MFA-L1.1

The MFA standard and casualty assessment

MFA-M1 · Assessment and resuscitation · MFA-M1-A How the MFA standard fits aboard, how to assess a casualty, and CPR, AED and choking.

Medical First Aid is the level between Elementary First Aid and full Medical Care. It starts with a **structured assessment** that stops you treating the loudest injury rather than the deadliest.

Entry & progression

Governing: STCW VI/4 and Table A-VI/4-1; MSN 1865 (M) Amendment 1, section 5.1. Builds on: Elementary First Aid (A-VI/1-3). Leads to: Proficiency in Medical Care Onboard Ship (PMC).

Where MFA sits

Level STCW Who holds it on a yacht
Elementary First Aid A-VI/1-3 Every crew member (basic safety)
Medical First Aid A-VI/4-1 Officers, engineers, pursers, often chief stews
Medical Care A-VI/4-2 The person in charge of medical care, normally master or chief officer

MSN 1865 section 5.1 is short: if you have designated duties to provide medical first aid, you complete an MCA-approved course meeting A-VI/4 paragraphs 1 to 3. The same section says no refresher is currently required for MFA under STCW. That does not make your skills permanent; CPR guidance changed in October 2025 and will change again.

MSN 1858 Amendment 2 section 6.2 requires Medical First Aid for Chief Mate (Yachts) <3000 GT, Master (Yachts) and the unlimited yacht certificates, and PMC requires MFA first. On the MNTB specification, the block course is normally 28 hours over four days, with at least 40% practical work on manikins and simulated casualties.

The one competence

Table A-VI/4-1 has a single competence, apply immediate first aid in the event of accident or illness on board, with knowledge of the first-aid kit, body structure, toxicological hazards (including MFAG), examination of the casualty, spinal injuries, burns and cold, fractures, care of rescued persons, radio medical advice, pharmacology, sterilisation, and cardiac arrest, drowning and asphyxia. The assessment criteria reward three things: prompt identification of cause and extent of injury, minimising risk to yourself and others, and treatment that follows recognised practice.

The sequence

  1. Danger. Machinery running, live cables, enclosed-space atmosphere, a moving tender, a hot galley. Make it safe or do not go in. Raise the alarm on the radio early; on a yacht that brings the rest of the team and the medical bag.
  2. Response. Speak loudly, tap the shoulders. Unresponsive and not breathing normally means cardiac arrest (lesson 1.2).
  3. Catastrophic bleeding. RCUK 2025 tells first aiders to pay immediate attention to safety, responsiveness and life-threatening bleeding before the rest.
  4. ABCDE.
Step Look for Immediate action
Airway Noise, obstruction, vomit Head tilt/chin lift, or jaw thrust if spinal injury suspected
Breathing Rate, effort, colour Sit up if conscious and breathless; oxygen if trained
Circulation Bleeding, pulse, skin colour and temperature Pressure, lie flat for shock
Disability Level of response, pupils, blood sugar if diabetic Recovery position if breathing and no trauma
Exposure Hidden injuries, temperature Expose, examine, then cover and keep warm
  1. Secondary survey. Head to toe, then the history: what happened, symptoms, allergies, medicines, past illness, last meal.

Recording

Write times and observations from the start: pulse, breathing rate, response level, what you did and when. The TMAS doctor (lesson 4.2) will ask for exactly these, and the master's log entry depends on them.

TIP — Two people, two jobs One treats, one writes and runs the radio. On a yacht with ten or twelve crew, agree in drills who fetches the Immediate Response Bag and oxygen.

CAUTION — Scope MFA is immediate care. Stitching, injections beyond an adrenaline auto-injector and prescribing decisions belong to the Medical Care holder working with TMAS.

Practice questions

5 questions

recall · core

Which STCW table sets the standard for Medical First Aid? (a) Table A-VI/4-1 (b) Table A-VI/1-3 (c) Table A-II/1 (d) Table A-VI/4-2

recall · core

Under MSN 1865 Amendment 1, what refresher training is required for the MFA certificate? (a) Every 2 years (b) Every 5 years (c) None is currently required under STCW (d) Annually on board

recall · core

In the RCUK 2025 first aid structure, what does the 'D' of ABCDE stand for? (a) Danger (b) Defibrillation (c) Dressing (d) Disability

recall · core

According to the MNTB specification, what share of the MFA course should be practical exercises? (a) 100% (b) At least 25% (c) At least 40% (d) At least 10%

scenario · core

A deckhand is found at the foot of the engine room ladder, groaning, with blood pooling under one thigh. The space ventilation fans have stopped and there is a smell of exhaust. What is your first action? (a) Establish the space is safe to enter and raise the alarm before going in (b) Log-roll him into the recovery position (c) Apply direct pressure to the thigh (d) Start an ABCDE assessment

Independent study. xplor is not an accredited training provider and awards no certificate or Certificate of Competency. The Medical First Aid certificate of proficiency is issued only on completion of an MCA-approved course with practical assessment on manikins and simulated casualties, and nothing here replaces hands-on training. AI-drafted content pending subject-matter-expert review.