Medical Care and First Aid On Board
What this domain tests
The medical care domain at management level covers first aid, the recognition of serious conditions, the use of the ship's medical stores and the Medical Guide, remote medical advice, and the chief engineer's role as a designated first aider. Croatian exams ask direct protocol questions - CPR ratios, burns, fractures, hypothermia, poisoning in enclosed spaces - and scenario questions on when to divert the ship.
Core rules and concepts
- Chain of survival. Recognition, early CPR, early defibrillation if an AED is carried, advanced care. Adult CPR: compressions at 100–120 per minute, depth 5–6 cm, ratio 30 compressions to 2 ventilations, and use of the AED as soon as available.
- Primary survey. Danger, response, airway, breathing, circulation, and then a secondary survey. Recovery position for an unconscious breathing casualty.
- Common emergencies. Chest pain (suspect cardiac, keep at rest, no exertion, get advice), stroke signs (face, arms, speech, time), severe bleeding (direct pressure, tourniquet only as a last resort), fractures (immobilise, check circulation beyond the injury), burns (cool with water, do not remove adherent clothing, cover), hypothermia (insulate, no rapid rewarming, handle gently).
- Enclosed space casualties. Rescuer safety first; SCBA; oxygen and resuscitation after recovery; suspect H2S or CO poisoning.
- Medical stores and the guide. Check expiry dates, controlled drugs register, and the requirement to carry the appropriate medical guide and stores according to the trade and the flag State.
- Radio medical advice. Contact via the appropriate service or MRCC, give the patient's history, vital signs and treatment so far, and record the advice and the actions taken.
- Deviation and evacuation. The master decides after medical advice; the chief engineer supports with logistics, fuel and speed considerations, and records the decision.
- Records. Medical log entries, injury reports, and notification to the company and flag State where required.
Worked example
A fitter collapses after entering a void space; he is unresponsive and breathing shallowly. Reasoning: possible oxygen deficiency or H2S exposure; the rescuer must not become a second casualty. Action: raise the alarm, don SCBA and harness, recover the casualty with the rescue kit, move to fresh air, check airway and breathing, give oxygen and start CPR if not breathing, call radio medical advice, and prepare for evacuation. The scoring answer puts rescuer safety first and names the radio medical route.
Traps that cost marks
- Rushing into the space without breathing apparatus.
- Wrong CPR ratio or rate.
- Removing clothing stuck to a burn.
- Warming a hypothermic casualty rapidly or rubbing the limbs.
- Failing to record vital signs and the advice received.