Surface Water Rescue : Surface Water Rescue
General Background : General Background Environments
Rivers
Streams
Canals
Pools
Lakes
Gravel Pits
Oceans
Storm drain systems Causes
Weather changes
Overconfidence
No PFD
Cramps
Submerged debris
Boat collisions
General Background : General Background Most incidents preventable
Essential EMS practices
Know how to swim
Wear a personal flotation device (PFD)
Take basic water rescue course
Water Temperature : Water Temperature Body cannot maintain temperature in water <92oF
Heat loss occurs 25x faster than in air
Water Temperature : Water Temperature Immersion can lead to hypothermia
Hypothermia can lead to
Inability to self-rescue
Inability to follow simple directions
Inability to grasp line, flotation device
Sudden immersion, laryngospasm, drowning
Water Temperature : Water Temperature Personal Flotation Devices
Slow heat loss
Less energy expended for flotation
Heat Escape Lessening Position (HELP)
Head out of water
Body floating in fetal position
60% heat loss reduction
Huddle together in groups
Basic Rescue Techniques : Basic Rescue Techniques REACH
THROW
ROW
GO ALWAYS WEAR YOUR PFD!
Moving Water : Moving Water
Moving Water : Moving Water Most dangerous water rescue
Requires proficiency in:
Technical rope rescue skills
Crossing moving water
Defensive swimming
Use of throw bags
Shore-based and boat-based rescues
Ability to package patient in water
Recirculating Currents : Recirculating Currents Develop as water moves over uniform obstructions (rocks, low head dams)
“Hydraulic” forms, moves against flow
Recirculating water traps people against object
Recirculating Currents : Recirculating Currents DROWNING MACHINE
Strainers : Strainers Partial obstructions that filter water
Downed trees, gratings, mesh
Creates unequal force across itself
People become pinned water’s force
Strainers : Strainers Attempt to swim over object
Do NOT put feet on bottom
Foot/Extremity Pins : Foot/Extremity Pins Walking in moving water over knee depth ALWAYS is hazardous!
Foot, leg may become entrapped
Person can be knocked below surface by water’s force
Extremity held in place by water’s weight, force
Intakes : Intakes Height is no indication of danger
All dams may have recirculating currents
Intake grates serve as strainers
Moving Water Self-Rescue : Moving Water Self-Rescue Avoid entering water except as last resort!
Cover mouth, nose
Protect head, keep face out of water
Do NOT attempt to stand up
Float on back, feet pointed downstream Steer with feet, point head toward near shore at 45o angle
Water move slower on inside of bends
Look for obstructions
Eddies on downside of objects may flow slowly upstream, moving you toward river’s edge
Flat Water : Flat Water
Flat Water : Flat Water
Factors Affecting Survival : Factors Affecting Survival Age
Position underwater
Lung volume
PDF use
Water temperature
Mammalian diving reflex
Factors Affecting Survival : Factors Affecting Survival PFD Use
89% of all boating fatalities are related to lack of a PFD
PFDs should be worn when working in, on, or near water
Swimming pools, flash floods can be water hazards even in arid areas!
Factors Affecting Survival : Factors Affecting Survival Mammalian Diving Reflex
Water <68oF
Bradycardia, intense peripheral vasoconstriction
Blood, oxygen shunted to core organs, circulated very slowly Hypothermia
Slows metabolism
Conserves oxygen
Only protective if it occurs BEFORE cardiac arrest occurs
Cold Protective Response : Cold Protective Response YOU’RE NOT DEAD UNTIL YOU’RE WARM AND DEAD!
Location of Victims : Location of Victims
Location of Victims : Location of Victims In flat water, location of average patient under average conditions = 1.5 x water depth of where he/she went down
Example:
Water is 10 feet deep
Patient will be within a circle with a 15 foot radius centered on spot where patient went down
Location of Victims : Location of Victims In moving water, patients will be within 100 to 150 yards downstream
Common locations:
Deep holes
Eddies downstream of large objects
Strainers
Rescue vs. Recovery : Rescue vs. Recovery Time submerged
Age
Physical condition
Known/suspected trauma
Water temperature
Estimated time for rescue/removal
In-Water Patient Immobilization : In-Water Patient Immobilization Assume cervical injuries in drowning victims until proven otherwise
Phase 1: In-Water SMR : Phase 1: In-Water SMR Splint victim head, neck with arms
Roll victim to face-up position
Assure open airway
Maintain position until cervical collar applied
Phase 2: C-collar Application : Phase 2: C-collar Application Primary rescuer maintains airway, SMR
Second rescuer sizes, applies collar
Second rescuer secures patient’s hand to patient’s waist
Phase 3: Backboarding : Phase 3: Backboarding Maintain airway and manual SMR
Submerge board under patient’s waist
Allow board to float up to victim
Secure victim with straps
Phase 4: Removal : Phase 4: Removal Move to extraction point
Extricate patient head first
Pass from water to rescuers on land
Avoid extrication thorough surf Use bystanders who can swim as a breakwater behind patient