Sunday, September 22, 2013

SAFETY PLAN - Emergency plans for recreational diving and snorkelling


Background

Workplace Health and Safety Queensland is issuing a safety alert following instances where recreational diving and snorkelling businesses have failed to respond effectively, efficiently and in a timely manner to an emergency situation.
Persons conducting a recreational diving and snorkelling business or undertaking must ensure that they are prepared to respond to an emergency situation. This must include supervising personnel, equipment and systems in place to:
  • recognise relevant hazards
  • recognise divers and snorkellers in difficulty
  • undertake a rescue
  • provide first aid, including CPR and oxygen resuscitation.
Persons conducting a business or undertaking (PCBUs) should have written emergency plans that are readily available to all workers. Workers should be trained so that that they are familiar with these plans. Plans should be developed for the following emergency situations:
  • first aid
  • rescue
  • evacuation
  • missing persons.

Recommendations

PCBUs should develop emergency plans relevant to their business. Existing emergency plans should be reviewed to ensure they are effective and efficient. Sample emergency plans are attached in Appendix A.
Below is advice to assist in reviewing control measures.

A. Emergency plan review

All plans

  • Plans should take into account the range of operational variables associated with a particular business. These may include:
    • activity type
    • customer types
    • employee numbers and competence
    • equipment available
    • environmental variables.
  • Plans should give specific directions to follow whilst allowing flexibility to address operational variables.
  • Plans should be developed through consultation with relevant employees and external service providers, including emergency service providers.
  • Plans and other procedural documents should detail specific duties, employee competencies, equipment required and procedures to be followed.
  • Practical testing of plans will assist in determining whether plans are efficient and effective.
  • Emergency plans should be reviewed periodically to ensure they continue to be effective and efficient. Internal and external consultation will assist in this process.

Missing persons plan

  • The plan should specify the triggers used to identify a missing person situation (Note: accurate information recorded on a dive safety log, which is monitored by a dive supervisor during diving, will assist in identifying missing diver situations).
  • The plan should list initial actions undertaken when a missing person situation is suspected and subsequent actions if it is confirmed.
  • Prompt recall and headcount procedures may assist in clarifying the situation and will allow persons at the site to be questioned regarding any sightings of the missing person/s.
  • The plan should include fixing a datum point for searches at the last known location of the missing person/s.
  • The plan should include a timeframe for notifying the emergency services. This timeframe should reflect the isolation of the site, response times, and the time of day.
  • A record should be made of all actions undertaken.
  • Many missing person situations are associated with currents. The timely deployment of a clearly visible marker buoy, configured to drift with any current and deployed at the datum point, may assist with subsequent searches.

Rescue plan

  • To develop a rescue plan, the following factors should be considered:
    • size, type and location of the site
    • appropriateness of the procedures to the site
    • adequacy of communications systems including between workers and with emergency services
    • location, skills and fitness of workers
    • availability, location and appropriateness of rescue equipment such as boards, tenders, flotation devices, lifting equipment and ropes. All equipment should be ready for use with a minimum delay. For example powered rescue tenders should be in the water and ready for immediate use.
  • Rescues should not be undertaken by one person unless they are physically able to undertake the rescue.
  • The plan should specify how the transfer of an injured person will occur, from water to vessel, vessel to vessel, or onboard vessel.
  • The rescue procedures should not cause excessive delay in the provision of first aid.
Note: Remember, lack of oxygen for as little as three minutes can lead to permanent brain damage.

Evacuation plan

  • The evacuation plan should specify how communication is to be maintained with any emergency services.
  • The plan should ensure the effective and timely transfer of an injured person from the activity site to emergency or other medical services, and the maintenance of first aid.
  • First aid during transfer.
  • Consideration should be given to the safety of any persons, vessels and aircraft used in an evacuation.

First aid plan

  • First aid kits should be sufficient to cater for the types of incidents that may occur and the numbers of participants. Consideration should be given to the equipment required for near drowning, lacerations, cardiac events, unconsciousness, sea sickness stings and sunburn.
  • Workers should be available at the surface on the site and have current training to use the available equipment
  • Oxygen equipment should be suitable for both breathing and non-breathing persons.
  • Oxygen equipment should be checked daily and sufficient oxygen should be available taking into account the isolation of the site.
  • An assessment should be undertaken to determine whether an automatic electronic defibrillator (AED) and trained operator should be available. Factors to consider include:
    • the safe use of the AED
    • the age profile of divers and snorkellers
    • access to emergency services
    • available personnel
  • The configuration of the workplace, including vessel and tenders, should ensure adequate first aid can be provided.
Note: Remember, lack of oxygen for as little as three minutes can lead to permanent brain damage.

B. Training

To assist in making sure workers are familiar with emergency plans, a system of training should be developed and implemented.
The training should include:
  • induction training for new employees on all emergency procedures
  • ongoing training, such as periodic emergency drills held on a monthly rotational basis.
The nature of diving and snorkelling emergencies lend themselves to practical as well as theoretical drills.
Appropriate records should be made of training that includes the date, the training undertaken, the trainer and trainee's names.

Appendix A

Example missing diver or snorkeller plan

General

In the event of any type of accident or emergency:
  • do not risk further injury to any other person under any circumstances
  • contact Emergency Services as soon as possible for assistance
  • do not panic, work as a team, communicate.

Duties

Dive/snorkel supervisor

  • Dive/snorkel supervisor notified of missing person (e.g. advised from customer, lookout report, dive safety log, head count).
  • Advise vessel master and lookout of missing person.
  • Assess degree of urgency. Consider time overdue, remaining daylight, dive plan and objectives, possible decompression and air status.
  • Recall other divers and/or snorkellers.
  • Record:
    • where and when last seen (ask dive/snorkel buddy)
    • dive details
    • what diver was doing, direction swimming
    • any obvious problems
    • maximum depth reached
    • last known gas pressure and likely gas consumption rate
    • diver’s likely action in the event of a buddy separation, and
    • where you surfaced relative to the position you last saw the other diver.
  • Mark last known location (GPS and shot line).
  • Deploy current/drift marker.
  • Organise as appropriate:
    • other persons to assist lookout
    • in water surface search using snorkel pairs
    • underwater search using buddy pairs
    • complete incident records
    • assume appropriate duties of the vessel master when shore diving (see below).
Note: An underwater search should only be undertaken where there is both a reasonable chance of being able to rescue a diver and where there is no additional risk to the rescuing divers. Examples of unacceptable risks include insufficient gas supply, hypothermia, wreck penetration, solo diving, and exceeding decompression limits.

Lookout

  • Continue searching surface for bubbles, along the shoreline, floats, signalling devices or divers.
  • Use binoculars, polarised sunglasses and customers who have returned to assist searching.
  • Observe current/drift marker and record bearing and speed of drift.
  • Scan 360 degrees, including checking areas previously searched.
  • Consider local current movement and possible changes.
  • Once the diver is spotted, do not lose sight of them.
  • Report to dive/snorkel supervisor.

Vessel master (or dive/snorkel supervisor if no vessel master)

  • Immediately notify emergency services and local vessels for assistance once missing diver/snorkeller emergency established:
    • VHF ch 16 Pan Pan
    • 000 Rescue Coordination Service and Water Police (refer to emergency contacts list).
  • Check that the missing person has not left the area or boarded nearby boats.
  • Assist with, or undertake search, as directed.
  • Maintain a running log of events and times in the ship's log.
  • Liaise with dive/snorkelling supervisor.
  • Advise emergency services and assisting vessels at conclusion.

Example rescue plan

General

In the event of any type of accident or emergency:
  • do not risk further injury to any other person under any circumstances
  • contact Emergency Services as soon as possible for assistance
  • do not panic, work as a team, communicate.

Duties

Dive/snorkel supervisor

  • Assist rescuer.
  • Recall divers/snorkellers if required (e.g. evacuation required or no lookout available).
  • Undertake headcount.
  • Set up oxygen and get first aid kit.
  • Assist egress and commence/assist first aid as necessary.
  • Complete incident records.
  • Assume appropriate duties of the vessel master when shore diving (see below).

Rescuer

Assess rescue options - Safe, quick, effective.
  • Tender:
    • rescuer and one other crew in tender
    • take radio and resuscitation mask
    • proceed to person
    • remove weight belt and scuba unit if necessary
    • egress into dive tender - lift or roll technique, horizontal if possible
    • assess and return-airway maintenance and commence CPR if required.
  • Main vessel:
    • assist master of vessel to do rescue from main vessel as from tender.
  • Throw/swim:
    • rescuer throws float line to assist in pulling person to main vessel, OR
    • rescuer enters water and assists person to main vessel
    • rescuer assess injuries and advise vessel
    • return to main vessel giving first aid if required
    • maintain airway and provide rescue breaths as necessary, and
    • rescuer and other persons lift person onto main vessel - horizontal if possible.
  • Move to assessment and first aid position - use stretcher and team lifting techniques. (If practical, retrieve scuba unit for any investigations).

Lookout

  • Advise dive/snorkel supervisor and others that a rescue is required.
  • Attempt to determine if conscious or unconscious.
  • Keep the person in sight at all times.
  • If the boat has to manoeuvre, advise the master of any snorkellers/divers and warn them to keep clear of the boat.
  • Look out for divers and snorkellers surfacing.
  • Assist as directed.
  • Commence running log.
  • Reassure and direct other passengers.

Master of vessel

Main vessel used for rescue:
  • attach a float to the mooring line to act as a datum and for others in the water, or deploy a shot line if anchored
  • when approaching the person, remember the following:
    • sound air horn to alert people to move clear of the boat and motors
    • approach at a safe speed; be careful not to run into anyone
    • approach from downwind if possible, so the boat is not blown over victim
    • be careful boat is not blown or swept by current into a dangerous area, and
    • place the motor into neutral when you are close to and are recovering the person (or any other divers/snorkellers).
  • assist rescuer
  • contact emergency services (refer to Emergency Contacts list)
  • prepare vessel for evacuation/transfer.

Example first aid plan

General

In the event of any type of accident or emergency:
  • do not risk further injury to any other person under any circumstances
  • contact Emergency Services as soon as possible for assistance
  • do not panic, work as a team, communicate.
Note: Most first aid training organisations and diver training organisations publish first aid plans and flow charts. These should follow the current resuscitation guidelines from the Australian Resuscitation Council. These plans should be adapted for use with diving and snorkelling first aid by including procedures for first aid the following matters. Advice for diving injuries can be obtained through the Divers Emergency Service hotline on 1800 088 200.
  • Conscious persons suffering from diving injuries or illness should be kept horizontal wherever possible, including during rescue and evacuation. An appropriate stretcher may assist in this. Unconscious persons should be kept in the recovery position.
  • Oxygen should be administered for all diving and snorkelling related injuries or illnesses using an appropriate delivery device.
  • Cases of possible decompression illness should be referred to the nearest recompression chamber as soon as possible.
  • Signs and symptoms of decompression illness may not be obvious and may appear some time after diving ceases.
  • They may include:
    • pain in joints and muscles
    • unusual fatigue
    • pins and needles (pricking and itching)
    • numbness
    • headache
    • weakness or paralysis
    • dizziness and nausea
    • difficulty breathing, and
    • unconsciousness.
  • A neurological exam may be performed to assist in determining signs and symptoms of decompression illness.
  • If hypothermia is suspected, avoid any further cooling by removing wet clothing (with the possible exception of wet suits) and insulating the diver with warm, wind-proof material(s). The head should be covered. Oral fluids should be warmed, but should only be given to fully conscious persons. A cold diver who has stopped shivering or who is unconscious represents a medical emergency and requires careful handling and urgent evacuation to the nearest appropriate treatment facility.
  • The first aid kit and training should include responses for any local marine envenomation risks.

Duties

Dive/snorkelling supervisor

  • Liaise with first aid provider.
  • Ensure emergency services are notified if required. Seek general or specialised medical advice. (Refer to Emergency Contacts list).
  • Prepare incident information (e.g. dive profile, symptoms) to accompany victim.
  • Complete incident records and secure equipment.

First aid provider(s)

  • Give first aid as required.
  • Monitor and reassure person.
  • Request assistance if required.
  • Liaise with supervisor.

Example evacuation plan

General

In the event of any type of accident or emergency:
  • do not risk further injury to any other person under any circumstances
  • contact Emergency Services as soon as possible for assistance
  • do not painc, work as a team, communicate.

Duties

Dive/ snorkel supervisor

  • Liaise with vessel master.
  • Lead transfer party.
  • Recall all persons to the vessel or shore.
  • Conduct a headcount and ensure no persons are left behind.
  • Prepare incident information (e.g. dive profile, symptoms) to accompany victim.
  • Complete incident records and secure equipment.
  • Assume appropriate duties of the vessel master when shore diving.

First aid provider

  • Give first aid as required.
  • Monitor and reassure injured person.
  • Prepare injured person for transfer without compromising first aid (e.g. secure to stretcher).

Master of vessel (or dive/snorkel supervisor if shore diving)

  • Liaise with dive/snorkel supervisor.
  • Contact emergency services:
    • VHF Ch 16 Pan Pan
    • 000 Rescue Coordination Service and Water Police, and
    • refer to Emergency Contacts list.
  • Contact Divers Emergency Services hotline for advice if required on 1800 088 200.
  • Advise the following:
    • your location
    • number of casualties
    • nature of injuries (e.g. life threatening, DCI, cuts)
    • first aid currently being conducted (e.g. CPR , bleeding control)
    • assistance required.
  • Follow advice of emergency services. Maintain communications with both EMS and any transfer party.
  • Proceed to nearest rendezvous with ship or shore EMS.
  • Prepare for helicopter transfer:
    • manoeuvre as directed
    • secure loose items
    • drop aerials if possible
    • do not attach winch cable from helicopter to any object
    • allow the helicopter winch cable to earth before touching.

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