Ice Rescue
What this domain covers
Ice rescue covers patients who have gone through ice on lakes, ponds, and slow rivers. The exam tests ice strength, the rescue sequence, cold-water care, and the judgment to stay off the ice.
Ice strength
- New clear ice is strongest; white or snow ice is roughly half as strong, and refrozen, slushy, or moving-water ice is unpredictable.
- Common thickness rules of thumb: stay off under 2 in; about 4 in for one person on foot; 5–6 in for a small group in single file; 8–12 in before a vehicle. Local SOPs override these.
- Never assume uniform thickness: current, springs, inlets, snow cover, and structure edges all thin the ice.
Rescue sequence
Self-rescue first (ice picks, kick and roll), then reach (pole, ladder, board), then throw (rope bag with a float), then go - a suited rescuer in an ice rescue suit on a tether, sliding flat, one rescuer on the ice at a time where possible. Command 'once on, once off' so only one rescuer leaves the solid edge. After rescue, handle the patient horizontally and gently: cold blood returning from the extremities can drop core temperature (afterdrop), and rough handling can trigger ventricular fibrillation.
Worked example
A 200 lb adult is through the ice 60 ft out, holding the edge. You throw a rope bag with a float, have them hold the line while a suited rescuer slides out on a tether, and bring them back to the edge rather than lifting them. Then package horizontally and evacuate.
Traps
Standing up on the ice. Sending three rescuers at once. Trusting a 4-inch reading as uniform. Sitting the patient upright for the walk to the ambulance.