Question 1

A crew member develops severe toothache on a 5-day offshore passage. The pain is preventing them from keeping watch. What options does a skipper have?

Accepted Answer

Ibuprofen (anti-inflammatory) + paracetamol (analgesic) alternating every 4h provides good dental pain control; oil of cloves (eugenol) applied to the tooth is a traditional temporary measure; request medical advice via Ch 16; consider diverting to nearest port if crew safety is compromised Dental emergencies are surprisingly common offshore. Ibuprofen 400mg + paracetamol 1g alternating every 4h provides near-opiate-level analgesia for dental pain. Oil of cloves (eugenol) applied directly to the tooth/socket is an effective topical anaesthetic. Antibiotics treat dental infection but NOT pain — never substitute them for analgesia. If a crew member cannot maintain watch, it becomes a seamanship and safety issue requiring passage revision. Request medical advice via the Coastguard.

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.