Textbook of Maritime Medicine

Cruise medicine is an integrated part of maritime medicine, but involves medical professionals (physicians / nurses) working and living aboard the vessel while caring for both passengers and crew. This gives them a unique opportunity to study seafarers in their ‘natural environment’ and offers them a perspective that is distinctly different from researchers visiting the ships and from doctors seeing seafarers in port.

Since cruise medicine requires the presence of medical professionals aboard, this text will focus on their various roles and duties and on their place of work, the Medical Center (MC). Thus, it is not a manual directing the practice of medicine on cruise ships, but addresses medical staffing, facilities, equipment and procedures for the MC.

The specific medical needs of a cruise ship are dependent on variables such as ship size, itinerary, anticipated patient mix, anticipated number of patients' visits, etc. These factors will influence the ship’s staffing, medical equipment and formulary, as well as the size and lay-out of the medical center aboard. The practice of cruise medicine will be very different on a small vessel with 50 people and a mega-liner carrying more than 8000 people, but many of the duties of the medical personnel aboard will be the same.

The individual patient treatment is the primary focus of cruise medicine, but procedures and particulars of medical examination, diagnosis and treatment are left to the skill, training and independent judgment of the ships’ doctors and nurses. However, over the years the medical staff members have also become increasingly involved in a variety of preventive shipboard measures, like:

• epidemiology and disease prevention
• hygiene measures
• systematic isolation
• vaccination programs (influenza, yellow fever, hepatitis, tetanus)
• drug and alcohol testing
• insurance – claims and law suits prevention
• assault investigations
• anti-terror activity & disaster planning