Abstract
1. Introduction

Oil and gas exploration and production are high-risk activities and often take place at remote locations. Operators are required to manage the related risks and an important element is ensuring provision of appropriate medical emergency care. This paper covers: the extent and nature of offshore oil and gas exploration and production operations in a Multinational Oil and Gas Company in Malaysia; challenges faced in ensuring provision of emergency medical services during these activities; and how this is managed using the Company Medical Emergency Response (MER) standards.

2. Offshore Oil and Gas Production in Malaysia

Today there is a full range of oil and gas businesses in Malaysia from exploration to production, refining, distribution and retail. The oil and gas resources have become less accessible resulting in recent exploration and production sites being further away from shore and in more remote locations.

This Multinational Oil and Gas Company in Malaysia operates a number of offshore platforms off the coast of Sarawak. Some of the platforms have living quarters and always has an offshore medic on board. Due to their distance from shore, patient transfer becomes a challenge for these platforms and other such work locations. The main mode of transport to offshore work location is helicopter and boat with traveling time between shore and offshore locations between one to two hours.

3. Challenges faced

The challenges of medical emergency provision offshore include ensuring: adequate number of competent medically trained personnel; availability of correct equipment in good condition; and effective plans to manage such medical emergencies. The company MER standards provide guidance on how to meet these challenges.

4. Company MER Standards

The aim of the company MER standards is to minimize the potential health consequences of workplace injury or acute illness. The standard provides assurance and helps ensure a standardised, simplified and streamlined approach towards MER within the company. Key elements in the company MER standard are: tiered response; resource requirements; training; equipment; drills; and exceptions for example non-routine activities and sites where tier times cannot be met.

4.1 Tiered response

Tiered response defines the required level of medical care and timeline. A tier 0 response, by a first responder is required immediately, a tier 1 response by a first aider within 4 minutes, a tier 2 response by a medical professional within 1 hour, a tier 3 response at a hospital within 4 hours and a tier 4 response at a tertiary care centre, depending on type of case. Exceptions are considered in non-routine activities and for sites where tier times cannot be met. Non-Routine Activities are defined as infrequent operations with high likelihood of an injury.

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