Drowning Calls & Prevention

By David I King Jr, Cpt. Chesapeake Fire Dept.

Well, we are in the thick of the summertime festivities. Kids are getting out of school, and it’s time to head to the beach, go on vacation and get that boat out on the water. Unfortunately, this is also the time of the year that keep the water rescue and dive teams busy. The Centers for Disease Control and Prevention (CDC) reports that close to 4000 fatal drownings occur each year. If you listen to the radio, you can hear the calls to 911 daily-riptides, boating accidents, unattended children, and alcohol-related issues.

Marine responders watching over divers

Education will always be the first step in preparing the public for these summertime accidents. If you are a career department or a volunteer department, getting the message out however you communicate to your citizens is an easy way to start the ball rolling. Social media accounts are a quick way to get notifications or warnings out to your followers. Weather hazards, beach updates, changes to laws, and Public Safety Announcements (PSAs), are all great things to push regularly. 

Educating your responders is also essential to ensure they are ready to respond to any incident. Water-related deaths can be just as dangerous to us as to the public. Anyone who has read my columns knows that I live in a world of The National Fire Protection Association (NFPA) with most of my classes, and this column is no different. 

NFPA 1006 – The standard for Technical Rescue Personnel Professional Qualifications, NFPA 1670 – Standard on Operations and Training for Technical Search and Rescue Incidents, and NFPA 1952 – Standard on Surface Water Operations Protective Clothing and Equipment are the primary standards for that every department should be made aware of.

Talking with Responders

Regardless of the drowning, you will respond to it, and it’s up to each responder and their officers to know their limitations. It is easy to get caught up in the moment and jump into the water with an active drowning, only to find yourself the next victim. SOPs will help you and your department to preplan each scenario so that you don’t have to act carelessly and outside your capabilities. Every department should have, at a minimum, Standard Operating Procedures (SOPs) that establish themselves as an Awareness Level response agency. If you have the abilities and personnel to be Operations level or Technician level, that’s even better. Review NFPA 1006 and ensure you align with each other level’s requirements. If you are in an Occupational Safety & Health Administration (OSHA) state, then be familiar with the OSHA requirements also. 

Knowing what your department can’t do outside the rules and guidelines will help to preplan the rest of the emergency. 

  • For example, are you BLS, and where will your ALS units come from? What if the victim has already gone below the surface? 
  • Where will your dive team come from? 
  • What marine resources will you need? 

All these questions should be answered long before the tones go out. 

Dispatch

We all know that the call starts with the 911 center. When your 911 center gets a call for a drowning, what is your run card? This is where you should start. My department’s run card for a drowning sends an ambulance and an Engine (one of which must be ALS), Battalion Chief, EMS Supervisor, closest Fireboat, and Police boat. Of course, we are a large department, and your department might only be able to send a medic and an engine. Whatever your response, getting enough qualified responders to the scene is essential and will often make the difference between a rescue and a recovery. A helicopter or military response may be best if you are in a rural area. While we are a large department surrounded by the military, we utilize the United States Coast Guard for their search and rescue resources. Try to look at your run cards every year and keep your responses up to date. People change, contact numbers change, and what works for you this year may not work next year. Maintaining a close relationship with your dispatch center is always a priority for any call type. 

Response

As we mentioned, preplanning should always occur before the incident occurs. Knowing your target hazards will help improve readiness for any water emergency. 

  • What are your targets? 
  • Do you have any high-traffic waterways, swim areas, or
    dive sites? 
  • Is your department located along the ocean, where tides and rip currents are an issue? 
  • Do you have inlets or waterways that will not ingress or egress? 

For example, my department has a series of locks located along the intercoastal waterway, where there is no way to get out of the water if you fall. These areas are popular for fishing and crabbing, but we realized that after several drownings, we had to make changes. 

Egress Ladder

Get your town or city government involved in these target hazards. They will often be able to help to prevent these incidents from occurring. Simple things such as posting signs, locating water rescue devices in the area, or having police patrols watch and visit these dangerous areas can help prevent accidents before they occur. When you are en route to the scene, knowing where you are going and what you will face will help to alleviate some of the stress of the incident because you know the location. While you are en route, review the comments, consider what resources you need, and ask for them early on. 

  • What is the weather like today? 
  • Are storms on the way? What are the water temps, air temps, and water conditions? 
  • The big one, how deep is the water? 
  • If someone were to go under in Lake Gaston, for example, which can be up to 100 feet deep in places, how would I find them? 

Now that you have all the information possible, it’s time to get there. 

Scene Operations

Once you have arrived on the drowning scene, it’s time to work quickly and efficiently. Everything we are talking about here, it’s assumed, will be coinciding. An incident command will be set up immediately, and people placed into the command roles. In a perfect world, all this would be filled out in every position, but we know that’s not a reality in most cases. At a minimum, the Incident Commander and a safety officer must be dedicated. Emotions will be high, especially if a child is involved, so remaining calm and gathering as much accurate information as possible is paramount. 

  • How many victims are there?
  • How old is the victim(s)?
  • Are they still on the surface? What time did you last see them?
  • Have them throw a small rock or something where there last saw them. 
  • What else did you see?

At this point, it’s time to decide, with the resources you have on scene, is this a rescue or recovery operation? Unless you are a dive team, if the person is not on the surface, there is not much you can do. In the old days, I have seen departments try to poke around with Pike poles or drag hooks, but you stand a good chance of severely injuring the victim, causing more problems. 

Rescue operations are usually anything within a concise time frame. Much debate has occurred on what that “time” is, but it depends. Most of us in the south don’t have cold water drownings, so the “golden hour” that people like to refer to does not apply to us. Realistically, brain death occurs within four to ten minutes of no oxygen. A “wet” airway in almost all civilian drownings also stacks the odds against you. If you still think it’s viable, then the next step is dependent on what level responder you are. 

Awareness Level Response

This should be the minimum for just about everyone’s department. Standard Operating Procedures (SOPs) should be written and followed regardless of what level you are at. 

Establish command

Identify who is in charge on the radio, announce it, and where will the command post be

Perform your scene size-up

Identify the scene, mark any hazards and make sure everyone is aware of what you are seeing so they can adjust accordingly.

Identify any additional needs

What else needs to be started? 

  • Additional medics
  • Helicopter
  • Boats
  • Police for crowd control
  • Dive team

Secure the scene and prevent any further people from becoming victims

This will be one of the most challenging jobs since most drownings occur in public, and everyone wants to help and be in the water. This includes responders. The first thing is to get everyone out who doesn’t belong there and secure the scene. 

Shoreline Search Operation

Establish your cold, warm and hot zones

The zones should be based on your SOPs, but the water line is often the hot zone. The warm zone is 25 feet from the waterline back, and everything else is the cold zone. 

Putting on water rescue PPE and Fire gear is a hazard to us while working along the water

Prepare any ingress and egress for the victims and responders who may fall in. Have a plan now!

Have rescue equipment and equipment ready to help responders. Boats, ladders, stokes baskets, rope bags, and extra Personal Flotation Devices (PFDs) must be prepared in the hot and warm zone.

When the Operations level folks arrive, update them and provide any assistance you can for them. Awareness level responders are not done, and they are the support for the Operations people.

Operations Level

Once Awareness level operations needs have been met, Operations tasks can be completed if indicated. Most of us are familiar with the acronym Reach, Throw, Row, Go, so this is where this occurs. What resources does your department have to get to the victim? Entering the water should always be the last choice. Throwing a rope bag or life ring from shore is a good option if they are close enough. Using a boat is the next choice using trained rescuers with PFDs and rescue devices. The drowning victim must be taken care of to prevent from tipping the boat or pulling in a rescuer in a panic. I keep mentioning SOPs, but we must have marine operations SOPs when it comes to operating on the water in our boats.

Technician Level

If you can operate at the Technician level, then you should be ready to do everything that we have talked about so far, and you can make that water entry if needed. Technician-level providers should be the strongest swimmers who can swim in a strong current, take control of a combative victim and bring them safely to shore. They also need to be the ones that can rescue themselves if the rescue goes terrible.

Summary

There is so much information to cover regarding all the possibilities of drowning. The biggest takeaway that I want all of you to have from this article is even though it’s our job to risk our lives to save another, it’s up to you as a responder and to those of us that are Incident Commanders (ICs) to know our department’s limitations and our responder’s limitations. Do not kill a firefighter, police officer, or other responders for someone who is most likely already lost. Getting these victims to recover once they go under the water is rare and not worth risking other people at that expense. Saves are possible and do occur (most are in residential pools), but risk a lot to save a lot, risk a little to save a little. Get everyone together when the call is over and perform a hotwash or full debrief. These reviews can help to discover the problems, identify issues and make corrections for the next call. Do it while it is still fresh in everyone’s mind, and everyone will be better for it. 

Finally, we don’t talk about it enough. After the call is over, check on each other. Drownings, especially ones involving children, can be emotional and have long-term effects on some people. Lean on each other, check on each other and get help if needed. We all want to be strong, but sometimes we must talk about it. 

Until next time! Thank you, and I hope everyone has a safe Summer!

David I. King Jr is a Captain with the Chesapeake Fire Department in Virginia. David has been a Firefighter and Paramedic for over 30 years. David is assigned to the Flammable Liquids Foam Team and one of the Chesapeake Police Underwater Search and Recovery Team Supervisors. David also teaches Public Safety Dive Medicine to Fire and EMS agencies in the region. David can be reached at underwatermedics@gmail.com or dking@cityofchesapeake.net

(https://www.cdc.gov/drowning/facts/index.html)

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