Chapter 20

Chapter 20: Reaching and Moving Victims in the Water

3AMERICAN RED CROSS FIRST AID–RESPONDING TO EMERGENCIES FOURTH EDITION

Copyright © 2005 by The American National Red CrossAll rights reserved.

Introduction

Water provides people with some of the most enjoyable recreational activities, but water can be dangerous.

Drowning is death by suffocation in water.

Drownings may occur during swimming, boating, hunting, fishing or while taking a bath.



The Risk of Drowning

Children younger than age 5 and young adults ages 15 to 24 have the highest rates of drowning.

Most young children who drown do so in home pools.



Preventing Aquatic Emergencies

The best thing anyone can do to stay safe in, on and around the water is to learn to swim.

The American Red Cross has swimming courses for people of any age and swimming ability. To enroll in a swimming course, contact a local Red Cross chapter.



Preventing Aquatic Emergencies (continued)

Follow these guidelines whenever you are swimming in any body of water (pool, lakes, ponds, quarries, canals, rivers or oceans):

Always swim with a buddy; never swim alone.

Read and obey all rules and posted signs.

Swim in areas supervised by a lifeguard.

Children or inexperienced swimmers should take extra precautions, such as wearing a U.S. Coast Guard-approved life jacket when around the water.



Preventing Aquatic Emergencies(continued)

Watch out for the “dangerous too’s”:

Too tired

Too cold

Too far away from safety

Too much sun

Too much strenuous activity

Be knowledgeable of the water environment and the potential hazards.

Know how to prevent, recognize and respond to emergencies.



Preventing Aquatic Emergencies(continued)

Use a feet-first entry when entering the water.

Enter head-first only when the area is clearly marked for diving and has no obstruction.

Do not mix alcohol with swimming, diving or boating.



Recognizing an Emergency

An emergency can happen to anyone in, on or around the water.

The key to recognizing an emergency is staying alert and knowing the signals that indicate an emergency is happening.



Recognizing an Emergency

There are two kinds of water emergency situations:

A swimmer in distress

A drowning victim

A distressed swimmer may be too tired to get to the shore or the side of the pool but is able to stay afloat and breathe and may be calling for help. (can become a drowning victim)

An active drowning victim is vertical in the water but unable to move forward or tread water. The victim is struggling to keep his or her head above water to breathe.

A passive drowning victim is not moving and will be floating face-down on the bottom or near the surface of the water.



Recognizing an Emergency(continued)

Once you know there is an emergency, you must decide to act and decide how to act.

Follow the emergency action steps: CHECK—CALL—CARE.

Make sure the scene is safe—do not go rushing into a dangerous situation where you too may become a victim.



Recognizing an Emergency(continued)

Always check first to see whether a lifeguard or other trained professional is present.

If you must assist someone who is having trouble in the water, you must have the appropriate equipment.

Send someone else to call 9-1-1 or the local emergency number.



Out-of-Water Assists

You can help a person in trouble in the water by using reaching assists or throwing assists.

Out-of-water assists are safer for you.

Start the rescue by talking to the victim.

Let the victim know help is coming.

Tell the victim what you want him or her to do to help with the rescue.



Reaching Assists

If the victim is close enough, you can use a reaching assist to help him or her out of the water.

If available, use any object that will extend your reach, such as a pole, an oar or paddle, a tree branch, a shirt, a belt or a towel.



Reaching Assists(continued)

If there is equipment available—

1. Brace yourself on a pool deck, pier surface or shoreline.

2. Extend the object to the victim.

3. When the victim grasps the object, slowly and carefully pull him or her to safety. Keep your body low and lean back to avoid being pulled into the water.



Reaching Assists(continued)

If you have no equipment available to perform a reaching assist, you should—

1. Brace yourself on the pool deck or pier surface.

2. Reach with one arm and grasp the victim.

3. Pull the victim to safety.

If you are already in the water—

1. Hold onto the pool ladder, overflow trough, piling or some other secure object with one hand.

2. Extend your free hand or one of your legs to the victim. Do not let go of the secure object and do not swim out into the water.

3. Pull the victim to safety.



Throwing Assists

You can rescue a conscious victim out of reach by using a throwing assist. Use anything that will provide the victim support.



Throwing Assists(continued)

A floating object with a line attached can be used to throw to the victim and pull him or her to safety.

To perform a throwing assist, follow these guidelines:

1. Get into a stride position.

2. Step on your end of the line with your forward foot.

3. Shout to get the victim’s attention.

4. Bend your knees and throw the object to the victim.

5. When the victim has grasped the object or the line, slowly pull him or her to safety.

6. If the object does not reach the victim, quickly pull the line back in and throw again.



Wading Assist with Equipment

To perform a wading assist, follow these steps:

1. Take a buoyant device with you.

2. Wade into the water and extend the object to the victim.

3. When the victim has grasped the object, tell him or her to hold onto the object tightly for support and pull him or her to safety.

A victim who has been lying motionless and face-down in the water for several seconds is probably unconscious.

1. If the water is not over one’s chest, wade into the water carefully with some kind of flotation equipment and turn the person face-up.

2. Bring him or her to the side of the pool or shoreline.

3. Remove the victim from the water.

4. Give care if needed.



Wading Assist with Equipment(continued)

If a victim is discovered on or near the bottom of the pool in deep water, call for trained help immediately.

If in shallow water less than chest deep and a head, neck or back injury is not suspected—

1. Reach down and grasp the victim.

2. Pull the victim to the surface.

3. Turn the victim face-up and bring him or her to safety.

4. Remove the victim from the water.

5. Give care if needed.



Walking Assist

If the victim is in shallow water where he or she can stand, he or she may be able to walk out of the water with some support.

To perform a walking assist, follow these guidelines:

1. Place one of the victim’s arms around your neck and over your shoulder.

2. Grasp the wrists of the arm that is over your shoulder and wrap your free arm around the victim’s back or waist.

3. Maintain a firm grasp and help the victim walk out of the water.



Beach Drag

You may use the beach drag with a victim in shallow water on a sloping shore or beach. This method works well with a heavy or unconscious victim.

To perform the beach drag—

1. Stand behind the victim and grasp him or her under the armpits. Support the victim’s head with your forearms.

2. While walking backward slowly, drag the victim toward the shore.

3. Remove the victim completely from the water or at least get the victim’s head and shoulders out of the water.



Head, Neck, or Back Injury Management in the Water

Most injuries to the head, neck or back occur in shallow water.

These injuries may result from diving into shallow water, diving into above-ground pools and unsupervised diving from starting blocks.

Injuries can also result from head-first entry into the surf at a beach, off a pier at a lake or from a cliff into a water-filled quarry or from falling while surfing or boogie boarding.



Recognizing a Head, Neck or Back Injury

Usually a head, neck or back injury is caused by hitting the bottom or an object in the water.



Recognizing a Head, Neck or Back Injury(continued)

Your major concern is to—

Keep the victim’s face out of the water to let him or her breathe.

Prevent the victim’s head and back from moving further.

Move the victim to safety.

Always check first whether a lifeguard or other trained professional is present.



General Guidelines for Care

Follow these guidelines for a victim with a suspected head, neck or back injury in shallow water:

1. Be sure someone has called 9-1-1 or the local emergency number.

2. Minimize movement of the victim’s head, neck and back.

• Try to keep the victim’s head in line with the body.

• This technique is called in-line stabilization.

• Do this without pulling the head.



General Guidelines for Care(continued)

3. Position the victim face-up at the surface of the water.

4. Check for consciousness and breathing once you have stabilized the victim’s head, neck and back using the in-line stabilization technique.

• A victim who can talk or is gasping for air is conscious and breathing.

5. Support the victim with his or her head, neck and back immobilized until help arrives.



Specific Immobilization Techniques

The following sections describe two methods for stabilizing the victim’s head, neck and back in the water.



Specific Immobilization Techniques(continued)

Two methods for immobilizing a head, neck or back injury are the hip shoulder support or the head splint technique.

To perform the hip and shoulder support—

1. Approach the victim from the side and lower yourself to chest depth.

2. Slide one arm under the victim’s shoulders and the other arm under the hip bones. Support the victim horizontally, keeping the face clear of the water.

3. Do not lift the victim, but support him or her in the water until help arrives.




To perform the head splint technique—

1. Approach the victim from the side.

2. Gently move the victim’s arms up alongside the head by grasping the victim’s arms midway between the shoulder and elbow.

• Grasp the victim’s right arm with your right hand.

• Grasp the victim’s left arm with your left hand.

3. Squeeze the victim’s arms against his or her head. This helps to keep the head in line with the body.




(Head splint technique continued)

4. With your body at about shoulder depth in the water, glide the victim slowly forward.

5. Continue moving slowly and rotate the victim toward you until he or she is face-up.

6. Position the victim’s head in the crook of your arm with the head in line with the rest of the body.

7. Maintain this position in the water until help arrives.

http://www.youtube.com/watch?v=l9Y1nU73KcQ&feature=related



Helping Someone Who Has Fallen Through Ice

If a person falls through ice, never go out onto the ice yourself to attempt a rescue.



Helping Someone Who Has Fallen Through Ice(continued)

Follow these guidelines:

1. Send someone to call 9-1-1 or the local emergency number immediately.

2. From a secure place on land, try a reaching or throwing assist.

3. If it is possible to do so safely, pull the victim to shore. If it is not, talk to the victim and make sure he or she is secure as possible with the object until help arrives.





Closing

Many drownings can be prevented by following simple precautions when in, on or around water.

Use the basic methods of reaching, throwing or wading to reach or assist a victim in the water without endangering yourself. Always remember to stay safe.

If there is any chance that you cannot safely and easily help the victim in trouble, call for professional assistance.

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