Acute illness occurring aboard a patrolling nuclear submarine is costly in terms of risk to the patient, the expense of evacuation, and compromise of national defense (if the submarine's mission must be terminated). There are currently no physicians assigned to submarines and medical responsibilities are borne by a senior enlisted paramedic who is a Hospital Corpsman especially trained for submarine duty. However, in spite of this advanced training, their clinical experience is not optimal since their duties are largely administrative. A microcomputer-based medical information system is being developed to assist Corpsmen in dealing with acute illness aboard submarines. Primary emphasis has been placed in the area of diagnosis since this is likely to result in a) appropriate therapy and b) a decrease in unnecessary evacuations. A system developed for use by physicians at the University of Leeds, England accurately diagnoses acute abdominal pain. We have modified the system for use by Hospital Corpsmen testing in a Naval hospital emergency room. We found that with proper training, Corpsmen diagnose abdominal pain as well as surgical residents. Also such a system used aboard submarines might reduce unnecessary evacuations by 50%.
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