Activities of the International Radio Medical Centre (C.I.R.M.) in Rome during the last five years (1996-2000). Centro Internazionale Radio Medico.

This paper reviews medical activity provided from 1996 to 2000 by the International Radio Medical Centre (Centro Internazionale Radio Medico, C.I.R.M.). C.I.R.M. is a non-profit organization headquartered in Rome and providing freely telemedical advice to ships flying of any flag navigating on all seas of the world, to civil airplanes and to small Italian islands. From 1996 to 2000 C.I.R.M. has assisted 4,982 patients, 4,686 of which (94%) on board ships, 85 on airplanes and 206 on small Italian islands. More than 65% of requests of telemedical advice received by C.I.R.M. were from non-Italian ships. This indicates the really international nature of C.I.R.M.'s activity. The largest number of medical requests come from the Atlantic Ocean, followed by the Mediterranean sea, Indian Ocean and Pacific Ocean. In terms of pathologies assisted, accidents took the first place, followed as main pathologies by gastrointestinal disorders, cardiovascular pathologies, respiratory disorders, infectious and parasitic diseases and nervous system complaints. Analysis of the outcome of C.I.R.M.'s medical activity showed that more than 50% of patients assisted were recovered or improved while assisted by the Centre.

Telemedicine and medical care to ships without a doctor on board.

Providing medical assistance to ships at sea was probably one of the first practical applications of telemedicine. At present, about 200 different organizations worldwide give medical assistance to ships without a doctor on board. The activity of the Foundation Centro Internazionale Radio Medico (CIRM), which probably has the largest experience in the world of telemedicine applied to seafarers, is reviewed. Medical assistance to seafarers has not improved in parallel with advances in medicine and telecommunications. Possible initiatives for improving teledelivery of medical assistance to seafarers are discussed.

Telemedicine for airline passengers, seafarers and islanders.

Airline passengers, seafarers and islanders are three different examples of people who can benefit from telemedicine. However, the peculiar characteristics of each group require different applications. In 60 years of activity, the CIRM has assisted more than 37,000 patients. In the 10 years from 1986 to 1996 the Centre provided radio medical assistance to 7647 patients, of whom 6981 (91.3%) were sailors, 642 (8.4%) were people living in isolated areas (small italian islands) with few medical facilities, while only 24 patients (0.3%) were airline passengers. In the same period, the telecommunication service received or transmitted almost 80,000 medical messages.

Organization and activities of the International Radio Medical Centre (CIRM).

The International Radio Medical Centre (CIRM) was founded in 1935, to provide free medical assistance by radio to ships with no doctor on board and others who cannot be reached by a doctor. In 1950 CIRM was established as a non-profit-making foundation and has benefited since 1957 from an annual contribution from the Italian government. The results achieved by the Centre over 61 years include medical assistance to 42,935 patients on board ships (as well as on small islands and aircraft), with 375,264 medical messages received and transmitted. CIRM is organized into a medical service, a telecommunications service and a studies section. The 24-h continuous medical service is provided by doctors at the CIRM headquarters. The doctor on duty gives instructions for managing the case. If necessary the medical service will coordinate the patient's hospitalization at the nearest port with suitable medical facilities or arrange the patient's transfer to another ship with a doctor on board, or an airlift. The telecommunications service receives requests for assistance, locates the ship or whoever made the request, passes the call to the doctor on duty, and relays the doctor's response to those requesting assistance. The studies section, established in 1957-58, researches occupational pathologies of sailors and contributes to their prevention. This provides a scientific basis for improving medical assistance to sailors at sea.