Resuscitation
Governing: RCUK Adult BLS Guidelines 2025 (27 October 2025); Table A-VI/4-1 'cardiac arrest, drowning and asphyxia'; MSN 1905 Amendment 5, Annexes 1 and 2.
Recognising cardiac arrest
The victim is unresponsive and not breathing normally. RCUK 2025 is explicit that slow, laboured breathing, agonal gasping or panting are signs of cardiac arrest, not reassurance. The commonest error at sea is waiting for a pulse you cannot find. Do not waste time; if in doubt, start.
The numbers
| Element | RCUK 2025 adult |
|---|---|
| Compression depth | At least 5 cm, not more than 6 cm |
| Rate | 100-120 per minute |
| Ratio (trained rescuer) | 30 compressions : 2 breaths |
| Breaths | Just enough to see the chest start to rise; avoid over-ventilating |
| Untrained or unwilling | Continuous compressions |
| AED | As soon as it is available |
Hand position is the centre of the chest, lower half of the sternum. Arms straight, shoulders over the hands, full recoil between compressions. Swap compressors about every two minutes, at the AED's analysis pause, because quality falls off quickly and no one notices it in themselves.
The AED
Anyone can use an AED; it talks you through it. Bare and dry the chest, pads as pictured, stand clear for analysis and shock, and restart compressions immediately after. On deck, move the casualty off wet teak or out of standing water before shocking and dry the chest. Remove medication patches under the pad sites.
MSN 1905 Amendment 5 lists defibrillators as subject to risk assessment (referring to MGN 297) rather than mandatory stores, and the Immediate Response Bag list includes a defibrillator if available. In practice most large yachts carry one, and many owners insist. Check its pads' expiry date and battery at the monthly medical check.
Continue until
RCUK 2025: professional help takes over, the casualty shows signs of life (speaks, opens eyes, moves purposefully, breathes normally), or you are exhausted. At sea, add a fourth: a TMAS doctor advises stopping. Record times of collapse, first compression, shocks, and when you stopped.
Choking
| Stage | Action |
|---|---|
| Can cough | Encourage coughing |
| Cough ineffective | Up to five back blows |
| Still obstructed | Up to five abdominal thrusts |
| Still obstructed | Keep alternating five and five; call for help |
| Becomes unresponsive | Start CPR |
RCUK 2025 says do not use blind finger sweeps. Anyone treated with abdominal thrusts needs a medical check because of the risk of internal injury, which on a yacht means a TMAS call.
WARNING — The guest dining table Choking in the saloon is one of the more likely emergencies on a charter yacht. Interior crew are usually first there; make sure they have at least Elementary First Aid and know where the AED lives.
Oxygen
If you are trained and the casualty is breathing, give oxygen by mask. Category A and B stores include an oxygen set, and the Immediate Response Bag includes a small cylinder and mask. Pocket masks with a one-way valve protect you during rescue breaths.