Keeping offshore environments safe: The power of remote medical teams

The offshore medical landscape is complex and full of challenges. Medical professionals regularly have to carry out the first line of emergency care in hard-to-reach locations with minimal support.

In the Covid-19 era, an extra layer of complexity has been added. Whereas offshore medics are experienced in providing first-response medical care, they are now having to do so in an arena where viral contagion is a life-threatening concern. Yet, the offshore energy industry has been extremely resilient since the first contracted case of Covid-19, and an important role, in part, has been carried out by remote medics.

THE NUANCES OF OFFSHORE SAFETY

Ensuring the safety of personnel stationed offshore comes with its own unique challenges; conditions can be spatially limited, and the work environment riskier than others. But additional complexities have been added to the medical response mix following the advent of Covid-19.

While ensuring relative health and safety on rigs and vessels has always posed nuanced challenges, it is only now that medical teams are having to navigate them while minimizing the potential of mass-spreading Covid-19.

In environments where teams can be made up of personnel from all over the world, mitigating the spread of the virus puts some significant demands on the medics involved. Common questions arise around how personnel are meant to socially distance, when they are working in such close quarters. Not only that, but medics are faced with the challenge of how to care for a potentially infected individual while minimizing the spread to others. Moreover, in locations that are hard to reach, medical teams have to battle the inability to test cases onsite, alongside instigating extraction protocols that can be challenging and costly.

As well as Covid-19 related cases, medics play a vital role offshore in helping to maintain day-to-day productive and safe working conditions. They are often responsible for the mental well-being of personnel, as well as taking care of all onsite incidents, however serious they may be.

WHY OFFSHORE MEDICS ARE SO IMPORTANT

Offshore medics, in the age of the Coronavirus, help provide a solution to two core medical issues: Covid-19 management and emergency response care.

In the case of the former, the global oil and gas industry has had to adapt rapidly to the changing nature of the virus, and the steps that must be taken to ensure relative safety. Changes that have occurred on a national level—for example, “key worker” status being achieved for some UK personnel in the energy workforce—have helped guide the Covid-19 response. However, at an asset level, it is still largely down to the individual medic stationed offshore to uphold the correct clinical procedures and regulations.

In terms of emergency response, medics can be stationed at hard-to-reach vessels and rigs, in order to oversee the safe functioning of personnel who are working in these challenging environments. Medics, doctors or offshore medical professionals will be highly qualified individuals, who have the experience required to reach injured parties and perform the first line of emergency response while extraction protocols are instigated. Where there is no national emergency response team in close proximity, being able to quickly access and treat an injured party in-situ can be the difference between life and death.

Providing these two core medical functions in the most volatile and distant locations is something very familiar to Remote Medical International (RMI). As a global medical and occupational healthcare provider, RMI’s business has changed rapidly as a result of Covid-19. Spearheaded by CEO Wayne Wager, who has over three decades of leadership experience in medical technology, RMI has been at the forefront of fighting the spread of the virus offshore since the beginning of the pandemic.

“COVID COPTERS” AND OFFSHORE MEDICAL SUPPORT

Fig. 1. To provide rapid medical care and extraction services to potentially infected parties offshore, RMI partnered with global helicopter operator CHC, to cover North Sea operations.

In a bid to provide rapid medical care and extraction services to potentially infected parties offshore, RMI partnered with CHC, a global helicopter operator, to cover operations in the North Sea, Fig. 1. Deployed from two locations in the United Kingdom—Norwich in the east of England and Aberdeen in the northeast of Scotland—a fleet of adapted helicopters has been used since Covid-19 cases started to rise exponentially in March 2020. Since then, helicopters have been mobilized on a weekly basis, in order to safely extract infected personnel and transport them to onshore testing facilities.

Due to the standardized specifications of search-and-rescue (SAR) helicopters, CHC had to work quickly to adapt them to make sure they were Covid-19-safe. This meant making changes that would not only promote the safe movement of infected personnel onboard but also to protect the medics from any possible viral infection. As the helicopters had not been designed with viral contagion in mind, CHC instigated a range of physical adaptations, such as erecting large screens between the cockpit and the cabin. RMI also worked alongside CHC to develop an entire set of operating procedures and protocols, designed to keep personnel onboard as safe as possible, considering their potential increased exposure to the virus.

At the forefront of designing and implementing new procedures and protocols for RMI’s Covid-19 management plans is Dr. Patrick Morgan. Dr. Morgan is one of RMI’s medical directors leading the global Covid-19 strategy for RMI UK, and doing it in an environment that is changing rapidly on both a regulatory front and global scale. For the North Sea Covid Copter operation, Dr. Morgan, alongside RMI UK Medical Manager Paul Savage and the operations team, wrote new standard operating procedures, to ensure the medics could deliver a high standard of clinical care while maintaining their own safety.

As a result of these adaptations and the medical leadership from RMI, the North Sea Covid Copters can now be mobilized in less than an hour, and they can reach suspected cases no more than three hours from the initial call, Fig. 2. This is an incredible asset to any offshore operation that wants to minimize the risk of Covid-19 being spread onsite.

Fig. 2. Thanks to adaptations and RMI’s medical leadership, the North Sea Covid Copters are an incredible asset that can now be mobilized in less than an hour. Thus, it can reach suspected cases in no more than three hours from the initial call.

The prevention of Covid-19 spreading on rigs, platforms and vessels is of paramount importance, when it comes to keeping offshore operations functioning. Alongside its Covid Copter services, RMI and its clinical governance team have been responsible for providing a comprehensive Covid-19 management plan that provides multiple layers of virus mitigation and prevention strategies.

In the case of offshore E&P, not only are potentially infectious personnel able to receive rapid extraction and transport back to shore, but the chance of infected cases arriving on site has been greatly reduced, too. RMI’s screening and testing services that are deployed at ports and airports work to identify personnel displaying symptoms consistent with Covid-19. These are personnel, who are potentially carrying the virus but have no symptoms before embarking. This has become a critical preventative measure that can stop the virus from spreading to assets offshore.

MEDICAL EMERGENCY RESPONSE IN OFFSHORE E&P

The working life of an offshore medical professional has clearly changed since the global pandemic gripped the energy industry in March 2020. However, medical teams still continue to provide other critical medical functions alongside Covid-19 management services as part of their normal day-to-day functions. Doctors, medics and nurses still provide a vital role in managing day-to-day medical incidents, as well as providing emergency response care for seriously injured and ill personnel.

RMI has worked with a major European drilling rig operator since 2018, looking after international assets to provide ongoing, day-to-day medical cover. With over 24 medical staff currently stationed at various offshore assets across the globe, RMI Project Coordinator Rachael Roberts works closely with the company to ensure the safety of their offshore workforce.

The project coordinator’s role at RMI is varied and at its core revolves around mobilizing a highly qualified offshore medical professional, who is stationed on each rig for three-to-six-week rotations. Navigating differing international procedures, sourcing the right staff, and managing varying Covid-19 governance procedures across borders are some of the issues that medical teams must face, not only on the ground but at a management level, too.

Regarding the professionals offshore, Rachel Roberts explains that “the role is largely universal. That means doctors, medics and nurses cover the same requirement, but it depends on the size of the rig and its geographical location that determines who is stationed where.” In essence, all sites are unique, and the rules and regulations in one location could vastly differ from that of another. This poses unique challenges for managing operations offshore and making sure that all rigs are kept fully up-to-date with current national procedures and protocols.

To maintain safe operations onsite, the remote medics are responsible for regularly carrying out training and information campaigns to promote physical and mental well-being. For this operator, RMI has worked closely with senior management to develop individual operating procedures for each unique asset. Through implementing mental well-being campaigns, RMI has found that delivering information designed to promote positive mental well-being has helped provide an additional layer of support to personnel, who previously may have struggled with being stationed out at sea.

The medic on each asset not only helps to deploy training and information campaigns but also assists with implementing social distancing guidelines, where possible. RMI has had to work closely with the operator to ensure that all personnel have sufficient PPE, and that the clinic on each asset is always well-stocked in case of an emergency. Colloquially called the “sick bay,” onsite clinics will hold all of the emergency equipment, defibrillators, medicines and equipment that may have to be relied upon in case of medical incidents.

Another critical task of the offshore medic is testing drinking water conditions and promoting onsite hygiene practices. The risk of contracting legionella can be high on worksites situated in international seas, so it is a critical responsibility of the medical team to test the water purity daily for any infectious bacteria.

As it is with any offshore project, having an occupational health strategy is also incredibly important in maintaining safe operating practices on offshore assets. RMI has worked closely with this major operator to make sure that there is support for personnel that may be sick, or who may have a non-life-threatening condition. The ability for personnel to receive medical reviews, as well as have consultations—either via a phone call or in-person—provides a critical function in keeping personnel healthy and happy. Without regular medical support, offshore assets can suffer issues with staffing and medically induced absences.

Alongside providing day-to-day support and medical emergency response care, RMI has been able to deploy Covid-19 testing capabilities before employees embark on their journeys offshore. In an environment where obtaining private Covid-19 testing has been incredibly challenging, RMI has considered it a major success in being able to provide this service so quickly and across borders.

Going forward, RMI will continue to deploy medical teams around the world to various assets, to help manage the pressures imposed by the global pandemic.

COVID-19 MEDICAL CARE IN MARINE ENVIRONMENTS

A Covid-19 outbreak on offshore assets, particularly vessels, can be difficult to manage for two key reasons: limited diagnostic capabilities in the remote environment, and the inability to effectively self-isolate in this setting. This means that in most cases, potentially infected personnel stationed offshore will have to be extracted and transported onshore to a specialist facility that has been designed to isolate and manage these individuals.

As a result, it is incredibly important to have an effective screening and testing procedure at ports and places of departure, to catch any potentially infected personnel prior to embarking. RMI has worked with partners to deliver rapid antigen testing, as well as RT-PCR testing, at hotels and pop-up testing sites in travel hotspots. Utilizing the Covid-19 rapid testing kit, RMI has been able to provide a rapid screening service to help identify, with greater probability and in under 30 min., whether a person is infected with the coronavirus responsible for Covid-19.

It’s not only important to catch potential cases early, but it’s also imperative to have an effective Covid-19 case management plan in place to manage individuals who have the virus, while mitigating the impact to the rest of the crew. Having a holistic outbreak management plan and return-to-work strategy is key for such individuals and is something RMI has been able to provide in the U.S. for a range of clients in the E&P space. These comprehensive, multi-faceted strategies are aimed at maximizing the health and safety of the crew while striving to maintain operational stability.

CONCLUSION

Offshore medical teams continue to provide a core function that has been responsible for keeping assets operational during the global pandemic. While medical teams are experienced in providing day-to-day and emergency response care in these challenging settings, it is only now that they have to do so in the context of a global, life-threatening virus.

As a result, the medical environment offshore is an incredibly complex one that must be met with careful consideration. It is of great importance, more so than it has ever been, to ensure your offshore worksite is supported by an experienced medical services provider.