Basic First Aid
Help offshore is measured in hours, not minutes — the crew has to cope until it arrives. This module covers the full IYT Module 24 syllabus at Working depth: hypothermia and cold water shock, cold-water survival positions, the ABC response and CPR sequence (with a step-through drill), bleeding and shock, burns, heat stroke, heart attack and stroke, drowning, choking, seasickness, carbon monoxide, and the PAN-PAN urgency call.
HypothermiaCold water shockHELP & huddleABC · CPR
Bleeding & shockBurnsHeart attack & stroke
DrowningChokingCO poisoningPAN-PAN
This module supplements — it does not replace — certified training. First aid and CPR guidance is updated regularly; IYT itself directs schools to current national material, and expects at least one trained crew member aboard. Send every student to a recognised first aid / CPR course (e.g. Canadian Red Cross or St. John Ambulance) — what's here is the IYT exam standard and a refresher, not a substitute for hands-on certification.
Hypothermia & Cold Water Shock
Hypothermia
A drop in core body temperature below 35.0 °C, from prolonged exposure — immersion in cold water, cold air and wind on wet clothing, or simply too long in the cold. It creeps: shivering, clumsiness, slurred thinking, then worse.
A drop in core body temperature below 35.0 °C, from prolonged exposure — immersion in cold water, cold air and wind on wet clothing, or simply too long in the cold. It creeps: shivering, clumsiness, slurred thinking, then worse.
Cold water shock — the faster killer
Sudden immersion in water of 15 °C or below: for the first 3–5 minutes the body gasps uncontrollably and muscles spasm while heart rate and blood pressure spike. The gasping ingests water — drowning; the cardiac spike can trigger heart attack or stroke. Cold water can paralyse you so fast that donning a lifejacket in the water becomes nearly impossible.
Sudden immersion in water of 15 °C or below: for the first 3–5 minutes the body gasps uncontrollably and muscles spasm while heart rate and blood pressure spike. The gasping ingests water — drowning; the cardiac spike can trigger heart attack or stroke. Cold water can paralyse you so fast that donning a lifejacket in the water becomes nearly impossible.
The key point: cold shock happens any month of the year — the water stays colder than the air well into summer — which is why the lifejacket goes on before the accident, not after.
Cold-Water Survival & Rescuing a Hypothermic Casualty
In the water — decide, then conserve
- Assess: lifejackets on everyone? shore or safety reachable? boats nearby? can you signal?
- Within about 50 m of shore — swim for it
- Stay put if injured, if help is close, or if you're beyond ~50 m
- Climb onto a floating object — but only if you can get most of your body out of the water
- Signal or call for help the moment you can
The two heat-saving positions
H.E.L.P. (Heat Escape Lessening Position), alone: arms crossed tight on the chest, knees drawn up against it, head and face out of the water.
Huddle, in a group: arms around each other's mid-to-lower backs, chests close to each other's sides, legs intertwined, children in the middle, movement to a minimum.
H.E.L.P. (Heat Escape Lessening Position), alone: arms crossed tight on the chest, knees drawn up against it, head and face out of the water.
Huddle, in a group: arms around each other's mid-to-lower backs, chests close to each other's sides, legs intertwined, children in the middle, movement to a minimum.
Rescuing a hypothermia casualty — before the rescue: get your own PFD on, assess their condition and response, inventory what aboard can warm them, judge your ability to help (distance to shore), and signal distress if warranted. Then:
Do
- Recover them from the water; dry head to toe; layers of dry clothing
- Shelter below deck if possible
- Rewarm slowly: cover head and neck, wrap in dry blankets or an insulating blanket
- Warm liquids; your own body heat works too
Don't
- No alcohol, no hot stimulants
- Do not rub or massage the body or limbs — it can damage nerve endings (and drives cold blood to the core)
- Don't rewarm fast; slow and steady
The ABC Response & CPR — Step-Through Drill
When breathing stops, the clock is brutal: 0–4 min clinical death · 4–6 min brain damage possible · 6–10 min brain damage likely · after 10 min irreversible. The IYT sequence for an unconscious adult (8+) is Airway → Breathing → Circulation. Run the drill — at each stage, choose the correct next action:
Rescue breathing (circulation present, no breathing)
Adult: 1 breath every 5 seconds × 1 minute (12 breaths), chin the highest point, nose sealed, chest must rise — then re-check circulation. Exhaled air still carries 16% oxygen: it genuinely keeps organs alive.
Adult: 1 breath every 5 seconds × 1 minute (12 breaths), chin the highest point, nose sealed, chest must rise — then re-check circulation. Exhaled air still carries 16% oxygen: it genuinely keeps organs alive.
CPR (no breathing, no circulation)
Heel of hand on the lower half of the sternum (the breastbone, down the centre of the chest), two fingers above its base, arms at 90°, elbows locked. 30 compressions, 1.5–2 inches deep, then 2 slow breaths — 4 cycles, then re-check circulation for no more than 10 seconds. Ribs crack? Keep going. Unsure whether there's circulation? Don't delay — start CPR.
Heel of hand on the lower half of the sternum (the breastbone, down the centre of the chest), two fingers above its base, arms at 90°, elbows locked. 30 compressions, 1.5–2 inches deep, then 2 slow breaths — 4 cycles, then re-check circulation for no more than 10 seconds. Ribs crack? Keep going. Unsure whether there's circulation? Don't delay — start CPR.
Stop rescue efforts only when
Medical help takes over · you're too exhausted to continue · the casualty breathes or vomits (→ recovery position) · circulation is lost (→ switch to CPR) · the location itself becomes dangerous.
Medical help takes over · you're too exhausted to continue · the casualty breathes or vomits (→ recovery position) · circulation is lost (→ switch to CPR) · the location itself becomes dangerous.
Two technique flags: suspected head/spinal injury → open the airway with a jaw thrust (index fingers lifting the jaw, head and neck kept still) instead of the head tilt. And use a breathing barrier whenever there's any transmission risk.
Bleeding, Shock, Cuts, Stings & Burns
External bleeding
Direct pressure with a sterile cloth until it stops — the casualty's own hand if no cloth, yours as a last resort (gloves or plastic wrap; wash thoroughly after any contact with body fluids). Elevate the wound. Deep wounds: control the bleed, then get medical help immediately.
Direct pressure with a sterile cloth until it stops — the casualty's own hand if no cloth, yours as a last resort (gloves or plastic wrap; wash thoroughly after any contact with body fluids). Elevate the wound. Deep wounds: control the bleed, then get medical help immediately.
Internal bleeding
Hard to identify, life-threatening, usually announced by shock symptoms. Nothing aboard fixes it: call for help, and if you can't reach medical care quickly, request helicopter evacuation.
Hard to identify, life-threatening, usually announced by shock symptoms. Nothing aboard fixes it: call for help, and if you can't reach medical care quickly, request helicopter evacuation.
Shock — the cardiovascular system collapsing. Blood flow slows or stops; heart and brain cells begin dying without oxygen. Triggers: major blood or fluid loss (wounds, burns, internal bleeding), nervous-system damage, poor cardiac pumping. Signs: cold clammy skin, profuse sweating, pallor — advancing to bluish lips, shallow gasping breaths, weak rapid pulse, extreme thirst, nausea.
Treatment, in order: ① clear and maintain the airway → ② lay them on their back, feet up 8–12" — unless head/neck/back injury, convulsions or breathing difficulty → ③ control bleeding → ④ keep warm and comfortable, no food or drink → ⑤ call for medical assistance if symptoms persist.
Treatment, in order: ① clear and maintain the airway → ② lay them on their back, feet up 8–12" — unless head/neck/back injury, convulsions or breathing difficulty → ③ control bleeding → ④ keep warm and comfortable, no food or drink → ⑤ call for medical assistance if symptoms persist.
Cuts
Clean thoroughly, antibiotic cream, dressing. Deep cut: pressure and professional help.
Clean thoroughly, antibiotic cream, dressing. Deep cut: pressure and professional help.
Bites & stings
Scrape the sting out — don't squeeze with tweezers — then ice or ointment. Watch for allergic reactions, which can arrive in minutes or days; in doubt, medical help.
Scrape the sting out — don't squeeze with tweezers — then ice or ointment. Watch for allergic reactions, which can arrive in minutes or days; in doubt, medical help.
Burns — by degree
1st: cool water (never ice), then dry sterile dressing — no grease or butter. 2nd (blistering): immerse in cold water; never pierce blisters; no sprays/ointments; keep above heart level; watch for shock. 3rd (white/grey/black charring): treat small areas as 2nd, no fluids or alcohol, immediate help. Pain is not a severity gauge — destroyed nerves don't hurt.
1st: cool water (never ice), then dry sterile dressing — no grease or butter. 2nd (blistering): immerse in cold water; never pierce blisters; no sprays/ointments; keep above heart level; watch for shock. 3rd (white/grey/black charring): treat small areas as 2nd, no fluids or alcohol, immediate help. Pain is not a severity gauge — destroyed nerves don't hurt.
The kit (minimum): sunscreen · bandages/gauze in sizes · band-aids · thermometer · antiseptic wipes · aspirin · motion-sickness tablets · antacids · scissors · tweezers · bite-relief swabs · alcohol prep pads · eyewash cup & pads · calamine · ice pack · antibiotic cream — plus a comprehensive first-aid manual, scaled to the voyage, with at least one crew member formally trained.
Heat Stroke, Heart Attack & Stroke
Heat stroke
The body's thermostat fails: sweating stops, temperature soars (to ~106 °F) — hot, red, dry skin, fading consciousness, weak rapid pulse. Brain damage territory.
Treat: call for help first → wrap in cool wet sheets and fan → watch for shock → worsening? ice packs on wrists, ankles, neck, groin, armpits → monitor airway, be ready for CPR.
The body's thermostat fails: sweating stops, temperature soars (to ~106 °F) — hot, red, dry skin, fading consciousness, weak rapid pulse. Brain damage territory.
Treat: call for help first → wrap in cool wet sheets and fan → watch for shock → worsening? ice packs on wrists, ankles, neck, groin, armpits → monitor airway, be ready for CPR.
Heart attack
Blocked coronary vessels. Classic signs: crushing pressure / fullness / squeezing behind the breastbone, radiating to torso or arms (left arm especially), sweating, nausea, laboured breathing — or deceptively mild "indigestion." Aspirin immediately is medically proven to save lives. If the heart stops (cardiac arrest — no pulse, no breathing): CPR, now.
Blocked coronary vessels. Classic signs: crushing pressure / fullness / squeezing behind the breastbone, radiating to torso or arms (left arm especially), sweating, nausea, laboured breathing — or deceptively mild "indigestion." Aspirin immediately is medically proven to save lives. If the heart stops (cardiac arrest — no pulse, no breathing): CPR, now.
Stroke
A clot starves the brain of oxygenated blood: one-sided facial or limb paralysis, confusion, dizziness, headache, vision or swallowing trouble, varying consciousness. Aboard you can only open the airway, reassure — and evacuate immediately: nothing on the boat changes the outcome.
A clot starves the brain of oxygenated blood: one-sided facial or limb paralysis, confusion, dizziness, headache, vision or swallowing trouble, varying consciousness. Aboard you can only open the airway, reassure — and evacuate immediately: nothing on the boat changes the outcome.
Drowning & Choking
Drowning — don't become victim two
Enter the water only as a last resort. First: throw anything that floats (PFD, ring, cushion) to buy time; beyond throwing range, row or motor to them. Must swim? PFD on, approach from behind, calm them, and stay alert — a panicking casualty will pull you under. Once recovered: airway, breathing check, rescue breathing as needed (abdominal thrusts ready if the airway's blocked), head turned to one side if no spinal injury is suspected, CPR if pulseless. Every near-drowning gets follow-up medical care — lungs deteriorate hours later.
Enter the water only as a last resort. First: throw anything that floats (PFD, ring, cushion) to buy time; beyond throwing range, row or motor to them. Must swim? PFD on, approach from behind, calm them, and stay alert — a panicking casualty will pull you under. Once recovered: airway, breathing check, rescue breathing as needed (abdominal thrusts ready if the airway's blocked), head turned to one side if no spinal injury is suspected, CPR if pulseless. Every near-drowning gets follow-up medical care — lungs deteriorate hours later.
Choking — the three-verb drill
Ask "are you choking?" Nodding but able to cough → "cough it out." Can't speak or cough:
① Slap it out — support the chest, bend them forward, 5 back blows between the shoulder blades with the heel of your hand; check the mouth.
② Squeeze it out — from behind, fist between navel and breastbone, other hand grasping it, pull sharply in and up, ×5; check the mouth.
③ Still blocked? Call the emergency number (or PAN-PAN afloat) and repeat 5-and-5 until it clears or help arrives. Unresponsive → open airway, check breathing, start CPR.
Ask "are you choking?" Nodding but able to cough → "cough it out." Can't speak or cough:
① Slap it out — support the chest, bend them forward, 5 back blows between the shoulder blades with the heel of your hand; check the mouth.
② Squeeze it out — from behind, fist between navel and breastbone, other hand grasping it, pull sharply in and up, ×5; check the mouth.
③ Still blocked? Call the emergency number (or PAN-PAN afloat) and repeat 5-and-5 until it clears or help arrives. Unresponsive → open airway, check breathing, start CPR.
Seasickness, Carbon Monoxide & Calling for Help
Seasickness
Motion confuses the inner ear — the brain sees "stationary" objects moving. Sequence: cold sweat → upset stomach and fatigue → nausea and vomiting; unmanaged, it can slide into heat exhaustion. Treat: midships (least motion), sit, breathe fresh air, watch the horizon's stillness, bland food, water/tea/ginger ale — ginger genuinely works — no alcohol, and the OTC remedies if needed.
Motion confuses the inner ear — the brain sees "stationary" objects moving. Sequence: cold sweat → upset stomach and fatigue → nausea and vomiting; unmanaged, it can slide into heat exhaustion. Treat: midships (least motion), sit, breathe fresh air, watch the horizon's stillness, bland food, water/tea/ginger ale — ginger genuinely works — no alcohol, and the OTC remedies if needed.
Carbon monoxide
Easy to miss: symptoms mimic flu, a cold or seasickness — fatigue, nausea, headache, dizziness, vomiting, confusion, shortness of breath, altered sight/hearing. Treat: fresh air immediately → open the boat up, gas appliances off, leave her if at dock → oxygen if carried → call emergency / radio for help → rescue breathing or CPR if not breathing → and no re-boarding until an expert clears the boat. Diagnosis is confirmed by blood test ashore.
Easy to miss: symptoms mimic flu, a cold or seasickness — fatigue, nausea, headache, dizziness, vomiting, confusion, shortness of breath, altered sight/hearing. Treat: fresh air immediately → open the boat up, gas appliances off, leave her if at dock → oxygen if carried → call emergency / radio for help → rescue breathing or CPR if not breathing → and no re-boarding until an expert clears the boat. Diagnosis is confirmed by blood test ashore.
Prevention beats treatment: a marine-grade CO detector with live batteries, no cooking or cabin heating without real ventilation, marine-certified appliances only, engine-room blowers and vents working — always.
Radioing for help: VHF Channel 16 is the distress, urgency, safety and calling channel — everyone monitors it, and you keep transmissions on it to the bare minimum. A medical emergency short of grave-and-imminent danger is an URGENCY call, second in priority only to distress, made on the skipper's authority. The exact IYT call format:
PAN-PAN, PAN-PAN, PAN-PAN,
ALL STATIONS, ALL STATIONS, ALL STATIONS,
THIS IS "MY BOAT", "MY BOAT", "MY BOAT",
MY BOAT — POSITION:
NATURE OF URGENCY AND ASSISTANCE REQUIRED,
ANY FURTHER RELEVANT INFORMATION,
OVER.
ALL STATIONS, ALL STATIONS, ALL STATIONS,
THIS IS "MY BOAT", "MY BOAT", "MY BOAT",
MY BOAT — POSITION:
NATURE OF URGENCY AND ASSISTANCE REQUIRED,
ANY FURTHER RELEVANT INFORMATION,
OVER.
Basic First Aid — Knowledge Check
12 questions at IYT exam standard (75% to pass), drawn from the IYT Module 24 knowledge review.