The primary survey

~9 minPriorities & resuscitation awareness

This module is theory preparation only. First aid is a hands-on skill: do an accredited practical course, and always follow the most current official resuscitation guidance — protocols are reviewed and updated over time. Reviewed against Resuscitation Council UK 2021 Guidelines and NHS guidance, June 2026.

Every casualty, every time, gets the same opening sequence — because in a crisis the rehearsed beats the clever. DANGER: make the scene safe; on a boat that means the boom secured, the casualty clipped on or moved off the side deck, the boat settled on a kind heading before anyone kneels down. RESPONSE: talk, then gently shake. AIRWAY: head tilted, chin lifted. BREATHING: look, listen, feel for up to ten seconds — normal breathing, not occasional gasps. Then act on what you find, and get the radio call moving in parallel (Pan-Pan Medico for advice, Mayday if life is threatened): on a boat, calling for help IS first aid.

An unresponsive casualty who IS breathing goes into the recovery position — on their side, airway draining downhill — and on a small boat that means wedged secure against the motion, checked continuously. An unresponsive casualty who is NOT breathing normally needs CPR: chest compressions, hard and fast in the centre of the chest at the widely taught rate of about 100–120 per minute, with rescue breaths in the long-standing 30:2 pattern if trained and willing — on a yacht, brace your knees and work with the roll. CPR afloat is exhausting: rotate compressors every couple of minutes and keep the evacuation request running. If an AED (defibrillator) is reachable — marina pontoons and clubs increasingly have them, some yachts carry them — send for it and follow its spoken prompts exactly: it is built for untrained hands, only shocks when a shock is right, and CPR continues between its analyses.

The practical course teaches your hands the depth, the rhythm and the swap; this lesson’s job is the ORDER and the parallel radio call. Drill the sequence in your crew brief the way you drill the MOB.

Choking

Galley plus motion makes choking a real boat risk. A casualty who can cough and speak is partially blocked: encourage coughing, touch nothing else. One who CANNOT cough, speak or breathe is fully blocked, and the widely taught sequence is up to FIVE FIRM BACK BLOWS between the shoulder blades with the casualty leaning well forward (a cockpit coaming helps), then up to FIVE ABDOMINAL THRUSTS — fists clasped above the navel, sharp pull inwards and upwards — alternating until the object shifts or the casualty becomes unresponsive (then CPR, and the radio call you already started). Anyone who has received abdominal thrusts needs medical review afterwards even if they feel fine.

The secondary survey

Once the primary survey is satisfied and the casualty is stable, slow down and look PROPERLY: a calm head-to-toe check — head, neck, collarbones, chest, abdomen, each limb — for the injuries the drama hid; the broken wrist nobody noticed under the bleeding scalp is a first-aid classic. Add the questions: what happened, where does it hurt, any medical conditions, any medication, any allergies — and WRITE IT DOWN with times, because your scribbled record is the handover the paramedic or radio doctor builds on.

Check yourself

The primary survey runs…

An unresponsive casualty who IS breathing normally goes…

Widely taught chest-compression rate and pattern are about…

An adult choking and unable to cough, speak or breathe gets…

After the primary survey, a stable casualty gets…

An AED (defibrillator)…

Answers count towards your topic mastery on the exercises page.