River Terminology, Rescues, and Medical

Swift Water Rescue • In the US 6-9k people die each year in water related emergencies• About 1/3 of these deaths are would be rescuers

Eddy

Pillows

Laminar and Helical Flows

THE RESCUE PHILOSOPHY • 1. YOUR SELF• 2. YOUR TEAM MEMBERS• 3. THE VICTIM

• Do not add to the incident

L.A.S.T• Locate the victim• Access the victim • Stabilize and extricate the victim • Transport the victim

You Fall in Moving Water• Stay calm • Don’t put your feet down • Float on your back with legs straight and feet pointed down stream.

Be ready to deflect incoming obstacles • Heads up!• If you go through a strainer go through head first • Try and move sideways to the shore

Someone falls out • DO NOT UNDER ANY CIRCUMSTANCES ENTER THE WATER • DO NOT TRY TO PULL ANYONE OUT USING YOUR HANDS OR

ANYTHING CONNECTED TO YOUR BODY • If possible throw the rope bag ahead of the victim, secure the rope to

the boat and row to shore

Diagonal Tensioned Line

Hypothermia 101• The body is sensitive to very small changes in temperature • A normal body temperature is 98.6 degrees F• A body temperature below 96 degrees F can lead to complications

Hypothermia temperatures

•Below 32 degrees F•Below 40 degrees F in wind and rain

Our weather• Night time temperatures projected between 20-40 degrees • Day time between 58-70 • Constant wind

Hypothermia Causes • Cold temperatures• Improper clothing and equipment • Wetness• Fatigue • Dehydration• Poor food intake• Alcohol intake

Mild Hypothermia• 98.6-96• Involuntary shivering • Watch for the “umbles” • Vasoconstriction to the periphery• Not life threatening. We stop, warm up, continue on our way.

Moderate Hypothermia• 95-93• Dazed, loss in coordination• Slurred speech• Violent shivering • Irrational behavior or apathy • Life threatening. • We stop and begin rewarming procedures (see emergency plans)

Severe Hypothermia• 92-86• Shivering in waves • Fetal positioning • Muscle rigidity • Complete loss of motor functions • Dilated Pupils, Cyanosis, Decreasing HR and BP• Immediately Life threatening• We stop and begin rewarming procedures• Initiate rescue plan (see emergency plans)

Treatment and Patient Management • Remove wet clothing and dry • Assess breathing, airway, and circulation • Reduce heat loss• Gradual rewarming • Add fluids and fuel • Hypothermia wrap • Move patients gently

Shock • Compensated Shock• Decompensated Shock• Irreversible Shock

• Hypovolemic Shock• Hemorrhagic Shock• Cardiogenic Shock • Neurogenic Shock

Signs and Symptoms • Altered mental status • Pale cool clammy skin • Nausea and vomiting • Vital sign changes • Increased pulse• Respirations increased• BP drops• Cyanosis • Thirst• Dilated pupils

The golden hour • Every minute between the time of injury and the

patient getting to an operating suite is linked to the probability of survival

Treatment and Management • Assess the pt • Maintain open air way, perform CPR as necessary • Control any external bleeding • If you suspect a head or neck injury immobilize the patient • Splint any suspected bone or joint injuries• Prevent loss of body heat • Start extrication and Rescue Plan

CPR 101 •Airway: Can they breathe?

•Breathing: Are they breathing?

•Circulation: Do they have a pulse?

Rescue Breathing • Tilt back the head and lift the chin into a “sniffing” position.

Hyperextending the airway will close it off• No mask• Plug the patients nose and deliver 1 rescue breath every 5 seconds for 2

minutes• Reassess after 2 minutes• Look for clear chest rise• Continue until spontaneous breathing occurs or there is no pulse• If you detect no pulse begin CPR

Steps• 1. Assess the patient ABC’s• Administer interventions as necessary

• 2. Open the airway• 3. Begin chest compressions at a rate of 100/minute 2 inches deep• 30:2 Compressions : Breaths

• 4. continue until there are active signs of life or you detect a pulse

• Hard and Fast• Don’t worry about the puke• Don’t worry about cracks and pops

The Rescue Plan• Step 1: We attempt to make contact with emergency services • Step 2A: Contact is a success• Wait for rescue• Manage patient

• Step 2B: Contact fails• Group will split into two separate three man units: UA and UB• Unit A will be responsible for pt management

• Unit A will continue to pursue additional means of rescue if possible• Unit B will continue down river until they are either able to make contact with

emergency services or contact a river checkpoint and alert them to Unit A’s last known location. From this point B will follow official direction. • Unit B will contact families and make them aware of the situation

Emergency Plans• Hypothermia• Drowning• Injury or death • Gear is rendered useless• Foodborne illness • Dehydration and Hyperthermia • Group separation• Member falls out of Vehicle• Bites and Stings