At 0300 a crew member collapses on the bridge. He is unresponsive and not breathing normally. You are OOW. Describe your immediate actions.

A. Immediate actions: (1) Call for help — shout to activate emergency response, ensure the master and medic/person with medical training are alerted; (2) Lay the casualty on a firm surface — the bridge deck; (3) Check airway — head tilt/chin lift, look for obvious airway obstruction; (4) Begin CPR — 30 chest compressions to 2 rescue breaths (ratio 30:2), compressions at 100-120 per minute, depth 5-6cm, allow full recoil; (5) Deploy AED (automated external defibrillator) as soon as available — apply pads and follow AED voice prompts without interrupting CPR except for shock delivery; (6) Contact CIRM (Italian Maritime Medical Centre) or flag state designated MRCC medical service for medical advice; (7) Do not abandon the bridge — delegate CPR if qualified crew arrive; alert watch and autopilot.

B. Call the master immediately and wait for his instructions before starting CPR — CPR requires authorisation from the master.

C. Place the crew member in the recovery position and monitor breathing. CPR is only indicated if the casualty has no pulse — check pulse for at least 30 seconds before starting.

D. Radio Mayday immediately for evacuation. Medical treatment at sea is not within the OOW's competency and should not be attempted.

A. Assessment using Rule of Nines: both arms = 9% each = 18%, hands included in arm total — approximately 18-20% BSA. This is a significant burn requiring urgent medical advice and likely evacuation. Immediate treatment: (1) Cool the burn — pour cool (not cold, not iced) water over the burns for minimum 20 minutes; this is the single most important first aid intervention — reduces depth of burn and pain; (2) Remove clothing and jewellery in the burned area before swelling occurs, unless stuck to the skin; (3) Cover with clean non-adherent dressings or cling film (do not burst any blisters); (4) Monitor for shock — burns cause fluid loss; elevate burned limbs; (5) Give oral fluids if conscious and not vomiting; (6) Contact medical radio advice immediately — burns >15% BSA in adults require IV fluid resuscitation (Parkland formula); (7) Prepare for possible MEDEVAC — 20% burns with airway involvement requires hospital.

B. Apply antiseptic cream to the burns and bandage tightly. Burns must be kept dry to prevent infection. Do not apply water — this causes shock in burn patients.

C. Burns below 25% BSA can be managed without medical advice. Treat with available burn gel and monitor for 24 hours before considering evacuation.

D. The priority is infection control. Cover burns with dry dressings and give oral antibiotics from the medical chest. Cool water treatment delays healing.

A. Primary survey (ABCDE): (A) Airway — open airway using head tilt/chin lift; check for vomit or obstruction; place in recovery position to protect airway if breathing; (B) Breathing — assess rate, depth, pattern — is it adequate?; (C) Circulation — check pulse and skin colour/temperature; look for bleeding; (D) Disability — assess level of consciousness using AVPU (Alert, Voice, Pain, Unresponsive) — this casualty is "P" or "U"; assess pupils (equal and reactive, asymmetry suggests head injury or drug); (E) Environment — check for cause (head injury, overdose, diabetic emergency, CO poisoning? — note the location below decks). Secondary: check blood sugar (hypoglycaemia is common and reversible — if low, give glucose gel/sugar orally if can swallow/IV if not); secure to stretcher in recovery position; monitor vitals every 15 minutes; seek medical radio advice and prepare MEDEVAC information.

B. Leave the casualty in the position found. Moving an unconscious person risks spinal injury. Monitor breathing and await the vessel's medic.

C. Check pulse and breathing. If both are present, the casualty is stable — no further intervention is required until they regain consciousness.

D. An unconscious breathing casualty should be laid on their back with a pillow under their head. The recovery position is only for conscious casualties who are vomiting.