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Questions on serious but not life threatening illness/accident onboard


khlim2005
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Recent on news a lady finger cut off by closing door onboard her cruise from Taiwan to Ishigaki, Japan. She loss her finger as medical facility onboard isn't equipe to stitches back.

 

As new cruiser onboard on our very first cruise soon, I feel that's a very real and frightening scenario, especially on sea day.

 

Anyone know the procedure on what can we do in this kind of scenario? Will air medical evacuation response to accident or illness that's every serious but perhaps not life threatening?

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I don’t know all the details in her case - sounds like she needed a surgeon to perform microsurgery to reattach the finger, much too sophisticated for ship care. But the medical group certainly can handle more routine stitches for cuts, care for many conditions until the next port is reached.

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Unlikely scenarios, from the prospects of a sinking to medical evacuation, are the subject of a disproportionate number of threads on Cruise Critic - a glance through some of them would make a novice very nervous about how safe it is to cruise.

Fact is, it's a damned sight safer than travelling by car.

 

That said..................

Cruise ships are obliged to have qualified medical staff aboard. They clearly can't have the expert knowledge or equipment to deal with all medical emergencies (the reason why for instance passengers in a fairly advanced state of pregnancy aren't permitted), but they can deal with most situations to at least triage until the patient can be transferred. That certainly includes stitching cuts, but there are plenty of folk who live or work a long way from a hospital which can make a decent job of re-attaching a finger. The only massive delay on a cruise is when a ship is several days from any port.

Evacuation from a ship might be by helicopter but in the vast majority of cases it's by transfer at or near a port.

During my many many cruises there's never been a transfer to a helicopter or even to another ship or boat, but on a couple of occasions the ship has diverted to an unscheduled port for a medical evacuation.

 

The number of situations requiring prompt evacuation and/or repatriation is very very low but the cost is way above most folks' ability to pay, and regardless of the low risk I'm amazed by how many folk don't bother to take out insurance.

But insurance claims are dominated by lost luggage, thefts, and other mundane matters and by cancellations ahead of a cruise.

And claims involving a fore-shortened cruise are mainly due to problems at home, rather than accident or illness aboard.

 

It bears repeating..............

Unlikely scenarios, from the prospects of a sinking to a medical evacuation, are the subject of a disproportionate number of threads on Cruise Critic - a glance through some of them would make a novice very nervous about how safe it is to cruise.

Fact is, it's a damned sight safer than travelling by car.:)

 

JB :)

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Recent on news a lady finger cut off by closing door onboard her cruise from Taiwan to Ishigaki, Japan. She loss her finger as medical facility onboard isn't equipe to stitches back.

 

As new cruiser onboard on our very first cruise soon, I feel that's a very real and frightening scenario, especially on sea day.

 

Anyone know the procedure on what can we do in this kind of scenario? Will air medical evacuation response to accident or illness that's every serious but perhaps not life threatening?

 

Lots of variables here. First off, where is the ship in relation to land, which country is closest, and what is the weather like. National agencies, like the USCG, that perform maritime SAR (which medical evacuation falls under) and which provide this service for free, will always have a flight surgeon at the base, who will confer with the ship's doctor and Captain, as well as the flight crew, to determine whether the medical needs of the patient outweighs the risk to the patient involved in an air evacuation, the risk to the flight crew, or the risk to the ship and its passengers. Also, there are limits to how far a rotary wing aircraft can fly, make an evacuation and recover to base.

 

Evacuation to a vessel of one of these national agencies is again limited by time and distance, and the same risk/reward analysis will determine whether someone is transferred, as doing this in the open ocean is extremely dangerous.

 

Various nations agree to take on the SAR functions for certain areas of the seas, but not all countries are well equipped, or well trained, and some areas just don't have coverage.

 

I have never heard of a private company that would do a air evacuation from a ship at sea, but there may be some (some nations like the Netherlands have privatized their SAR functions). In this case, it would be a discussion between the ship's doctor and the Captain about the risks to the ship and passengers as well as the patient as to whether or not the helo would be allowed to land, or attempt a basket recovery.

 

For an amputation of a finger, I doubt you would get an air evacuation, as even then the time frame would most likely be too long for successful reattachment.

 

These are the facts of going to sea, but as John says, you are dealing with rare instances.

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Recent on news a lady finger cut off by closing door onboard her cruise from Taiwan to Ishigaki, Japan. She loss her finger as medical facility onboard isn't equipe to stitches back.

 

As new cruiser onboard on our very first cruise soon, I feel that's a very real and frightening scenario, especially on sea day.

 

Anyone know the procedure on what can we do in this kind of scenario? Will air medical evacuation response to accident or illness that's every serious but perhaps not life threatening?

 

If a cruise ship was diverted for every serious but not life threatening problem, they would never get more than miles from port. That is the chances you take when you cruise. Live with it.

 

 

DON

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If a cruise ship was diverted for every serious but not life threatening problem, they would never get more than miles from port. That is the chances you take when you cruise. Live with it.

 

 

DON

Bluntly put, but to the point: better to understand the risks involved so you can make an informed decision to either "Live with it" - or find a lower-risk alternative to cruising.

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It’s not a bad idea to put the risks in perspective, either. How many millions of people cruise every year? The last time anyone quoted it on a thread here, it was upwards of 20 million. How many of those millions lost a finger on board ship? And how many of those who lost a finger were too far from shore to be evacuated for reattachement? This person is the only one that I’ve heard of. If it happened often, I’m sure we’d hear more about it.

 

The vast majority of injuries/illnesses on cruises are things that can be at least stabilised, and then referred ashore for more specialist care.

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You need to get a travel insurance where medical evacuation to the nearest port with hospital is covered.

 

 

Sent from my iPhone using Forums

 

I think we need to clarify what Medical Evacuation insurance does not cover. The insurance DOES NOT cover evacuation from the ship.....but covers evacuation (generally from a land based medical facility) to another hospital (possibly in a different country). Evacuation off a ship, if done by helicopter is generally free to the passenger as its done by a Coast Guard who does not charge for services.

 

But, whether a passenger will even be evacuated off a ship is a decision made primarily by the ship's physician in conjunction with the ship's Captain. As an alternative, a Captain may (and I emphasize "may") deviate to a closer port if recommended by the ship's physician. In over 1000 days on cruise ships all over the world we have only had 3 helicopter evacuations and perhaps twice that many deviations.

 

Detached fingers are a bad situation if it happens at sea. When I was a paramedic the rule of thumb was that a reattachment was only possible within 12 hours...and this was really pushing the max. In many cases it is impossible to evacuate a passenger from a ship to a hospital in that time period. I guess the good news is that a traumatic amputation is generally not life threatening and can certainly be stabilized onboard but getting to a facility in time, that can handle reattachments, is a long shot. I once witnessed the reattachment of a thumb and it was a very technical procedure where the vascular surgeon spent lots of time doing microvascular surgery while peering through a microscope. This is very highly specialized work.

 

Hank

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According to several medics I've spoken to, unfortunately, having fingers or a thumb mangled in a door isn't that rare an event.

 

The cause is almost always the same - the bathroom door. Although on many ships they are held open with a magnetic catch, it's not that strong. So if someone puts their hand in the door jamb and the ship moves then the door can suddenly close. Ouch. Also people close the door using the edge of the door instead of the handle, again if the ship moves then the door could move rather more quickly than expected and again, ouch.

 

So folks, please *never* put your hand where a door can close on it, and always use the handles....

 

VP

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It’s not a bad idea to put the risks in perspective, either. How many millions of people cruise every year? The last time anyone quoted it on a thread here, it was upwards of 20 million. How many of those millions lost a finger on board ship? And how many of those who lost a finger were too far from shore to be evacuated for reattachement? This person is the only one that I’ve heard of. If it happened often, I’m sure we’d hear more about it.

 

The vast majority of injuries/illnesses on cruises are things that can be at least stabilised, and then referred ashore for more specialist care.

 

20,335,000 according to the stats I found.

 

Since 1979 there have been 172 deaths, but all causes. Of course, this does not count someone who is alive when they are removed from the ship, but die soon after.

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In over 1000 days on cruise ships all over the world we have only had 3 helicopter evacuations and perhaps twice that many deviations.
In about 125 days we've seen two (one or both a crew evacuation, I forget the details), so your mileage may vary.
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The cause is almost always the same - the bathroom door.
DW seems to get her thumb in the bathroom door about once per cruise (without significant injury aside from a sore thumb, thankfully). We thought it was notable on this summer's Alaska cruise when it didn't occur.
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Detached fingers are a bad situation if it happens at sea. When I was a paramedic the rule of thumb was that a reattachment was only possible within 12 hours...and this was really pushing the max.

 

Hank

 

I regard this idea as an oxymoron.

 

Regards John

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  • 2 weeks later...

On a cruise ship you can find yourself too far from medical care to get what is required in time. The same can be said for nearly any trip that gets off the beaten path. Antarctica, Galapagos, the Serengeti, etc. if you can’t accept this possibility than you are best to only vacation in major cities. For the record, you can also have a heart attack in your home and pass before the paramedics get there. Nothing in life in guaranteed. You should certainly look into medical insurance with evacuation coverage and then decide if you are willing to take the risk of injury. Keep in mind the chance of an injury where you can’t get sufficient treatment is incredibly unlikely, though possible.

 

If you get a balcony cabin, be cognizant if the fact that if the balcony is open, and you try to open the room door it creates a ‘wind tunnel’ effect. This can cause doors to slam with a lot of force. So not leaving your balcony door open is good advice. Also agree that the bathroom doors are weighted to stay close.

 

 

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