title: Shipboard medicine: a new niche for emergency medicine.
abstract: OBJECTIVE
  To describe the spectrum of illness that presents to shipboard hospitals and thereby recommend optimal qualifications for the ship's medical personnel.
  
  
  METHODS
  Retrospective review of medical logs from two cruise ships' hospitals.
  
  
  METHODS
  Two passenger cruise ships, with seven-to-ten day cruises in the Caribbean.
  
  
  METHODS
  All patients presenting to the ships' hospitals from January 4, 1989, to June 10, 1989, on one ship and from October 13, 1990, to November 10, 1990, on another ship.
  
  
  METHODS
  Analysis of ship medical logs with regard to patient complaint, diagnosis, and treatment.
  
  
  RESULTS
  Of 1,547 new patient visits, 12% were related to injuries and 88% to medical problems; 97% of visits were noncritical, and 3% required immediate emergency intervention. Among these were four cardiac arrests, two stab wounds, two serious ocular injuries, one closed-head injury, and one near-drowning. Five patients required endotracheal intubation.
  
  
  CONCLUSIONS
  There is a sizeable number of visits to ships' hospitals by patients with acute and serious problems of a wide variety. Physicians and nurses with significant emergency training or experience are best qualified to deal with this broad spectrum of patient problems in this isolated environment.
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: T
authors.initials: T
authors.lastname: DiGiovanna
authors.forename: T
authors.initials: T
authors.lastname: Rosen
authors.forename: R
authors.initials: R
authors.lastname: Forsett
authors.forename: K
authors.initials: K
authors.lastname: Sivertson
authors.forename: G D
authors.initials: GD
authors.lastname: Kelen
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology; D004635:Emergency Medicine / Q000458:organization & administration / Q000639:trends*; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D006782:Hospitals, Special / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012767:Ships; D014195:Travel; D014947:Wounds and Injuries / Q000453:epidemiology