Fire Chief: Watery Saves

Byline: Steven Orusa

Public safety diving operations are extremely complex and involve a tremendous amount of risk, but those risks can be eliminated, avoided, shared or mitigated. Because most fire departments don't encounter such operations on a routine basis, they can be categorized as high-risk/low-frequency events. This makes preparation and training even more critical to safety and effectiveness. Most of us do not have enough water rescues or enough of the same type of water rescues to rely on our call volume to prepare us to perform safely and effectively. The same is true for many special operation disciplines.

Risk management is the process of looking into the future, anticipating things that can go wrong and then doing something in the present to prevent them from going wrong in the future. Any risk manager will confirm a systems approach is paramount. From the space shuttle disaster to the E. coli outbreak that affected the beef industry, if we are not using sound risk-management practices, we are gambling with our security.

In public safety operations we use this systems approach in everything we do to ensure the safety and effectiveness of our people. We wouldn't think of sending a firefighter into a house fire without being certified at the basic level, operating at a fire without using the Incident Management System, or not doing a primary survey on a patient. But we put people in harm's way underwater by providing them with training only as recreational divers, despite the necessity and availability of proven and affordable public safety diving systems.

Causes of death

On average, two to three public safety divers perish each year in the United States. If we were to count the drowning of swiftwater rescue personnel, these numbers would at least double. Over a recent three-year period, there were seven public safety diving fatalities: three law enforcement officers, three career firefighters and one volunteer firefighter.

For years, the International Association of Dive Rescue Specialists and Dive Rescue International have gathered information on public safety diving fatalities in an attempt to learn how to prevent these tragedies from occurring. Although they continually monitor and update these statistics, the causes of the accidents for the most part remain the same.

In most cases of a public safety diver fatality, the diver didn't have the proper skill level or equipment for the dive being made. In many instances public safety dive - specific training and operational systems were not in place. Despite having had capability minimums outlined since 1999 in NFPA 1670, Operations and Training for Technical Rescue Incidents, we are still losing public safety divers to the same mistakes year after year.

In about 15% of fatalities, entanglements led to the accident. The lack of proper equipment also contributed to several accidents. Complete equipment failure was rare and did not appear to be the cause of any of the fatalities; however, poor equipment maintenance did contribute to some accidents.

Heart attacks accounted for several of the deaths and were suspected in others, but due to incomplete autopsies following in-water fatalities, the primary cause of death was assumed to be a drowning. It is difficult to determine if these fatalities could have been prevented with an occupational medical examination, although proper physical conditioning could have prevented several of them.

Inadequate SCUBA skills may be the leading cause of public safety diver accidents. In many cases, a problem developed that the diver was unable to solve due to a low basic skill level. In most cases, divers had received either insufficient or non-existent SCUBA skills refresher training after initial certification. Even experienced divers and instructors broke many basic safety rules and made mistakes that were difficult for them to solve.

Early program resources

It's important to note that 86% of the fatalities occurred in recovery mode or training and only 14% in rescue mode. Statistical data gathered over the last four decades supports the fact that we must make some changes to keep divers out of harm's way underwater. Inadequate skills can be offset only by training, which can be difficult to provide in-house when taking on an infrequent response type like dive rescue.

In other special operation disciplines, the fire service has relied on outside programs to help us get started. For example, in the early 1980s when we formally recognized a need for vertical rescue, our first resource was the recreational climbing community. During the research and development of fire service vertical rescue programs, however, we discovered that while we could learn valuable lessons from the recreational climbing community, its members didn't address all our public safety rescue needs. While recreational climbing is challenging and involves risk, it was not the complete answer to our challenge.

From that collaboration evolved specific equipment, knowledge and skills to meet our public safety needs. Over the years we have continuously improved our safety and effectiveness by applying lessons learned through sharing our operational experiences. Additionally, conferences and outside training opportunities keep us abreast of changes in equipment and techniques. Without these relationships we might still be using hemp rope for rescue operations.

In the aforementioned challenge the recreational community was a basic resource for the evolution of safe and effective techniques to meet the needs of public safety. They were a piece of the puzzle but not the entire solution. In much the same way, we have learned and continue to learn from the recreational diving community. But we can't rely solely on them to meet our public safety diving needs.

Beyond recreation

Recreational diving agencies provide safe and effective dive training to the general public. The business model of a recreational SCUBA agency is to teach the client to have fun underwater. But John Q. Public is not performing dives in zero visibility, dives with prolonged bottom times, dives with entanglement hazards, dives requiring heavy physical exertion, or dives at all times of the day and night in extreme weather conditions. That's public safety diving!

Many people have recreational instructor certifications and are teaching their own flavor of diving within the public safety community. Many of our colleagues are recreational dive instructors. In an effort to provide safe and effective public safety dive training, they create or borrow diving techniques from the recreational dive industry and attempt to adapt them to meet the public safety dive needs in their communities.

It is important to note that their recreational teaching outline, which they author, is submitted to their recreational agency but is not evaluated by a public safety diving professional. To my knowledge, there is currently no recreational dive agency that employs a public safety diving professional on their staff. Because of recent fatalities, some recreational agencies have considered revoking such programs from their recreational instructors. Simply stated, the dollars generated from providing public safety dive training are dwarfed by the revenue from recreational instruction, not to mention the increased liability associated with teaching public safety personnel to dive in hostile environments. It isn't difficult to understand why a recreational agency wouldn't want to take that chance.

The intention of these recreational instructors is honorable, and they do an excellent job within the constraints of their respective programs. Nevertheless, there is too much at stake to allow for anything other than the safety of our divers to be paramount. Fire and rescue agencies need to continually strive to make all operations safer by preventing the situations that have historically led to tragedy.

Proper education

Throughout NFPA 1006, Rescue Technician Professional Qualifications, and 1670, Operations and Training for Technical Rescue Incidents, hazard analysis and risk assessment are addressed. One of the most hazardous events a diver can encounter is not being able to solve problems or make decisions underwater.

The typical chain of events in a public safety diving accident is as follows:

*Diver becomes cold and/or tired.

*Diver's stress level, which is already high under such circumstances, increases.

*Diver encounters a hard-to-solve problem or makes a mistake.

*Diver panics.

*Diver is seriously injured or dies.

Managing risk includes mandatory continuing education and skills documentation programs. We must have a systems approach to manage the risk our divers face every time they are operational underwater. If specific systems aren't implemented, the potential for disaster is imminent. There is overwhelming documentation that provides evidence of serious safety concerns when relying solely on recreational training for public safety dive teams.

To alleviate such concerns, training should be provided by a certifying agency that offers the following:

Public safety diving - specific training standards define the degree of excellence of any training program. They are the principles by which the quality of the program is judged. The benchmarks for instruction, equipment, safety, documentation, skill maintenance and conduct must be clearly defined and address the distinctive needs of public safety diving.

Public safety diving - specific curriculum provides clearly defined objectives for each classroom, pool and open-water training session. In some accidents, recreational instructors teaching public safety diving changed training exercises to meet their needs and not the realistic needs of their students. This put the students in a no-win situation with tragic results. A training system with a public safety dive - specific curriculum prevents this from happening.

The curriculum should be developed through years of experience in public safety diving and observations of what does and does not work in the field. The job-specific dive training should be realistic, practical and controlled in a safe environment. The program should reinforce learning through variety as well as repetition, and it should require problem-solving, decision-making and crisis aptitude underwater.

Instruction must be tailored to solve specific problems presented to agencies by their respective water environments. A basic program should include areas such as line tender skills; scene management; risk/benefit analysis; witness interviews; vehicle-in-the-water accidents; and selecting, equipping and training the dive rescue specialist.

Converting a department from recovery to rescue mode capacity, training and equipping personnel for underwater investigations, and assisting departments in development and management of a new dive team should rank among a training agency's achievements. The agency should provide in writing that its training is NFPA-compliant.

Models for standard operating procedures and diving operations manuals. The agency should be a resource for SOP templates from safe and effective public safety dive teams. It should also provide assistance in conducting a water rescue needs assessment for your community and developing public safety diving operations manuals to meet those needs. The agency should have in place programs identifying the functional requirements for creating a basic rescue team or a highly technical rescue team.

Instructors with operational experience. The instructors must be experienced members of a public safety dive team. While recreational instructors and dive shop owners may have good intentions, they do not have the experience or skill level to provide credible public safety diver training programs. In many public safety diving accidents, experienced recreational divers and instructors drowned.

Affordable instructor/trainer programs. Initial training and recertification programs must make good financial sense for the department. No fire department should be held hostage by a certifying agency. Programs should be available to empower the department to control the majority of the training with their own qualified personnel. This is a prudent use of resources and develops team leadership.

Current references. The certifying agency should gladly provide you with a list of other public safety dive teams that use their system. Take the time to check these references. This tool provides valuable insight into the credibility of the program. For example, some agencies have included in their reference list the names of public safety organizations whose personnel have attended a seminar or sought information. There is a big difference between seeking information and trusting an agency to meet the training needs of your organization. A few phone calls can be priceless.

Continued training

With all of these factors in mind, you also should research successful teams throughout the country and use them as a resource. Who do they trust to provide them with a safe and effective public safety dive training system?

Once the dive training program is established, fire and rescue departments must mandate continuing education/skills maintenance as part of the certification program. We have lost public safety divers who had not been in the water for years between the time of their initial certifications and the incidents where they lost their lives. The public safety diver certification must be contingent on the fact that every diver has regularly demonstrated a proficiency level necessary to function safely. We have mandatory continuing education programs in EMS to ensure quality patient care but no mandatory skills maintenance programs to keep our public safety divers safe.

To put it bluntly, if we don't use it, we lose it. Not having the skills necessary to solve problems and make decisions underwater has proved fatal. Being a good public safety diver two years ago doesn't mean you'll function safely and effectively today. Skill levels, if not reinforced, deteriorate over time. You can't crack your mask to take a breath at any depth. We do not have the luxury or the flexibility to be 99% efficient underwater. Mandatory skill checks at 100% efficiency are the answer.

Implementing a public safety dive - specific training system with all the aforementioned components will contribute to the prevention of injuries and loss of rescue personnel in the line of duty. If we are going to commit our people to an underwater environment, we ethically, morally and legally have a duty to prepare them to be effective public safety divers. There is no greater responsibility than safety.

A 19-year fire service veteran, Steven Orusa is the deputy fire chief for the Waukegan (Ill.) Fire Department and a corporate trainer for Dive Rescue International. A member of International Association of Dive Rescue Specialists and Illinois USAR TF-1, Orusa has chaired the Illinois Office of the State Fire Marshal Water Rescue Committee and is a past team leader for the Lake County Specialized Response Dive Rescue Team as well as a former Trident Foundation mission specialist. He has a bachelor of science in law enforcement administration and is completing a master of science in human resource management. The Waukegan Fire Department was the first fire department dive rescue team in the country to receive national accreditation.