TLDR: On a remote and hazardous island known for its dangerous surf, marine life, and limited emergency services, a swimmer went missing, prompting a rescue operation. Bystanders initially performed CPR, and despite communication challenges, lifeguards and paramedics coordinated effectively, with two rescue helicopters aiding in the patient's successful recovery. The incident highlighted the need for better preemptive safety measures, improved communication infrastructure, and thorough staff familiarization with the area to enhance future emergency responses.

The story below comes from a rescue I was involved in two years ago on a remote island and rugged destination known for its stunning natural beauty and adventurous spirit. (location and name of writer redacted). This island, largely untouched by development, poses several risks to visitors. Its hazardous surf conditions, characterized by strong currents and unpredictable waves, make swimming perilous, especially for the inexperienced.

The island is also home to dangerous marine life, including sharks and jellyfish, which can pose significant threats to swimmers and divers. On land, visitors must be cautious of venomous snakes and spiders that inhabit the island. The intense heat, particularly in the summer months, can lead to dehydration and heat-related illnesses. Compounding these dangers is the island's remoteness and limited emergency response capabilities, which mean that help can be slow to arrive in case of an emergency. This combination of natural hazards and isolation makes the island a beautiful yet potentially perilous destination for those unprepared for its challenges.

This island is manned by a few lifeguards during the busy summer periods. There is no designated swimming area and the lifeguards perform surveillance/roving patrols throughout daylight hours. Over the 6-week summer period, lifeguards at this location perform between 20-30 rescues per day including minor and major first aids. There is no hospital on the island. Ill patients are required to be treated on the island by lifeguards or by one of two paramedics on the island. Any critically ill patients' will be picked up by rescue helicopter or a boat via marine rescue. 

1. What was the call?

We received a call about a missing swimmer reported by members of the public. The swimmer was last seen entering the water in 6ft surf for a snorkel but had not returned to the beach. The location was 25 minutes north of our lifeguard station by car and 20 minutes by jet ski. The distress call came through to the ambulance officer on the island, who picked me up. We proceeded code 1 (lights and sirens) to the location. The paramedic picking the lifeguard up and driving with them is not normal practice. Due to the potential of the swimmer still being in the water, he decided it would be beneficial. During the journey our jet ski was also tasked to the scene because it was unknown if the swimmer was still in the water. Although the jet ski operator was a veteran, it was his first day at this location, and he had to navigate to the site independently while still in the middle of his familiarization. Upon arrival, we found the patient had been washed ashore 500m north of his entry point, with bystanders performing CPR and others rescuing his friend, who had jumped in to save him. Due to the remoteness, radio communications with our dispatch to request a helicopter were limited. Consequently, two rescue helicopters were dispatched. Advanced life support was initiated on the patient by myself and the paramedic, leading to a successful outcome for the patient.

2. What actually happened?

         When we arrived at the scene, bystanders had already performed a heroic rescue by pulling the patient from the water and beginning CPR. Communication was challenging due to limited radio and phone reception, leaving us uncertain about the specifics we were walking into. Despite these hurdles, our team quickly assessed the situation and took over revival efforts from the good samaritans. We coordinated with other emergency services, including the dispatch of two rescue helicopters, which played a critical role in ensuring the patient received advanced care and was transported to a trauma center.

3. What went well?
 

The interagency communication was effective, and the response time was swift. The decision to dispatch the jet ski operator, even though he was new to the location, was crucial. His experience ensured he could navigate to the site quickly despite his unfamiliarity with the area. The coordination between lifeguards, ambulance services, and helicopter units was seamless, leading to an efficient rescue operation and a positive patient outcome.

4. What didn’t go well?

We missed an opportunity for proactive safety measures. We should have conducted an early morning rove patrol to this location to inform vacationers about the hazards. This would have been particularly useful in preventing such incidents, especially in a remote area known for strong surf and unpredictable conditions. The limited radio communication also posed a significant challenge, delaying the coordination of resources and response.

5. Why did it happen?

The successes were largely due to our team's training and willingness to collaborate and communicate effectively during the incident. Our ability to adapt quickly helped us manage the case efficiently. The challenges, however, stemmed from environmental factors such as the remote location, radio black spots, and the lack of pre-emptive patrols. These factors, combined with the inexperience of the jet ski operator at this particular location, contributed to the initial confusion and delays.

6. What can be improved?

To improve future responses, we should ensure all staff undergo a thorough induction, including familiarization with maps and potential hazards of their designated areas before starting their duties. Enhancing our communication infrastructure to address radio black spots is crucial. Implementing regular early morning patrols during high-traffic periods can help identify and mitigate risks before they result in emergencies. Additionally, continued training on interagency coordination and scenario-based drills will further enhance our preparedness.

7. What do you wish you had known prior to this call?

         Knowing about the radio black spots and the exact travel time to the location would have allowed for better preparation and coordination. With this information, we could have planned our approach more effectively, ensuring faster response times and more efficient use of resources. Understanding these factors beforehand would also have helped us anticipate potential communication issues and address them proactively, improving overall response efficacy.

Takeaways from the Lifeguard and organization:

1. Staff Induction and Training:
   • Conduct comprehensive inductions for all new staff, including detailed briefings on maps and local hazards.
   • Scheduled regular training sessions focused on navigation, communication, and emergency response scenarios.
2. Communication Upgrades:
   • Investment has been made in better communication tools and infrastructure to eliminate radio black spots.
   • Ensure all team members are familiar with alternative communication methods in case of equipment failure.
3. Proactive Safety Measures:
   • Initiate early morning rove patrols during peak periods to identify and mitigate hazards.
   • Increase public awareness through signage and direct communication about potential risks in the area.
4. Interagency Coordination:
   • Enhance coordination protocols with other emergency services to streamline responses.
   • Conduct joint training exercises to improve teamwork and communication during multi-agency responses.

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