
   • Flash burns (arc eye)
   • Smoke inhalation
10. Heat stroke and other heat disorders
    • Heat stroke
    • To prevent heat stroke
    • Stoker’s cramps
    • Heat exhaustion (or “heat collapse”)
11. Poisoning
    • Poisoning with ingested drugs and chemicals
    • Red flags
    • Common poisoning agents
    • Paracetamol (acetaminophen)
    • Acetylsalicylic acid (Aspirin®)
    • Methanol and ethylene glycol
    • Organophosphate and carbamate insecticides
    • Anticoagulants (warfarin, rat poison)
    • Petroleum products
    • Caustics
    • Disinfectants and bleach
    • Dangerous prescription drugs
    • Poisoning from exposure common to gases or vapours
    • Carbon monoxide
    • Cyanide
    • Irritant gases – phosgene, chlorine, ammonia
    • Carbon dioxide
    • Flammable liquid vapours
    • Freons
    • Hydrogen sulphide (“Rotten egg gas”, “Sewer gas”) 1
    • Bites and stings
    • Rat bites
    • Snake bites
    • Jellyfish stings
    • Venomous fish
    • Sea urchins
    • Scorpions and spiders
12. Examination of the patient
    • Introduction
    • Consent
    • Privacy and confidentiality
    • The physical examination
13. Paralysis, strange behaviour, unconsciousness
    • Stroke
    • Transient ischaemic attack (TIA)
    • Headache
    • Red flags
    • Seizures and epilepsy
    • Types of epileptic seizure
    • Red flags
    • Drugs that can precipitate seizures
    • Loss of consciousness
    • Sudden loss of consciousness (syncope)
    • Finding an unconscious person
    • Diabetes mellitus and coma
    • Diabetic ketoacidosis
    • Hypoglycaemia
    • Bell’s palsy
    • Mental illness
    • Psychosis
    • Forms of psychosis
    • Depression
    • Violent or threatening behaviour
    • Suicide
    • After an unsuccessful suicide attempt
    • Post-traumatic stress disorder
14. Chest pain and other disorders of the heart and circulation
    • Angina pectoris
    • Complications of myocardial infarction
    • Palpitations
    • Blocked arteries in the legs
    • Deep vein thrombosis
15. Respiratory diseases
    • Bronchitis
    • Bronchitis due to infection
    • Bronchitis due to cigarette smoking
    • Bronchiectasis
    • Common cold
    • Pleurisy
    • Pneumothorax
    • Pneumonia
    • Lobar pneumonia
    • Empyema
    • Aspiration pneumonia and lung abscess
    • Sinusitis
    • Hay fever
    • Asthma
16. Gastrointestinal and liver diseases
    • Abdominal pain – general points
    • Red flags in abdominal pain
    • Severe abdominal pain
    • Appendicitis
    • Pancreatitis
    • Bowel obstruction
    • Diarrhoea
    • Food borne illness
    • Dysentery
    • Traveller’s diarrhoea
    • Food poisoning from marine toxins
    • Inflammatory bowel disease (colitis)
    • Ulcerative colitis
    • Crohn’s disease
    • Antibiotic-associated colitis
    • Indigestion and pain related to meals
    • Gastro-oesophageal reflux disease
    • Peptic ulcer
    • Red flags
    • Heavy bleeding from the gastrointestinal tract
    •  (gastrointestinal haemorrhage)
    • Heavy upper gastrointestinal bleeding
    • Heavy lower gastrointestinal bleeding
    • Anal fissure
    • Haemorrhoids (piles)
    • Anal pruritis (anal itch)
    • Hernia
    • Inguinal (groin) hernia
    • Liver and biliary disease
    • Jaundice
    • Liver failure
    • Alcoholic liver disease
    • Gallstones
17. Kidney and other urinary disorders
    • Disorders of the kidney
    • Acute renal (kidney) failure
    • Chronic renal failure (Bright’s disease)
    • Kidney stones (renal colic)
    • Other urinary disorders
    • Red urine
    • Urinary tract infection
    • Urinary tract infection in women
    • Urinary tract infection in men
    • Prostatitis
    • Chronic pelvic pain in men
    • Benign prostatic hyperplasia (BPH, enlarged prostate)
    • Acute urinary retention
18. Pregnancy and childbirth
    • Pregnancy
    • Drugs in pregnancy
    • Vaginal bleeding during pregnancy or suspected pregnancy
    • Ectopic pregnancy
    • Miscarriage
    • Salpingitis (inflammation of a fallopian tube)
    • Pruritus vulvae (external genital itching)
    • Childbirth
    • Preparing for the birth
    • Managing the early stages of childbirth
    • Managing the birth
    • Caring for the baby after delivery
    • Caring for the mother after delivery
    • Post-partum haemorrhage
    • Other possible problems after childbirth
19. Sexually transmitted infections
    • Urethritis
    • Urethritis in women
    • Gonococcal proctitis
    • Gonococcal pharyngitis
    • Genital ulcers
    • Acute pain in the scrotum
    • Epididymitis
    • Testicular torsion
    • Trauma to the scrotum
    • Testicular inflammation (orchitis)
    • Balanitis
    • Lymph node swelling in the groin
    • Vaginal discharge
    • Bacterial vaginosis
    • Vaginal candidiasis
    • Trichomoniasis
    • Pelvic inflammatory disease
    • Ano-genital warts
    • Pubiclice
    • Acquired immunodefi ciency syndrome (AIDS)
    • Later stages of HIV and AIDS
    • Treatment of HIV infection
    • Post-exposure prophylaxis
20. Skin diseases
    • Questions to ask a patient
    • Barber’s rash
    • Folliculitis
    • Pseudofolliculitis (also called “razor bumps”)
    • Tinea barbae
    • Acne
    • Chaps
    • Dermatitis
    • Irritant contact dermatitis
    • Eczema (atopic dermatitis)
    • Allergic contact dermatitis
    • Fungal skin infections
    • Tinea pedis (athlete’s foot)
    • Tinea corporis (ringworm)
    • Tinea cruris (Jock itch, Dhobie itch)
    • Bacterial skin infections
    • Impetigo
    • Carbuncles and furuncles (furunculosis)
    • Skin abscess
    • Pediculosis (lice infestation)
    • Scabies
    • Shingles (herpes zoster and varicella zoster)
    • Urticaria (hives)
    • Cellulitis and erysipelas
    • Cellulitis arising from wounds exposed to estuary or seawater
21. Bone, joint, and muscle disorders
    • Joint inflammation
    • Gout
    • Septic arthritis
    • Rheumatoid arthritis
    • Osteoarthritis
    • Problems in specific joints
    • The knee
    • The shoulder
    • The back
    • Red flags
    • The neck
    • Red flags
22. Tobacco, alcohol, and drug use
    • Four main questions to consider
    • Alcohol intoxication
    • Alcohol withdrawl
    • Minor withdrawal (“the shakes”)
    • Major withdrawal (delirium tremens, DTs)
    • Cannabis intoxication
    • Opioids, opiates, and related drugs
    • Heroin intoxication
    • Heroin overdose
    • Infection in heroin users
    • Heroin withdrawal
    • Other opioids
    • Cocaine (“coke“, “snow“, etc.)
    • Amphetamines
    • Hallucinogen intoxication
    • Lysergic and diethylamide (LSD)
    • Phencyclidine (“PCP“, “angel dust“)
    • Plant hallucinogens
    • “Flashbacks“
    • Kava kava
23. Infectious diseases
    • Infectious agents
    • How infections spread
    • Common terms used in connection with infections
    • Onset
    • Fever
    • Rash
    • Management of infectious diseases – general principles
    • Isolation
    • Needle-stick injuries
    • Treating infectious diseases
    • Food
    • Some common or important infections that could occur on board
    • Anthrax
    • Chickenpox and shingles (varicella-zoster virus)
    • Cholera
    • Dengue
    • Diphtheria
    • Ear infections
    • Hand infections in seafarers and fishers
    • Infectious mononucleosis (glandular fever)
    • Influenza
    • Malaria
    • Meningitis and meningococcal infection
    • Mumps
    • Plague
    • Rabies
    • Rubella (German measles)
    • SARS (severe acute respiratory syndrome)
    • Sore throat
    • Red flags
    • Tetanus (lockjaw)
    • Tuberculosis
    • Typhoid and paratyphoid fever
    • Viral hepatitis (hepatitis A, B, and C)
    • Whooping cough (pertussis)
    • Worms
    • Yellow fever
24. Dental problems
    • Some common dental problems
    • Tooth decay (caries)
    • Pulpitis and peri-apical abscess
    • Periodontal disease (gum inflammation)
    • Pericoronitis
    • Red flags
    • Lost fillings and broken teeth
    • A bleeding socket
    • Lost teeth
25. External assistance
    • Medical advice
    • Evacuation by helicopter
    • Ship-to-ship transfer of doctor or patient
    • Referral information to accompany evacuated patients
26. Nursing care and medical procedures
    • Nursing care
    • Preparing sick-quarters
    • First steps on a patient’s arrival
    • Basic principles of nursing care
    • Caring for the bed-bound patient
    • Monitoring the vital signs
    • Bodily functions
    • Examining faeces, urine, sputum, and vomited matter
    • Mentally disturbed patients
    • The unconscious patient
    • Medical procedures
    • Applying cold
    • Applying heat
    • Catheterizing the urinary bladder
    • Surgical dressings
    • Administering medicines – basic principles
    • Routes of administration
    • Injections
    • Eye medication
    • Ear medication
27. Death at sea
    • Signs of death
    • Examining a dead body
    • Disposal of the body
    • Burial at sea
28. Medical care for survivors at sea
    • Abandoning ship
    • Surviving in a survival craft
    • Near-drowning
    • Generalized hypothermia due to cold water immersion
    • Cold exposure injuries
    • Frostnip
    • Frostbite
    • Immersion foot (trench foot)
    • Other medical problems aboard survival craft
    • Seasickness
    • Sunburn
    • Dehydration and malnutrition
    • Heat exposure
    • Contamination with oil
    • Food and water for rescued survivors
    • Medical resources on a lifeboat
29. Environmental control and hygiene
    • Ventilation
    • Lighting
    • Food hygiene
    • Food-handlers
    • Food service facilities
    • Food storage
    • The galley (ship’s kitchen)
    • Toilet and washing facilities
    • Liquid transport and potable water
    • Potable water sources
    • Potable water transport system
    • Potable water storage
    • Taking water on board
    • Disinfection of potable water
    • Disposal of liquid and solid wastes
    • Combating disease vectors
    • Rodents
    • Insects
    • Flies
    • Mosquitoes
    • Cockroaches
    • Bedbugs
    • Sanitary inspection
30. Preventing disease and promoting health in seafarers
    • Preventing communicable diseases
    • Isolation
    • Immunization
    • Hepatitis A and hepatitis B
    • Other infections
    • Preventing other diseases
    • Stopping smoking
    • A balanced diet
    • Personal hygiene
    • Sleep
    • Preventing illness from exposure to extremes of temperature
    • Sunburn and skin cancer
    • Lifting heavy weights
    • Foot Injuries
    • Lack of exercise and boredom
    • Preventing ill-health from seafaring work
    • General principles of promoting safety on board ship
    • The Health and Safety Committee
    • Briefing for new tasks
    • Work place assessment
    • Provision of good medical care
    • Seafarers’ lifestyles
31. Anatomy and physiology
    • Cells
    • Tissues
    • Organs
    • Note on anatomical terms and descriptions
    • The skeletal system
    • The muscular system
    • The circulatory system
    • The respiratory system
    • The digestive system
    • The urinary system
    • The nervous system
    • The endocrine system
    • The blood
    • Blood and anaemia
    • The immune system
    • Allergy
32. International Health Regulations
    • International Health Regulations (2005)
    • Part I – Definitions, purpose and scope, principles and responsible authorities
    • Part IV – Points of entry
    • Part V – Public health measures
    • Part VI – Health documents
    • Part VII –  Charges
    • Annex 1 – B. Core capacity requirements for designated airports, ports and ground crossings
    • Annex 2 – Descision instrument for the assessment and notification of events that may constitute a public health emergency of international concern
    • Annex 3 – Model ship sanitation control exemption certificate/ship sanitation control certificate
    • Annex 4 – Technical requirements pertaining to conveyances and conveyance operators
    • Annex 5 – Specific measures for vector-borne diseases
    • Annex 6 – Vaccination, prophylaxis and related certificates
    • Annex 7 – Requirements concerning vaccination or prophylaxis for specific diseases
    • Annex 8 – Model of maritime declaration of health
33. The ship’s medicine chest
    • Introduction
    • Basic rules for managing the medicine chest
    • Anaphylaxis
    • Drug rash and other drug-related skin problems
    • Controlled drugs
    • Ships carrying dangerous goods
    • Specific categories of medicines
    • Fluids for intravenous infusion
    • List of recommended medicines and equipment
    • Annex A: Forms for case reporting, referral, and evacuation
    • Ship master’s report form
    • Ship’s identity and navigational status form
    • Patient health status form
    • Primary physician’s report form