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  • Codex Form Usla

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    Srikant m
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    This document contains a checklist for responding to a reported submerged victim at a lifeguard agency. It outlines the steps taken which include commencing preliminary and full searches, requesting rescue vessels, EMS, and helicopters if needed. The checklist tracks arrival times of responding units and rescuers. It also notes if the victim was recovered or if the search was terminated by the incident commander.

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    This document contains a checklist for responding to a reported submerged victim at a lifeguard agency. It outlines the steps taken which include commencing preliminary and full searches, requesting rescue vessels, EMS, and helicopters if needed. The checklist tracks arrival times of responding units and rescuers. It also notes if the victim was recovered or if the search was terminated by the incident commander.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    3 views1 page

    Codex Form Usla

    Uploaded by

    Srikant m
    This document contains a checklist for responding to a reported submerged victim at a lifeguard agency. It outlines the steps taken which include commencing preliminary and full searches, requesting rescue vessels, EMS, and helicopters if needed. The checklist tracks arrival times of responding units and rescuers. It also notes if the victim was recovered or if the search was terminated by the incident commander.

    Copyright:

    © All Rights Reserved
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    of 1

    Date:___________

    United States Lifesaving Association


    ____________________ Page 1 of ___________
    Lifeguard Agency Search & Rescue Checklist Report #:___________

    Time

    __________ Submersion victim reported by: ____________________________________________________

    Location of last seen point: ________________________________________________________

    Victim last seen time: __________

    ___________ Preliminary search commenced

    ___________ Incident Commander (name): ________________________________________ declares Code X

    ___________ All units advised of incident via radio broadcast or other means (specify): ___________________

    ___________ Search and rescue team summoned

    ___________ Full search commenced

    ___________ Rescue vessel(s) requested and dispatched to scene

    ___________ Emergency medical services (EMS) ambulance requested to respond and standby at scene

    ___________ Availability of search helicopter(s) determined, Incident Commander advised

    ___________ Helicopter requested for aerial search from (agency): ___________________________________

    ___________ Medical evacuation helicopter placed on standby, Incident Commander advised

    ___________ Crowd control assistance requested from (agency): ____________________________________

    Arrived at Scene Times • Who? • What unit number? • How many rescuers? • Other information?

    ___________ ______________________________________________________________________________

    ___________ ______________________________________________________________________________

    ___________ ______________________________________________________________________________

    ___________ ______________________________________________________________________________

    ___________ Emergency medical services (EMS) at scene

    ___________ Search helicopter at scene

    ___________ Medical evacuation helicopter at scene

    ___________ Victim recovered (or) □ no recovery

    ___________ Search terminated on order of Incident Commander

    __________________________________________ ___________________________________________
    Report Completed By Report Approved By

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