This case shows how close coordination between Vessel Command and the OneHealth by VIKAND telehealth team can stabilise and manage a serious burn injury at sea. What began as a high-risk incident was contained through structured remote support, clear protocols and consistent onboard execution, without the need for immediate evacuation.
Case Summary
- Patient: Male, 48 years old
- Injury: Burn to the right leg following exposure to residual steam and hot water during engine room maintenance
- Burn surface area: Approximately 8%
- Burn depth: Deep partial-thickness, with areas of full-thickness involvement
- Location: Engine room
- Disembarkation: Not possible, vessel at sea
Clinical Course & Telemedical Management
Following notification via VIKAND Connect, Vessel Command and the OneHealth telehealth team initiated a coordinated response. The captain carried out treatment onboard under continuous medical guidance, covering wound care, infection prevention, pain control and haemodynamic monitoring throughout the voyage.
Initial Management
- Antibiotics: Augmentin 875/125 mg every 12 hours for 10 days
- Pain management: Tramadol 50 mg every 8 hours as needed, paracetamol as required
- Gastric protection: Omeprazole
- Wound care: Daily cleaning and dressing using burn gel, paraffin gauze and sterile coverings
- Hydration: Oral rehydration with monitoring
- Monitoring: Daily observations and wound imaging shared with the telehealth team
Ongoing Monitoring
Daily clinical review and communication were maintained throughout. Blood pressure was stabilised with the introduction of metoprolol 50 mg twice daily. The wound progressed as expected, with gradual drying and epithelialisation and no signs of infection. Pain levels reduced steadily and mobility improved, allowing the full course of treatment to be completed onboard.
Follow-up & Resolution
The patient remained afebrile, stable and mobile. Wounds were dry, healing and infection-free. Shoreside assessment confirmed recovery and fitness to travel, allowing for safe repatriation and formal case closure.
Outcome
- No infection or sepsis
- Progressive wound healing and recovery
- Safe repatriation following clinical clearance
Key Takeaways
- Telemedicine is a critical link at sea: Continuous oversight enabled accurate treatment, appropriate antibiotic use and early identification of risk, effectively extending clinical capability onboard.
- The role of Vessel Command: Consistent execution of medical guidance, including medication, wound care and reporting, was central to the outcome.
- Stability in a remote setting: Structured monitoring and clear protocols allowed the patient to remain stable for more than three weeks, avoiding escalation or evacuation.
- A coordinated continuum of care: From onboard management through to shoreside follow-up, the case reflects a fully integrated approach that supports continuity, accountability and clinical confidence.
This case demonstrates how telehealth, when paired with disciplined onboard execution, can manage complex conditions in remote maritime environments. Through real-time coordination and a structured care pathway, a potentially serious injury was resolved safely, without evacuation and without compromise to clinical outcome. To learn more, visit vikand.com/Telehealth
