LE CONOSCENZE INFORMATICHE DEL FARMACISTA I RISULTATI DI UN

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Medical care to a special population of
travelers The seafarers
Francesco Amenta Fondazione Centro
Internazionale Radio Medico (CIRM), Roma Centro
di Telemedicina e Telefarmacia Università di
Camerino, Camerino, Italy

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(No Transcript)
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Medical Travel

• Medical travel indicates traveling for medical
  care. In general it is referred to patients
  travelling in search of specialised treatments,
  surgeries or rehabilitation programs in
  high-level hospitals with qualified personnel and
  innovative technologies.
• The term is also used when healthy patients
  decide to travel to improve their health.
• There are also other travellers for medical
  care. It is the case of workers on board merchant
  ships or airlines. In case of diseases or
  accidents that cannot be treated satisfactorily
  on board they go to a physician/hospital in the
  first port/airport.

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Injuries and illness at sea who cares?

• The largest majority of merchant ships do not
  have on board a doctor or adequately trained
  paramedic personnel
• Merchant ships can be at sea for days or weeks
  before they can reach a port
• For centuries medical assistance to people on
  board ships was left to the responsibility of the
  ships captain. He helped himself with notions
  learned in courses of hygiene in nautical
  institutes or with medical books
• The level of medical assistance in these
  conditions was extremely poor.

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Medical Assistance at Sea

• Since the first Radio Medical service started in
  New York City (1920), between 1922 and 1939 12
  countries have developed Radio Medico
• All countries ratifying ILO 106 (1958) are
  required to have a Radio Medical Service free of
  charge
• No distinction made between nationality of
  patients using Radio Medical services

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Telemedicine at Sea

• More advanced telemedical systems are slowly
  being taken on board the ships
• Circular IMO MSC/circ 960 (2000) emphasizes the
  relevance of telemedical services for providing
  high quality medical assistance to sealing
  seafarers
• The circular introduces the Telemedical Maritime
  Assistance Service (TMAS) and defines standards
  and roles for TMAS

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Maritime telemedicine
Satellite

Land Earth Station


Ship with patient
Landbased network
Speach
Medical service

• Communication from ship via satellite
• Expensive use

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Advantages offered by telemedicine
1938 Transmission of breathing and pulse rate
by radiotelegraphy
2002 Store-and-forward picture of an ankle
injury used for guiding medication
2000 Dermatological lesion
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Injuries and illness at sea who cares?

• A medical officer is in charge of the patient
• On land, several doctors (TMAS) are available to
  give advise
• The doctor will need the best possible
  information about the state of the patient
• The doctor will need the best collaboration from
  the ship side
• Knowledge of the patients medical history is
  extremely useful

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ELECTRONIC HEALTH RECORD SOFTWARE
TELEMEDICAL EQUIPMENT AND SOFTWARE
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http//217.59.1.178/_medicirm
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SEAFARERS HEALTH PASSPORT

• Knowledge of the patients medical history is
  extremely useful

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THE NEAR FUTURE

• New Health Requirements for European Flag Ships