The Ruby Princess is escorted by a U.S. Coast Guard 45 foot Response Boat-Medium into Juneau downtown harbor on Monday, April 30, 2018. (Michael Penn | Juneau Empire)

The Ruby Princess is escorted by a U.S. Coast Guard 45 foot Response Boat-Medium into Juneau downtown harbor on Monday, April 30, 2018. (Michael Penn | Juneau Empire)

Moving target: How do you medevac embarked patients?

How Juneau handles sickness and injury in our at-sea visitors

This is a three-part series on how first responders, Coast Guardsmen, and the medical community in Juneau treat tourists aboard cruise ships who become sick or injured while visiting. See the next part in the series in Wednesday’s newspaper.

Every year, more than a million people visit Juneau, mostly by cruise ship. With any group of humans over any period of time, illnesses and accidents occur. Most of the cruise ships have perfectly capable medical staff, said Capt. J. Russell Bowman, a senior Coast Guard medical officer, and they can handle most of the colds and mild injuries that occur.

But when a passenger has a stroke, or a major fracture of a critical bone, or any other affliction involving long term, specialized medical care, it can get a little more complicated.

“They make the determination if the injury or medical problem requires a higher level of care,” said Lt. Brian Dykens, a Coast Guard officer. “We’ll take the request, get all the info we can, and talk to duty flight surgeon, and they’ll make a recommendation of whether they recommend if we make a medevac or not.”

Juneau Station has performed 23 medevacs since last October, including six off of cruise ships. Two of those happened in the past two weeks. The first was when a passenger had a heart attack on Aug. 15. The onboard doctor was able to stabilize the patient, but they required further care that needed a specialist. The second involved a passenger suffering a severe allergic reaction on Aug. 22.

“A significant injury or illness, that’s where we come in to action,” Dykens said.

The Ruby Princess is escorted by a U.S. Coast Guard 45 foot Response Boat-Medium into Juneau downtown harbor on Monday, April 30, 2018. (Michael Penn | Juneau Empire)

The Ruby Princess is escorted by a U.S. Coast Guard 45 foot Response Boat-Medium into Juneau downtown harbor on Monday, April 30, 2018. (Michael Penn | Juneau Empire)

In both cases, Coast Guard Station Juneau deployed its 45-foot Response Boat-Medium to medevac the passenger from the Norweigian Bliss to Don D. Statter Harbor in Auke Bay, where Capital City Fire/Rescue personnel assumed care of the patient.

“With the Bliss, the recommendation was that they come close enough that we could use our small boat to pick them up and get them safely into town,” Dykens said.

Southeast Alaska has a number of medevac-capable options, from its response boats here in Juneau to the three SH-60 Jayhawk helicopters stationed at Air Station Sitka. All of them can perform rescue, provided the weather conditions aren’t dangerous.

“Hoisting someone off the deck is a very risky operation,” said Bowman.

The choice of asset — and the decision to deploy at all — depends on the window of stability the patient has before permanent harm or death is likely, said Bowman. When the Coast Guard gets a medical emergency call, the on-duty flight surgeon, a naval medical officer, will talk to the doctor aboard the cruise ship, and determine patient’s status, and how quickly the patient needs to get to a higher level of medical care.

Keeping it all in the air: How does Juneau handle all its air traffic?

The flight surgeon will talk to the search and rescue mission coordinator (SMC), and advise them whether they recommend a medevac from a medical point of view. The SMC will make the final call to deploy a medevac, said Dykens.

CCFR also plays a role, with EMTs sometimes riding along with the response boats to provide in-transit medical care, said Dykens. All Coast Guardsmen are trained in emergency first aid, but not for more intensive care.

Vying for Glory: These Olympic-style games make Coast Guard training fun

When the medevac gets back to the pier or the air station, personnel on the ground will assess whether to transport them to somewhere like Bartlett Regional Hospital or to evacuate them to somewhere like Seattle or Anchorage, if the window of best results will allow, said Bowman.

All of this activity in this region is coordinated through the Coast Guard’s 24/7 command center here in Juneau. The command center gets the call, alerts the crews, coordinates with CCFR and BRH, and if further transport is required, they line that up too.

Photos: Coast Guard competes in Buoy Tender Olympics 2019

“Coordination and communication between all these partners is key to maintaining the safety of the patient,” said Dykens, lauding the partnership between the Coast Guard, CCFR and BRH, as well as all the other agencies who pull together to make these evacuations possible.

And is it difficult, transporting an immobilized patient from one moving ship onto another moving vehicle at sea?

“We make the abnormal look normal,” Bowman said.

• Contact reporter Michael S. Lockett at 523-2271 or

More in News

The Norwegian Cruise Line’s Norwegian Encore docks in Juneau in October, 2022. (Clarise Larson / Juneau Empire File)
Ships in Port for t​​he Week of Sept. 17

Here’s what to expect this week.

A rainbow appears over downtown as residents check out rows of electric vehicles at Juneau’s EV E-bike Roundup Saturday afternoon. (Clarise Larson / Juneau Empire)
Capital city celebrates 10th annual Juneau EV and E-bike Roundup

Juneau’s electric vehicle growth among fastest in the country, organizers say.

U.S. Sen. Dan Sullivan, R-Alaska, gives a live speech via video from Washington, D.C., to attendees at the annual Southeast Conference meeting in Sitka on Thursday. (Screenshot from video by Southeast Conference)
Murkowski, Sullivan warn of domestic, foreign threats to Southeast Alaska’s economy

Issues from Russian seafood imports to ferry funding cited by senators during Southeast Conference.

(Michael Penn / Juneau Empire File)
Police calls for Thursday, Sept. 21, 2023

This report contains public information from law enforcement and public safety agencies.

This is a photo of Juneau International Airport. (Clarise Larson / Juneau Empire File)
Email threat to Alaska airports doesn’t appear credible, police say

Heightened presence of officers at Juneau airport planned Friday.

A 2023 municipal election ballot is placed in the drop box at Douglas Library/Fire Hall Community Building. (Clarise Larson / Juneau Empire File)
Number of residents registered to vote ‘nearly identical’ to last year

More than 1,100 ballots counted so far during this municipal election.

Samantha Crain, of the Choctaw Nation, sings to the crowd during a performance Thursday night as part of the Áak’w Rock music festival at Centennial Hall. (Clarise Larson / Juneau Empire)
‘It’s pure resiliency’: Áak’w Rock kicks off

The three-day Indigenous music festival attracts full crowds during its first night.

U.S. Sen. Dan Sullivan, R-Alaska, walks down a hallway Tuesday, Feb. 7, 2023, at the Alaska State Capitol. (James Brooks/Alaska Beacon)
With Alaska’s federal judge vacancy nearing 2-year mark, Sullivan breaks from nomination tradition

Murkowski appears skeptical about the switch, saying she’s prepared to advance nominees to Biden

Jordan Creek flows over a portion of a footbridge behind a shopping center Thursday evening. The National Weather Service has issued a flood warning for Jordan Creek, Montana Creek and Auke Lake until 10 a.m. Friday. (Mark Sabbatini / Juneau Empire)
Flood warning for Jordan Creek, Montana Creek and Auke Lake issued until 10 a.m. Friday

Glacier Highway, structures near Jordan Creek may inundated, according to National Weather Service.

Most Read