USCG Certification Requirements
What You Need
- ▸First Aid certificate — current, from an accepted organization
- ▸CPR/AED certificate — may be combined with first aid or separate
- ▸Both must be valid (not expired) at time of application or renewal submission
- ▸Course must include a hands-on skills component — online-only courses not accepted
Accepted Organizations
- ✓American Red Cross (Standard First Aid / Wilderness First Aid)
- ✓American Heart Association (Heartsaver First Aid CPR AED)
- ✓National Safety Council
- ✓American Safety & Health Institute (ASHI)
- ✓Medic First Aid
- ✓Other nationally recognized programs with skills evaluation
CPR Quick-Reference Card
Current guidelines follow the CAB sequence for cardiac arrest: Circulation (compressions) → Airway → Breathing. For drowning victims, give 2 rescue breaths before beginning compressions.
Confirm scene is safe. Tap shoulders: 'Are you OK?' If unresponsive, call MAYDAY / 911. Send someone for AED.
Place heel of hand on center of chest (lower half of sternum). 30 compressions: depth 2–2.4 inches, rate 100–120/min. Let chest fully recoil between compressions.
Tilt head, lift chin. Pinch nose. Seal mouth — give 1 breath over 1 second; watch for chest rise. Give 2 breaths total. If breaths don't go in, reposition and retry once.
Continue 30 compressions then 2 breaths. Minimize interruptions — no more than 10 seconds between compressions for any check.
Power on AED, attach pads per diagram, follow voice prompts. Deliver shock if advised. Resume CPR immediately after shock — do not pause to check pulse.
Tap and shout. If alone with no phone, give 2 minutes of CPR before leaving to call for help.
Use 1 or 2 hands on center of chest. Depth: at least one-third AP chest diameter (~2 inches). Rate: 100–120/min.
Smaller breaths than adult — just enough to see chest rise. Avoid over-inflation (gastric distension risk).
Use pediatric pads/dose attenuator if available for AED. If only adult pads available, use them — position anterior/posterior if possible on small child.
Tap foot rather than tapping shoulders. Shout for help. Place infant on hard, flat surface.
Place 2 fingers on center of chest, just below the nipple line. Depth: ~1.5 inches. Rate: 100–120/min. 2-thumb encircling technique preferred with 2 rescuers.
Cover infant's mouth AND nose with your mouth. Tiny puffs — just enough to see chest rise. Avoid forceful inflation.
Same cycle. With 2 rescuers, use 15:2 ratio. Do not use AED on infants under 1 year unless no other option exists.
AED Use — 4 Universal Steps
AEDs are designed to be used by untrained bystanders — the device gives spoken instructions. Know the 4-step sequence and how it integrates with CPR.
Power On
Open the lid or press the power button. The AED will immediately begin giving voice instructions.
Attach Pads
Peel pads; place per diagram — one on upper right chest, one on lower left side. Bare, dry skin. Remove pacemaker area if visible bump present.
Analyze
Do not touch the patient during analysis. AED determines if a shockable rhythm is present. Everyone clear while analyzing.
Shock + Resume CPR
If shock advised: announce 'clear,' confirm no one touching, press shock button. Resume CPR immediately after shock. Reanalyze every 2 minutes.
Choking Response — Adult, Child & Infant
Choking (airway obstruction) is a time-critical emergency. A victim who can cough forcefully should be encouraged to do so — do not intervene unless they can no longer speak or breathe.
- ▸Ask: 'Are you choking?' — if they can speak/cough, encourage forceful coughing
- ▸If unable to speak/cough/breathe: stand behind, lean victim forward slightly
- ▸Give 5 sharp back blows between shoulder blades with heel of hand
- ▸5 abdominal thrusts (Heimlich): fist above navel, below xiphoid; firm inward-upward thrusts
- ▸Alternate 5 back blows + 5 abdominal thrusts until object is expelled or victim loses consciousness
- ▸Lower victim to ground; call for help
- ▸Begin CPR — every time you open the airway to give breaths, look for the object
- ▸If you see the object, remove it; do not perform blind finger sweeps
- ▸Hold infant face-down on your forearm, head lower than chest
- ▸Give 5 firm back blows between shoulder blades with heel of hand
- ▸Turn face-up on your forearm; give 5 chest thrusts with 2 fingers on lower half of sternum
- ▸Alternate 5 back blows + 5 chest thrusts; check mouth between sets
- ▸Never do abdominal thrusts on an infant — can rupture internal organs
- ▸Begin infant CPR; check mouth before rescue breaths
- ▸Remove only objects you can clearly see
Marine-Specific Emergencies
These emergencies are unique to — or dramatically worsened by — the marine environment. A licensed captain is expected to know field treatment for all of them.
- •Retrieve victim with throw rope or pole — don't jump in unless trained
- •Begin CPR with 2 rescue breaths first (respiratory, not cardiac arrest)
- •Do NOT attempt to drain water from lungs — it doesn't work and wastes time
- •Treat for hypothermia even in warm water
- •MAYDAY on VHF Ch 16 immediately
- •Transport to hospital even if victim recovers — risk of secondary drowning up to 24 hours later
- •Stage 1 (mild, 89–95°F): shivering, impaired coordination — remove from cold/wet, rewarm gently
- •Stage 2 (moderate, 82–89°F): muscle rigidity, no shivering, confusion — horizontal position, gentle handling
- •Stage 3 (severe, <82°F): unconscious, no pulse — CPR; 'not dead until warm and dead'
- •Heat core first: armpits, groin, neck — NOT extremities (drives cold blood to heart)
- •Handle victim gently — rough movement can cause ventricular fibrillation
- •Keep horizontal — standing drops blood pressure dangerously
- •Hot, dry (or sometimes wet), red skin; temperature >104°F; confusion or unconscious
- •Aggressive cooling NOW — immerse in cold water, ice packs to armpits/groin/neck
- •Fan and mist with water continuously
- •Do NOT give fluids by mouth to unconscious victim
- •Call MAYDAY — this is a life-threatening emergency
- •Different from heat exhaustion: exhaustion = sweating, cool/pale skin, still conscious
- •Heavy sweating, pale/cool/moist skin, weakness, dizziness, nausea
- •Move to shade or below deck; loosen all clothing
- •Cool with water spray and fanning
- •Give cool water or sports drink if fully conscious
- •Elevate legs slightly if no head/chest injury
- •Monitor for progression to heat stroke — if confusion develops, treat as heat stroke immediately
- •Nausea, vomiting, cold sweats, pallor, headache — caused by sensory conflict
- •Position at center of vessel (least motion), fix gaze on horizon
- •Fresh air, lying down, avoiding engine fumes and below-deck smells
- •Oral rehydration if able to keep fluids down; severe vomiting → IV fluids needed
- •Preventive: scopolamine patch (Rx), dimenhydrinate (OTC) 30–60 min before departure
- •Risk: prolonged severe vomiting can cause dehydration and electrolyte imbalance requiring evacuation
- •Do NOT rub the area — activates unfired nematocysts
- •Remove tentacles with tweezers or card edge — not bare hands
- •Rinse with seawater (NOT fresh water — osmotic shock fires nematocysts); vinegar for box jellyfish
- •Immerse in hot water (as hot as tolerable, ~110°F) for 20 minutes — denatures venom proteins
- •Anaphylaxis risk: hives/swelling elsewhere, difficulty breathing → epinephrine auto-injector, MAYDAY
- •Portuguese Man O'War: same treatment; more systemic symptoms possible
Bleeding Control
Uncontrolled hemorrhage is the leading preventable cause of trauma death. On a vessel far from shore, the captain must manage major bleeding with the tools onboard — typically gauze, pressure bandages, and a tourniquet.
- 1.Apply firm, continuous pressure with gloved hand and clean cloth/gauze
- 2.Do not lift dressing to check — add more gauze on top if soaking through
- 3.Maintain pressure for minimum 10–15 minutes without releasing
- 4.Elevate the injured limb above the heart if no fracture
Works for 80%+ of wounds. Never remove initial dressing.
- 1.Wear gloves; pack hemostatic gauze (Quikclot, Combat Gauze) or plain gauze directly into wound cavity
- 2.Push packing deep — fill the cavity, do not just cover the surface
- 3.Apply firm direct pressure over packed wound for 3 minutes
- 4.Maintain pressure; do not remove packing until advanced medical care is available
Hemostatic gauze preferred if available; plain gauze with firm pressure is also effective.
- 1.Apply 2–3 inches above the wound (proximal) — not over a joint
- 2.Tighten windlass until bleeding stops and distal pulse is absent
- 3.Note the exact time of application — write it on victim's forehead or arm in marker
- 4.Do NOT remove in the field — leave for hospital
Tourniquet causes pain and tissue damage with prolonged use, but it saves lives in arterial bleeding. The risk of leaving it on is far less than removing it.
Shock — Recognition & Treatment at Sea
Shock is inadequate tissue perfusion — the body is not delivering enough oxygen to vital organs. Multiple causes (blood loss, severe dehydration, allergic reaction, spinal injury) but the recognition and field treatment are similar.
Signs & Symptoms
Field Treatment
Control bleeding, treat severe allergic reaction with epinephrine, manage dehydration
Supine (flat on back); elevate legs 8–12 inches if no head, chest, or spinal injury suspected
Insulate from cold deck and wind; shock victims lose body heat rapidly
Supplemental O₂ increases tissue oxygenation; use if vessel carries O₂
Oral fluids only if fully conscious and no abdominal injury. Do not give fluids if altered mental status.
Shock is a progressive, life-threatening emergency — definitive treatment requires IV fluids and hospital care
Track pulse, breathing, mental status, skin color. Deterioration may be rapid. Report changes on radio.
Emergency Action Plan on a Vessel
A well-executed emergency response begins before any incident. Licensed captains are expected to have a plan, brief their crew, and execute it without confusion.
Ensure Scene Safety
Before approaching a victim, confirm the scene will not injure you. On a vessel: engine off, lines clear, fire/electrical hazard checked. A second victim helps no one.
Call for Help — VHF Ch 16
Transmit MAYDAY immediately if there is any threat to life. Do not wait to see how things develop. Include: 'MAYDAY MAYDAY MAYDAY, vessel name, position, nature of emergency, number of persons, vessel description.'
Assign Roles to Crew
Designate one person as primary caregiver, one to navigate/operate the vessel, one to communicate on the radio. A captain managing all three functions simultaneously makes critical errors.
Assess and Treat
Primary survey: Circulation (major bleeding) → Airway → Breathing. Correct life-threatening problems in this order before doing a full secondary assessment.
Keep Victim Warm and Still
Hypothermia sets in faster than most mariners expect — even in summer. Insulate from deck and wind. Immobilize potential spinal/fracture injuries. Do not move the victim unnecessarily.
Document and Report
Record the time of injury, treatment given, medications administered (including dosages), and any changes in patient condition. This information is critical for the receiving medical team.
Proceed to Nearest Port or Rendezvous
Get underway toward the nearest medical facility or Coast Guard rendezvous point. Communicate ETA and patient status updates on Ch 16. Time is tissue.
USCG Exam Tips — What First Aid Actually Tests
What the exam tests
- ✓Priority order: CAB sequence (Circulation → Airway → Breathing)
- ✓Recognizing and treating shock — not the exact cause, but the field response
- ✓Hypothermia stages and core rewarming principle
- ✓Near-drowning response: rescue breaths first, CPR, no water drainage
- ✓When to call MAYDAY vs. self-treat and proceed
- ✓Heat stroke vs. heat exhaustion: which is the emergency
Common traps & how to avoid them
- ✗Drowning CPR: start with compressions — WRONG. Drowning is respiratory; give 2 breaths first.
- ✗Hypothermia: rub extremities to warm — WRONG. Drives cold blood to the heart, can trigger cardiac arrest.
- ✗Near drowning: tilt victim to drain water — WRONG. Ineffective; wastes critical time.
- ✗Shock: sit victim up — WRONG. Lay flat with legs elevated (unless contraindicated).
- ✗Heat stroke: give water to drink — WRONG. Unconscious victim cannot swallow safely.
- ✗Jellyfish sting: rinse with fresh water — WRONG. Use seawater; fresh water fires nematocysts.
Frequently Asked Questions
Does the USCG require a first aid card to get a captain's license?
Yes. A valid first aid certificate is required for OUPV (6-pack) and Master captain's license applications. The USCG accepts first aid cards issued by organizations with nationally recognized training programs, including the American Red Cross, American Heart Association, National Safety Council, and ASHI. The card must be current at the time of application — most cards are valid for 2 years. CPR certification (including AED training) is also required separately or as part of a combined first aid/CPR course.
How often do captains need to renew their first aid and CPR certifications?
Most first aid and CPR certifications are valid for 2 years. For USCG license renewal (every 5 years), you must hold a current first aid certificate at the time of renewal. This means you will need to renew your first aid/CPR certification at least once — and typically twice — during a single license period. CPR-only cards may have the same 2-year validity or a shorter term depending on the issuing organization. Always verify currency with the issuing organization before submitting renewal paperwork to the National Maritime Center (NMC).
What does the USCG exam actually test on first aid?
The USCG OUPV exam typically includes 1–3 first aid questions in the Deck General & Safety section. Common topics tested include: the priority order of emergency response (scene safety → call for help → CAB — circulation/airway/breathing), recognizing and treating shock, hypothermia stages and field treatment, near-drowning response steps, and when to stop CPR. The exam does not typically ask detailed CPR compression ratios from memory — it tests judgment and recognition of correct response priority.
What is the correct treatment for hypothermia at sea?
For hypothermia at sea: (1) Remove the victim from the cold water and wind immediately. (2) Handle gently — sudden movement can trigger ventricular fibrillation in a cold heart. (3) Replace wet clothing with dry insulation; cover the head. (4) Apply heat to the core (armpits, groin, neck) using warm compresses or body heat — do not rub extremities (drives cold blood to the core). (5) Keep the victim horizontal if possible — standing up causes blood pressure drop. (6) For severe hypothermia (unconscious, no pulse), begin CPR and do not stop until the patient is rewarmed — the saying is 'not dead until warm and dead.' (7) Evacuate to advanced medical care immediately.
What is compression-only CPR and when is it appropriate?
Compression-only CPR (also called Hands-Only CPR) involves continuous chest compressions at 100–120 per minute without rescue breaths. It is appropriate for adult victims of sudden cardiac arrest when the rescuer is untrained, unwilling to give rescue breaths, or in a setting where rescue breaths are impractical. For children and infants, drowning victims, and any respiratory arrest (where the problem is lack of breathing rather than cardiac arrest), rescue breaths are important and should be included if the rescuer is trained. Compression-only CPR maintains some circulation and is significantly better than no CPR.
How do you treat a near-drowning victim on a vessel?
Near-drowning (submersion) response: (1) Get the victim out of the water using a throw rope or reaching pole before entering the water yourself. (2) Check for responsiveness — if unresponsive and not breathing normally, begin CPR immediately starting with 2 rescue breaths (drowning is a respiratory emergency — rescue breaths matter). (3) Do not try to drain water from the lungs — this is ineffective and wastes time. (4) Treat for hypothermia — even in warm water, extended immersion causes cooling. (5) Activate EMS/Coast Guard immediately via VHF Channel 16 MAYDAY. (6) Even if the victim recovers consciousness, evacuation is required — secondary drowning (delayed pulmonary edema) can occur 1–24 hours later.
What is the difference between heat exhaustion and heat stroke?
Heat exhaustion: the body is struggling but still compensating. Symptoms include heavy sweating, pale/cool/moist skin, weakness, dizziness, nausea, and normal to mildly elevated temperature (up to 104°F). Treatment: move to shade/cool area, loosen clothing, cool with water, give fluids if conscious. Heat stroke: a life-threatening emergency — the thermoregulation system has failed. Symptoms include hot/dry/red skin (sometimes wet), confusion or unconsciousness, rapid strong pulse, and temperature above 104°F. Treatment: aggressive cooling immediately — immerse in cold water, ice packs to armpits/groin/neck, fan with water misting. Call MAYDAY. Heat stroke can kill within minutes if cooling is delayed.
What accepted organizations can issue first aid cards for a USCG captain's license?
The USCG accepts first aid certifications from nationally recognized organizations whose curricula meet or exceed OSHA first aid standards. Accepted issuers include: American Red Cross (Standard First Aid or Wilderness First Aid), American Heart Association (Heartsaver First Aid CPR AED), National Safety Council, American Safety & Health Institute (ASHI), Medic First Aid, and similar accredited programs. Online-only courses without a hands-on skills component are generally not accepted — the certification must include a practical skills evaluation. When in doubt, contact the National Maritime Center (NMC) before taking a course.
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