Elements and Performance Criteria

General context
Work must be carried out in compliance with relevant maritime regulations and rules dealing with medical care on board a vessel.

Work is performed relatively independently under broad operational requirements, with accountability and responsibility for self and others in achieving the prescribed outcomes.

Work involves the application of a knowledge of first aid and medical techniques required to provide medical care for crew and/or passengers on board a vessel. Contribution to the planning and organisation of medical care on board a vessel is required. Accountability and responsibility for self and others in providing medical care is involved.

Work requires significant judgement in planning and leadership functions related to the provision of medical care for crew and/or passengers on board vessels of 500 gross tonnage or more.

Worksite environment
Vessel may include any commercial Australian or international vessel of 500 gross tonnage or more.

Medical care and procedures may be carried out:
by day or night in both normal and emergency situations
under any possible conditions of weather and loading
while underway or at anchor
during quarantine procedures when entering port.

Medical emergencies may include:
acute chest pain
acute respiratory conditions
acute abdominal pain
diabetes
seizures.

Management of injuries on board vessel may include:
head injuries
chest injuries
haemorrhage
shock
spinal injuries
fractures and dislocations
cold injury and hypothermia
inhalation, ingestion and skin or eye contact with industrial chemicals.

Diagnosis and management of infectious diseases may include:
typhoid
cholera
dysentery
malaria
heat exhaustion
influenza
pneumonia
tonsillitis
meningitis
inguinal hernia.

Diagnosis and management of cardiovascular and central nervous system disorders may include:
angina pectoris
coronary occlusion
paroxysmal tachycardia
facial palsy
cerebral haemorrhage
cerebral thrombosis.

Diagnosis and management of sexually transmitted diseases may include:
urethral and urine smear tests
basic medical treatment for various sexually transmitted diseases
counselling.

Measures for the prevention of disease in seafarers may include:
immunisation and vaccination
methods for the prevention of malaria
precautions to be taken when in endemic zones for malaria and yellow fever
precautions and methods for the prevention of disease spread on board a vessel.

Sources of information/documents
Documentation/records may include:
ISM Code safety management system plans, procedures, checklists and instructions
IMO STCW Convention and Code dealing with medical care on board a vessel
AMSA Marine Orders dealing with medical care on board a vessel
The Ship Captain's Medical Guide
International Medical Guide for Ships
Medical Section of the 'International Code of Signals'
Medical First Aid Guide for Use in Accidents involving Dangerous Goods
Marine Drug Guide
vessel's log
vessel medical records
shipboard patients' health records
drug register
quarantine records and documentation
company procedures concerning medical care on board a vessel
instructions of relevant maritime, health and quarantine authorities related to the medical care of crew and passengers on board a vessel
relevant Australian and international standards.

Applicable International, Australian and State/Territory regulations and legislation
Applicable procedures and codes may include:
IMO STCW 95 Code and Convention related to vessels of 500 gross tonnage or more
relevant sections of AMSA Marine Orders
ISM Code Safety Management System
relevant international, Australian and State/Territory health and quarantine regulations
relevant international, Australian and State/Territory OH&S legislation.

Critical aspects of evidence to be considered
Assessment must confirm appropriate knowledge and skills to:
Take charge of typical medical emergencies on board a vessel
Carry out routine medical procedures on board a vessel
Carry out medical procedures as directed from shore-based medical advisers
Identify typical medical problems and emergencies and take appropriate action
Educate passengers and crew on shipboard health and hygiene
Complete quarantine requirements when entering a port from overseas
Communicate effectively with others during medical emergencies and health care
Maintain medical records in accordance with company and regulatory requirements.

Interdependent assessment of units
This unit of competency must be assessed in conjunction with other mandatory units that form part of a job role of the master of a commercial vessel of 500 gross tonnage or more.

Required knowledge and skills
Relevant maritime regulations related to medical care on board a vessel
Emergencies, injuries and medical problems that may occur on board a vessel and appropriate action, treatments and solutions
Relevant OH&S and health legislation and policies
Shipboard procedures for:
conducting an initial patient assessment
managing injuries
managing medical emergencies
carrying out resuscitation techniques
treating infectious diseases
treating of commonly encountered industrial related medical conditions
caring for eyes, ear, nose, rehydration and urinary retention
managing surgical emergencies
managing drug and alcohol abuse
treating disorders of the central nervous system and cardiovascular diseases
caring for dying or dead persons
managing sexually transmitted diseases
shipboard hygiene and health education
implementing quarantine regulations
administering drugs and subcutaneous and intramuscular injections within legal and practical guidelines
Suturing techniques as per the Ship Captain's Medical Guide
Techniques for care of wounds
Quarantine procedures when entering a port from overseas
Potential dangers associated with contaminated ballast water
Precautions for the prevention of disease in seafarers
Ways in which disease can spread on board a vessel and ways of preventing the spread
Principles of shipboard hygiene including adequate ventilation, healthy lifestyle, disinfection of potable water, food hygiene, and disposal of liquid and solid waste from a vessel
Legal issues surrounding drug administration on board a vessel
Knowledge of body structures and functions relevant to possible injury and disease that may be encountered on board a vessel
Maritime communication techniques related to health care and receiving radio medical advice from shore-based advisers
Duties and responsibilities of the designated medical officer on board a vessel
Marine publications containing information on first aid and medical treatment on board a vessel.

Resource implications
Access is required to opportunities to either:
participate in a range of role plays, case studies and other simulated practical and knowledge assessments that demonstrate the skills and knowledge to manage and coordinate the medical care of crew and passengers on board vessels of 500 gross tonnage or more, and/or
assist in the coordination of medical care procedures on board an operational vessel.

Consistency in performance
Applies underpinning knowledge and skills when:
providing medical care on board a vessel
identifying and evaluating medical problems and emergencies and taking appropriate courses of action
identifying and implementing improvements to medical care on board a vessel
applying aseptic and other precautionary techniques when carrying out medical procedures on board a vessel
assessing operational capability of vessel and manoeuvring plant and equipment.

Shows evidence of application of relevant workplace procedures including:
Relevant sections of IMO STCW 95 Convention and Code and AMSA Marine Orders
ISM Code and associated vessel's Safety Management System and procedures
OHS regulations and medical care policies and procedures
issue resolution procedures
relevant medical and first aid instructions
shipboard safety procedures.

Action taken promptly to report and/or rectify injuries and medical incidents in accordance with established procedures.

Work is completed systematically with required attention to detail.

Context for assessment
Assessment of competence must comply with the assessment requirements of the relevant maritime regulations.

Assessment of this unit must be undertaken within relevant marine authority approved and audited arrangements by a registered training organisation:
As a minimum, assessment of knowledge must be conducted through appropriate written/oral examinations
Appropriate practical assessment must occur:
at the registered training organisation, and/or
on an appropriate working or training vessel.