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 caught in the surf zone and is in imminent danger.
• Other efforts to get the patient onto the sled have been unsuccessful.
  

To perform the rescue:

1. On approach the Operator will direct the Crewperson to where the patient is and will count them in 10m, 5m, 4m, 2m, and 1m.
2. At the 1m count, the Crewperson will slide off the back of the sled keeping hold of the last handle on the sled on the inside of the turn. This rescue can be performed on either side of the RWC.
3. When the Operator is in arms reach of the patient contact can be mad. The Operator will turn the ski and put it into reverse so that the sled is offered up to the patient. The Operator will then select neutral and manoeuvrer the craft as required.
4. The pickup is performed by the Crewperson ‘scooping’ the patient and getting them centred in the arch of 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 bodyweight over the patient with knee in between the patient’s legs. The Crewperson will slide their hands under the patient’s armpits, grabbing the centre two handles.
7. When the patient is appropriately secure the Crewperson will notify the Operator. 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.
8. 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. If a wave must be navigated, the Operator will instruct the Crewperson to brace by shouting “Brace, Brace, Brace.”
9. 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.
10. If the patient is unconscious, or other factors require the Operator to beach the RWC, as the RWC approaches the beach, the Operator will instruct the Crewperson that they are about to beach, again shouting “Brace, Brace, Brace.”
11. Once on the beach, the Crewperson will begin preparing the patient for transfer if necessary.
    

Leg Lock with Crewperson

Insert photo of positioning sequence

TO BE REWRITTEN AS A CREWPERSON PICKUP

This rescue can be used when:

• Patient is conscious or unconscious
• Patient is larger than the Operator
• Other efforts to get the patient on to the sled have been unsuccessful
• Rescue is in suitably calm conditions
• Can be performed with or without a Crewperson
  

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 with a solo rescue, obtain a Crewperson or abandon the rescue to maintain your own safety.
3. If leg lock is identified as the suitable rescue technique, the Operator makes contact by securing the patient and then exit the side of the RWC, whilst ensuring they maintain contact with the RWC by holding on to the gunwale of the RWC.
4. Once in the water, the Operator should roll the patient onto their back, so their airway is clear.
5. To perform the pickup the Operator then needs to lock onto the patient by hooking knees under the patient’s underarms and securing with ankle cross or small amount of inward pressure
6. The patient should be positioned face up on the rescuer’s backside/thighs.
7. The Operator legs should be kept bent, pulling their heels towards their backside.
8. The Operator moves to rear of ski and back of the sled, grips the rescue sled handles on each side and pulls chest up the rescue sled.
9. Once the Operator has grip on sled with hands on handles and forearms stable on sled, take hold of one of the patient’s wrists to secure patient.
10. Then, with the Operator knees on the bottom of the sled, in one movement: raise hips upwards, allowing the patients head and back to release and drop fully onto the sled, releasing the Operator from leg lock position.
11. With wrist secure after release of the leg lock, move to top of sled seated position, lifting the patient to take up the unconscious position and return to shore for transfer and call for assistance.
12. Should a leg lock be used by a Crewperson, they should return to unconscious crewing position, on top of patient with knee between legs, before communicating to Operator when safe to move off.
    

Aided Rescue with Crewperson

Insert photo of positioning sequence

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.

*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. The RWC Operator will steer the safest course through the surf to reach the patient, dropping the Crewperson as close to the patient as possible.
2. The Crewperson should be ready with swim fins on (as required).
3. 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) and commanding “patient on the left in 5 metres, 3 metres, 2 metres, 1metre” and then signal to indicate when it is safe for the Crewperson to leave the sled.
4. On exiting the sled the Crewperson should signal “all clear/ OK” to the Operator.
5. The Operator will move off to 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.
6. 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.
7. The Crewperson will need to signal to the RWC for pickup and position themselves surf side of the patient their left hand holding the patients’s left elbow above the waterline.
8. The Operator will acknowledge the Crewpersons signal and make their way out to complete the rescue.
9. Approach the patient safely as the conditions allow, maintaining a safe distance.
10. To maximise time for pickup the Operator should aim to be approximately one sled length from the patient as a wave passes.
11. The Operator should position themselves with their left leg as far back as possible, to maximize their reach to guide the Crewperson and patient to the sled.
12. The Operator will raise their left arm straight up and issue the command, “Left hand up.”

*NOTE: This rescue is to be conducted at slow speed and may require the Operator to select neutral on reaching down to grab the patient’s arm.

13. To perform the pickup the Operator should manoeuvring 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 to ensure that RWC remains heading into the conditions.
14. Once the patient is positioned along the port (left) side of the RWC, level with the Operator grasps the patient’s left wrist issuing the command “grab my wrist”.
15. Once contact has been made, the Crewperson will release the patient and with their left hand, reach for the first rung on the rescue sled.
16. 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.

17. 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.
18. The Crewpersonr will then need to use their shoulder to flick the patient onto the rescue sled. At no time should the Operator let go of the patients’s wrist during the pickup.
19. The Crewperson will then climb aboard and secure the patient to the sled by sliding their hands under the patients arms, grabbing the centre two handles and placing their knees on either side of the patients knees.
20. Once the patient is secured the Operator can let go of their wrist.
21. The Operator must ensure the safety of the patient and Crewperson by conducting regular visual checks and inform Patrol of intensions.
22. When appropriate, brief the patient on when and how they should disembark the sled.

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. Effort to make verbal contact with the patient prior attempting the rescue should be prioritised.

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 postion 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 that limbs and body parts are not between the two craft to avoid the risk of crush or amputation injuries.

It is recommended, 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, in the case of an accident the patient will remain afloat.

TO ADD: Photos of strops, spinal boards and lifting baskets