Question 1

What does the ABCDE primary survey assess and why must it be done in this order?

Accepted Answer

Airway, Breathing, Circulation, Disability (neurological), Exposure. Done in order because: a blocked airway kills in 3 min; breathing failure in 3 min; circulation failure in less than 10 min; neurological and exposure issues allow more time. Always treat life threats at each level before moving to the next ABCDE is a systematic approach taught at all levels from lay first aid to hospital medicine. The order reflects urgency: Airway obstruction kills fastest; Breathing failure next; Circulatory collapse; Disability (AVPU: Alert/Voice/Pain/Unresponsive and pupil check); Exposure (expose to find hidden injuries while keeping warm). Identify and treat life threats at each level before moving on. In a maritime mass casualty, it provides a consistent triage framework for multiple casualties.

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.