As a precaution, adult volunteers or youth members should consider a hepatitis B vaccination. The cost of the shots will not be borne by BSA, nor is the chartered organization required to underwrite the cost. The chartered organization may arrange to have shots given at a reduced rate or free of charge. If vaccination is recommended, any adult volunteers and youth members who decline the shots, either at full cost to them or at a reduced rate, or free, should sign a refusal waiver that should be retained by the council for five years. Lung rupture can occur during the submersion or consequent to the resuscitation efforts.
Pneumonia is a later complication in the injured lung.
The hypothermic victim requires special attention.