CVFD Training – Rescue Operations

SFFMA Training Objectives:9-01.07 – 9-01.09

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

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

Water Temperature

• Body cannot maintain temperature in water <92oF

• Heat loss occurs 25x faster than in air

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

• 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

• REACH• THROW• ROW• GO

ALWAYS WEAR YOUR PFD!

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

• Develop as water moves over uniform obstructions (rocks, low head dams)

• “Hydraulic” forms, moves against flow• Recirculating water traps people against

object

Recirculating Currents

DROWNING MACHINE

Strainers

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

Strainers

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

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

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

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

Type of water Drownings (%)Swimming pools 53%Bath tubs 15%Buckets 4%Fish ponds, tanks

4%

Toilets 4%Washing machines

1%

Ocean 1-2%TOTAL ~83%

Factors Affecting Survival

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

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

• 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

YOU’RE NOT DEAD UNTIL YOU’RE WARM AND DEAD!

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

• 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

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

In-Water Patient Immobilization

Assume cervical injuries in drowning victims until proven otherwise

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

• Primary rescuer maintains airway, SMR• Second rescuer sizes, applies collar• Second rescuer secures patient’s hand to

patient’s waist

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

• 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