The MERMAID Project has set up an integrated multilingual emergency service that uses telematics to transfer medical expertise to sea borne vessels whenever and wherever necessary.  MERMAID provides the person acting as a paramedic on board a merchant marine vessel with a set of procedures and guidelines that ensure his correct response to illness and accidents, and guides him through these procedures whilst providing effective communication with medical teleconsultants.  The main components of MERMAID are a multimedia medical guide and messaging system.  The multimedia medical guide, based on the WHO Ship Captains Medical Guide, is for both crew training in basic procedures and as a reference during consultaions.  The guide is coupled with an effective communications and networking system which allows the paramedic to transmit clinical information to the shore based doctor for medical decision support.  The link is initially INMARSAT based and the transfer is then routed to the appropriate medical care centre.  The system is a scaleable messaging service which utilises whatever bandwidth and hardware is available on board.  The application is being evaluated at several sites and ships.  The demonstrator allows medical report generation and transfer, still image, video and audio clip capture and transfer, videoconferencing as well as access to the medical guide.  Crew member details and drugs stocks are stored on board and can be accessed by the doctor for case history and prescribing.