MARINE ORDERS Part 10 Medical first aid on ships Issue 4 Order No 13 of 2001 Pursuant to Section 425(1AA) of the Navigation Act 1912, I hereby make this Order repealing Marine Orders, Part 10, Issue 3, and substituting the attached Marine Orders, Part 10, Issue 4, to come into operation on 1 February 2002. Clive Davidson
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Table of Contents
1 Purpose of this Part
2 Definitions of words and phrases used in this Part
3 Interpretation
4 Application
5 Requirements
Appendix: Guidance notes on medical facilities aboard ships
Previous issues
Issue 1, Order No 1 of 1985
Issue 2, Order No 7 of 1987
Issue 3, Order No 4 of 1998
1 Purpose of this Part
Section 125 of the Navigation Act 1912 deals with the medicines, medical and surgical stores and appliances and anti-scorbutics (in this Part referred to as "medical supplies") that must be provided on a ship. Under the section, it is an offence for the master of a ship to take it to sea unless it is provided with medical supplies, and instructions for their use, in accordance with the regulations. Sections 270, 283A and 283E of the Navigation Act 1912 allow the regulations to make similar provision for ships carrying passengers, special purpose ships and off-shore mobile units. This Part of Marine Orders provides for those matters left to the regulations.[1]
operator means the owner or any organisation or person who has assumed responsibility for the operation of the ship;
penal provision means a penal provision for the purposes of Regulation 4 of the Navigation (Orders) Regulations;[2]
specified drug means diazepam, morphine, nitrazepam or pentazocine.
In this Part:
headings and sub-headings are part of the Part;
a footnote is not part of the Part.
4 Application
This Part applies to:
5 Requirements
5.1 General considerations
To the extent that is reasonable, adequate medical supplies and appropriately competent persons must be available to treat injuries and diseases aboard ship, until a patient can be transferred to the care of a medical practitioner.
There is no internationally agreed list of medical supplies that should be carried on a ship. The list in Annex 1 of the Guidance notes on medical facilities aboard ships (attached to this Part) should be of considerable assistance to the ship operator in determining the medical supplies appropriate for any particular situation. The Ship Captain's Medical Guide contains information to assist ships' crews in diagnosing and treating sick and injured seafarers.[4]
5.2 Duties of the operator
5.2.1 It is the responsibility of the operator of a ship to arrange for the provision of such medical supplies as are reasonably necessary to ensure that persons on board the ship have access to adequate first-aid. What constitutes "reasonably necessary" will depend on circumstances[5] and the operator will need to take into account a number of factors including the following:
the number and sex of persons who will be on board ship at any particular time;
the type of ship and the particular health hazards of the cargoes being carried;
the length of the proposed voyage;[6]
the facilities available for communication with shore-based advice;
the distance the ship will be from medical facilities on shore and the capacity for evacuation of sick or injured persons in an emergency.
5.2.2 The operator of a ship must also ensure that medical supplies are capable of being stored on board the ship in such a way that they are adequately protected from premature deterioration. Storage should be secure enough to prevent misuse, while ensuring that prompt access to them is available when they are required.
5.2.3 The operator of a ship must ensure that the master and crew of the ship are provided with a list of medical supplies on the ship, written instructions and adequate training on the proper use of medical supplies. The instructions must cover the obtaining of advice from qualified medical personnel.
5.2.4 The operator of a ship must not send the ship to sea, or allow the ship to be taken to sea, unless the operator has met the requirements set out in 5.2.1 to 5.2.3.
This is a penal provision.
5.3 Duties of the master
5.3.1 It is the responsibility of the master of a ship to ensure that the medicines are in date and the medical supplies are in working order and readily available for use.
5.3.2 The master must also ensure that all members of the crew are aware of the operator's instructions on the proper use of medical supplies.
5.3.3 The master of a ship must ensure that non-reusable medical supplies used, or otherwise becoming unserviceable, during a voyage are replaced at the earliest opportunity and if, for whatever reason, the master of a ship considers that the medical supplies provided on the ship are inadequate, he or she must take necessary steps to rectify the deficiency.[7]
5.3.4 The master of a ship must not take the ship to sea unless the master has met the requirements set out in 5.3.1 to 5.3.3.
This is a penal provision.
5.4 Duties of crew members
5.4.1 A person who is a member of the crew of a ship must comply with the operator's directions on the use of medical supplies.
This is a penal provision.
5.4.2 A person who is a member of the crew of a ship must report to a responsible officer any deficiencies in the medical supplies that comes to the person’s notice.
This is a penal provision.
5.5 Control of certain drugs
5.5.1 The use of certain drugs is controlled by law and their use on board ship must conform as far as practicable with relevant laws. The operator of a ship is responsible for ensuring that a Controlled Drug Register is provided on the ship
5.5.2 A person who dispenses a specified drug must record the particulars set out in 5.5.3 in the Controlled Drug Register.
5.5.3 The particulars that must be recorded in the Controlled Drug Register are:
the full name of the person to whom the specified drug is administered;
the reason for administering the specified drug;
the date and time at which the specified drug was administered;
the name and quantity of the specified drug administered;
the name and designation of the person who administered the specified drug.
5.5.4 The master must ensure that any loss or theft of a specified drug is recorded in the Controlled Drug Register.
This is a penal provision.
5.5.5 If any loss or theft of a specified drug occurs or is detected while the ship is in port, the master must report the loss or theft of the specified drug immediately to the appropriate law enforcement agencies.
This is a penal provision.
5.5.6 If any loss or theft of a specified drug occurs or is detected while the ship is under way the master must report the loss or theft of the specified drug to the appropriate law enforcement agencies as soon as practical after arrival of the ship in port.
This is a penal provision.
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[1] Where the Occupational Health and Safety (Maritime Industry) Act 1993 applies to a vessel, this Part will be of assistance for operators to meet their obligations under s.11(7) of that Act, which requires an operator to take all reasonable steps to “provide appropriate medical and first aid services for employees”.
[2] Regulation 4 of the Navigation (Orders) Regulations provides that a person who contravenes a provision of an order made under subsection 425(1AA) of the Navigation Act 1912 that is expressed to be a penal provision is guilty of an offence and is punishable, upon conviction:
(a) if the offender is a natural person—by a fine not exceeding $2,000; or
(b) if the offender is a body corporate—by a fine not exceeding $5,000.
By virtue of sections 4AB and 4AA of the Crimes Act 1914, these penalties are now $2,200 and $5,500 respectively.
[3] As a result of the operation of section 8B or 283G of the Navigation Act 1912, this Part may apply to a ship not registered in Australia.
[4] Masters and officers are reminded that if they are in any doubt as to the cause of a patient's symptoms, or are uncertain as to the treatment to be adopted, they should seek medical advice.
[5] Where the operator has carried out a risk assessment to determine the appropriate medical supplies to be provided, this should be documented and made available as part of the ship’s ISM documentation if applicable. When the operator of a ship varies the provision of medical supplies on board a vessel from those suggested in the Guidance notes on medical facilities aboard ships, evidence of assessment should be available on board. An appropriately qualified medical practitioner should undertake assessment or review of medical supplies carried on board a vessel.
[6] Operators should note that only in respect of frequently dispensed items, such as aspirin or indigestion tablets, is consumption likely to be proportionate to the length of the voyage.
[7] For example, a ship might take on board an unplanned cargo presenting hazards for which adequate provision has not been made by the operator in advance.