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Rescue Scene Management

RESCUE SCENE MANAGEMENT OF RIVER ACCIDENTS
                                                                                                                           -- Jim Simmons

Whenever river accidents happen paddlers need the capability and knowledge to implement a plan of action. Specifically, the ability to employ a few basic rescue roles, and to recognize the 'strengths' and 'limitations' of planned actions, is vital.
Because of the 911 event in 2001 Homeland Security established the National Incident Management System (NIMS) so that rescuers, nationally, could speak a common rescue language. NIMS incorporated the existing best practices, such as the Incident Command System, into a broader organization that emphasizes a comprehensive national approach to domestic incident management. The need for this common language was especially highlighted by hurricanes Katrina and Rita, as well as other natural disasters in the U.S. Recently, on the international scene we continue to see natural disasters occuring.

The ACA Swiftwater Rescue program teaches a modified version of the long standing Incident Command System (ICS)--a flexible based team approach to accident management. ICS has a 50 year history of emergency management service to society and is specifically based on the following principles:
1) It insures that a rescue effort will be conducted in an organized manner, to manage and reduce risks to rescuers and all involved.
2) It allocates necessary resources (rescuers, gear, etc) where they are needed most.
3) It manages an accident scene, supervises first aid, and plans any necessary evacuation.

At the Moment an Accident Occurs
If an accident takes place within your own paddling group, or if you come upon a situation with other paddlers, here are tips to consider:
  • Initially, gain control of your emotional realm. Clear your thinking and focus on rescue principles and strategy. Maintain the 'big' picture rather than failing into the trap of tunnel vision.
  • Size up the situation and determine scene safety. What happened? How many victims? How fast to move? Is the situation likely to change? Will it become worse? What are the risks to rescuers? Above all else, don't compound the situation.
  • Interview the victim(s), if possible gathering necessary information about the people involved. Learn if anyone in the group is injured, or has a medical issue.
  • What resources do you have available (equipment/gear, number of rescuers, experience, etc.)? This will impact your plan of action.
  • Apply the acronym of L.A.S.T.--locate, access (assess), stabilize and transport (evacuate) as an organizational structure.
  • Maintain communication with the victim(s) because the rescuers 'become the victim's lifeline'. A victim needs reassurance that your group will help and information about what you're going to do.

VARIOUS ROLES PADDLERS CAN ASSUME IN A RESCUE EFFORT
If paddlers within a group have been trained in rescue an absolute leader may not be apparent, or necessary, and each person simply does what is needed without a lot of discussion. The most frequent rescues will be more of a simple variety anyway, but when needed the following rescue roles can be used.

 Leader. It's ideal if the leader can be 'hands-off' but that may not be possible if the group has limited numbers. The leader manages the effort, supervises the plan and sets actions to protect the rescuers in the water. A designated leader may not be the most skilled rescuer but possesses solid knowledge and good leadership ability.

Rescuer. The 'hands-on' person(s) who accesses the victim or 'object' (such as equipment) to be rescued, and may need specific rescue and first aid skill because the victim may have been injured, or is ill.

Safety. Downstream backup is set to protect rescuers in the water in the event of an unexpected swim; an upstream spotter is positioned to warn oncoming boaters, or to observe for floating debris in the water that could injure rescuers.

Rigger (techinical skill). A rescuer with excellent knowledge of rescue systems. Hopefully, all the members of your group will have had swiftwater training and can set rope systems.

What is taught in formal rescue workshops ('ideal world') can be contrasted with what paddlers encounter in actual rescue situations on the river ('real world'). Within paddling groups a rescue effort is often performed and completed quickly (such as a boat rescue) without the need for a formal type structure. Recreational boaters, especially if they've had swiftwater rescue, should be able to apply various roles with or without a formal structure, however, do not waste time trying to establish a formal structure when a quick solution is needed. It is ideal if everyone in a paddling group is capable of filling whatever role is needed, and many times a rescuer's role is dependent on proximity relative to the accident site.

Other Roles That May Possibly Be Needed--
Gopher. This person can perform multiple tasks, ranging from gathering equipment from the group to performing tasks that can aid the overall effort.

Medical. This person may have specialized medical training or first. ACA Swiftwater Rescue instructors now must have taken at least CPR and Basic First Aid, and workshop participants are always encouraged to take CPR/First Aid, preferably Wilderness First Aid or beyond.

Evacuation. A member of the group works on a plan to transport/evacuate a seriously injured paddler if this becomes the decision of the group.

Effective Management of Groups
Implementing an overall plan is easiest with structured groups, or rescue groups accustomed to paddling and working together, but is essential with larger groups, or among paddlers who may be strangers. Experts in group dynamics indicate that four to six rescuers is an ideal number to manage. Groups larger than seven may require dividing into teams. Even though more people requires more command and control having more rescuers allows more techniques to be employed and more rescue roles to be filled.

 In a more formal rescue other important roles might be required. A Security person might secure the perimeter of the effort keeping out others not involved in the rescue, and a Comfort person, who could provide support to the rescuers involved in the rescue effort (food, water, extra clothing, etc). Rescues that take time require being creative with role assignments making sure everyone has a task. If the rescue group is small some may have to fill multiple roles.

 A phenomenon that sabotages many rescues is human ego, and rescuers must not allow ego to get in the way of sensible actions. Find agreement with others and work together!

Commentary on Interaction Between Professional Rescuers and Recreational Paddlers
Professional rescue groups must be compliant with NIMS and they use the ICS format as the basis of their work in the field. They must meet certain training and operations standards that have been established in the various aspects of rescue. Because public rescue squads have legal responsibility at an accident scene they have an obligation to manage a scene as safely as possible. Recreational boaters and river paddlers may not always fit into such a formal system. In recent times there have been examples of conflict between emergency responders and paddlers trained in swiftwater rescue, over "who is in charge". In certain situations recreational paddlers might possibly possess more swiftwater training than a local rescue squad, but because professional SAR personnel are required to secure the scene they will likely be reluctant to let outsiders assist with the rescue. Of course, arguing with professional authorities won't help either and could actually lead to your removal from an accident scene.

Be polite in your interactions with professionals yet inform them of your capabilities and training and that you stand ready to assist in whatever way you can. Speak directly with the Incident Commander (IC) letting the IC know of your experience and river ability. If you believe the SAR personnel are about to take an action that is a risk of serious injury or death, then you might choose to intervene. Even then, think twice about any decision you make.

Jim Simmons 8/'07; revised 9/2011 (Jim Jones contributed to this discussion).

 

 

 

 

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