Question 1

A crew member struck the winch barrel hard on the chest during a gybe. They are now breathless, with reduced breath sounds on one side, distended neck veins, and rapidly declining consciousness. What do you suspect?

Accepted Answer

Tension pneumothorax — air accumulating in the pleural space is compressing the heart and great vessels. This is immediately life-threatening. Transmit Mayday immediately and request emergency helicopter evacuation — definitive treatment (needle decompression) is beyond first aid scope without training Tension pneumothorax: the classic triad is tracheal deviation (away from affected side), absent breath sounds on one side, and raised JVP (neck veins). It progresses to cardiovascular collapse rapidly. This is beyond standard first aid — it requires needle thoracostomy to decompress. Transmit Mayday immediately. Keep the casualty sitting upright to optimise breathing. This is one of the few truly immediately fatal injuries that helicopter evacuation can save.

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.