Tele-Medical First-Hour Protocol — the "golden hour" protocol at sea

There is an unwritten rule in the maritime industry: the first hour after an injury or sudden illness is critical for survival. On land, it is called the “golden hour,” but at sea, it is often an hour of uncertainty, when the ship is far from coastal services and decisions about assistance depend on officers without medical training. Despite the existence of mandatory instructions under the SOLAS Convention and the International Medical Guide for Ships (IMO/WHO), the actual algorithms for action in the first hour after an incident often differ from the standards. The reason is simple: officers do not have the time or knowledge to quickly analyze symptoms, and access to a doctor via radio communication (Radio Medical Advice / TMAS) is not always stable or responsive. [1] It was these factors that prompted maritime specialist Maksym Marichev to develop the Tele-Medical First-Hour Protocol (TMFHP) — a unified first aid algorithm with telemedicine scenarios adapted to the real conditions of the Ro-Ro/PCTC fleet. The purpose of the protocol is to provide the crew with a clear, step-by-step plan of action within the “golden hour,” which is integrated into the standard procedures of the Safety Management System and can be performed even without a permanent medical professional on board. Unlike conventional procedures, TMFHP does not duplicate instructions but creates an interconnected system: “situation — response — communication — transfer.” This makes it the first example in Ukraine of adapting telemedicine to maritime safety standards.