The IMRF has published a questionnaire on horizontal rescue online. We hope that as many SAR organisations as possible will answer it, to help improve and spread knowledge of life-saving techniques. The more information we can collect and disseminate on this vitally important subject the better.
The questionnaire may be found at www.international-maritime-rescue.org/horizontal-rescue-imrf-questionnaire. It is a tool for obtaining information about the commonly used systems for rescuing a casualty from the water; and about related procedures and experiences. It is also intended to evaluate the practicability of the various systems under different conditions. These data will enable rescue services to share their experience with each other and make improvements overall.
It will be particularly helpful if pictures accompany questionnaire returns. Pictures may be simply uploaded as the questionnaire is completed.
Survivors in the water suffer from a decrease in circulating blood volume, and from an impaired cardio-vascular function. It must be assumed that they also suffer from hypothermia. Their manual dexterity, handgrip strength and swimming performance are reduced, and it is most likely that they cannot assist in their own rescue. The risk of a ‘circum-rescue collapse’ is of paramount importance at all stages of the rescue procedure.
Survivors in the water should be lifted in a horizontal or near-horizontal position if possible – for example, by means of any kind of rescue or scramble net or in two strops or loops; one under the arms, the other under the knees – to minimize the risk of shock induced by sudden transfer from the water and possible hypothermia.
This procedure is recommended if the person has been exposed for more than 30 minutes or shows signs of hypothermia; and if the lift will take more than a few seconds.
However, especially for short lifts, do not delay if the survivor’s airway (mouth/nose) is threatened by, for example, backwash from the rescuing vessel; or if moving him into a position which would allow horizontal rescue would submerge his head. If such threat exists, lift the survivor by the quickest method.
Persons who have been drifting in, for example, a liferaft for an extended period of time are also likely to be lacking body fluid, and it must be assumed that they are suffering from hypothermia. They too should be rescued in a horizontal position whenever possible, and they should be handled with care!
The importance of preventing hypothermia and early application of adequate insulation is one of the cornerstones of pre-hospital primary care. The removal of wet clothing or the addition of a vapour barrier will reduce heat loss effectively and is of great importance in pre-hospital rescue scenarios in cold environments.
A simple procedure to accomplish this is to use plastic film (or any other moisture-proof layer) applied closest to the skin; over that insulation material and then finally a windproof layer (the so-called Hibler’s method).
The rescue of a victim from the water is a rare event. The procedures should be trained regularly, including under adverse conditions. If possible a heavyweight dummy (90 kg / 200 lbs) should be used.
As stated, there is always the risk of circum-rescue collapse. The transfer to a place of safety should be performed as carefully as possible, and preferably in a horizontal position.