Yachtmaster Safety, First Aid & Emergency Procedures
Everything you need to know for the safety and first aid elements of the RYA Yachtmaster exam. This is a skippering exam, not a medical exam — the examiner wants to see you take charge, make decisions, communicate clearly, and manage your crew safely.
What The Examiner Tests
You must hold a valid First Aid certificate, but the examiner will not test detailed medical knowledge. The three topics that will be probed in the practical exam:
- Hypothermia treatment and cold shock effects
- Calling for medical assistance by radio (Pan Pan Medico / Mayday)
- Helicopter evacuation procedures (Hi-Line)
Your exam will likely begin with a safety briefing. The examiner wants to see you cover: location of safety equipment, VHF/Mayday procedure, engine checks, emergency procedures (fire, flooding, MOB, dismasting), grab bag contents, gas isolation, and seacocks.
1. Cold Shock & Immersion
Cold water immersion follows four predictable stages. This is critical exam knowledge.
1. Cold Shock
The initial gasp reflex when hitting cold water. Uncontrollable hyperventilation, panic, massive increase in heart rate and blood pressure. This is the most dangerous phase — most drowning deaths happen here, not from hypothermia. Risk of cardiac arrest in those with underlying heart conditions.
Action: This is why lifejackets must be worn BEFORE going in. You cannot hold your breath or swim effectively during cold shock.
2. Swimming Failure
Cold blood reaches the muscles. Progressive loss of grip strength, coordination, and swimming ability. The casualty becomes unable to keep their airway clear of the water.
Action: Recovery must happen in this window if possible.
3. Hypothermia
Core body temperature drops below 35°C. Progressive confusion, loss of consciousness, cardiac irregularity.
Action: See Hypothermia section below.
4. Post-Rescue Collapse
Circumrescue collapse can occur immediately before, during, or shortly after rescue. Caused by the sudden removal of hydrostatic pressure (water pressure) when lifted vertically from the water, leading to a drop in blood pressure and cardiac arrest.
Action: ALWAYS lift casualties HORIZONTALLY. Lay them down immediately. Handle gently. Do not stand them up.
Why This Matters for Your Exam
- Prevention: lifejackets, harnesses, jacklines, awareness
- Speed of recovery: cold shock kills faster than hypothermia
- Horizontal recovery: vertical lifting can cause cardiac arrest
- Once on deck: lay flat, assess, keep warm, monitor
- Decision: when to call for help vs when to divert to harbour
2. Hypothermia & Rewarming
COLD — "Little Sick"
Immersion under 30 minutes
- Casualty is shivering, conscious, lucid
- Protect from further cooling and wind
- Remove wet clothing, wrap in blankets
- Give warm sweet drinks
- Can be rewarmed: sit them in a warm shower (supervised at all times)
HYPOTHERMIC — "Big Sick"
Immersion over 30 minutes
- Memory loss, foetal position, AVPU deterioration
- Shivering replaced by muscle spasm
- Cap refill IS NOT RELIABLE — use AVPU and breathing rate
- Handle VERY gently (rough handling can trigger cardiac arrest)
- Lift horizontally
- Do NOT actively rewarm — needs hospital
- Insulate, cover head, monitor and evacuate
Exposure Hypothermia
Not just immersion — hypothermia can also occur from prolonged exposure to cold, wet, windy conditions on deck. Especially common on long night passages, in crew who are tired, seasick, dehydrated, or wearing inadequate clothing. Same treatment principles apply. Prevention is key: proper watch rotation, warm clothing layers, hot food and drinks, monitoring crew wellbeing.
Key Points for the Exam
- Know the difference between cold shock (immediate, kills in minutes) and hypothermia (gradual, kills in hours)
- Horizontal lift — always
- Cold casualties can be rewarmed; hypothermic casualties need hospital
- Never give alcohol (vasodilator, accelerates heat loss)
- Be gentle with hypothermic casualties
- Supervise rewarming at ALL times
3. Medical Assistance by Radio
Pan Pan Medico
Urgent but NOT immediately life-threatening
"PAN PAN, PAN PAN, PAN PAN"
"ALL STATIONS"
"THIS IS [vessel name x3]"
"[callsign and/or MMSI]"
"I HAVE A MEDICAL EMERGENCY /
REQUIRE MEDICAL ADVICE"
"MY POSITION IS [lat/long]"
"[Persons on board, nature of problem]"
"OVER"
HM Coastguard can connect you to a doctor for telemedical advice.
Mayday
LIFE-THREATENING — immediate assistance needed
"MAYDAY, MAYDAY, MAYDAY"
"THIS IS [vessel name x3]"
"MAYDAY [vessel name]"
"MY POSITION IS [position]"
"[Nature of distress]"
"I REQUIRE IMMEDIATE ASSISTANCE"
"[Persons on board]"
"OVER"
Also press the DSC distress button (lift cover, hold 5 seconds).
What to Have Ready Before Calling
- Your vessel name, callsign, MMSI
- Your position (GPS lat/long)
- Number of persons on board
- Casualty details: age, sex, symptoms, when they started
- Treatment given so far
- Casualty's medical history and medications (S.A.M.P.L.E.)
- Your intentions (continuing to port, requesting helicopter, etc.)
Beyond VHF range: Satellite phone, Inmarsat, EPIRB for distress alerting. In UK waters, the Coastguard can also be reached on 999 from a mobile phone (with signal).
4. Helicopter Evacuation
Before the Helicopter Arrives
- Brief your crew — communication is impossible once the helicopter is overhead
- Assign roles: helmsman (must hold a steady course and NOT look up), one person on the hi-line, radio operator
- All other crew stay below or out of the way
- Clear the deck of ALL loose gear (it becomes a missile in rotor downwash)
- Drop sails, motor at steady speed and course as directed by pilot
- Lower or secure aerials and rigging near the pickup area
- Prepare the casualty: attach a written note with name, age, symptoms, treatment given, medications
The Hi-Line Procedure (UK Standard)
- Sailing yachts: sail close-hauled on PORT TACK. Motor vessels: steer steady course/speed as directed by pilot.
- The helicopter approaches from your PORT QUARTER (pilot sits starboard side, needs line of sight into your cockpit).
- A weighted hi-line (~30m) is lowered first. Let the weight touch the deck or water BEFORE you grab it — this earths the static charge.
- NEVER attach the winch wire or hi-line to any part of the yacht. Keep it free at all times.
- Pull in the hi-line, taking up slack. Coil into a bucket to prevent tangles.
- The winchman or rescue device descends on the main winch cable. Use the hi-line to guide them onto the deck.
- Once the winchman is on deck, THEY ARE IN CHARGE. Follow their instructions.
- For evacuation: the process reverses. Pay out the hi-line as directed, maintaining slight tension to control swing.
- When complete and instructed, let go the hi-line and throw clear into the water.
Key Safety Rules
- NEVER attach the wire to the yacht — it can drag you or damage the helicopter
- Let the wire/weight earth on deck or water FIRST (static discharge)
- The winchman is in charge once on deck
- Helmsman must hold course and NOT look up
- Hypothermic casualties may be lifted in a DOUBLE STROP (horizontal) to prevent post-rescue collapse
- If being lifted yourself: keep arms DOWN by your sides
- When entering the helicopter, do NOT try to help — the crew will push you in
Exam Tip: Heart Attack Offshore
The examiner may ask: "A crew member has a suspected heart attack 30 miles offshore. Talk me through what you would do."
- Assess the casualty (AVPU, breathing, symptoms)
- First aid (sit in W position, aspirin if appropriate, keep warm, reassure)
- Call Coastguard on Ch16 — Pan Pan Medico for advice, upgrade to Mayday if deteriorates
- Prepare for helicopter evacuation (brief crew, clear deck, assign roles)
- Prepare casualty information note for handover
- Consider diverting to nearest port as backup plan
- Monitor casualty continuously
- Be prepared for CPR if cardiac arrest occurs
5. First Aid Essentials
Assessment (DR ABC)
- D — DANGER: Is the scene safe?
- R — RESPONSE: AVPU scale (Alert / Voice / Pain / Unresponsive)
- A — AIRWAY: Open and clear? Injury = Jaw Thrust. Illness = Head Tilt / Chin Lift.
- B — BREATHING: Rate per minute. Effective or ineffective?
- C — CIRCULATION: Cap refill (press 5 sec: 1–2 sec normal, 3+ sec shock). Bleeding?
S.A.M.P.L.E. history for conscious casualties: Signs/Symptoms, Allergies, Medications, Past history, Last meal, Events leading to incident.
CPR — Including Drowning Protocol
- Standard adult CPR: 30 compressions : 2 breaths at 100–120/min
- Child: 15 compressions : 2 breaths
- DROWNING DIFFERENCE: Start with 5 RESCUE BREATHS before compressions — the primary problem is oxygen deprivation, not cardiac failure
- Use an AED as soon as available
- On a yacht: you may need to do CPR on a cockpit sole or cabin floor — "over the head" CPR using a pocket mask may be necessary in narrow spaces
- Send a Mayday BEFORE starting CPR — once you start, you cannot stop
Recovery Position
- For unconscious, breathing casualties
- Space is limited on a yacht — modify for narrow bunks, cockpit floors, or cabin soles
- Boat motion means securing the casualty is important — use lee cloths, cushions, or wedge against bulkheads
- Monitor airway continuously as boat movement can compromise the position
- Pregnant casualties: LEFT SIDE
Bleeding Control
- Direct pressure on the wound with a dressing or clean cloth
- Elevate the limb if possible
- If severe bleeding won't stop: apply a tourniquet (note the time)
- Internal bleeding signs: pale, cold, clammy, rapid breathing, confusion, hard/swollen abdomen, bruising — recognise it, treat for shock (lie flat, raise legs, keep warm), evacuate urgently
Shock
- Shock = failure of the circulatory system
- Causes: blood loss, burns, heart failure, severe allergic reaction, spinal injury
- Signs: pale, cold, clammy skin, rapid weak pulse, rapid shallow breathing, confusion, thirst, nausea
- Treatment: lie flat, raise legs, keep warm (blankets, not hot water bottles), reassure, do NOT give food or drink
- Monitor continuously. Evacuate.
Drowning
- Remove from water quickly
- Conscious: assess, warm, dry, monitor — warn of possible delayed complications (secondary drowning)
- Unconscious and breathing: recovery position
- Not breathing: 5 rescue breaths then CPR
- Suspect hypothermia if immersion over 30 minutes
- Handle horizontally. Vomiting is common — be ready to clear the airway
Chest Pain / Heart Attack
- Central crushing/constricting pain, may radiate to arms, jaw, neck, back. Pale, clammy, nauseous, sense of doom.
- Sit in W position (knees up, leaning back). Keep calm.
- Aspirin 300mg — casualty chews (if over 16, not allergic, no stomach bleed)
- Call for medical advice immediately
- Be prepared for CPR if they arrest
- Do NOT lay flat or transport head-down
Seasickness
- Severe seasickness can cause: complete incapacitation, dehydration, hypothermia (they stop caring, stop eating, stop keeping warm), crew safety risk
- Prevention: medication BEFORE departure, adequate rest, hydration, avoid going below
- Treatment: fresh air, horizon focus, sips of water, anti-sickness medication
- As skipper: you may need to alter passage plans to get a sick crew member ashore
Diabetic Emergency (Hypo)
- Low blood sugar can mimic drunkenness: confused, aggressive, pale, clammy, vacant expression, sudden mood change
- Conscious: give sugar immediately — sweets, glucose gel, sugary drink. Once recovered, give slow-release carbohydrates.
- Unconscious: glucose gel rubbed into gums. Recovery position. Call for help.
- NEVER give insulin. When in doubt, give sugar — it is safe even if the diagnosis is wrong.
Seizures
- Protect the casualty from injury. Clear the area. Do NOT restrain or put anything in their mouth.
- When the fit stops: check airway, recovery position, monitor
- Could this be low blood sugar? Give glucose gel if any doubt.
- Fitting lasting over 5 minutes, or repeating without recovery = medical emergency — call for help
Burns (Including Scalds)
- Very common on yachts from stoves, engines, hot drinks, ropes
- Cool the burn under running cold water for at least 10 minutes
- Remove watches/jewellery. Cover with cling film or clean non-adhesive dressing.
- Do NOT burst blisters. Do NOT remove clothing stuck to the burn. Do NOT use ice directly.
- Facial burns with soot around mouth/nose or singed facial hair = suspect airway swelling — medical emergency, evacuate
Fractures & Spinal Injury
- Fractures: immobilise in the position found. Splint using battens, rolled magazines, cushions. Pain relief if available.
- Spinal injury (suspect after any fall, blow to head, high-energy impact): do NOT move unless in immediate danger. Support head and neck in neutral alignment. Log roll with help if you must move.
- Head injuries: monitor consciousness closely (AVPU). Any deterioration = urgent evacuation. Vomiting, unequal pupils, increasing confusion or drowsiness are danger signs.
Anaphylaxis
- Severe allergic reaction: swelling (face, throat), rash/hives, difficulty breathing, wheeze, rapid deterioration
- Help them use their own adrenaline auto-injector (EpiPen) if they have one
- Sit upright if breathing is difficult — NEVER lay a conscious anaphylaxis casualty flat
- Call for help immediately
6. First Aid Kit & Yacht Preparation
Recommended Kit Contents
Category C Medical Stores
If you hold or plan to hold a commercial endorsement for your Yachtmaster, you must carry Category C medical stores as specified in MSN 1905 (M+F). Additional items include: pocket mask, larger quantities of dressings and bandages, eye pads, specified medications, and written guidance on use. Check the current MSN for the full list.
Skipper's Responsibilities
- Ensuring adequate first aid equipment is on board and in date
- Knowing where the kit is and how to use it
- Briefing crew on its location and basic contents
- Knowing crew medical conditions and medications BEFORE departure
- Carrying contact details for Coastguard medical advice
- Having a passage plan that accounts for nearest ports of refuge for medical emergencies
- Maintaining your first aid certificate (renew every 3 years)
7. Exam Scenarios
Practise talking through these scenarios out loud. The examiner is looking for a calm, structured response — not a perfect textbook answer.
Scenario 1: MOB in Cold Water
"Your crew member falls overboard in 10°C water. You recover them after 8 minutes. They are conscious but shivering violently and confused. What do you do?"
Model Answer
- They are in the cold shock to swimming failure phase, not yet hypothermic
- Recover HORIZONTALLY if possible (davit, sling, or crew lifting together)
- Lay flat on deck, do not stand them up (post-rescue collapse risk)
- Get below, remove wet clothing, wrap in dry blankets
- Warm sweet drinks once fully alert and able to swallow
- Monitor continuously — AVPU, breathing rate
- Consider calling Coastguard for medical advice
- Consider diverting to nearest port for medical assessment
- Record the incident and observations
Scenario 2: Suspected Heart Attack Offshore
"35 miles from port, a crew member has central chest pain radiating to their left arm. They feel sick and look pale and sweaty. What do you do?"
Model Answer
- Sit in W position, loosen clothing, reassure
- Give 300mg aspirin (chewed) if over 16 and not allergic
- Call Coastguard on Ch16: Pan Pan Medico for medical advice
- Be prepared to upgrade to Mayday
- Prepare for helicopter evacuation (brief crew, clear deck, assign roles, write casualty info note)
- Monitor continuously, be prepared for CPR
- Do NOT lay flat, do NOT transport head-down
- Have another crew member plot course to nearest port as backup
Scenario 3: Severe Seasickness
"On a 48-hour passage, one crew member has been vomiting for 12 hours and is now unable to stand, dehydrated, and barely responsive. What do you do?"
Model Answer
- This is now a serious medical situation, not just discomfort
- Get them below into a secure bunk, recovery position if drowsy
- Small sips of water, rehydration salts if they can keep them down
- Monitor AVPU — reduced consciousness is a red flag
- Assess: are they hypothermic? Dehydrated? Both?
- Call Coastguard for medical advice
- Seriously consider diverting to nearest port
- This also affects your passage plan: you are now effectively short-handed
Scenario 4: Head Injury from Boom
"During a gybe, the boom strikes a crew member on the head. They are dazed, have a cut on their head, and vomit once. What do you do?"
Model Answer
- This is a potential serious head injury until proven otherwise
- Get them sitting/lying safely, steady the head
- Control bleeding with direct pressure on the wound
- Monitor AVPU closely — any deterioration is urgent
- Vomiting after head injury is a warning sign
- Ask them questions: name, where they are, what happened (assess confusion)
- Call Coastguard for medical advice
- Do NOT give Entonox or strong pain relief
- Plan to get them ashore for medical assessment
- Record all observations with times
8. Quick-Fire Flashcards
20 rapid-fire questions and answers. Cover the answers and test yourself, or use these to revise key facts before the exam.
What are the four stages of cold water immersion?
1. Cold Shock (0–3 min) 2. Swimming Failure (3–30 min) 3. Hypothermia (30+ min) 4. Post-Rescue Collapse
Why must you lift a MOB casualty horizontally?
Vertical lifting removes hydrostatic pressure suddenly, causing blood pressure to drop, potentially triggering cardiac arrest (post-rescue collapse).
Cold vs hypothermic: which can you rewarm ashore?
COLD (<30 min, shivering, lucid) = warm shower, supervised. HYPOTHERMIC (>30 min, confused, foetal position) = needs hospital.
What VHF call for medical ADVICE?
Pan Pan Medico on Channel 16.
What VHF call for LIFE-THREATENING emergency?
Mayday on Channel 16 (and DSC distress button).
Helicopter approaches from which side?
PORT QUARTER (pilot sits starboard side for line of sight).
First thing to do when the hi-line weight descends?
Let it touch the deck or water FIRST to discharge static electricity. Then grab it.
Can you attach the winch wire to the yacht?
NEVER. It must remain free at all times.
Who is in charge once the winchman is on deck?
The winchman. Follow their instructions.
Drowning CPR: what do you do differently?
Start with 5 RESCUE BREATHS before compressions (primary problem is oxygen deprivation).
Aspirin dose for suspected heart attack?
300mg, chewed. Over 16 only. Check not allergic, no stomach bleed.
Casualty position for heart attack?
W position (sitting, knees up, leaning back). Never lay flat.
What is S.A.M.P.L.E.?
Signs/Symptoms, Allergies, Medications, Past history, Last meal, Events.
Diabetic hypo: give insulin or sugar?
ALWAYS sugar. NEVER give insulin.
When should you send a Mayday BEFORE starting CPR?
Always. Once you start CPR you cannot stop to make the call.
Recovery position for pregnant casualty?
On their LEFT SIDE.
Cap refill: how long do you press?
5 seconds. 1–2 sec refill = normal. 3+ sec = shock.
Jaw Thrust vs Head Tilt: when do you use each?
Jaw Thrust for INJURY (protects spine). Head Tilt/Chin Lift for ILLNESS/IMMERSION.
Why is severe seasickness a medical emergency?
Dehydration, hypothermia risk, incapacitation, reduced consciousness. It also makes you short-handed.
Facial burns with soot around mouth: what do you suspect?
Airway swelling. Medical emergency. Evacuate urgently.
Ready to Test Your Knowledge?
Take the interactive Yachtmaster Safety quiz or explore related courses.