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newSchoolWorks.com › VoTechWorks › Transportation › Maritime Crew (deck/engine) › STCW Basic Safety for Maritime Crew › Lesson 4
TRN-MARI24-02 · Lesson 4 · 10 clock hours · practice

Elementary First Aid — CPR, Bleeding Control, and Shock Management

Objective. Students will perform adult one-rescuer CPR with AED operation and apply direct-pressure wound care and shock-positioning techniques that meet the STCW elementary first-aid performance standard.

⚠ Pending professional review

This lesson, its worked examples and its practice questions has not yet been verified by a certified examiner or master technician in the trade or by a certification or approval body. It is a study draft and may contain errors. Do not use it as instructions for work on a job site or on live equipment. Always follow your instructor, your supervising professional, and current official references and regulations.

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Why These Skills Matter at Sea

At sea, the nearest hospital may be hours or days away. When a crewmember collapses, bleeds severely, or goes into shock, you are the first responder. STCW Basic Safety training requires every mariner to be able to deliver elementary first aid immediately and competently. The three skills you will practice today — CPR with AED, bleeding control, and shock management — address the emergencies most likely to kill a victim before professional medical help arrives.

Adult One-Rescuer CPR

Scene safety first. Before approaching any victim, scan the area for hazards: electrical sources, toxic atmosphere, moving machinery. Do not become a second victim. Put on gloves before contact whenever possible.

Once safe, use the C-A-B sequence recognized by the American Heart Association (AHA):

1. Check responsiveness. Tap shoulders firmly and shout. If unresponsive, call for help immediately. Assign a specific person to radio the bridge and retrieve the AED.

2. Compressions. Place the heel of one hand on the center of the chest (lower half of the sternum), interlace fingers, keep arms straight, and compress at least 2 inches deep at a rate of 100–120 compressions per minute. Allow full chest recoil after each compression — do not lean on the chest.

3. Airway. After 30 compressions, tilt the head back and lift the chin to open the airway. Look, listen, and feel for no more than 10 seconds.

4. Breaths. Give 2 rescue breaths (roughly 1 second each); watch for chest rise. Return immediately to compressions. Minimize pauses — the goal is high-quality chest compressions with minimal interruption.

Continue 30:2 cycles until the AED is ready, the victim shows obvious signs of life, or you are relieved by a higher-trained responder.

AED Operation

An Automated External Defibrillator (AED) analyzes heart rhythm and delivers a shock if needed. Training AEDs simulate this process without real electrical output.

1. Power on the AED (open lid or press button — most units give voice prompts).

2. Attach pads to bare, dry skin: one pad below the right collarbone, one on the left side below the armpit.

3. Plug in the connector.

4. Stand clear — announce "Clear!" and ensure no one is touching the victim while the AED analyzes.

5. If a shock is advised, ensure everyone is clear, then press the shock button.

6. Resume CPR immediately after the shock — do not wait to reassess. Follow AED prompts for subsequent cycles.

Bleeding Control

Severe hemorrhage can be lethal within minutes. Your priorities are: protect yourself, control bleeding, and prevent shock.

Arterial vs. venous bleeding: Arterial blood is bright red and spurts with each heartbeat — it is the more immediately life-threatening. Venous blood is darker red and flows steadily. Both require prompt direct pressure.

For wounds on limbs that do not respond to direct pressure, a commercially manufactured tourniquet may be applied per your vessel's medical kit instructions. Document application time on the patient.

Shock Management

Shock is a life-threatening state in which the body cannot deliver enough oxygenated blood to vital organs. Common causes at sea include severe bleeding, crush injuries, severe burns, and cardiac events.

Signs of shock: pale, cool, clammy skin; rapid weak pulse; rapid shallow breathing; confusion or anxiety; nausea.

Steps:

1. Lay the victim supine (flat on back) on a firm surface.

2. Elevate the legs approximately 8–12 inches unless you suspect spinal, pelvic, or lower-limb injury — in those cases, keep the victim flat.

3. Maintain body warmth (blanket); prevent heat loss to a cold deck.

4. Do not give food or water by mouth.

5. Monitor and reassure the patient continuously.

6. Call for medical assistance using the vessel's radio. Use the correct procedure: identify your vessel, state the nature of the emergency, give the victim's condition, and request guidance.

Spinal Precautions After a Fall

A crewmember who falls from a ladder may have a spinal injury. Assume spinal injury is present until ruled out. Minimize movement of the head and neck. A training cervical collar immobilizes the neck — measure sizing per the manufacturer's guide, apply without moving the head, and maintain manual stabilization until the collar is secured. Log-roll the victim only if absolutely necessary, keeping head, neck, and torso aligned.

Documenting the Injury

Complete a first-aid report form as soon as the victim is stabilized. Record: victim name, time of incident, mechanism of injury, signs and symptoms observed, treatments given (with times), and who provided care. Accurate records support the ship's medical officer and shoreside medical consultation.

Key terms10

Cardiac arrestSudden cessation of effective heart pumping, causing loss of consciousness and absence of normal breathing; requires immediate CPR and defibrillation.
Chest compression rate and depthAHA guidelines specify compressions at 100–120 per minute and at least 2 inches deep for an adult, with full chest recoil between compressions.
Automated External Defibrillator (AED)A portable device that analyzes heart rhythm and delivers an electrical shock to restore normal rhythm in ventricular fibrillation or pulseless ventricular tachycardia.
Direct pressureThe primary method of bleeding control: firm, continuous manual pressure applied to a wound with a sterile dressing to promote clotting and reduce blood loss.
Arterial bleedingBleeding from a damaged artery; characterized by bright red blood that spurts rhythmically with each heartbeat and is rapidly life-threatening.
Shock (circulatory)A life-threatening condition in which inadequate blood flow fails to supply enough oxygen to body tissues; signs include pale clammy skin, rapid weak pulse, and altered mental status.
Supine positionLying flat on the back; the standard position for a shock patient, with legs elevated unless spinal or lower-limb injury is suspected.
Cervical collarA rigid or semi-rigid device applied around the neck to limit movement and protect the cervical spine following a suspected spinal injury.
30:2 compression-to-ventilation ratioThe AHA-recommended cycle for adult one-rescuer CPR: 30 chest compressions followed by 2 rescue breaths, repeated continuously.
HemostasisThe process of stopping bleeding, whether by direct pressure, bandaging, tourniquet, or the body's own clotting mechanisms.
In class: CPR skills station: using an adult manikin, each student performs at least two full cycles of 30 compressions and two rescue breaths at the correct rate and depth, then attaches and operates a training AED; the instructor provides real-time feedback using a CPR feedback device · Wound-care scenario: students work in pairs using a wound-care kit to apply direct pressure, bandage a simulated laceration, identify signs of arterial versus venous bleeding, and document the injury on a basic first-aid report form · Shock and fracture management exercise: given a scenario card describing a crewmember who fell from a ladder, students assess responsiveness, position the patient for shock (supine, legs elevated where appropriate), apply a cervical collar (training model), and call for medical assistance using proper radio protocol
Materials: Adult CPR manikins (one per two students), CPR feedback devices, training AED units, wound-care kit (gloves, dressings, bandages, tape), training cervical collar, first-aid report forms, American Red Cross or American Heart Association CPR course materials
Check: Structured skills evaluation: CPR rate and depth scored by feedback device must meet AHA guidelines; wound-care bandage must achieve simulated hemostasis (no exposed wound after bandaging); shock positioning must be correct for the scenario; student must score satisfactory on all three components to pass

Practice check8

Answer each question, then check it. Nothing is recorded; this is your own practice.

STCW Basic Safety — Elementary First Aid
1. According to AHA guidelines, what is the correct compression depth for adult CPR?
STCW Basic Safety — Elementary First Aid
2. What is the correct compression-to-ventilation ratio for adult one-rescuer CPR?
STCW Basic Safety — Elementary First Aid
3. When using an AED, what must you do immediately before the device delivers a shock?
STCW Basic Safety — Elementary First Aid
4. A crewmember has a deep arm laceration with bright red blood spurting rhythmically. Which type of bleeding is this, and what is the immediate action?
STCW Basic Safety — Elementary First Aid
5. A victim in shock is conscious and breathing, with no suspected spinal or lower-limb injury. Which position is most appropriate?
STCW Basic Safety — Elementary First Aid
6. A crewmember fell from a ladder and is unconscious. You suspect a spinal injury. What is your priority regarding movement?
STCW Basic Safety — Elementary First Aid
7. During a bleeding-control scenario, the original dressing becomes saturated with blood. What should you do?
STCW Basic Safety — Elementary First Aid
8. Which combination of findings most strongly indicates a victim is developing circulatory shock?
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