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The Rescue Call Mode is used when there is a chance to save
a human life. Brief witness interviews, last seen point, search patterns,
the golden hour, risk/benefit factor, and gathering basic information highlight
this event.
The Recovery Call Mode is used without the goal of saving
a human life. A slower pace, the gathering, documenting, and preservation
of evidence, the witness interviews, follow-ups, and the risk/benefit factor
highlight this event.
To illustrate the process, let us examine a potential
scenario for a drowning:
A seventeen year old male is with four of his friends
at the river. They decide to dive off of a bridge and swim to an island
that is downstream from the bridge in the middle of the river. The distance
to the island is approximately 300 yards.
The five friends dive into the river and start swimming
toward the island. What began as a fun swim to the island quickly turns
into a race. With two hundred yards to the island still to go, our subject
is tiring rapidly. His friends have left him behind, and he expends additional
energy trying to catch up.
One hundred and fifty yards from the island he stops
to catch his breath, treading water while he watches his friends swimming
away from him. He is still closer to his friends than he is to the shore
of the river, so he resumes his attempt to catch up to them.
One hundred yards from the island he is concentrating
more and more on his tired arms and legs. Most of his energy is being used
to keep afloat with his head above water and less is being used to swim
towards the island. His breathing comes in short and irregular gasps. He
takes a small amount of water into his mouth and he coughs. All his concentration
is focused on breathing and keeping his head above water. He never thinks
to call for help.
He flounders for only a few seconds before more water
enters his mouth and throat. He begins to cough violently, fighting to
keep his head above water. As he coughs, he expels more and more air from
his lungs and his breathing becomes shallow, rapid and less efficient.
With less air in his lungs, he is less buoyant. Keeping his head above
water becomes more difficult. Lactic acids begin to build in his muscles.
He slips below the surface of the water. Sinking slowly,
he loses his ability to hold his breath and carbon dioxide buildup forces
his diaphragm to contract uncontrollably. A deep inspiration of water occurs.
He now has little or no buoyancy in his lungs and he sinks faster. The
water in his lungs allows the carbon dioxide in his blood to leave quickly
through the alveolar bed, satisfying his urgent need to breathe. Without
oxygen being supplied by the lungs, his blood undergoes a drastic change
in chemistry. He may experience the effects of the "Mammalian Dive Reflex",
his body shunting blood away from his arms and legs and into is internal
organs.
As his desire to breathe comes back under control,
drowning loses its horror and he sinks faster, not realizing he is quickly
losing all voluntary muscle control. In his dazed state he may not feel
the affects of the water pressure on his body. He reaches the bottom and
as he becomes unconscious, he instinctively grasps at it.
As instinct takes over, he breathes in deeply and forcefully.
His breathing may continue for a time, with large quantities of water and
silt entering his lungs. He may vomit and then inhale some of the contents
into his lungs. The forceful inspiration of water into his lungs may rupture
alveoli, allowing the water to enter directly into the blood stream while
his heart is still beating. Blood may enter the lungs. His heart stops.
Meanwhile his friends have reached the island and looking
back, cannot see him. They yell out his name, but get no response. They
swim to the shore of the river and run back towards the bridge looking
for him. Unable to find any signs of their friend, they activate 911. Within
35 minutes of our subject slipping beneath the water, the dive rescue team
arrives on scene.
The dive team's duty officer locates the witnesses
and has them take him to the "last seen point ", in this case, the location
on the bridge where they entered the water. Meanwhile, divers are suiting
up with the assistance of shore support. Since there is no last seen point
other than the bridge, a search with divers behind a boat is started at
the island, moving towards the point on the bridge that the group dove
into the river from.
The water temperature is 56 degrees. Less than an hour
has passed since the five friends dove into the water. The dive team is
still operating within the "Golden Hour" or in "rescue mode". The entire
team feels an urgent need to find the boy quickly because there is still
a chance to save his life.
We now branch to two different scenarios:
Rescue
Fifty five minutes have passed since the five friends
dove into the water. One of the divers signals that he has a find. The
diver surfaces with the victim and the boat crew pulls them both on board
the boat. The divers caution the boat crew to be gentle with the victim.
A paramedic who is trained in cold water near drownings takes a few seconds
to suction clear the victims mouth and airway. He then ventilates the diver
using oxygen that has been prewarmed in hot water. CPR is started. As others
move to help, they cover the victim with blankets and start to rub his
arms and legs. The paramedic directs them to stop. He tells them that the
boy must be rewarmed slowly, from the inside out. They arrive at the shore
and the boy is transferred to an ambulance.
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Recovery
An hour and fifteen minutes after the victim and his
friends dove off of the bridge, the Team Leader pulls up his divers to
check their air and replace divers that may be tiring. He tells his divers
that they are now outside of the golden hour. He directs shore support
to contact fire dispatch and reduce the call to "recovery mode". Anyone
that is still responding to the call will now slow their pace. The dive
team still desperately wants to find the boy for his family and friends
sake, but there is less of an urgency now. Safety is increased as the urgency
diminishes. The search resumes. Two hours after the boys entered the water,
a diver signals a find. The diver surfaces, leaving the victim underwater.
He is pulled to the side of the boat that is away from onlookers. A body
bag is lowered over the side and the boy is placed inside. the diver clears
the area as the boy is pulled from the river. The boat then motors down
to a nearby marina where a coroner can look at the body before the family
arrives.
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