Entry & progression
Governing: STCW Section A-VI/1 and Table A-VI/1-3; MSN 1865 (M) Amendment 1, sections 3.4, 4.4 and 5. Builds on: nothing, start here.
Where EFA fits
Elementary First Aid is one of the four STCW basic training elements (see Personal Survival Techniques for the full list). Its competence is simple to state: take immediate action upon encountering an accident or other medical emergency.
MSN 1865 section 3.4 requires, for the certificate of proficiency, age at least 16 and training at an MCA-approved provider to the Table A-VI/1-3 standard. Unlike PST and FPFF, EFA does not appear in the list of certificates that must be updated every five years (MSN 1865 section 4.4). Skills fade regardless; practise.
| Level | STCW | Who |
|---|---|---|
| Elementary First Aid | A-VI/1-3 | Everyone with safety duties |
| Medical First Aid | A-VI/4, paras 1-3 | Anyone designated to give first aid on board |
| Medical Care | A-VI/4, paras 4-6 | Whoever is in charge of medical care |
On a yacht, the designated medical person is often an officer or chief stew with Medical First Aid or Medical Care. But the first person on scene is usually whoever is nearest. That is why everyone does EFA.
Table A-VI/1-3 in brief
- assessment of the casualty's needs and threats to your own safety;
- appreciation of body structure and functions;
- immediate measures: position the casualty, resuscitation, control bleeding, manage shock, burns and scalds including electrical accidents, rescue and transport, and improvise bandages and use the emergency kit.
How the body works
You do not need a doctor's anatomy. You do need to know what keeps a person alive.
| System | Parts | Why it matters in first aid |
|---|---|---|
| Respiratory | Airway (mouth, nose, throat, windpipe), lungs | Air must get in. An unconscious person's tongue can block the airway |
| Circulatory | Heart, arteries, veins, blood | Carries oxygen. Blood loss and cardiac arrest stop delivery |
| Nervous | Brain, spinal cord, nerves | The brain is damaged within minutes without oxygen. The spinal cord runs through the spine |
| Skeletal | Skull, spine, ribs, pelvis, limbs | Protects organs; fractures cause pain, bleeding and deformity |
| Muscular | Muscles and tendons | Movement; strains and crush injuries |
| Skin | The largest organ | Barrier to infection and heat loss; burns destroy it |
| Digestive | Stomach, intestines, liver | Abdominal injury can bleed internally |
The oxygen chain
Air enters the airway, reaches the lungs, oxygen passes into the blood, the heart pumps it to the brain and body. Break any link and the brain starts to die within minutes. Almost every priority in first aid, airway, breathing, circulation, is about keeping that chain intact.
Vital signs
| Sign | What to look for |
|---|---|
| Responsiveness | Alert, responds to voice, to pain, or unresponsive |
| Breathing | Normal, noisy, laboured, gasping, absent |
| Pulse | Rate and strength, at wrist or neck |
| Skin | Colour, temperature, sweating |
CAUTION — Skin colour RCUK 2025 guidance notes that colour changes are unreliable across skin tones. For cyanosis in darker skin, look for pallor or blue tinges inside the lips.
TIP — Know your medical locker On your first day, find the first aid kits, the AED, the stretcher and the medical log. Who holds the keys, and who is the designated medical person?