First Aid at Sea revision module 1 of 8

AID

First-Aid Response Afloat

A teaching-first afloat response model for protecting the scene, checking the casualty, calling early, coordinating the crew, monitoring change, and handing over safely.

parallel emergency responsedynamic scene safetystructured casualty surveycrew roles

8 guided lessons · 8 practice questions · 8 flashcards

3 outcomes · self-guided revision

Coordinate immediate casualty care, vessel safety and outside help without waiting for one person to finish every task in sequence.
Identify and control the immediate afloat hazards that can injure the casualty, rescuer or remaining crew during care.
Evaluate whether the onboard first-aid equipment is accessible, maintained, risk-appropriate and usable by the trained people aboard.

A self-guided revision companion that explains essential concepts, then helps you practise and test them. It supports—but does not replace—recognised instruction, practical training, assessment or certification. Access is a one-time payment, not a subscription.

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Lesson 1 of 8

Afloat First-Aid Priorities

What you will learn

Coordinate immediate casualty care, vessel safety and outside help without waiting for one person to finish every task in sequence.

First aid afloat is a parallel response: protect people, check the casualty, call early, give trained care, monitor change and prepare a factual handover while somebody continues to control the boat.

Begin with three simultaneous questions: what still threatens the casualty or rescuer, what time-critical condition must be checked now, and how will professional help reach this position? On a moving boat, helm, traffic, sails, machinery, fire, water, weather and access remain part of the medical incident. A rescuer who becomes injured and a vessel that loses control both reduce the casualty's chance of receiving useful care.

Use Protect, Check, Call, Care, Monitor and Handover as a coordination model, not as six isolated jobs that must wait for the previous one to finish. Resuscitation Council UK guidance puts scene safety and early help at the start, while the RYA course explicitly notes that one person may be unable to navigate, helm, call and resuscitate together. With enough crew, assign these tasks in parallel; with fewer people, combine them deliberately and use speaker, radio relay or other operator guidance where available.

This module rehearses decisions around practical first aid. It does not teach CPR, bleeding control, casualty movement, medication or other physical techniques, and it cannot diagnose or replace a current recognised course. In a real emergency use current training, contact HM Coastguard or the applicable emergency service promptly and follow their instructions.

Afloat emergency response board

Keep casualty care, boat control and outside help moving together

Select a situation and rehearse the coordination decisions around the practical first-aid skill. Every stage is written in text and does not depend on colour.

1Protect
2Check
3Call
4Care
5Monitor
6Handover

The stages overlap. A time-critical call can begin while a trained first aider checks and cares for the casualty, provided another person keeps the vessel safe.

1 · Protect

Control the vessel, prevent another person entering danger, isolate an immediate hazard when safe, and place a competent person on helm and lookout. Recovery from the water must not create a second casualty.

2 · Check

Check responsiveness, breathing and life-threatening bleeding using current practical training and the call handler's instructions. An unresponsive person is an immediate help gate, not a wait-and-see diagnosis.

3 · Call

Start the fastest effective emergency contact for the position. At sea use the trained GMDSS, DSC or VHF route; on the coast or where a phone is the effective route, call 999 or 112 and ask for the Coastguard. Give position first and keep the channel open.

4 · Care

Follow current training and the emergency operator. If CPR, drowning care or an AED is required, use the trained sequence and the separate practical skill; this board does not teach the physical technique.

5 · Monitor

Record the time found, response, breathing description, actions, operator instructions and every change. Recheck after movement, treatment or any deterioration.

6 · Handover

State what happened, the known time line, observed condition, care given, response to care and any unresolved hazard. Do not add a guessed diagnosis.

Coordination rehearsal only. This board does not diagnose and does not prescribe, teach a physical first-aid technique, replace current practical training or provide instructions for a real emergency. In an emergency contact HM Coastguard or the applicable emergency service promptly and follow the operator and your current training.

Choose a situation and rehearse how casualty care, boat control, communication and handover stay coordinated.

Worked example

A three-person crew is sailing in traffic when one person collapses in the cockpit. The boat is still making way and the cause is unknown.

1Crew one takes helm and lookout, reduces immediate vessel risk and states the safe treatment area; they do not crowd the casualty.
2Crew two checks the casualty using current training and begins only the care supported by the observed condition and emergency instructions.
3Crew three starts the effective emergency contact, gives position and observed condition, records times and relays questions without inventing a diagnosis.

Sense check: The tasks overlap: boat control does not wait for assessment, and the emergency call does not wait for a complete diagnosis.

Afloat First-Aid Priorities
Response strand	Evidence question	Unsafe shortcut
Protect	What can still harm the casualty, rescuer or boat?	Starting treatment while nobody controls a moving hazard
Check	What do response, breathing and life-threatening signs show now?	Naming a diagnosis before checking immediate threats
Call and care	Can help and trained care begin in parallel?	Waiting for all onboard options to fail before contact
Monitor and handover	What changed, when, after which action?	Relying on memory or reporting only the latest state

Speak the first six commands

A crew member must organise the first minute without knowing the final diagnosis.

1. Protect
Name the immediate vessel and scene control.
2. Check
Name the trained casualty check and critical finding to report.
3. Call
Assign contact, position source and communications route.
4. Continue
Assign care, monitoring, record and access preparation.

Sense check: Every command has one owner; no task assumes that an untrained person can diagnose or perform a physical skill they have not learned.

Common mistake or limitation

Treating boat control as background work rather than part of the emergency response.
Waiting for one person to complete assessment before anybody calls or prepares access.
Using a remembered acronym as permission to deliver untrained treatment.

Recap

Protect, Check, Call, Care, Monitor and Handover are parallel response strands.
Observed condition and urgency matter more than a guessed diagnosis.
Revision supports coordination; recognised practical training supplies the physical skills.

Optional quick check

Section 1 of 8

A casualty collapses while a three-person boat is still moving in traffic. What is the strongest first organisation?

Continue

Lesson 2 of 8

Scene Safety on a Moving Boat

What you will learn

Identify and control the immediate afloat hazards that can injure the casualty, rescuer or remaining crew during care.

Scene safety afloat is dynamic. The treatment space can change with speed, heel, traffic, weather, machinery, sails, fire, electricity, water and access, so it must be actively controlled and reassessed.

Name the hazard before touching the casualty: moving boom or line, rotating or hot machinery, live electrical source, fire or fumes, chemical, contaminated fluid, unstable deck, cold water, traffic, surf or a casualty still overboard. Control only what can be controlled safely; an attempted isolation or recovery that exposes another person is not scene safety.

Choose a vessel state that makes trained care and rescue access safer without creating a new navigational emergency. The action might involve reducing speed, changing sail, stopping machinery, anchoring, steering for shelter or requesting assistance, but the correct choice depends on the boat, water, traffic, weather and competent boat handling. The lesson supplies the decision questions, not one universal manoeuvre.

Use gloves or another suitable barrier when available for body-fluid exposure, but do not turn barrier use into a reason to withhold immediately life-saving care. Move a casualty only when staying creates greater danger, immediate airway or breathing care requires it, or current training and professional advice support the move. A blanket 'never move' rule can be as unsafe as dragging everyone below.

Worked example

A crew member is injured beside a loaded sheet in a pitching cockpit. The engine is running and the companionway is the only route for equipment and later evacuation.

1Assign helm/lookout and control the sail, line and propulsion state using competent boat handling; keep another person out of the loaded-line zone.
2Create a treatment and access area without dragging the casualty through the companionway solely for comfort or privacy.
3Use a barrier if available, begin the trained check and tell the communicator which hazard remains and how rescuers can approach.

Sense check: A quieter cabin is not safer if the move crosses a loaded line, blocks access or delays an immediate life-saving check.

Scene Safety on a Moving Boat
Hazard class	Control question	Residual risk to report
Boat movement	Who has helm/lookout and what state supports care?	Traffic, sea room, heel, impact or loss of access
Energy	Can machinery, electricity, heat or pressure be isolated safely?	Unproved isolation or equipment needed for vessel safety
Environment	Can water, cold, fumes, fire or chemical exposure be reduced?	Continuing exposure or unsafe rescue route
Body fluids/movement	What barrier and movement boundary apply now?	Exposure, airway need, trauma concern or blocked evacuation

Build a live scene-safety sentence

The communicator needs one useful update while the first aider begins assessment.

1. Hazard
Name the exact moving, energy, exposure or access hazard.
2. Control
Name who controls it and the vessel state selected.
3. Limit
State what could not be isolated or moved safely.
4. Access
State the treatment position and rescue approach.

Sense check: 'Scene safe' is too broad unless the crew can state which risks are controlled and which remain.

Common mistake or limitation

Declaring the scene safe once and not reassessing weather, traffic, vessel motion or energy.
Moving the casualty below automatically, without balancing airway, trauma and access needs.
Attempting an isolation, water recovery or treatment position that creates a second casualty.

Recap

Scene safety changes with the boat and must be reassessed.
Vessel control and treatment access are clinical-support decisions, not background chores.
Movement and barrier rules are conditional, not absolutes.

Optional quick check

Section 2 of 8

An injured casualty is beside a loaded line, but moving below would cross the same danger and delay the trained check. What comes first?

Previous Continue

Lesson 3 of 8

First Aid Kit Readiness

What you will learn

Evaluate whether the onboard first-aid equipment is accessible, maintained, risk-appropriate and usable by the trained people aboard.

A kit is a capability chain, not a sealed box. Setting and voyage risk select the contents; access, packaging, expiry, instructions, user competence and replacement determine whether the kit can support care.

Start with the people, boat and trip: crew medical needs disclosed appropriately, voyage duration and remoteness, likely work and hazards, operating area, evacuation delay, water and weather exposure, and any commercial or coded-vessel requirement. Resuscitation Council UK says kit contents should reflect the setting, expected risks and users; the RYA syllabus adds safe storage, expiry and suitable boat-specific selection.

Separate legal or coded-vessel medical-store requirements from a private leisure-vessel kit. Category C stores, medicines and record duties are not a shopping recommendation for every boat. Equipment and medicines are used only within current training, permission and applicable guidance, or when an emergency service directs their use. Personal prescription medicine remains assigned to the person and plan for whom it was supplied.

Test the chain: can a crew member name the location, reach it when lockers shift or the cabin is wet, open it, recognise the item, see intact packaging and expiry, use it safely, and record/replenish it afterward? Split daily-use items from incident supplies when that prevents critical stock being consumed unnoticed, and keep the inventory and emergency record material usable in the expected environment.

Worked example

A commercially packaged kit is sealed beneath a berth. It has not been inventoried, the crew do not know whether voyage-specific items are present, and one person carries prescribed emergency medication elsewhere.

1Reject 'sealed' as readiness evidence. Compare the inventory with the people, trip, expected risks and any applicable vessel requirement.
2Move or label the kit so it remains reachable, check packaging and expiry, and record the personal medication location and ownership without treating it as communal stock.
3Brief the crew on access, trained-use limits, emergency contact material and who will replace anything used or expired.

Sense check: A kit can be complete on paper and still fail because it is inaccessible, unknown, expired or outside the user's competence.

First Aid Kit Readiness
Readiness gate	Evidence	Failure hidden by a sealed kit
Risk and requirement	Crew/trip risk assessment and applicable leisure/commercial standard	Generic contents do not match the boat or voyage
Access	Known, labelled, reachable and openable in the expected vessel state	Kit is trapped behind gear or unknown to crew
Condition	Inventory, intact packaging, expiry and environment checked	Missing, wet, opened or expired items
Use and recovery	Trained user, instructions, record and replacement owner	Equipment exists but cannot be used or replenished safely

Audit one kit as a capability chain

Use a fictional voyage and crew rather than prescribing a universal contents list.

1. Need
State users, setting, trip risk and applicable vessel requirement.
2. Reach
State location, access test, label and backup in the expected vessel state.
3. Use
State trained people, intact/expiry evidence and instructions.
4. Recover
State record, quarantine and replacement after use or damage.

Sense check: Do not add medicine or specialist equipment solely because it appears on another boat's list.

Common mistake or limitation

Treating a sealed commercial kit as proof of suitable contents and condition.
Copying Category C or another voyage's contents without checking the applicable requirement and competence.
Briefing the location but not testing access, packaging, expiry, records and replenishment.

Recap

The kit is selected for the real people, setting, risks and rules.
Access, condition, competent use and replacement are independent gates.
Possessing medicine or equipment does not authorise its use.

Optional quick check

Section 3 of 8

A sealed kit is aboard, but nobody has checked its inventory, expiry or access under way. What is proved?

Previous Continue

Lesson 4 of 8

Crew Roles and Escalation

What you will learn

Allocate a workable emergency team and escalate from observed urgency without waiting for diagnostic certainty or exhausted onboard options.

Afloat medical response has four functions even when only one or two people are available: control the vessel, lead trained casualty care, communicate with help and maintain lookout, record and access.

Allocate functions, not impressive titles. The vessel controller keeps helm, navigation, traffic, propulsion or sail state and rescue access safe. The first-aid lead performs only current trained assessment and care. The communicator makes contact, relays exact questions and instructions and protects the position source. A fourth person can keep the time line, equipment, lookout and rendezvous path; with fewer crew, combine functions explicitly and state which task is temporarily paused.

Escalate from observable condition, change, location and capability. Unresponsiveness, abnormal breathing, life-threatening bleeding, serious mechanism, severe symptoms, deterioration, remoteness or care beyond onboard competence are reasons for early professional contact. Do not wait to name the illness or use every item aboard. The emergency service, HM Coastguard or telemedical provider helps select the response and evacuation plan.

Use the current emergency route and radio procedure for the position. At sea, HM Coastguard guidance points to GMDSS distress or urgency contact; on the coast call 999 and ask for the Coastguard. The exact use of DSC, Mayday, urgency traffic or phone belongs to the real urgency, equipment and current SRC training. State facts truthfully and follow the operator rather than trying to force the incident into a memorised phrase.

Worked example

Two people remain able after a serious incident. One is the more competent helmsman; the other has current first-aid training. The casualty is worsening and the boat is near traffic.

1The helmsman controls the boat and begins the Coastguard contact on hands-free or radio, giving position and requesting guidance while maintaining lookout.
2The trained first aider checks and cares for the casualty, calls out findings and times, and pauses only when scene or boat control requires it.
3Both agree the rendezvous/fallback and keep one running record; they do not delay contact because a dedicated communicator is unavailable.

Sense check: The four functions still exist with two people; deliberate combination is safer than pretending each person can do everything continuously.

Crew Roles and Escalation
Function	Minimum responsibility	Overload signal
Vessel control	Helm, traffic, sea room, machinery/sails and approach	Nobody can state the vessel plan or hazard
First-aid lead	Structured check and trained care	Care stops whenever equipment or radio work is needed
Communicator	Position, facts, questions, instructions and updates	Messages are delayed, guessed or detached from the casualty
Record/access	Times, observations, kit, lookout and rescue route	Changes, equipment or approach constraints are lost

Allocate roles for the crew actually aboard

Choose a one-, two- or four-rescuer fictional case and state the overload controls.

1. Control
Assign the vessel and scene-safety function.
2. Care
Assign the person with current relevant training.
3. Contact
Assign position, emergency route and instruction relay.
4. Combine
State which functions combine and what triggers more help or a changed vessel plan.

Sense check: If nobody can keep the vessel safe while care continues, that limitation belongs in the emergency call immediately.

Common mistake or limitation

Assigning everyone to the casualty and leaving helm, lookout or traffic unmanaged.
Waiting for a diagnosis or failed treatment before professional contact.
Using a rehearsed radio category while omitting the casualty's actual condition and change.

Recap

Four response functions exist even when the crew is smaller than four.
Observable urgency, deterioration and limits justify early escalation.
The communicator keeps position, condition, vessel plan and professional instructions aligned.

Optional quick check

Section 4 of 8

Only two capable crew remain and the casualty is deteriorating. What is the strongest response?

Previous Continue

Lesson 5 of 8

Use a Structured Casualty Survey

What you will learn

Use a repeatable trained assessment to recognise immediate threats and changes without turning observations into an unsupported diagnosis.

A structured survey reduces omissions under pressure. Scene safety, responsiveness and life-threatening bleeding receive immediate attention, followed by the current ABCDE sequence from practical training and repeated comparison after change or care.

Resuscitation Council UK 2025 guidance identifies scene safety, decreased responsiveness, abnormal breathing and life-threatening conditions as first-aid priorities, and uses ABCDE to structure assessment. The letters support memory: Airway, Breathing, Circulation, Disability and Exposure. They do not teach how to perform each check or treatment; those psychomotor and judgement skills require current practical training and emergency-service guidance.

State what you can actually observe: response to voice or touch when safe, normal or abnormal breathing description, visible severe bleeding, skin or behaviour change, symptoms in the casualty's own words, mechanism and exposure. Do not infer a normal airway from speech heard earlier, declare shock from one vague sign or manufacture a pulse, saturation or blood pressure that was not measured reliably.

Repeat the same sequence after movement, treatment, a new symptom or an operator instruction. Comparison is the value: 'now less responsive than at 10:14' is more useful than 'looks worse'. Uncertainty plus deterioration is evidence to escalate. Any critical finding, deterioration or assessment beyond competence is a call/update gate, not a reason to keep examining until certainty appears.

Worked example

After a fall, a casualty initially answers clearly. Four minutes later they answer slowly and repeat a question. No reliable instrument observations are available.

1Record the two observed response states and times; do not label a concussion or exclude other serious injury.
2Repeat the trained structured survey, control unnecessary movement and update professional help with the changed responsiveness and mechanism.
3Continue monitoring and record advice, care and further change while the vessel prepares the agreed access or rendezvous.

Sense check: A specific change in response is actionable evidence even when the crew cannot diagnose its cause.

Use a Structured Casualty Survey
Survey stage	Reportable observation	Claim it cannot support alone
Response	Exact response to voice/touch and any change	Cause of reduced response
Breathing	Normal/abnormal description and change	A named lung or heart diagnosis
Circulation/bleeding	Visible bleeding, colour, temperature and trained observations	A precise blood-loss or shock diagnosis
Disability/exposure	Behaviour, symptoms, mechanism, environment and visible injury	Clearance from head, spine or internal injury

Convert an impression into observations

A crew member says the casualty 'looks bad' after a sudden illness.

1. Quote
Record the casualty's own words or exact response.
2. Observe
State breathing, visible bleeding, behaviour and environment as actually seen.
3. Compare
State what changed from the previous timed check.
4. Escalate
Name the finding or uncertainty being reported, not a diagnosis.

Sense check: If the statement cannot be traced to an observation, reliable measurement or casualty report, label it as uncertainty.

Common mistake or limitation

Reciting ABCDE without carrying out the trained checks or comparing change.
Using one reassuring sign to dismiss an independent critical warning.
Delaying contact while trying to complete a diagnosis beyond first-aid competence.

Recap

Structure prevents omissions; it does not grant practical competence.
Specific timed observations are stronger than labels such as stable or worse.
Critical findings and deterioration trigger help and reassessment.

Optional quick check

Section 5 of 8

A casualty answers more slowly than four minutes earlier after a fall. What is the strongest report?

Previous Continue

Lesson 6 of 8

Make the Emergency Call and Rendezvous Plan

What you will learn

Start the effective Coastguard or emergency contact early and keep position, casualty facts, vessel plan and rescue access current.

The call is part of care, not an administrative step after treatment. Give position and observable urgency early, answer questions, follow instructions and update both casualty and vessel changes.

Select the effective route for where the boat is. HM Coastguard's current guidance says that an emergency at sea should use GMDSS distress or urgency contact, while a coastal emergency can use 999 and ask for the Coastguard. MGN 623 says HM Coastguard is the first contact for UK Telemedical Advice Service access. Equipment, coverage, urgency and current SRC training decide whether the live route is DSC/VHF, other GMDSS equipment or telephone; this lesson does not substitute for radio certification or a live operator.

Lead with what helps response: reliable position and time, vessel identity and contact route, what happened, casualty count, current observable condition and change, trained care already given, immediate hazards, vessel capability and the assistance or advice being requested. Keep charts, GNSS source and communicator aligned; a position copied once can age while the boat moves.

Build the rendezvous as part of the call. State course, speed, sea room, harbour or landing options, weather/sea limits, access to the casualty and any obstruction to lifeboat, shore team or helicopter work. Do not independently commit to a transfer or high-risk manoeuvre that professional coordinators have not agreed. Update whenever condition, position, communication route or vessel plan changes.

Worked example

A casualty has severe chest symptoms ten miles offshore. The boat can make sheltered water but the casualty is worsening and the crew are unsure whether continuing is safe.

1Contact HM Coastguard early through the effective trained route, give reliable position, observed symptoms/change, crew capability and care already given without diagnosing the cause.
2Answer the operator and telemedical questions, agree the immediate vessel and rendezvous plan, and record the instruction and time.
3Update promptly if the casualty, weather, position, propulsion or access changes; do not continue towards shelter solely because it was the first idea.

Sense check: Early contact preserves options. The Coastguard and medical adviser need the real condition and vessel limits, not the crew's preferred diagnosis or destination.

Make the Emergency Call and Rendezvous Plan
Call element	Useful content	Failure mode
Where	Position source/time, movement, vessel identity and contact	Stale or unverified position
What	Mechanism/illness, observed condition, change and casualty count	Guessed diagnosis or vague 'medical issue'
Care and limits	Trained care, response, hazards and crew/vessel capability	Claiming treatment or measurements not performed
Next	Advice/assistance requested, route, access and update trigger	Ending contact without a shared plan

Build a 30-second factual call brief

The radio operator must be ready before transmitting and able to answer follow-up questions.

1. Position
State source, time, movement and vessel identity.
2. Casualty
State event, count, observed condition and timed change.
3. Action
State trained care, advice already received and immediate hazards.
4. Need
State help/advice requested, vessel limits and access options.

Sense check: If the position or condition has changed since the brief was written, update it before relying on the script.

Common mistake or limitation

Waiting for diagnostic certainty or exhausted onboard care before contact.
Giving a stale position, guessed cause or treatment that was planned but not delivered.
Agreeing a rendezvous without stating vessel handling, weather, access and casualty constraints.

Recap

Contact starts early and uses the effective route for the position.
Facts, changes and limits drive coordination better than diagnosis labels.
The shared plan remains live until handover or the emergency service releases it.

Optional quick check

Section 6 of 8

A casualty is worsening offshore and the cause is uncertain. What should the communicator do?

Previous Continue

Lesson 7 of 8

Monitor, Record and Hand Over

What you will learn

Build an accurate time line of observed condition, care, advice and change that another responder can use without reconstructing the incident from memory.

Monitoring is repeated comparison. A useful record separates what happened, what was observed, what was done, what followed and what remains uncertain.

Start the record when the incident is recognised, not at the end. Use a stable clock and write event/mechanism, response, breathing description, visible bleeding, symptoms in the casualty's words, relevant known history offered, trained observations, care, equipment or medicine actually used, professional instructions, vessel position/plan and each change. Record uncertainty openly; a blank or 'not measured' is safer than an invented value.

Repeat the same relevant observations after care, movement, deterioration or an operator instruction. The fictional record 'found at 10:14, emergency contact at 10:16, less responsive at 10:18' contains a four-minute observed time span: 10:18 − 10:14 = 4 minutes. That arithmetic organises the sequence; it is not a treatment interval, response standard or permission to wait four minutes.

Handover should let the receiving person continue, not restart, the reasoning. Give identity where appropriate, event/mechanism, current observed state, important time line, care and response, allergies/medicines/history only when reliably known, professional advice, vessel/access facts and unresolved uncertainty. Protect privacy, but do not withhold safety-critical information from the authorised responders coordinating care.

Worked example

The record shows: 10:14 found responsive but confused after a fall; 10:16 Coastguard contact begun; 10:18 answers slower; no instrument observations taken.

1Calculate only the record span: 10:18 − 10:14 = 4 minutes. Do not convert it into an acceptable observation interval.
2Update help with the exact response change and mechanism, repeat the trained survey and write the advice and care actually delivered.
3Hand over both negative and uncertain evidence: no reliable instrument measurements, cause not diagnosed and any movement or access constraint.

Sense check: The record is valuable because another responder can distinguish facts, changes, actions and unknowns.

Monitor, Record and Hand Over
Record field	Good evidence	Unsafe wording
Event and time	Observed mechanism/event and clock source	'A while ago' or reconstructed guess
Condition	Response, breathing, bleeding, symptoms and reliable measurements	Diagnosis or invented normal values
Care and response	Exact action/item/time and what changed afterward	Planned care recorded as completed
Advice and plan	Source, instruction, position/access and open uncertainty	'Coastguard informed' without the agreed next step

Turn one line into a handover

The note currently says only 'fell, treated, worse'.

1. Event
Add the observed mechanism, place and time source.
2. State
Add the comparable response, breathing, bleeding and symptoms.
3. Action
Add exact trained care, advice and the response that followed.
4. Open
Add current position/access and every material uncertainty.

Sense check: A receiving responder should not have to ask whether a treatment was delivered, merely considered or only recommended.

Common mistake or limitation

Waiting until the end and reconstructing times from memory.
Recording planned care or guessed measurements as completed facts.
Handing over a diagnosis label without mechanism, observed change, treatment response or uncertainty.

Recap

A time line makes deterioration and treatment response visible.
Unknown and unmeasured are legitimate record states.
A good handover preserves continuity of care and the rescue plan.

Optional quick check

Section 7 of 8

A four-minute record shows worsening response, but no reliable measurements. What belongs in handover?

Previous Continue

Lesson 8 of 8

Close the Incident and Preserve Readiness

What you will learn

Close records, equipment, crew support and training gaps after handover without treating a successful outcome as proof of future competence.

The response does not end when the casualty leaves the boat. Records, privacy, used equipment, vessel hazards, responder wellbeing and unresolved competence gaps need deliberate closure.

Complete the authorised incident and vessel records while events are fresh, preserve relevant times and professional instructions and handle personal medical information only for legitimate care, reporting and safety needs. Follow the applicable accident, commercial-vessel, medicine and controlled-drug recording duties; this revision cannot determine the legal record for every vessel and operation.

Quarantine, clean, dispose of or replace used, contaminated, opened, wet or expired kit items through the appropriate process. Restore access, labels and crew briefing before relying on the kit again. One unused dressing cannot average away a missing barrier, empty critical compartment or an equipment item that nobody is trained to use.

Debrief the coordination without assigning clinical blame: what was observed, what protected people, where workload or communication failed, which source or skill was missing and what practical refresh is needed. Resuscitation Council UK specifically asks courses to help responders manage fear, anxiety and moral distress during and after first aid. A correct quiz answer or a favourable outcome does not certify practical performance; arrange recognised training and human support where required.

Worked example

A casualty has been transferred safely. The emergency dressing compartment is partly empty, a rail was damaged during access and one crew member is distressed and believes they failed because they froze briefly.

1Complete the required factual record and preserve professional instructions and privacy; do not rewrite uncertainty as certainty because the outcome was favourable.
2Mark the kit and damaged rail unavailable, assign replacement/repair and prevent departure reliance until the relevant gates close.
3Run a supportive debrief, identify workload and practical-training needs and offer appropriate human support rather than treating distress as incompetence.

Sense check: Successful transfer closes the casualty handover, not every equipment, vessel, record or wellbeing gate.

Close the Incident and Preserve Readiness
Closure area	Evidence of closure	Still open
Record	Required log/report complete and information handled appropriately	Missing times, treatment detail or reporting route
Equipment	Used items quarantined/replaced and access restored	Empty, contaminated, expired or untrained capability
Vessel	Emergency changes reversed and hazards repaired or isolated	Damaged gear, blocked access or unsafe operating state
People/learning	Support offered and practical training gap assigned	Distress, overload or skill gap normalised by a good outcome

Write four closure owners

The boat may be asked to sail again before the next crew change.

1. Record
Assign the applicable report/log and privacy check.
2. Kit
Assign quarantine, replacement, expiry and access restoration.
3. Boat
Assign damage, emergency configuration and departure limits.
4. People
Assign debrief, support and recognised skill refresh.

Sense check: No closure item disappears because it is less visible than the casualty transfer.

Common mistake or limitation

Treating the casualty handover as closure of equipment, vessel and reporting duties.
Using a favourable outcome or quiz score as proof of practical competence.
Debriefing blame while ignoring workload, communication design and responder distress.

Recap

Closure covers record, equipment, vessel and people.
One open safety or capability gate prevents readiness by majority vote.
Practical training and responder support remain outside self-guided revision.

Optional quick check

Section 8 of 8

After a successful transfer, the kit is depleted and a crew member is distressed. What is complete?

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Lesson previewAfloat First-Aid Priorities1 section shown

Preview lesson

Afloat First-Aid Priorities

What you will learn

Coordinate immediate casualty care, vessel safety and outside help without waiting for one person to finish every task in sequence.

First aid afloat is a parallel response: protect people, check the casualty, call early, give trained care, monitor change and prepare a factual handover while somebody continues to control the boat.

Afloat emergency response board

Keep casualty care, boat control and outside help moving together

Select a situation and rehearse the coordination decisions around the practical first-aid skill. Every stage is written in text and does not depend on colour.

1Protect
2Check
3Call
4Care
5Monitor
6Handover

The stages overlap. A time-critical call can begin while a trained first aider checks and cares for the casualty, provided another person keeps the vessel safe.

1 · Protect

2 · Check

3 · Call

4 · Care

5 · Monitor

Record the time found, response, breathing description, actions, operator instructions and every change. Recheck after movement, treatment or any deterioration.

6 · Handover

State what happened, the known time line, observed condition, care given, response to care and any unresolved hazard. Do not add a guessed diagnosis.

Choose a situation and rehearse how casualty care, boat control, communication and handover stay coordinated.

Worked example

A three-person crew is sailing in traffic when one person collapses in the cockpit. The boat is still making way and the cause is unknown.

1Crew one takes helm and lookout, reduces immediate vessel risk and states the safe treatment area; they do not crowd the casualty.
2Crew two checks the casualty using current training and begins only the care supported by the observed condition and emergency instructions.
3Crew three starts the effective emergency contact, gives position and observed condition, records times and relays questions without inventing a diagnosis.

Sense check: The tasks overlap: boat control does not wait for assessment, and the emergency call does not wait for a complete diagnosis.

Afloat First-Aid Priorities
Response strand	Evidence question	Unsafe shortcut
Protect	What can still harm the casualty, rescuer or boat?	Starting treatment while nobody controls a moving hazard
Check	What do response, breathing and life-threatening signs show now?	Naming a diagnosis before checking immediate threats
Call and care	Can help and trained care begin in parallel?	Waiting for all onboard options to fail before contact
Monitor and handover	What changed, when, after which action?	Relying on memory or reporting only the latest state

Speak the first six commands

A crew member must organise the first minute without knowing the final diagnosis.

1. Protect
Name the immediate vessel and scene control.
2. Check
Name the trained casualty check and critical finding to report.
3. Call
Assign contact, position source and communications route.
4. Continue
Assign care, monitoring, record and access preparation.

Sense check: Every command has one owner; no task assumes that an untrained person can diagnose or perform a physical skill they have not learned.

Common mistake or limitation

Treating boat control as background work rather than part of the emergency response.
Waiting for one person to complete assessment before anybody calls or prepares access.
Using a remembered acronym as permission to deliver untrained treatment.

Recap

Protect, Check, Call, Care, Monitor and Handover are parallel response strands.
Observed condition and urgency matter more than a guessed diagnosis.
Revision supports coordination; recognised practical training supplies the physical skills.

Optional quick check

Section 1 of 1

A casualty collapses while a three-person boat is still moving in traffic. What is the strongest first organisation?

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Lesson routeAfloat First-Aid Priorities0/8 read

Lesson 1 of 8

Afloat First-Aid Priorities

What you will learn

Coordinate immediate casualty care, vessel safety and outside help without waiting for one person to finish every task in sequence.

First aid afloat is a parallel response: protect people, check the casualty, call early, give trained care, monitor change and prepare a factual handover while somebody continues to control the boat.

Afloat emergency response board

Keep casualty care, boat control and outside help moving together

Select a situation and rehearse the coordination decisions around the practical first-aid skill. Every stage is written in text and does not depend on colour.

1Protect
2Check
3Call
4Care
5Monitor
6Handover

The stages overlap. A time-critical call can begin while a trained first aider checks and cares for the casualty, provided another person keeps the vessel safe.

1 · Protect

2 · Check

3 · Call

4 · Care

5 · Monitor

Record the time found, response, breathing description, actions, operator instructions and every change. Recheck after movement, treatment or any deterioration.

6 · Handover

State what happened, the known time line, observed condition, care given, response to care and any unresolved hazard. Do not add a guessed diagnosis.

Choose a situation and rehearse how casualty care, boat control, communication and handover stay coordinated.

Worked example

A three-person crew is sailing in traffic when one person collapses in the cockpit. The boat is still making way and the cause is unknown.

1Crew one takes helm and lookout, reduces immediate vessel risk and states the safe treatment area; they do not crowd the casualty.
2Crew two checks the casualty using current training and begins only the care supported by the observed condition and emergency instructions.
3Crew three starts the effective emergency contact, gives position and observed condition, records times and relays questions without inventing a diagnosis.

Sense check: The tasks overlap: boat control does not wait for assessment, and the emergency call does not wait for a complete diagnosis.

Afloat First-Aid Priorities
Response strand	Evidence question	Unsafe shortcut
Protect	What can still harm the casualty, rescuer or boat?	Starting treatment while nobody controls a moving hazard
Check	What do response, breathing and life-threatening signs show now?	Naming a diagnosis before checking immediate threats
Call and care	Can help and trained care begin in parallel?	Waiting for all onboard options to fail before contact
Monitor and handover	What changed, when, after which action?	Relying on memory or reporting only the latest state

Speak the first six commands

A crew member must organise the first minute without knowing the final diagnosis.

1. Protect
Name the immediate vessel and scene control.
2. Check
Name the trained casualty check and critical finding to report.
3. Call
Assign contact, position source and communications route.
4. Continue
Assign care, monitoring, record and access preparation.

Sense check: Every command has one owner; no task assumes that an untrained person can diagnose or perform a physical skill they have not learned.

Common mistake or limitation

Treating boat control as background work rather than part of the emergency response.
Waiting for one person to complete assessment before anybody calls or prepares access.
Using a remembered acronym as permission to deliver untrained treatment.

Recap

Protect, Check, Call, Care, Monitor and Handover are parallel response strands.
Observed condition and urgency matter more than a guessed diagnosis.
Revision supports coordination; recognised practical training supplies the physical skills.

Optional quick check

Section 1 of 8

A casualty collapses while a three-person boat is still moving in traffic. What is the strongest first organisation?

Continue

Lesson 2 of 8

Scene Safety on a Moving Boat

What you will learn

Identify and control the immediate afloat hazards that can injure the casualty, rescuer or remaining crew during care.

Worked example

A crew member is injured beside a loaded sheet in a pitching cockpit. The engine is running and the companionway is the only route for equipment and later evacuation.

1Assign helm/lookout and control the sail, line and propulsion state using competent boat handling; keep another person out of the loaded-line zone.
2Create a treatment and access area without dragging the casualty through the companionway solely for comfort or privacy.
3Use a barrier if available, begin the trained check and tell the communicator which hazard remains and how rescuers can approach.

Sense check: A quieter cabin is not safer if the move crosses a loaded line, blocks access or delays an immediate life-saving check.

Scene Safety on a Moving Boat
Hazard class	Control question	Residual risk to report
Boat movement	Who has helm/lookout and what state supports care?	Traffic, sea room, heel, impact or loss of access
Energy	Can machinery, electricity, heat or pressure be isolated safely?	Unproved isolation or equipment needed for vessel safety
Environment	Can water, cold, fumes, fire or chemical exposure be reduced?	Continuing exposure or unsafe rescue route
Body fluids/movement	What barrier and movement boundary apply now?	Exposure, airway need, trauma concern or blocked evacuation

Build a live scene-safety sentence

The communicator needs one useful update while the first aider begins assessment.

1. Hazard
Name the exact moving, energy, exposure or access hazard.
2. Control
Name who controls it and the vessel state selected.
3. Limit
State what could not be isolated or moved safely.
4. Access
State the treatment position and rescue approach.

Sense check: 'Scene safe' is too broad unless the crew can state which risks are controlled and which remain.

Common mistake or limitation

Declaring the scene safe once and not reassessing weather, traffic, vessel motion or energy.
Moving the casualty below automatically, without balancing airway, trauma and access needs.
Attempting an isolation, water recovery or treatment position that creates a second casualty.

Recap

Scene safety changes with the boat and must be reassessed.
Vessel control and treatment access are clinical-support decisions, not background chores.
Movement and barrier rules are conditional, not absolutes.

Optional quick check

Section 2 of 8

An injured casualty is beside a loaded line, but moving below would cross the same danger and delay the trained check. What comes first?

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Lesson 3 of 8

First Aid Kit Readiness

What you will learn

Evaluate whether the onboard first-aid equipment is accessible, maintained, risk-appropriate and usable by the trained people aboard.

Worked example

1Reject 'sealed' as readiness evidence. Compare the inventory with the people, trip, expected risks and any applicable vessel requirement.
2Move or label the kit so it remains reachable, check packaging and expiry, and record the personal medication location and ownership without treating it as communal stock.
3Brief the crew on access, trained-use limits, emergency contact material and who will replace anything used or expired.

Sense check: A kit can be complete on paper and still fail because it is inaccessible, unknown, expired or outside the user's competence.

First Aid Kit Readiness
Readiness gate	Evidence	Failure hidden by a sealed kit
Risk and requirement	Crew/trip risk assessment and applicable leisure/commercial standard	Generic contents do not match the boat or voyage
Access	Known, labelled, reachable and openable in the expected vessel state	Kit is trapped behind gear or unknown to crew
Condition	Inventory, intact packaging, expiry and environment checked	Missing, wet, opened or expired items
Use and recovery	Trained user, instructions, record and replacement owner	Equipment exists but cannot be used or replenished safely

Audit one kit as a capability chain

Use a fictional voyage and crew rather than prescribing a universal contents list.

1. Need
State users, setting, trip risk and applicable vessel requirement.
2. Reach
State location, access test, label and backup in the expected vessel state.
3. Use
State trained people, intact/expiry evidence and instructions.
4. Recover
State record, quarantine and replacement after use or damage.

Sense check: Do not add medicine or specialist equipment solely because it appears on another boat's list.

Common mistake or limitation

Treating a sealed commercial kit as proof of suitable contents and condition.
Copying Category C or another voyage's contents without checking the applicable requirement and competence.
Briefing the location but not testing access, packaging, expiry, records and replenishment.

Recap

The kit is selected for the real people, setting, risks and rules.
Access, condition, competent use and replacement are independent gates.
Possessing medicine or equipment does not authorise its use.

Optional quick check

Section 3 of 8

A sealed kit is aboard, but nobody has checked its inventory, expiry or access under way. What is proved?

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Lesson 4 of 8

Crew Roles and Escalation

What you will learn

Allocate a workable emergency team and escalate from observed urgency without waiting for diagnostic certainty or exhausted onboard options.

Worked example

Two people remain able after a serious incident. One is the more competent helmsman; the other has current first-aid training. The casualty is worsening and the boat is near traffic.

1The helmsman controls the boat and begins the Coastguard contact on hands-free or radio, giving position and requesting guidance while maintaining lookout.
2The trained first aider checks and cares for the casualty, calls out findings and times, and pauses only when scene or boat control requires it.
3Both agree the rendezvous/fallback and keep one running record; they do not delay contact because a dedicated communicator is unavailable.

Sense check: The four functions still exist with two people; deliberate combination is safer than pretending each person can do everything continuously.

Crew Roles and Escalation
Function	Minimum responsibility	Overload signal
Vessel control	Helm, traffic, sea room, machinery/sails and approach	Nobody can state the vessel plan or hazard
First-aid lead	Structured check and trained care	Care stops whenever equipment or radio work is needed
Communicator	Position, facts, questions, instructions and updates	Messages are delayed, guessed or detached from the casualty
Record/access	Times, observations, kit, lookout and rescue route	Changes, equipment or approach constraints are lost

Allocate roles for the crew actually aboard

Choose a one-, two- or four-rescuer fictional case and state the overload controls.

1. Control
Assign the vessel and scene-safety function.
2. Care
Assign the person with current relevant training.
3. Contact
Assign position, emergency route and instruction relay.
4. Combine
State which functions combine and what triggers more help or a changed vessel plan.

Sense check: If nobody can keep the vessel safe while care continues, that limitation belongs in the emergency call immediately.

Common mistake or limitation

Assigning everyone to the casualty and leaving helm, lookout or traffic unmanaged.
Waiting for a diagnosis or failed treatment before professional contact.
Using a rehearsed radio category while omitting the casualty's actual condition and change.

Recap

Four response functions exist even when the crew is smaller than four.
Observable urgency, deterioration and limits justify early escalation.
The communicator keeps position, condition, vessel plan and professional instructions aligned.

Optional quick check

Section 4 of 8

Only two capable crew remain and the casualty is deteriorating. What is the strongest response?

Previous Continue

Lesson 5 of 8

Use a Structured Casualty Survey

What you will learn

Use a repeatable trained assessment to recognise immediate threats and changes without turning observations into an unsupported diagnosis.

Worked example

After a fall, a casualty initially answers clearly. Four minutes later they answer slowly and repeat a question. No reliable instrument observations are available.

1Record the two observed response states and times; do not label a concussion or exclude other serious injury.
2Repeat the trained structured survey, control unnecessary movement and update professional help with the changed responsiveness and mechanism.
3Continue monitoring and record advice, care and further change while the vessel prepares the agreed access or rendezvous.

Sense check: A specific change in response is actionable evidence even when the crew cannot diagnose its cause.

Use a Structured Casualty Survey
Survey stage	Reportable observation	Claim it cannot support alone
Response	Exact response to voice/touch and any change	Cause of reduced response
Breathing	Normal/abnormal description and change	A named lung or heart diagnosis
Circulation/bleeding	Visible bleeding, colour, temperature and trained observations	A precise blood-loss or shock diagnosis
Disability/exposure	Behaviour, symptoms, mechanism, environment and visible injury	Clearance from head, spine or internal injury

Convert an impression into observations

A crew member says the casualty 'looks bad' after a sudden illness.

1. Quote
Record the casualty's own words or exact response.
2. Observe
State breathing, visible bleeding, behaviour and environment as actually seen.
3. Compare
State what changed from the previous timed check.
4. Escalate
Name the finding or uncertainty being reported, not a diagnosis.

Sense check: If the statement cannot be traced to an observation, reliable measurement or casualty report, label it as uncertainty.

Common mistake or limitation

Reciting ABCDE without carrying out the trained checks or comparing change.
Using one reassuring sign to dismiss an independent critical warning.
Delaying contact while trying to complete a diagnosis beyond first-aid competence.

Recap

Structure prevents omissions; it does not grant practical competence.
Specific timed observations are stronger than labels such as stable or worse.
Critical findings and deterioration trigger help and reassessment.

Optional quick check

Section 5 of 8

A casualty answers more slowly than four minutes earlier after a fall. What is the strongest report?

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Lesson 6 of 8

Make the Emergency Call and Rendezvous Plan

What you will learn

Start the effective Coastguard or emergency contact early and keep position, casualty facts, vessel plan and rescue access current.

The call is part of care, not an administrative step after treatment. Give position and observable urgency early, answer questions, follow instructions and update both casualty and vessel changes.

Worked example

A casualty has severe chest symptoms ten miles offshore. The boat can make sheltered water but the casualty is worsening and the crew are unsure whether continuing is safe.

1Contact HM Coastguard early through the effective trained route, give reliable position, observed symptoms/change, crew capability and care already given without diagnosing the cause.
2Answer the operator and telemedical questions, agree the immediate vessel and rendezvous plan, and record the instruction and time.
3Update promptly if the casualty, weather, position, propulsion or access changes; do not continue towards shelter solely because it was the first idea.

Sense check: Early contact preserves options. The Coastguard and medical adviser need the real condition and vessel limits, not the crew's preferred diagnosis or destination.

Make the Emergency Call and Rendezvous Plan
Call element	Useful content	Failure mode
Where	Position source/time, movement, vessel identity and contact	Stale or unverified position
What	Mechanism/illness, observed condition, change and casualty count	Guessed diagnosis or vague 'medical issue'
Care and limits	Trained care, response, hazards and crew/vessel capability	Claiming treatment or measurements not performed
Next	Advice/assistance requested, route, access and update trigger	Ending contact without a shared plan

Build a 30-second factual call brief

The radio operator must be ready before transmitting and able to answer follow-up questions.

1. Position
State source, time, movement and vessel identity.
2. Casualty
State event, count, observed condition and timed change.
3. Action
State trained care, advice already received and immediate hazards.
4. Need
State help/advice requested, vessel limits and access options.

Sense check: If the position or condition has changed since the brief was written, update it before relying on the script.

Common mistake or limitation

Waiting for diagnostic certainty or exhausted onboard care before contact.
Giving a stale position, guessed cause or treatment that was planned but not delivered.
Agreeing a rendezvous without stating vessel handling, weather, access and casualty constraints.

Recap

Contact starts early and uses the effective route for the position.
Facts, changes and limits drive coordination better than diagnosis labels.
The shared plan remains live until handover or the emergency service releases it.

Optional quick check

Section 6 of 8

A casualty is worsening offshore and the cause is uncertain. What should the communicator do?

Previous Continue

Lesson 7 of 8

Monitor, Record and Hand Over

What you will learn

Build an accurate time line of observed condition, care, advice and change that another responder can use without reconstructing the incident from memory.

Monitoring is repeated comparison. A useful record separates what happened, what was observed, what was done, what followed and what remains uncertain.

Worked example

The record shows: 10:14 found responsive but confused after a fall; 10:16 Coastguard contact begun; 10:18 answers slower; no instrument observations taken.

1Calculate only the record span: 10:18 − 10:14 = 4 minutes. Do not convert it into an acceptable observation interval.
2Update help with the exact response change and mechanism, repeat the trained survey and write the advice and care actually delivered.
3Hand over both negative and uncertain evidence: no reliable instrument measurements, cause not diagnosed and any movement or access constraint.

Sense check: The record is valuable because another responder can distinguish facts, changes, actions and unknowns.

Monitor, Record and Hand Over
Record field	Good evidence	Unsafe wording
Event and time	Observed mechanism/event and clock source	'A while ago' or reconstructed guess
Condition	Response, breathing, bleeding, symptoms and reliable measurements	Diagnosis or invented normal values
Care and response	Exact action/item/time and what changed afterward	Planned care recorded as completed
Advice and plan	Source, instruction, position/access and open uncertainty	'Coastguard informed' without the agreed next step

Turn one line into a handover

The note currently says only 'fell, treated, worse'.

1. Event
Add the observed mechanism, place and time source.
2. State
Add the comparable response, breathing, bleeding and symptoms.
3. Action
Add exact trained care, advice and the response that followed.
4. Open
Add current position/access and every material uncertainty.

Sense check: A receiving responder should not have to ask whether a treatment was delivered, merely considered or only recommended.

Common mistake or limitation

Waiting until the end and reconstructing times from memory.
Recording planned care or guessed measurements as completed facts.
Handing over a diagnosis label without mechanism, observed change, treatment response or uncertainty.

Recap

A time line makes deterioration and treatment response visible.
Unknown and unmeasured are legitimate record states.
A good handover preserves continuity of care and the rescue plan.

Optional quick check

Section 7 of 8

A four-minute record shows worsening response, but no reliable measurements. What belongs in handover?

Previous Continue

Lesson 8 of 8

Close the Incident and Preserve Readiness

What you will learn

Close records, equipment, crew support and training gaps after handover without treating a successful outcome as proof of future competence.

The response does not end when the casualty leaves the boat. Records, privacy, used equipment, vessel hazards, responder wellbeing and unresolved competence gaps need deliberate closure.

Worked example

1Complete the required factual record and preserve professional instructions and privacy; do not rewrite uncertainty as certainty because the outcome was favourable.
2Mark the kit and damaged rail unavailable, assign replacement/repair and prevent departure reliance until the relevant gates close.
3Run a supportive debrief, identify workload and practical-training needs and offer appropriate human support rather than treating distress as incompetence.

Sense check: Successful transfer closes the casualty handover, not every equipment, vessel, record or wellbeing gate.

Close the Incident and Preserve Readiness
Closure area	Evidence of closure	Still open
Record	Required log/report complete and information handled appropriately	Missing times, treatment detail or reporting route
Equipment	Used items quarantined/replaced and access restored	Empty, contaminated, expired or untrained capability
Vessel	Emergency changes reversed and hazards repaired or isolated	Damaged gear, blocked access or unsafe operating state
People/learning	Support offered and practical training gap assigned	Distress, overload or skill gap normalised by a good outcome

Write four closure owners

The boat may be asked to sail again before the next crew change.

1. Record
Assign the applicable report/log and privacy check.
2. Kit
Assign quarantine, replacement, expiry and access restoration.
3. Boat
Assign damage, emergency configuration and departure limits.
4. People
Assign debrief, support and recognised skill refresh.

Sense check: No closure item disappears because it is less visible than the casualty transfer.

Common mistake or limitation

Treating the casualty handover as closure of equipment, vessel and reporting duties.
Using a favourable outcome or quiz score as proof of practical competence.
Debriefing blame while ignoring workload, communication design and responder distress.

Recap

Closure covers record, equipment, vessel and people.
One open safety or capability gate prevents readiness by majority vote.
Practical training and responder support remain outside self-guided revision.

Optional quick check

Section 8 of 8

After a successful transfer, the kit is depleted and a crew member is distressed. What is complete?

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