Question 1

The TMAS doctor advises a specific course of action, including some treatment from the medical chest that nobody aboard has given before. What is the correct approach?

Accepted Answer

Follow the telemedical doctor's specific instructions carefully, asking them to clarify or repeat anything unclear — the doctor is qualified and is directing treatment from a distance using the crew as their "hands"; write down or record the instructions and what was actually done, including times This is precisely the value of TMAS — a qualified doctor directs treatment remotely, with ship's crew acting as their hands on the casualty. Crew should not be expected to already know every treatment; the doctor talks them through it. Substituting medication without checking is dangerous, and declining a clearly explained instruction from a doctor (rather than asking for clarification) can deny the casualty appropriate treatment. Recording exactly what was done and when is also valuable for ongoing advice and for any later medical handover.

Question 2

A crew member on MV STARLING reports to the bridge feeling unwell — one side of their face looks slightly drooped, their speech sounds slurred, and they seem confused about simple questions. As OOW, what is your immediate thought process, bearing in mind you are not medically trained?

Accepted Answer

You do not need to diagnose what is wrong — facial drooping, slurred speech, and confusion are recognised warning signs (commonly taught as part of FAST: Face, Arms, Speech, Time) that something serious may be happening, possibly a stroke. Your job is to recognise the pattern, note the time symptoms started, and escalate immediately — not to work out exactly what condition it is This question deliberately avoids asking the OOW to diagnose anything — that is exactly the point of FAST-style recognition tools used worldwide for stroke awareness. The OOW's job is pattern recognition and fast escalation, not clinical diagnosis. Noting exactly when symptoms started is genuinely useful information for the telemedical doctor later, since some treatments are extremely time-sensitive. Waiting to "see how it develops" wastes time that, in a real stroke or similar event, directly affects outcome.

Question 3

You suspect something serious is happening. Who should be informed first, and why?

Accepted Answer

Alert the master immediately — they hold overall responsibility for the medical response and for deciding whether to contact the company's TMAS (Telemedical Maritime Assistance Service) provider. On most ships the master or a designated medical officer/trained crew member makes the TMAS call, but the OOW's job is to raise the alarm without delay Time matters enormously in genuine medical emergencies, so the master must be told immediately, not at handover. The master (or a designated officer) typically initiates the TMAS call, since this is a structured process with company-specific procedures and account details. Attempting to treat a suspected serious neurological or cardiac event using the medical chest, without first getting professional advice, risks doing more harm than good.