MCA Medical Stores revisions & Ships Captains Medical Guide (SCMG) 23rd edition
MCA M-Notice MSN 1905
The newly published MSN 1905 outlines Ships Medical Stores requirements dependent on distance offshore and number of crew. The MSN 1905 supersedes the previous MSN 1768 that were published in 1995. As with the SCMG, the guidelines were due for a revision and modernisation to align with the SCMG latest edition. The new standards need to be implemented by March 2022, so a year is allowed to complete onboard updates. The changes reflect an overall change of content for some equipment items and additions, subtractions, and replacement of some of the medicines.
SCMG – SCMG-1
The SCMG has been periodically updated since 1868, and a total of 22 editions have been published over the last 150 years. Changes have included developments in the understanding of disease, notably of infections. Treatments have been updated, with amendments to the required medical stores, and technical developments such as access to radio-medical advice have been incorporated. With the introduction of training in first aid and medical care for officers, the SCMG became the course textbook, in addition to its main role as an indispensable aid to treatment of injury and illness at sea.
The most recent version of the SCMG was published in 1998, and a lot has changed in medicine during the last 20 years. The evolution in how medical care can be delivered in remote areas has included:
Medical technology. The capability for ‘point-of-care’ testing has fundamentally changed how medicine is practiced, from the bedside in the most technical Intensive Care Unit, to the remotest place on Earth. Vital signs can be measured with remarkable accuracy, and tests and examinations performed on a patient to a level previously not possible. All this objective clinical information better guides the process of making diagnoses, and thus formulating more effective treatments that fundamentally improves and preserves lives.
Treatment algorithms. The advent of Advanced Life Support and Advanced Trauma Life Support emergency treatment algorithms in the 1980s-90s introduced a structured way of delivering care in emergency clinical situations. The concept of treatment algorithms has been extended to many other areas of emergency medical and trauma conditions, and also other more routine medical conditions. Such an approach gives the non-medical professional clear guidance on recognising serious clinical situations (using ‘red-flags’), required immediate actions, and also when to call for advice.
A revolution in global communications. Telemedical advice is available almost instantaneously, from anywhere in the world. Also, images and medical test results can be sent to shore-based medical advisors in almost real time, to aid the advice given back to the vessel.
The new 23rd edition of the Ship Captain’s Medical Guide was published in 2019.
The book has been completely rewritten, with the aim of reflecting current best medical practice, applying this to the maritime environment. The new SCMG also incorporates the advances in medical technology, treatment algorithms and communications described above.
The cover of the new SCMG echoes the past editions, whilst intimating the new approach to dealing with medical problems, new medical technology, and global communications, that are fundamental elements of the new guide.
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