Question 1

A wound sustained 2 days ago is now red, swollen, warm, and has yellow discharge. The crew member has a fever. What does this indicate and what is the response?

Accepted Answer

Wound infection — clean with saline, change dressing, give ibuprofen for inflammation; if antibiotics are carried on board (amoxicillin or flucloxacillin for skin infections), administer per the Ship Captain's Medical Guide dosing; request medical advice via Ch 16; monitor for spreading cellulitis or systemic infection (sepsis) Wound infection signs: erythema (redness), swelling, warmth, purulent discharge, fever — all present here. Early management: thorough cleaning, fresh dressings, pain management. Spreading cellulitis (red tracking lines, systemic fever >38.5°C, confusion) indicates possible sepsis — Mayday, divert urgently. The Ship Captain's Medical Guide (MCA) provides prescribing guidance for skippers of vessels required to carry medicines. Obtain the guide and medications appropriate to your passage.

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.