As a dive guide and instructor, I drew more from the American Red Cross Advanced Lifesaving Course than any dive rescue course I have ever taken when making rescues. I took Advanced Lifesaving during my freshman year of college for the entire semester. It was truly a kick @$$ course. I remember how hard we trained, yet extremely fit young men and women, could barely summon the energy to walk to the showers after our final test. It didn't matter if it was on the surface or underwater. The guiding principles of lifeguard training served me well. Unfortunately, that course no longer exists. Lifeguarding stopped using a hands on approach in favor of the rescue tube and all of the lifesaving toys (many of which you can make on the fly for use in scuba rescue -- such as tying a spool to a bottle for a throw line) are no longer a part of lifeguard training.
Over the years, I've made a bunch of rescues. Many were on the surface. I once surfaced from a dive on the Benwood in Key Largo only to be directed to swim a lifeline to a rebreather diver in trouble on the surface. Many happened when I wasn't wearing scuba gear. For example, I had an instructor wisely yell for help when caught in a rip current when he knew he was exhausted rather than let pride and ego get in the way. I swam out and put him in an old-fashioned cross-chest carry. A few were underwater. One underwater rescue was an NSS-CDS Basic Cave trained frozen diver on the line in Ginnie. Another was a panicked GUE Tech 1 trained diver on the Spiegel Grove who had run low on gas after being blown off the wreck, fighting the current in a drysuit, and being unaware of how fast his gas went as he worked at depth. He became a panicked diver on a deco bottle after I switched him to Nx50. A third was a GUE-F trained diver who found himself descending with an empty tank on the Yukon. He became a panicked diver on my long hose. Looking good was never a part of the equation during a rescue. In each and every case, reaching the victim, protecting myself as well as my mask and reg, and maintaining control of the victim and the situation from start to finish had been drilled into me from that early class and reinforced with each lifeguard re-certification and each scuba rescue course or skill.
I require all my divemaster candidates to have either had a lifeguard course in the past or to take one before I certify them. One of my PADI instructor friends took a lifeguard course at age 50 and it changed his approach to aquatic safety. Even though his real job was as an engineer, he ended up lifeguarding part-time at that age at a YMCA and applying how to maintain safety of an aquatic facility to his scuba classes.
It might seem strange to many divers that I would encounter so many rescue situations, but keep in mind I do this stuff full time day in and day out and have been doing so for a long time. In the Caymans, it seemed we made a rescue or assist every day. As I write this, I'm on the shores of Lake Ontario, where each and every day I'm diving the St. Lawrence Seaway. Earlier tonight, I made 2 dives in Canada. Yesterday, I was coaching in Alexandria Bay, where we rescued boaters on 2 occasions. Once a guy's boat slipped a mooring and was running away down river. I swam out to it and drove it back to the dock where my friend Jimmy helped me tie it off. In another incident, a family left someone in the boat who didn't know how to drive it and the boat went adrift. I did the same thing.
High levels of personal physical fitness, being well-trained for surface swimming rescues, and being well-trained to deal with OOG and panicked divers are the benchmarks of dive rescue regardless of agency. In my experience, even well-trained divers (such as those trained by GUE ) are not immune from panic. Looking good underwater does not make you a superhero. Looking good and being good are two different things. The same with rescue. The fastest swimmer isn't always the best lifeguard. Sometimes, he is. My friend Billy beat me to a victim -- a diver who surfaced at the training platforms at Bonnie Castle who ran OOG and did a CESA. His buddy was missing. Billy, me, and my friend Jamie did a search. The diver was located on shore later, but Billy is one heck of a public safety diver. Yet, PSD divers get in trouble. My friend Rob, a cave diver and PADI instructor, and I swam a couple hundred yards to rescue two guys from a dive team who ran OOG at the tanker truck from the student side of Dutch. The very next weekend, members of the same PSD team went out to retrieve the weightbelts of those two divers, and got in trouble. Rob was working as Dutch lake staff when he had to row a dingy out to help them. I once had to rescue a Newark, NJ ESU diver who was overweighted and drowning on the surface.
I've been rescued myself on 3 occasions. I had 3 blackouts while freediving. A French freediver pulled me up from the bottom of a pool when I blacked out doing static apnea. A female DM or instructor rescued me after I suffered a SWBO and I was unconscious on the surface. A freediving student rescued me from a deep water blackout.
The type of diving you do should dictate the type of rescue course you take. Bringing up a toxing tech diver while looking good might not help you as a resort DM as much as a PADI rescue course. A PADI rescue course might not help you deal with divers using multiple bottles or rebreathers either.