A crew member is struck on the head by the boom. They seem initially OK but 30 minutes later become drowsy and confused. What does this suggest and what action is required?

A. Normal concussion — rest and monitor; no further action needed unless they vomit

B. Seasickness brought on by the impact — give anti-emetics

C. Shock from the impact — lay flat and raise legs

D. A possible intracranial bleed (lucid interval) — this is a medical emergency requiring urgent evacuation; monitor airway and level of consciousness; transmit Pan Pan or Mayday and request medical advice via Coastguard

A. Severe hypothermia — perform CPR immediately regardless of pulse

B. Heat exhaustion — cool the casualty and give cold water

C. Mild to moderate hypothermia (core temp ~32–35°C) — remove wet clothing, insulate from wind and cold, warm with blankets and foil, give warm sweet drinks if conscious and no injury suspected, handle gently and do NOT rub limbs

D. Mild hypothermia — exercise to generate body heat

A. Start rescue breaths (5 initial breaths) immediately, then begin standard CPR (30 compressions : 2 breaths) — airway and breathing take priority as drowning is a hypoxic event

B. Place in recovery position and monitor — never start CPR on a drowning victim who may vomit

C. Clear the airway by holding the casualty upside down first

D. Start chest compressions only — do not give rescue breaths