Features
Recovery mode: the unavoidable reality of drownings

Faced with that tough moment in a water rescue, you cannot always find the victim. You are doing everything possible, but sometimes it is an unavoidable reality.  You couldn’t rescue them in 10 minutes, so after 60 minutes of searching, the incident commander makes the call. There will be a shift from rescue mode to recovery mode.

Gordon Graham, international risk management consultant, states incidents like water rescue and drownings fall into the category of high risk – low frequency. They are rare occurrences and present a host of risks and consequences.

Making the decision to move from rescue mode to recovery mode is tough. It is that time that an IC must go by best-guess and accept the challenges ahead on scene, or take command of the terms of recovery and manage the operation with foresight, tact and professionalism.

What is a recovery?
Recovery is the coordinated efforts of trained personnel to search and recover a fatal drowning victim.  

Fire rescue services are very often first on scene. Sometimes it is because of fire station locations and their proximity to residential areas possibly with pools, or areas with ponds, lakes, creeks, or other waterways. Police patrol officers may be first on scene due to their mobility and flexibility. However, it is rare, but a single officer might initiate a rescue before backup arrives.  

Whether you are certified to NFPA 1670 Surface, Swift, Ice, Boat, or Dive Operations, or your internal procedures keep you limited to shore, attending a water rescue can result in a recovery operation.  It is all based on your Hazard Identification and Risk Analysis.   

According to the Canadian Drowning Prevention Plan, of the 450 fatal drownings per year, there one in four who have a non-fatal drowning experience. The report always shares some disturbing trends in Canada

Of the average 10 fatal drowning victims: 

1. Eight are male
2. Two are female
3. Two are between ages of 20-34
4. Five are over age of 50 plus
5. Six of them happened when in recreational waterway.
6. Ninety per cent of children who drowned were under five and not adequately supervised.
7. The cost breakdown for each incident by type was: $623,226 per fatal drowning death, $27,981 per hospitalization, $4,019 per emergency room visit cost, and $115,825 for each non-fatal drowning-related disability.

This makes most people sit up, take notice, and think of how your fire department responds. What are your community’s hazards and statistics?

How do we support the family in this crisis?
I have witnessed drowning incidents and the range of human responses that can accompany them, including crying, collapsing, aggression, screaming, shock, desperation and everything in between. 

The point is you have to be prepared to encounter a range of behaviour. Establish zones, secure or isolate the area, take steps to ensure your team and civilian’s safety, then focus on the rescue and coordinating efforts.

Choose a family liaison
Appoint one person to be the family liaison to collect and record information and be available to answer questions. It is highly recommended this is not the IC. It should be someone who is not part of the rescue operation directly and can build a rapport quickly with the family, friends or witnesses.

 If not automatically tiered, request police to attend, and request they have their victim services representative attend. If required, consider access to translation services, or familiarity with apps such as Google Translate, to facilitate incident details in the language of those involved. Communications should be established with any on scene partner agency to ensure all are on the same page and informed of each other’s movements, and additional resources can be considered.

Collecting information
Fire services can have a unique ability to receive information that those on scene may not communicate with police. We are focused on the victim and their situation or condition, not pursuing criminal charges. We are seen as impartial and focused on one thing – rescue.

Identify as much victim information as possible, including the person’s name, age, height, size, clothing worn, and if they were with anyone else or whether anyone else has attempted rescue. Were they injured before, or during, their entry into the hazard?  

Determine the point last seen. Put a boat in water with direction from shore using a civilian witness, who is standing in the same spot from which they saw the victim last. Direct the boat on top of PLS and drop a marker buoy. 

If on shore only, triangulate on shore by having two people stand at points and try to set a visual line. If available, set a waypoint on GPS.

After initiating the rescue operation consistent with your Establishing and Regulating Bylaw, and in accordance with the level of NFPA Surface, Swift, or Ice rescue training, there comes a time where all the people in water, and all the boats are not making a difference. 

Unfortunately, the time may come when it is time for a team huddle to discuss changing the strategy from rescue, and the need to maintain the optics of doing 110 per cent but with lower risk.  

If on flatwater, this means getting surface rescuers out of the water. Reduce the boats involved. Structures around water are difficult since there are pressure differentials from what’s upstream versus downstream of the dam, boat lock, generating station, trash racks, and intakes, so it results in staff moving to observing roles only.  

Incoming recovery divers required the lake bottom to not be disturbed by raking, dredging, or blind hooking because it often leads to moving the body away from its highly probably location – in still-water usually in an area equal to 1.5 times the waters depth.

The risks of raking, hooking, or dredging can cause damage to the body’s tissues, and could complicate the post-mortem autopsy.  The coroner will now be trying to determine if the injuries were part of the accident, intentional injury caused by another suspect, or by the well-intentioned rescuer.  

Aerial Support
Working with aviation support during a live rescue, or possible fatal drowning means contacting external agencies which can include your regional police. The most direct method is to communicate with the on-scene police officer in charge who will make their request through their dispatch and see what is possible for helicopter flyover. Perhaps a drone can be considered for an overhead view. They will need a GPS waypoint, or major intersection or park area.  

The visual from air will be dependant on time of day, clarity of water, and depth of the body itself, and if the clothing or skin colour will contrast with the underwater surroundings (weeds, sand, rock, etc.) 

As we know from use during overhaul, when thermal cameras are deployed, the profile is only good when the heat signature is at the surface, not three inches under.

Underwater Search and Recovery Teams
The dive and recovery unit will utilize all your information on the patient and PLS, then they will initiate their protocol.  

In Ontario, the Ottawa Police Service, Toronto, Niagara, York and Peel Region have underwater search and recovery teams. In British Columbia, Alberta, the territories and prairie provinces – it is RCMP. In Quebec it is the Sûreté du Québec, and for the Atlantic provinces – it is the RCMP.

In the Ontario example, OPP will deploy a dive team from Gravenhurst, unless on another call. Their response time is usually within one hour plus drive time and there is no financial charge back to have them respond to a body search and recovery. The municipal IC must formally request the OPP dive team attendance through OPP Communications Centre. They will respond province wide, from Cornwall, to Windsor, to Kenora.  

Municipal police, provincial police, and RCMP underwater teams advise that can call anytime for a phone consultation. When an IC calls for advice during an incident, this puts the team on notice, familiarizes them with the incident details and it also helps them prepare for a probable request and operational response. 

Recovery Steps
Have you marked the area? Do you carry a stokes basket?  Do you have a body bag, or heavy tarp to give the victim dignity, and protect the family and bystanders from the harsh visual of a water-absorbed body?

When a body is recovered, whether free floating or from a vehicle, the physiological process of rigor mortis may have begun. That means the body may not lay flat on a stokes basket, and arm or leg may be in unusual position. Their eyelids may be open, and can be closed if you are bringing them to shore.  

Depending on the duration underwater, their skin will be cold, and the body may have absorbed water. The decomposing process has started, with gases expanding within the body giving it an inflated look.  If the body was underwater for days, the tissue may decompose and skin or tissue will be loose to the touch. When the body is transported to shore, it is critical to have enough personnel to adequately and safely lift and carry the body without tripping or letting the load fall. 

 Years ago, it was common to toughen up the rookie and look under the tarp. Considering the mental health impact of witnessing death – there is no value to this practice for fatal drownings. Where is the benefit in creating visuals for flashbacks? Instead, prepare the team for the supporting the family and in supporting each other.  

As we saw in the Kobe Bryant helicopter accident, taking private photographs of someone’s death is callous, unprofessional, can easily spiral out of control. Ask bystanders to put their smartphones away and clear the area. Let the investigators and coroner be the only ones to take the photographs.  

We are there to stabilize a situation and prevent it from getting worse. Unfortunately, death is a reality and those experiencing extreme grief and offering closure with your agency’s body recovery methods will be paramount, supporting your team afterward then becomes your next priority.

In Gordon Graham’s words, “if you can predict the emergency, you can prepare for it.” 

Pre-plan how you are going to handle your next drowning and the family in crisis. Brief your crew on your expectations, requests for assistance, recovery procedures, and implement some of these points. Depending on the significance of this high-risk-low-frequency event, and its impact consider checking in on the mental health of your staff after the call.  

Prepared with information from Staff Sgt. Kevin Gorman of OPP Underwater Search & Recovery Unit. 

Dave Gillespie is a captain and has been a fire rescue technician for over 27 years.  He is an instructor of Surface, Swiftwater and Ice Rescue. He has authored a book with Fire Engineering titled “Developing Firefighter Resiliency”. Dave has contributed to program development in Canada and USA, and and has participated in a variety of roles on water rescue teams in Ontario.