Fire 4 th Quarter-Water/Ice Rescue/Hypothermia Patient INTRODUCTION: Water rescue operations can be one of the most dangerous incidents a firefighter may encounter. In some cases, the victim can be seen which can result in the emotions of the bystanders influencing our decisions. Witnesses may expect firefighters to immediately go into the water and attempt a rescue. That is the last thing a would be rescuer should do and it should never be done without the proper training and a personal flotation device. The National Fire Protection Agency Standard 1670 classifies water related incidents as Surf, Swift Water/Flood, Surface, Dive, and Ice. The following information contains water related statistics, basic implementation measures to control and execute a water related rescue for Swift Water/Flood and Ice Rescue. BASIC STATISTICS: The third leading cause of death in the United States is drowning The number one weather related killer is flash floods 8,000 Drowning deaths occur in the U.S. each year Nearly 40% of drowning victims are under the age of 5 Men account for 85% of all downing s A drowning can occur in any body of water Public Safety personnel are part of these statistics 3 to 4 Public Safety Personnel die each year by drowning Water being forced through a small opening creates a vortex and sucks debris into the opening. Missing manhole covers, sewer grates, drains, sewer pipes, etc Reverse water pressure could also remove the covers SITE CONTROL, SCENE MANAGEMENT and RISK BENEFIT ANALYSIS The procedure and process of maintaining control of the site and perimeter will include management of all civilian and non-emergency personnel and establishment of operational zones and site security. EVERY firefighter at the scene of a water rescue incident should have an approved Personal Flotation Device (PFD) on. Personnel without PFD s should be kept well back from the water s edge Rescuers must not attach themselves to a tether line in water. It can pull the rescuer under. Rescuers will not wear turnout gear in water or approach the water s edge with turnout gear on.
Establish the perimeter and containment zone Request Cleveland Police to assist in securing the area, limiting access to and from the rescue scene Prevent unauthorized personnel from entering or exiting the perimeter, hazard zone and rescue area. Establish a diagram of the area, use caution tape or landmarks to assist in designating the hazard zone. Determine the time the victim was last scene to establish survivability. Establish the Incident Management System based on the National Incident Management System (NIMS) Secure evidence & property (Contact CPD if you suspect a crime scene) Risk Benefit Analysis: Determining rescue versus body recovery Rescue Mode: used when there is a chance for saving a human life. Usually defined as one hour elapsed submersion time. The rescue time may be increased during cold water rescues. If the time period for survival, has passed, move rescue efforts to the recovery phase. Recovery Mode: used when saving human life not possible. Submersion time greater than one hour. Operational pace slower with focus on rescuer safety Re-evaluate water rescue techniques to minimize potential for rescue injury or loss of life. SWIFT WATER/FLOOD RESCUE: Is a specialized field requiring additional training, practice and protective equipment. Even a shallow stream can have considerable force if the water is moving fast. Rescue personnel must not use an attached tether line in moderate to fast moving water, if not properly equipped and trained. Properly trained operational and technician swift water rescuers are essential for a successful rescue. However, some basic rescuer safety procedures can be implemented. All rescuers must wear PFD s Encourage victim(s) to remain calm and keep afloat until a trained and equipped swift water unit arrives
If immediate rescue must be implemented attempt to float, a PFD, to the victim by use of a throw line. Once the victim has the throw line, encourage them to don the PFD. The throw line should be thrown well upstream of the victim to allow the, drift of the current, to drift the rope towards the victim. The rope is to be used as a guide rope not a tether line. THIS IS A LAST DITCH EFFORT. Let the victim drift into the stream, holding the rope, release enough slack to let the victim swing towards the shore. General Hazards: Current is the most overlooked hazard on any river. Current on top of the surface is much stronger the current on bottom of river. Hydraulic Drowning Machine is formed when water flowing over the top, of a low head dam, usually less than ten feet in height, hits the water below and creates a depression which is filled in by the downstream water. The uniform flow of water, over the top, creates the hydraulic. The hydraulic will not permit any breaks to form, objects can not get flushed out, will continually re-circulate within the hydraulic. ICE RESCUE The safest way to ensure safety is to stay off the ice. If a rescuer must go on the ice; the safety precautions mentioned earlier also apply to ice rescue. The procedures and hazards are similar with the added component of extreme cold. Trained rescuers must consider the following tactics. Tactical ICE Considerations: Wear cold water exposure suits (MUSTANG SUITS). The Mustang suit will provide flotation and protection from the extremely cold water. (A PFD can be worn with a Mustang Suit) o Other rescue equipment needed Ice cleats Ice awls Ice tending line Helmet Radio
PFD or PFD s Hypothermia bag Sked DO NOT WEAR TURN OUT GEAR ON ICE DO NOT approach the hole too closely. The ice is not stable in that area. Use whatever is available to distribute your weight over a large area. o Inflatable boat (Rescue 4 is equipped with an inflatable) o Ladder o Plywood o Backboard o Improvise Rope throw bag, Rescue Disc, Long Hook or Rescue Rocket are options for reaching out to victims o These methods depend on the victim s ability to hold on. The effects of hypothermia and the added weight of wet clothing may prevent the victim from holding on or even following instructions. (REMEMBER SELF RESCUE IS THE BEST RESCUE FOR THE VICTIM) General Ice Formation and Characteristics: Frazil ice initial ice crystals Clear ice strongest! Requires a long, hard freeze Snow ice milky or opaque, weak Anchor ice ice around obstructions Drift ice floating ice Signs of Weak Ice: Appearance Ice near obstructions Bubbles Honeycombed or Candled ice Cracks Pressure ridges or faults Water running underneath ice Open water or water on ice Ice strengths load capabilities based on thickness:
1 inch = Stay Off!!! 2 inches = Unsafe 3 inches = One person 4 inches = One person with ice fishing equipment 5 inches = One snowmobile 6 inches = Ice boating 7 inches = Group activities 8 inches = One automobile 9 inches = Several snowmobiles 10+ inches = Light truck Hypothermia: Hypothermia is defined as a core body temperature of less than 95 degrees Fahrenheit (35 degrees Celsius) Levels of Hypothermia C F Signs and Symptoms 37 98.6 Normal body temperature 36 96.8 Increased metabolic rate 35 95.0 Maximum shivering 33 91.4 Changes in mental status 29-31 85-88 Progressive loss of consciousness. Cardiac dysrhythmias may develop. Slow heart rate and respiratory rate. Increased muscular rigidity. 25-28 77-82 Unconsciousness. Ventricular fibrillation may occur. Loss of papillary light reflex. Victim appears Dead Treatment of Hypothermia: It is important to remember that there are cases where a person has been submerged for over 90 minutes and have been resuscitated without any medical problems. Listed below are BLS and ALS procedures: The patient must be handled VERY gently. Remove all wet clothing. Do not start the re-warming process if it can not be maintained Give warm humidified Oxygen and warm IV fluids. Do Not give warm drinks or rub the extremities. Follow the City of Cleveland Medical protocols. o Attached are Hypothermia (Traums-8) and Routine-2 trauma assessment and care