Six in 11 °C water: prioritising the raft and recognising severe hypothermia
At 05:15 a 24 m stern trawler capsizes 12 nm off the Nigerian coast. Six survivors are in the water at 11 °C, air 18 °C, sea state 3, wind 20 knots. You are the senior survivor, wearing a 5 mm neoprene immersion suit and lifejacket. Two others wear immersion suits but no gloves or hoods; one wears oilskins over jeans; the fourth wears only shorts and a T-shirt; the sixth, a 58-year-old man, has been in the water 45 minutes, is confused, has stopped shivering, and his skin is cold and waxy. One survivor's hands are so stiff he cannot close the raft's painter clip. A sealed 10-person liferaft is 15 m away, still attached to the sinking hull by its painter, and the raft's canister is partly submerged. No EPIRB was taken.
1. Set out your priorities and boarding order for the next 15 minutes, with the reasoning behind the order.
Read the worked answer
Priority order:
- Keep everyone together and afloat - lifejacket check, huddle or HELP position, no swimming. Swimming increases heat loss and gets nobody 15 m faster in a sea.
- Get the worst-off into the raft first: the shorts-and-T-shirt survivor, then the confused 58-year-old. Heat loss is fastest in thin clothing and in older, leaner casualties, and the confused man will drown if a wave breaks over him.
- Then the oilskins man, then the suited survivors, who can tolerate the water longest.
- Secure and board the raft, headcount six.
Do not leave anyone clinging to the hull, and do not let the man with stiff hands work the painter clip alone - buddy him. The raft is the objective, but reaching it in an uncoordinated rush loses people; the weakest get the dry platform first because they have the least margin.
2. How do you classify and manage the confused 58-year-old, both in the water and once in the raft?
Read the worked answer
Confusion, shivering stopped, cold waxy skin after 45 minutes in 11 °C water is severe hypothermia until proven otherwise, with a real risk of cardiac arrest. Shivering stopping is a deterioration sign, not an improvement.
In the water: check breathing. If breathing, keep the airway clear and handle him horizontally; no rubbing, no forced movement, no alcohol, no hot drink. If he is not breathing, give rescue breaths only if you have flotation and can do it without inhaling water - full CPR is ineffective in water and belongs on a stable platform.
In the raft: insulate and keep him horizontal; remove wet clothing only if it can be done gently and replaced with dry insulation. Warm the trunk first, not the limbs, and avoid active rewarming such as rubbing or hot water, which can drive cold peripheral blood back to the heart. Monitor breathing continuously; be ready to start 5 rescue breaths then CPR if he arrests.
3. The raft painter is attached to a partly submerged, sinking hull. When do you cut it, and how do you manage that with a survivor whose hands are too stiff to work the clip?
Read the worked answer
The painter is the hazard: if the hull goes down with the painter fast, the raft is dragged under or capsized. But cutting too early loses the raft.
Sequence: get the raft inflated and held alongside by the strongest survivors; board the weakest first; once at least two able people are in the raft and can hold it, cut the painter with the raft knife and then stream the sea anchor. If the hull starts to slip before boarding is complete, cut immediately and pick up the swimmers from the raft - a floating raft is far easier to reach than a submerged one.
The man with stiff hands does not handle the knife or the clip. He is a passenger for this task: buddy him, put him in the raft early, and give the knife to someone with working hands. This is the judgement - the person nearest the painter is not necessarily the person who should operate it.