Water

Need for water rescue training in the fire service.

At a minimum, all personnel in the fire service should be trained to the awareness level in water rescue. Most jurisdictions have some type of body of water (lakes, rivers, ponds, retention ponds, etc.). In addition, most jurisdictions have the potential for flooding. This may include areas near rivers and lakes that flood slowly over a period of time or deadly ravine flash flooding. If there is a water-related emergency, there is usually a request for the local fire department to respond.

Many water-related incidents require resources and expertise beyond the normal capability of some fire departments, including divers, technicians, and teams trained to the operations or technician level. Many fire departments lack the necessary personal protective equipment and technical rescue equipment. This list of equipment may include PFD's, ropes, exposure suits, helmets, boats, SCUBA diving equipment, etc. The AHJ should consider the use of mutual aid when they lack the necessary trained personnel and equipment.

NFPA 1670

NFPA 1670 recognizes four different water related disciplines at the operations and technician level. They are dive, ice, surf, and swift water.

Environmental hazards.

Environmental hazards can include temperature extremes. Extreme cold causes hypothermia, frostnip, and frostbite. When rescuers are cold, that can affect their ability to think clearly or perform simple motor skills. Cold temperatures can also cause equipment failures, including boat motors, diving regulators, etc. In hot temperatures, rescuers can easily become exhausted, overheated, and dehydrated. Personal protective equipment, designed to keep the wearer from sinking in the water, can also cause overheating on a hot day.

Weather, such as snow, rain, and fog, adds another hazard to the incident. High winds often produce waves large enough to keep rescue teams from operating on or near the water. As soon as rescue team members get wet, they are much more prone to become hypothermic.

Body heat is lost to still water 25 times as fast as to still air of the same temperature.

The aquatic environment can add hazards to the scene. This can include aquatic life, animal life, and insects. Plant life, like seaweed, can reduce or impair visibility .It can also become an entanglement hazard.

The water quality in itself can be a hazard. Heavy sediment or silt can result in zero visibility .Some aquatic environments contain harmful bacterial or viral biohazards.

General hazards.

Utilities such as electrical, gas, sanitary, and communications can present a hazard at the water rescue incident. If this is the case, requesting assistance from the responsible utility company, early into the incident, can prove to be very valuable, if not life saving.

Various hazardous materials can be present at water rescue incidents. Operating in this environment will require the assistance from a qualified hazardous materials team. They should be prepared to advise on the proper personal protective equipment and decontamination procedures/guidelines.

Personal hazards at a water rescue incident can include simple trips and falls on uneven, steep, and slippery terrain, which are typically found at the water's edge. The presence of such hazards often requires the assistance of rope rescue technicians. They can rig systems to assist personnel and equipment up and down steep, slippery terrain.

Hazards associated with dive operations.

A water rescue incident may require the assistance of trained, qualified SCUBA divers. SCUBA diving can be a hazardous activity. Some diving emergencies may include decompression sickness, nitrogen narcosis, oxygen toxicity, and embolism. Drowning of a diver may result from panic or anxiety .These conditions may have been the result of the diver getting lost, trapped, or by them losing their air supply. Entrapment in a submerged vehicle is also another danger for divers trying to attempt rescues within them.

Fatigue and exhaustion are common hazards to divers. Their equipment is extremely heavy and difficult to don. Once the diver is in the water, the equipment is no longer heavy. Getting into the water is the difficult part. Assisting a diver by helping them into their suit and equipment and by carrying their equipment to the water's edge will make for a more effective and safer water rescue incident.

Without the proper protective suit, a diver can become hypothermic in a short period of time. The suit, designed to keep them warm in the water, can also become a hazard outside of the water. A diver fully dressed in their equipment, outside the water, can easily become heat stressed and dehydrated. A diver will often ask to stage or wait in the water during standby if they are fully dressed in their suit and equipment.

There are certain pre-existing medical conditions that can make SCUBA diving a very hazardous activity. Divers who smoke and/or use medications are at higher risk.

Hazards associated with ice operations.

As it was mentioned earlier, the colder the temperatures, the more likely it is there will be a problem with hypothermia and frostbite. During ice dive operations, there is also the chance for the malfunctioning of diving regulators. Support personnel can help a diver by keeping their regulator dry and warm until it is needed.

Emotions can run very high when there is a person who has broken through the ice and is now holding on to the ice shelf. This victim cannot last very long in this environment and may slip under the water in a short period of time. Knowing this, many would-be rescuers attempt to execute a rescue without the proper equipment and training, only to become another statistic. Rescuers trained at the operations or technician level should not attempt a "go" rescue without thermal protection, buoyancy, and an attached rope. Anyone attempting this type of rescue with anything less will very likely be taking an ice water bath or find themselves trapped under the ice shelf. Although your fire fighting turn out gear may keep you warm on a cold day, it is not the proper personal protective equipment for a water/ice rescue.

Hazards associated with surf operations.

Surf operations do not generally come to mind when discussing water rescue in the state of Illinois. Even though you will not find any ocean water front property in Illinois, you will find large fresh water lakes such as Lake Michigan. Some of the storm related and hydraulic hazards found at ocean beaches can also be found at fresh water lake beaches.

Storms and high winds can produce very large waves and swells. These large waves can capsize a boat and make it very difficult to keep track of people in the water.

As large waves approach the beach and the bottom contour rises quickly, the large waves will break over. This type of large, breaking wave can produce thousands of pounds of force, crushing and destroying anything in its path.

Other surf related hazards might include undertows, tidal surges, and currents.

Hazards associated with swift water operations.

The major hazard associated with fast moving inland water is the constant, awesome, relentless power of water. Swift water found in streams, rivers, or flooded ravines can sweep people away without mercy and with a force they cannot overcome.

Rescuers must always be aware of possible weather changes while working in or near a moving body of water. A heavy downpour, from an upstream storm, can transform a placid stream into a killer wall of water. If you ever find yourself swept away in this type of condition, do not try to stand up. Trying to place your feet on the stream bottom can get your feet caught in a hole or trapped in debris. If your feet are stuck, your upper body will be bent over by the water force and you will quickly drown. Try to float on your back with your feet up and pointed down stream. If you are driven into a stationary object, it would be better to hit it with your feet instead of your head. Also, it is usually best to not fight the current. Guide yourself towards shore, on an angle, with the current.

In swift water, the water moves you into objects that are stationary .A type of stationary hazard is the strainer. A strainer is an obstruction in the river that allows the current to pass through it but does not allow the clear passage of larger objects such as people or boats. An example would be a downed tree lying in the river. A person could quickly drown if caught in a strainer.

During flood conditions, it would be likely to find obstructions in or just under the moving water. A person could be smashed into or held against these objects by the fast moving current. An upstream or downstream V in the water can indicate an obstruction just under the water.

Some other current patterns found in fast moving water can include laminar flow and helical flow. In laminar flow, the water close to the river bottom moves at a slower rate than the water at the surface. This is due to the friction or drag at the bottom. Helical flow is found in steep slopped channels. Water quickly rises from the deep middle to the shallow bank. The twisting action of this current then drives the surface water out to the middle where it then plunges back down to the bottom. An eddy is a type of back current found on the downstream side of a stationary object.

Hazards associated with low head dams.

By definition, a low head dam is a uniform barrier across a body of moving water. The dam is usually level or horizontal, with water falling equally along its entire face. The low head dam is also known by another name. It is also called the "Killing/Drowning Machine".

One of the reasons the low head dam is hazardous, is because it does not look particularly dangerous. Some people treat these dams as aquatic thrill rides. Another problem with the low head dam is the illusion that is perceived from upstream. It is difficult to see the drop in the river, at the dam, when approaching the dam from upstream.

As water flows over the dam and falls vertically, it drives to the bottom and then rises to the surface slightly downstream. At this point, some of the water continues to flow downstream while some of the water flows

back upstream towards the dam. This point, where the water breaks into two different directions, is known as the "boil line". Once you have crossed the "boil line", you have entered the "Killing/Drowning Machine". This type of flow on the downstream side of a dam is also known as a vertical whirlpool.

At this point, it seems obvious why personnel should never let themselves get caught in a vertical whirlpool. Attempting a rescue or recovery in a vertical whirlpool without the proper training and equipment will just cause the body count to rise. Do not be misled into thinking you can drive a boat into a vertical whirlpool to execute a rescue or recovery. Because of the aeration of the water in the hydraulic, objects become less buoyant and boat motors become useless due to the cavitation of the boat propellers. A boat being driven into the face of a low head dam will quickly fill up with water, turn over, and dump its occupants into the Killing Machine.

Personal protective equipment during water rescue incidents.

Firefighting helmets, boots, and turnout gear are not typically appropriate personal protective gear for water rescue incidents. If you want to perform water rescues, wearing the proper thermal protection, with buoyancy, is essential.

Common outerwear for performing water rescues might include cold-water rescue suits, wet suits, and dry suits.

All personnel working at the scene, in a boat, near the water, or as a line tender, should wear a properly fitted PFD (personal flotation device ). Having a PFD hang around your neck, without it being secured, will not do you any good if you fall into the water. Secure it properly. Support personnel who find it necessary to wear their turnout coat for warmth, will often wear their PFD under their coat. Equipment you might consider adding to your PFD could include a whistle and a rescue knife.

Taglines, lifelines, helmets, and gloves are some of the other pieces of PPE items you may find necessary for a water rescue incident.

The cold water near drowning incident.

There are many factors that can influence the chance of a victim surviving a "cold water near drowning". younger victims tend to have a better chance of surviving. The victim's health can also be a factor. Temperature and clarity of the water plays a major role. Colder, clean, fresh water provides the victim with the best chance of survival. Cold water is considered below 70 degrees F. Even if a drowning incident happens on a hot summer day, the victim is usually found at the bottom of the water. This means the victim is probably below the thermocline, where the temperature is usually below 70 degrees F. Length of submersion is another factor. The less time the victim is under water, the better the chance of survival. In the past, if a victim was under the water for 60 minutes or less, you should still be in rescue mode. Recently, victims have been revived after being submerged for more than one hour. If you would like to give a "cold water near drowning" victim the benefit of a doubt, stay in rescue mode whenever the victim has been submerged for 90 minutes or less. After 90 minutes, you may consider changing the mode of your incident to recovery mode. Other factors that can influence the chance of victim survival include prompt, aggressive, high quality BLS and ALS patient treatment. Remember, a patient is not dead until they are warm and dead.

The water rescue response for awareness level trained personnel.

When responding to a water rescue incident, assessment is the initial phase. This starts at the time of dispatch, when you begin to gather information. When you arrive on the scene, begin your size-up. What is the scope and magnitude of this incident? What type of incident is this? Are victims above or below the surface of the water? Evaluate the environmental factors involved. Those factors can change quickly with changing weather conditions. If the sun is about to set, you will need to consider lighting for the scene. Water levels and current changing drastically (flash flooding).

Assess the hazards at the scene. As soon as possible, determine the location and number of victims. As with any other rescue incident, do a risk/benefit analysis. Is this a rescue or a recovery? All personnel operating on the scene need to know this information. Are there any access problems at the scene for responding companies?

The initial tasks that must be performed by a first responder to a water rescue incident require an overall level of control at the scene. This means keeping control of all personnel. Also, it is necessary to control the bystanders. This is accomplished by establishing control zones. Use the assistance of police personnel to establish site security .Establish command and use your incident command system. Accountability and safety of your personnel is paramount. Evaluate the resources you have available and those that will be needed.

Secure and interview any witnesses to the incident. If a victim, boat, plane, or vehicle has disappeared below the surface of the water, any witness will be extremely valuable. Witnesses should be interviewed separately. If witnesses are interviewed together, one could influence the other. Witnesses should be kept at the scene for as long as possible. If they do need to leave the scene, collect their personal information. They may need to be interviewed in the future.

Try to establish a "last seen point" you can triangulate the "last seen point" with more than one witness. A helpful technique in assisting the witness to describe the "last seen point" is to use a reference object. A reference object is the same size object (such as a boat or a person) that sank below the surface of the water. In order to create the reference object, put a person, boat, etc. in the water and have the witness visualize the "last seen point".

At an ice incident, such as a person or a snowmobile through the ice, there is usually a well- defined hole in the ice. Upon arrival at the scene, rescuers may find that the victim is now below the surface of the water. That hole in the ice provides an excellent last seen point. Don't destroy it!

Evaluate any other physical evidence that might be found at the scene. This evidence could help determine the probability of a victim location. This type of evidence might include notes, clothes, footprints, etc. If a vehicle has entered the water, evidence such as tire tracks, debris, or oil and bubbles surfacing may be found.

Identifying the need for a water rescue response beyond the awareness level.

The AHJ should have an emergency response system established for water related incidents. This is especially important if a single agency does not have all the necessary equipment and trained personnel. This emergency response system should include the response of divers, ice divers, swift water technicians, etc. They should be trained to the operations or technician level.

Police personnel and evidence technicians can be very valuable at many water rescue incidents. Specialized equipment is often necessary. Such equipment includes diving equipment, sonar, boats, tow trucks, extrication equipment, dog teams, lift bag systems, etc.

EMS should be included in the rescue response. It is not unreasonable for the AHJ to dispatch an ambulance for each victim and have an extra ambulance standing by for diver support. The AHJ may find it appropriate to request air transport to stand by if there is a prolonged rescue and a need for the patient to be transported to a level I trauma center.

This type of incident could cause first arriving personnel to tire quickly in a prolonged incident. Consider rehab personnel early on in the incident. Try to keep the incident operating in rescue mode.

For personnel trained to the operations or technician level, a simple operational plan may include: reach, throw, row, and go. A "reach" rescue should provide the least amount of risk to rescue personnel, while a "go" rescue would involve the most risk to rescue personnel.

You may arrive on the scene of a water or ice rescue incident with the victim still at the surface in need of a surface rescue. You should quickly request the response of technicians and equipment necessary to execute this type of rescue. While technicians are preparing for a "go" rescue, it would be appropriate for trained personnel to attempt a "reach" or "throw" rescue, minimizing the risk. This victim hanging on at the surface could suddenly sink below the surface while the rescue is attempted. For that reason, consider requesting divers early on in the incident. This option provides the best possible chance of survival to the victim.