Understanding and following the “Talk, Reach, Throw, Row, Go Tow” approach ensures that EMS Providers prioritize safety and efficiency during water rescues.
Each step is designed to minimize risk while maximizing the chances of a successful rescue. Here is a overview of these principles:
1. Talk
Overview: The first step in any water rescue is to establish verbal contact with the victim. This is a crucial initial approach as it avoids placing the rescuer in danger while offering immediate assistance.
Purpose: Engaging with the victim verbally can calm them down, offer reassurance, and direct them on what to do until further help arrives. It’s especially effective if the victim is conscious and within earshot.
Implementation:
Calm the Victim: Use a confident and reassuring voice to reduce panic. Simple commands like “Stay calm,” “Float on your back,” or “Kick your legs toward me” can make a significant difference.
Assess Victim's State: While talking, gauge the victim's physical and mental status, identifying signs of distress or fatigue.
Instructions: If safe, guide them toward a nearby safe zone or floating device. Sometimes, victims can self-rescue if given clear, step-by-step instructions.
2. Reach
Overview: This involves using an extended object such as a pole, branch, or specialized rescue tool to reach the victim while the rescuer remains on solid ground or a stable surface.
Advantages: Keeps the rescuer out of the water, minimizing risk.
Techniques:
Secure Position: Ensure a stable footing or a firm hold on a structure before extending an object to the victim.
Encourage Victim to Hold: Guide them to grasp the object securely before pulling them to safety.
3. Throw
Overview: If the victim is beyond reach, throwing a buoyant object (such as a life ring, rope with a float, or even a makeshift floatation device) is the next option.
Key Points:
Accurate Throw: Aim for the throw to land close to the victim without hitting them.
Communication: Maintain eye contact and provide clear instructions, like “Grab the rope and hold on tight.”
Steady Retrieval: Once the victim has secured the object, slowly pull them to safety, avoiding jerky movements that could cause them to let go.
4. Row
Overview: When a victim is too far for a reach or throw, using a boat or flotation device to approach them is the safest option before entering the water.
Execution:
Boat Handling: EMS providers should be familiar with operating small boats, kayaks, or other flotation devices and should always wear personal flotation devices (PFDs).
Maintain Safety: Keep an eye on currents, waves, and potential obstacles. Approach the victim from downstream or downwind to avoid drifting into them uncontrolled.
Steady Approach: Row steadily and communicate with the victim, preparing them to grab the edge of the boat or flotation device.
5. Go
Overview: This is the most hazardous option and involves entering the water to rescue the victim directly. EMS Providers should only attempt this step if they are properly trained in water rescue techniques and have necessary safety equipment.
Preparation and Equipment:
Wear a PFD: Ensuring the rescuer’s safety is paramount. A PFD reduces the risk of the rescuer becoming another victim.
Rescue Aids: Bring a floatation device or rescue tube to aid in keeping the victim buoyant.
Techniques:
Approach Cautiously: Swim with strong, controlled strokes and avoid sudden movements that might startle the victim.
Contact Rescue: If the victim is panicking, use techniques to maintain distance until they calm down. Only make physical contact when safe, positioning yourself behind the victim to avoid being grabbed and pulled under.
Backup and Teamwork: Always have another team member on standby, either on land or in a secondary boat, to assist if needed.
6. Go Tow (Advanced Step)
Overview: This refinement of the “Go” principle emphasizes the use of towing techniques where the rescuer enters the water but minimizes direct contact by using a floatation device or rope to tow the victim to safety.
When to Use: The “Go Tow” method is ideal when entering the water is necessary, but maintaining distance from the victim is critical for safety.
Execution:
Secure Towing Equipment: Ensure a floatation device is connected to a rope or line that can be held or attached to the rescuer.
Approach and Transfer: Swim to a safe distance from the victim and pass them the floatation device, maintaining communication to keep them calm.
Tow Position: Once the victim has a firm hold on the device, use a strong swim stroke to pull them back to shore or the boat.
Safety Precautions: Regularly practice towing techniques and ensure proper training to avoid potential risks such as being overwhelmed by the victim’s movements.
Key Points for EMS Providers
Personal and Team Safety: Always assess the scene for hazards like strong currents, underwater debris, or dangerous weather conditions.
Call for Backup: Notify specialized water rescue teams when necessary; collaboration enhances the overall safety and efficiency of the operation.
Training: Continuous training in water rescue techniques, such as swift-water rescue, is vital. Familiarity with tools like throw bags, rescue tubes, and PFDs can significantly enhance rescue capability.
By following these structured principles, EMS Providers can effectively respond to water emergencies while ensuring their safety and the safety of their team.
Further Reading:
Alexander, M. & Belle, R. (2017) Advanced EMT: A Clinical Reasoning Approach (2nd Ed). Hoboken, New Jersey: Pearson Education
Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023) Paramedic Care: Principles and Practice (6th Ed) Boston, Massachusetts: Pearson
Ferrero, F. (2006) Whitewater Safety & Rescue (2nd Ed). Bangor, Gwynedd: Pesda Press
Grayson, S. & Gandy, W. (2011) Environmental Emergencies. EMS World Online. Accessed November 8, 2024.
Limmer, D., O'Keefe, M. F., & Dickinson, E. T. (2020) Emergency Care (13th Ed) - Chapter 31: Environmental Emergencies. Accessed November 8, 2024
Mistovich, J. J. & Karren, K. J. (2014) Prehospital Emergency Care (11th Ed). Hoboken, New Jersey: Pearson Education
Ostis, N. (2015) NOLS River Rescue Guide. Mechanicsburg, Pennsylvania: Stackpole Books
Peate, I. & Sawyer, S (2024) Fundamentals of Applied Pathophysiology for Paramedics. Hoboken, New Jersey: Wiley Blackwell
Schimelpfenig, T. (2021) NOLS Wilderness Medicine (7th Ed). Mechanicsburg, Pennsylvania: Stackpole Books
Ray, S. (2013) Swiftwater Rescue (2nd Ed). Asheville, North Carolina: CFS Press
