The Epidemiology of Maritime Patients Requiring Medical Evacuation: A Literature Review

Abstract

This literature review aims to provide an analysis of the current trends in at-sea medical evacuations (medevacs), with the objective of providing insights to decision-makers to improve patient outcomes. Sixteen sources spanning diverse research methodologies were employed for data collection. The findings point to medical disease processes outweighing trauma and psychiatric conditions as the primary justifications for medical evacuations in the international maritime community. In particular, suspected cardiovascular pathologies emerge as the most prevalent grounds for recommended evacuations, underscoring the impact of their diagnosis and treatment in maritime healthcare scenarios. Enhancing the capabilities of on-site maritime healthcare providers to obtain cardiovascular diagnostic data to facilitate shoreside interpretation is proposed to mitigate the speculations inherent to long-distance medevac decisions. Furthermore, existing research indicates that sustaining a proactive approach focusing on prevoyage health screenings for seafarers and passenger vessel patrons holds promise in minimizing the risk of emergency evacuations resulting from the exacerbation of chronic medical conditions. This review reveals that while a limited portion of the cruise ship industry possesses established tactical medevac data on crucial aspects of patient care (such as transportation delay, pre-and mid-transport level of care, and ultimate patient outcomes), there exists a dearth of equivalent information for comparable maritime communities. This knowledge gap necessitates further exploration and research to understand and address diverse seafaring populations' unique challenges. In conclusion, this literature review holistically examines the landscape of at-sea medical evacuation statistics. By assimilating the collective knowledge gleaned from internationally sourced data, this study underscores the urgent need for continued research, comprehensive data collection, and strategic interventions to optimize patient care, enhance tactical decision-making, and ultimately shape a more resilient and responsive healthcare network for maritime communities worldwide.