McKay Mary Pat
The George Washington University Medical Center-Emergency Medicine, 2150 Pennsylvania Avenue, NW Suite 2B, Washington, DC 20037, USA.
Occup Med (Lond). 2007 Sep;57(6):453-5. doi: 10.1093/occmed/kqm053. Epub 2007 Jul 25.
Commercial ships flying the US flag must conform to Coast Guard standards and have medical care available onboard. Consultation with a physician is required if medication is to be prescribed.
To evaluate the epidemiology of medical contacts for US ships at sea.
Retrospective analysis of cases where shipboard caregivers made contact with US emergency medicine physicians for advice.
There were 866 cases and 1720 contacts in 48 consecutive months of study. Eighty-eight per cent of cases were men with a mean age of 43.7 years (SD 13.7). Eighty-four per cent of cases were medical, 14% were injuries and 2% were purely psychiatric. Fifty-eight per cent of medical cases, 50% of psychiatric cases and 42% of injury cases were handled with a single contact. Injuries and psychiatric cases required a higher number of contacts per case compared with medical cases (P < 0.01). Five categories of illness accounted for 43% of medical cases (respiratory infections, abdominal problems, genitourinary complaints, rashes and dental issues). Psychiatric cases required the most medication, with 12% requiring four medications. The most common categories of medication given were pain relievers (non-steroidal anti-inflammatory drugs, opiates, heartburn relief) and antibiotics.
Even with pre-screening of seafarers and the potential dangers of life at sea, the majority of cases requiring physician advice are not related to trauma. However, cases of injury or acute psychiatric problems required more physician interaction and medication than medical cases.
悬挂美国国旗的商船必须符合海岸警卫队的标准，且船上要有医疗服务。如需开处方用药，则需要咨询医生。
评估美国船只在海上时医疗接触的流行病学情况。
对船上护理人员与美国急诊医学医生联系寻求建议的病例进行回顾性分析。
在连续48个月的研究中，共有866例病例和1720次接触。88%的病例为男性，平均年龄43.7岁（标准差13.7）。84%的病例为内科疾病，14%为受伤，2%为单纯精神疾病。58%的内科病例、50%的精神疾病病例和42%的受伤病例通过单次接触得到处理。与内科病例相比，受伤和精神疾病病例每例所需的接触次数更多（P<0.01）。五类疾病占内科病例的43%（呼吸道感染、腹部问题、泌尿生殖系统疾病、皮疹和牙科问题）。精神疾病病例所需药物最多，12%的病例需要四种药物。最常用的药物类别是止痛药（非甾体抗炎药、阿片类药物、抗酸药）和抗生素。
即使对海员进行了预筛查，且海上生活存在潜在危险，但大多数需要医生建议的病例与创伤无关。然而，受伤或急性精神问题病例比内科病例需要更多与医生的互动和用药。
