Question 1

Based on the symptoms described, the TMAS doctor recommends the ship divert to the nearest port with hospital facilities. Who makes the final decision to divert, and what should the master weigh up?

Accepted Answer

The master makes the final decision, taking the telemedical doctor's recommendation very seriously, alongside practical factors such as distance and time to the nearest suitable port, weather and sea conditions, and informing the company/ship manager — but a clear medical recommendation to divert for a time-critical condition should not be overridden for commercial reasons alone The master retains command authority and makes the final operational decision, but a clear telemedical recommendation for a time-critical condition (such as a suspected stroke or heart attack) carries very serious weight and should drive that decision — commercial considerations should not override a genuine medical emergency. The company/ship manager and P&I Club are normally informed as part of this process, but they support the decision, they do not make it instead of the master.

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.