• Seasickness may vary in symptoms and severity, ranging from mild epigastric discomfort to severe forms with repeated vomiting, subsequent dehydration and apathy.
  • When recruiting personnel for ships, the MMSQ-short questionnaire may serve to identify incumbents with increased sensitivity for seasickness.
  • Though seasick patients usually recover well, seasickness should be regarded a treacherous condition, impairing mental and physical performance of seafarers and passengers
  • Seasickness should be considered a serious medical condition which may not only affect the individual but may have deleterious impact on the safety of the vessel (all aspects of safely handling the ship including navigation).
  • Mental impairment mediated by sea sickness may be more serious than the predominantly mild side effects of the anti-motion-sickness drug. Howeve, this may vary depending on the drug and the individual. This is relevant for seafarers with operational tasks on board.
  • Vomiting and altered drug absorption may put patients at risk of insufficient medication, patients with chronic diseases in particular should be monitored carefully for symptoms or signs of exacerbation (e.g. diabetes mellitus, epilepsy) .
  • Pharmacological and behavioural prophylactic measures may help to avoid or attenuate seasickness symptoms in many cases.
  • When seasickness symptoms occur, appropriate treatment should be started early on. In case of nausea (malaise IIa + III) avoid oral medication and administer drugs either via transdermal, rectal, i.m., or i.v. route.
  • Always check for medication that has already been taken before (including medication for chronic diseases) and avoid subsequent or parallel co-administration of anti-histamines and scopolamine.
  • Carefully mind restrictions of some anti-motion-sickness remedies with regards to children or pregnant women.
  • In the elderly carefully inquire about co-morbidities and contraindications to common motion sickness remedies, e.g. glaucoma, urinary retention or arrhythmia.

In emergency situations requiring abandoning ship, fluid loss and either cold or heat (depending on circumstances, sea area, weather and integrity of the rescue vessel) may pose serious threats. Both body temperature loss aswell as fluid loss are aggravated by seasickness, thus prophylactic medication should become part of rescue algorithms. All passengers should receive motion sickness medication (scopolamine patch, dimenhydrinate supp.) ideally in due time before embarkation on a life raft or survival craft.