Every day in the United States, an average of 13 people drown, compared to nine who die from fire. Drowning is one of the leading causes of accidental death in the United States. About 4,000 people of all ages die every year from it, and that number doesn't include the 700 who die from drowning in boating accidents, because the Centers for Disease Control and Prevention classifies them differently. Drowning also is the second-leading cause of accidental death in children ages 1 to 15, after motor-vehicle accidents.

Water operations long were the sole responsibility of police agencies; for fire departments, they were considered primarily recovery operations. This was the case until emerging data showed cold-water near-drowning victims could survive extended periods of time underwater. After that, dedicated and well-trained dive-rescue units emerged in fire-service agencies across the country.

Dive-Rescue Developments

In the 1970s, the few fire departments capable of responding to open-water drowning events were mostly ill-equipped and trained only to civilian open-water SCUBA certifications. Last-seen points (LSPs), zero-visibility environments, swiftwater diving and specialized search equipment use weren't even considered. Predictably, a high number of public-safety personnel, both police and fire, became casualties of poorly planned and executed recoveries. And operations truly were recoveries, because it was rare for resuscitation efforts to be initiated for someone who had been submerged for any length of time.

One seminal event helped change how the public looked at near-drowning victims and the possibility of resuscitating them — and it happened to be televised.

During the winter, a young boy had been riding on the back of his father's motorcycle when they lost control and went into a roadside pond. The water was mostly frozen over and very cold, and the boy was underwater for more than an hour. Chicago Fire Department divers entered the icy water and found the boy, and aggressive EMTs restored his cardiac and respiratory function. At the hospital, emergency-room staff worked quickly to resuscitate the boy, who eventually made a full recovery.

While some called it a miracle, clearly there was some scientific reason the victim recovered without profound brain damage or other debilitating medical problems. Now we know the effects of cold on the body and how it reacts even after breathing and cardiac activity have ceased. In fact, cold environments are now used in clinical situations to assist medical personnel in preserving and sustaining patients undergoing long, complex operations.

Studies show near-drowning victims have the best chance of being revived if the water is cold, fresh (i.e., non-saltwater), and not polluted. There are other key factors. Significant trauma, from a motor-vehicle accident for example, is a contraindication of successful resuscitation. Also, the younger the victim, the better the chance for survival. And if the “Mammalian diving reflex” kicks in or the submersion is considered a dry-lung drowning, the statistics become more favorable.

Successful Teams

The assistance and expertise the fire service already provides in several technical-rescue disciplines make it a pretty good fit for water rescue.

While there are very successful volunteer and non-fire-service dive-rescue teams, the large majority of 24/7/365-capable units are either dedicated rescue companies, such as those in New York City, Los Angeles County and Seattle, or use the automatic-aid model employed by a large number of suburban and rural departments.