Assessment of needs of casualties and threats to own safety
Governing: STCW Table A-VI/1-3; Resuscitation Council UK 2025 First Aid and Adult BLS guidelines. Builds on: L1.1.
Danger first
The STCW table puts threats to own safety alongside the casualty's needs. On a yacht, the scene that injured one person can injure you:
| Scene | Danger |
|---|---|
| Engine room | Live electrics, moving machinery, hot surfaces, fumes |
| Enclosed space | No oxygen, toxic gas; never enter without authorisation and BA (see PSSR) |
| Deck | Falling objects, snatching lines, crane loads, slippery surfaces |
| Water | Drowning, cold shock, propellers, jet skis |
| Galley | Hot oil, knives, gas |
| Smoke | Fire and toxic atmosphere |
Stop. Look. Make it safe, or wait for it to be made safe. Then approach.
Responsiveness and help
- Approach, speak loudly, tap the shoulders: "Are you all right?"
- Call for help early. On board, that means the bridge, by radio or phone, and whoever is nearest. Ashore, 999 or 112.
The RCUK 2025 adult guidance changed the order: call 999 for any unresponsive person before assessing breathing, and assess breathing while waiting. On a yacht at sea, the equivalent is to alert the bridge immediately; the master will seek radio medical advice (L4.2).
TIP — Speaker phone RCUK advises activating a mobile's speaker so the call handler can guide you while your hands work. The same applies to a handheld radio: have someone else hold it.
The ABCDE assessment
RCUK 2025 recommends the ABCDE framework to structure assessment of anyone who appears ill, injured or in shock.
| Check | Act | |
|---|---|---|
| Airway | Is it open? Can they speak? Noises, vomit, swelling? | Head tilt, chin lift; clear visible obstruction; recovery position if appropriate |
| Breathing | Rate, depth, effort, sounds | Sit up if breathless; if not breathing normally, start CPR (L2.1) |
| Circulation | Bleeding, pulse, skin colour and temperature | Control bleeding (L2.2); treat for shock (L2.3) |
| Disability | Level of response, pupils, blood sugar if known diabetic | Recovery position if unresponsive but breathing; glucose if awake and hypoglycaemic |
| Exposure | Look for other injuries; check temperature | Expose only as needed; keep warm; protect dignity |
Work through it in order. If you find a problem, fix it before moving on.
Life-threatening bleeding
RCUK 2025 is explicit: alongside safety and responsiveness, pay immediate attention to life-threatening bleeding. Catastrophic bleeding can kill before an airway problem does.
Taking a history
Once immediate threats are dealt with, find out what happened. A common aid is SAMPLE:
- Signs and symptoms;
- Allergies;
- Medications;
- Past medical history;
- Last ate or drank;
- Events leading up to it.
Write it down with times. The designated medical person, a radio doctor or a paramedic will ask for it.
Record and hand over
Note what you found, what you did and when, and any change. At handover, give a short summary: who, what happened, what you found, what you did, how they are now.
CAUTION — Consent A responsive adult can refuse help. Explain what you want to do and ask. An unresponsive casualty is treated on the basis of implied consent.
WARNING — Enclosed spaces More rescuers than casualties have died in enclosed spaces. If someone has collapsed in a tank, void or chain locker, raise the alarm and wait for the rescue team with breathing apparatus.