GET OUT FAST!

Audrey Fraizer

Audrey Fraizer

Best Practices

By Audrey Fraizer

Physiologists Gordon Giesbrecht and Gerren McDonald have sunk literally hundreds of cars and trucks in studies involving cold-water submersion as part of their overall research into the effects of extreme environments on the human body.

Results from submerged vehicle studies conducted since 2005 are central to the IAED’s development of the Sinking Vehicle Protocol and, later, the creation of the Vehicle in Floodwater Protocol.

Giesbrecht shared his insights at NAVIGATOR 2014, and led discussion about modifications to the Sinking Vehicle Protocol based on his research.

Escapable or inexplicable

The call is unnerving and uncomfortable to hear. Karla Gutierrez is alone in a car that is sinking into a canal off the Florida Turnpike in West Miami-Dade County on Feb. 16, 2001.

The 32-year-old woman successfully reaches 9-1-1. But the calltaker is unable to provide help beyond trying to reassure the caller that response is on the way if she can only provide her location.

“Relax, honey,” the calltaker says repeatedly in the 3 1/2 minutes before the car is submerged. “We need to know where you are.”

The story does not end well. Gutierrez is dead by the time divers are able to reach the submerged vehicle.

A second example is no less chilling. Lisa Roswell pleads for assistance. Water is up to her knees, then her waist, and the car is “wiggling” in the floodwaters that are sweeping her small car into a creek in northeast Ohio.

“I don't know what to do,” Roswell says. “What if it gets up to my neck?”

“You should be uh ... They should be able to get to you before that,” the calltaker replies.

Fire crews arrived in three minutes, just long enough for the waters of Cole Creek to swallow Roswell’s car. She drowns inside the submerged car on Feb. 28, 2011.

The two deaths, though tragic, were not extraordinary.

According to statistics compiled by Giesbrecht, 400 people in North America die each year in submerged vehicles, accounting for 5 to 11 percent of all drownings. About half of people that Giesbrecht polled, as part of a study, would let the vehicle fill with water before attempting to exit. It’s the way we’ve been taught despite a lack of evidence supporting the ideas and practices, he said.

“In Florida, we were taught to stay in the car with the windows up and wait for the air bubble and then open the door and leave,” said Giesbrecht, who grew up in the state. “But it’s these types of incorrect and inadequate escape instructions provided by authorities or believed by the public that most probably contribute to the drownings.”

Incident leads to studies

Giesbrecht began his research into vehicle submersion nearly a decade ago after testifying at the inquest of a snowplow driver who died when his vehicle broke through ice on a lake. The event sparked his scientific inquiry.

Although Giesbrecht focused his expert opinion during the investigation on the driver’s potential for survival in the frigid waters, subsequent testing with a five-ton snowplow showed that the victim would have drowned regardless of water temperature. The issue, he theorized, was the lack of an escape route.

Studies point the way

Giesbrecht published a seminal study in 2010 in which he used a crane and two passenger vehicles of the same make, model, and year—one with the passenger compartment intact and one with holes in the floor—to conduct occupied and unoccupied submersions.1 The research redefined the flotation phase of a submersion event, clarified the best options for occupant survival, and identified other countermeasures.

According to the findings, there are three phases to submersion: floating—vehicles floated for 15 to 63 seconds before the water reached the bottom of the side windows; sinking—the subsequent period until the vehicle is completely under water, but before it fills completely; and submerged—the vehicle was full of water and several feet below the surface.

Their research led to the founding of Operation ALIVE (Automobile submersion: Lessons In Vehicle Escape) and the formulation of escape and emergency response strategies.

The authors have pushed public education focus on immediate self-rescue through side windows during the floating phase and, also, 9-1-1 response protocols developed specifically for vehicle submersion cases.

Dispatch protocol follows

Giesbrecht’s research caught the attention of Priority Dispatch Corp.™ Fire Consultant Jay Dornseif and in 2010 collaborations began on refining the original Sinking Vehicle Protocol released in 2008.

The approach at that time lost precious time for callers.

The bottom line, corroborated by research, is taking action, rather than waiting for rescuers to arrive, Giesbrecht said.

“You have about a minute to get out of a vehicle that’s sinking, or you will drown,” he said. “Any longer and it’s probably too late.”

The existing protocol was modified, directing the calltaker to give Pre-Arrival Instructions (PAIs) with the calltaker focusing attention on instructing the victim to open or break the windows and exit the vehicle as quickly as possible. The primary immediate steps are:

•Seatbelts (unfastened)

•Windows (open)

•Children released from restraints and brought close to an adult

•Out, with children exiting first

Continued discussions over the years have led to enhancements in existing protocol, including guidelines to escape a vehicle carried away in floodwaters.

The rule of thumb in a sinking vehicle is to get out NOW, he said; while a car stranded in water—not moving and not sinking—lends to a more controlled escape from the car and waiting for rescue to arrive from a position on top of the vehicle.

Points to remember

According to Giesbrecht’s primary rules2:

•The dispatcher must weigh the facts of each situation, as conditions may change rapidly (sinking, wet phone problems, car rolling over, car upside down, car moving in the current), and, consequently, must navigate among the most appropriate advice items in the protocol.

•At some point the phone will likely short out; this can happen at any time. Certain instructions must be given early in the instructions sequence prior to losing contact with the caller to prepare the person as much as possible for the escape attempt.

Giesbrecht said not everyone can be saved from a vehicle submerged in water, despite the calltaker’s best attempts at providing instructions.

But that doesn’t mean giving up while the occupant is still on the line.

“There are things you can keep doing to help,” he said. “And continuing to give instructions is infinitely better than telling the occupant to sit calm and wait for someone to come to the rescue.”

Sinking Vehicle Protocol

The Sinking Vehicle Protocol is identical in all three of the Priority Dispatch Systems: Police Priority Dispatch System (PPDS), Fire Priority Dispatch System (FPDS), and Medical Priority Dispatch System (MPDS). Each system’s code provides agencies with the ability to plan the most appropriate response configuration for a sinking vehicle emergency based upon the resources within their jurisdiction.

The PPDS and FPDS address sinking vehicles with a caller inside through a direct Dispatch Life Support (DLS) Link from Case Entry. The PPDS codes the call a 131-E-1, and the FPDS codes it a 72-E-1. Case Entry Protocols link directly to PAIs for a sinking vehicle. In MPDS Protocol 29, the dispatcher moves from Case Entry, but does not ask any Key Questions. The call is coded a 29-D-2 and links to the Sinking Vehicle PAI Protocol. =

Sources

1Giesbrecht GG, McDonald GK. “My car is sinking: automobile submersion, lessons in vehicle escape.” Aviat Space Environ Med. 2010. 81:779–84. http://www.ncbi.nlm.nih.gov/pubmed/20681239 (accessed July 25, 2014).

2Giesbrecht, GG. “Improved emergency response to reduce vehicle drownings.” 2013; March 15. http://www.swfltim.org/Docs/Submerged%20Vehicle%20Presentation.pdf (accessed July 25, 2014).