Medical First Aid Guide (MFAG) Introduction & Contents:
The IMO/WHO/ILO Medical First Aid Guide for Use in Accidents involving Dangerous Goods (MFAG) refers to the substance, material and articles covered by the International Maritime Dangerous Goods Code (IMDG Code), and the materials covered by Appendix B of the Code of Safe Practice for Solid Bulk Cargoes (BC Code). It is intended to provide advice necessary for initial management of chemical poisoning and diagnosis within the limits of the facilities available at sea.
This Guide should be used in conjunction with the information provided in the IMDG Code, the BC Code, the Emergency Procedures for Ships Carrying Dangerous Goods (EmS), the International Code for the Construction and Equipment of Ships Carrying Dangerous Chemicals in Bulk (IBC Code), and the International Code for the Construction and Equipment of Ships Carrying Liquefied Gases in Bulk (IGC Code).
The MFAG itself gives general information about the particular toxic effects likely to be encountered. The treatment recommended in this Guide is specified in the appropriate tables and more comprehensive in the appropriate sections of the Appendices. However, differences exist between countries on certain types of treatment and where these differences occur they are indicated in the relevant national medical guide.
Treatments in this guide cater for the accidental human consequences of the carriage of dangerous goods at sea. Accidental ingestion of toxic substances during voyage is rare. The guide does not cover ingestion by intention.
Minor accidents involving chemicals do not usually cause severe effects provided that the appropriate first aid measures are taken. Although the number of reported serious accidents is small, accidents involving those chemicals which are toxic or corrosive may be dangerous, and must be regarded as being potentially serious until either the affected person has completely recovered, or medical advice to the contrary has been obtained.
Information on the treatment of illnesses which are of a general nature and not predominantly concerned with chemical poisoning may be found in the ILO/IMO/WHO International Medical Guide for Ships (IMGS).
CONTENTS:-
Table 1 – Rescue
Table 2 – Cpr (Cardio-Pulmonary Resuscitation)
Table 3 – Oxygen Administration and Controlled Ventilation
Table 4 – Chemical-Induced Disturbances Of Consciousness
Table 5 – Chemical-Induced Convulsions (Seizures, fits)
Table 6 – Toxic Mental Confusion
Table 7 – Eye Exposure To Chemicals
Table 8 – Skin Exposure To Chemicals
Table 9 – Inhalation Of Chemicals
Table 10 – Ingestion Of Chemicals
Table 11 – Shock
Table 12 – Acute Kidney Failure
Table 13 – Pain Relief
Table 14 – Chemical-Induced Bleeding
Table 15 – Chemical-Induced Jaundice
Table 16 – Hydrofluoric Acid And Hydrogen Fluoride
Table 17 – Organophosphate And Carbamate Insecticides
Table 18 – Cyanides
Table 19 – Methanol (Methyl Alcohol) And Ethylene Glycol
Table 20 – Radioactive Material
APPENDICES
Appendix 1 Rescue
Integrated Response
Emergency Response Plan
Arrival At The Scene
Establishment Of An Exclusion Or Hot Zone
Assessment, Decontamination And Initial Treatment Of Casualties
Decontamination
Considerations For Casualty Treatment
Transport Of Casualty To Medical Area Of Ship
Medical Management Of Casualty
Appendix 2 Cpr (Cardio-Pulmonary Resuscitation)
Assessment Of Breathing
Assessment Of Heart Function
Breathing, Heart Is Beating, Unconscious
Not Breathing But Heart Is Beating
Breathing And Heart Have Stopped
Appendix 3 Oxygen Administration & Controlled Ventilation
Suffocation
Oxygen Resuscitation Kits
Insertion Of Guedel Airway
Oxygen For The Casualty Who Is Not Breathing
Oxygen For The Casualty Who Has Difficulty In Breathing
Appendix 4 Chemical-Induced Disturbances Of Consciousness
The unconscious position
Unconscious casualities
Appendix 5 Chemical-Induced Convulsions (Seizures, fits)
Appendix 6 Toxic Mental Confusion
Appendix 7 Eye Exposure To Chemicals
Appendix 8 Skin Exposure To Chemicals
Appendix 9 Inhalation Of Chemicals
Suffocation (asphyxia)
Chemical irritation of the lungs: dry cough, breathlessness and wheezing
Chemical irritation and oedema of the lungs: severe breathlessness and frothy sputum
Chemical irritation and secondary infection of the lungs: productive cough (sticky white, yellow or green phlegm [sputum])
The chemical hazards from fire
Chemical hazards from welding
Chemical hazards from explosive chemicals
Appendix 10 Ingestion Of Chemicals
Perforation of the gut and peritonitis
Appendix 11 Shock
Fainting
Circulatory collapse and shock
Heart failure
Appendix 12 Acute Kidney Failure
Appendix 13 Fluid Replacement
Oral fluids
Intravenous fluids
Rectal fluids
Appendix 14 List Of Medicines And Equipment
List of equipment
Appendix 15 List Of Substances
UN Number sortation
Alphabetic sortation
MFAG Guide:-
- Information on medical first aid to be provided in the incidents involving dangerous goods is enlisted in the MFAG Guide, which is provided as a supplement in the IMDG Code.
- The advice given in the guide refers to the substances materials and articles covered by the IMDG code & materials covered by Appendix B of the IMSBC Code.
- It is intended to provide advice necessary for chemical poisoning and diagnosis within the limits of facilities available at sea.
- The treatment recommended in this guide is specified in the appropriate tables and more comprehensive in the appropriate section of Appendices.
- For the convenience of user this guide is divided into three step approach procedure:
Step 1: Emergency Action & Diagnosys.
Step 2: Table – The tables give brief instruction for special circumstances.
Step 3: Appendices – The appendices provide comprehensive information a list of medicines / drugs and list of chemicals {in alphabetical & UN No. (Numerical)} in Appendix 15.
MFAG Table No.: The “Medical First Aid Guide for Use in Accidents involving Dangerous Goods” is a supplement to the IMDG code.
After looking up the MFAG Table No., see the table in the MFAG. It gives likely signs, symptoms, treatment and other advice as per the effect of goods under that table.
It suggests treatment in case of skin contact, eye contact inhalation and ingestion. The procedures for the treatment are also mentioned.