Your vessel is in heavy weather and four crew members are severely incapacitated by seasickness. Watch schedules are disrupted. Describe how you manage this as OOW.

A. Reduce ship's speed to Force 4 immediately. Proceeding in conditions causing widespread seasickness is unsafe and constitutes unseaworthy operation.

B. Seasickness is not a medical condition. Crew members who cannot stand watch due to seasickness are in breach of their employment contract and should be logged in the Official Log.

C. Give maximum dose of anti-emetics to all four affected crew members immediately. If they are still unable to work after 2 hours, log them as sick.

D. Manage the immediate watch situation: assess which crew members are fit to stand watch — if a watch cannot be safely maintained, inform the master immediately. Crew welfare: severe motion sickness causing inability to work is a genuine medical issue, not malingering. Management: (1) Anti-emetic medication from ship's medical chest (promethazine / prochlorperazine / scopolamine patches — as per medical chest contents); note sedating effects of promethazine reduce alertness; (2) Hydration — motion sickness with vomiting causes dehydration; encourage oral fluids (small amounts frequently); (3) Position — lying down in the centre of the ship at the waterline reduces motion effects; (4) Ventilation — fresh air helps; diesel fumes worsen nausea; (5) Acupressure wristbands — some evidence for prophylaxis; (6) Refer to master and medical radio advice if crew member cannot stand watch after medication and rest.

A. 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.

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

C. 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.

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

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

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. 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.