A crew member receives an electrical shock from 440V ship's power. He is thrown clear and is lying on the engine room floor. Another crew member is still in contact with the live equipment. What are your immediate actions?

A. Do NOT touch the casualty in contact with live equipment — you will be electrocuted. Immediate actions: (1) Isolate the power at the nearest isolator, fuseboard, or emergency stop — if safe and immediately accessible; (2) If isolation is not immediately possible, break the contact using a non-conducting object (wooden plank, rope — NOT metallic tools or wet materials); (3) Once the current is isolated, the casualty is safe to approach — carry out primary survey ABCDE; (4) Electrocution causes cardiac arrhythmia (VF is common) — check for cardiac arrest and start CPR/AED immediately if indicated; (5) Look for entry and exit burns — AC current may cause deep tissue injury with relatively small surface burns; (6) Treat the second casualty (thrown clear) for any injuries; (7) The thrown-clear casualty may also need cardiac monitoring — all significant electrical injury cases require hospital assessment for delayed arrhythmia.

B. Pull the casualty away from the live equipment immediately — seconds count in electrical injury and CPR should begin before power is isolated.

C. Call for the chief engineer first. Electrical equipment isolation on a ship must only be done by a qualified engineer.

D. Only 110V AC is dangerous. Ship's 440V DC power cannot cause fatal electrocution due to the high voltage suppressing the current to a safe level.

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.