A crew member discloses to you privately that he has been taking medication for a psychiatric condition that he did not declare in his pre-employment medical. As OOW, how do you handle this?

A. This is a safety-sensitive disclosure: the OOW has a duty of care to the crew member and a safety responsibility. Action: (1) Do not promise confidentiality — explain that a watchkeeper with an undeclared medical condition that may affect watchkeeping capacity is a safety issue that must go to the master; (2) Encourage the crew member to speak to the master directly; (3) If the condition may impair the crew member's fitness for watchkeeping, the master MUST be informed — the OOW cannot withhold this; (4) The master will follow the company's medical fitness procedure (typically: seafarer is stood down from watchkeeping, medical authority is consulted, P&I Club notified); (5) Document the disclosure in a restricted log noting time and that the master was informed; (6) Under MLC 2006 the seafarer has rights to confidential medical treatment, but not to conceal a condition affecting fitness for duty from the master.

B. Maintain strict medical confidentiality. The crew member's medical history is private and must not be disclosed to anyone, including the master, without the crew member's written consent.

C. Complete a MCA ENG1 revocation form immediately. Any seafarer with an undisclosed medical condition has automatically invalidated their ENG1 certificate.

D. Take no action. Medical conditions are between the crew member and their doctor ashore. The OOW has no authority to act on medical information disclosed during conversation.

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.