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Ship Medicine Chest and First Aid Kits
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Ship Medicine Chest and First Aid Kits

What a ship medicine chest and first aid kit must contain by flag state, vessel class and voyage, how to stock and inspect it, and which medicines crews actually use.
15 articles
Reviewed by Ann Jarris MD, FACEP
Primary sources cited
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About this category

Written for the operator, cited to the rule

What this category covers

Chest contents, quantities, the medical guide, equipment, inspection intervals and the flag-state notices that override the general rule.

Where the requirements actually come from

MLC 2006 Standard A4.1(4)(a) sets the obligation. The WHO International Medical Guide for Ships and its Quantification Addendum set contents. Category A, B and C classification comes from EU Directive 92/29/EEC, not WHO or IMO. Open registries publish their own, for example Marshall Islands MN 7-042-1.

What medical equipment and guides must a ship carry?

Under MLC 2006 Standard A4.1(4)(a), every ship must carry a medicine chest, medical equipment and a medical guide, inspected at regular intervals and at least once every 12 months. Contents are set by the flag state using the WHO International Medical Guide for Ships. Vessels holding controlled substances also need a DEA-registered medical officer under 21 CFR 1301.25.
Sources: MLC 2006 Standard A4.1 and Guideline B4.1.1 (ILO), WHO International Medical Guide for Ships 3rd edition and its Quantification Addendum, 21 CFR 1301.25 (eCFR).
Start here

The guide operators open first

MOST READ · GUIDE

21 CFR 1301.25 explained, for the people who have to comply with it

The whole rule, paragraph by paragraph: who it applies to, the three medical officer conditions, and both annual reports.
All guide articles

Everything in Guide

The medicines ships actually use: 11,698 prescriptions and what they mean for your chest, | Discovery Health MD

The medicines ships actually use: 11,698 prescriptions and what they mean for your chest

Naloxone on vessels: why 92% of fishing boats are not ready for an overdose, | Discovery Health MD

Naloxone on vessels: why 92% of fishing boats are not ready for an overdose

Expired medicines on ships: the 12-month rule, disposal routes and a calendar that works, | Discovery Health MD

Expired medicines on ships: the 12-month rule, disposal routes and a calendar that works

Does a commercial vessel need an AED? The rules and the numbers | Discovery Health MD

Does a commercial vessel need an AED? The rules and the numbers

Medical Oxygen Rules for US Vessels, Discovery Health MD

Oxygen is the one item in the chest that answers to two regulators, and most fleets satisfy only one

Vessel Medical Waste Disposal, Discovery Health MD

A sharps container is plastic, so it can never go over the side

The US Medicine Chest Statute, Discovery Health MD

The US medicine chest law is a statute, it fines the master personally, and it never says what goes in the chest

Uninspected Vessel First Aid Requirements, USCG, Discovery Health MD

Uninspected vessel first aid requirements, and why the rules you will be shown do not apply

Lifeboat First Aid Kit Rules, Discovery Health MD

The first aid kit in your lifeboat is set by a Swiss standard, and one US rule still points at a subpart that no longer exists

MLC Medicine Chest Inspection: What a PSCO Checks, Discovery Health MD

What a port state inspector actually opens in your medicine chest

USCG First Aid Kit Requirements by Vessel Class, Discovery Health MD

Coast Guard first aid kit requirements, and why the answer depends entirely on your vessel class

46 CFR 28.210 First Aid and Medicine Chest Rules, Discovery Health MD

46 CFR 28.210 requires a medicine chest and never says what goes in it

EU Directive 92/29/EEC Medicine Chest Categories, Discovery Health MD

Category A, B and C medicine chests: what 92/29/EEC actually requires

How to Stock a Ship Medicine Chest: 6 Steps, Discovery Health MD

How to stock a ship medicine chest, step by step

Ship Medicine Chest Requirements by Flag State, Discovery Health MD

Ship medicine chest requirements by flag state, compared

Common questions

Answers operators and search engines look for

At regular intervals and at least once every 12 months under MLC 2006 guidance and most flag-state rules. The inspection covers contents, quantities and expiry, and should be documented. See MedChest for how we document it.

The flag state decides, using the WHO guide as the reference. The Category A, B and C vessel classification comes from EU Directive 92/29/EEC, which is frequently misattributed to WHO or IMO.

Yes, and a general supplier cannot legally handle them. That portion needs a DEA-registered medical officer under 21 CFR 1301.25. See Controlled Substances.

The WHO guide is read alongside the Medical First Aid Guide (MFAG) for vessels carrying dangerous goods, which adds substance-specific treatment guidance.

Reading about compliance is not the same as being compliant

Tell us your vessels, flags and routes. A physician reviews your controlled substances, medicine chest and regulatory picture and shows you the gaps.

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888.683.7988

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