Scene safety, the primary survey and calling for help
1The lesson in plain words
Make yourself and the boat safe first. Then check the casualty in a fixed order, deal with what kills first, and call for help early.
Danger first on a moving boat
Scene safety means you do not become the second casualty. Check for a swinging boom (the spar along the bottom of the mainsail), loaded sheets (sail-control ropes), a turning propeller, hot machinery, fumes and sudden movement. Ask the person steering to steady the boat and control the boom. Stop the engine if anyone is near the propeller. Attach your safety harness to a secure point when needed. Wear gloves when handling blood.
The primary survey
The primary survey finds life-threatening problems in order. DR ABCDE means Danger, Response, Airway, Breathing, Circulation (look for serious bleeding), Disability and Exposure. Make the scene safe, check response, open the airway and check breathing. If breathing is absent or abnormal, start CPR; do not finish the survey first. Otherwise look for serious bleeding, check how alert the person is, then look for hidden injuries and cover them again. Treat each problem as you find it.
Catastrophic bleeding comes first
After an injury, blood pouring or spurting from a wound can kill in a few minutes. Many courses therefore put a C in front: <C>ABCDE, where the first C stands for catastrophic bleeding. If you see it, press hard on the wound at once, even before you check the airway. The Injuries unit shows how to control it.
Response and breathing
Speak loudly and tap the shoulders. If there is no answer, call for help immediately. Open the airway with head tilt, chin lift: one hand on the forehead, two fingertips lifting the chin. Look, listen and feel for normal breathing for no more than 10 seconds. Slow, noisy gasps are agonal breathing. They are not normal breathing: treat them as cardiac arrest.
Call for help early
Call as soon as someone is unresponsive, seriously ill or injured; delegate the radio while you treat, and see Radio medical advice for the call.
2Key data
- Memory aid
- DR ABCDE; <C>ABCDE for catastrophic bleeding
- Breathing check
- No more than 10 seconds
- Spanish courses (PER)
- PAS: Proteger, Avisar, Socorrer (protect, alert, help)
3Key points
- 1
Make the scene safe first: boom, sheets, propeller, fumes and the motion of the boat.
- 2
Check in a fixed order: DR ABCDE, or <C>ABCDE when there is catastrophic bleeding.
- 3
Unresponsive with absent or gasping breathing means cardiac arrest.
- 4
Call for help early and give the radio to another crew member.
4Frequent mistakes
Wrong: Rush to the casualty as soon as you see them fall.
Right: Take a second to check for danger: a swinging boom or a turning propeller can injure you too.
Wrong: Gasping breaths mean the casualty is still breathing.
Right: Slow, noisy gasps are agonal breathing. Treat an unresponsive person who gasps as being in cardiac arrest.
Wrong: Call for help only once you know what is wrong.
Right: Call early. Help at sea takes time, and the radio doctor can guide you while you treat.
5Practice case & exam keys
Sailing into the wind in a fresh breeze, a crew member is hit by the boom and lies still in the cockpit. A small scalp cut is oozing, without pooling blood or rapidly soaking clothing. What do you do first?
Show the answer
Ask the person steering to steady the boat and secure the boom against swinging. Approach when safe. Check response; if there is none, send a crew member to call for help at once. Open the airway and check breathing for no more than 10 seconds. If absent or abnormal, start CPR. Otherwise, keep the airway open and press on the cut. The small, oozing cut is not life-threatening.
Exam keys
- Scene safety first: do not become the second casualty.
- Primary survey order: DR ABCDE; <C>ABCDE puts catastrophic bleeding first.
- Check breathing for no more than 10 seconds; agonal gasps are not normal breathing.
- Call for help early and delegate the radio.
Finish this unit
When you've read it, answer three questions. Get all three right to finish the unit; opening the page alone doesn't count.
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