If the victim on the surface has no pulse, you should start in-water resuscitation immediately.

In-water resuscitation is not typically initiated while still in the water if a victim is unresponsive and has no pulse. The immediate focus should be on removing the victim from the water as soon as it is safe to do so. Once on land, more effective resuscitation methods, including CPR, can be applied.

Rescuing a victim from water typically allows for better management of the situation, as the rescuer can directly assess and address airway, breathing, and circulation needs on a stable surface. Water adds complications such as continued exposure and challenges in performing chest compressions effectively. Hence, the procedure emphasizes reaching an appropriate site for resuscitation, which is why starting in-water resuscitation immediately is not advised under standard protocols.

The incorrect options hint at specific conditions where in-water resuscitation might be considered, but they do not align with the standard operational protocols for managing such emergencies effectively and safely. The general rule is to prioritize getting the victim out of the water for effective resuscitation efforts.