Don’t Wait for the Dive Team

Immediate Actions for Submerged Swimmers and Drownings

(1) Rescuers use a personal watercraft to deploy a buoy which will mark the last-known location of the victim. Photos by author.

The successful rescue of a drowning victim in open water is dependent exclusively on rapid water rescue and high-performance CPR, performed within a 300-second window. With dive teams few and far between in our response areas and most rescue divers acting in that assignment secondary to firefighting duties, we cannot reasonably expect a dive team to deploy and effect rescue of a submerged victim within that time frame.

FDIC 2025 Preview: Advanced Open Water Rescue and Drowning Resuscitation

In a drowning scenario, every second counts. Irreversible brain damage can occur within four to six minutes of submersion. Immediate action is crucial. In the absence of a dive team arriving within this critical time frame, what tactics can we equip our members with to begin effective rescue efforts?

The United States Lifesaving Association (USLA) sets national standards for open water lifeguarding, and promotes beach safety to prevent aquatic injuries and drownings. USLA-certified beaches employ a tactic known as CODE-X for the search and rescue of a submerged swimmer. CODE-X is a protocol for rapidly locating and rescuing a submerged swimmer by focusing on their last-seen location and deploying immediate, coordinated, systematic, grid-style search efforts. In the absence of specialized water rescue equipment and dive gear, CODE-X is an effective option for first-arriving firefighters to a drowning incident. Unlike traditional rescue diving, CODE-X prioritizes survival over recovery. The primary objective is to locate and rescue the submerged swimmer as quickly as possible.

There are five key components to a successful CODE-X rescue operation.

1. Identify the last-known location of the victim.

This information is usually obtained by witnesses or the 911 caller. This location will be the basis for the ensuing search operation and accuracy is paramount. The point can be marked with a buoy, if available, or a marker on the shoreline. A rescuer can also be assigned to stay at the last-known location. All operations that follow will be relative to the last-known location, often referred to by the acronym, “LKP,” for “last-known point.”

2. Establish a search zone.

Using the last-known location of the victim, rescuers establish a search zone. The search zone can be influenced by currents, tide, drift, and any other factor that may influence the victim’s underwater trajectory. A lake’s search zone, unlikely to be influence by currents, might look like a circle. A river’s search zone, or any water with strong current, might take the shape of a triangle, with its peak being the last-known location, and its sides expanding outward with the flow of water.

Up until now, CODE-X, being employed by ocean lifeguards, is almost exclusively utilized on beaches up and down the continental united states. Swell, tide, wind and current will always influence the search pattern in these areas.

(2) Rescuers enter the water together in a line.

3. Deploy firefighters immediately.

Available, able-bodied members must rapidly enter the water with personal equipment (goggles, fins, snorkel, etc.) At least one member or officer will remain on shore. The USLA defines a minimum swimming standard for lifeguards, but CODE-X operations require only a baseline competency to perform.

4. Execute a grid search.

Rescuers form a line spaced evenly apart, typically at arm’s length or slightly more, depending on water visibility and conditions. They simultaneously dive and surface repeatedly, traveling along the predetermined search route. Members communicate continuously to adjust the search pattern based on findings or updated conditions.

In open water with no current, members may conduct a circular search. They form a line extending from the last-known location and begin their dives either clockwise or counterclockwise around the point. In a body of water with current, rescuers may form a line perpendicular to the flow of water, and search in the direction of the current. The more members in line, the more area can be covered. Additional lines can be added as more members arrive.

During a CODE-X search, dives should be conducted systematically and efficiently, prioritizing speed, coverage, and safety. Dives should target depths where the swimmer is most likely to be given the water conditions and last-seen location. In shallow water, members may use surface dives to quickly scan the bottom. In deeper areas, dives should be limited by the member’s ability to resurface safely and efficiently.

Rescuers begin their systematic dives along a pre-designated search pattern — (3) Rescuers begin their systematic dives along a predesignated search pattern.

5. Coordinate with shore-based members.

The incident commander and/or supervisory staff will remain on shore. Their higher vantage point is better for monitoring water conditions and making changes to search patterns, if necessary. Additionally, the taxing nature of CODE-X operations will require resource and staffing coordination to swap out with members in the water as they inevitably become fatigued.

A successful CODE-X operation still warrants additional resources. Marine assets, like boats and personal watercraft, compliment rescue efforts with a surface-based search and are a lifeline for our members operating in water. In the event the operation transitions from rescue to recovery, dive teams should still be requested on the initial response. Additional resource requests, including air assets and rehab, should be considered.

Training your department for a CODE-X procedure requires a structured approach that emphasizes readiness, teamwork, and proficiency in open water rescue techniques. All department members shall understand the purpose of CODE-X (rapid response to submerged swimmer incidents) and recognize its time-critical nature. Individually, members that may respond to a drowning should focus on building stamina, breath-holding capacity, and underwater skills. This tactic requires nothing more than baseline physical fitness, along with proficiency and comfortability in open water. Drills should simulate rescue conditions and include open water swimming and repeated surface dives.

Members should be familiar with equipment used during CODE-X, including goggles, rescue fins, rescue flotation devices, and snorkels. They should practice systematic search patterns, minimizing coverage gaps, and learn to safely manage depth limits based on conditions. Conceptually, these tactics are no different than performing a primary search at a house fire—prioritize quick and efficient search in near zero-visibility conditions.

Preplanning a CODE-X operation should include designating hand signals for communication between shoreline and water operations. Verbal and radio communication are impossible given that the distance is too great and water prevents radio use. All members must be fluent in communicating with these hand signals before any emergency response.

Drills should be realistic. Departments can use a weighted object or submerged manikin to simulate a victim. While a pool is the perfect place to demonstrate and learn these tactics, training should be conducted in open water under realistic conditions. All evolutions should be timed to reinforce urgency and assess proficiency under pressure.

CODE-X, like all rescue disciplines, is a perishable skillset. Departments should keep a consistent rotation with drills and exercises, especially during peak water recreation seasons or after periods of inactivity/low water-related call volume. Agencies should also encourage members to maintain peak physical performance. Many local gyms offer first responders partnership programs for use of their pools.

CODE-X doesn’t come without its challenges for the fire service. For starters, it cannot be accomplished when donning a personal flotation device (PFD). In the absence of a PFD, chiefs may be concerned about firefighter fatigue, drowning, or being overwhelmed by currents during a water rescue. Despite expertise in other rescue disciplines, members may lack advanced open water skills, including diving and sustained swimming under challenging conditions. These concerns can be addressed through proper training and clarification of operational roles. Operational roles should be predetermined, and members not qualified to operate in open water will be assigned to other tasks. Fire chiefs can mitigate risks by emphasizing training, role definition, and ensuring safety while supporting the lifesaving mission effectively.

Shallow water blackout (SWB) is another concern during CODE-X operations. SWB is a condition that occurs when a person loses consciousness due to a lack of oxygen (hypoxia) during or immediately after a breath-hold dive in shallow water. It is silent and sudden and can be fatal. Currently, there are no documented cases of shallow water blackout (SWB) occurring during CODE-X operations. With strong accountability, limited dives, and frequent rotation of personnel, the risk of SWB can be mitigated.

CODE-X enables faster victim location in the critical minutes after submersion. By reducing reliance on dive teams, which often face travel and setup delays, fire departments can improve survival chances significantly, particularly in cases of shallow or nearshore incidents. Additionally, CODE-X provides a structured, scalable framework that can integrate existing resources and limited specialized equipment, making it a practical and lifesaving alternative for agencies responsible for water rescue.

References

International Life Saving Federation. Shallow Water Blackout. 2011, www.ilsf.org/wp-content/uploads/2018/11/MPS-16-2011-Shallow-water-black-out.pdf

United States Lifesaving Association. Open Water Lifesaving: The United States Lifesaving Association Manual. 3rd ed., United States Lifesaving Association, 2017.

American Heart Association. Basic Life Support (BLS) Provider Manual. 2020, American Heart Association, 2020.

Jack Gramlich is assistant chief with Spring Lake (NJ) Fire Rescue and training officer with Spring Lake Ocean Rescue.