Maritime Telemedical Assistance Service (TMAS)

French system of medical assistance at sea

The aim of medical assistance at sea (MAS) is to treat patients on board with resources and within timescales similar to those on land, thanks in particular to telemedicine. MAS applies from the moment the ship passes the port’s administrative piers, and is implemented under the authority of the Maritime Prefect (préfet maritime) for the zone.

Which organisations are involved when a patient is treated on board a French-flagged vessel?

• The Maritime Rescue Coordination Center (MRCC) is responsible for deploying and coordinating the various sea and air rescue resources;
• the Maritime Telemedical Assistance Service (TMAS) at the Purpan Hospital (Toulouse) has been officially designated since 1983 to provide medical assistance to ships flying the French flag;
• the Maritime medical coordination emergency aid service (SCMM) has medical responsibility for the rescue operation (this is a French specificity).

It is compulsory for MRCC to put any French-flagged vessel with a medical problem on board in touch with the MMCC.

In the event of a medical problem, the ship calls the TMAS directly or goes through the MRCC in the SRR zone. The decree of 10 May 1995 relating to the qualification of the Toulouse maritime medical consultation centre as a maritime telemedical consultation and assistance centre within the framework of medical aid at sea means that in France, it is this service that performs the functions of the telemedical assistance service (TMAS) defined by IMO circular MSC/Circ 960. Medical advice from the TMAS is compulsory for a patient whose evacuation to French territory is envisaged or when the ship on which the patient is embarked is going to call at a French port or in French inland waters.

The treatment of a patient (sick or injured) on board a ship then depends on the TMAS doctor carrying out the telemedical consultation. At the end of the teleconsultation, the CCMM doctor analyses the situation, makes a diagnosis, prescribes the appropriate treatment and recommends, for the attention of the captain, the type of operational action to be taken, with reference to the typology below.

TMAS of Purpan hospital

The TMAS provides seafarers on board ships flying the French flag with high-quality local care during the sea voyage, thereby limiting the possible consequences of illnesses or injuries sustained on board.

The call for a teleconsultation is answered by an auxiliary medical regulator (ARM). He identifies the ship, the patient, the reason for the call, the degree of urgency and passes the call on to the TMAS doctor. CCMM doctors are emergency physicians. Their work is split between the SAMU 31 (Centre 15 regulating doctor and SMUR doctor), the emergency reception service and the TMAS. They carry out teleconsultation in a room adjoining the SAMU 31 call reception and regulation room.

MAS is part of the urgent medical assistance (UMA) framework and is subject to the same constraints. All communications are recorded and archived. Telemedical consultation is considered to be a medical act identical to any other and, as such, is subject to the same rules. There is therefore an obligation to open a medical file, which will be closed and archived once the patient has been discharged and is no longer considered to be under the responsibility of the TMAS.

The TMAS then contacts the referent MRCC. The rescue mission co-ordinator on the MRCC is responsible for co-ordinating medical evacuation and intervention operations in liaison with the TMAS and the SCMM.

In 2022, TMAS doctors responded to 6,489 (+10.1% compared with 2021) telemedical consultation calls for 2,817 patients.

Contact the TMAS

Urgent medical consultations

For urgent medical consultations, the TMAS can be reached at any time (24/7/365):

• live by satellite or mobile;
  • 32 or 38 on the INMARSAT network
  • on + 33 (0) 5 34 39 33 33
• via MRCC along the coastline;
  • VHF channel 16
  • GSM mobile -> dial 196

Non-emergency medical consultations

For non-urgent medical consultations, the TMAS can be contacted, Monday to Friday from 08:00 am to 06:00 pm and Saturday morning from 08:00 am to 13:00 pm, by the same means as above or by e-mail.
This e-mail is in no way a means of alert or consultation, but is a useful complement to telephone consultations (information transmitted anonymously in compliance with medical confidentiality).