First Aid, CPR, and Basic Medical Response for Mariners

Why First Aid Matters at Sea

A vessel at sea may be many hours — or even days — from the nearest hospital or emergency medical service. When a crew member collapses, suffers a serious cut, or goes into shock, the people on deck are the first responders. There is no ambulance coming. That reality is why STCW Basic Training requires every seafarer to demonstrate competency in personal survival and elementary first aid, and why the U.S. Coast Guard holds mariners to a documented standard for medical care aboard vessels that carry no physician.

This lesson prepares you to meet that standard: you will perform CPR on adults, children, and infants; attach and operate an Automated External Defibrillator (AED); control serious bleeding; manage shock; and document care in a shipboard medical log — all to the pass/fail checklist of a nationally recognized first aid/CPR certification (American Red Cross or American Heart Association).

Scene Safety First

Before you touch any patient, confirm the scene is safe. On a vessel this means: Is there a live electrical hazard? Is the deck slippery with oil or water? Is machinery still running near the casualty? Call out "Scene safe" only when you have visually confirmed it. If the scene is not safe, make it safe or move the patient only if you can do so without injuring yourself. An injured rescuer creates two patients.

Don gloves before contact with any patient. Disposable nitrile gloves are standard in every shipboard first aid kit. Eye protection is appropriate whenever there is a risk of blood splash.

Cardiac Arrest: Recognize and Act Fast

Cardiac arrest means the heart has stopped pumping blood effectively. Brain damage begins within minutes of no blood flow. The chain of survival has four links: early recognition and call for help, early CPR, early defibrillation, and early advanced care.

Recognize cardiac arrest: The patient is unresponsive (tap shoulders and shout), has no normal breathing (gasping is not normal breathing), and has no pulse detectable within ten seconds. If you are unsure, begin CPR — starting CPR on someone who does not need it causes far less harm than withholding it from someone who does.

Adult CPR sequence:

1. Confirm unresponsiveness; shout for help and send someone for the AED.

2. Call for help on VHF Channel 16 if on open water (or designate someone to do so).

3. Position the heel of one hand on the center of the chest (lower half of the sternum), place the other hand on top, and interlock fingers.

4. Compress at least 2 inches deep, at a rate of 100–120 compressions per minute. Allow full chest recoil between compressions. Minimize interruptions.

5. After 30 compressions, give 2 rescue breaths (tilt head, lift chin, seal mouth, watch chest rise) — approximately 1 second each. If you are not trained or willing to give breaths, hands-only CPR with continuous compressions is acceptable for adult victims.

6. Continue 30:2 cycles until the AED is ready, the patient shows signs of life, or you are relieved.

Child (ages 1 to puberty) and infant (under 1 year) differences: Use one hand or two fingers respectively for compressions; compress about 2 inches for a child and about 1.5 inches for an infant. Begin with 5 cycles of CPR (about 2 minutes) before leaving an unwitnessed arrest victim to call for help.

Using an AED

An AED analyzes the heart's rhythm and delivers a shock only if the rhythm is shockable. Turn it on, follow the voice prompts, and attach pads to bare dry skin — one pad below the right collarbone, one on the left side below the armpit. Clear everyone before the device analyzes and before it shocks. Resume CPR immediately after the shock; do not wait to check for a pulse. Keep the AED attached and powered on throughout care.

Bleeding Control

Severe bleeding can cause death in minutes. Your priority sequence:

• Direct pressure: Apply firm, continuous pressure with a gloved hand and a dressing. Do not lift the dressing to check — add more material on top if it soaks through.
• Pressure dressing: Wrap a bandage firmly over the dressing to maintain pressure hands-free.
• Tourniquet: For a limb with life-threatening bleeding that cannot be controlled by pressure, apply a commercial tourniquet (such as a CAT or SOFT-T Wide) 2–3 inches above the wound on bare skin. Tighten until bleeding stops. Write the time of application on the tourniquet or the patient's skin with a marker. Never remove a tourniquet once applied; that decision belongs to a physician.

Managing Shock

Shock is inadequate blood flow to vital organs. Signs include pale or gray skin, rapid weak pulse, rapid breathing, confusion, and nausea. Management steps: control the cause (stop the bleeding), lay the patient flat, keep them warm, do not give food or water, and provide calm reassurance. Elevating legs is no longer universally recommended if a spinal injury is possible; keep the patient still.

Shipboard Medical Log

Every intervention you perform must be documented. The log entry must include: date and time (use 24-hour format), patient name and position, what you found (chief complaint, signs), what you did (interventions in order with times), the patient's response, and your name as the person providing care. Clear, accurate records support any future medical consultation, including radio medical advice from the U.S. Public Health Service or Coast Guard.

Handoff to Higher Medical Authority

When Coast Guard or other responders arrive, give a structured report: patient name, age, what happened, vital signs, interventions performed and when, and current status. Practice this in the scenario drill so the handoff is calm and complete under stress.