Lesson routeRecognise, Call, Then Check Breathing0/8 read
Lesson 1 of 8
Recognise, Call, Then Check Breathing
What you will learn
Apply the current adult basic-life-support recognition sequence without waiting for certainty or mistaking abnormal breathing for recovery.
For an unresponsive adult, make the emergency call immediately, assess breathing while the call connects, and assume cardiac arrest when breathing is abnormal or uncertain.
Resuscitation Council UK changed the adult recognition sequence in 2025: if a person is unresponsive, call 999 without delay and assess breathing while the call is connecting. Afloat, start the effective trained emergency route for the vessel's position so HM Coastguard or the applicable emergency service can help with recognition, dispatch and access. The call is not postponed until a rescuer has proved cardiac arrest.
Normal breathing is the decision boundary. Slow, laboured, irregular, gasping, panting or apparently near-normal breaths immediately after collapse can still be abnormal; a short seizure-like episode can also occur at the onset of cardiac arrest. If the person remains unresponsive and breathing is abnormal or there is doubt, assume cardiac arrest and begin the CPR response supported by current training and the operator.
This lesson teaches recognition and coordination, not the physical skill of airway opening, breathing assessment, compressions or rescue breaths. Those actions require current hands-on training and practice. In a real emergency, follow the call handler, Coastguard and your recognised training rather than returning to this page for instructions.
CPR and drowning sequence board
Rehearse the decision sequence without pretending to practice CPR
Select a situation to compare recognition, emergency contact, the drowning-specific ventilation start, AED prompts and handover. Every state is written in text and does not depend on colour.
- 1Recognise
- 2Call + boat
- 3CPR decision
- 4AED decision
- 5Continue
- 6Handover
The stages overlap. The drowning difference is five initial rescue breaths after safe recovery before standard CPR; it does not replace the call, AED, vessel control or practical skill.
1 · Recognise
Unresponsiveness triggers the emergency call. Gasping, panting, slow or laboured breathing may be abnormal and must not be treated as normal breathing.
2 · Call + boat
Start the effective emergency contact immediately and assess breathing while it connects. Give position and observed state; keep helm, lookout and access owned.
3 · CPR decision
If breathing is abnormal or uncertain, assume cardiac arrest and begin the adult CPR response from current practical training and the call handler.
4 · AED decision
Ask a helper to bring an available AED. Do not stop CPR for a distant search when no safe helper or immediately accessible device exists.
5 · Continue
Continue until professional help takes over or directs a change, the person shows purposeful signs and breathes normally, or the rescuer is exhausted.
6 · Handover
Report unresponsiveness, the exact breathing description, call and CPR times, AED events, changes and every uncertainty without diagnosing the cause.
Choose a situation and rehearse which decisions stay the same, which drowning step differs and what must continue alongside casualty care.
Worked example
A crew member collapses in the cockpit, does not respond to voice and appears to take occasional gasps. A phone has signal and another crew member has the helm.
- 1The first rescuer states that the person is unresponsive; the second starts the emergency call on speaker and gives the vessel's position while the first assesses breathing.
- 2The gasps are not accepted as normal breathing. The first rescuer follows current training and the call handler's CPR instructions while the second arranges AED retrieval if one is available.
- 3The helm remains owned and the communicator updates the operator with any purposeful movement or return of clearly normal breathing.
Sense check: The crew did not diagnose the cause of collapse or wait for breathing to stop completely; unresponsiveness plus abnormal breathing was enough to act.
| Observed state | Current recognition decision | Unsafe interpretation |
|---|---|---|
| Unresponsive | Call immediately and assess breathing while connected | Finish a long assessment before contacting help |
| Unresponsive with abnormal breathing | Assume cardiac arrest and start the trained CPR response | Wait for absent breathing or a pulse diagnosis |
| Gasping, panting or slow/laboured breathing | Treat as potentially abnormal and use call-handler support | Count any movement of air as normal breathing |
| Responsive or clearly breathing normally | Continue structured assessment and professional guidance | Assume the emergency has ended |
State the recognition handover
The emergency operator needs a short factual description while the boat is still being controlled.
1. Response
State exactly how responsiveness was checked and what happened.
2. Breathing
Describe what was observed; use normal, abnormal or uncertain rather than guessing a diagnosis.
3. Position
Give a reliable position and the vessel's current state.
4. Action
State which trained care, communications and AED tasks have begun.
Sense check: The description lets the operator support recognition without the crew claiming a pulse, diagnosis or certainty they have not established.
Common mistake or limitation
- Delaying the emergency call until abnormal breathing has been confirmed without support.
- Treating gasping, panting or slow, laboured breaths as normal breathing.
- Using an online lesson as a substitute for hands-on CPR training or live call-handler instruction.
Recap
- Unresponsive means call now; assess breathing while the call connects.
- Unresponsive plus abnormal or doubtful breathing means assume cardiac arrest.
- Recognition is an observed-state decision, not a diagnosis of why the person collapsed.
Optional quick check
Section 1 of 8
An adult is unresponsive and makes occasional gasping breaths. What is the strongest current response?
Lesson 2 of 8
Call, CPR and Vessel Roles
What you will learn
Organise emergency contact, CPR support, AED retrieval and vessel control so one time-critical task does not cancel another.
CPR afloat is a whole-crew response: trained casualty care, the emergency call, AED retrieval, helm and lookout, access and records must be owned in parallel or deliberately combined.
The emergency call is part of resuscitation, not an administrative step after it. With several crew, one trained person can begin the casualty response while another starts the effective emergency contact and another controls the vessel. The communicator gives position and observed condition first, keeps the channel usable and relays the operator's instructions without paraphrasing them into a diagnosis.
A two-person crew has to combine functions deliberately. Speakerphone or a safely managed radio relay may allow the call and care to overlap; the boat still needs a controlled state and a viable rescue approach. A single rescuer follows the emergency operator and current training, recognising that leaving the person or abandoning vessel control can each create serious risk. This lesson cannot prescribe one manoeuvre for every boat, sea state or position.
Name roles by function rather than by a fixed person: casualty care, communication and record, AED/equipment, helm/lookout and access. Reassign them when fatigue, sea state or the casualty's condition changes. Nobody should stop a time-critical action merely because the original role card no longer fits the crew available.
Worked example
On a four-person yacht, one crew member is unresponsive with abnormal breathing while the vessel is under sail close to traffic.
- 1The most capable boat handler takes helm and lookout, reduces vessel risk and states the treatment and rescue-access plan.
- 2The trained first aider begins the current CPR response while a second person calls for help, gives position and relays operator instructions.
- 3The remaining person brings the AED and record, then supports pad preparation or crew rotation only as directed and trained.
Sense check: Everyone has a life-preserving function; nobody crowds the casualty and neither the call nor vessel control waits for CPR to finish.
| Function | First useful output | Failure to prevent |
|---|---|---|
| Casualty care | Observed response and breathing; trained care started | Waiting for a diagnosis |
| Communication and record | Position, condition and immediate need | A late call or lost timeline |
| AED and equipment | Known location, readiness and prompt-led use | Stopping CPR while everyone searches |
| Helm, lookout and access | Controlled vessel state and rescue route | A second casualty or blocked evacuation |
Build a minimum-crew role plan
Only two people are available after one becomes the casualty.
1. Call
Choose the effective trained route and how operator audio can remain available.
2. Care
State which current practical skill begins and what would trigger a change.
3. Boat
Choose a competent vessel state that supports care and rescue access.
4. Equipment
Retrieve only what is immediately accessible without abandoning the casualty or boat.
Sense check: The plan exposes the trade-offs instead of pretending a single rescuer can perform every function continuously.
Common mistake or limitation
- Sending every available person to the casualty while nobody controls the vessel or makes the call.
- Stopping CPR for a long AED search when no safe helper or immediately accessible device is available.
- Treating one rehearsed role allocation as suitable for every crew size and sea state.
Recap
- The call, CPR response, AED search and vessel control are concurrent functions.
- Small crews combine functions deliberately and follow operator guidance.
- A useful role produces an observable output, not merely a title.
Optional quick check
Section 2 of 8
A second trained crew member is available while CPR starts. What is the strongest assignment?
Lesson 3 of 8
Compression, Breathing and Interruption Boundaries
What you will learn
Recall the current adult CPR parameters and distinguish useful adaptations from delays or untrained improvisation.
Adult CPR uses 100–120 compressions a minute at 5–6 cm depth; trained rescuers use 30 compressions to 2 breaths, while an untrained rescuer follows the call handler and gives continuous compressions.
For adult basic life support, Resuscitation Council UK specifies compressions in the centre of the chest at 100–120 a minute and a depth of at least 5 cm but not more than 6 cm, allowing full recoil and minimising interruptions. A rescuer trained to give breaths alternates 30 compressions with 2 breaths and gives only enough air for the chest to start to rise. If not trained to ventilate, give continuous compressions and follow the call handler.
The numbers are retrieval cues, not proof of physical competence. Hand position, depth, recoil, ventilation and fatigue require instruction and practice on appropriate equipment. An online answer cannot show that the learner can deliver effective CPR on a moving deck, and a remembered rate does not justify improvising beyond training.
A firm surface supports effective compressions, but the 2025 adult guideline says not to move a person from a soft bed to the floor merely to achieve firmness; start CPR there and compensate as trained. Afloat, any move must also balance scene danger, access, airway, trauma and operator instruction. Do not spend life-saving time engineering a perfect textbook space.
Worked example
An unresponsive adult with abnormal breathing is on a cockpit cushion. A crew member proposes spending several minutes moving below to find a flatter floor before starting CPR.
- 1The emergency call begins and the trained rescuer starts CPR promptly rather than waiting for a redesigned treatment area.
- 2The crew controls the boat and removes only immediate hazards; any movement is justified by safety, access or operator guidance rather than surface perfection alone.
- 3A second person prepares the AED and records any interruption while CPR continues as much as possible.
Sense check: The decision minimises delay without pretending that the page can choose the safest physical position for this particular boat.
| Revision cue | Governing principle | Boundary |
|---|---|---|
| 100–120/min | Maintain the current adult compression rate | A number cannot verify pace, position or fatigue |
| 5–6 cm | Compress at least 5 cm and not more than 6 cm | Depth needs hands-on feedback and practice |
| 30:2 | Trained rescuers alternate compressions and breaths | Do not claim ventilation skill from reading |
| Few interruptions | Pause only when the sequence, AED or safety requires it | Do not wait for ideal kit or layout |
Audit an interruption
A crew is about to pause compressions during a resuscitation response.
1. Reason
Name whether the pause is required by the AED, ventilation sequence, safety or professional instruction.
2. Owner
Assign the person who will make the pause as short and controlled as possible.
3. Restart
State the exact cue for immediate resumption.
4. Record
Capture the relevant AED prompt, response or handover fact without estimating false precision.
Sense check: Convenience, searching or uncertainty alone are not good reasons for a prolonged interruption.
Common mistake or limitation
- Remembering 100–120 and 30:2 but assuming that recall demonstrates practical technique.
- Delaying CPR while the crew looks for a perfect surface or waits for the AED.
- Giving untrained breaths badly rather than following call-handler guidance and the supported compression-only route.
Recap
- Current adult parameters are 100–120/min, 5–6 cm and 30:2 for trained rescuers.
- Continuous compressions are the supported route when a rescuer is not trained to give breaths.
- Start promptly and minimise interruptions; practical quality must be learned hands-on.
Optional quick check
Section 3 of 8
A rescuer is not trained to give rescue breaths. What should the revision plan reinforce?
Lesson 4 of 8
Drowning Protocol Context
What you will learn
Explain why drowning resuscitation starts with five initial ventilations and apply that difference without unsafe water rescue or outdated terminology.
After safe recovery to land or a rescue boat, an unresponsive drowning casualty who is not breathing receives five initial rescue breaths, then standard CPR; rescuer safety and rapid professional help remain part of the sequence.
Drowning is the process of respiratory impairment caused by submersion or immersion in liquid; outcomes can be fatal or non-fatal. Current WHO terminology avoids misleading labels such as dry, secondary or near drowning. A person recovered from water without respiratory impairment has had a water-rescue incident, while distressed coughing, difficulty breathing, unresponsiveness or absent breathing can indicate a drowning process and requires professional assessment and direction.
Because oxygen deprivation is central, Resuscitation Council UK says that once the person is on land or a rescue boat, an unresponsive casualty who is not breathing should immediately receive five initial rescue breaths and then standard CPR. Five initial breaths means five breaths before the standard cycle, not five rounds of CPR and not a reason to delay the emergency call.
Do not enter the water unless trained for rescue; use flotation or rescue equipment within competence and recover the person as soon as possible. Trained rescuers with effective flotation may provide five breaths in the water only when feasible and safe. Spinal precautions must not delay recovery when resuscitation is required. The physical rescue, breathing and CPR techniques require current practical training.
Worked example
A person is recovered over the bathing platform after a witnessed submersion. They are unresponsive and not breathing; the crew has already made the distress call.
- 1The trained first aider recognises the drowning-specific start and gives five initial rescue breaths after safe recovery.
- 2They then move into standard CPR while another crew member prepares the AED, controls the vessel and follows Coastguard instructions.
- 3The record states submersion and recovery times if known, observed breathing, the five initial breaths, CPR start and any subsequent change.
Sense check: The five breaths address the drowning mechanism but do not replace standard CPR, the emergency call, AED use or practical training.
| Situation | Decision | Misconception to reject |
|---|---|---|
| Person still in water | Use safe rescue and trained flotation methods; call professional help | An untrained rescuer should enter immediately |
| Recovered, unresponsive, not breathing | Five initial rescue breaths, then standard CPR | Start with compressions and omit the drowning difference when trained to ventilate |
| Recovered and breathing | Structured assessment, monitoring, warmth and professional direction | The absence of arrest means there was no drowning risk |
| Possible trauma | Airway and resuscitation take priority while movement is minimised | Spinal immobilisation must delay removal from water |
Separate the common and different steps
A learner is comparing sudden adult cardiac arrest with arrest after drowning.
1. Common
Safety, emergency contact, recognition, standard CPR, AED and handover still apply.
2. Different
Drowning adds five initial rescue breaths after safe recovery before standard CPR.
3. Rescue
Water entry and in-water ventilation remain competence- and flotation-dependent.
4. Language
Report observed respiratory impairment and outcome; avoid dry, secondary or near-drowning labels.
Sense check: The drowning difference is specific and bounded; it does not create a completely separate emergency system.
Common mistake or limitation
- Confusing five initial rescue breaths with five CPR cycles or a delay before standard CPR.
- Entering the water or attempting in-water ventilation without training and effective flotation.
- Using dry, secondary or near drowning as if they were current diagnostic categories.
Recap
- Drowning is respiratory impairment from submersion or immersion, with fatal or non-fatal outcomes.
- The resuscitation difference is five initial rescue breaths after safe recovery, then standard CPR.
- Safe rescue, early contact and hands-on competence remain essential.
Optional quick check
Section 4 of 8
After safe recovery, a drowning casualty is unresponsive and not breathing. What is the current trained sequence?
Lesson 5 of 8
AED Use Afloat
What you will learn
Integrate an AED promptly, preserve pad contact and obey analysis, shock and CPR prompts without interpreting the device as a diagnosis.
Switch on an available AED, attach the pads to a bare chest as shown, keep everyone clear for analysis or shock, and restart compressions immediately after either a shock or no-shock instruction.
Anyone can use an AED. Use it as soon as it is available: switch it on, follow its audio and visual prompts, and place the pads on the bare chest in the positions shown on the device or pads. With more than one rescuer, CPR continues while the pads are attached and stops only when the AED instructs for analysis or shock.
For a wet casualty, dry the chest quickly so the self-adhesive pads will stick. Resuscitation Council UK notes that use on a wet or metal surface is usually safe when pads are correctly attached and nobody has direct contact with the casualty during shock. Follow the exact device and operator instructions; do not invent a universal boat-specific electrical rule from this summary.
A no-shock instruction does not mean the casualty needs no further care and does not diagnose the rhythm's cause. Current adult guidance says to restart compressions immediately after either shock or no shock and continue following the AED. Keep the emergency service informed and record the prompt and any delivered shock accurately.
Worked example
An AED arrives during CPR on a wet cockpit surface. It analyses and announces that no shock is advised.
- 1While CPR continues, a helper exposes and quickly dries the chest, attaches pads as shown and switches on the device if it is not already active.
- 2The crew makes a positive clear check for analysis; nobody touches the casualty when the AED requires it.
- 3At the no-shock prompt, compressions restart immediately and the communicator reports the prompt without saying that the casualty is beyond help.
Sense check: No shock is an AED rhythm decision at that moment, not an instruction to stop CPR or a diagnosis of death.
| AED stage | Crew action | Dangerous inference |
|---|---|---|
| Arrival | Switch on and follow prompts while CPR continues if another rescuer is available | Pause everything to read the entire case |
| Pads | Bare, quickly dried chest; position as shown | Hold loose pads by hand or place over clothing |
| Analysis/shock | Clear all contact and say the clear command | Assume visual distance alone proves nobody is touching |
| Shock or no shock | Restart compressions immediately and continue prompts | Treat no shock as permission to stop |
Run the AED words aloud
A crew needs a short closed-loop script while noise and movement compete for attention.
1. On
Confirm the AED is active and prompts can be heard or seen.
2. Pads
Confirm bare, quickly dried chest and placement shown by the device.
3. Clear
Name the analysis or shock pause and check every person is clear.
4. Resume
Restart compressions immediately when the device says shock or no shock is complete.
Sense check: Each word produces an observable crew action; nobody substitutes memory for the exact AED prompt.
Common mistake or limitation
- Delaying AED use until the casualty, deck or whole body is completely dry.
- Stopping CPR for pad preparation when another rescuer can continue compressions.
- Interpreting a no-shock prompt as no further CPR, no emergency or a diagnosis of death.
Recap
- Switch on, follow prompts and attach pads to the bare, quickly dried chest.
- Clear means nobody is touching during analysis or shock.
- Shock and no shock both lead back to immediate compressions unless the device or professional responder directs otherwise.
Optional quick check
Section 5 of 8
The AED says no shock is advised while the casualty remains unresponsive and is not breathing normally. What next?
Lesson 6 of 8
AED Readiness and Device Limits
What you will learn
Evaluate whether a carried AED is accessible and serviceable without assuming every vessel must carry one or that possession proves readiness.
MCA guidance recommends a vessel-specific risk assessment for AED carriage and, where one is carried, manufacturer-led testing, consumable control, familiarisation and refresher training.
An AED cannot shorten time to defibrillation if nobody knows it is aboard, it is buried behind stores, its pads or battery are expired, or its case cannot be opened in the expected conditions. Readiness means a known location, current consumables, completed device checks, clear access, crew familiarisation and integration into the emergency plan.
MCA MGN 297 Amendment 2 recommends that operators of UK vessels assess whether to carry an AED using the people aboard, risk profile, voyage and access to higher medical care. It does not create one universal rule that every leisure boat carries the same unit. If carried, the AED and consumables are tested according to the manufacturer and first aiders receive familiarisation and refreshers.
The AED analyses whether a shock is advised; it does not replace recognition, CPR, the emergency call, evacuation planning or hospital care. A successful shock may restore circulation while the casualty remains seriously ill. At sea, the communicator should keep HM Coastguard involved and use the TMAS route when arranged rather than letting the device become the whole medical plan.
Worked example
A yacht has an AED in a locked aft locker, but the crew briefing only says that medical equipment is somewhere below.
- 1The operator's risk review confirms whether the carried device fits the voyage and who owns its inspection and consumables.
- 2The crew briefing names the exact accessible location, retrieval route and person who will bring it without abandoning helm or casualty care.
- 3Familiarisation uses the manufacturer's training process and confirms that the emergency call, CPR and evacuation plan continue alongside AED use.
Sense check: Owning the device is not readiness evidence until access, condition, people and the wider response have all been tested.
| Readiness evidence | Useful check | False reassurance |
|---|---|---|
| Location/access | Can the crew retrieve and open it promptly in the actual stowage plan? | It is listed somewhere on the inventory |
| Device/consumables | Are status, battery, pads and dates within manufacturer requirements? | The case is sealed |
| People | Who has current CPR training and device familiarisation? | Anyone can use it, so no rehearsal is needed |
| System | How do call, CPR, AED, boat control and evacuation overlap? | The AED alone is the emergency plan |
Ask the four AED readiness questions
Before departure, a skipper wants a concise evidence check rather than a yes/no inventory tick.
1. Need
What vessel, people, voyage and access-to-care factors support the carriage decision?
2. Ready
What manufacturer status, battery, pad and date evidence is current?
3. Reach
Can the crew identify and retrieve the device promptly without creating another hazard?
4. Use
Who is familiarised, and how does the AED fit the call, CPR and evacuation plan?
Sense check: A complete answer is traceable to the exact device and voyage rather than a generic claim that AEDs are simple.
Common mistake or limitation
- Assuming MCA guidance requires the same AED carriage decision for every leisure vessel.
- Treating an unopened case as proof that pads, battery and self-test status are current.
- Letting AED ownership replace CPR practice, communication rehearsal or evacuation planning.
Recap
- Carriage is risk-assessed; readiness is device-, voyage- and crew-specific.
- Manufacturer checks and consumables matter as much as the box itself.
- The AED is one part of a complete resuscitation and rescue system.
Optional quick check
Section 6 of 8
Which statement is the strongest evidence that a carried AED is ready?
Lesson 7 of 8
After Normal Breathing Returns
What you will learn
Respond to a return of clearly normal breathing without declaring recovery, losing the airway or cancelling professional assessment and evacuation.
A return of normal breathing changes the immediate task from CPR to airway protection, repeated assessment, warmth and professional direction; it does not end the emergency.
Current first-aid guidance continues CPR until professional help takes over or tells the rescuer to stop, the person becomes responsive or breathes normally, or the rescuer is exhausted. Purposeful movement, eye opening, speech or clearly normal breathing are meaningful changes; occasional gasps are not. Tell the operator exactly what changed and follow their instruction rather than stopping on an ambiguous sign.
When a person does not meet the criteria for CPR but has a decreased level of response, airway protection and continuous monitoring remain central. Use the recovery position only when appropriate under current training; RCUK specifically warns that agonal breathing is not a recovery-position state. Afloat, balance position with trauma, vessel movement, access and the operator's guidance.
Prevent further cooling, continue timed observations and prepare urgent evacuation or transport as directed. MCA guidance says a person whose circulation returns after AED treatment may remain very ill and needs urgent hospital transport. After respiratory impairment from submersion or immersion, use the factual term non-fatal drowning and do not self-clear the casualty because they briefly look better.
Worked example
During CPR after a drowning event, the casualty starts moving purposefully and then breathes in a regular pattern while the Coastguard remains connected.
- 1The rescuer reports the exact purposeful movement and breathing pattern rather than announcing that the casualty has recovered.
- 2Following operator and current training, the crew transitions to airway protection, repeated assessment and prevention of further cooling.
- 3The vessel keeps the evacuation route open and the record continues with time, change, care and any further deterioration.
Sense check: The response changes because the observed state changed, but professional assessment and the rescue plan do not disappear.
| Change | Immediate meaning | What still continues |
|---|---|---|
| Occasional gasp | Still abnormal breathing | CPR response and operator support |
| Purposeful movement or clearly normal breathing | Report and reassess | Airway protection, monitoring and professional direction |
| Normal breathing after drowning | Non-fatal outcome is possible | Medical assessment, warmth, trend and evacuation plan |
| Circulation after AED | The shock may have restored a rhythm | Urgent hospital transport and ongoing support |
Make a change report
The communicator must update Coastguard after a possible return of normal breathing.
1. Before
State the previous response and breathing state.
2. Change
Describe movement, eye opening, speech or breathing exactly and give the time.
3. Now
State current airway, breathing, response, warmth and position as observed.
4. Need
Confirm the continuing assessment, evacuation and access requirement.
Sense check: The update separates an observed change from an unsupported claim that the person is now safe.
Common mistake or limitation
- Stopping CPR because of a gasp or other ambiguous movement rather than clearly normal breathing or professional direction.
- Putting a person with agonal breathing into the recovery position.
- Cancelling evacuation or assessment because normal breathing briefly returns.
Recap
- Gasps are abnormal; purposeful signs and clearly normal breathing are changes to report and reassess.
- Airway protection, monitoring, warmth and professional direction continue after CPR stops.
- A non-fatal drowning or successful AED response can still leave the casualty seriously ill.
Optional quick check
Section 7 of 8
A casualty begins breathing normally after CPR and AED use. What is the strongest next response?
Lesson 8 of 8
Resuscitation Record, Handover and Crew Support
What you will learn
Create a factual resuscitation handover and recognise the post-incident support boundary without inventing times, diagnoses or outcomes.
Record the known timeline, observed state, exact CPR and AED actions, drowning exposure, changes and operator advice, then hand over uncertainty as honestly as facts.
A useful record begins during the response when crew permit. Capture the time found or recovered, last-known-well time if reliable, responsiveness and breathing as observed, the start and type of CPR, five initial drowning breaths where applicable, AED connection, shock or no-shock prompts, signs of life, cooling measures, injuries, vessel position and instructions received. Mark estimates and unknowns as such.
The handover should follow the casualty's timeline, not the order in which facts come to mind. State what happened, the known mechanism, first observations, care and equipment used, response to each material action, current condition, relevant history if reliably known, and the evacuation/access plan. Do not diagnose a rhythm from an AED prompt or report an exact submersion time that nobody witnessed.
Resuscitation attempts can be distressing for rescuers and witnesses. Resuscitation Council UK recognises that lay rescuers may benefit from support. A debrief should preserve welfare and learning without claiming blame or competence from one outcome; equipment must be restored, records secured appropriately and training gaps taken to a recognised provider. This module cannot judge the medical outcome or the crew's practical performance.
Worked example
A casualty recovered after an unwitnessed water entry received drowning CPR and one AED shock before normal breathing returned. Nobody knows the exact submersion time.
- 1The recorder labels the water-entry time unknown, gives the known recovery, CPR and AED times, and states who observed each event.
- 2The handover describes initial unresponsiveness and absent breathing, five initial breaths, standard CPR, one shock, purposeful movement and the later normal breathing pattern.
- 3It closes with current airway and monitoring, cooling, other injuries or unknowns, Coastguard advice and the evacuation access plan.
Sense check: The unknown submersion interval remains unknown; honest uncertainty is safer than a precise-looking guess.
| Handover field | Strong evidence | Weak substitute |
|---|---|---|
| Timeline | Known, estimated and unknown times labelled separately | One invented exact time |
| Condition | Observed response and breathing before and after actions | A guessed diagnosis |
| Care | CPR type, drowning breaths, AED prompts/shocks and professional instructions | Medical equipment was used |
| Current need | Present state, vessel position, access and evacuation plan | They seem better now |
Build the sixty-second handover
A rescue team is approaching and needs the facts in a stable order.
1. Event
State what happened, known mechanism and reliable time anchors.
2. State
Give response and breathing before care, then each material change.
3. Care
Name CPR, drowning breaths, AED prompts or shocks and instructions exactly.
4. Now
Give current condition, unresolved concerns, position, access and evacuation plan.
Sense check: The handover is complete enough to continue care but contains no diagnosis, invented interval or claim that the outcome proves performance quality.
Common mistake or limitation
- Inventing a precise collapse or submersion time because the handover feels incomplete without one.
- Reporting no shock as a diagnosis or successful shock as proof that the casualty is safe.
- Ignoring the welfare and support needs of rescuers after a distressing resuscitation attempt.
Recap
- A strong handover is a factual timeline of state, care, change and current need.
- Unknown and estimated facts must remain visibly different from observed facts.
- Post-incident support and equipment restoration matter, but outcome alone cannot prove competence.
Optional quick check
Section 8 of 8