Question 1

A crew member has an asthma attack at sea. They have their blue reliever inhaler. What is the correct management for a moderate attack?

Accepted Answer

Sit upright in fresh air; give 2–4 puffs of blue reliever (salbutamol) via spacer or direct; wait 15 minutes; if improved, continue and monitor; if not improved or worsening: give up to 10 puffs (one at a time, breathe each in); transmit Pan Pan if severe (cannot speak in sentences, SpO2 Mild-moderate asthma: sit upright, blue reliever inhaler (salbutamol) 2-4 puffs, reassess after 15 min. Moderate-severe: up to 10 puffs over 15 min. Signs of life-threatening attack: silent chest (no wheeze = no air movement), cyanosis, exhaustion, cannot speak. At this point: Mayday, position report, prepare for helicopter. Have the crew member's own asthma action plan — many asthmatic sailors carry prednisolone tablets for exactly this scenario.

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.