Towing And Removal

The rescuer should never jeopardize himself in any rescue attempt. He should know his limitations. If you think the situation is against an in water rescue, do not attempt it. Reassess the situation continually. Pace yourself. Remember to use team rescues. Remember the four-P's and KISS principle. Never attempt anything you have not done in training. Whenever going in the water after a victim always wear fins and some type of flotation device. Towing without fins is slow and fatiguing, try not to do it.

Keep the victim buoyant. Protect his airway and spine. Frequent eye contact reassures a conscious victim. Do not assume a conscious victim will hold onto you. Floating the victim with a ring buoy or other flotation device is preferred to using yourself. Ensure that you have control of the victim with one hand whenever changing your position. When towing be sure you have a firm grasp and reassure the victim. Reduce drag to maximize propulsion. Keep checking your course. There are many methods to tow someone but always use the simplest and safest. Condition of the victim, environment, and equipment influence the method of tow.

Line tows are the safest and quickest way to tow a victim. It can be used without the rescuer entering the water. The technique is mealy the throwing of a line to the victim. To do this throw past the intended target and pull the line to him. It is best to have a ring buoy or boat bumper attached to the line, however, nothing needs to be. In the water hand the line to the victim or toss it to him, and tow by pulling the line. This type of in water tow makes it easier to trade off between buddies. When pulling the line do not pull to fast.

Be sure the victim is not panicky whenever doing contact tows. There are several different tows with unlimited variations, we will only discuss the most used and cover all situations. It is best to only have a few tows because it limits the options the rescuer has to consider. We will discuss the arm-in-arm or do-si-do, cross chest, tank valve tow, and fin push. For panicky persons there are two tows that work best and those are the BC or life vest tow and the in water line tow.

The do-si-do or arm-over-arm tow offers control, and support of head and back. It is the best tow to use when having to perform artificial respirations. It quickly and easily adapts to two man towing. It is easy to watch where you are going. The cross chest has excellent control but very little spinal protection. Do not use on a trauma victim.

For divers, towing is easiest by doing a tank valve tow. It also offers great protection to the rescuer if the victim panics. The tow is performed by pulling the tank valve, not the first stage of the regulator. If the victim is conscious and responsive, the fin push can be done. It is accomplished by placing the victim's feet against the rescuer's shoulders. The victim is face up and the rescuer is face down. It allows best observation of the victim. This can be done for swimmers if the rescuer brings a PFD for the victim.

Buoyancy compensator, or life vest tow is accomplished by giving the victim the floatation device and having him place an arm through one of the arm holes. The rescuer then tows from the other arm hole. This tow has the draw back that it requires the victim to think in a rational manner. It works well with tired rational swimmers.

Rescue devices, backboards, and surf boards can all be used to get a victim to shore. Backboards can be slid under the victim quite easily in the water and it is recommended you do this before extrication on all trauma victims. Surfboards also can be used as backboards and extrication boards but remember the skag under the board. When using a surfboard flip it first so the fin faces up out of the water. By doing this the board can be laid flat on shore or the deck of a boat.

When crossing surf to get to a victim or bringing him to shore, wind and wave action must be considered. Rips can be used to get to a victim. Whether going out or coming in the rescuer must get through the surf zones as quickly as possible. Never enter a surf zone without fins. In surf, problems can multiply. Jettison all unnecessary gear and hold the victim tightly. If unconscious, cover the victim's nose and mouth when a wave hits. Performing artificial respiration can be very difficult, and almost impossible in heavy surf. Use a rescue device. Team rescue works best.

Extracting the victim from the water should be as easiest as possible to the rescuer, and the victim's safety must be kept in mind. Divers gear must be removed before exiting the water.

Stokes baskets are one of the most versatile pieces of equipment. They can be floated and brought up under the victim for extrication. Stokes baskets and the preferred method of extrication on steep banks. Ladder trucks from the fire department can sling a load stokes basket as can helicopters. If using a Stoke's basket, the wire are preferred for water rescue work, due to their better drainage.

Backboards are excellent for support, and carrying the victim. They are easy to employ but don't offer the victim protection of the stokes basket.

Ladder carries are used in swimming pools and piers. The victim should be lighter than the rescuer. Ladder must be strong and stiff. The bottom rung must extend into the water. When taking a victim up a ladder you must keep your knee higher than your groin so the victim will not slid off your thigh. If the rescuer has towed a victim to the ladder, another rescuer should carry the victim up the ladder, use a team approach.

For shore exits when a backboard or Stoke's is not used, the saddle back (fireman's carry), back pack, and two man carries work well. The best carry is one developed for use at the water's edge and is a modified fireman's carry. Once the victim is in about waist deep water, float the victim by placing your hand at his center of gravity. Then lift the arm closest to your body over his head. Next grab the wrist of the opposite arm (the arm farthest from you). Hold the wrist tight and pull it towards the opposite arm pit. Now as the rescuer, quickly submerge still holding the wrist. The victim will roll over on to your back. When you stand up, the opposite arm will be dangling to your front, and you can grab it. You now have both arms and the victim high on your back so you can walk out with him.

Multiple rescuers make rescues and victim removal easier. As soon as possible check the victim's pulse. After removing the victim from the water position him to allow fluids to drain, normally this is the head towards the water.

If alone, and having to load a victim in a small boat, hook the victims arms over the transom. Then get in the boat and pull the victim by the arms straight up until the waist bends into the boat. Then shift to the hips and pull into the boat. Depending on the height of the gunnel from the water line the rescuer may be able to use the water to lift the victim. This is done by holding the victims arms and submerging him, and quickly pulling him into the boat. The water can give an extra lift.

If the victim is just tired he may be able to board by using the rescuers shoulders as a step. A line can be made into a step if needed.

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