3Site reference Four river references relate to facing downstream River CenterFour river references relate to facing downstreamRiverRightCurrentRiverLeftTest Question #3:Orientation on a river is made in _____ basic directions.A. 4B. 3C. 2D. 1River 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
4Site referenceUpstreamReferences remain the same even when the perspective is reversedRiver RightRiver CenterReferences stay the same no matter which way you’re facing!CurrentRiver LeftDownstream
5Swiftwater HydrologyThe study of the hydraulic effects and dynamics of water flow and the associated forces of moving waterStudy 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.
6Basic characteristics of moving water PowerfulRelentlessPredictable.Test Question #2:Name two characteristics of moving water:A. Powerful and fastB. Deep and challengingC. Relentless and predictableD. Cold and unpredictableWater has different personality traits that can change based on: speedwater amountbed constructionbank formation.
7Laminar flowLayers 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
8Laminar flowOutside BendStraight SectionFastestFastSlowSlowestWater layers slow near the bottom and along banks due to frictionLaminar 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.
9Helical flowA circular flow of water along the bank forcing water to midstreamPhenomenon caused by friction between current and debris and material on the bankTest Question #4:Water flows down a river bed in two forms, laminar and ____________.A. HydraulicB. HydroformC. HelicalD. HeliformHelical 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.
10Helical & 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
11Water 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 atA. River center, close to the surfaceB. Upstream of an eddyC. In a hydraulic or holeD. Below a low head dam
12Time for float to travel 100 feet Surface VelocityTime for float to travel 100 feetThrow a floating object (e.g. stick) in the water and record the time it takes to travel 100 feetI 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
13Test Question #8:A river is 100’ wide and averages 6’ deep. The velocity is 3 ft/sec. What is the volume flow?A cfsB cfsC cfsD cfsVolume (CFS) = Width x Depth x VelocityOTHER RIVER VOLUME EXAMPLES:A river 500’ wide, 10’ deep with a velocity of 2’ per second flows 10,000 cfsA 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)
14Force of moving water Rule of thumb... Water Velocity x 2 = Water Force x 4(double the velocity = quadruple the force)Test Question #9When the water velocity doubles, the force of the water goes up by:A. 2B. 3C. 4D. 5All 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.
15Forces 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 forcelbf =Pounds of ForceThe 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
16Pillow Swelling on the surface caused by an underwater obstruction Obstruction is usually just beneath the surfacePillowPillow-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 orobstruction
18Hole Created by water dropping vertically over an obstruction The larger the drop, the more defined the holeHoleA 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 orobstruction
20Caused by obstructions in current that extend above the water’s surface Water flows around obstacle and reverses direction to flow upstreamEddyRock orobstructionEddiesTest Question #6:Water flows upstream around an obstruction, causing which of the following:A. HydraulicB. PillowC. EddyD. UpstreamEddies 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.
21AWARENESSRock 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.EddiesRocksEddy
22Standing wavesWave stands in one place as it crashes into shallower waterNormally found in chutes, bends in river and downstream VsIncrease in water speed as it descends chuteStanding wavesTest Question #23:Normally found below a downstream “V”, faster water descending a chute and crashing into slower water creates:A. PillowB. EddyC. ErosionD. Standing WavesStanding 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.
24Upstream & Downstream Vs Upstream V created by water hitting an object and going around itUpstream VRiver leftDownstream VDownstream V caused by water flows converging at point of least resistanceAvoid Upstream V’s!Downstream V’s usually mark the safest path of travel.River right
26CurrentUpstream V’s mark obstructions and areas to avoid.Upstream V
27“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.
28Categories of swiftwater Class IClass IIClass IIIClass IVClass VClass VIFew obstructions, very small wavesEasy rapids up to 3 feet wide, obvious clear channelsHigh irregular waves, narrow channels, requires scoutingDifficult long rapids, turbulent water requires scouting, rescue is difficultViolent long rapids, scouting is mandatory, extremely dangerous rescueAlmost impossible to navigate, rescue is almost impossibleTest 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.
29SummaryMoving water always follows the path of least resistance. Look for downstream Vs. This is generally the safest path to travel in the laminar flow.
30Lesson 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.
31Natural and man-made hazards are an ever present threat to the victim and rescuer! DrowningEntrapmentTraumaHypothermia
32Swiftwater hazardsDebris Top/floating debris Suspended debris Bottom debrisFixed obstacles Rocks, bridge abutmentsStrainers Barb wire, tree limbs, branches, log jams, fencesLow head damsSpecial 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.
33Strainers 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. HoleB. EddyC. WaveD. Strainer
34Fence 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.
35Low 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 shoresB. A flowing together of two or more streamsC. Re-circulating current formed when water drops over a ledge or low head damD. The movement of water along the banks of a riverLow head dam used for:Flood controlPower generationFor passing utilities under river channelsRescue: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 sectionof Low Head Dam
36Other hazards... Slippery, unsure footing Difficult topography access, cliff faces, drop-offsEnvironmental conditions weather, cold waterBio-hazards flood waters, runoff from agricultural productsLocal hazards?.Know your area, pre-planDress for successBiohazardsSepticTertiary PondsCoffinsHow can we protect ourselves?Dry SuitStay out
37Summary 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!
39Preplanning...…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 livesB. It saves moneyC. It saves unnecessary boat launchingsD. It saves equipment usagePrior planning prevents poor performance.Preplanning saves time and lives!
40Always consider the Risk/Benefit Analysis of every operation! Always ask, “Is the RISK worth the BENEFIT?”Requires an evaluation of all hazards!
41Preplanning Accident Site Evaluation Low flowMedium flowHigh flowFlood stageAsk “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 dramaticallyB. Low/high water levels may present new rescue hazardsC. Trees may have created strainers due to bank erosionD. All of the above
42Map and photograph potential accident sites during low water... Two spillways showing Low flow. The next slide shows the same site with higher flow rates.
43...toprovide insight on what to expect during high water. The same spillways as the previous slide showing higher rates of flow.
44Preplanning Accident Site Survey Record width, depth, velocity, river characteristicsLocate natural and manmade hazardsRecord access routes, launch sites, high danger areasDetermine ability to control flowInform class of “River Survey Form” at the back of student packet to assist with site survey.
45Personal Protective Equipment for Shore-Based rescuers... Always wear a PFD (equipped with whistle & knife) in and near the waterWear proper environmental protectionHave appropriate foot protectionLeather gloves for rope managementHelmet (when necessary)Multiple throwline bags.PPE = Personal Protective EquipmentTest Question #14:The single most important piece of equipment needed by every person on a water rescue team is:A. Throw bagB. Ring buoyC. Polypropylene lineD. Personal flotation device (PFD)Test Question #15:As a rescuer, when should a PFD be worn?A. When effecting a shore-based rescueB. At all times when on, or near the waterC. Entering the waterD. When effecting a low-head dam rescueStress importance of having more than one throwline bag available.
46PPE for Swiftwater Rescue Thermal protectionPFD with knife & whistleHelmetSwiftwater rescue boardHand & foot protectionFins/mask/snorkelThrowline bagsPPE = Personal Protective EquipmentThermal 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.
47Swiftwater team equipment Throwline bagsLine gun (w/ hearing & eye protection)Tag line buoyMulti-chambered inflatable boatRope rescue equipment/hardwareCommunication equipmentAdditional PFDs & helmetsOther specialized equipment.Test Question #24:Swiftwater Rescue Team equipment should include:A. Throwline bagsB. Inflatable boatC. Rope rescue equipment/hardwareD. All of the aboveTag line buoy pictured on slide #78.Additional helmets and PFD’s for victim or rescuer use.Specialized equipment includes:Hose inflation device1st aidchemical strobeslightszip ties
48Always use the SANE approach to swiftwater rescue! S imple approachA dequate backupN ever take chancesE liminate the “beat the water” attitudeTest Question #1:In the SANE approach to swiftwater rescue, the “S” stands for:A. Shore personnelB. Shouldn’t take chancesC. Swimming the river is dangerousD. Simple approachTest Question #22:In the SANE approach to swiftwater rescue, the “E” stands for:A. Examine personnelB. Eliminate the “beat the water” attitudeC. Evaluate costD. Enter the waterMaintain a step by step approach in all aspects of the operation.
50Self-rescue techniques Swimming in current (defensive maneuvers) Body positioning... On your back Face up Horizontal posture Feet downstream Ferry anglesTest 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.
51Swiftwater 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
52Swiftwater maneuvering Test Question #25:To maneuver a boat, rescue board, or swimmer across swiftwater, the proper ______________ must be maintained to be effective.A. Launch SiteB. Foot ProtectionC. Ferry AngleD. Hand SignalsSame 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
53Self-rescue techniques Avoiding entrapment (aggressive maneuvers) Body positioning... Head first, swim/up and over strainers/hazardsDangers of foot entrapment in strong currentYou 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!
54Victim rescue Scene assessment Safety first Evaluate Risk/Benefit Victim contact make attempt to talk with victimAlways 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.
55As a rescuer...Never tie yourself (or a victim) to a rope when working in moving waterNever tie a line across the river, perpendicular to the flow, in hopes of catching a victimNever enter swiftwater wearing firefighter turnout or bunker gearRemember, specialized ice rescue suits are not designed for swiftwaterIn 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.
56Rescue Methods in order of preference... ReachThrowRowGoTest 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, 4B. 3, 4, 1, 2C. 2, 1, 4, 3D. 3, 2, 1, 4
57“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 holdVictim must be able to assist in rescue by holding on to object extended to themMaintains high degree of safety for rescuerThe 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.
58“Throw” MethodThrow method is used when distance to victim exceeds ability to use the reach methodMethod limited by distance and throwing accuracy of the rescuerVictim must be able to assist in rescue by holding on to object thrown to themStill maintains high degree of safety for rescuerThe 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…CoolerPicnic jugSpare tireBoat seat cushion
59Water 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.
60Water rescue throwline bags Throwline bags are a highly effective tool in swiftwater rescueEasy tool to master but requires some practiceDynamics of throw bag use: stay on shore stay on the move coach victimTerrain considerations/victim accessThrow 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).
61“Row” MethodThis method enables rescuers to close the gap between victim and the shoreIncorporates use of watercraft and allowing rescuers a safe approach to victimA reach, throw or go rescue can now be attemptedAllows 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.
62“Go” Method Most dangerous method of victim rescue Requires approach and direct contact with victim in waterLast resort when reach and throw methods will not work or the victim is unable to help themselvesPlaces rescuer in greatest dangerDecision to “go” requires an accurate assessment of the victim and potential dangers of the situationThis 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.
63The “Go” method is potentially dangerous! Swimming while trying to control a victim is difficult even over short distancesKnow your own capabilitiesHave back-up rescuer ready to assist.Be prepared with proper equipment PFD and thermal protection Helmet Fins Swiftwater rescue boardImportant 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.
64Shallow water crossing Single personMulti-person lineMulti-person wedgeOne 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.
65Multi-person line Biggest person in front facing downstream. Move in unison with proper communication.
66Multi-person wedgeBiggest person in front facing downstream. All others interlocked.Move in unison with good communication.Creates eddy behind wedge to work in or place victim.
67Lesson 5 Technical Rescue Systems Material to be discussed in this section includes boat operations and communications.
68Swiftwater maneuvering River left ferry angleBoat ferry angles operate under the same principles as those learned in lesson 4.450 angleBow upstreamBow toward direction of travelLet water do the work.River right ferry angle
69Technical rescue systems Two-line tetherFour-line tetherHigh line systemTwo-boat tether
70Technical rescue systems Two-linetetherTwo 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.
71Technical rescue systems Four-linetetherTest Question #18:To maneuver an inflatable rescue boat in turbulent waters, a ________ system is usually the best choice.A. Four line tetherB. Two boat tetherC. Two buoy high-lineD. Tag lineThis 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.
72Technical 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
73Technical rescue systems High linesystemThe 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.
74...used where verbal communication is not effective Rescue hand signals...used where verbal communication is not effectiveTeam leaderSelect good vantage pointUse whistlePractice is important to maintain standardization and efficiency.
75Rescue hand signals Help-Emergency Also, give 3 long blasts on a whistle and wave a helmetor paddle over your head
76Rescue hand signals Direction Point and hold indicating proper directionImportant: Continue to hold position until you want boat to stop!
77Rescue hand signalsStop!Also, blow one long blast on whistle
78Rescue hand signals “OK” Signal Touch top of head with a controlled and deliberate motion
79Rescue hand signals Lengthen line (slack) Arms moving out from center Make two fists, touch hands and move arms from center out. Repeat!
80Rescue hand signals Shorten line (tension) Fists moving up and down from elbow
81Rescue hand signals Near shore Arms moving backward and hold, indicating directionImportant: Continue to hold position until you want boat to stop!
82Rescue hand signals Far shore Arms moving forward and hold, indicating directionImportant: Continue to hold position until you want boat to stop!
83Lesson 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.
85Field management Maintain local standard of care Proper airway management/ ABC’sPrevent further heat lossProper immobilizationGentle handlingProper packaging and transport.Test Question #20:Swiftwater rescue team responsibilities include proper patient ___________ and ____________.A. handling and transportationB. handling and long term careC. education and trainingD. notification and identificationThe 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.
86A special note on hypothermia: Water conducts heat from the body 25 times faster than air of same temperatureHypothermia can occur in water below 910Body core temperature quickly loses heat in cold water and hypothermia can have a rapid onsetTest Question #19:Which of the following statements best describe the term hypothermia?A. Lowering of the body defense temperatureB. Lowering of the body core temperatureC. Raising of the body defense temperatureD. Raising of the body core temperatureOften 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.