A child screams somewhere aft and you are the first person there. Your instinct is to drop to your knees and start doing something, anything. Resist it for ten seconds. In those ten seconds the most valuable thing you can possibly do is not treatment: it is making sure the right people know.
The Chain
- Ensure your own safety first. A second casualty helps nobody. Identify the hazard that caused the injury: water, hot surfaces, chemicals, live equipment, a swinging watertight door.
- Shout for help and raise the alarm. Immediately and loudly, using whatever method this vessel uses: a shout, the PA, a radio call on the working channel.
- Send someone to the bridge. Name them. "You, go to the bridge now: child injured, aft deck, send the medical person." A named person carrying a specific message beats a general appeal to the air.
- Begin only what you are trained to do. If you hold a current, assessed qualification, work within it. If you do not, make the area safe, stay with the child, keep watch, gather the parents and their information, and let the trained responder work.
- Telemedical advice is obtained. The bridge raises a doctor by satellite or radio.
- The captain decides. Manage onboard, divert, tender ashore or evacuate. That authority is the captain and nobody else.
Who Is Who
| Role | What they do |
|---|---|
| First responder | Whoever is there. Safety, alarm, stay with the child |
| Designated medical person | Holds the qualification; leads treatment |
| Bridge / OOW | Position, communications, calls the doctor, logs times |
| Captain | Authority for diversion and evacuation |
| Parents | Consent, history, allergies, the child own medication |
Things That Break the Chain
- Nobody actually raised the alarm, because everyone assumed somebody else already had.
- The message to the bridge was vague, so nothing was prepared.
- An untrained crew member attempted a technique instead of shouting for the trained one.
- The parents were never asked about allergies, asthma or existing medication.
- Six crew crowded the scene. Two people help; six obstruct.
The Discipline
The chain works because each link does its own job and not somebody else job. Unless you are the trained responder, your task is to raise the alarm, keep the scene safe and stay useful. That is not a minor role. It is the link on which every other link depends.
Onboard Notes
- Learn the alarm procedure on this vessel today: what you shout, who you call, on what channel.
- Rehearse the sentence you would give the bridge: what, who, where, how bad.
- Know the line between what you are trained to do and what you have merely read about.
- Preparatory study only. Awareness, not first aid training. This course teaches no techniques and does not qualify you to treat a child. A current, practically assessed paediatric first aid certificate from an approved provider is required.