Doctors on call in middle of ocean

Following the dramatic rescue of a crew member who fell overboard in the freezing Pacific Ocean for 90 minutes, Global Medical Emergency Support Partner PRAXES responded to assist. 

PRAXES gave emergency advice on Andrew Taylor’s symptoms presenting potential hypothermia, shock and a suspected broken leg, with regular follow-ups every few hours during his recovery on board his yacht, Derry~Londonderry~Doire. 

The incident is an unusually extreme one, but the Halifax, Canada company has provided more than a hundred remote consultations since the start of the Clipper 2013-14 Race in September 2013. 

There have also been five medevacs on the current race. These occur primarily near land where the logistics make it possible to evacuate a crew member in need of medical attention.  In mid ocean crews need to rely solely on the PRAXES doctors as a first line of assessment.  

PRAXES emergency physicians are trained specially to assess patients injured or ill in the world’s most hostile environments where there are limited options for a medical evacuation and there is no rapid access to x-rays or hi tech hospital equipment. They have many years of experience assisting people in remote locations providing advice with very little information – sometimes just a satellite connection with a medic or even the patient themselves. 

Crew members and skippers on the race can call PRAXES 24 hours a day and know there will be a qualified doctor on the phone within five minutes to give emergency specialist care and advice and permission to prescribe drugs. PRAXES physicians know what is in the medical chest on board and so can advise crew about the use of on board medications. 

PRAXES doctors have responded to call outs from every one of the 12 yachts on everything ranging from respiratory problems, infections, eye injuries, rashes, dislocations and broken ribs and they also have access to the medical records of the crew and skippers. They also provide a virtual in-port Skype service for sailors when they are thousands of miles away from their GP and do not necessarily need a time-consuming hospital visit. 

Derry~Londonderry~Doire crew member Andrew Taylor made a full recovery following his man overboard and managed to restart the race with the team in San Francisco following a visit to the hospital for an x-ray of his leg, which turned out not to be broken. 

PRAXES emergency physician Dr. Sam Campbell delivers specialist care to people who are facing life or death situations on oil rig platforms, mines, navy, coast guard and fishing vessels and in other remote environments such as at Everest Base Camp. 

“It’s an intellectual exercise. We are making assessments on critical things with people who are already working in extremely dangerous environments and are more at risk. We are at a disadvantage immediately - we cannot touch or see the patient to assess the extent of the injury. We also have to try and imagine what it’s like to be in that environment and be empathetic.  A medevac to a hospital is often not an option,” he said. 

“It’s all about risk adjustment and reducing the odds by making decisions without full knowledge.

"You don’t want to overcall for medevacs so you have to see whether the risks of a medevac are valid if you even have that option. The patient and care giver can be desperate and under an extreme amount of pressure, but there is a good physiological effect having a voice on the phone, which can reassure people in the middle of the ocean. 

“Experience gives a certain amount of fatalism,” he added. 

For crew and family at home the value comes from knowing that a PRAXES doctor is on standby to assist in the case of a medical query or incident.    The PRAXES medical service also enables a reduction in unnecessary hospital visits for crew in ports through easily accessible consultation.

John Hockin, vice president of marketing for PRAXES added: “Our doctors face some pretty extreme situations, and have to have a special kind of skillset. They have saved lives and comforted many seafarers since our inception in 1997. Supporting people in remote corners of the world is challenging but also satisfying. Every incident allows us to help people who have few options.We love working with some of the world’s most adventurous people.”