Gas Supply
Tanks are best placed either side of the victim, strapped to the edge/rim of the stretcher with the tap at the feet end. It may be possible to lay a tank in between the legs. If a drag sheet is used then the victim will have to wear the tanks if possible in the conventional manner. Perhaps a tank can be used as a splint? They must be secure – tanks falling off all over the place will cause serious problems. In most cases, a full-face mask will be used. Clearly there has to be overkill as far as gas supplies are concerned. There is little merit in successfully rescuing the victim only to find that he has died through lack of air. There are attachments available that allow the change of tanks underwater, but again this is a last resort issue. A full-face mask is clearly the best method, ensuring the flow rate is generous, preferably on free-flow rather than on demand. The victim does not want the feeling that there is insufficient air. It must be doubly sure that the mask has a good seal with no or very minimal water ingress.
Buoyancy
A buoyancy device must be used; either the victim can wear it depending on the injury, or it can be wrapped and strapped onto the stretcher/drag sheet. The Wookey experiment revealed that shifting a lump weight without buoyancy is virtually impossible. Polystyrene slabs were used as a bed on which the “victim” lay in the Wookey practice to take up some buoyancy, supplemented with an ABLJ for “fine tuning”. The inflation tap/valve/device must be within easy reach of one of the divers, whomever is best positioned to see what is going on, probably the rear pusher. Excessive buoyancy can perhaps be countered in an emergency by placing rocks picked up from the floor where possible and placed on the stretcher.
Signals
Clearly vital. The pusher and puller must know what is going on. The Wookey divers had a simple audible system using a stone picked up from the floor, or a knife, banged on their own tanks, or any nearby piece of metal such as the stretcher. One bang for stop and two for forward. Frenzied multiple banging indicates a real problem but retreat is not really an option unless there is a real problem not too far into the sump. There will come a point where there is no merit in going back, the divers may as well press on despite the possible consequences. Note that, depending on his condition and mental state, the victim must be aware of the signals also, and have a few of his own e.g. pointing to ears if they are not clearing, “slow down”, “hurry up” etc.
Pushers, Pullers & Helpers
Depending on the nature of the sump, two drag and push divers will probably be enough. There is little that third or successive accompanying divers can do. They will probably only get in the way. Needless to say, they will use large quantities of gas so their gas supplies must be considered. The victim should be taken through feet first with the rear diver responsible for looking at the face of the victim on a regular basis as he will be closest, and probably also looking after buoyancy control. The front diver will have hold of the front of the stretcher/drag sheet /victim so his body will be under or alongside the front half of the contraption. The front diver can guide the whole assembly, as well as being responsible for holding onto the dive line. It will probably not be possible for the rear diver to hold the line also, he must keep hold of the stretcher or drag sheet. There may be case for a head first drag, depending on the circumstances and the wishes of the victim if he is lucid. All support divers must be well dressed, preferably with dry suits.
The Victim
As the victim will be conscious (it is most unwise to take an unconscious diver through in a stretcher – consider what happens if he wakes up!) he must decide whether he wants his arms tethered or free. Most victims would rather have their arms and hands free; if they are reasonably lucid they can possibly help by fending off rock walls and generally aid guiding. Free hands also allow them to make signals, to clear ears and boost morale. The victim must obviously be well dressed also, certainly with a dry suit if his injuries allow him to wear one, or be inserted in one.
Warmth
A dry suit must be used if possible. If an internal body-heating device is used, such as Little Dragon, before diving, this may give the victim carbon dioxide poisoning for a few days afterward if for some reason the device is cranked open too vigorously or if there is a leak.
The line through the sump(s) must be changed to a bombproof stout rope.
The stretcher/drag sheet must ideally be specifically designed for the purpose. It is incumbent on the various cave rescue organizations to obtain such a vehicle.
It must be remembered that, despite whatever procedure is annunciated here, the rescuers must use common sense, ingenuity, resourcefulness and guile depending on the situation at hand. It has been suggested that the first, say, four rescue divers on the scene be immediately transported to a local pool, river, lake or reservoir to carry out a quick practice. It is argued that, depending on the injury, it will take some time for the rescue personnel to assemble and sort themselves out. It may thus be beneficial to waste an hour or so to practice the situation beforehand.
To labour the point even further, it will be seen from the above that you will not want to be significantly injured on the wrong side of a sump. If you cannot get yourself out, it is very likely that you will not be fed or watered for some time, will spend considerable time in uncomfortable conditions, will get very cold, will probably be in no condition to be dragged out, and that you will probably die. Take care.
Communication is clearly a vital part of any rescue. Some caves, such as Dan-yr-Ogof in South Wales, have a telephone line permanently laid through an entrance sump, or a lake or passage that are prone to regular flooding. However, the installation of any form of permanent communication gear as part of a rescue dump is impractical for longevity and maintenance purposes. The diving in of communication gear and the laying of a telephone line by the rescue team would be an essential part of the initial rescue process anyway.