title: A first response bag with standardized contents for medical emergencies on cruise ships.
abstract: BACKGROUND
  There are no international rules regarding which medical supplies to bring when the nurseon- duty is called to emergencies outside a cruise ship's infirmary. Ideally, one First Response Bag should contain all that is needed to manage the initial 10-15 minutes of any medical emergency until the patient can be safely transported to the ship's infirmary. Royal Caribbean Cruises Ltd recently decided to establish a fleet-wide standardized First Response Bag for initial management of cardiac and other emergencies encountered by the nurse-on-duty outside the ship's infirmary.
  
  
  METHODS
  A prototype First Response Bag was tried out on one ship. A PowerPoint presentation of the bag with its contents was then circulated by e-mail to all 33 infirmaries of the fleet, and comments from all 181 medical staff members were invited. All responses were discussed fleet-wide for consensus.
  
  
  RESULTS
  Responses from 18 ships triggered eager discussions. The resulting First Response Bag was considered by all an improvement compared to the solutions practiced previously on most ships of the fleet. The bag is a lightweight combined roller and backpack with 12 compartments, and it has well-organized, easily accessible, fleet-wide standardized minimal supplies. It contains what is needed to manage the initial phase of a cardiac arrest and other emergencies.
  
  
  CONCLUSIONS
  This initiative may inspire other companies in standardization efforts and trigger cruise industry-wide cooperation'with the ultimate goal of an internationally accepted first response bag standard.
authors.affiliation: Institute of Medicine, University of Bergen, and the Norwegian Centre for Maritime Medicine, Department of Occupational Medicine, Haukeland University Hospital, Helse Bergen HF, Bergen, Norway. eilifdahl@hotmail.com
authors.forename: Eilif
authors.initials: E
authors.lastname: Dahl
authors.forename: Art
authors.initials: A
authors.lastname: Diskin
authors.forename: Angela C
authors.initials: AC
authors.lastname: Giusti
authors.forename: Anne
authors.initials: A
authors.lastname: Bilé
authors.forename: Steve
authors.initials: S
authors.lastname: Williams
mesh_terms: D004632:Emergency Medical Services / Q000458:organization & administration*; D004864:Equipment and Supplies; D006323:Heart Arrest; D006801:Humans; D007899:Leisure Activities; D012767:Ships