FALL PREPLANNING FOR SAFE ICE RESCUE OPERATIONS, PART 1

FALL PREPLANNING FOR SAFE ICE RESCUE OPERATIONS, PART 1

ANDREA ZAFERES

WALT “BUTCH” HENDRICK

The following article specifically addresses ice rescue operations, but the process is the same for all water-related incidents.

We frequently ask fire, police, and EMS personnel who have worked on a surface ice rescue incident, “What was the most important thing you learned from the operation?” The most common response is, “We were not prepared! We didn`t have the right equipment or procedures. We did not have standard operating procedures and guidelines, and the incident management system fell apart.”

The universal result of not being prepared is the endangerment of rescue personnel`s lives in conjunction with a severely decreased chance of saving the original victims. When unprepared public safety departments attempt a surface ice rescue, the scene typically can involve any of the following:

•a weak or nonexistent incident management system (IMS);

•no real plan of action;

•no safe, functional staging areas;

•everyone scrambling around trying to find something with which to reach the victim(s);

•poor or no scene control;

•personnel without personal flotation devices or other personal protective equipment (PPE) on or near the ice;

•little or no accountability for rescuers on the ice;

•unprepared, unprotected, hypothermic rescue personnel, overloaded with ring buoys, inflated fire hoses, lines, and other gear they have little idea of how to use, repeatedly crashing through the ice trying to reach the victim;

•unprotected rescue personnel on boats laboriously using poles and other extensions to break the ice between them and the victim(s); and

•victims` fragile bodies banged, yanked, and dropped at least three times en route back to shore and the waiting ambulance.

Sometimes the victim is saved, sometimes not. Sometimes the rescuers make it back to shore, and sometimes they do not. In almost every case we have studied, the reckless endangerment of rescuers` lives could have been prevented with preplanning.

Preplanning is critical even for well-trained and well-equipped teams. Preplanning can greatly decrease the time it takes to reach the victim, which can make the important difference between life and death.

REVIEW PAST INCIDENTS AND POTENTIAL PROBLEM SITUATIONS

To perform safe and effective rescues, public safety agencies must be well-prepared. To be prepared, they must know what to prepare for so they can preplan responses to potential incidents. All responding agencies should be involved in the preplanning process for the following reasons:

•to create the safest and most effective standard operating standards and guidelines possible;

•to ensure better cooperation and organization during actual incidents;

•to develop an effective incident management system (IMS) so that each agency understands that there will be only one incident commander (IC) and one command post (CP) and how the IMS is established and managed; and

•to ensure that interagency communication and pooling of resources will be facilitated.

We cannot stress enough the importance of interagency preplanning and follow-up drill sessions with debriefings. Without effective and knowledgeable leadership and an IMS, a simple ice rescue can become a disaster for all involved. For example, consider a simple ice rescue incident of a boy in the ice 50 feet from shore. How difficult is it to plan, command, manage, and perform such a rescue? Not very. With a well-trained and well-equipped team, the rescue should take less than 10 minutes from time on-scene to the time the victim is in the ambulance.

Unfortunately, such organization is not often seen in the real world. Who shows up for an ice call? Either no one or the entire world. Turf wars, battles for the IC position, lack of equipment and trained personnel, difficulties accessing the site, freelancing rescuers, uncontrolled media and bystanders, lack of interagency coordination, and a variety of other problems often arise. Interagency preplanning and drills can prevent almost all, if not all, of these problems. Without preplanning and drilling, at least some of these problems are almost guaranteed to occur, and everyone loses.

A major portion of preplanning is reviewing prior problem sites to determine the following:

•Where are the most common problem locations?

•What are the best access and exit points?

•Typically, how far from shore do rescues take place in each area?

•What have been past causes of ice incidents (e.g., motor vehicle accidents, snowmobiling, ice fishing)?

•What agencies responded to past incidents, and what were the results? (Were there too many responders, or too few? Were responders trained with proper procedures, or was it chaotic? Was the necessary equipment available? Were rescuers ever put at unnecessary risk? Was there an effective debriefing?)

•Did the IMS work, and if not, why not, and what needs to be done to prevent the same problems from recurring?

•Are there any measures the community can take to prevent future ice incidents, such as putting signs up in known problem areas, increasing public education, putting up fences, making problem areas shallower in the winter, conducting ice accident prevention programs in schools, and passing laws imposing fines for driving on the ice?

You may find no consistency that can be tracked and that preplanning is minimal based on the total unknown. On the other hand, you may discover a consistency, such as the same general location year after year or the same causes being repeated. For example, if you discover that several incidents last year involved snowmobilers two miles from shore, then you can do the following:

•obtain long-distance ice operation training and equipment;

•write a long-distance ice operation standard operating guideline;

•further train rescuers in patient handling, as there will be a longer latency to transport the patient(s) to the ambulance and hospital;

•make sure rescuers are physically fit for a long-distance ice operation;

•petition the county to pass laws to impose fines on reckless snowmobilers who require this tremendous rescue effort.

Review past ice rescue incidents to identify the potential ice problem areas in your district. Ask the following:

•Where do people most commonly congregate on the ice? Where do they ice fish, snowmobile, ski, and skate?

•Where might cars accidentally end up on the ice?

•What ice areas are known to be potentially weak? Where do geese and other waterfowl commonly congregate in the winter?

•Are there areas of hidden ice, such as cross-country ski trails alongside snow-covered lakes?

•Are there ponds or lakes near schools or in restricted wilderness areas where teenagers hang out?

Once you locate and mark on maps the potential sites, determine the potential problems and hazards these sites might present.

•Incidents involving a vehicle in the water require a haz-mat operation.

•Ice rescues of snowmobilers may be compounded by trauma and may require head and spine stabilization transport procedures.

•Is the site difficult to access because of steep embankments, trees, large rocks, fencing, other obstructions, ice, or deep snow?

•Is the problem area a long distance from shore, or is the body of water a long distance from road access?

•Could a plane, bus, or train end up in the ice, causing a mass-casualty incident? How about a truck with hazardous materials?

•Are there any potential avalanche problems that may affect the staging areas?

Next, figure out what equipment, training, personnel, standards, and guidelines are needed for these operations to be safe and effective.

SPECIAL CONSIDERATIONS

Vehicle involvement. Do rescuers have the training to understand and manage the specific hazards of vehicles in the water, such as rescuer entanglement and entrapment, objects containing air shooting out at rescuers, jagged metal, fuels, and patients with trauma or entrapment problems? Do rescuers fully understand that if they are close to a submerging vehicle, they can easily be pulled under with it? Do they understand that aspiration of fuels can result in lipoid pneumonia and other problems? The dangers of immersed vehicles often arise out of ignorance of the potential consequences of seemingly normal rescue procedures.

Trauma. Remember that not all ice calls involve immersion. Departments may need to be prepared to handle everything from fish hooks in eyes to broken bones, burns, frostbite, and major trauma. Of course, each of these problems could be compounded by immersion.

If trauma may be involved, perhaps the best choice of ice rescue technicians would be first responders or EMTs who really understand the importance of gentle handling, maintaining open airways, stopping major bleeding, and other life-threatening problems. Are any cross-certified EMT/ice rescue technicians available? If not, perhaps some need to be trained. Are ice transport devices available that would be suitable for trauma, or head and neck injury patients?

Have operational- and technician-level rescuers planned and practiced procedures for handling hypothermic trauma patients on and off the ice? Have they done this while wearing ice exposure suits and gloves?

What problems could snowmobile suits, helmets, or skis present?

Ice fishing shacks. What problems could ice shacks with heaters present? People of all ages and sizes go ice fishing, so all kinds of problems can occur, including medical emergencies and hypothermia. Ice shacks can puncture the ice roof with the occupants still inside, creating an even greater confined space problem.

Alcohol. Perhaps alcohol is a common denominator for past ice incidents. If such is the case, rescuers may need to be prepared to handle less than helpful and perhaps even belligerent victims. Intoxicated victims have a greater risk of drowning, as their epiglottis is less likely to close (laryngospasm) when water is aspirated. Also, vomit may cause additional airway problems.

Weather and low-visibility conditions. If a response is needed during a blizzard, what tactics may need to be deployed? Deep snow not only weakens ice but hides where the ice starts. Preplan how hot and warm zone sectors can be obviously divided with visual markers once the shoreline is found. If severe winds are known to occur over a body of water in the district, what special equipment and procedures are in place to work in such conditions? Is there enough personal protective equipment to shield rescuers from the chilling effects of rain, wind, and snow?

How does the operation change during nightfall? Is there sufficient lighting capability for the staging areas, the command post, and different sectors of the operation? What is the plan for large-area surface ice searching during nightfall? Can a helicopter with a spotlight be deployed? Do ice rescue technicians have waterproof hood lights mounted on their suits?

What policies are in place for water-related incidents during electrical storms?

Shore access locations and staging areas. Decide on planned shore access points, and have the necessary tools to make the location usable. Find the shortest route to the middle of every body of water. Make sure all personnel are aware of these preferred routes, access, and staging locations. Draw and label these sites on maps.

If a body of water is completely surrounded by thick forest, chain saws may be needed to clear a staging area. Be prepared to manage deep snow or icy shore conditions.

Ambulances may need chains on their tires. Perhaps only four-wheel-drive vehicles can be used.

If helicopter transport is necessary, where can a landing zone be staged? If embankments are steep, do rescuers know how to belay and tether shore personnel and technicians?

Bodies of water far from road access. How do rescuers reach the site? Do they even know how to get there? Is there a common rendezvous site? What is the best route? Are snowmobiles with sleds accessible to transport equipment and personnel? Know about all these bodies of water, and make sure they are clearly documented on maps. If a child or adult is reported missing in the winter, these areas may need to be searched.

Once you find routes and transport devices, figure out how many personnel are needed and what equipment must be brought to the scene. Then figure out how to load these resources on the transport devices, and go for a test run. How long does it take to load up the gear and personnel, travel, and reach the destination?

Learn how to avoid fatiguing and stressing the ice rescue technicians before they get to the scene. Let support personnel and transport devices carry the gear to save rescuers` strength. Have rescuers dress at the scene for incidents far from road access.

Devise and test a plan for transporting the victim(s) from the remote site. Is the transport device sufficient for a patient with head or back injury, trauma, hypothermia, and other problems? At least one rescuer with EMT or higher status should be on the scene.

PERSONNEL CHECKLIST

•What time of day are calls most likely to come in? If most of the rescuers are volunteers, how many can be available during those times, and from where will they be coming? Do they keep warm clothing, boots, gloves, and hats in their vehicles at all times?

•Are all personnel trained and certified at minimum to the Ice Rescue Awareness level?

•Are sufficient numbers of the right rescuers trained at the Ice Rescue Operational and Technician levels, and will they be the personnel available during the high-risk times? By “right” rescuers, we mean technicians who are not very large, heavy, unfit, older, hypertensive, insulin-dependent diabetics, poor swimmers, or afflicted with asthma, who do not belong out on the ice performing ice rescues.

•Are a sufficient number of EMTs and paramedics trained to the Awareness level?

•Do EMS and hospital emergency department staff have written protocols for long-term drowning, near drowning, immersion hypothermia, cold stress, fuel contamination, and other related problems?

•Does everyone know what their responsibilities and duties are, and have they redundantly practiced them?

•Are police trained to recognize homicide, neglect, or abuse by drowning?

•Are officers sufficiently trained to manage ice incidents?

EQUIPMENT CHECKLIST

•Toward the end of fall, outfit gear and rescue vehicles for ice operations. Make sure everyone knows where everything is.

•Make laminated cue cards for communication signals between tenders and on-ice rescuers, and mount them on personal flotation devices (PFDs) with lanyards. Practice these signals.

•If you have sized ice rescue suits, make sure sizes are clearly written on the suit and the suit bag. Make sure all suit zippers are paraffin waxed and that the suits have no leaks.

•Have profile slates and other documentation paperwork ready and easily accessible with writing instruments.

•Make sure rope bags are clearly marked for length and that the line itself is marked in increments and is in good working condition. Make sure personnel know which bags to use and how to read the line markings.

•Check on equipment log sheets that all equipment is functional and in its place.

•Set up the gear for easy and rapid access, with each complete tender-technician`s gear stored and set up in individual bags that personnel can quickly pull off the truck and use. A common mistake is to put all like gear together. That means for a tender-rescuer pair to dress, they must go to the personal flotation device area to grab a PFD, pull out the harness box to get a harness, reach for a suit in the suit locker, and so on. This wastes time and increases the chance of lost and forgotten gear.

•Be sure to meet all equipment requirements in the standard operating guideline.

There`s only one job you must do every time–go home! Preplanning will help make sure you and, hopefully, the victims can do just that.

Fall preplanning should include interagency drills to make sure that the incident management system is agreed on in advance for safe and efficient operational organization during actual calls. Fire, police, and EMS personnel must agree on leadership and organization, or chaos and less-than-optimal results are likely to occur. (Photos by Andrea Zaferes.)

Review past and potential ice accidents to see if head and spine injuries are possible. If so, make sure your transport device can serve as a backboard and that you have at least a few ice rescue technicians at the EMT-level of patient care.

Are your ice rescue technicians physically fit enough to safely handle the types of ice incidents your community may have? Fall is a great time to get in the pool for swimming drills.

In the fall, identify the potential ice accident areas in your district, and plan access areas for each. When a call comes in, everyone should know where and how to stage for the particular location.

Without the right equipment, training, and support, this rescuer would be no better off than the original victim. Fall is the time to make final training and equipment preparations for the upcoming ice season.

It is also a good time to make a new set of ice rescue poles, check ice rescue suits for leaks and other damage, and check tether lines.

ANDREA ZAFERES is the head instructor trainer for Lifeguard Systems, Inc.; a NAUI and ACUC course director; a PADI, DAN, and ARC instructor; an EMT-D; a noted author and public speaker; and co-author with Walt “Butch” Hendrick of Surface Ice Rescue (Fire Engineering, 1999). She teaches more than 30 courses including Underwater Vehicle Extrication, Rapid Deployment Search & Rescue Diving, Ice Rescue, Shark Attack Rescue, and Blackwater Rescue. With Hendrick she started RIPTIDE, a drowning prevention nonprofit organization that also helps communities find drowning victims.

WALT “BUTCH” HENDRICK is the founder, president, and training director of Lifeguard Systems. He has been teaching and performing water rescue operations for more than 35 years. He has trained in more than 15 countries and has trained dive teams for FDNY, Washington D.C., South Africa, and the U.S. Parks Department, among others.