Q18

EMT Responsibilities in Water-Related Incidents

1. Primary Assumption in Unwitnessed Incidents
   • When an EMT arrives at a water-related incident that was not witnessed, the highest priority clinical assumption is a possible spinal injury.
   • This protocol exists because the mechanism of injury (e.g., diving into shallow water, hitting a submerged object) is unknown.
   • Failure to assume a spinal injury could lead to improper handling, resulting in permanent paralysis.
2. Secondary Considerations
   • Cold-water immersion: A physiological state where body temperature drops. While common, it is treated after or during spinal stabilization.
   • Air embolism: A condition primarily associated with scuba diving (breathing compressed air) rather than general submersion.
   • Alcohol intoxication: A likely contributing factor or cause of the incident, but not a traumatic injury that dictates immediate physical rescue techniques.
3. Protocol Priority
   • EMTs must prioritize manual stabilization and the use of a backboard during the extrication of any patient found in the water where the cause of entry is unknown.