Chapter 37 Search and Rescue

Donald C. Cooper, Patrick H. Lavalla, Robert C. Stoffel

For online-only figures, please go to www.expertconsult.com

As ever-increasing numbers of outdoor users turn to the wilderness for recreation, the medical community and search and rescue (SAR) organizations are contending with a growing number of lost, sick, and injured persons. Wilderness search, rescue, and medical intervention are unique in several ways. All aspects of SAR are enormously time consuming. Simply raising the alarm for someone lost or injured in an isolated area may take hours, days, or even weeks. Organizing a response, including obtaining equipment and transportation for responders, requires a variable amount of time, depending on the level of preparedness of the response organization. Locating, gaining access to, stabilizing, and transporting a victim to definitive care can be a lengthy process.

Because it takes many people to perform a wilderness rescue (six or eight people are required to carry a litter 1 mile), logistic considerations such as food, shelter, and transportation for responders quickly create their own problems. SAR personnel are subjected to the same risks and environmental stresses that compromise victims. To obviate further tragedy, they must have a heightened awareness of potential danger, adverse conditions, and personal limitations. In addition to basic and advanced life support training, rescuers must have extensive wilderness experience—or experience in the particular environment in which they will be operating—that combines practicality with creativity and resourcefulness. SAR personnel must have training in survival, improvisation, communications, leadership, navigation (e.g., map, compass, and Global Positioning System [GPS]), first aid, and specific SAR techniques. Many interventions, such as cardiopulmonary resuscitation, defibrillation, tube thoracostomy, tracheal intubation, and intravenous therapy, are difficult—if not impossible—in the wilderness setting. Examinations may be hampered by the bulky clothing necessary to keep the victim warm and dry. Medications and equipment are subject to rough handling and extremes of temperature, which may render them ineffective, unsterile, or inoperative (see Appendix: Drug Storage and Stability).

Finally, decision making that optimizes patient care while not unduly risking the well-being of SAR personnel requires experienced leadership grounded in both common sense and technical skill. Perhaps the demands of SAR were best summarized by the wise rescuer who said that climbers, divers, hikers, and other outdoor enthusiasts get to choose where they practice their skills, but SAR personnel have no such choice. The situation, usually urgent, dictates where and when rescuers practice their art. The same situation that already compromised at least one person’s health or well-being subsequently endangers the SAR participants.

This chapter introduces medical personnel to some of the unique search, rescue, and medical problems encountered in wilderness, remote (including urban disaster environments), and backcountry situations. The rudiments of SAR coordination, resources, and specialized problems are discussed. This information will help medical personnel understand how the SAR community works and provide an educational foundation to help prevent situations requiring undue risk or SAR personnel themselves from having to be rescued.

Search and Rescue: An Overview

SAR systems provide the response for overdue, lost, injured, or stranded persons, usually in connection with outdoor activities and environments. In the context of SAR, wilderness can take on several meanings. For instance, most consider wilderness to be regions that are uninhabited and uncultivated. Personnel may be called out to search a natural area such as a large park or desert, but it is equally likely that a search will be urban, in an area devastated by a natural disaster such as an earthquake or hurricane. Because most of the population in the United States resides in urban areas, emergency responders and SAR personnel are far more likely to encounter urban wilderness than a natural one. However, this chapter focuses on the nonurban setting.

Types of SAR emergencies vary nationally and internationally, as do the responders. Programs, equipment, and personnel differ geographically in accordance with local needs and available resources. SAR can generally be defined as “finding and aiding people in distress—relieving pain and suffering.”⁶ However, contemporary references find it most useful to define search and rescue separately (Box 37-1).¹⁹

BOX 37-1

Search and Rescue Defined

Search—An operation using available personnel and facilities to locate persons in distress.

Rescue—An operation to retrieve persons in distress, provide for their initial medical or other needs, and deliver them to a place of safety.

From the International Maritime Organization and International Civil Aviation Organization (IMO/ICAO): International aeronautical and maritime search and rescue manual, vol I, Organization and management, vol II, Mission co-ordination, and vol III, Mobile facilities, London/Montreal, 1999, International Maritime Organization and International Civil Aviation Organization.

SAR often involves a great many volunteers and entails a multitude of skills. The Bhola (now Bangladesh) cyclone in 1970 (500,000 died); the collapse of the Banqiao, China, Dam in 1975 (230,000 died; 11 million were affected); the Tangshan, China, earthquake in 1976 (250,000 died); the eruption of Mt St Helens (1980); the terrorist attacks on the World Trade Centers (2001); multiple Atlantic hurricanes that struck the southeastern United States in 2004 and 2005, including Katrina; the Indonesian earthquake and subsequent tsunamis of 2004; and the 2010 Haiti earthquake (250,000 died) are all examples of significant, yet vastly different threats, hazards, and environments requiring widely diverse sets of SAR skills.

SAR operations benefit comprehensive emergency management, providing a training ground and experience builder for disaster response capability at the most elementary level. The management concepts used in SAR operations establish foundation principles for providing response capability to large-scale emergencies and disasters. Nearly every type of hazard mentioned in comprehensive emergency management plans (local and state disaster coordination plans, mandatory in all states) and international treaties require planning for search and rescue.²⁸ Management of these SAR operations can range from directing the actions of a few responders in a small community to managing an effort involving thousands of responders in a large urban disaster. Often, large situations involve several political subdivisions (e.g., cities, counties, states, countries) and coordination of air, ground, and/or marine resources. Local governments and other agencies that participate in SAR must coordinate diverse, multiskilled responders. In addition, many agencies that collectively support multiorganizational SAR responses operate under their own specific statutory authority.^46,⁴⁷

Time is almost always a factor in SAR operations, which tends to focus efforts on a quick conclusion. The general idea is to find or rescue the missing, lost, or injured subject before he or she succumbs to the effects of the environment, injuries, or a specific hazard.

International Agreements

International conventions are often what countries use to establish rules between them. The Convention on International Aviation, the International Convention on Maritime Search and Rescue, and the International Convention for the Safety of Life at Sea (SOLAS) include rules requiring countries that are parties to these agreements to provide aeronautic and maritime SAR coordination and services for their territories and territorial seas. Coverage of the high seas is apportioned among the member countries by these instruments as well. To carry out its SAR responsibilities, a country usually establishes a national SAR organization or joins one or more other countries to form a regional SAR organization. In the United States, the national SAR organization is called the National Search and Rescue Committee (NSARC).

While airborne, virtually all commercial aircraft on international routes are under positive control (e.g., followed by radar and in direct communication with air traffic controllers) by air traffic services (ATS) units. The International Civil Aviation Organization (ICAO) has linked ATS units into a worldwide system. Consequently, SAR agencies are usually notified very quickly when an international commercial flight has an emergency. Commercial aircraft on domestic routes and general aviation aircraft may not be under positive control, which can result in delayed reporting of their emergencies. The international aeronautic distress frequency is 121.5 MHz, and it is monitored by ATS, some commercial airliners, and other aeronautic facilities where needed to ensure immediate reception of distress calls. Emergency locator transmitters (ELTs) are carried in most aircraft and are required in most aircraft flown in the United States (see COSPAS-SARSAT).

Additional information on international SAR may be found at the International Maritime Organization (IMO) website (http://www.imo.org) and ICAO website (http://www.icao.int).

International Stages of SAR Operations

The international SAR community has developed an approach to organizing operations that has evolved over the past several decades. This system is documented in the International Aeronautical and Maritime Search and Rescue (IAMSAR) Manual,¹⁹ which was developed jointly by the ICAO and the IMO. Each of the three IAMSAR Manual volumes is written with specific SAR system duties in mind and can be used as a stand-alone document or in conjunction with the other two volumes as a means to attain a full view of the SAR system. Volume I, Organization and Management, discusses the global SAR system concept, establishment and improvement of national and regional SAR systems, and cooperation with neighboring countries to provide effective and economical SAR services. Volume II, Mission Co-ordination, assists personnel who plan and coordinate SAR operations and exercises. Volume III, Mobile Facilities, is intended to be carried aboard rescue units, aircraft, and vessels to help with performance of search, rescue, or on-scene coordinator functions and with aspects of SAR that pertain to their own emergencies.

The IAMSAR Manual describes a series of five stages of a SAR operation through which most SAR events pass: Awareness, Initial Action, Planning, Operations, and Conclusion. The manual suggests that, “These stages should be interpreted with flexibility, as many of the actions described may be performed simultaneously or in a different order to suit specific circumstances.”¹⁹ The reason the IAMSAR Manual does not have a “Preplanning” stage is twofold. First, the five stages of a SAR operation are about what happens in a specific incident. Preplanning can address types of incidents, but not specific incidents. Second, the preplanning function is addressed in what are called plans of operations or operations plans (OPLANs); see Appendix C of the IAMSAR Manual, volume II. These are standing plans for how to deal with various kinds of situations.

Cospas-Sarsat

The SARSAT system (search and rescue satellite-aided tracking) was developed in a joint effort by the United States, Canada, and France. In the United States, the National Oceanic and Atmospheric Administration (NOAA) is the lead agency and coordinates national participation in SARSAT and associated international programs. The COSPAS system (cosmicheskaya sistyema poiska avariynich sudov; in English, “space system for the search of vessels in distress”) (Box 37-2) was developed by the Soviet Union. These four nations (United States, Canada, France, and now Russia) banded together in 1979 to form COSPAS-SARSAT. In 1982, the first satellite was launched and the first life saved using the system, and the system was declared fully operational in 1984. The COSPAS-SARSAT system ceased satellite processing of the original 121.5/243-MHz beacons on February 1, 2009. Second-generation 406-MHz beacons were introduced in 1997 that allow transmission in the 406-MHz message of encoded position data acquired by the beacons from global satellite navigation systems such as GPS, using internal or external navigation receivers. As of this writing, the 4 original member nations have been joined by 36 other nations and 2 regional organizations that operate 76 ground stations and 30 mission control centers worldwide or serve as search and rescue points of contact (SPOCs). As of December 2008, the COPAS-SARSAT system had provided assistance in rescuing about 27,000 persons in over 7,200 incidents. Visit http://www.cospas-sarsat.org or http://www.sarsat.noaa.gov for more details.

The system uses satellites to detect and locate emergency beacons carried by ships, aircraft, and individuals transmitting on 406 MHz. The system consists of a network of satellites, ground stations, mission control centers, and rescue coordination centers. When an emergency beacon is activated, the signal is received by a satellite and relayed to the nearest available ground station. The ground station, called a local user terminal (LUT), processes the signal and calculates the position from which it originated. This position is transmitted to a mission control center (MCC), where it is joined with identification data and other information on that beacon. The MCC then transmits an alert message to the appropriate rescue coordination center (RCC), based primarily on the geographic location of the beacon. If the location of the beacon is in another country’s search and rescue region (SRR), then the alert is transmitted to the appropriate MCC.

Distress Radio Beacons

The most recognizable component of the SARSAT system is the distress radio beacon, also known as a “beacon.” There are generally three types of beacons used to transmit distress: emergency position-indicating radio beacons (EPIRBs) designed for maritime use, emergency locator transmitters (ELTs) designed for aviation use, and personal locator beacons (PLBs) designed for use by individuals and land-based applications. Although the three types of devices are physically different owing to the differing environments in which they must operate, they all work on the same principle and in the same way. When turned on (automatically or manually), each transmits alert signals on specific frequencies intended to be received by COSPAS-SARSAT satellites.

Only a few frequencies are used by these beacons:

• 121.5 and 243 MHz are used by many existing analog beacons, but the COSPAS-SARSAT system ceased satellite processing of these signals in 2009. Other devices (such as man-overboard systems and homing transmitters) that operate at 121.5 MHz and do not rely on satellite detection are not affected by the cessation of satellite processing of 121.5 MHz. The 121.5 frequency is still used in aviation for voice communication of an emergency.

• 406 MHz is used in digital beacons and is the only type of beacon currently detected by the COSPAS-SARSAT satellite system.

Emergency Position-Indicating Radio Beacons

There are several types of EPIRBS in use for maritime applications. The U.S. Coast Guard (USCG) maintains an outstanding website with more information on EPIRBs: http://www.navcen.uscg.gov/marcomms/gmdss/epirb.htm.

Emergency Locator Transmitters

ELTs were the first emergency beacons developed, and most aircraft are required to carry them. ELTs were originally intended for use on the 121.5-MHz frequency to alert aircraft flying overhead. Obviously, a major limitation to these is that another aircraft must be within range and listening to 121.5 MHz to receive the signal. One of the reasons the COSPAS-SARSAT system was developed was to provide a better receiving source for these signals. Another reason was to provide location data for each activation (something that overflying aircraft were unable to do).

Different types of ELTs are currently in use. There are about 170,000 of the older-generation 121.5-MHz ELTs in service in the United States. Unfortunately, these have proved to be highly ineffective. They have a 99% false-alert rate, activate properly in only 12% of crashes, and provide no identification data. To fix this problem, 406-MHz ELTs were developed to work specifically with the COSPAS-SARSAT system. These ELTs have unique identifiers and dramatically reduce the false-alert impact on SAR resources, have a higher accident survivability success rate, and decrease the time required to reach accident victims by an average of 6 hours.

Most aircraft operators are now mandated to carry an ELT. Although 121.5/243-MHz ELTs used by some aircraft may still be used, the COSPAS-SARSAT system ceased satellite processing of these beacons in 2009, and alerts from these devices (and from 121.5/243-MHz EPIRBs) are no longer acted on unless detected by an overflying aircraft or ground-based receivers. This is why all beacon owners and users should replace their 121.5/243-MHz beacons with 406 MHz beacons as soon as possible.

Personal Locator Beacons

PLBs are portable units that operate much the same as EPIRBs or ELTs. These beacons are designed to be carried by an individual person instead of on a boat or aircraft. Unlike ELTs and some EPIRBs, they can only be activated manually and operate exclusively on 406 MHz in the United States. Similar to EPIRBs and ELTs, all PLBs also have a built-in, low-power homing beacon that transmits on 121.5 MHz. This allows rescue forces to home in on a beacon once the 406-MHz satellite system has put them within 3.2 to 4.8 km (2 to 3 miles). Some newer PLBs also allow GPS units to be integrated into the distress signal. This GPS-encoded position dramatically improves the location accuracy down to the 100-m level.

In the United States, PLBs were in limited use until July 1, 2003, after which they were fully authorized for nationwide use. NOAA encourages all PLB users to be acutely aware of the responsibility that comes with owning one of these devices. PLBs are a distress-alerting tool and work exceptionally well. PLB users should familiarize themselves with proper testing and operating procedures to prevent false activation and be careful to avoid their use in nonemergency situations.³⁰

Search and Rescue in the United States

SAR involves many agencies and volunteers. The federal government assumes some responsibility for overall coordination, especially of federal or military resources requested by local or state agencies.

U.S. National Search and Rescue Plan

The U.S. National Search and Rescue Plan (NSP) was first published in 1956. It provides guidance to signatory federal agencies (Departments of Transportation, Homeland Security, Interior, Defense, and Commerce, as well as the Federal Communications Commission [FCC], and the National Aeronautics and Space Administration [NASA]) for coordinating civil SAR services to meet domestic needs and international commitments. The federal government assists with coordination of certain SAR services, including any federal or military resources that are requested by local or state agencies.

NSARC ³² is responsible for coordinating and improving federal involvement in civil SAR for aeronautic, maritime, and land communities within the United States. It is also the federal-level committee formed to oversee the NSP and coordinate civil SAR matters of interagency interest within the United States. Member agencies of NSARC are the signatories of the NSP. More information about NSARC may be obtained from the committee’s website at http://www.uscg.mil/NSARC.

The NSP defines an SRR as “an area of defined dimensions, recognized by IMO or ICAO, associated with a rescue coordination center (RCC), within which SAR services are provided.”³² An RCC is a unit responsible for promoting efficient organization of SAR services and for coordinating the conduct of SAR operations within an SRR. For every SRR, there is one RCC, and the goal is to have no overlaps or gaps between SRRs around the world. The ultimate goal, of course, is to ensure SAR services are available to those in need of them. To this end, SRRs are not considered to be either jurisdictional or territorial in nature. They do not supersede territorial sovereignty, not even for SAR missions. However, clearances for entry into territorial waters or airspace are usually expedited and/or relaxed for SAR activities. In addition, the SAR mission coordinator (SMC) for an incident may not be located with the RCC responsible for the SRR. The SMC may be located anywhere. For example, when the Achille Lauro caught fire and sank in international waters off Somalia in 1994, the SMC was located at RCC Stavanger, Norway, which had received the vessel’s radio distress calls and was able to establish communications with her and other vessels in the area to coordinate the rescue of passengers.

In the United States, there are two types of SRRs: maritime and aeronautic. Although only the ocean areas surrounding the United States and its territories fall within the maritime SRRs (marine vessels cannot sail on land), both the ocean and land areas of the United States fall within aeronautic SRRs (aircraft can fly over both water and land). The maritime SRRs surrounding the United States include, in the Pacific: Juneau, Honolulu, Seattle, and Alameda; and in the Atlantic: Boston, Norfolk, Miami, New Orleans, and San Juan. The oceans surrounding the United States and its territories also fall within aeronautic SRRs whose names and limits coincide with their maritime counterparts. However, with the exception of U.S. islands (e.g., Hawaiian, Puerto Rico) that are contained entirely within maritime SRRs and the Great Lakes (Cleveland Maritime SRR), all U.S. land falls within either the Elmendorff Air Force Base (Anchorage, Alaska) Aeronautical SRR (Alaska) or the Tyndall Air Force Base (Panama City, Florida) Aeronautical SRR (continental United States).

According to the NSP, a SAR coordinator is “a federal person or agency with overall responsibility for establishing and providing SAR services for a search and rescue region(s) for which the U.S. has primary responsibility.”³² The SAR coordinators for the United States are as follows:

• U.S. Air Force: Recognized SAR coordinator for the U.S. aeronautic SRR corresponding to the continental United States other than Alaska

• U.S. Pacific Command: Recognized SAR coordinator for the U.S. aeronautic SRR corresponding to Alaska

• U.S. Coast Guard: Recognized SAR coordinator for all other U.S. aeronautic and maritime SRRs. This includes the State of Hawaii, as well as waters over which the United States has jurisdiction, such as navigable waters of the United States.

Outside these SAR coordinators, state and local authorities are responsible for land-based SAR and designate a person to be “SAR coordinator” within their respective jurisdictions.

The NSP covers most types of SAR operations, such as land, maritime, aeronautic, urban, mass rescue, and those associated with what the document defines as “Incidents of National Significance.” However, it does not cover air ambulance service that does not result from a SAR or recovery operation, rescue from space, military operations, salvage operations, civil disturbances, or “Operations and coordination in addition to those…that might be carried out concurrently with civil SAR operations on scene, such as could occur during a disaster or terrorism response situation, or an Incident of National Significance.”³²

Although not considered a federal SAR coordinator, the U.S. Department of the Interior National Park Service (NPS) provides SAR and other emergency services on lands and waters administered by the NPS. These services often include SAR operations, including emergency medical aid conducted in a wide variety of environments, such as remote and rural areas, lakes, rivers and oceans, and deserts, mountains, and caves. They also often require extended response times and use of specialized equipment. In small parks, this may be achieved through agreements with surrounding emergency service providers. Outside national parks, state and local authorities or SAR units often accept responsibility for providing SAR services.

Because of the unique scale and SAR challenges in Alaska, the USCG is often the lead federal agency for inland SAR incidents in certain areas of the state, including the Alaska Peninsula (south of 58 degrees N), the Aleutian Islands, and other coastal islands. The reason for this is simple: In these areas, USCG assets can often respond much more quickly than can those available through the U.S. Alaska Rescue Coordination Center at Ft Richardson, Alaska, north of Anchorage. For Alaskan inland areas, SAR is carried out by Air National Guard units, the Alaska State Troopers, and local borough SAR organizations. Because of the unforgiving environment, all federal, state, and local agencies work together closely in response to SAR missions in Alaska.

Many U.S. states have chosen to retain established SAR responsibilities within their boundaries for incidents primarily local or intrastate in character. In such cases, agreements have been made between federal SAR coordinators and relevant state organizations.³² These local and state SAR coordinators, if established, become important contacts for federal SAR coordinators.

National Response Framework

The National Response Framework (NRF)⁴⁷—its previous iteration was referred to as the “National Response Plan”—is a guide that details how the U.S. government conducts all-hazards response, from the smallest incident to the largest catastrophe. It establishes a comprehensive, national, all-hazards approach to domestic incident response and identifies the key response principles, as well as the roles and structures that organize national response. The document describes how communities, states, the federal government and private-sector and nongovernmental partners apply these principles for a coordinated, effective national response (Box 37-3). In addition, it describes special circumstances in which the federal government exercises a larger role, including incidents in which federal interests are involved and catastrophic incidents for which a state would require significant support. It lays the groundwork for first responders, decision makers, and supporting entities to provide a unified national response.

The NRF is addressed to senior elected and appointed leaders, such as federal department or agency heads, state governors, mayors, tribal leaders, or city managers—those who have a responsibility to provide for effective emergency management. It also informs emergency management practitioners, explaining the operating structures and tools used routinely by first responders and emergency managers at all levels of government.

The NRF retains the same core principles of the National Incident Management System (NIMS), in which first responders from different jurisdictions and disciplines can work together more closely to effectively respond to natural disasters and emergencies, including acts of terrorism. The NRF Resource Center (http://www.fema.gov/NRF) is an online reference center that provides access to the NRF and supporting documents.

The National SAR Supplement

NSARC also directs preparation of the National SAR Supplement (NSS) to the IAMSAR Manual—under revision in 2010 to be renamed the National SAR Manual—which provides guidance to federal agencies concerning implementation of the NSP. The NSS provides specific additional national standards and guidance that build on the baseline established by the IAMSAR Manual. It provides guidance to all federal forces, military and civilian, that support civil SAR operations.³¹

Specifically, the NSS is designed to serve as both a training and operational tool for civil SAR operations. SAR planning is both an art and a science, relying greatly on the creativity and experience of the personnel involved. Because of the many variables encountered during SAR operations and the individuality of each SAR case, the guidance provided in the NSS must be tempered with sound judgment, having due regard for the individual situation. Very little in the NSS is mandatory because it is not intended to relieve SAR personnel of the need for initiative and sound judgment.³¹

Each of the signatory agencies of the NSARC (and NSP) are encouraged to develop an addendum to the NSS for their agency. Such documents could include policies, information, procedures, and so forth on civil SAR matters applicable to the agency concerned and consistent with the IAMSAR Manual and NSS.

Catastrophic Incident SAR Addendum to the National SAR Supplement

The tragedies of September 11, 2001, Hurricane Katrina in 2005, and other calamitous events continue to challenge federal, state, tribal, territorial, and local SAR responders in the planning and execution of large-scale SAR operations. NSARC realized the federal government’s response to large-scale catastrophic incident SAR (CISAR) needed to improve. As a result, the CISAR Addendum to the NSS ³³ was developed to provide guidance for SAR (Box 37-4) operations during catastrophic incidents to complement the overarching strategy for a national response to a catastrophic incident provided in the Catastrophic Incident Annex of the NRF. CISAR consists of civil SAR operations carried out as all or part of the response to an emergency or disaster declared by the president, under provisions of the NRF and its emergency support function (ESF) No. 9, Search and Rescue. This CISAR Addendum does not supersede other federal, state, tribal, or territorial SAR plans.

BOX 37-4

From the U.S. Department of Homeland Security: The national response framework, Washington, DC, 2008. http://www.fema.gov/emergency/nrf/ and The U.S. Department of Homeland Security: The national response framework, Washington, DC, 2008. http://www.fema.gov/emergency/nrf/.

“Catastrophic Incident” as Defined in the U.S. National Response Framework

Any natural or manmade incident, including terrorism, that results in extraordinary levels of mass casualties, damage, or disruption severely affecting the population, infrastructure, environment, economy, national morale, and/or government functions.

There are many different federal, state, tribal, territorial, and local SAR response cultures. Each possesses unique capabilities, language, and responsibilities. During a catastrophic incident, NSARC member departments and agencies are required to conduct multiagency SAR operations within a unified command (e.g., a command in which responding agencies and/or jurisdictions with responsibility for the incident share incident management). The CISAR Addendum is intended to (1) provide a concise description of the federal government’s civil SAR response to catastrophic incidents; (2) guide federal authorities involved in the response; and (3) inform states, tribes, and territories about what to expect from federal SAR responders.³³

The primary federal agency responsible for CISAR operations depends on the nature of the SAR operation to be conducted. ESF No. 9 of the NRF lists the Federal Emergency Management Agency (FEMA) and its Urban Search and Rescue Response System as being responsible for urban SAR; the USCG as being responsible for maritime, coastal, and waterborne SAR; and the U.S. Departments of the Interior and Defense (DOD) as being responsible for land SAR during a CISAR event. Regardless of which federal agency takes the lead, the primary agency works closely with the respective federal SAR coordinator in the affected area.

U.S. Rescue Coordination Centers

The USCG and Air Force both operate RCCs in the United States, but each service takes a slightly different approach. The Air Force RCC (AFRCC) coordinates inland SAR activities in the continental United States but does not directly conduct SAR operations. In most situations, the Civil Air Patrol (CAP), state police, or local rescue services carry out the actual SAR operations. In contrast, the USCG not only coordinates but also conducts maritime SAR missions.

U.S. Air Force Rescue Coordination Center

Established in 1947 to meet the growing demand for SAR and its legislated responsibility, the original three AFRCCs have evolved into a single RCC located under the 1st Air Force (AFNORTH) at Tyndall Air Force Base, Florida. As the U.S. inland SAR coordinator, the AFRCC serves as the single agency responsible for coordinating on-land federal SAR activities in the 48 contiguous states, Mexico, and Canada. Since the center opened in 1974, the AFRCC recorded the prosecution of more than 60,000 SAR missions, resulting in more than 13,900 lives saved.⁴²

The AFRCC functions around the clock and is staffed by people trained and experienced in the coordination of SAR operations. The center is equipped with extensive audio and digital communications equipment and maintains a comprehensive resource file listing federal, state, local, and volunteer organizations that conduct or assist in SAR.

There are four types of authorized AFRCC missions: search, rescue, medivac, and mercy.

Search

Once a distress situation is determined to exist but a location is unknown, federal SAR forces may be activated to search for, locate, and relieve the distress situation. The object of these searches may be in the form of overdue aircraft, ELTs, hunters, hikers, or children.

Rescue

A rescue mission entails the use of federal SAR forces to recover persons in distress whose location in a remote area is known, but who need assistance. This may be in the form of transportation to safety or to an adequate medical facility. These requests are normally received by the AFRCC from park service personnel or the local law enforcement authority.

Medivac

The transportation by federal assets of persons from one medical facility to another is defined as aeromedical evacuation, or medivac. Requests are normally received from a local hospital when no commercial transportation is available, the person’s life is in jeopardy, and time is critical. Each request is evaluated, and the decision to use federal resources is weighted heavily by the attending physician’s medical opinions.

Mercy

A mission to transport blood, organs, serum, medical equipment, or personnel to relieve a specific time-critical, life-threatening situation is referred to as a mercy mission. Requests are normally referred from a local hospital authority or, in some cases, the American Red Cross when commercial transportation is not available.

Although the AFRCC will accept and act on initial notification from any person or agency, it will attempt to determine the urgency and the facts pertaining to the situation before obliging itself. Several aspects of the situation are considered before a mission is opened, including the following:

1 Medical evaluation and urgency

2 State agreement requirements

3 Posse Comitatus Act

4 Conflict of interest with commercial resources

5 Resource availability

The medical condition of the victim or victims is the most important aspect of mission consideration. The AFRCC will consider a request valid only when there is an immediate threat to life, limb, or sight. A mission will be started only to prevent death or aggravation of a serious injury or illness. The observations and opinions of a physician at the incident site weigh heavily on the decision to open a mission, and a flight surgeon is on call at the AFRCC when a local physician is unavailable.

Each state has an agreement on file in the AFRCC describing the responsible agency and coordinating requirements for the various types of SAR missions. Each request for federal assistance is evaluated to ensure the requirements stipulated in the relevant agreement are met. Title 18 USC 1385 (the Posse Comitatus Act) prohibits military participation in civil law enforcement activities. Although there are some exceptions to the prohibition, as a general rule, DOD forces, including the CAP, will be restricted from participating in searches in which the person being sought is evading searchers, or is a fugitive, or when foul play is considered.

On medivac or mercy missions in which the patient is not eligible for DOD medical benefits, federal assets cannot be used when commercial resources are available. Even when a patient is unable to pay or is destitute, commercial resources will be checked for availability and provided the opportunity to accept the mission before allocating federal resources.

Although any SAR-capable asset belonging to the federal government may be requested, each resource is evaluated for distance from the distress location, special equipment requirements, urgency of the situation, and which resource can best accomplish the mission. Military forces may be called on to assist in civilian SAR missions. However, their participation in these activities must not interfere with their primary military mission. Once the decision has been made to use federal resources, a mission number is assigned and SAR forces are selected based on the geographic location and mission requirements. The Air Force coordinator then works closely with the responsible agency in an attempt to provide the resources best suited to accomplish the mission.⁴²

Additional information on the AFRCC can be found at http://www.1af.acc.af.mil/units/afrcc/.

U.S. Coast Guard Rescue Coordination Centers

The USCG, now a division of the U.S. Department of Homeland Security (DHS), is designated as the federal SAR coordinator for the maritime SRRs surrounding the United States and large portions of the high seas. The USCG is responsible for providing and coordinating SAR services over 28 million square miles of the world’s oceans, mostly in the northern hemisphere. This responsibility is divided into several districts, which are further divided into sectors (several per district) and stations. A 24-hour alert status is maintained year-round at all levels; Coast Guard resources can be under way or airborne within minutes of notification of a SAR incident. At its headquarters, each district maintains a fully staffed operations/command center responsible for coordinating operations within the area or district on a 24-hour basis. When coordinating SAR missions, these operations centers are called RCCs. Although minor SAR incidents are often resolved at the station or sector level, the district assumes the duties of the SAR mission coordinator in more complex or large-scale missions.⁴³

The USCG arguably prosecutes more SAR missions than does any other organization or agency. It is also notable that the USCG, although considered an important part of the U.S. military forces, is a separate federal agency now under the DHS, not under the DOD, as is the Air Force.

An important global SAR-related service of the USCG is the automated mutual-assistance vessel rescue (AMVER) system. AMVER is a global system that involves ships, regardless of flag, voluntarily providing information about their capabilities (e.g., medical personnel on board, rescue equipment), sail plans for voyages, and regular reports of their locations to a computer system that tracks their whereabouts. When a situation arises that requires SAR capabilities, a surface picture is produced that graphically shows the locations of all AMVER participants in the vicinity. The RCC can use this information to select the best one or several ships to respond to the emergency and allow all others to continue their voyages. Today, about 12,000 ships from more than 140 countries participate in AMVER. On average, 3600 ships are on the AMVER plot each day, with more than 100,000 voyages tracked annually. The AMVER system has saved more than 2000 lives since 1990 and 450 in 2007 alone.⁴⁴

A “preventive SAR” service provided by the USCG as a direct result of the Titanic disaster is the International Ice Patrol, with operations funded by SOLAS signatories.¹⁸ Since 1913, the Ice Patrol has amassed an enviable safety record, with not a single reported loss of life or property caused by collision with an iceberg outside the advertised limits of all known ice in the vicinity of the Grand Banks. However, the potential for a catastrophe still exists, and the Ice Patrol continues its mission using high-tech sensors and computer models.⁴³

The USCG also performs or coordinates the medical evacuation of seriously ill or injured persons from vessels at sea if the patient’s condition warrants and USCG assets are within range. For less serious situations, USCG flight surgeons offer medical advice by radio. On rare occasion, the RCC may coordinate with a U.S. Navy ship to allow a USCG medivac helicopter to refuel to extend its range. On rare occasion, the RCC may coordinate with the Air Force to dispatch pararescue personnel to parachute to the vessel and stabilize the patient. In either case, these actions are taken only in the most serious situations, when one or more lives depend on such drastic actions.

If a vessel is reported overdue or unreported (i.e., failed to check in when expected), USCG assets may or may not launch immediately, depending on whether the overdue craft is thought to be in immediate danger. Regardless, an extensive investigative effort is initiated immediately. During this investigation, a preliminary communications check and extended communications check (EXCOM) will likely take place. These actually include more than just contacting intended destinations. They also include interviewing persons who may be knowledgeable about the craft, as well as dispatching USCG vehicles or small boats to physically check harbors, marinas, launching ramps, and the like. In addition, an urgent all-ships broadcast is initiated, requesting information on any recent or future sightings that might be the missing vessel, and extended communications checks are repeated on a regular basis.¹²

If none of these communications and investigation efforts produces positive results (i.e., locating the vessel or indications that the persons on board are not in immediate danger), a search is undertaken. Search planning is conducted by the RCC staff, but additional assets can be requested from other agencies (e.g., U.S. Air Force and Navy) or foreign governments in a position to assist. With assistance from the USCG’s Search and Rescue Optimal Planning System (SAROPS), the RCC develops scenarios based on the available information. These scenarios are then weighted according to a subjective estimate of how likely each one is to represent the true situation. Further analysis of available information leads to development of probability maps (using SAROPS), from which SAROPS computes an optimal (maximum probability of success) search plan. Orders are then issued to all participating units. The search continues until either the survivors are found and rescued or it is deemed that further searching would be fruitless.¹²

Because SAR regions are not construed as boundaries to effective SAR action, and because the aeronautic SRRs are surrounded by the maritime SRRs, coordination between the AFRCC and the Coast Guard RCCs is a daily occurrence. Missions that involve portions of both regions will be coordinated through the AFRCC or the appropriate Coast Guard RCC. It is not unusual for the Coast Guard to call on the AFRCC for a particular resource needed to prosecute a mission in the maritime region or, conversely, for the AFRCC to use a Coast Guard resource in the aeronautic region.

Additional information about the USCG can be found at http://www.uscg.mil/.