Medical Service Guidelines for Remote Sites
Authors: Samad A.H. , Lindemann K.C. 
Published: December 2007

Abstract
To better meet the challenges of increasing exploration and production activities in remote areas of the world, where local medical resources may be limited, a set of medical service guidelines was developed to provide general guidance regarding the expected level of on-site care. For any given remote location, the company physician responsible for the operation can use the guidelines to generate risk-based, operation-specific recommendations for local management to insure that health and safety needs are met. The guidelines are intended to aid in the selection of third party medical providers at the start-up of an operation by insuring that vendors are bidding to deliver a comparable set of services. They can also provide a basis for conducting professional evaluations of established operations to insure consistency of care and services. The guidelines cover three broad support areas: personnel, facilities and equipment, and procedures. Three categories of medical support personnel are defined. In addition to the on-site health care provider (HCP), whose typical qualifications, skills, and responsibilities are detailed, there are also defined roles for an external consulting physician and the Company physician responsible for the operation. These latter two individuals should be available to provide clinical advice, guidance, and oversight to the HCP, from an off-site location. General specifications for the physical facilities and examples of critical equipment and medications for use at the remote site are described. Expectations regarding organization and operation of the remote site clinical facility are also defined and include general procedures and guidelines for conducting medical evacuations, as well as administrative procedures to guide the HCP on working relationships, documentation, reporting, inspections and inventory control.

Introduction
Exploration and production activities in remote areas of the world are increasing. Operations ranging from small venture offices to larger scale activities in support of seismic, drilling, and production involve the movement of employees, contractors, and sometimes dependents into areas where health risks may be increased and medical resources may be limited.
Safety and health are the highest priority in all Company operations. However, the prevention and management of health issues are complicated by remote locations, communication difficulties, and lack of reliable public health resources and infrastructure. Primary health concerns in remote locations relate to environmental factors, endemic diseases, psychosocial adjustment and management of common non-occupational illnesses or injuries.
Prompt diagnosis and treatment of illnesses and injuries, and ready access to critical life support services are expected in all operating locations. Furthermore, it is generally accepted that providing a range of on-site health services from emergency care to primary care and prevention can improve the outcome of more serious medical problems, prevent minor problems from becoming more serious, and reduce overall productivity loss due to illness and injury.
In view of these factors, Medical Service Guidelines for Remote Sites, a set of professionally defined requirements for medical personnel, facilities, equipment, and operating procedures in high occupational risk locations was developed to help insure that acceptable routine and emergency medical services are available to promote and maintain a healthy workforce.
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