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Cardiovascular events on board commercial maritime vessels: a two-year review
Paulo M Alves1, Robb Leigh, Ginger Bartos
1MedAire, Tempe, Arizona, USA. palves3@cox.net
Insights
Cardiovascular diseases (CVDs) are a significant maritime health concern, causing most non-injury deaths at sea. This study highlights the challenges in preventing onboard CVD events and managing them effectively with available resources.
Area of Science:
- Maritime Health
- Cardiovascular Epidemiology
- Telemedicine Applications
Background:
- Cardiovascular diseases (CVDs) are the leading cause of death at sea, excluding injury or violence.
- Understanding CVD epidemiology is crucial for maritime operations safety.
- Merchant maritime operations face unique health challenges due to remote environments.
Purpose of the Study:
- To investigate the epidemiology of cardiovascular diseases (CVDs) in merchant maritime operations.
- To assess the impact of CVDs on maritime health and operations.
- To evaluate the effectiveness of current pre-employment screening and onboard medical resources for CVDs.
Main Methods:
- Retrospective analysis of medical events from a US-based telemedicine provider database.
- Data collected over a two-year period from merchant maritime vessels.
- Inclusion of 1,394 medical cases to identify CVD-related incidents.
Main Results:
- Cardiovascular diseases (CVDs) were diagnosed in 29 cases, ranking eleventh in telemedicine consultations.
- CVDs were associated with three of the five deaths during the study period.
- CVD incidents led to increased vessel diversions and urgent communication.
Conclusions:
- Cardiovascular diseases (CVDs) pose a significant challenge to maritime health and safety.
- Current pre-employment screening may not be cost-effectively preventing onboard CVD events.
- Onboard medical resources, including Automated External Defibrillators (AEDs), require further evaluation for efficacy in maritime settings.
Background:
Cardiovascular diseases (CVDs) are an important concern in merchant maritime operations. They are responsible for the majority of deaths at sea that are not related to injury or violence. The objective was to better understand the epidemiology of CVD in merchant maritime operations.
Material And Methods:
Retrospective review of medical events on board merchant maritime vessels over a period of two years, from a US-based telemedicine provider's database.
Results:
A total of 1,394 cases were initially retrieved from the database. CVD was diagnosed in 29 cases and was the eleventh leading cause for accessing the telemedicine provider. Five deaths occurred in the study period, three of which related to CVDs. CVDs resulted in more diversions and the utilization of more urgent means of communication.
Discussion:
CVDs present a challenge in maritime health. The current pre-employment system is not, in a reasonable cost/benefit balance, able to prevent on board events from occurring. The success of telemedicine depends heavily on the onsite resources, both human and material. Automated External Defibrillators (AEDs), along with other devices such as multi-parameter monitors, are tools generally available to address acute presentations of CVDs, but their applicability on board commercial ships is a matter of controversy.
Conclusions:
CVDs are an important concern in commercial maritime operations due to the need for subsequent evaluation and potential complications including the risk of sudden cardiac arrest. In this study, CVDs were probably responsible for three on board deaths. Additional research is warranted to provide more evidence about the best resources to have on board to handle CVDs more effectively.
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