Saving lives at sea

Dr Clive Strauss points to the anaesthetic monitor above the simple anaesthetic machine. A cardiac monitor and defibrillator are in the yellow pack on the shelf above, while the blue screen of the transport ventilator can be seen below.
Dr Clive Strauss points to the anaesthetic monitor above the simple anaesthetic machine. A cardiac monitor and defibrillator are in the yellow pack on the shelf above, while the blue screen of the transport ventilator can be seen below. (Photo: Wendy Pyper)
A white shipping container with a green cross on the side.Dr Strauss sitting on the edge of the operating table with medical equipment behind him and operating theatre lights above.Looking towards the stainless steel scrub area to the left of the door and to the right, bolted to the floor, is the X-ray machine.The computerised digital X-ray processor (right) and monitor.An anaesthetic machine with glass cylinders, flow controls and dials for administration of gases.A small blue autoclave to sterilise instruments and a fridge for medicines and vaccines.

A medical facility in a shipping container will provide a life saving capability for Australian Antarctic Program doctors on board the chartered resupply vessel MPV Everest this Antarctic season.

The Containerised Medical Facility (CMF), designed by the Australian Antarctic Division’s Polar Medicine Unit, contains everything a trained generalist doctor might need to undertake emergency surgery and anaesthesia, ventilation, cardiac defibrillation and monitoring, x-ray diagnosis of fractures, and general consultation and testing.

Acting Chief Medical Officer, Dr Clive Strauss, said the 15 year-old facility contains the same equipment used at Australia’s Antarctic stations, allowing doctors to provide a high standard of medical care while at sea.

“A lot of ships don’t have all the equipment we require as standard, so we realised that to continue to deliver our standards of medical care, we needed to be self-sufficient,” Dr Strauss said.

“It’s a bit cramped for surgery, but it really is life and limb saving.”

Just like a hospital, the CMF has a hot water tank and scrub area for hand washing and surgical scrubbing, pre-operation. A HVAC (heating, ventilation and air conditioning) system directs HEPA-filtered air from the top of the facility over the patient on the operating table, preventing dust and microbial contaminants blowing up from below. All instruments are pre-sterilised, but there is a small autoclave to resterilise equipment if needed.

Beside the operating table is a simple anaesthetic machine and anaesthetic monitor, a cardiac monitor and defibrillator, and a transport ventilator to assist breathing – which can be moved with a patient on a stretcher.

A fridge contains medicines and vaccines for such things as tetanus, whooping cough and flu. And the doctors’ traditional black bag – or in this case a bright red Thomas Pack – contains all the emergency medicines and equipment that might be needed on the run.

A digital x-ray machine, a small library, and a back-up power supply, complete the facility.

Dr Strauss said the most common major operation performed in the Australian Antarctic Program is an appendectomy. While the generalist doctors are trained to remove appendixes, telemedicine support from specialists in Hobart and Melbourne, for this and other procedures, is also available via satellite link.

“We train our doctors specifically on this equipment, and the support system we’ve created backs them up,” Dr Strauss said.

“Our specialist consultants know what our doctors can do and understand the paradigm of remote medicine, and they advise accordingly.”

To meet changing maritime standards a new CMF is in the pipeline, but there’s still plenty of life in the existing facility.

“This facility can withstand extreme temperatures and blizzards, at sea or on land. So it can be towed into the deep field to support scientific projects, such as our search for a million year ice core, or it can be deployed in an emergency if we lose critical medical infrastructure on one of our Antarctic stations,” Dr Strauss said.