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Medical Handbook for Seafarers

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Medical Handbook for Seafarers Heikki Saarni Leena Niemi Medical Handbook for Seafarers Finnish Institute of Occupational Health Ministry of Social Affairs and Health Ministry of Labour Helsinki Finnish Institute of Occupational Health (FIOH) FIOH Bookstore Topeliuksenkatu 41 a A FI-00250 Helsinki, Finland Telephone +358 (0)30 474 2543 Telefax +358 (0)9 477 5071 www.ttl.fi/bookstore © 2007 Finnish Institute of Occupational Health, Heikki Saarni and Leena Niemi Participants in the preparation of the manuscript • Ari-Pekka Aarnio (37,40) • Eeva Ekholm (29) • Harri Kankare (11, 14) • Kari Koskela (23) • Leena Niemi (1, 2, 3, 4, 5, 9, 10, 11, 12, 13, 39, 41, 43, 45, 46, 47, 48, 49, 50) • Sinikka Niemi (7, 20, 44) • Petri Nieminen (21) • Erkki Nylamo (8, 28, 30) • Lassi Pakkala (16, 24, 25, 57, 58) • Heikki Saarni (15, 26, 27, 31, 32, 33, 34, 36, 38, 42, 49, 50, 51, 52, 53, 54, 55, 56) • Ulla-Maija Saarni (22) • Heikki Suoyrjö (35) • Erkki Säkö (6, 17, 18, 19) Translated by a group of students from the Department of English Translation and Interpreting at the University of Turku. Editor: Maisa Hurme Linguistics Editor: Terttu Kaustia Graphic Design: Aino Myllyluoma Photographs: Samuli Saarni Turku University Hospital, Department of Ophthalmology (Figure 13) Turku University Hospital, Department of Otorhinolaryngology (Figure 21) Turku University Hospital, Department of Dermatology (Figures 29–39) Drawings: Heikki Saarni ISBN: 978-951-802-743-3 Gummerus Kirjapaino Oy, Jyväskylä 2007 Contents I Emergency first aid ..............................................................................................7 1 First aid of vital functions ..............................................................................8 2 Foreign object in respiratory tract ................................................................14 3 Stopping major bleeding .............................................................................15 4 Shock ...........................................................................................................16 5 Classification of patients according to treatment requirement ......................19 II Accident injuries and their treatment ..............................................................21 6 Skull injuries and cerebral haemorrhage .......................................................22 7 Injuries to the eye ........................................................................................24 8 Injuries to the abdominal area ......................................................................28 9 Bone, joint and muscle injuries .....................................................................30 10 Amputation..................................................................................................35 11 Burns and frost injuries .................................................................................36 12 Heat-induced illnesses ..................................................................................38 13 Electrocution ................................................................................................40 14 Thermoregulation of organs and hypothermia .............................................41 15 Near drowning ............................................................................................44 16 Poisoning .....................................................................................................45 III Symptoms and diseases and their treatment .................................................51 17 Headache, and pain in the head region .......................................................52 18 Vertigo .........................................................................................................55 19 Alteration of consciousness and seizures .......................................................56 20 Eye problems and symptoms ......................................................................60 21 Illnesses of the ear and the throat .................................................................62 22 Problems of the mouth and the teeth ..........................................................65 23 Chest pain and cardiovascular diseases.........................................................66 24 Difficulty in breathing ..................................................................................70 25 Diseases of the airways .................................................................................72 26 Vomiting, fever and diarrhoea ......................................................................75 27 Constipation and haemorrhoids ..................................................................78 28 Abdominal pain ..........................................................................................79 29 Obstetrics and gynaecological disorders ......................................................84 30 Symptoms of the lower abdomen and acute diseases of the urinary organs 90 31 Sexually transmitted diseases (STD) .............................................................93 32 Dry and itchy skin ........................................................................................97 33 Rash .............................................................................................................98 34 Protective gloves and protective skin ointments ........................................106 35 Joint and muscle pain .................................................................................107 36 Mental disorders ....................................................................... 109 37 Alcohol and drugs ..................................................................... 113 38 Infectious and contagious diseases ............................................ 118 39 Diabetes .....................................................................................122 IV Treatment procedures .................................................................... 125 40 Securing the airways, intubation ................................................126 41 Measuring the blood sugar ........................................................131 42 The drugs in the ship’s pharmacy and their use ..........................133 43 Drug injections ...........................................................................135 44 Drug treatment of the eyes ........................................................137 45 Intravenous (IV) infusion therapy ................................................139 46 Measuring blood pressure ..........................................................143 47 Wounds ....................................................................................144 48 Retention of urine and catherization of urinary bladder ..............152 49 Positioning, moving, and evacuating a patient ...........................153 50 Cleaning hands and instruments ................................................156 V Self-protection ................................................................................. 159 51 Self-protection and prevention of infections ...............................160 52 Vaccinations for seafarers ............................................................161 53 Death on board ..........................................................................162 VI Advice and instructions .................................................................. 165 54 Radio Medical ............................................................................166 55 Confidentiality and seafarers’ health care ...................................168 VII Structure and functions of the human body, examination and recording the information ............................................................ 171 56 Structure and functions of the human body ...............................172 57 Examining the patient ................................................................181 VIII Forms .............................................................................................193 58 Patient information ....................................................................194 59 Treatment on board ...................................................................204 60 Patient follow-up form ...............................................................205 The drugs mentioned in the book; concentrations, drug forms and treatment equipment .......................................................................... 206 Index .................................................................................................. 210 FOREWORD hen a vessel is at sea, it is often difcult or even impossible to get a doctor on board or to transport the ill or injured patient ashore. The success of the treat- W ment depends on the medical know-how and treatment facilities on board. The captain of the ship is ofcially responsible for the treatment given on board. In practice, the person in charge is the captain himself or a person appointed by him. In- ternational and national regulations and instructions determine the crew’s level of medi- cal training (e.g. STCW-95). In addition, the ship has a medical chest and the necessary medical equipment. The international Radio Medical system was developed to compensate for the lack of well-trained medical sta on board. Via the service system of Radio Medical, a doctor on shore can be consulted free of charge. Improved telecommunication systems have facilitated direct contact between the crew and the shipping company’s occupational health service or, for example, a designated
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