By Greg Merrell
Swiftwater rescue incidents are some of the most common technical rescue incidents that we will experience as first responders and can also be the most challenging. For an incident commander (IC), effective command and control involves 10 steps, outlined in the word SWIFTWATER: Size-up, Water, Incident priorities, Focus, Timely, Wear Proper PPE, Accountability, Take Action, Evaluation, and Review.
- The Dirty Dozen of Swiftwater Rescue
- Dramatic Swiftwater Escape, Passaic, New Jersey
- Swiftwater Rescue: Are We Ready?
Size-Up
Size-up is key to all rescues. Proper size-up determines actions necessary, rescue needs, and personnel requirements. It does not start on arrival at a water rescue emergency scene. Size-up involves four phases: preplanning, en route, on arrival, and continuous.
Preplanning size-up means knowing the areas in your community that are prone to flooding and identifying the hazards before a flood occurs. For example, to preplan water rescue incidents, a city might study its flood history for the past 50 years. It finds that major flooding occurred in the middle of the city, preventing access between the north and the south sides. Before this study, all its water rescue assets were in one station. As a result of the study, the city divided its water rescue assets and personnel between two stations, one north of the city’s center and one south of it. So, when major floods occurred, rescuers could access their entire city more quickly, enhancing their response.
En route size-up uses mobile computers and any other smart devices, mapping programs, and other applications to obtain aerial views to identify hazards that floodwaters may hide from responders on arrival. Aerial views seen en route can help locate access points for rescue teams based on the emergency’s reported location.
On arrival size-up involves locating and numbering the victims, gathering witnesses’ information, assessing the equipment and personnel needs, assessing the hazard initially, and analyzing the risks.
Continuous size-up is the most important part of size-up since it is often overlooked. Once rescuers have completed the initial on-scene size-up and have decided on the rescue tactic, they often commit to the plan as the only option. Continuous size-up will assist ICs with avoiding this pitfall. If a rescue tactic is successful for one victim, that does not mean it will work for all victims. Because you performed a certain rescue at a particular location previously does not mean it will work every time. Conditions constantly change and aren’t the same at each event; rescue personnel may have changed and this may have affected their capabilities, and victims’ mindset, physical abilities, and limitations vary at each rescue. Continually evaluating the scene is paramount.
As part of his continual size-up, the IC should ask the following: Are the rescue tactics effective? Are conditions getting better or worse? If conditions are getting better, then the risk may be less and you may be able to slow down and reevaluate your rescue tactics. If conditions begin to worsen, you may need to make a more rapid and risky rescue. Conditions may worsen to a point that a rescue becomes a no-go situation. A no-go decision may be the most difficult decision for an IC; however, you must perform a risk benefit analysis and ensure you are making decisions with your head, not your heart. The safety of our crews is vital when making command decisions.
Water
First-arriving units need an immediate evaluation of water conditions when establishing command and developing an incident action plan (IAP). On arrival, note the water level—where is the water line around the victim, at the rescue point of entry, and at your staging site? Use this as a measuring stick to determine the water’s rise and fall to assist with decision making. Note the hydrology surrounding the incident. Knowledge of hydrology as it affects rescue selection, the rescuers, and the victim is paramount for the IC at water rescues. Important: Determine the water temperature to ensure rescuers are wearing the proper thermal protection. Also, noting the water temperature will assist in determining the effects of possible hypothermia on victims. A hypothermic victim may not have his normal mental faculties or physical capabilities, so you must adjust your rescue tactics. A teach-or-reach rescue may require a more advanced hands-on water rescue because the hypothermic victim is unable to understand simple directions and does not have the strength to hang onto a rope, a stick, or another reach device (photo 1).
(1) Photos by author.
Incident Priorities
You must establish incident priorities on arrival at a swiftwater incident. Evaluate the immediate risk to the victim and the dangers to rescuers. Your incident priorities must include the safety of your rescue crews. The victim is important and why we are on scene, but an IC must place the rescuers’ life safety above that of the victim. The rescuers’ safety is incident priority number one and that of the victim is number two through a thorough risk benefit analysis. First responders understand that with each rescue they take on inherent risks, but the life safety of rescuers is the priority at incident scenes. Decision making for an IC should always include the safety of your crews along with that of the victim.
Focus
Focus on the entire scene when in command of water rescue incidents—maintain situational awareness. An IC must look at the big picture, focusing beyond the victims and where they might be. You must look at all aspects of the scene, searching for hazards in addition to that of the water level and speed. These include powerlines down in or near the water; debris in the water that may compromise rescues; and slip, trip, and fall hazards on the terrain.
Properly allocate resources and assign upstream spotters and downstream safety personnel. If rescue personnel on scene are limited, use other first responders in areas that will allow your water rescue team to work together, such as assigning law enforcement personnel as upstream spotters. Although this is a very important assignment, it does not require a swiftwater technician to perform it. Advise the upstream spotter to look for victims, communicate his location to rescue personnel, and identify hazards that may be coming downstream.
Focus is not only limited to the IC; rescuers must focus on their given assignments, too. To ensure accountability and avoid duplicating efforts, rescue teams must maintain focus on their tasks and on their capabilities too; never allow rescuers to work outside their scope of training.
Do not let the situation overwhelm you and result in your making decisions that compromise safety. The IC must focus on the tactics and the techniques required for each individual rescue. Do not let the gathering crowds, witnesses, or family members dictate your decisions. Don’t let the victim’s perception of his danger obscure the actual danger.
Consider a person stranded in a stable vehicle in the middle of a flooded intersection in one foot of standing water, and this person is screaming hysterically. Do not allow the vehicle occupant’s fear compel you to make a quick, hasty decision. Organize your resources properly, perform a thorough crew brief, place a downstream safety team, ensure all rescuers have all appropriate PPE and are using walking sticks, and assign upstream spotters. Focusing on the scene involves situational awareness, capturing the entire scene, and making the right decisions based on current conditions.
Timely
Timely decision making is important at water rescue incidents because of these events’ dynamic nature. On arrival, your first actions help you as the IC develops an effective IAP. First, the IC must identify the immediate hazards to the victim to help assess the immediate actions to take and select the rescue tactic. This assists with determining the window of time you have in which to make decisions, since the immediate hazards to the victims determine whether you have time to act or must act now.
Identifying the hazards to rescuers facilitates our decision making. Regardless, if you determine you need to perform an immediate rescue based on the victim hazards or you have more time, the IC must always evaluate the hazards to rescuers prior to selecting the rescue. Using the incident priorities to ensure rescuers’ safety prior to making the final rescue decision is imperative.
Decision making is also determined by evaluating our rescue personnel, their training level, and their equipment. These three are considered the tripod of rescue—without all three, your decision is destined to fail. Regardless of their training level, rescuers must have the appropriate PPE and equipment for the rescue selected. Otherwise, the rescue will fail and lead to injury or death of the would-be rescuers. The IC must ensure that the tripod of rescue is appropriate for the rescue tactics selected. Ensure that the rescuers are properly trained, you have deployed the appropriate number of trained rescuers on scene, and that they are equipped with the proper PPE and equipment.
Wear Proper PPE
Wearing the proper PPE and having the equipment ready are imperative. Most water rescues are flood related, resulting from a large amount of rainfall in a short time. Watch the weather regularly; when heavy rains are forecast, double-check the water rescue equipment for readiness: Confirm that rafts and boats are fully inflated and fuel cans are full and that multiple sizes of victim personal flotation devices (PFDs), Type V PFDs, and water rescue helmets are easily accessible by rescue crews. Remind personnel that no bunker gear is to be worn at water rescue incidents. Many water rescue standard operating procedures (SOPs) from across the country require wearing PFDs when within 10 feet of the water. However, as an IC, I require all personnel on the water rescue scene, including myself, to wear a PFD regardless of the distance from the water.
I have seen firefighters continue to “creep” into the danger area from a safe area at incidents. They want to be involved, are curious, or want to help a rescuer in trouble. To eliminate personnel creeping into the hot zone without proper PPE, require all rescue personnel on scene to wear appropriate PPE for the incident. PPE includes proper thermal protection based on water and air temperatures. Consider also proper decontamination of all personnel, PPE, and equipment after water rescue incidents because of the possibility of floodwater contaminants.
Accountability
Accountability is key to ensuring a safe and successful rescue. Accountability is not limited to only the rescue team members; it includes other first responders, victims, family members, witnesses, and the media.
Accountability includes the IC and the rescuers; it’s not solely the IC’s responsibility. The rescue team’s accountability means no freelancing, communicating and confirming that assignments are understood, performing the assignments, advising the IC if an assignment cannot be completed, and reporting that the assignment has been completed. The rescue team must inform the IC of location or any other changes to the briefed plan or given assignment.
The IC’s accountability means ensuring resources are properly allocated and knowing which resources are assigned to all incident tasks. The IC maintains accountability by stabilizing the incident scene. He should organize and separate witnesses to provide critical information. Use law enforcement personnel for crowd control and to keep nonrescue personnel away from danger areas to eliminate the possibility of additional victims and civilian interference with rescue operations.
On large, prolonged incidents, designate a staging area for incoming rescue personnel to check into the incident to ensure accountability for mutual-aid companies and other first responder agencies.
Take Action
Take action once you have made the rescue decision based on a proper size-up, risk benefit analysis, and rescuer evaluation. When deciding to act, move from the simplest to the more complex. The decision-making complexity begins with talking to the victim, moving to shore-based operations including reaching with objects or throwing a rope or PFD to the victim. The next complexity moves to boat rescues (motorized or rafts) (photo 2) and then putting rescuers in the water with wade rescues (photo 3), moving to the complex and the dangers of swim rescues.
(2)
(3)
The crew must be properly briefed before taking the action. The crew brief should involve all rescue personnel to ensure everyone is on the same page. You must base the rescue selection on the capabilities of the team on site. As an IC, don’t let your water rescue experience drive a rescue selection that the team on site may not be able to perform because of a lack of training, lack of personnel, or lack of PPE and equipment on scene. The IC may have an initial plan of a tethered swim rescue because of current conditions. However, the first-arriving rescue team may be limited to swiftwater operations training level. Therefore, the IC must change tactics and look for shore-based rescue options until a swiftwater technician team arrives. During all rescues, ensure crews understand and use crew resource management to ensure focus on assigned tasks and proper communications.
Evaluation
Evaluating the water rescue continuously is important during the incident. Proper decision making involves being able to adjust the plan as the situation dictates. Planning evaluation uses the Primary, Alternate, Contingency and Emergency (PACE) method. For example, the primary plan is a wade-out rescue to the victims stranded on top of a car. The alternate plan is to use a motorized boat, so have a crew move downstream to launch the boat and be ready if the wade-out rescue is unsuccessful. The contingency for the wade-out crews is that once the water level approaches the waist or the current is too powerful, they are to abort their attempt and return to shore to allow rescue boat operations. The emergency plan is, if during the wade-out rescuers lose their footing and are washed downstream, they will all swim river left or river right, whichever is identified as the safe zone.
The emergency plan will include the downstream safety technique used. Let everyone know what tactic will be used and the location. For example, tell the rescue teams that downstream safety will be three rescue personnel with throw bags on river right or the downstream safety will be a tension diagonal with a rope curtain (photo 4). Rescuers need to know what to look for.
(4)
The PACE method is a moving target during the incident. Once an IC moves from the primary plan to the alternate, the alternate becomes the primary, so a new alternate plan must be developed, and the contingency and emergency may need to change too. Constantly evaluating the rescue is important to ensure safety. The IC must continue to monitor conditions for his crew and to monitor the crew for fatigue, hypothermia, and stress. Look for changes in environmental conditions and personnel, such as the transition from day to night, a significant temperature change, or a shift change that may change crew capabilities. A shift change may allow for more advanced techniques because a fresh and well-rested crew is coming on duty to relieve an exhausted crew going off shift. Also, if it’s a mutual-aid response, you may no longer have the staffing you had initially; this may require alternate tactics.
Review
Review every incident on completion. Regardless of its success or failure, all incidents should have an after-action review (AAR) to document lessons learned and improve or reinforce your rescue tactics and techniques. Success does not always mean that all decisions made were appropriate; you need an AAR even after a positive outcome. Gather all rescue team members to gain their perspectives including their successes and struggles. Don’t just say “Good job” after a positive outcome; analyze why a decision was good and why it succeeded. Maybe it was luck and the team accidentally succeeded. You want to identify how to approach situations properly and perform tactics based on sound decision making and training, not luck.
The AAR allows team members to hear why the right decisions were made. It may have been because of the conditions and the situation, but unless you share it with everyone, less experienced personnel will not know. Sharing the good and the bad decisions allows all to learn and become better decision makers. A proper AAR will lead to more safe and successful rescues on future incidents.
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Command and control of swiftwater incidents is imperative for safe operations for rescuers, first responders, victims, witnesses, and bystanders. As with all rescue incidents, the initial decisions and command presence will dictate the success or failure of an incident. An IC at water rescue emergencies will achieve command presence and ensure a successful rescue following the acronym SWIFTWATER.
Greg Merrell is a battalion chief with the Oklahoma City (OK) Fire Department, where he has served as a technical rescue company officer. He is a task force leader with OK-TF 1 US&R team and has deployed on multiple flood responses within Oklahoma and across the country. Merrell has taught swiftwater rescue and boat operations to emergency responders and military personnel nationwide.
