Dream Cruise Vacations - Medical Services

DOCTORS ON THE HIGH SEAS
Grand Princess Medical Marvel

The GRAND PRINCESS cruise ship, in the booming annals of the ever-changing cruise industry, had a moment of glory in Istanbul, Turkey when she proudly set sail as the "World's Largest Cruise Ship."

With a coy blush or two, the 109,000-ton beauty, lofty, powerful and sleek, and too hefty to fit through the Panama Canal, acknowledged her position as the Amazon of the seas and the new Queen of cruise "firsts."

Truly a floating resort, the ship is breaking new waves in the cruise industry with a breakthrough telemedicine program that is the essence of the expression "Doctors on The High Seas."

SAFETY AT SEA WITH CEDARS-SINAI MEDICAL CENTER
The unprecedened concept, developed by ImageView in conjunction with physicians, engineers and telecommunication experts, known as SeaMed, directly links the ship's medical staff with Emergency physicians and specialists at Cedars-Sinai Medical Center in Los Angeles.

The spectacular program assists in the management of complex and emergency medical situations in the nooks and crannies of world travel.

The technology is also a first for Cedars-Sinai Medical Center, an internationally acclaimed facility and teaching center with more than 2,000 physicians.

A custom telemedicine suite was installed on GRAND PRINCESS and at Cedar-Sinai's Emergency Department where a roster of specialists are on call 24-hours a day, seven days a week.

Spencer Koerner, M.D., senior consultant, Cedars-Sinai Telemedicine and International Health said, "SeaMed provides a safety platform for passengers on GRAND PRINCESS and will be useful for a wide variety of medical conditions, including cardiac, pulmonary, orthopedic, and neurologic emergencies."

This new application of technology nicely compliments Princess' existing telemedicine program.

A splendid idea when you consider the ship at full capacity can host 2,600 passengers and also carries a whopping 1,100 crew members.

SeaMed offers a live two-way video link and a virtual ER visit allowing radiographs, EKG's and other physiologic data to be transmitted to the hospital and to the appropriate specialist stationed at the Cedars-Sinai Emergency Department by worldwide satellite.

No other cruise ship in the world is providing real time audio-visual telemedicine or medical care at this level.

Thomas Conroy, CEO of ImageView said, "We developed the PC-based SeaMed system specifically for communications with remote locations complete with voice, x-ray photographs and EKG tests. The time will come when passengers will demand access to specialists via telemedicine as a prerequisite to booking a cruise vacation."

DR. ALASTAIR SMITH
Dr. Alastair Smith, Princess' vice president of fleet medical which includes 10 ships, carrying 600,000 passengers, calling at 220 ports with approximately 1,500 itineraries said, "Princess has long been known for its quality medical care." The facts support his statement.

The GRAND PRINCESS has two doctors and four nurses dedicated to maritime medicine who work or assist with SeaMed's intuitive on-screen user interface, utilizing a dual monitor capability for multi-processing of information along with a mounted camera and integrated medical devices.

A MEDICAL LAB AFLOAT
The ship's lab is equipped for general analysis and consulting such as blood tests for kidney and liver functions and heart diagnosis.

Other new, potentially life-saving features are two portable, two-pound, semi-automatic cardiac defibrillators available in medical lockers in the main dining room and the Promenade Deck.

Smith explained, "The SeaMed system is a 911 interface, a backup, a security web. Most problems onboard are not surgical; they're medical which we are setup to handle. We can stabilize a problem then work with a valuable second opinion. If someone is sailing with a new or on-going diseas they can bring along their full medical records.

"A click of a button and the system is up and running. The Cedars-Sinai emergency team, interacting with the ship's doctors, can examine patients based on the data they see."

REDUCE THE NEED FOR EVACUATIONS
SeaMed will allow Princess to reduce the need for evacuations and early disembarkations of critically ill or injured passengers, and could save a thousand mile air evacuation and a huge dent in the checkbook.

The Love Boat Care & Care Gold programs also offer peace of mind for most medical expenses.

Telemedicine is only one of many surprises aboard the ship. For all it's size, the GRAND is jammed with intimate areas and enough attractions to keep children hopping till they slip into the sheet dazed but smiling.

Passengers choose from five swimming pools including the first ship with a swim-against-the-current lap pool.

You can head to the nine-hole putting green and work on your stroke, shoot some hoops, play a game of paddle tennis on the top deck Center Court or do some serious exercise in the state-of-the-art gymnasium and health spa.

Teens chill out in a two-level complex designed just for them.

Three main show lounges and three main dining rooms are another first, as are the large selection of wheelchair-accessible cabins (28), and 710 balcony cabins, the most on any cruise ship.

The Skywalkers Nightclub, the first disco "in the sky," suspended 150 feet above water atop the 18th deck and reached by a moving skywalk can make you giddy if you glance out at the vast immersion of sea, sky and horizon.

TIE THE KNOT
For those in a moment of passion who decide to tie the knot under sail, the GRAND PRINCESS is at the ready.

The ship's captain will make it happen in the first-ever ocean-going wedding chapel. The GRAND also offers a wedding program, reception and honeymoon planning.

A couple on the inaugural cruise did just that and were the first to officially be married at sea since the turn-of-the-century.

From medicine to marriage, the GRAND aims to please.

WHEN YOU SAIL
Check with your travel professional for special money saving packages. Log in to the GRAND PRINCESS website for a "virtual tour" of the ship at www.grandprincess.com Brochures are available by calling (800) PRINCESS.

Each ship has a fully staffed medical center. The doctors and nurses that work there keep regular hours when passengers can visit which are usually posted in the ships onboard daily newsletter.

When a medical emergency happens though, they're available 24 hours a day, usually by dialing 911 on any phone you can find.

Here's an account of what really went down when one passenger had an allergic reaction to shellfish from the Caribe Cafe buffet while aboard the Caribbean Princess

Around 8pm, DH started to complain of some tingling in his throat and some discomfort and swelling. By 845pm, he was wheezing so badly, I thought he was having an asthma attack. Since hot coffee did not help this time, I headed downstairs for Benadryl.

On my arrival back in the room, I noticed he had a blue tinge to his lips and his face was becoming very swollen. Plus, he was barely able to breathe. I decided to contact the Front Desk. Unfortunately I got no answer when I called. I decided to hit the button for 911. After one misdial, I reached a nurse in the infirmary that asked if my husband could come downstairs. When I answered no, she immediately headed to the room.

After assessing him, she called someone and an ALPHA CODE was issued. I later learned that meant it was ?life or death?. An announcement was made across the loud speaker and our room was immediately filled with a large crowd. There were 2 doctors, 4 nurses, and assorted support personnel filling the halls. My husband was transported to the infirmary where he was administered emergency care/meds and kept for 3 hours. I as extremely impressed with the abilities of the medical staff, especially Dr. Peter Hibbard and Faye, the nurse. Even though she was off duty, Faye stayed with me the whole time in the room and made sure that I, and the couple traveling with us, was settled in the waiting area. She would not leave until she made sure I was alright. My husband had to go back to see the doctor twice during the rest of the cruise for follow-up.

He was monitored closely and we were given all the medical information of his treatment, including a detailed letter, for our family physician. Even though I never thought I would need to use the medical facilities, it is nice to know the staff is highly skilled and very competent. We also found out later that the Cruise Director and the Captain came to our cabin to see if there was anything they could do to assist. Thankfully the medical staff had everything under control.

Our next day was spent relaxing in the room and taking short walks around the deck to build up DH?s strength. Since so many passengers heard the code, he soon became the ?Alpha Man?, which delighted him to no end.

Your Travel Health
What Happens If You
Become Ill While Cruising?

By Debbie Miller, R.N., BSN

Cruising is both an enjoyable and affordable way to travel. But illness isn’t planned and it can interrupt your holidays. What happens if you need medical treatment while on board?

I recently had the pleasure of sailing on the Navigator of the Seas with Royal Caribbean Cruise Lines and decided to research this very question. What I found was impressive.

To begin my research, I headed to the ship’s medical clinic, where I spoke with Kobus Bronkhurst M.D., one of the two physicians on board. The doctor, a native of South Africa, assured me that the ship’s facilities were fully equipped to deal with most emergency situations.

The Navigator Clinic, like most large cruise ship clinics, has a five-bed unit, with one bed available for “high care” patients and another designated for intensive care. The medical staff’s goal is to stabilize the patient for the short term until they can be transported to a hospital in the next port.

A helicopter pad on the ship can be used to transport trauma patients. However, most of the basic technology necessary to sustain life is available on board. X-ray technology is also available, as well as lab testing (including blood chemistries).

Basic emergency equipment and other medical care
is available at the ship's medical clinic.

The medical team on board the Navigator consisted of two doctors and three nurses, all ACLS (Advanced Cardiac Life Support) and PALS (Pediatric Advanced Life Support) certified.

One additional comforting thought is that if there were an emergency on board, the ship’s medical team could respond even faster than an ambulance on land.

Those guests who require oxygen have two choices. They may bring their own oxygen or arrange for a company to deliver it to their room. Royal Caribbean cannot arrange this, but will provide individuals with names of qualified companies who work with them. Either way, Royal Caribbean needs to have advance notice to obtain clearance for onboard oxygen tanks.

For those on dialysis, traveling can be difficult, but it’s not impossible – especially with cruising. Persons on peritoneal dialysis can arrange for a company to deliver supplies to their room. Again, Royal Caribbean can provide them with a list of companies. Guests need to contact Royal Caribbean ahead of time to gain clearance for the supplies.

Since hemodialysis needs to be administered by a health care professional, Royal Caribbean suggests using Dialysis at Sea. Dialysis at Sea provides a Nephrologist and one to four nurses per cruise depending on the number of dialysis patients. Visit www.dialysisatsea.com to receive more information on the cruises available.

Guests who forget their medications at home can request an emergency replacement or alternative from the clinic’s pharmacy until the ship arrives at the next port where the prescription can be filled.

Because of the number of insurance companies worldwide, guests need to pay onboard medical charges out of pocket (or have it charged to their onboard account) and then get reimbursed by their insurance company later.

Cruising is an excellent way to travel for many reasons. But should a medical need arise, a cruise ship is not a bad place to be. However, be sure to check out your cruise line before traveling, as facilities vary. Ask your travel agent to help you select the cruise line and ship that best suits your medical and physical needs.

Most cruise ships today have a ship’s hospital, along with qualified medical staff of doctors and nurses that is appropriate for that size of ship. It is customary that the medical staff are on call 24 hours when a ship is at sea and will also be available at selected times during the day for private consultations. When a ship is docked there maybe a reduction and limited availability of medical staff onboard, although they will make themselves available for private consultations at specified times and this will vary from cruise line to cruise line. A Cruise ship’s hospital is equipped to provide medical care for passengers and crew who have an accident and/or an illness that occurs while aboard. Passenger may be charged for medical services and medications that are used for their medical treatment. These facilities are not intended or designed to provide for ongoing treatment of pre-existing conditions or extended critical care.

There is a wide variation in medical standards and equipment that the cruise lines provide depending on the ships registration. Aboard many ships doctors and nurses come from a variety of countries and disciplines. Cruise Lines that cater to the North American market will tent to carry medical personnel that are licensed in the USA, Canada and the UK. Most shipboard doctors are not certified for trauma treatment or emergency medical evacuation.

There is no International Maritime Law that requires the cruise lines to have a hospital or medical staff onboard a ship. The only exception is that ships registered in both Norway and Great Britain are required to provide medical facilities and qualified medical staff.

Pre-existing Medical Conditions

If you have a pre-existing condition or anticipate a need for medical services and/or must travel with special medical apparatus such as wheelchairs, motorized scooter, oxygen therapy, etc., while aboard a ship, you must notify the cruise line, in writing, of your special requirements at time of booking and deposit. The cruise line will then respond with an appropriate written authorization confirmation. Passengers wishing to bring their own portable oxygen tanks must obtain prior written permission from the cruise line as restriction may apply.

Physical Disabilities

While many cruise lines have made tremendous effort to improve facilities for people with physical disabilities such as special designed cabins to meet their requirements, most cruise lines offer limited facilities for disabled passengers aboard a ship. To ensure the well being and safety of passengers confined to a wheelchair or with significant health problems the cruise lines will normally insist that disabled passengers be accompanied by a non-handicapped adult. You must notify the cruise line in writing of your condition and/or special requirements at time of booking and deposit. The cruise line will then respond with an appropriate written authorization confirmation.

Pregnancy

At time of booking, most cruise lines require expectant mothers to provide them with a medical certificate establishing their fitness for travel. Most cruise lines are unable to accommodate expectant mothers who will be in their third trimester of pregnancy at any time during their cruise.