Spring Preplanning For Safe Ice Rescue Operations: Part 1
By Andrea Zaferes and Walt “Butch” Hendrick Copyrighted 1995 Lifeguard Systems
The following article specifically addresses ice rescue operations, but the preplanning process is the same for all water-related incidents. Much of the information comes from Surface Ice Rescue by Walt Hendrick and Andrea Zaferes.
We frequently ask fire, police and EMS personnel who have worked on surface ice rescue incidents, “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 didn’t have standard operating procedures and guidelines (SOP/G), and incident command fell apart.”
Water-rescue operations typically stand alone from other fire-service operations when it comes to preparedness. No fire department in this country would allow anyone without fire training to enter a building and fight a fire as part of their team. No EMS organization would let a basic EMT, let alone a person with no medical training, insert an IV into a patient. What chief would allow a firefighter with no high-angle training to step off a high-rise during a rescue? Those same departments and chiefs, though, would most likely allow their members to go onto ice to save someone, even if those members had no ice training.
Would your chief allow you to enter a fully involved fire without turnout gear or SCBA? Of course not. Would your chief allow you to step onto that ice without an ice rescue suit to save a child? Very likely, if you are like most departments.
The Value of Preplanning
We as a society and as public servants often do not understand the power of water and cold. It is not uncommon for ice incidents to claim the lives of would-be rescuers. If performed with the right equipment and training, surface ice rescue is one of the safest types of rescue a firefighter can perform. If conducted improperly, the results can be fatal.
The first step in preplanning is to get into the mind-set that ice rescue requires training, standard operating procedures and guidelines, and the right equipment—just like confined-space, hazmat, high-angle and all other rescue disciplines.
The universal result of not being prepared is the endangerment of rescue personnel lives in conjunction with a severely decreased chance of saving the original victim(s). When the responding departments are unprepared, a surface ice rescue scene typically looks like the following:
1) A weak or nonexistent incident management system (IMS);
2) No real plan of action;
3) Lack of safe, functional staging areas;
4) Everyone scrambling around trying to find something to reach the victim with;
5) Poor or no scene control; personnel without personal flotation devices or other personal protective equipment on or near the ice;
6) Little or no accountability for rescuers in the operations zone or on the ice;
7) Unprepared, unprotected, untrained, hypothermic rescue personnel, overloaded with ring buoys, inflated fire hoses, lines and other gear they have little idea what to do with, repeatedly crashing through the ice trying to reach the victim;
8) Unprotected rescue personnel on boats laboriously using pipe poles and other extensions to break the ice between them and the victim;
9) If the victims are reached, their fragile bodies are 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 rescuer lives could have been easily prevented with proper preplanning. Preplanning includes discovering the needs of the community in regards to ice rescue, obtaining the necessary trained personnel and equipment, and writing safe and effective SOP/Gs.
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 an important difference between life and death. Let’s take a look at the first step in preplanning: Reviewing past incidents and potential problem situations.
What You’re Getting Into
To be prepared, teams need to know what to be prepared for, so they can preplan responses for a variety of potential incidents. All responding agencies (fire, police, park rangers, EMS) should be involved in the preplanning process to:
1) Create the safest and most effective standard operating procedures and guidelines possible;
2) Facilitate better interagency cooperation and organization during actual incidents;
3) Develop an effective incident management system (IMS), so that each agency understands there will be only one incident commander (IC) and one command post (CP), and they will understand how the IMS is established and managed;
4) Increase interagency communication and pooling of resources.
The importance of interagency preplanning and follow-up drill sessions with debriefings cannot be stressed enough. Without effective and knowledgeable leadership—an IMS—a simple ice rescue can become a disaster. For example, consider 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 equipped team, the rescue should take less than 10 minutes from time on scene to the time the victim is packaged in the ambulance. But how often is this actually accomplished in 10 minutes? Very rarely.
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. Inter- and intra-agency preplanning and drills can prevent almost all of these problems.
The first step is reviewing prior problem sites:
1) Where are the most common problem locations?
2) What are the best access and exit points to these locations?
3) What hazards are known and potential in these areas?
4) Typically, how far from shore do incidents take place in each area?
5) What have been past causes of ice incidents (e.g., motor vehicle accidents, snowmobiling, ice fishing)?
6) What month is most likely to have the most incidents, and what time of day is most common?
7) What agencies responded to past incidents, and what were the results?
• Were there too many responders, or too few?
• Did responders have the right training for the operations at hand?
• If they had training, did they use it, or was the operation chaotic?
• Was the necessary equipment available?
• Were rescuers ever put at unnecessary risk?
• Was there an effective debriefing?
• How gentle and effective was the patient-handling?
8) Did the IMS work, and if not, why didn’t it, and what needs to be done?
9) Are there measures the community can take to prevent future ice incidents, such as putting signs or fences up in known problem areas, making problem areas shallower in the winter, conducting ice-accident prevention programs in schools or passing laws imposing fines for driving on the ice?
If you find no consistency that can be tracked, preplanning may have to be based on unknowns. 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 it is discovered that several incidents last year involved snowmobilers two miles from shore, then:
• Long-distance ice operation training and equipment must be obtained.
• A long-distance ice operation SOG must be written.
• Rescuers must be further trained in patient handling, as more time and distance must be covered to transport the patient(s) to the ambulance and hospital.
• Rescuers must be trained and physically fit enough for a long-distance ice operation.
• The county may want to pass laws to impose fines on snowmobilers who end up requiring this tremendous rescue effort, costing taxpayers thousands of dollars and damaging the environment with fuel spillage.
Saranac Lake Fire Department in New York, for example, discovered it had enough long-distance operations, because of snowmobilers and large lakes, that it invested in an
airboat. A review of past incidents showed that the SLFD needed to apply gunwale reinforcements to its airboat because an incident with a large victim caused the gunwale to blow out when it came into hard contact with broken ice blocks. The department also realized it needed some type of thermal recovery capsule to contain hypothermic victims during the relatively lengthy airboat trip back to shore.
The Review Process
Let’s take a look at a sample review process.
1) Review past ice rescue incidents to find the potential problem areas in your district.
• Where do people most commonly congregate on the ice? Where do they fish, snowmobile, ski and skate? Do they ice-fish in shacks, and do they drive their vehicles to these shacks?
• 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? Where are bubblers installed? What areas of the lake have natural springs? Where does the water have a current in the winter?
• Are there areas of hidden ice? Where might cross-country skiers or snowmobilers unknowingly end up on a snow-covered body of water?
• Are there ponds or lakes near schools or in restricted wilderness areas where children or teenagers hang out?
• Is the first ice in November or December a common time for ice accidents? What time of day is most likely to have ice incidents?
2) Once potential sites are located and marked on maps, determine the potential problems and hazards these sites might present.
• Incidents involving vehicles in the water require a hazmat operation and the necessary training to safely approach vehicles on or in the ice.
• If there is a major roadway near waterways, could a truck with hazardous materials be a potential threat? Are the guardrails designed to keep trucks on the road should an accident occur? If hazardous materials are spilled into the water, where will they go? What parts of the road are typically icy?
• Are there biological-contaminant concerns, such as from geese, farm manure or sewage? Are there chemical hazards, such as pesticides and PCBs? Golf course ponds, for example, are often toxic enough to require anyone entering them to wear dive gear with, at minimum, full face masks and hazmat-tested drysuits.
• Could a plane, bus or train end up in the ice, causing a mass casualty incident? Think about the Air Florida crash into the frozen Potomac River in Maryland. Consider how preplanning between and within responding agencies could have dramatically changed that event.
• Ice rescues of snowmobilers may be compounded by trauma and head- and spine-stabilization transport procedures. Some type of backboard transport capability will be necessary, as will the shortest victim-recovery time possible.
• Is the site difficult to access because of steep embankments, trees, large rocks, fencing, ice, deep snow or other obstructions?
• Is the problem area a long distance from shore, or is the body of water a long distance from road access? Will snowmobiles, horses or other transport modes be necessary to reach the shore from the road?
• Where are the closest helicopter landing zones to the water area?
• What are the potential water currents and depths? Currents over a half knot (50 feet per minute) require advanced training and additional equipment.
• Are there potential avalanche problems that may affect staging areas?
• Are there known or potential “suspended ice roof” hazards caused by the water table being lowered after ice has formed? This can happen from ski resorts draining water to make snow, fire departments filling their tankers from small ponds, or purposeful lowering of the water level.
Suspended ice roof incidents are very risky and require far more training, equipment and personnel than standard ice operations.
• Can there be moving blocks of ice? Harrison Township Fire Department in Michigan discovered the severe hazards of being caught on a moving ice block and the length of time it can take to rescue the rescuers, not to mention the potential trauma that can occur.
• Time of day can be important. Will calls occur at night, requiring artificial lighting? Do calls occur in late afternoon, when kids are out playing and happy hour is in effect—when it may be difficult to assemble a volunteer crew?
3) Next, figure out what equipment, training, personnel, standards and guidelines are required for these operations to be safe and effective.
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 and/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 are often based on ignorance of the potential consequences of seemingly normal rescue procedures. Incidents involving partially or wholly submerged vehicles should warrant response by a dive team with submerged-vehicle and ice training and equipment.
Serious hazards: The following hazards should be written directly into the SOPs as “no-gos” for the majority of the surface ice rescue team. If they are not written as “no-gos,” then the department is more likely to be held liable for not responding. If a community wants rescuers to be able to respond to such incidents, then it needs to provide the necessary funds for training, equipment and personnel.
• Hazmat: If the water has biological or chemical contamination, then hazmat-capable ice-rescue divers should be the technicians for the rescue. Next, the shore and medical personnel who handle the patient(s) need to be protected as well. It is likely that would-be rescuers will attempt to immediately get out on the ice to save someone who is immersed in contaminated water because the threat of contamination is not as easily perceived as other threats, such as fire or a collapsing trench. The need for secure scene zones is imperative to keep this from happening.
• Suspended ice roofs: If a victim falls through ice that is suspended above the water level, there is far less chance the victim will be alive by the time responders arrive. The dangers to anyone attempting to perform such a rescue from the surface are immense—what if the original victim is alive under the ice and rescuers crash the remaining ice roof down onto the victim? This is a job for dive teams trained for suspended ice roof operations.
• Moving ice blocks: This is a potential problem for communities with very large bodies of water that get thick ice. Technicians should not enter the water when the possibility of their heads being crushed between moving ice blocks exists. If it’s moving, a block just one foot square is large enough to cause serious trauma. Victims can be stranded on a block that has broken away and is moving with the wind or water current, or a block may break free during a rescue attempt. If there is water-current potential, estimate the strongest it could be in knots, and then calculate how far a block could drift in the time it would take to get a boat or helicopter response. For example, a two-knot current could push a block 2,000 feet in 10 minutes. That will determine where a boat should be launched and where a helicopter should begin a search. And approaching boats should understand that a floating iceberg could be twice as wide underwater as it is above water. Wind can also have an effect, so estimating wind speed will be important as well.
Trauma: Remember that not all ice calls involve immersion. Departments may need to be prepared to handle everything from a person lying on the ice with a fish hook in his eye to broken bones, burns, frostbite and major trauma. And of course, each of these problems could be compounded with immersion.
If trauma is involved, perhaps the best choice as ice rescue technicians would be first responders or EMTs who really understand the importance of gentle handling, maintaining open airways and stopping major bleeding and other life-threatening problems. Are there 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 patients with head and neck injuries? 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 a 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 victims, perhaps even belligerent ones.
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 call comes through during a blizzard, what tactics may need to be deployed? Are tow trucks part of the standard dispatch to ice scenes? How about sand/salt and plow trucks? Is the standard that the EMS duty crew stay in the ambulance to remain warm, dry and functional while other responders bring the victim to the ambulance?
• Deep snow not only weakens ice, but hides where the ice starts. Preplan how hot and warm zones 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? Are enough ice cleats available for rescuer boots? Is there enough personal protection equipment to protect rescuers from the chilling effects of rain, wind and snow?
• How does the operation change during nightfall? Is there a sufficient lighting capability for the staging areas, the command post and different sectors of the operation? What is the plan for searching large surface areas at night? 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 those locations usable. Find the shortest or safest route to the middle of every body of water. Sometimes rescuers respond to the shore area closest to the victim. This may not be the best option if that area is particularly steep, rocky or full of trees. An area farther away with a more-friendly embankment may be a better choice. Make sure all personnel are aware of the preferred routes, access and staging locations. Draw and label these sites on your maps.
• If a body of water is completely surrounded by thick forest, chainsaws 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, a rope team should be deployed.
• For 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. In the event a child or adult is reported missing in the winter, these areas may need to be searched. Is a helicopter accessible for assisting with the search?
• Once routes and transport devices are found, 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 technicians before they get to the scene. Let support personnel and transport devices carry the gear to save rescuer strength and equipment. Have rescuers dress at the scene for incidents far from road access. Ice rescue suits are not designed to be worn for long periods of time on land.
• Lastly, a plan must be made and tested 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/or other problems? At least one rescuer with a status of EMT or higher should be on the scene.
4) Make all personnel and equipment ready to do the job.
Personnel: What time of day are calls most likely to occur? If most of the rescuers are volunteers, how many can be available during those times, and where will they be coming from? 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 Operations and Technician levels, and will they be available at high-risk times? (By “right” rescuers, we mean technicians who are not large, heavy, unfit, older, hypertensive, insulin-dependent diabetics, poor swimmers and/or people with asthma, none of whom belong out on the ice performing 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 repeatedly practiced them? Immersion causes a rise in blood pressure, so is a system set up to check the blood pressure of every technician before suiting up and after they leave the ice? Are police officers sufficiently trained to manage ice incidents? Are they able to recognize homicide, neglect and/or abuse by drowning?
Equipment: Late autumn is a good time to prepare equipment and rescue vehicles for ice operations while making sure all personnel know where everything is and how to use it. This is also a good time to purchase equipment deemed necessary at the preplanning meetings.
• Make laminated cue cards for communication between tenders and on-ice rescuers, and mount them on PFDs with lanyards. Practice these signals.
• If you have sized ice rescue suits, make sure sizes are clearly and dramatically written on both the suit and the suit bag. Make sure all zippers are paraffin-waxed, and the suits are in good working order without 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 in good working condition. Make sure personnel know which bags to use and how to read the line markings.
• Use equipment-check log sheets to ensure all equipment is functional and in its place. Set up gear for easy and rapid access with each complete tender/technician’s gear stored and set up in individual bags that can quickly be pulled off the truck and used. A common mistake is to put all like gear together. That means for a tender/rescuer pair to dress, they must go to the PFD area to grab a PFD, pull out the harness box to get a harness, reach for a suit in the suit locker… This wastes time and increases the chance of lost or forgotten gear.
• Make sure all equipment requirements in the SOP/Gs are met. If your department follows NFPA standards, check that all the standards in Document 1670 are met.
There’s only one job you must do every time: Go home! Preplanning will help make sure you, and hopefully the victims, can do that most important job.
For more education or to share your ideas and ask questions, visit the water-operations discussion group at www.wateroperation.com. To learn more about ice rescue and patient management, see the Surface Ice Rescue book (Pennwell Publishing) and video by Andrea Zaferes and Walt Hendrick. We welcome your questions and comments at www.teamlgs.com, telephone/fax 845/331-3383, or at Lifeguard Systems, P.O. Box 548, Hurley, NY 12443.
Andrea Zaferes, the head instructor trainer for Lifeguard Systems, is a NAUI and ACUC course director; a PADI, DAN and ARC instructor; an EMT-D; and a noted author, speaker and award winner. With Hendrick, she coauthored the Public Safety Diving, Field Neurological Evaluation, Surface Ice Rescue, Oxygen & the Scuba Diver and The Scuba Instructor Readiness Series books and audiovisuals. She teaches more than 30 different courses, including Underwater Vehicle Extrication, Rapid Deployment Search & Rescue Diving, Ice Rescue, Shark Attack Rescue and Blackwater Rescue. With Hendrick, she started Riptide, a non-profit drowning-prevention organization that also helps communities find drowning victims.
Founder, president and training director of Lifeguard Systems, Butch Hendrick has been teaching and performing water-rescue operations for more than 35 years. He trained Fire Department of New York dive teams for more than 15 years, as well as Federal Aviation Administration and Washington, DC fire department teams, South African dive teams and U.S. Parks Department teams, to name a few. Hendrick has been published over 250 times. An international award winner and program and equipment designer, he developed many rescue procedures used today and is considered one of the fathers of diving rescue and safety.