Question 1

A crew member dislocates their shoulder after a crash gybe. They are in severe pain and the arm hangs at an abnormal angle. What is the correct management at sea?

Accepted Answer

Do NOT attempt to relocate the shoulder — immobilise in the position found using a broad arm sling; give pain relief (ibuprofen + paracetamol if no contraindications); seek medical advice via Ch 16; divert to port for reduction under medical supervision Shoulder dislocation at sea: DO NOT attempt reduction unless specifically trained and conditions allow — uncontrolled reduction can damage nerves, blood vessels, and the rotator cuff. Immobilise in position of comfort (usually a broad arm sling with the arm across the chest). Pain management is important — ibuprofen and paracetamol at appropriate doses. Divert to port. Medical reduction under sedation is safer and less traumatic.

Question 2

A crew member recovered from cold water is shivering violently, confused, and pale. What stage of hypothermia is this and what is the correct treatment?

Accepted Answer

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 Shivering with confusion = mild-moderate hypothermia. Treatment: protect from environment; remove wet clothing (avoid vigorous movement — cold blood from extremities flushing to core can cause cardiac arrest); insulate; warm externally; do NOT rub limbs; give warm fluids only if conscious and uninjured. Severe hypothermia (rigid, no shivering) — treat as cardiac arrest, CPR may be needed.

Question 3

A near-drowning casualty has been recovered from the water. They are unconscious and not breathing. What is the immediate priority?

Accepted Answer

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 Drowning is a hypoxic (oxygen deprivation) emergency. Unlike cardiac arrest in adults, rescue breaths are critical — give 5 initial rescue breaths, then 30:2 CPR. Continue until breathing resumes or help arrives. If on a vessel with no AED, focus on quality CPR with rescue breaths. Do NOT attempt to drain water from the lungs — it delays oxygenation and is ineffective.