Surface Water Rescue

1
Surface Water Rescue
2
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

3
General Background

• Most incidents preventable
• Essential EMS practices
• Know how to swim
• Wear a personal flotation device (PFD)
• Take basic water rescue course

4
Water Temperature

• Body cannot maintain temperature in water lt92oF
• Heat loss occurs 25x faster than in air

5
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

6
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

7
Basic Rescue Techniques

• REACH
• THROW
• ROW
• GO

ALWAYS WEAR YOUR PFD!
8
Moving Water
9
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

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Recirculating Currents

• Develop as water moves over uniform obstructions
  (rocks, low head dams)
• Hydraulic forms, moves against flow
• Recirculating water traps people against object

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Recirculating Currents
DROWNING MACHINE
12
Strainers

• Partial obstructions that filter water
• Downed trees, gratings, mesh
• Creates unequal force across itself
• People become pinned waters force

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Strainers

• Attempt to swim over object
• Do NOT put feet on bottom

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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 waters
  force
• Extremity held in place by waters weight, force

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Intakes

• Height is no indication of danger
• All dams may have recirculating currents
• Intake grates serve as strainers

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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 rivers edge

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Flat Water
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Flat Water
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Factors Affecting Survival

• Age
• Position underwater
• Lung volume
• PDF use
• Water temperature
• Mammalian diving reflex

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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!

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Factors Affecting Survival

• Mammalian Diving Reflex
• Water lt68oF
• 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

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Cold Protective Response

• YOURE NOT DEAD UNTIL YOURE WARM AND DEAD!

23
Location of Victims
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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

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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

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Rescue vs. Recovery

• Time submerged
• Age
• Physical condition
• Known/suspected trauma
• Water temperature
• Estimated time for rescue/removal

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In-Water Patient Immobilization

• Assume cervical injuries in drowning victims
  until proven otherwise

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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

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Phase 2 C-collar Application

• Primary rescuer maintains airway, SMR
• Second rescuer sizes, applies collar
• Second rescuer secures patients hand to
  patients waist

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Phase 3 Backboarding

• Maintain airway and manual SMR
• Submerge board under patients waist
• Allow board to float up to victim
• Secure victim with straps

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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