Wilderness Emergency Medical Services Institute

TEAM MEMBERING

Skills for the individual

CHAPTER 7: RESCUE PRACTICES

PERSPECTIVE

As has often been said, rescues are just transportation problems. The victim is in the wrong place. Rescuers must figure out how to get the victim to the right place. We know where the victim is. How do we get the victim from there to safety? Do you go up or down? Do you travel a ways and then go up or down? Do you wheel the victim out of the mountains in a stokes? Do you work all night cutting a new trail through a mile of dense brush and then wheel the victim out this shortcut in the morning? Maybe a short carry to a helicopter? Or maybe the victim could ride out on horseback?

RESCUE PLAN

The above talks more to the management end of rescues than to the individual's efforts. But it helps to at least understand the thinking behind the rescue plan that will eventually be employed. All sorts of things come into the design of a rescue plan. The relative urgency of getting the victim out. Is he or she going to die soon or do you have some time to work? Is it easier to haul up hill to a highway or wheel the stokes downstream to a helispot? Are there sufficient volunteers for an extended carryout? Or do the people that responded to the page have the skills to effect a very technical evacuation? What is the weather going to do? What problems have we forgotten?

That's a lot for the uninitiated to consider. So until you are one of the initiated, just be aware of the above questions while you stick to the fundamentals. The main thing you need to understand about rescues is that, in the big picture, they aren't so much organized by rescuers as they are by events. We respond to the call, and discover that our options are generally very limited. We don't have the time to study, plan, and make detailed assignments of who goes where to do what with this or that equipment. The immediate and dynamic character of a rescue situation normally precludes the making of finely detailed plans. We must each respond with creativity and we must all be self-starters.

Rescues are sort of like brain storming sessions, but with `biners and dirt rather than coffee and donuts. As problems arise those on scene must do a quick analysis and come up with a workable rescue plan. It doesn't have to be the niftiest plan since the invention of the rope, it just has to work and provide positive control of risks. So the most experienced will toss a few quick ideas back and forth, and some particular answer will present itself. As the plan unfolds, problems and improvements will make themselves known. When they do we may ignore the little problems and press on. Or we might reject the latest idea as pretty good, but too late to act on. Occasionally it may be necessary to drastically alter or even abandon a plan.

For the typical Team Member, all this means being ready to pitch in just about anywhere. You arrive at say, SARA 1, and somebody hands you something and says to deliver it yonder. You deliver the stuff to yonder and now you're free to do something else. So you look around and you see that this location is being set up for a haul system. Well, all haul systems need anchors for the haul, reset, and belay lines. So too do all haul systems need pulleys laid out and brush cleared for a haul area. So you pick some part of this haul system that needs setting up and you set it up. If you're on your toes, you'll not be stepping on others. That means you ask the people who got there first what needs doing. No need for long winded discussion, just find out enough about the plan to make your own invaluable contribution.

TAKING RESPONSIBILITY

Have you noticed that I've been jumping back and forth in this discussion between manager and member concerns? The reason is simple. In your typical rescue everything seems to be happening at once. Both the creation and the implementation of the plan happen simultaneously, and continue to happen this way even after the victim is out of the field. Different people will be working on different parts of the rescue scene pretty much independently. There will be coordination between the separate parts, but each separate unit of the effort must complete its work as much on its own as possible. This means that once somebody blurts out "I'll go clear the helispot", that helispot becomes that persons own personal piece of the rescue plan.

RISK MANAGEMENT

The one thing you always are totally responsible for is the safety of yourself and your team mates. Let's put a little life into that dry statement. If you see something you don't feel too good about, like an anchor or such, then you had damned well better speak up about it!

There is a long standing, if not long stated, tradition that nothing moves in a rescue until all systems have been checked by someone other than them who put it together. This means that when the haul system has been put together and checked by thems who done it, you step up and try to find out what's wrong with it. Decide that you will find something wrong, and go after it! Even if it's just a knot that needs a little massaging, you've improved the survivability of your friends and the victim. If after applying your very critical eye to someone else's work you do not find any thing wrong with it, well, that just means things are going better than expected.

RIVER RESCUE

Of the many situations that Search & Rescue volunteers may expose themselves to, River Rescue offers the greatest danger of a rescuer being killed. For this reason SARA has developed, in cooperation with other agencies, proven techniques and procedures for saving lives and preventing rescuer deaths. These concepts are well covered in the various yearly training sessions, so only a few key points will be mentioned here.

SARA RIVER RESCUE PROCEDURES: The following are the essential concepts upon which successful River Rescues are planned.

a). SAFETY OF SEARCH & RESCUE PERSONNEL IS #1: Safety is always something well beyond the first thing to be considered. The safety of the rescuers is absolutely paramount in all aspects of River Rescue. Never forget this!

b). "REACH, THROW, ROW, GO": These are the order by which we consider our actions to secure a victim from risk, while minimizing our own. These four steps describe a process of risk escalation in the rescue of a victim.

c). PFD, WETSUIT, HELMET, LIGHT: All personnel near water are to wear a PFD. Going into the water requires the rest.

d). UPSTREAM WATCH: Well up stream of the rescue site personnel should be carefully monitoring the water level and reporting all changes to the Operations Leader. The idea is a simple one, don't be surprised by upstream rains! Remember that flash flooding is commonly caused by distant and unseen rain.

e). DOWNSTREAM BACKUP TEAMS: Sudden surges of water or any of a myriad number of other problems can send a victim or rescuer zooming downstream very unexpectedly. For this reason teams are sent downstream to standby with throw bottles

.

f). WATER TEAM EXPERIENCE: The less experience you have in River Rescue the less responsibility you should seek or accept. This is an area of the rescue business to work your into slowly. Rescuer safety and the likelihood of success are very tightly linked to experience in River Rescue.

g). TWO PERSON WATER TEAM: Never go into the water by yourself! Just as important is to have more than one water team available at the rescue site with at least one team in reserve for unexpected difficulties.

SOME RIVER RESCUE RISK FACTORS: Here is a sampling of some of the things to worry about.

a). UNSTABLE RIVER BOTTOM: Typical of river rescue scenarios is a semifluid bottom. Sand and water are both moving to sometimes surprising depths. Deep, running sand can be only inches from the solid footing you are standing on. Vortexes may form and drill deep holes which fill with fine loose muck.

b). HIGH or LOW WATER LEVEL: Humans walk far better than they swim. Once the water rises above your center of gravity you will begin to float and have difficulty walking. Thus you are forced to swim as soon as your feet lose traction. As if this weren't insulting enough, fast moving but shallow water can whip your feet out from under and force you to swim where there is too little water too support you.

c). FAST WATER: The faster the water, the greater its effect at any depth. As speed increases, the fluidity of the bottom increases. Also the ability to move in shallow water is greatly lessened. Swimming in fast water is mostly an effort to avoid obstacles, even with strong and skilled personnel.

d). WEATHER: The time of year is very important when judging the likelihood of additional rainfall upstream of the rescue site. Early in the monsoon season followup rains are unlikely after the initial downpour is spent. This changes rapidly as the monsoon season advances. At other times of year the probability of followup rains are totally unpredictable. After a few years of drought the ground will be able to absorb huge amounts of rainfall before serious flooding occurs. In wetter years washes may run heavily with very little rain.

e). LOCATIONS HISTORY: Natural indicators show severity and extent of past floods. The debris left from a flood hangs in the brush for a very long time. Even should brush leveled by strong water recover to an upright position, the debris caught in it would serve as an alarm of previous high water. If flood debris is hanging in the brush above the present water level, you can be sure that water will reach that high again.

f). TRAINING AND EXPERIENCE OF PERSONNEL: Many have needlessly died attempting river rescues. Generally this can be attributed to a lack of awareness of both the risks involved, and the procedures for managing those risks. Make a point of attending as many River Rescue practices as possible. Pay close attention and ask plenty of questions until you have a complete understanding of the information being presented.

A good habit to get into is to go back to rescue scenes a day or two after the fact. The idea is to take a second look once time has allowed you to reconsider past actions. In river rescue scenarios this has helped me to develop an awareness of the hidden dangers of low water. While high water does considerable damage, it dissipates quickly. This lends an appearance of safety. Yet I have often observed washes where sink holes and other traps were created by initial high water, but were hidden by low water during the rescue. Only the final clearing of water reveals all the dangers high water generates.

One example is the old crossing of Lambert Lane and the Canyon del Oro in Oro Valley. Before I joined any team I helped out with a rescue at this point. The victim was sitting on the roof of his company truck, with water less than a foot up the tires. The truck was at a slight list on the downstream side of the crossing and at the very edge of the roadway. The water was several hundred feet across, and an extensive rope and raft system had been assembled to go out and get the victim. Just as the raft was about to launch the victim got tired of waiting and walked out. The water was barely covering his shoes as he walked along the very edge of the roadway on the downstream side.

Later that day I stopped by to have another look. The water was down to a trickle and I walked along the road to the victim's truck. What I saw absolutely amazed me. The underside of the road had been undercut in places more than six feet back under the pavement! There were a good half dozen six to ten foot deep sink holes along the immediate downstream edge. Some of these great hollows were right below where the guy walked out. Two of the trucks tires had sunk into the pavement.

None of these problems were obvious during the rescue. At that time the water was flowing flat and smooth, with no distortions of any serious degree. All this damage had been done by the initial flooding, but was hidden by the calm water existing throughout the rescue. Had the victim taken a step a little too wide and gone through the undercut pavement or into a sink hole, it is very doubtful rescuers could have reached him in time to do any good.

Another case was a river rescue at Ina Road and the Santa Cruz River, before the present bridge was built. The river was flowing very fast and wide. A fellow in a full size pickup truck with cab-over camper tried to drive across in perhaps a foot of water. His truck stalled but the water didn't, it kept rising. I got there about the same time as a fire department ladder truck and crew arrived. By this time the water was near the top of the cab, with the driver on the roof of the camper. The truck was listing at an uncomfortable angle. The ladder was extended out and I gave a firefighter a PFD and belayed him out to the truck. The rescue went swiftly, although the driver was not very happy about us leaving his truck unrescued.

When the water went down I went to have a look. It was rather puzzling how such a tremendous force of water could fail to sweep the truck away. But low water revealed the secret. A huge tree trunk with long thick branches was on the downstream side of the truck when it got stuck. The water pushed the truck the few feet to the tree, with one of the branches piercing the camper and impaling it. Other branches were buried in the streambed. Usually trees in washes serve to drown people swept downstream when they become entangled in the branches and roots. But this was a case where a tree saved the mans hide!

On to CHAPTER EIGHT...


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