By Jonathan Rigolo
June 30, 2011, started out as a typical day for the Virginia Beach (VA) Fire Department. It was a typical day was filled with a number of emergency medical service (EMS) incidents; a few fire responses that turned out to be minor in nature; and, of course, typical daily assignments such as target hazard updates and prefire plans.
I’m a captain assigned to Fire Squad 10, one of two staffed rescues in the department. The other squad (Squad 3) is responsible for hazardous materials incidents as well as typical firefighting and extrication responses. Squad 10 is the lead technical rescue company along with Engine 10 and Tech 1, and also responds to fires, extrications, and EMS incidents.
While out in our first-due area conducting preplan work, we heard the dispatchers call to have our marine units and other ground apparatus to respond to a report of an injury off-shore in the waters of the Chesapeake Bay. The response to this incident included Battalion 2, Fire Boat (FB) 1, Zodiac 1, Engine 4, Ladder 2, and a number of EMS units, including a volunteer boat team. Obviously, a dispatch of that unusual type of incident received our immediate attention. On arrival, FB 1 found a 14-year-old female trapped between the propellers of a 24-foot pleasure craft approximately 200 yards off shore. The weather was not a factor; the swells on the bay were one to two feet with an occasional three-footer. The boat was drifting south toward the shoreline. The trapped girl, wearing a personal flotation device (PFD, was being supported by an adult male later identified as the operator of the boat.
The first-arriving unit was a Virginia Beach Police Department (VBPD) marine unit with one officer on board. The officer placed his vessel alongside the boat with the trapped patient and anchored both vessels to stop the southward drift. A second VBPD marine unit arrived; that officer donned an escape self-contained underwater breathing apparatus (SCUBA) system and began to assist the patient. VBFD Fire Boat 1 arrived shortly after and determined this to be an entrapment that required additional equipment and expertise to mitigate. Squad 10 was requested to respond. While en route, we were assigned a tactical (TAC) channel; this is standard procedure for every incident requiring more than a single-unit response.
On the TAC channel, I asked FB 1 for a description of the situation and the equipment needed for the extrication. The FB 1 captain described a patient trapped in an inboard-style boat propeller. The patient was conscious and alert and had minor bleeding from the leg. This information proved to be partly correct. The type of propulsion system was a Volvo Penta Duo-Prop System. This type of boat-drive system consists of an inboard motor with a outdrive system that has two counter rotating propellers. The patient’s left leg was trapped between the two propellers at the upper-thigh area.
On arrival, Zodiac 1 sent two swimmers to assist the patient. They used an endotracheal (ET) tube from the airway kit as a makeshift airway for the patient. The patient used the tube as a straw to draw in air while submerged as a result of the wave action.
On arrival at the command post that was set up on the beach, I was assigned as the extrication officer. My crew was already busy gathering the tools and equipment needed for a machine incident. The curve ball here was that the extrication would have to take place in the water. A Zodiac ferried me out to the incident site offshore. I asked the operator to stop short of the incident to stop additional wakes from disturbing the patient. I swam to the incident and did my own assessment. The patient had a patent airway, but her skin color was ashen and she was displaying signs of shock. Each swell that came through rocked the boat in a way that caused her to submerge momentarily. The patient said to us several times, “Please do not let me drown.” Obviously, the patient was in distress. Since the patient’s leg was trapped below the water surface, I could not assist with the extrication while wearing a PFD. In fact, many of the responders worked the entire incident without the safety of a PFD. This will be addressed later.
While assessing the patient’s leg, I found several large lacerations but no apparent broken bones. The leg was also wrapped with a tow rope used for towing a tube behind the boat.
On arrival, the remaining members of my crew boarded the vessel with the trapped patient. My senior member established communications with the command post by radio and cell phone since I was in the water. My other firefighters began to assist with stabilizing the incident. They removed the keys from the boat and had the boat occupants move to the bow area, to reduce the load on the rear of the boat and to get them away from the trapped patient.
Our firefighter/paramedic began to assist the patient. He established an IV, which was no easy task since he was working on a patient while reaching across the transom on a vessel that was rolling with each swell. At this time, I requested the response of additional resources—the department’s boat mechanic, a local marine contractor with heavy lift capabilities, and a Federal Emergency Management Agency team doctor to respond as a last-resort option.
During this time, a VBPD diver showed up with a full SCUBA system. I directed him to place the SCUBA rig on the transom of the boat and to give the patient the second-stage regulator as an avenue to give her a good air supply. This proved successful: The patient’s color improved, and she became less distressed.
While the request for additional resources was being processed, the crews in the water began to disentangle the patient by cutting away the tow rope wrapped around her leg. This action enabled us to see the extent of the entrapment by the propellers. Both propellers were trapping the leg between the two props and the outdrive housing. Around this time, a boat mechanic arrived. He said that he knew this boat and had recently serviced the vessel. After getting in the water, the mechanic began to dismantle the first propeller. With assistance, it was removed. The second propeller still trapped the patient. Unfortunately, the mechanic did not have the proper tools to remove the second propeller. However, since he had just serviced the boat, he decided to try to loosen with his hand the retaining nut holding the prop on. This was difficult, but he loosened the propeller enough to free the patient’s leg.
Once the patient was released, we focused on stopping the bleeding. There was very little bleeding during the extrication since the limb was compressed. We applied and tightened a tourniquet, and placed the patient on a Miller and loaded her on a Zodiac 1 for transport to the beach, where an air ambulance was standing by.
JONATHAN RIGOLO is a captain with the Virginia Beach (VA) Fire Department, where he is assigned to Rescue Company 2. He has been in the fire service for more than 30 years. He is a rescue team manager for the VA-TF2 and a lead instructor for the FEMA USAR Structural Collapse program. He teaches firefighting, technical rescue, and structural collapse classes for government and private organizations worldwide