Alternate rescue techniques

The alternate rescue methods listed below are among the other more commonly used approaches. This is not an exhaustive list and Operators should keep in mind that there will be many factors that can impact the rescue process. A dynamic risk assessment should always be conducted, with the ultimate aim being to get the patient onto the RWC sled as effectively as possible. Operators should aim to minimise delay and prevent injury to the RWC Operator, Crewperson (where applicable) or patient. This some situations, a patient pickup may be necessary that doesn’t strictly adhere to techniques outlined in this manual.

Scoop

This rescue can be used when:

• Patient is conscious or unconscious.
• Patient is in a position where direct access is not available to conduct the rescue.
• The rescue is in suitably calm conditions.
  

*NOTE: Care should be taken to ensure the Operator is prepared for the size of the patient and operates only within their limitations.

To perform the rescue:

1. Approach the patient safely as the conditions allow, maintaining a safe distance.
2. Upon approach, assess the situation. If there are no signs of life, conduct a dynamic risk assessment to aid in deciding to either proceed, or abandon the rescue to maintain you and your Crewperson’s safety.
3. As required the Operator will present the sled to the patient, the Crewperson will slide off the sled keeping hold of the last handle on the sled on the inside of the turn and making contact with the patient. This rescue can be performed on either side of the RWC.
   

*NOTE: The Crewperson can control the rate of the sled movement by their position in the water.

4. The pickup is performed by the Crewperson ‘scooping’ the patient and getting them centred in the arch of the sled with the patients back to the sled. The Crewperson should then reboard the RWC maintaining contact with the patient.
5. Once the Crewperson is on board, the sled will be naturally lower in the water and the Crewperson can heave the patient on board the sled. If required, the Crewperson can call for the Operator to select reverse to lower the sled.
6. The Crewperson should secure the patient by positioning their bodyweight over the patient with their knee in between the patient’s legs. The Crewperson will then slide their hands under the patient’s armpits, grabbing the centre two handles.
7. When the patient is appropriately secured the Crewperson will notify the Operator.
8. During the rescue, the Operator must ensure the RWC is facing the prevailing conditions and communicate via radio to update the patient’s condition and request assistance if required.
9. The Operator will take the shortest and safest route back to shore and ensure the safety of the patient and Crewperson by conducting regular visual checks.
10. On reaching the beach, if the patient is conscious, the Operator should turn the RWC to face the prevailing conditions in shallow water and instruct the Crewperson to assist the patient off the sled and to safety.

If the patient is unconscious, or other factors require the Operator to beach the RWC, the Operator will instruct the Crewperson that they are about to beach, commanding “Brace, Brace, Brace”.

11. Once on the beach, the Crewperson will begin preparing the patient for transfer if necessary.
    

Leg Lock with Crewperson

This rescue can be used when:

• Patient is conscious or unconscious
• Patient is larger than the Crewperson
• Other efforts to get the patient on to the sled have been unsuccessful
• Rescue is in suitably calm conditions
• A Crewperson is available to assist
  

To perform the rescue:

1. Approach the patient safely as the conditions allow, maintaining a safe distance.
2. Upon approach, assess the situation. If there are no signs of life, conduct a dynamic risk assessment to aid in deciding to either proceed, or abandon the rescue to maintain you and your Crewperson’s safety.
3. IIf leg lock is identified as the suitable rescue technique, and the patient is conscious, the Operator will make contact by securing the patient, typically with their left hand as per a solo operator unassisted pickup, and then passing them to the Crewperson.
   

If the patient is unconscious, then the Operator should manoeuvre the sled to present the patient to the Crewperson so that they can make contact.

1. The Crewperson should roll the patient onto their back, so their airway is clear.
2. To perform the pickup, the Crewperson then needs to manoeuvre the patient into a position where they can lock onto the patient by hooking their knees under the patient’s underarms and securing the patient by crossing their ankles, or with a small amount of inward pressure. The Crewperson must always maintain contact with the RWC and patient.
3. The patient should be positioned face up on the rescuer’s backside/thighs.
4. The Crewpersons legs should be kept bent, pulling their heels towards their backside.
5. The Crewperson grips the rescue sled handles on each side and pulls their chest up the rescue sled until they reach a safe position with their hands on the handles and their forearms stable on the sled, with the patient securely locked.
6. If in a dangerous position, the Crewperson will signal the Operator that they are secure, and the Operator can drive the RWC to a safe location before repositioning the Crewperson to secure the patient better.
   

*NOTE: If the patient and Crewperson are not far enough up on the sled then the patient may be subject to the RWC jet wash. As the RWC Operator applies power the patient will drag in the water.

7. Otherwise, once the Crewperson has a safe grip on the sled, with their hands on the handles and their forearms stable on the sled, they will take hold of one of the patient’s wrists to secure the patient.
8. Then, with the Crewperson’s knees on the bottom of the sled, in one movement: the Crewperson raises their hips upwards, allowing the patients head and back to release and drop fully onto the sled, releasing the Crewperson from the leg lock position.
9. The Crewperson should return to the unconscious crewing position, with their bodyweight over the patient and their knee between the patients legs, before communicating to the Operator that it is safe to move off.
10. The Operator should then provide an update via radio on the patient’s condition and request assistance, if required.

Aided Rescue with Crewperson – No Gear

This rescue can be used when:

• The patient is unconscious.
• The patient is conscious but may be physically exhausted.
• The patient is caught in the surf zone and is in imminent danger.
• The patient needs some assistance by a Crewperson to safely get on the RWC.
• The RWC Operator may not be able to immediately manoeuvre to safety to enable a traditional pickup.

*NOTE: Care should be taken to ensure the Operator is prepared for the size of the patient and operates only within their limitations.

To perform the rescue:

1. Approach the patient safely as the conditions allow, maintaining a safe distance
2. Upon approach, assess the situation. If there are no signs of life, conduct a dynamic risk assessment to aid in deciding to either proceed, or abandon the rescue to maintain you and your Crewperson’s safety.
3. The RWC Operator will drop the Crewperson as close to the patient as possible.
4. The Crewperson should be ready with swim fins on (as required).
5. On approach to the patient, the Operator should indicate to the Crewperson where the patient is located. The Operator will do so by indicating with their left hand (if it is safe to do so) pointing to the patients location.
6. The Operator will indicate to the Crewperson when it is safe for the Crewperson to leave the sled.
7. On exiting the sled the Crewperson should signal “all clear/ OK” to the Operator, who should confirm receipt of the signal.
8. The Operator will move off to a safe standoff position, usually back inside of the surf zone so as to monitor the progress of the Crewperson and await their signal. The Operator will notify the patrol of the current situation as applicable.
9. On reaching the patient the Crewperson will make contact and secure the patient by sliding one arm under the patients armpit from behind and maintaining jaw support to hold the patient afloat.
10. The Crewperson will then need to signal to the RWC for pickup and position themselves surf side of the patient with their left hand, holding the patients’s left elbow above the waterline.
11. The Operator will acknowledge the Crewpersons signal and make their way out to complete the rescue.
12. The Operator will approach the patient safely as the conditions allow, maintaining a safe distance.
13. To maximise the time for the pickup the Operator should aim to be approximately one sled length from the patient as a wave passes.
14. The Operator should position themselves with their left leg as far back as possible, to maximize their reach to guide the Crewperson and patient onto the sled.
15. The Operator will raise their left arm straight up and issue the command, “Left hand up.”

*NOTE: This rescue is to be conducted at a slow speed and may require the Operator to select neutral on reaching down to grab the patient’s arm. This will depend on the Operators approach speed, the conditions and patient variables.

16. To perform the pickup the Operator should manoeuvre the RWC to the patient, reduce the throttle as much as possible, while maintaining momentum and use brief throttle inputs to maintain steering control if required, ensuring that the RWC remains heading into the conditions.
17. Once the patient is positioned along the port (left) side of the RWC, level with the Operator, the Operator grasps the patient’s left wrist issuing the command “grab my wrist”.
18. Once the Operators has made contact and secured the patients left wrist, the Crewperson will release the patient and with their left hand, reach for the first rung on the rescue sled.
19. The Operator will then guide the patient to the sled.

*NOTE: To perform the pickup, it is essential to step your left leg to the rear of the footwell, to ensure enough reach to land the patient onto the rescue sled. The Operator acts as a pivot, keeping their arm outstretched and leaning back to guide the patient to the sled. This is important to ensure the patient clears the back of the RWC.

20. The Crewperson should reach under the patients’s back with their right hand and grab hold of the third rung down on the rescue sled. At no time should the Operator let go of the patient’s wrist during the pickup.
21. Once the patient is onboard the sled, the Crewperson will board the sled.
22. The Crewperson should secure the patient by positioning their bodyweight over the patient, with their knee in between the patient’s legs. The Crewperson will slide their hands under the patient’s armpits, grabbing the centre two handles.
23. When the patient is appropriately secured the Crewperson will notify the Operator.
24. During the rescue, the Operator must ensure the RWC is facing the prevailing conditions and communicate via radio to provide an update on the patient’s condition and request assistance, if required.
25. The Operator will take the shortest and safest route back to shore and ensure the safety of the patient and Crewperson by conducting regular visual checks.
26. On reaching the beach, if the patient is conscious, the Operator should turn the RWC to face the prevailing conditions in shallow water and instruct the Crewperson to assist the patient off the sled and to safety.

If the patient is unconscious, or other factors require the Operator to beach the RWC, the Operator will instruct the Crewperson that they are about to beach, commanding “Brace, Brace, Brace”.

27. Once on the beach, the Crewperson will begin preparing the patient for transfer if necessary.
    

Rock retrieval/offloading

RWCs can be an effective tool for operations in areas with coastline that is difficult to access, this may include operations around rocks. If required to operate near rocks, the RWC Operator should take care in the approach to a rock or cliff face as hazards could be hidden or beneath the water line. Your safety is the highest priority.

Only attempt this rescue if it is safe to do so and within the craft and your limitations. Prior to undertaking the rescue, the Operator should consider:

• Ocean Conditions: Evaluate the current and wave patterns. Strong currents, rough waters and water clarity can complicate the rock retrieval process.
• Weather Conditions: Consider the direction and strength of wind, rain and visibility, as these can impact safety.
• Geography: Understand the location of rocks and potential hazards, including underwater obstacles and rock shelves.
• Communication: Ensure all involved have been briefed on the planned operation to ensure mutual understanding. Attempt to make verbal contact with the patient prior to attempting the rescue.

Operational Techniques:

• Approach and Manoeuvring: Time the approach in line with your conditions assessment. Approach the rocks carefully and avoid sudden movements that could destabilise the craft. Slowly turn the RWC to face the craft into the oncoming conditions.
• Positioning the craft: Position and distance of the craft from the rocks will depend on the environmental conditions and communicated retrieval / offloading requirements.
• Presenting the sled: Carefully position the sled toward the rock shelf, keeping in mind the oncoming ocean conditions.
• Retrieving or Offloading: Should be done in between oncoming swells, this ensures a higher level of craft stability. Ensure no Crewperson or patients are caught directly between the craft and the rock shelf.

Vessel to Vessel Transfer

Vessel to vessel transfers can be an effective tool to evacuate a patient for further care or transport, particularly in locations were returning to land is not a suitable option due to conditions, terrain or location. Vessel to vessel transfers are best done while moving to maximise stability.

The Operator should contact the vessel master prior to attempting a vessel transfer. Both the RWC Operator and Vessel Master should coordinate a plan. The following should be considered prior to approach:

• Prevailing Wind
• Vessel’s type
• Sea Conditions
• Other equipment available

Care should always be taken to ensure that limbs and body parts are not between the two craft to avoid the risk of crush or amputation injuries.

It is recommended, that where this is a regular occurrence, adequate training should be conducted with relevant response vessels and stakeholders.

If available, refer to local SOP’s and training, on how to conduct Vessel to Vessel transfers.

*NOTE: Where the patient transfer involves larger boats, a vertical lift may be necessary and may even involve the use of a rope sling if the vessel is adequately equipped. Where such a lift must be utilised, it is important to secure a rescue tube to the patient, so that in the case of an accident the patient will remain afloat.

A vessel to vessel transfer may also be used when the RWC Operator needs to collect a Crewperson to assist in performing a rescue. Where applicable this skill should be practiced.