Swiftwater Rescue I See Program Schedule.

Swiftwater Rescue I See Program Schedule

Lesson 1 Swiftwater Orientation

Site reference Four river references relate to facing downstream
River Center Four river references relate to facing downstream River Right Current River Left Test Question #3: Orientation on a river is made in _____ basic directions. A. 4 B. 3 C. 2 D. 1 River orientation is always relative to facing downstream. Four (4) basic directions from river center. *Advise students that some labels in the river drawings in their notes did not print and they may want to add labels to their drawings. Upstream

Site reference Upstream References remain the same even when the perspective is reversed River Right River Center References stay the same no matter which way you’re facing! Current River Left Downstream

Swiftwater Hydrology The study of the hydraulic effects and dynamics of water flow and the associated forces of moving water Study of hydrology allows rescuer to gain ability to “read” a river or other moving body of water. What is a hydraulic? A re-circulating current formed when water drops over a ledge or low head dam.

Basic characteristics of moving water
Powerful Relentless Predictable. Test Question #2: Name two characteristics of moving water: A. Powerful and fast B. Deep and challenging C. Relentless and predictable D. Cold and unpredictable Water has different personality traits that can change based on: speed water amount bed construction bank formation.

Laminar flow Layers of moving water which are slower on the bottom and along the banks (due to increased friction) Moving water is faster toward the center, midstream and on the outside of bends

Laminar flow Outside Bend Straight Section Fastest Fast Slow Slowest Water layers slow near the bottom and along banks due to friction Laminar flow refers to how the current travels downstream. Several layers of water will be moving together at different speeds. Faster water is usually located near the center of the river just below the surface. Faster water should NOT have a wider path on the outside of a curve. Things floating top river center are more likely to travel greater distances.

Helical flow A circular flow of water along the bank forcing water to midstream Phenomenon caused by friction between current and debris and material on the bank Test Question #4: Water flows down a river bed in two forms, laminar and ____________. A. Hydraulic B. Hydroform C. Helical D. Heliform Helical flow: water traveling along the banks of the river. The friction between the water and the banks will cause the water to spiral downstream between the banks and main current.

Helical & Laminar flow Laminar Flow Helical Flow
Helical flows can be used by the rescuer to move upstream with little effort. Helical flows can also be areas of safe refuge and provide a place to rest. Helical flow is an area of high probability when searching for victims or other evidence materials. Helical Flow

Water dynamics Water is fastest… at the surface and midstream.
Water slows down… along banks and bottom. Water is faster… at the outside of bends and slower on the inside of bends. Water slows down and deepens… in front of dams and other obstructions. Test question #5: Moving water is normally fastest at A. River center, close to the surface B. Upstream of an eddy C. In a hydraulic or hole D. Below a low head dam

Time for float to travel 100 feet
Surface Velocity Time for float to travel 100 feet Throw a floating object (e.g. stick) in the water and record the time it takes to travel 100 feet I knot = 1.15 mph. This will give you a quick reference to determine potential downstream travel. * Advise students to add the “Seconds” column to their notes. Velocity: measured in feet per second

Test Question #8: A river is 100’ wide and averages 6’ deep. The velocity is 3 ft/sec. What is the volume flow? A cfs B cfs C cfs D cfs Volume (CFS) = Width x Depth x Velocity OTHER RIVER VOLUME EXAMPLES: A river 500’ wide, 10’ deep with a velocity of 2’ per second flows 10,000 cfs A river 50’ wide, 10’ deep with a velocity of 20’ per second flows 10,000 cfs (this river will provide a more dangerous situation because a larger amount of water is going through a smaller amount of space)

Force of moving water Rule of thumb...
Water Velocity x 2 = Water Force x 4 (double the velocity = quadruple the force) Test Question #9 When the water velocity doubles, the force of the water goes up by: A. 2 B. 3 C. 4 D. 5 All personnel must have the knowledge and a clear understanding of the power of water. It doesn’t take much velocity to create considerable force, which can overcome a victim or rescuer. The force can also knock you down and/or pin and trap you.

Forces exerted by moving water...
The force exerted on an object in water is proportional to the surface area that is exposed to the force. Double velocity, quadruple the force lbf =Pounds of Force The force trapping a body depends on the amount of surface area exposed. Moving water creates tremendous forces that have the power to move cars, boulders, etc. Rescuers must consider the amount of force not only on themselves but when retrieving victims as the surface area will be double or more. This also needs to be mentioned when considering live bait rescue. The forces are increased when the rescuer make positive contact with a victim. This has a profound effect on the shore personnel holding the rope. River Rescue, Ohio Department of Natural Resources, 1980

Pillow Swelling on the surface caused by an underwater obstruction
Obstruction is usually just beneath the surface Pillow Pillow-forms when water is forced higher than the river level on the upstream side of the object. The water on the downstream side is lower than the river level so the water flows up and around the object and then back towards it to fill in the lower area on the downstream side of the object. Rock or obstruction

Pillow Pillow

Hole Created by water dropping vertically over an obstruction
The larger the drop, the more defined the hole Hole A hole is recognized as a standing wave that breaks on the downstream side of the object. A hole is able to retain floating objects but is not as dangerous as a hydraulic, even though the hole and hydraulic may be substituted for one another. Rock or obstruction

Caused by obstructions in current that extend above the water’s surface
Water flows around obstacle and reverses direction to flow upstream Eddy Rock or obstruction Eddies Test Question #6: Water flows upstream around an obstruction, causing which of the following: A. Hydraulic B. Pillow C. Eddy D. Upstream Eddies are usually found at or near the surface. An eddy is created by an obstruction in the river causing a void on the downstream side. Standing waves are often mistaken for eddies. Discuss the differences. SWR victims often become trapped in eddies. Why? Both sides of an eddy should be checked during victim searches. Remind students that water levels can change on a daily basis so the river will need to be evaluated on scene. The size of an eddy is relative to current speed.

AWARENESS Rock groupings: Outcroppings and clusters of rock in the river channel need to be approached collectively as one large rock. Avoid entering the eddy behind the first rock. It isn’t uncommon to find a debris strainer located there and the chance for entanglement or foot entrapment between rocks is more likely. If the goal is to get into an eddy for safe refuge, catch the farthest eddy downstream behind the rock grouping. Eddies Rocks Eddy

Standing waves Wave stands in one place as it crashes into shallower water Normally found in chutes, bends in river and downstream Vs Increase in water speed as it descends chute Standing waves Test Question #23: Normally found below a downstream “V”, faster water descending a chute and crashing into slower water creates: A. Pillow B. Eddy C. Erosion D. Standing Waves Standing wave-A single wave or succession of waves caused by an obstruction under the water. Standing waves can gain force as the gradient steeps and decreases as the water flows further downstream. If there is an anomaly in a series of standing waves, an underwater obstruction is probably the cause.

Standing waves

Upstream & Downstream Vs
Upstream V created by water hitting an object and going around it Upstream V River left Downstream V Downstream V caused by water flows converging at point of least resistance Avoid Upstream V’s! Downstream V’s usually mark the safest path of travel. River right

Current Downstream V

Current Upstream V’s mark obstructions and areas to avoid. Upstream V

“Look for downstream Vs”
Moving water always follows the path of least resistance. This is generally the safest and least obstructed path of travel in laminar flow. “Look for downstream Vs” Emphasize “Path of Least Resistance” as the safest place to travel within the laminar flow. This path often provides easier access to the victim and is therefore preferred for victim rescue. Reminder: Being able to effectively read the river is the key to safety.

Categories of swiftwater
Class I Class II Class III Class IV Class V Class VI Few obstructions, very small waves Easy rapids up to 3 feet wide, obvious clear channels High irregular waves, narrow channels, requires scouting Difficult long rapids, turbulent water requires scouting, rescue is difficult Violent long rapids, scouting is mandatory, extremely dangerous rescue Almost impossible to navigate, rescue is almost impossible Test Question #7: Class IV swiftwater can be described as: A. Very violent long rapids, mandatory scouting, rescue extremely dangerous. B. High irregular waves with narrow channels. C. Almost impossible to navigate, rescue almost impossible. D. Difficult long rapids with turbulent water, difficult rescue.

Summary Moving water always follows the path of least resistance. Look for downstream Vs. This is generally the safest path to travel in the laminar flow.

Lesson 2 Hazard Awareness
Hazard awareness enable us to safely and effectively put hydrology to use and maintain safe operations. The paradox is that the hazards rescuers should recognize and stay away from are also the areas of high probability for victim entrapment.

Natural and man-made hazards are an ever present threat to the victim and rescuer!
Drowning Entrapment Trauma Hypothermia

Swiftwater hazards Debris Top/floating debris Suspended debris Bottom debris Fixed obstacles Rocks, bridge abutments Strainers Barb wire, tree limbs, branches, log jams, fences Low head dams Special Note: White water is a hazard in and of itself that is often overlooked during an assessment of other physical dangers. White water is highly aerated (“foamy”) and therefore consists mostly of air. It isn’t possible to breathe aerated water and it will not support a rescuer at the surface even with a PFD or Rescue Board. Floatation is not possible until “solid” water can be reached below the aerated water. Unknowing victims may remain down for extended periods of time if the water is re-circulating. This hazardous environment often catches students off guard.

Strainers allow water but not solids to pass through
Test Question #10: An obstruction in a river or stream which is usually made up of trees and other debris will allow the current to pass through, but does not enable larger objects, such as people or boats, to pass through. This obstruction is called a: A. Hole B. Eddy C. Wave D. Strainer

Fence lines create deadly strainers that often go unseen…
Strung just above the water, this barb wire fence is difficult to see from a distance and may become invisible at dusk or in the dark of night. There is no way to know exactly what danger may lay just beneath the surface. This photograph demonstrates the importance of scouting moving water and pre-planning prior to tactical action.

Low head dam Backwash Boil Outwash Escape route Cross section
Test Question #11: Which of the following best describes a hydraulic? A. Friction slowing the water along the bottom and along the shores B. A flowing together of two or more streams C. Re-circulating current formed when water drops over a ledge or low head dam D. The movement of water along the banks of a river Low head dam used for: Flood control Power generation For passing utilities under river channels Rescue: Never remove PFD in an attempt to escape. Escape route theory (Down and out along bottom - last resort). Boat systems (four line tether & two boat tether). Cross section of Low Head Dam

Other hazards... Slippery, unsure footing
Difficult topography access, cliff faces, drop-offs Environmental conditions weather, cold water Bio-hazards flood waters, runoff from agricultural products Local hazards?. Know your area, pre-plan Dress for success Biohazards Septic Tertiary Ponds Coffins How can we protect ourselves? Dry Suit Stay out

Summary Know your area and preplan!
Know the hazards present in your area and pre-plan around them to stay safe and effective. Know your area and preplan!

Lesson 3 Preplanning & Equipment
Pre-planning prevents poor performance.

Preplanning... …is the key to safe and effective water rescue operations! Test Question #13: What is the most important reason for accident scene preplanning? A. It saves time and lives B. It saves money C. It saves unnecessary boat launchings D. It saves equipment usage Prior planning prevents poor performance. Preplanning saves time and lives!

Always consider the Risk/Benefit Analysis of every operation!
Always ask, “Is the RISK worth the BENEFIT?” Requires an evaluation of all hazards!

Preplanning Accident Site Evaluation
Low flow Medium flow High flow Flood stage Ask “How can water levels affect our river?” (See test question below.) Test Question #12: A preplan site should be surveyed in different seasons because: A. Water levels may make access points change dramatically B. Low/high water levels may present new rescue hazards C. Trees may have created strainers due to bank erosion D. All of the above

Map and photograph potential accident sites during low water...
Two spillways showing Low flow. The next slide shows the same site with higher flow rates.

...toprovide insight on what to expect during high water.
The same spillways as the previous slide showing higher rates of flow.

Preplanning Accident Site Survey
Record width, depth, velocity, river characteristics Locate natural and manmade hazards Record access routes, launch sites, high danger areas Determine ability to control flow Inform class of “River Survey Form” at the back of student packet to assist with site survey.

Personal Protective Equipment for Shore-Based rescuers...
Always wear a PFD (equipped with whistle & knife) in and near the water Wear proper environmental protection Have appropriate foot protection Leather gloves for rope management Helmet (when necessary) Multiple throwline bags. PPE = Personal Protective Equipment Test Question #14: The single most important piece of equipment needed by every person on a water rescue team is: A. Throw bag B. Ring buoy C. Polypropylene line D. Personal flotation device (PFD) Test Question #15: As a rescuer, when should a PFD be worn? A. When effecting a shore-based rescue B. At all times when on, or near the water C. Entering the water D. When effecting a low-head dam rescue Stress importance of having more than one throwline bag available.

PPE for Swiftwater Rescue
Thermal protection PFD with knife & whistle Helmet Swiftwater rescue board Hand & foot protection Fins/mask/snorkel Throwline bags PPE = Personal Protective Equipment Thermal protection reduces threat of hypothermia and increases in-water search time. PFD must be Coast Guard Approved-type 3 or better. Carry two cutting tools. Helmet must be designed for water sports with adequate drainage. NO FIRE OR ROCK CLIMBING HELMETS! A mask and snorkel provide for clear, uncompromised vision & breathing at the surface and enhances subsurface search efforts. Stress the importance of securing all equipment in order to keep a streamlined, low profile attitude in the water and minimize the threat of entanglement or entrapment.

Swiftwater team equipment
Throwline bags Line gun (w/ hearing & eye protection) Tag line buoy Multi-chambered inflatable boat Rope rescue equipment/hardware Communication equipment Additional PFDs & helmets Other specialized equipment. Test Question #24: Swiftwater Rescue Team equipment should include: A. Throwline bags B. Inflatable boat C. Rope rescue equipment/hardware D. All of the above Tag line buoy pictured on slide #78. Additional helmets and PFD’s for victim or rescuer use. Specialized equipment includes: Hose inflation device 1st aid chemical strobes lights zip ties

Always use the SANE approach to swiftwater rescue!
S imple approach A dequate backup N ever take chances E liminate the “beat the water” attitude Test Question #1: In the SANE approach to swiftwater rescue, the “S” stands for: A. Shore personnel B. Shouldn’t take chances C. Swimming the river is dangerous D. Simple approach Test Question #22: In the SANE approach to swiftwater rescue, the “E” stands for: A. Examine personnel B. Eliminate the “beat the water” attitude C. Evaluate cost D. Enter the water Maintain a step by step approach in all aspects of the operation.

Lesson 4 Fundamental Rescue Techniques

Self-rescue techniques
Swimming in current (defensive maneuvers) Body positioning... On your back Face up Horizontal posture Feet downstream Ferry angles Test Question #17: Which of the following statements best describes the self-rescue position that should be assumed to lessen the possibility of injury and entrapment when floating in a hazardous current? A. On your back with feet pointed downstream and at the surface of the water. B. On your back with feet pointed upstream and at the surface of the water. C. On your back with feet kicking at the surface of the water pointed toward the shore. D. On your back with feet kicking at the surface of the water and pointed downstream. Feet in front to push off obstructions. Keep feet off the bottom! Do not try to stand in moving water due to the threat of foot entrapment. A foot entrapment can be deadly as the force of moving water can hold the victim underwater.

Swiftwater maneuvering
Position head upstream and toward the direction of desired travel. For optimum efficiency, the rescuer should maintain a 450 angle to the current. See next slide for river right ferry angle. River left ferry angle

Test Question #25: To maneuver a boat, rescue board, or swimmer across swiftwater, the proper ______________ must be maintained to be effective. A. Launch Site B. Foot Protection C. Ferry Angle D. Hand Signals Same principle used for directing boats across current. More on ferry angles and swiftwater boat maneuvering in the lesson on Technical Rescue Systems. River right ferry angle

Self-rescue techniques
Avoiding entrapment (aggressive maneuvers) Body positioning... Head first, swim/up and over strainers/hazards Dangers of foot entrapment in strong current You have more control when you are moving FASTER than the current. Strainers must be avoided at all cost. However, if you cannot avoid a strainer, swim at it head first as fast as you can. Swim up and over. Do not roll!

Victim rescue Scene assessment Safety first Evaluate Risk/Benefit
Victim contact make attempt to talk with victim Always choose rescue methods that provide the highest degree of effectiveness while minimizing the risk to the rescuer. In order to minimize the risk to the rescuer, choose only those tactics that have been proven and practiced.

As a rescuer... Never tie yourself (or a victim) to a rope when working in moving water Never tie a line across the river, perpendicular to the flow, in hopes of catching a victim Never enter swiftwater wearing firefighter turnout or bunker gear Remember, specialized ice rescue suits are not designed for swiftwater In reference to being tied off in moving water: The force of moving water will tension the line, push anything tied to it under the water and hold it there as long as the line remains under tension. SPECIAL NOTE: Some students may be aware of a swiftwater rescue technique referred to as a “Live Bait Rescue”. This rescue method involves the rescuer attached to a rope with a quick release that is woven into the buckle of the PFD. The rescuer enters the water, secures the victim and pendulums to shore. In the event of a problem, the rescuer escapes by releasing the buckle and freeing themselves from the tether. The “Live Bait Rescue Technique” will not be discussed in SWR1 class. It is considered a specialized tactic with limited application. Obstructions along the bank or in the water prevent the safe deployment of rescuers using this technique. Flood operations or white water are extremely dangerous environments with a high probability of entanglement. It is advised that rescuers not attempt this technique under these conditions.

Rescue Methods in order of preference...
Reach Throw Row Go Test Question #16: Arrange the following in the proper rescue sequence that should be carried out at the scene of a water rescue: 1. Throw (rescue ring, throwline) 2. Reach (pike pole, fire hose, branch or stick) 3. Go (rescuer in the water with proper equipment and training) 4. Row (inflatable boat with motor or tether system) Choices: A. 2, 1, 3, 4 B. 3, 4, 1, 2 C. 2, 1, 4, 3 D. 3, 2, 1, 4

“Reach” Method Simple technique used when the victim is close to shore
Makes use of any object that can be extended to the victim for them to hold Victim must be able to assist in rescue by holding on to object extended to them Maintains high degree of safety for rescuer The REACH method minimizes the threat to the rescuer while still achieving a high degree of success. Allows the rescuer to stay warm, safe and dry. Examples of reach devices include: Pike pole, hose, branch, jumper cables, antennae, paddle, etc.

“Throw” Method Throw method is used when distance to victim exceeds ability to use the reach method Method limited by distance and throwing accuracy of the rescuer Victim must be able to assist in rescue by holding on to object thrown to them Still maintains high degree of safety for rescuer The victim MUST be able to assist for this method to be effective! Effective range is generally limited to feet. Effectiveness drops substantially when distances exceed 75 feet. Throw devices include: Rescue ring, throwline, line gun, etc. Other improvised throw devices include… Cooler Picnic jug Spare tire Boat seat cushion

Water rescue throwline bags
There is a right way... …and a wrong way. The top, left picture is correct while the lower left picture is incorrect. Never place your hand through the loop of the throwline rope. Instead, place the loop over the thumb, wrap around the back of the hand and back through the palm of the hand. Then form a fist to secure the rope. In this fashion, if an emergency arises, simply open the hand and the rope will immediately release.

Water rescue throwline bags
Throwline bags are a highly effective tool in swiftwater rescue Easy tool to master but requires some practice Dynamics of throw bag use: stay on shore stay on the move coach victim Terrain considerations/victim access Throw the bag just above the head and shoulders on the upstream side of the victim. If your throw is slightly off, the line will drift quickly downstream into the victim’s reach. Do not throw the line downstream of the victim. This is much more difficult to reach as the victim will have to swim after a rope that is quickly floating away. It is best to have more than one throw bag available. If you miss on the first throw or the line becomes entangled, there will be another readily available to attempt another throw. Rule of thumb, “If you grab one throwline bag, grab two”. If multiple rescuers are available, coordinate your efforts and have the upstream rescuer make the first throw attempt followed up by the downstream rescuer(s).

“Row” Method This method enables rescuers to close the gap between victim and the shore Incorporates use of watercraft and allowing rescuers a safe approach to victim A reach, throw or go rescue can now be attempted Allows for working platform to be brought to the victim. This method is limited by the rate of flow and by obstructions and other hazards (strainers, boulder sieves, etc.). Depending on location, water craft may be tethered or motorized.

“Go” Method Most dangerous method of victim rescue
Requires approach and direct contact with victim in water Last resort when reach and throw methods will not work or the victim is unable to help themselves Places rescuer in greatest danger Decision to “go” requires an accurate assessment of the victim and potential dangers of the situation This method may be necessary when victim is unable to help self. Requires an accurate assessment of victim and hazards. Is rescuer capable of safely entering the environment? Is rescuer able to secure and control victim? Is rescuer in danger from down-stream hazards? Rescuer must enter water properly prepared with proper equipment and training. Approach victim from rear or extend a swiftwater rescue board for them to grab onto. Then tow the victim to safety.

The “Go” method is potentially dangerous!
Swimming while trying to control a victim is difficult even over short distances Know your own capabilities Have back-up rescuer ready to assist. Be prepared with proper equipment PFD and thermal protection Helmet Fins Swiftwater rescue board Important to know capabilities and limitations of team, equipment and rescuers. Rescuer must be properly prepared and have back-up in place acting as downstream safety before initiating in-water rescue attempts.

Shallow water crossing
Single person Multi-person line Multi-person wedge One person crossing involves the use of a pole or stick to maintain three-points of contact. Be sure of footing and move only one foot (or pole) at a time.

Multi-person line Biggest person in front facing downstream.
Move in unison with proper communication.

Multi-person wedge Biggest person in front facing downstream. All others interlocked. Move in unison with good communication. Creates eddy behind wedge to work in or place victim.

Lesson 5 Technical Rescue Systems
Material to be discussed in this section includes boat operations and communications.

River left ferry angle Boat ferry angles operate under the same principles as those learned in lesson 4. 450 angle Bow upstream Bow toward direction of travel Let water do the work. River right ferry angle

Technical rescue systems
Two-line tether Four-line tether High line system Two-boat tether

Two-line tether Two lines attached to each side of the bow in order to move the boat back and forth across the flow of the moving water. This technique is ideal for low flow, slow moving water where only minimal manpower is needed to control the boat. This rigging method is quick to set up and simple to execute.

Four-line tether Test Question #18: To maneuver an inflatable rescue boat in turbulent waters, a ________ system is usually the best choice. A. Four line tether B. Two boat tether C. Two buoy high-line D. Tag line This technique is the best choice for maneuvering a boat in turbulent water. It is quick to set up and relatively easy to control the boat making use of ferry angles to move the boat back and forth.

Technical rescue systems Proper tag line management
Line tenders must be dynamic and move up and down along the bank to maintain optimal ferry angle as the boat is tracking from river left to river right and vice versa. Optimum line management may be influenced by vegetation, rocks or other obstructions along the shoreline. A good assessment of the incident site will help determine the best location to establish this system. Proper tag line management

High line system The boat is rigged to a movable control point on a highline system placed above the water. Tag lines are attached to the movable control point to move the boat to river right and river left. For high flow operations, the upstream/downstream control can be to shore (as pictured) or be operated from within the boat for low flow operations. Optional stern lines allow for additional control as needed and when sufficient manpower is available. This technique requires more equipment, manpower and training to successfully execute.

...used where verbal communication is not effective
Rescue hand signals ...used where verbal communication is not effective Team leader Select good vantage point Use whistle Practice is important to maintain standardization and efficiency.

Rescue hand signals Help-Emergency Also, give 3 long blasts on a
whistle and wave a helmet or paddle over your head

Rescue hand signals Direction
Point and hold indicating proper direction Important: Continue to hold position until you want boat to stop!

Rescue hand signals Stop! Also, blow one long blast on whistle

Rescue hand signals “OK” Signal Touch top of head
with a controlled and deliberate motion

Rescue hand signals Lengthen line (slack) Arms moving out from center
Make two fists, touch hands and move arms from center out. Repeat!

Rescue hand signals Shorten line (tension)
Fists moving up and down from elbow

Rescue hand signals Near shore
Arms moving backward and hold, indicating direction Important: Continue to hold position until you want boat to stop!

Rescue hand signals Far shore
Arms moving forward and hold, indicating direction Important: Continue to hold position until you want boat to stop!

Lesson 6 General Patient Care
Primary objective: Provide optimum level of patient care and cause no further harm. Special note: This section is intended to provide an awareness level for the medical concerns associated with swiftwater incidents. SWR teams are encouraged to contact local medical control to establish an acceptable standard of care.

Medical considerations
Hypothermia Near drowning Trauma C-spine care Cuts and lacerations Broken bones Proper patient handling & transportation

Field management Maintain local standard of care
Proper airway management/ ABC’s Prevent further heat loss Proper immobilization Gentle handling Proper packaging and transport. Test Question #20: Swiftwater rescue team responsibilities include proper patient ___________ and ____________. A. handling and transportation B. handling and long term care C. education and training D. notification and identification The rescuer must accept responsibility for properly patient packaging and delivery to the back of the ambulance. Rescuer cannot abandon patient and should do no further harm. Standard of care: All field care should be based on local emergency medical protocols as dictated by local EMS director (medical advisor, etc.). Water rescue teams should be familiar with EMS protocol and system director if not already directly associated with the EMS system.

A special note on hypothermia:
Water conducts heat from the body 25 times faster than air of same temperature Hypothermia can occur in water below 910 Body core temperature quickly loses heat in cold water and hypothermia can have a rapid onset Test Question #19: Which of the following statements best describe the term hypothermia? A. Lowering of the body defense temperature B. Lowering of the body core temperature C. Raising of the body defense temperature D. Raising of the body core temperature Often overlooked, hypothermia is a potentially dangerous condition that can affect both victim and rescuer. Hypothermia occurs when the body’s core temperature drops below 950 F. Cold water drowning occurs when water temperatures are less than 700 F.

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