Fire Service Water Rescue Teams
By virtue of considering fire load, wind, physical attributes of a building, etc., we are able to predict fire and smoke travel in a structure with fairly consistent results. Unlike a fire incident, which can be broken down into facts and probabilities, a water-rescue incident has only one fact that is constant: No two incidents will take place at the same location, under the same static conditions, with the same responders, and with the same results.
Many times in water-rescue incidents, whether they are surf, bay, lakefront, or swift-water in character, we are not allowed the advantage of predicting the changes dictated by natural conditions. We can, however, establish some guidelines as to how a typical rescue should evolve. This will allow us to establish our priorities and determine our main considerations. Investment in preparation will often times counter the unpredictability factors that we are presented.
When we establish a rapid rescue response system, our first goal should be to explore all means of “gaining the advantage.” We should target the type or types of incidents that we will be called upon to intercede. Once we determine this, we can recognize our immediate and long-term needs. Establishment of standard operating guidelines, acquisition of the appropriate equipment, and implementation of training should follow in that order.
Although it takes some effort on the part of all involved, we should pursue, combine resources, and train with other available mutual-aid agencies. This is the quickest and least expensive way of acquiring equipment resource, technical assistance and expertise, thus increasing the potential for a successful rescue.
Support is one of the major factors that will either make or break any attempt to establish and operate a rescue response team program. Statistics can play a positive role when proposing the establishment or acquisition of funding to support equipment and training needs of the team. The following paragraph indicates one approach that can be used both effectively and beneficially.
“In 1991, statistics indicated that there were more fatalities in water related incidents than fires in San Francisco. This statistic reinforces the need for maintaining a professional Surf Rescue Team which can effectively meet the public safety demands. The commitment of the Department to maintaining this unit demands constant training, evaluation and revision of operational procedures as warranted.”
Once the system is up and running, the most important factor is the evaluation of your target responses. It is imperative to prepare for unique calls as well as the typical rescue call. “Rare events rarely happen,” but Murphy’s Law being what it is, you can count that it will happen when you have the maximum media coverage at the rescue event. There is a relationship between positive exposure and the potential for increased funding.
Evaluation of your target area should identify those factors that will be constant and those that are changeable. San Francisco’s Ocean Beach, for example, has several constants. The water is always within a few degrees above or below 50 degrees all year long. There are stationary and changeable rip tides. Although the strength may change with the time of year, we have longshore currents and offshore currents that follow set patterns. There is the “Taravel Trough,” where there is always a rip current. These are the constants that are fairly predictable.
We also have rip currents that may change from one location to another on a daily basis. Sometimes, this may happen on an hourly basis. So, the only constant is that these conditions will be changeable. Taking all these factors into consideration, pre-evaluation will help when establishing the standard operating guidelines for the responders.
It is difficult to set down hard-and-fast rules that can be used due to the vast amount of variables that ocean and weather conditions presents. Firefighters by nature often call upon their ingenuity, adaptability, and common sense, usually developed through training. These compensating gifts are no more apparent in a fire incident than in a surf- or water-rescue incident.
Professional lifeguard associations state that their main goal is to prevent situations requiring rescues by enforcement and education. Due to the nature the fire department's response, units will be receiving the dispatch after the fact. By the time the fire department arrives on the scene, the incident is usually in the critical stages and the element of risk has already begun to escalate.
Time is the most critical factor! When arriving on scene and upon establishing visual contact with the victim, it is imperative that firefighters maintain visual contact throughout the event. Initial rapid intervention should take place as soon as the victim has been sighted. When the location is determined, a command post should be established in a location that will afford a visual overview of the situation. Incoming companies should be updated via radio as to the best route and location for staging equipment and personnel resources.
Question all bystanders who witnessed the incident to establish if there are any other victims. If you are fortunate to secure a witness or witnesses, do not release them. Attempt to extract as much information as possible. Friends and family can usually give you information about the victim's age, physical condition, swimming ability, color of clothing, and color of hair. This may be important as the event progresses. Some general rules to note when interviewing witnesses are as follows:
Never lose sight of the fact that there is always a likelihood that there could be more than one victim. It is not unusual that a non-trained person witnessed the victim struggling and has attempted to effect rescue. They can become a secondary victim, and you may find that you are now presented with a multiple-rescue event.
The usual candidates for drowning fall into distinct groups. Teenage children are the leading victims of drowning accidents in the United States. Another group that is prominent in drowning accidents are young adult males between the ages of 19 and 25. Often for this group, alcohol or drugs have been used in quantities sufficient to impair physical and/or mental judgment.
Statistics also indicate that most rescues will occur late in the day or at sunset. Typically, the swimmers have been at the beach for the entire day. Body resistance is lower, food and drink usually have been ingested, and the body's energy reserves have been lowered or depleted. After a day of swimming in the surf, a person will begin to build a false sense of confidence for the ocean conditions. Wave and tidal changes often go unobserved.
If heavy surf conditions are present or your area has an “impact zone” of surf crashing against cliffs, always assume that the drowning victim has suffered head and neck trauma until you can rule it out. Insure that C-Spine precautions are given consideration as soon as it is feasible.
A near-drowning victim may have ingested saltwater. They should always be advised to seek medical attention after the incident. Even though they say that they feel fine, they may later suffer from water that was ingested into the lungs. Saltwater in the lungs can cause pulmonary edema. Saltwater will "pull" the water out of the cells and into the lungs. Fresh water can cause irreversible damage to the alveoli of the lungs by causing the red blood cell to rupture when it dilutes the electrolyte balance in the bloodstream. Bacteria may be transmitted into the lungs from contaminated water and may not show signs of injury for days until it has had a chance to grow. A victim may be reluctant to seek additional help due to embarrassment.
If the water is extremely cold or the victim has been exposed to it for a significant length of time, keep in mind that it is very possible that he may be in some stage of hypothermia. Due to the cold temperature of the water, the victim may be suffering from bradycardia and apnea. If indicated, CPR should be initiated as soon as possible but defibrillation is usually contraindicated until the body is warmed. A person should not be pronounced dead until warm and dead. [Note: To be effective, the patient will be warmed and given drug treatment prior to the use of a defibrillator. This warming process typically takes place in an Emergency Room.]
A positive aspect of cold-water drowning is that, according to many documented cases, victims who have been considered clinically dead were successfully resuscitated with little or no ill effects. Studies have shown that the younger the victim, the shorter the submersion time; the colder the temperature of the water, the less the struggle; and the quicker the person received CPR, the better the chances were for survival. If a rescue is ongoing, appropriate resuscitation equipment and backboard should be available at the water's edge in anticipation of possible CPR when the rescuer/victim reaches the beach.
Depending on a combination of factors (clothing, age, physical conditioning, body fat, diet, etc.) the drowning victim can be positive (surface) or negative (below surface) buoyant. If it is possible to have a helicopter respond to the scene, it may be possible for the crew to see the negative buoyant victim who is just under the surface of the water. Prearrangement with the United States Coast Guard, sheriff’s department or police department, or with interested, motivated pilots from the private sector can prove instrumental when searching for a victim. This is a good time to furnish the information gained by the witness’s description.
Safety First is the main consideration at all surf-rescue incidents.You do not want to compound a single-person rescue into a multi-victim rescue by having a rescuer getting into trouble or injured. The greatest insurance for a safe operation is based on prior training and actual ocean drills. More water training time equates to a more confident and effective rescuers.
When working in cold water, full wetsuits should always be used. A “four/three” has been very workable for conditions at or similar to those inherent in San Francisco’s waters. This type and weight of wetsuit affords enough warmth to the body core and is still flexible in the arms and legs to allow for effective swimming and maneuvering.
All rescuers who respond should be instructed to carry a rescue device. There are two basic models used in the industry: the rescue tube and the rescue buoy. The rescue buoy is constructed of hard plastic and is filled with an inert gas to provide exceptional buoyancy. It is torpedo-shaped and has handles. It is an excellent choice when confronting a multiple rescue. It can support more than two adults. Its drawbacks are that it cannot be used on an unconscious victim and it could be a detriment as it can become a hard, "launched" projectile when caught by a large wave.
The rescue tube, on the other hand, is constructed of a soft, flexible, neoprene rubber with a strap and metal hook. This device can be used in a wider variety of circumstances. The main advantage of the rescue tube over the rescue buoy is that it can be bent and strapped securely around a victim. It can be adapted for use with both conscious and unconscious victims, self-rescue, and as a flotation (resting) device. Its adaptability allows it to be secured around victims of different physical stature. It’s important to determine which device best satisfies your conditions and needs.
Depending upon the size of the waves, different techniques can be used to advantage. If the waves are large, it is better to dive under the wave and surface behind it. When in shallow water, the rescuer can dive to the bottom, dig his or her hands into the sand, and spring off the bottom when the wave has passed. On smaller waves, the rescuer can swim over the top. While doing this, the rescuer will have time to make visual contact with the victim and evaluate the incoming wave conditions. Swim high in the water and, if necessary, do a "push up" on the rescue flotation device in order to maintain visual contact with the victim.
Upon reaching a struggling victim, the rescuer should observe the victim's eyes. Eyes that are wide open and fixed are a good indicator of fright or panic. The rescuer must decide on the most appropriate technique for the rescue. Reassure the victims and have them agree and repeat the instructions you have given them as to what you will be doing. If the person is panicking, you will represent an island to them. Their natural urge will be to attempt to climb to safety on top of you. They will be experiencing an adrenaline rush and have superhuman strength on their side. The rescuer’s equalizer and advantage is being highly trained, confident, and properly equipped for the situation.
Should the rescuer be confronted with a multi-victim rescue, the rescuer should give his or her priority to the victim in the most life-threatening condition. If the call for assistance comes late in the day, critical factors are compounded by the potential of limited visibility caused by the loss of light as the sun goes down.
It is very important that our decisions be based on facts and probabilities and not emotion. Factors such as the age of the victim (child vs. adult) or emotions encountered should not have any bearing on your decision of attempting or performing a rescue under perilous condition. Only the natural conditions, ability level of the rescuer, and lack of availability of alternate means of rescue are the relative factors that should be considered.
In closing, no matter how noble the attempt may seem, it is important not to overlook the fact that SAFETY is always the most important consideration. It should never be encouraged by any Water Rescue Team that rescuers take any initiative that may place them into a more precarious position than that dictated by the situation. When rescuers determine that the natural conditions exceed their ability, they should make this known and not complicate the rescue by becoming additional victims. Rescuers must consider their own safety as the first priority on any rescue incident.
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