By Walt “Butch” Hendrick and Andrea Zaferes

The Miracle Girl

scenario: At 9:00 on the night of February 25, 1985, a van with five young passengers sped down a city street, and then lost control. It flew off of a ten-foot-high embankment, and plunged into fifteen feet of water in the Mill Basin Creek in Brooklyn, New York. Having recently completed underwater vehicle extrication training with Hendrick, Firefighters of Rescue Company 2, Fire Department New York, responded to the situation. Gearing up en route, the divers arrived fully prepared to enter the 31-degree blackwater. Tethered with a surface tender, diver David VanVorst entered the submerged van, where he found 14-year-old Dierdre Silverman and gently took her to the surface. As VanVorst descended back to the van, resuscitation efforts were begun on Silverman. Although the four other youths in the van did not survive, Dierdre Silverman, now known as “The Miracle Girl,” made a full recovery. She was submerged for 27 minutes in not the cleanest of water. This incident requiring vehicle extrication skills was one of the first cases of coldwater drowning saves.

When we respond to a land-based motor vehicle accident we reflexively use our senses. The visual sense sees the twisted, collapsed metal, the possibly entrapped victims, and victim injuries. You hear the sounds of victims and other responders, your sense of smell searches for odors of fuel and alcohol, and your sense of touch feels for patient injuries and vital signs. Perceptions from these senses integrate instantly with the result that the brain knows what needs to be done and sets the body in motion. Rescuers, fire, EMS, and police all know what to do. Command knows what to do. We have all trained for this situation, and we all know our jobs. What happens, though, if a vehicle goes in the water?

When we arrive to a submerged vehicle scene our visual senses see an undisturbed water surface. There are none of the normal signs to cue responders on what to do to best utilize the available personal and equipment. Our prepackaged duties of being EMS, fire, or law enforcement, no longer apply.

Without good water visibility there is not much to see besides how or where the vehicle may have entered the water. Training in underwater vehicle extrication should teach responders to begin using the mind’s eye to visualize the underwater scene. This is critical for rapidly creating a safe and effective plan of action.

We know from experience and such resources as the Michigan State Police S.T.A.R. research that cars normally take more than three minutes to fully submerge. For example, a re-enactment of the incident of Susan Smith murdering her two sons by rolling her car down a boat ramp, demonstrated that it took over six minutes for the car to fully submerge. Other types of vehicles may submerge more quickly. The S.T.A.R. research showed that traditional school bus windshields are likely to dramatically blow out with front first entries.

The more airtight the vehicle is the longer it will float. See if witnesses can say what kind of car it may be, consider the weather to estimate the probability of the window positions upon entry, and then factor in current and wind variables to calculate the most likely location of the submerged vehicle. Susan Smith’s car was found 125 feet from shore. The last vehicle our team worked on involved a car moving over 30 mph over a 10-12 foot high cliff and on the bottom 61 feet from shore. Meet with mutual aid teams to look at all known vehicle incidents and recap data on car model, state of car when found (damage, window positions), distance from shore, environmental conditions (depth, current, wind), and any known information on how the vehicle entered the water. This can prove to be very useful information for future calls.

While a hot search zone is being calculated, a search should be set up to look for passengers or pedestrians who may be at the water surface or on shore. Infants have been known to float when ejected from vehicles because of their higher fat to muscle ratio and air trapped in diapers or clothing. One infant was found floating after such an ejection and cause of death was hypothermia, not drowning. Helicopters, boats, dogs, and walking searchers, are viable resources to deploy for such an incident. If a vehicle went through the ice pay close attention to any other ice holes that could be from passengers who escaped from the vehicle and then fell through the ice away from the vehicle.
The surface search should also look for fuel and other objects that may have left the vehicle and are now floating at the water surface, which can give additional clues on vehicle location. If there is wind or a current, then it will be necessary to estimate the depth to calculate where the vehicle is based on the location of floating fuel or items. As soon as possible delegate someone to calculate water speed in knots by seeing how far an object floats in thirty seconds. One knot is a rate of 100 feet per minute. If the object, for example, floats 75 feet in 30 seconds, then the rate of travel is 1.5 knots. Conduct a drill and release vegetable oil from the bottom and see how long it takes to reach the surface and convert that to time in minutes. Once you know the time for oil to surface from a particular depth, multiply the time by the current for the distance of travel.

Once a hot zone is designated, a dive team is needed with the appropriate underwater vehicle extrication training/certification and equipment. If a team does not have the right training or equipment, they should not be allowed to dive. There are serious hazards to understand and mitigate, while the benefit is small. If the vehicle is submerged then all the passengers are dead. A team can choose to respond in a rescue mode with only slim hopes of a successful resuscitation leading to a patient coming out of a coma and having any quality of life.

We once met a public safety diver (PSD) instructor who insisted to us that it is acceptable for their F.D. dive team standard to allow the first diver on the scene to enter the water without a backup and 90% diver on the scene, without pony bottles, without three cutting tools, and without tender-directed-tethered diving with certified tenders, because the team was in a rescue mode. The victims are dead we said. He said “no”, he was “talking about a rescue mode”. Right, but once submerged, there are no pockets of air, so those passengers are dead, and in warm water canals the chance of victims having their lives back is less than the chance of injuring a diver in a substandard dive operation.

Sure, there are plenty of instances where a victim’s heart is re-started, which makes sense because the heart is very resilient. Unfortunately, with our current medical technology, the nervous system rarely recovers. If a “save” is designated as any time a victim’s heartbeat returns, rather than a return to consciousness, then benefits may be unsafely inflated. If this happens, divers are more likely to be put at unacceptable risk by their own hearts, their department, the victim’s family, and the media. If the public wants us to get them out of submerged cars, then the public has to provide a budget for the necessary training and equipment.

So what are the hazards?

Vehicle shifting resulting in diver entrapment:

Never get on the downstream side of a vehicle in a current moving faster than one-quarter of a knot (25 feet per minute). The moving water will eddy on the downstream side, and the eddying will begin digging a hole in soft bottom just past the car. The hole may eventually become large enough for the car to flip and fall into the hole, creating the potential for a diver to become trapped under it.
Sharp objects and entanglements:

Water is not compressible so when a vehicle hits the water surface, there is often damage that can expose divers to sharp objects, jagged metal, broken glass, and plenty of entanglement hazards. Always be prepared for entanglements, which is our most common problem. A diver of the Sacramento DART team became serious snagged during a vehicle call. By accident he landed on the wrong vehicle, which had been down for quite some time. This vehicle was upside down with the underside covered in fish hooks. The diver did not know he was on the wrong vehicle and laid on the underside to set a tow hook. The fish hooks caught in the neoprene of his exposure suit in many different places along the length of his body. He learned to appreciate having a pony bottle and backup divers trained in air and entanglement management. The team also learned one of the many values of wearing EPDM vulcanized rubber drysuits instead of suits made out of neoprene, and the value of hardwire electronic communication systems.

Another hazard involves containers that have a gas in them. If dislodged, air-filled containers will shoot for the surface. A spare tire could hit a diver hard enough to possibly cause a head or neck injury. Training should therefore include the proper diver body position to decrease the risk of being hit by rapidly ascending objects as the diver searches inside a vehicle.
Entrance inside a vehicle is entrance inside a confined space. On land, we climb in and out of cars several times a day, so we may think nothing of entering a car underwater. But, when was the last time you got in your car with a full exposure suit and scuba gear? That roomy sedan suddenly seems a lot smaller when you are wearing bulky dive gear, and debris is floating all around. When divers poke their heads, arms, or worse, their whole bodies into a car, they have entered one of the most dangerous diving environment possible: an overhead restriction that prevents direct access to the surface. Any overhead environment, be it a vehicle, ice-covered pond, cave, or floating dock is potentially extremely dangerous and requires both training and careful procedures. Vehicles may present some of the greatest hazards because they are such a small, confined space. For example, the space inside a vehicle does not allow a back-up diver to easily access a trapped primary diver to provide air and assistance getting free. To worsen matters, submerged vehicles may have been damaged before or during water entry, thereby decreasing space and increasing restrictions.
Fuel contamination: Submerged vehicles present hazmat problems including fuel, biohazards, and possibly other chemicals carried inside the vehicle. Even in a short period, gasoline, oil, and diesel fuel can break down the neoprene and latex of many exposure suits. Upon contact with the skin, they can cause burning and irritation. Fuel in the eyes can cause temporary blindness. High-octane aviation gasoline is particularly nasty, because it eats suits faster and causes more severe burning and blindness. If divers aspirate oil-contaminated water through a wet-breathing regulator or because they take their regulators out of their mouths, they create the possibility of lipoid pneumonia, a life-threatening condition.

Also consider what other substances might be in the vehicle. Cocaine, for example can become an acid when exposed to water. Therefore, the hazmat team should be called in for every submerged vehicle incident to help mitigate the floating fuel problem and to decontaminate divers and tenders as they leave the water site. In ice situations divers may want to be deployed in a different hole than the one directly above the vehicle to stay out of the fuel slick. We have found that coating the divers with dishwashing liquid before water entry helps keep the fuels off of them.

Live victims:

If you attempt to rescue victims from a vehicle that is only partially submerged, consider that victims inside may still be alert, because they were able to keep their airways above water. A panicked, entrapped victim, may grab you and possibly dislodge a diver’s air source. Approach such victims cautiously. Use eye contact to calm them down, and, if possible, have someone from shore use a bullhorn or other amplifier to talk to victims in order to calm them down. However, do not remove your own regulator to talk with them. As explained below, removing your regulator can expose you to hazardous materials in the water.

To protect divers from these hazards, divers need proper personal protection equipment that includes appropriate full face masks, hazmat tested drysuits , quick-release pony bottles, harnesses with locking carabiners, backup diver contingency straps, an 80 cuft contingency cylinder, Kevlar glove liners, and three or more cutting tools (at least two shears or wire cutters mounted on the harness and the rest in the torso golden triangle area). Electronic communication systems are also strongly recommended, and really should be mandatory if at all possible. Tenders should also wear appropriate personal protective equipment including gloves and personal flotation devices. Divers should also carry strong bungee cords with steel S hooks to secure open one or more vehicle doors.

Orientation is also an issue. If the water depth is greater than the length of the vehicle, there is a good chance that the vehicle will lay on the bottom tires up. In this case divers need to be capable of working upside down in a supine position so that they are oriented to the vehicle in a normal fashion when searching for, or extricating, victims. Without excellent buoyancy control skills divers are more likely to face entanglement and entrapment hazards. If there is any visibility it should be maintained, which requires advanced buoyancy control skills. A stirred up bottom almost always means that divers are over-weighted and were not trained to swim across silty bottoms without creating a mess.
Once a proposed hot search zone is designated the next step is to figure out the safest and most effective place and way to deploy the primary diver. If the water has low or zero visibility, dives should be tethered and tender directed to provide direct line access to shore and the backup divers, and for the search to be accurate and effective. Without being able to see, divers do not know where they are going or where they have been, and can easily miss an object the size of a car let alone an ejected child. Some divers choose to use sport diver type patterns that involve buddy divers working their way back and forth along a line with weights at either end that is moved arms length out each time a sweep is completed. This is not as effective a search pattern as is solo-diver-tethered-tender-directed patterns for a variety of reasons, and does not provide direct access between the diver and topside help.

The maximum tether line length under good conditions is 125 feet. If it is believed the submerged vehicle is farther out, then a boat with three anchors (hurricane anchoring) becomes necessary as a dive platform. If the current is more than .5 knots then the operation cannot be conducted from shore and a dive platform becomes necessary. If the current is greater than 1.25 knots then the decision should most likely be a “no-go” unless the team has extensive PSD moving water training.
As with other low or zero visibility PSD dive operations, submerged vehicle divers should be back on deck with at least 1000 psi in an 80 cuft cylinder; maximum dive times are 20-25 minutes; there is a primary tender, backup tender, backup diver and 90%-ready diver for each primary diver down; and the backup tender documents the primary diver’s every location on a profile map and should document the diver’s breathing rate every five minutes to calculate how much air the diver has at any point during the dive. The team should have well-practiced, specific, zero-visibility hand-to-hand signals for “I am entangled,” “I am hurt,” and “I am out-of-air” to allow the most effective rescue of a primary diver.

Direct line access is defined as a straight, taut line between the diver and the diver’s tender, and is critical for an accurate search pattern, for quickly recognizing when a diver is snagged, to decrease the chance of line entanglement, and to rapidly reach a needy primary diver. In non-vehicle dives, direct line access is easily achieved and maintained by the diver being tethered into an effective harness, and by maintaining a 45 degree angle away from the tender without holding on to the line. Once the vehicle is found then direct line access may be lost as the diver reaches into the vehicle. For this reason the also tethered backup diver is sent down the primary diver’s line with a contingency strap once the primary diver gives the “object found” signal. The backup diver then serves as the primary diver’s tender on the bottom, and direct line access is maintained between the primary diver and the backup diver. Once this is in place, the primary diver can investigate the state of the vehicle to determine the best location inside or outside the vehicle to begin searching for victims. The back up diver can carry the bungee cords for securing a door open, and can pass them to the primary diver when necessary.

Preparing the dive team

A prerequisite for learning how to perform operations with submerged vehicles is enough training and experience to safely work in blackwater and successfully manage entanglement, injury, and out-of-air-while-entangled problems. The only job that must be successfully completed after every dive operation is to go home, hence, the most important part of training is accident prevention and contingency plans.

If dive teams use electronic communication systems then they should make sure that divers and tenders can manage the entangled, injury, and out-of-air contingency situations without these communication systems. Many teams tell us that they would abort any dive if their communications failed. Although generally we believe it is not necessary to abort all failed communication system dives since line signals are very effective, we also believe that any choice that decreases risks is a good one. The problem arises though that a dive can only be aborted if the divers can reach the surface. Murphy’s law is such that an electronic communication system is more likely to fail when the diver is entangled or entrapped. If contingency plans are not thoroughly practiced without electronic communication systems then the needy diver’s life is seriously at risk.

Far too many teams and instructors do not think about problems realistically. Consider the following example. For example, communication systems are worn in full face masks. If a diver runs out of air and needs to access a second air source then the full face mask must be removed unless a block is used to access the second air source. Almost all the teams that have told us they abort dives if communication systems fail, do not wear blocks and have never thought about, or physically practiced, zero-visibility contingency plans without a communication system. And even if you have a block, a full face mask can be accidentally knocked off, which is particularly true during vehicle dives. A diver on our team had his mask knocked off as the chin of his mask knocked onto an open door as he descended in blackwater to search for the car. When it comes to training, realism is critical.
Once basic contingency plans are well practiced, the next consideration is what do we train for – to enter, or not to enter the vehicle. Many teams tell us that they will not allow their divers to reach in or enter a vehicle because they only operate in recovery modes. Their plan of action is to set a tow hook and let the car be pulled out. If any passengers are inside, they will be removed when the vehicle is on land. That is an excellent standard since entering a vehicle greatly increases risk for the diver. The problem with this though is that in the real world even strict recovery teams may some day be faced with a rescue situation, and then what? Will they stick to their no vehicle entry standard? Consider what happened to Houston Police Department’s recovery dive team when they were suddenly faced with a school bus in a flooded road filled with handicapped children strapped in their wheel chairs with water rapidly rising above their necks. Or how about a dive team in South Africa that responded in a rescue mode to a double-decker bus filled with school children? Were divers in these two incidents going to follow a no-entry policy? No, and like most teams, they went in.
Another time that a diver may choose to enter a vehicle is when the windows are broken open and it is necessary to search for possible evidence of foul play. If the car is pulled out without first searching it, valuable evidence could be lost out the window(s). It is more common than most people think for a submerged vehicle to be the result of suicide, homicide, a combination of both, or insurance fraud. It may be worthwhile to check the contents of any vehicle with open windows before pulling it out to prevent fraud. For example, the car owner later claims that he had a set of $1500 golf clubs in the back seat that must have fallen out in the water. If the vehicle is well sealed, then it may make more sense to document that it was sealed, keep it sealed, remove it, and then search it on land.

Training for rescue modes includes teaching divers how to secure open a passage way to reach and remove victims. Opening a door is the first choice, but unfortunately that is not always a possibility depending on damage and how the vehicle is laying. Divers need to learn how to move over the top of the vehicle to search for the best way to get inside. Never go around because a tether line could become snagged under the vehicle.

When a door is opened it is crucial to secure it open so it cannot close on the diver. This procedure was put in place after Author Hendrick entered a van in blackwater to find the bodies of two boys in a rescue mode in the 1970’s. The fashion of that time was to put shag carpeting on van walls and ceilings. With a boy under each arm, Walt became entrapped under the ceiling carpet that fell down as his bubbles seeped through the carpeting, separating it from the ceiling. As he attempted to back out he discovered that the van doors were closed. The morale to that story is always secure open doors with strong, trucker bungee cords. Some teams prefer to jam wood wedges in the open door hinge, which is less effective because if the door is pushed open any further accidentally, the jams could fall out.

Divers must learn how to reach in a vehicle that is strewn with entanglement hazards and sharp debris, and work with the backup diver to manage entanglements. Once divers can confidently work in a confined, entanglement and debris-filled space, then it is time to work on searching for victims or evidence. This is then followed by procedures for victim/evidence removal and transport to the surface. The last step is how to set a tow hook and lift bags to assist with vehicle removal. An important consideration for any action involved in vehicle removal is the possibility that the team may fall under OSHA standards because vehicle removal is not part of a rescue operation. The OSHA dive team exemption is not as black and white as it appears in the written documents. Discussions with OSHA representatives have proved that this issue is a bit muddier than anyone would like. Make sure to speak with your OSHA representative to see where your department falls for this type of operation.
The team should begin training on land with instructors certified to teach underwater vehicle extrication. Begin by stringing the interior of the land vehicle with fishing line, string, and wire so the divers learn how to deal with entanglements and proper cutting methods. Mannequins should be slightly enwrapped in the entanglement, too. This process should be beyond any possible reality, allowing the divers to learn how to deal with the worst case scenario.

Place mannequins in different positions inside the vehicles. Arbitrarily attach seat belts, and affix some belts so that they must be cut. For teams that include evidence searching in their dive duties, add small pieces of evidence in the vehicle, and require that all pieces of evidence be recovered before vehicle removal.

Divers should wear full gear, except for tanks (plastic display tanks or rolled cardboard will make a good substitute), and attempt to extricate the mannequins and avoid entanglements. Initially do not allow any verbal communication between divers or between divers and tenders. Using line pull signals is allowed. Once the mission can be accomplished without verbal communication (simulating electronic communication systems) then allow verbal communication.

Once the team can successfully operate on right-side-up vehicles, place a training vehicle on its roof. You may choose to allow the vehicle to remain there for twenty-four hours before training to monitor the integrity of the vehicle. Apply supports as necessary.

Divers should learn how to move “low and slow” to decrease the risks of being hit by a dislodged gas-filled container or injured by a sharp object.

During practices, keep in mind that working a real submerged vehicle extrication involves still more complications. Petrol in the water is a major concern to the diver, mostly during surface time, ascent, and decent. Divers should be trained to get below the surface quickly, and out of the fuel-contaminated areas. Go to network love to determine the techniques. There are liquids that can be put on the surface of the water and the divers gear that will repel some types of fuel oils. You must check with your local regulations to define whether or not you may use such detergents in your waterways, as they can be harmful to fish and other water life.