Surface Water Rescue


CarolinaFireJournal - David King
David King
10/18/2019 -

There are quite a few specialties when it comes to technical rescue and water. Dive rescue, surface water rescue, swift water rescue, ice rescue, surf rescue, just to name some of the big ones. A team that wants to be successful and operate safely in these very dangerous environments needs to make sure that they are familiar with all aspects of what they are about to do. 

NFPA 1670 – is the standard on operations and training for technical search and rescue incidents. While we know that NFPA’s documents are guidelines, they represent many of the country’s expert opinions on how to do it correctly.​

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They also are often the standard used to compare a department’s actions when going to court. Chapter 16 is the surface water rescue chapter and describes how the different levels of training should be deployed. Most of us in the fire service today are familiar with the standard Awareness, Operations and Technician levels, so having them listed in surface water rescue should not be a surprise.

Each “AHJ” (Authority Having Jurisdiction), this would be your city, county, town, etc., has a responsibility to identify the hazards in your area and continue to reassess these hazards every year. In an inland town that has no water exposures at all, the AHJ might not need to have anything for water related events, but they may have nearby caves that may need cave rescue situations addressed. Each locality is going to be different, so each specialty that’s needed will be different also. Many areas of South Carolina, North Carolina and Virginia can have water related hazards throughout the year and possibly some ice issues in the winter. Even in Virginia the thin ice created in our mild winters can be tempting to a young child.

Once you have determined that a water related hazard exists, beginning with surface water rescue makes the most sense. The AHJ is responsible for establishing SOPs, or guidelines so that everyone understands how to respond and operate at the emergency. This also includes any documentation that needs to be completed after the incident is over. This is usually covered by the normal post call state paperwork.

Awareness Level

This is the most basic of the levels and requires that responders have the basic understanding of the hazard and how to recognize it. It also requires that the responders understand how to safely work around the water at least in the “Cold Zone” of the incident. Knowing the simple requirements of having protective gear on such as PFDs in case someone was to accidently fall into the water. At a medical level, everyone should have CPR qualifications at a minimum.

Operations Level

The next level involves the “Warm Zone” in which responders have the knowledge and abilities to perform limited work during a water rescue. This may include having a throw ring, or a boat to help someone. This level of training is not expected to make an in-water rescue at any time.

Technician Level

This is the most advanced of the water rescue training and the most dangerous to the responder. At this level, properly trained personnel may make an in-water rescue to try to save a victim.

These levels all represent proper planning, training and system design to perform properly. Standard Operational Procedures should always outline exactly how each situation would be handled, so that when needed, all responders and agencies are operating within the same guidelines. The most important reason to not just “fly by the seat of your pants” is to make sure we never lose one of our own people. Too many responders have lost their lives trying to recover a life already lost. Safety should always be paramount in any water rescue situation.

Most if not all technical rescue incidents should be setup in the same manner, regardless of what the nature is. It doesn’t matter if it’s a dive scene, an ice rescue, or a swift water situation, the same format should be followed.

Prepare for the Event

Before you can properly handle an event, whatever the type, you have to be prepared for it. This is going to include having the personnel and equipment for the situation. In this case, do you have enough responders to handle the call if you are dispatched and when you get there? Can you deploy throw bags, boats, life rings, or other water rescue equipment to help someone? What water locations are in your first due and what challenges do you face at each one?

Using Lake Gaston in North Carolina as an example, it’s about 35 miles long and can be as deep as 100 feet. There are well defined swimming areas, dams and lots of water activities on a daily basis.  If an event occurs on Goat Island, where do we bring the patient for transport? (North Shore towards Virginia or South shore back toward North Carolina) What hospital do we go to for a medical emergency? What about a trauma? What if it’s a diver that needs a chamber? There are so many factors to consider, the more you can work through now, the easier it is when it happens. Now I used Lake Gaston, but you can plug in any location you are familiar with for this example. Have outside resources like a medevac ready to go with phone numbers and a landing zone(s) pre-determined.  I’m sure pre-incident planning is not new to most firefighters that are reading this, but they work great for non-fires also.

Train for the Event

Now that your department has a plan to handle the next water event, it’s a great time to get out and try it. Pick a day and set up a scenario that would normally challenge you. Get a “victim,” some responders, contact your local helo and ask them for their assistance in a mock call. Most medevacs are more than willing to help train, provided that they don’t get an actual mission. Staff your equipment, get a couple people to act as evaluators and run the call. Crews can practice rescuing the victim, extricating them to shore, packaging and getting them to the next level of care. That could mean getting an LZ identified, setting it up and loading them into the helicopter. Once the training is over, get your feedback and make any changes you need to. One of the areas that OSHA can gig you on is not training to the mission you are performing. Document all your training and track everyone’s certifications. Each piece of equipment that you would utilize needs to be trained on and practiced with, including your PPE. The Incident command system is also required training and the expectation is that it will be used on every call, so that mutual aid agencies can all integrate seamlessly in any larger event. A safety officer should always be appointed to assist the incident commander and maintain a safe environment for the responders.

Respond to the Event

This should be the easy part now that you have already pre-planned it and trained on it. When the call goes out, gather as much intel as you can and get the correct resources going early on. If it’s a water rescue, then you will need PFDs, boats and throw bags. You might need to have the dive team ready in case the victim goes under.  If it’s at night time, make sure you have plenty of lighting and thermal imagers on hand. Accountability is always going to be important. No one should be freelancing at a water rescue and safety for the responders should always be the top priority. Stage equipment so that its close but not clogging up the scene. Setup your hot, warn and cold zones. Police is usually going to be on hand to assist, so put them to work also. Communication is always the #1 failure at most larger incidents, so have radios available, make the command post or IC well known and keep comms short and to the point. Most water rescues can become a technical event, so don’t feel like you have to do it all yourself. Swallow your pride and ask a neighboring agency to assist. Working together and combining resources can often turn a failing incident into a successful one.

Control the Incident

The goal of a fire response is to put out the fire, rescue any victims and not hurt your firefighters. The goal of the water rescue is to rescue the victim, control the location and not hurt your responders. For anyone who has ever arrived early on during a water rescue, you know it can be very chaotic and dangerous. People arriving before you are often trying to save the person themselves. This often creates additional victims, as parents of children, or other family members rush into the water to try to help. The same thing can happen to untrained first responders. People expect us to be able to handle any incident when we arrive, however the first arriving rescuers may not be the ones you want entering the water. Everyone needs to know their limitations and not contribute to the victim count. Controlling the incident starts with making sure no one else gets hurt. The drowning victim may or not be salvageable, so as in any other technical rescue always perform a risk/benefit analysis. Is what you are willing to risk, worth risking? Do you have the proper resources available to perform the rescue safely? Are you better off to barricade the scene, setup your zones, take command and wait for the proper resources? All questions that only you or your department can answer. Ultimately controlling the incident and not allowing it to progress can be one of the most important decisions for the entire call.

Take Action

Once the decision is made to take action, then it’s important to be organized, efficient and safe. The more you have practiced this scenario, the easier it will be. Many Incident Commanders have a “cheat sheet” that is laminated with step by step check offs for a fire. Your department can have the same style checksheet for a water rescue. This helps to keep you organized and it makes sure that everyone is on the same page for the next action. The amount and type of action will be determined by the level of response and the amount of training. This is where our Awareness, Operations and Technician levels kick in and dictate how involved we get and what training we need. Once the victim is rescued and returned to shore, then standard procedures will take over that dictate where and how they will be treated and transported.

Scale Down

Once the event has been resolved and the victim transported from the scene, the personnel can start to scale down the incident or as some refer to the phrase demobilize. This would include making the scene safe from any other incidents, cleaning and returning equipment to service for the next emergency. Accountability should be finalized and making sure that everyone is present and healthy should be high on the list. Another great thing to do is to get a full set of vital signs for each person before leaving the scene. Not enough departments capture a full set of vitals after a stressful call like a water rescue. This would help to prevent sending someone home, that isn’t physically well enough to leave. Many first responders have died during and after a technical rescue or fire due to medical issues compounded by the exertion and stress placed on them by a difficult call. Please take care of your people, they are your most important resource. Once everything is cleaned and ready to go, it’s time to rest, relax and recover. Hydration, and eating a healthy meal are both important parts of the scale down portion of the incident and easily overlooked.

Terminate

Termination of the call is the final step to closing out the incident. This means the trucks and personnel are ready for the next call, all paperwork has been filed and everyone is safe. This is a good time to get everyone involved to give their feedback and find ways to improve anything for the next run. If mutual aid is involved, have someone collect their feedback also. Larger incidents may decide to have a full debrief to bring all of the responders together. This allows everyone to get in the same room, tell their part of the call and allow everyone to see the full incident from start to finish. A debrief also is a good morale and team builder by getting people together that may otherwise not see each other again until the next call.

Conclusion

Technical rescues can be some of the most exciting and dangerous calls that we respond to. They are almost guaranteed to make the headline in the paper or be a story on the nightly news. This call is your chance to shine or to fail in front of your citizens. Proper planning, training and response is the key to success in almost any type of call that your department will respond to. Review the NFPA guidelines for your type of Technical Rescue and use it to guide your department down the road to success. Good luck and be safe!

(Sources - NFPA 1670 – 2017 Standard on Operations and Training for Technical Search and Rescue Incidents.)

David I King Jr. has been with the Chesapeake Fire Department for 20 years and is currently a Special Operations Captain with the Flammable Liquids Firefighting team. He is also certified as a Dive Medic Technician and is the Dive Medic Coordinator for the Chesapeake Police Underwater Search and Recovery team. He is the Medical Director for Law Enforcement United’s National Board and is the owner of Underwater Medics LLC, a Public Safety Dive Medic Instruction company. You can contact him at [email protected] or hear him on “The Dive Medic Podcast” on iTunes or Stitcher.
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