Ellis & Associates Lifeguard Training Vocabulary
E.A.P
Emergency Action Plan
statistic
For every minute that defibrillation is delayed, the chance that a guest in cardiac arrest will survive decreases 7% - 10%.
Cardiac Arrest
If the heart muscle is damaged severely, a guest's heart can cease to function. The guest will become unresponsive, non-breathing, and pulseless. What to Do: - activate EMS - provide cardiopulmonary resuscitation (CPR) until a defibrillator is available
N.O.A.A
National Oceanic and Atmospheric Administration
Lifeguard Equipment (pg. 20)
Rescue tube, Whistle, Hip pack, and Sun protection
S.D.S
Safety Data Sheet
What are the most common devices used in aquatic facilities?
• Whistles • Two-way radios • Flags • Hand signals • Telephones • Megaphones • Public address systems • Automated audio repeater systems
Legal Concepts That Apply To Lifeguards (pg. 12-13)
(1) Abandonment (2) Confidentiality (3) Consent (4) Documentation (5) Duty to Act (6) Negligence (7) Refusal of care (8) Standard of care
Describe the components and function of the respiratory system:
(1) During inhalation, air is drawn into the body as the muscles in the chest wall and the diaphragm contract. (2) Air enters the mouth and nose, where it is filtered, warmed, and humidified. (3) The air passes down the pharynx (throat), and past the epiglottis (4) Once past the epiglottis, air enters the trachea (windpipe). The trachea divides into two main branches known as bronchi, which allow air to enter both lungs. (5) Bronchi divide into smaller tubes known as bronchioles in the walls of the lungs (6) At the end of the bronchioles, air enters small air sacs known as the alveoli which are in tiny blood vessels known as capillaries (7) Oxygen and carbon dioxide are exchanged in the alveoli. (8) When the muscles of the chest and the diaphragm relax, air is exhaled
What are the two main types of lifeguard positions?
(1) Elevated stands - generally a chair with extend legs, this is supposed to allow the lifeguard to see farther distances (2) Roving - ground-level position in which the lifeguard is moving round and walking along the side of their zone of protection
How to tell Respiratory Arrest from Cardiac Arrest:
(1) If the guest is unresponsive, not breathing (or only has occasional gasps), but has a pulse, the guest is in respiratory arrest and needs rescue breathing. (2) If the guest is unresponsive, not breathing (or only has occasional agonal gasps), and no pulse, the guest is in cardiac arrest and needs cardiopulmonary resuscitation (CPR).
electrode pads
(1) Peel the protective backing off the pads and place the pads on the chest according to the diagram on the packaging. (2) For adults, one pad is placed just below the right collarbone. (3) The other pad is placed on the lower left side of the chest Follow the manufacturer's instructions for use of pediatric pads if you have these available. (4) If advised to shock, make sure no one is in contact with the guest before the shock is administered If no shock is advised, it means that the AED did not find a shockable rhythm (V-fib or V-tach). (5) Regardless of whether a "shock" or a "no shock" advisory is given, follow with 2 minutes of CPR if the guest is in cardiac arrest (6) In some cases, more than one shock will be needed to correct the dysrhythmia. (7) Two minutes of CPR should be given following every analysis or shock If the shock is successful, the guest may begin to show signs of life.
The Drowning Process
(1) Surprise - panic - struggling to remain on the surface - erratic and ineffective leg movements - head back in an effort to keep water out of mouth - breath holding if submerging > this stage may last up to 30 seconds > rescued during this stage the guest rarely needs any further care (2) Respiratory Arrest & Unconsciousness - Carbon dioxide build up triggers the automatic response to breath (agonal breath) - If submerged, water will cross the larynx and enter the lungs, this causes laryngeal spasm, leading to respiratory arrest - Unconsciousness will occur shortly after respiratory arrest > Rescued during this time may allow the guest to begin breathing once the face is removed from any water and airway is opened (3) Hypoxic Convulsions - lack of oxygen (hypoxia) can result in convulsions - Addition agonal breaths may displace lung surfactant resulting in froth/foam in the guest's mouth - cardiac arrest will ultimately result if respiratory arrest is not corrected. > Rescue before cardiac arrest occurs, and provided with rescue breathing and supplemental oxygen, cardiac arrest may be avoided. (4) Cardiac Arrest & Death - As time passes through cardiac arrest irreversible damage can occur to organs, especially the brain > Care during this stage requires CPR, an AED, supplemental oxygen support, and suction. > Chance of full recovery at this stage is significantly less than interventions provided in earlier stages. The time span for the drowning process to occur varies from seconds to minutes. Children may move through the drowning process quicker than adults. A child may appear to be bobbing in the water but is in distress. If you observe a child showing the slightest indication of distress, you need to respond immediately.
What are the two ways to manually provide oxygen to the lungs of a guest?
(1) giving ventilations using your own breath: use a resuscitation mask (2) Use of a bag-valve-mask (BVM)
If An Exposure Occurs
(Disease prevention strategies are designed to minimize the likelihood of an exposure while you are on the job.) If you suffer an occupational exposure, follow the guidelines below for immediate care and report the incident according to your facility's Exposure Control Plan. 1. Clean the contaminated area, including any penetrating injuries involving cuts or punctures thoroughly with soap and water 2. If you are splashed with blood or OPIM around or in your mouth, nose, or eyes, flush the area thoroughly with water 3. Report the exposure incident to your supervisor immediately and to the EMS personnel if they are arriving to take over care of the guest 4. Document with your supervisor what happened. Include the time, date, and circumstances of the exposure as well the immediate actions taken post exposure 5. Seek immediate follow-up care with a qualified health care professional according to your facility's exposure control plan. The evaluation will determine the best course of treatment
Airway Obstruction in a Responsive Adult or Child
- Airway obstruction (choking) in a responsive adult most often results from an object, such as food, becoming lodged in the throat. - Children and infants also choke on small objects such as coins or toys. > If the guest can cough, the airway is only partially obstructed. - tell them to continue to cough. > If the guest cannot cough, speak, cry, or breathe, or is coughing weakly or making high pitched "crowing" sounds, the airway is severely obstructed, and immediate care is needed.
Bloodborne Pathogen Transmission (pg. 37)
- Hepatitis B virus: Transferred Through - Blood, saliva, vomit, semen - Hepatitis C virus: Transferred Through - Blood, saliva, vomit, semen - Human Immunodeficiency virus (HIV): Transferred Through - Blood, semen, vaginal fluids
Hand signals (pg. 83: Table 9.3)
- Hold the signal until you are sure it is noticed - Often combined with whistle codes to ensure that the messages are being received Common Hand Signals Include: > Pointing - Identify a location or person, provide direction > Raised clinched fist - Assistance needed from another lifeguard or a supervisor > Crossed arms above head - Stop dispatch. Used to stop sending guests into an area or down a water slide or an attraction > Thumbs up - All clear. It's safe to continue normal activity. > Tapping of top of your head - Used to signal the bottom is clear during the Proactive Bottom Scan Watch my zone. Indicates you are asking another lifeguard to watch your area.
Contacting EMS
- It is a part of your EAP - Normally done by calling 9-1-1 in the US, Canada, and Mexico - Clearly communicate all pertinent information
Special Situations
- Laryngectomy: Guest's larynx was removed, they breath through a stoma. (1) Close the guest's mouth and nose (2) place a pediatric sized resuscitation mask over the stoma, and give ventilations. - Vomiting: If guest vomits while you are trying to provide ventilation... (1) Turn the guest to the side while trying to maintain the head and body inline. (2) With your gloved hand, wipe the guest's mouth clean, roll the guest back and continue rescue breathing. - Dentures: It is not necessary to remove them. Dentures will help maintain a seal on the facemask. However, if the dentures are very loose and may prevent air from entering freely, then the dentures should be removed - Air in the Stomach: Provide proper ventilations to avoid getting air into the guest's stomach (gastric distention) which can result in vomiting. Air in the stomach often results from one of the following errors: • Not properly opening the airway • Giving ventilations that are too deep • Giving ventilations too fast - Suspected Spinal Injury: Avoid moving the victim's head and neck more than is needed. (1) Use the jaw thrust without head tilt
Practices you can use to overcome challenges and remain vigilant: (pg. 72: Table 8.2)
- Rive minute scanning strategy® - Station Rotations - Rotational task balance - Strategic break - Personal self-care
Whistle Codes (pg. 82: Table 9.2)
- The most frequently used device you will use to communicate - Whistle at all times when on duty - Common whistle codes involve short blasts and long blasts Common Whistle Code Include: > One Short Whistle Blast: To get a guest's attention. > Two Short Whistle Blasts: To get the attention of another lifeguard or staff member. > One or Two Long Whistle Blast(s) : To activate the Emergency Action Plan (EAP); indicating an emergency that may require a rescue and the assistance of others.
Airborne Pathogen Transmission
- Tuberculosis: Transferred Through - Air droplets from cough or sneeze - Measles: Transferred Through - Air droplets from cough or sneeze - Chickenpox (Varicella): Transferred Through -Air droplets from cough or sneeze; touching the blisters or mucous secretions - Mumps: Transferred Through - Air droplets from cough or sneeze, saliva - Meningitis: Transferred Through - Air droplets from cough or sneeze, saliva, or direct contact
How to clean up a spill mixed with sharp objects:
- Use a broom, dustpan or cardboard to properly remove the broken glass and deposit it in the proper container - Use a disinfectant to clean the surface of any remaining blood. - If you must make a disinfectant, prepare a mixture of 1 part bleach to 9 parts water. - Flood the area and allow it to stand for approximately 15 minutes. - Wipe up the remaining solution and dispose of it in a labeled biohazard container.
Secondary Drowning
- sometimes called "delayed drowning," or "silent drowning. - occurs following a submersion incident in which the guest appears fine at first but within 24 hours shows signs of drowning - Secondary drowning happens when some water is inhaled into the lungs. If you suspect a secondary drowning, don't hesitate. Immediately call Emergency Medical Services (EMS).
Handling Accidental Fecal Release Incidents (pg. 33)
1. Close the aquatic attraction where the event occurred 2. Remove as much of the fecal matter as possible using a net/scoop and dispose of it 3. Contact the person responsible for water chemistry and filtration 4. Properly sanitize equipment used before placing it back in service 5. Wait for instructions regarding when to reopen the attraction
Proper Glove Removal (pg. 41)
1. Pinch the outside of the glove near the wrist. 2. Peel downward and the glove will turn inside out. Secure this glove in your gloved hand. 3. Slide your finger(s) under the wrist of the remaining glove. 4. Peel downward and the glove will turn inside out over top the first glove. Dispose properly.
Single Rescuer Adult CPR (pg. 106: Table 11.1)
1. Position the adult on his/her back on a firm surface 2. Determine that the adult is unresponsive, not breathing, and pulseless 3. Kneel alongside the adult's chest 4. Place the heel of one hand on the center of the chest between the nipples. Place your other hand on top of the first hand. Straighten your arms and lock your elbows 5. With your shoulders over your hands, compress the chest at least 2 inches and allow the chest to return to its normal position. Give 30 chest compressions at a rate of 100 - 120 compressions per minute (almost 2 per second) 6. Open the adult's airway and give 2 ventilations. Each ventilation should last about 1 second and make the chest rise 7. Repeat cycles of 30 compressions and 2 ventilations until a defibrillator is available or the adult shows signs of life
Primary Check
10 seconds to determine the presence of immediate threats to life: • Check a guest for responsiveness (responsive guests will answer, move, or moan) • Check to see if the guest is breathing normally • Check for a pulse
The 10/20 Protection Standard
> 10 Portion - You must be able to scan your entire zone within 10 seconds and recognize if a guest is in distress. > 20 portion - You must be able to reach any part of your zone within 20 seconds so that in the event of an emergency you can travel to the guest in distress quickly.
Universal Distress Sign of Choking
A choking guest may clutch the throat.
Bag Valve Mask (BVM)
A device with a one-way valve and a face mask attached to a ventilation bag; when attached to a reservoir and connected to oxygen, it delivers more than 90% supplemental oxygen.
Test-ready
A lifeguard always needs to be prepared and be capable of everything they have learned and practiced. Your training does not end after the course. Your skills need to be maintained at a test-ready level throughout your credential validity period.
Resuscitation mask
A pliable, dome-shaped device that fits over a person's mouth and nose; used to assist with rescue breathing. - These devices involve a face mask and a one -way valve that attaches to the mask.
Life jackets: Finding the Right Fit
A properly fitted life jacket: • Fits snugly but comfortably to allow for the guest's arm movement without restricting breathing • Does not allow a child's chin and ears to slip through • Is tested out by the guest in shallow water to verify the guest's mouth does not slip below the water's surface • Has all buckles connected
Rescue Tube (pg. 20)
A safe, lightweight, and an effective lifesaving device for situations requiring rescues from the water. Using a rescue tube has advantages such as: • The ability to support several large people in the water • Reducing the amount of energy that you must expend when bringing one or more guests in distress to safety • Provides lifeguard safety. Positioned between you and a guest, the rescue tube reduces the likelihood that the guest will grab you during a rescue. And if a guest does happen to grab you, the rescue tube is likely to keep both you and the guest above water • The ability to quickly position the guest on the tube so that rescue breathing can be provided in the water when necessary • The ability to support a backboard in the water while performing extrications in which spinal injury issuspected
A.F.R
Accidental Fecal Release
Administrative Controls
Administrative controls include the programs and policies that support and direct the overall disease prevention plan. Examples of this Include: - training program - vaccination program - exposure control plan
Rotational task balance
Alternating your primary duty to watch your zone with other activities such as cleaning, slide dispatch, life jacket distribution, customer service, and breaks. - Moving in and out of your primary duty that requires you to maintain the 10/20 Protection Standard can help keep you more alert.
Circulatory Assist Devices (CADs)
Alternatives to conventional manual cardiopulmonary resuscitation (CPR). - Designed to provide continuous maximum compression and maximum recoil helping improve blood return to the heart while preventing rescuer fatigue.
ASTM International
American Society for Testing and Standards: A set of industry standards that provide guidance for amusement devices. There are specific standards for maintenance and operation for aquatic facilities operating water slides, and water tree house attraction elements.
"Rebooting" the Heart
An AED restarting the heart in the same way you would reboot a computer when it locks up. You shut it completely down and then restart it. That's how an AED works to "reboot" the heart.
A.F.O
Aquatic Facility Operator
Secondary Responsibilities Of Lifeguards
As a lifeguard you will have numerous secondary responsibilities such as: • Inspecting the facility • Documentation • Cleaning the facility • Testing water chemistry • Crowd control • Providing guest services
Other Unique Weather Conditions
As with other environmental conditions, follow your Emergency Action Plan (EAP) to provide for the safety of your guests and yourself.
Standard Precautions
Assume that all bodily fluids may be infectious, so precautions must always be taken. - Can be applied to engineering and work practice controls and to the use of Personal Protective Equipment (PPE).
Bloodborne And Airborne Pathogens
Bacteria and viruses are pathogens (germs) present in blood and other bodily fluids. Bacteria and viruses can live on surfaces outside the body for varying periods of time. - Medications such as antibiotics and anti-viral agents are used to treat bacterial or viral infections once they occur. But not all infections can be treated effectively.
Actively Drowning Characteristics of Active (Responsive) Guests in Distress
Be aware of the body position, movement, facial expression, and breathing effort of guests in distress. - Body position is typically vertical. - Arms are extended; as if trying to grab something for support. - Minimal leg movement; no forward progress being made. - Facial expression can be panic or fear - Eyes may be closed or widely opened; as if they are surprised to be drowning. - Head may be tilted back; to keep water out of their mouth. - Rarely call for help because they are focused on breathing.
Opening the Airway
Before providing rescue breathing you must open the guest's airway. There are two common maneuvers used by lifeguards to open the airway: • Jaw trust with head tilt • Jaw thrust without head tilt
Work Practice Controls
Behaviors (practices) that are required to implement engineering controls. - Properly using washing stations, sharps containers, and waste containers are examples of work practice controls. Specific work practice controls include protocols that: • Provide steps for removing soiled medical exam gloves • Provide steps for cleaning up sharp items and contaminated spills • Require hands to be immediately washed after removing soiled medical exam gloves • Require that you clean and disinfect equipment and surfaces if soiled
Vigilance
Being alert, attentive and always prepared to react while on watch. A proactive strategy applied to protect guests.
When to Summon EMS for Medical Problems:
Besides drowning incidents, call 9-1-1 for other serious conditions such as: • Loss of consciousness or an altered level of consciousness such as drowsiness or confusion • Absent breathing or breathing difficulty • Chest discomfort or pressure not relieved by resting, including pain radiating to the shoulder, arm, neck, jaw, stomach, or back • Fracture or dislocation • Persistent abdominal pain • Possible spinal injury • Severe burns • Severe external bleeding • Suspected poisoning including drug overdose • Vomiting blood
Strategic break
Breaks help keep you refreshed. - Certain points during your shift when a break will have the most positive impact on your ability to stay alert. - Your supervisor will schedule your breaks accordingly.
Wind
Can agitate the water's surface enough to affect your ability to see the pool bottom. Wind gusts can be dangerous, resulting in flying objects like furniture, umbrellas, towels, water bottles, and other items that are not secured. - Emergency Action Plan (EAP) provides procedures in case wind conditions become dangerous.
C.P.R
Cardiopulmonary Resuscitation
Example of how a Shallow Water Blackout may occur:
Cause: Sometimes guests play games in the water to see who can hold their breath the longest while submerged. - They may breathe rapidly (hyperventilate) in preparation for this challenge. Effect: This practice of hyperventilating and then seeing how far or deep they can swim underwater is dangerous because it can lead to loss of consciousness while submerged.
Ventricular tachycardia (V-tach)
Causes the ventricles to beat far too fast. The chambers cannot fill properly or pump blood effectively. - No pulse = cardiac arrest
C.D.C
Center for Disease Control
C.P.O
Certified Pool Operator
Rive minute scanning strategy®
Changing your posture every five minutes to stay alert. - - You might move from a sitting position to a standing or roving position
Water Quality in Pools and Hot Tubs
Chlorine (in some form) is one of the most common chemicals used to disinfect water. When dissolved in water, chlorine disinfects and sanitizes the water by killing germs and oxidizing contaminants.
Communication Methods (pg. 81: Table 9.1) (pg. 84)
Codes and signals are two methods used for communicating when working at an aquatic facility. - relay messages quickly - minimizing the need for discussion Common Communication Modes: (1) whistle codes (2) hand signals
Cardiovascular Disease
Conditions that involve the heart and the blood vessels (arteries, veins, and capillaries). - Coronary heart disease (CHD): narrowing of the coronary arteries, the blood vessels that supply oxygen and blood to the heart > Caused by atherosclerosis, which is the plaque (bad cholesterol substances) that accumulates on the inside walls of the arteries, causing them to narrow > CHD commonly causes chest discomfort, shortness of breath, heart attack, or sudden cardiac death, known as cardiac arrest - Diseases of the blood vessels can also affect other organs, such as the brain, resulting in a stroke.
Proactive Bottom Scan
Conducted prior to accepting and also when exiting zone of protection responsibilities. This scan is a careful check of the bottom of the zone that is already being protected by another lifeguard. - confirming that the zone is free of any guests in distress before you assume responsibility for the zone - repeat the scan verifying that the bottom is clear before transferring the zone to the incoming lifeguard - communicate using verbal and hand signals to the lifeguard you are rotating with acknowledging that the zone is clear
Sun Protection
Dermatologists recommend a "broad spectrum" sunscreen with a sun protection factor (SPF) of at least 30. • Waterproof sunscreen is capable of maintaining its SPF rating for 80 minutes when exposed to water • Water resistant sunscreen is capable of maintaining its SPF rating for 40 minutes when exposed to water
Vigilance Awareness Training® (VAT)® (pg. 74)
Designed by Ellis & Associates (E&A) to evaluate the ability of lifeguards to recognize and respond to a guest in distress. - helps you to remain rescue-ready at all times - real emergencies are simulated to evaluate your ability to to evaluate your awareness relative to your assigned zone - drills use objects like submersible manikins, silhouette dolls, or live persons to test your ability to recognize a problem in your zone and respond accordingly
Disease Prevention Practices
Disease prevention practices are made up of: • Administrative controls • Engineering controls • Work practice controls • Standard precautions • Personal Protective Equipment (PPE)
Ventricular fibrillation (V-fib)
Disorganized, chaotic electrical activity that results in quivering of the ventricles. Blood cannot be pumped out of the heart so the guest will be pulseless. - No pulse = cardiac arrest
Life Jackets
Drowning incidents among guests that are weak or non-swimmers can be prevented by using life jackets. - Life jackets should be U.S. Coast Guard approved and in good condition. - The inside of the life jacket lists sizes by weight load for each type. - The best life jacket is the one that is properly fitted and always worn.
Pre-existing Medical Conditions that can cause drowning:
Drownings (active or passive) can be caused by various medical conditions or special situations including heart attack, seizure, stroke, diabetic emergencies, head injury, shallow water blackout or substance abuse.
Lifeguard Zones
Each duty station has an assigned area of water to monitor. - referred to as "zones" - Zones overlap - Your assigned zone is your primary responsibility. - You need to know your zone and where you and other lifeguards share overlapping areas.
Engineering Controls
Efforts implemented to minimize disease transmission through workspace design or equipment use. Examples of this Include: - selfsheathing needles - hand and eye washing stations - biohazard waste containers - sharps containers - spill clean-up kits
The Heart's Electrical Conduction System
Electrical conduction system of the heart sends the signal that results in the contraction of the chambers of the heart and the pulse that is felt. - Pulses are generated by the heart's SA-node and AV-node
Technology Distractions
Electronic devices such as two-way radios, smart phones, watches, and other gadgets can cause your attention to be diverted away from your zone. - Immediate access to such devices may be necessary at your duty station, you should use these as your local protocols dictate, such as emergency situations. - Non-work-related electronics should not be used while on duty.
E.M.S
Emergency Medical Services
Chemical Safety
Employers implement a Hazard Communication Standard to reduce and prevent injury and illness resulting from exposure to chemicals. (required by OSHA) - This standard is met by requiring facilities to provide and make available Safety Data Sheets (SDS) for each chemical.
OSHA Protection Standards
Established regulations to protect employees from on-the-job exposure to bloodborne and airborne pathogens and OPIM. This includes reducing or removing hazards from your workplace that may place you in contact with infectious materials. The regulations are known as: • OSHA's Bloodborne Pathogens Standard 29 CFR 1910.1040 • OSHA Respiratory Protection Standard 29 CFR 1910.334
Single Rescuer Child CPR (pg. 106: Table 11.1)
For the purpose of CPR, a child is a guest between the ages of 1 year and puberty (about age 12). 1. Position the child on his/her back on a hard surface 2. Determine that the child is unresponsive, not breathing, and pulseless 3. Kneel alongside the child's chest 4. Place the heel of one hand on the center of the chest between the nipples. Straighten your arm and lock your elbow. For large children use 2 hands as you would for an adult 5. Compress the chest at least one third the depth of the chest (about 2 inches) and allow the chest to return to its normal position. Give 30 chest compressions at a rate of 100-120 compressions per minute (almost 2 per second) 6. Open the child's airway and give 2 ventilations. Each ventilation should last about 1 second and make the chest rise 7. Repeat cycles of 30 compressions and 2 ventilations until a defibrillator is available or the child shows signs of life
Single Rescuer Infant CPR (pg. 106: Table 11.1)
For the purpose of CPR, an infant is a guest between the ages of birth and 1 year of age. 1. Position the infant on his/her back on a hard surface 2. Determine that the infant is unresponsive, not breathing, and pulseless 3. Kneel alongside the infant's chest 4. Place 2 fingers on the center of the chest slightly below the nipples 5. Use your fingers to compress the chest at least one third the depth of the chest (about 1 1/2 inches) and allow the chest to return to its normal position. Give 30 chest compressions at a rate of 100-120 compressions per minute (almost 2 per second) 6. Open the infant's airway and give 2 ventilations. Each ventilation should last about 1 second and make the chest rise 7. Repeat cycles of 30 compressions and 2 ventilations until a defibrillator is available or the infant shows signs of life
Personal self-care
Getting adequate sleep, eating healthy, staying hydrated, exercising regularly, and wearing the proper clothing for the environment can help you stay alert at work.
Lifeguard Appearance And Behavior (pg. 18-19)
Guests view you as a professional, they are more likely to follow your directions. These lifeguard behaviors identify you as a professional: • Being Prepared • Rescue Ready • Safety Aware • Vigilant • Identifiable • Punctuality • Team Member • Focus on Health • Guest Ambassador
Passively Drowning Characteristics of Passive (Unresponsive) Guests in Distress
Guests who have lost consciousness. They may be seen bobbing or floating at the surface or submerged. - A submerged guest may look like a blurred spot or an object, such as piece of clothing - If you notice something below the water surface and cannot quickly identify it, activate your Emergency Action Plan (EAP), and enter the water to determine what it is.
Health Codes, Laws And Standards
Health codes, laws, and standards exist to provide direction and guidelines for how to best design, and safely operate aquatic facilities. - Your job as a lifeguard is to enforce all the procedures and rules established by management to keep your guests safe.
Zone Documentation & Training
How to Know the Zones in your facility: • Zone of Protection area document illustrating your zone responsibilities • Unique physical characteristics of each zone • All zones for an entire attraction or pool • Zone Coverage diagram illustrating lifeguard team zone responsibilities that overlap and how they work together • Specific rules or policies a lifeguard must enforce while on duty relative to the zone If a specific zone changes for special events or unique situations, your supervisor should provide a document that highlights the revised zone for any position that has a zone change. - If you are uncertain do not assume your zone, ask your supervisor.
Recovery Position
If a guest is unresponsive but is breathing and has no other life-threatening conditions, the guest can be placed in the recovery position. Placing a guest in the recovery position will ensure that any vomit or fluid will not cause the guest to choke.
Exposure Control Plan
If an exposure does occur, the exposure control plan states how to report the exposure and what to do next.
How to care for an airway obstruction in a conscious (responsive) infant?
If an infant (birth to 1 year) is responsive and choking, use a series of back slaps and chest compressions to relieve the obstruction. Follow these steps to relieve a severe airway obstruction in an infant: 1. Grasp the infant's jaw, position the infant's face down on your forearm, and lower your forearm to your leg 2. Use the heel of your free hand to give 5 back slaps between the infant's shoulder blades 3. Grasp the back of the infant's head, roll the infant face up on your forearm, and lower your forearm to your leg 4. With your free hand, place 2 fingers on the breastbone, about a finger width below the nipples, and give 5 chest compressions. Each compression should be at least 1/3 the depth of the chest (about 1.5 inches) and allow the chest to fully recoil after each compression 5. Look in the mouth for any object. If an object is visible sweep the object out with your gloved finger 6. Repeat these steps until the obstruction is dislodged or the infant becomes unresponsive. If the infant becomes unresponsive, begin CPR
How to care for an airway obstruction in a conscious (responsive) adult and child?
If the choking guest is an adult or child, use the Heimlich Maneuver to dislodge the obstruction. (1) Stand behind the guest. (2) Reach around the guest's waist with one hand and locate the navel. (3) Make a fist with your other hand and place the fist just above the navel. (3) Grasp your fist and give inward and upward thrusts to force the object out (4) Repeat these thrusts until the object is dislodged or the guest becomes unresponsive. (5) If the guest becomes unresponsive, you will need to begin CPR. If a choking guest is too large and you are unable to reach around the guest to give effective abdominal thrusts, or if the guest is obviously pregnant, give chest thrusts. (1) Reach under the guest's armpits and place the thumb side of your fist against the center of the guest's chest. (2) Grasp your fist with your other hand and give quick, inward thrusts
"if you don't know, go!"
If you are ever unsure about a situation in your zone, or if you are in doubt about something you are seeing, treat it as an emergency and respond immediately. - When in doubt, check it out.
Secondary Check
If you do not find any life-threatening conditions during the primary check, you should perform a secondary check. - Try to gather any medical history - If the guest is responsive ask if the guest has had any previous medical problems or is currently taking any medications for the condition. - Perform a quick check of an injured guest from head to toe looking for wounds, deformities, tenderness, or swelling. - If the guest is ill look for signs like hives, rashes, or temperature extremes.
How to care for an airway obstruction in a unconscious (unresponsive) guest?
If your ventilations fail to make the chest rise, reposition the head and mask, and repeat ventilations. If still unsuccessful, suspect an airway obstruction. (1) Provide 30 chest compressions to dislodge the object. (2) Look in the mouth for any object and sweep the object out with your finger if you see it (3) Reattempt ventilations. > This is normally all that is needed to dislodge the object. (4) Repeat this process until chest rise is obtained.
Heart Electrical Impulses
Impulses originating in the upper right side of the heart, move along an electrical conduction system in a wavelike pattern throughout the heart. When these impulses reach specialized muscle tissue, the chambers of the heart contract and then relax. This action moves blood throughout the body and generates a pulse. The electrical impulses in the heart can be viewed and interpreted through an electrocardiogram (ECG).
Dehydration
Inadequate hydration can lead to dehydration, a loss of body fluid that leads to fatigue. - Drink plenty of fluids throughout your shift to avoid the effects of dehydration.
In-Service Training
Intended to serve as an ongoing practice session for you to maintain and enhance your skills learned during the original lifeguard class.
Convulsions
Involuntary muscular contractions, spasms, or jerking - a seizure; due to the hypoxia, the brain is not receiving enough oxygen which will cause an epileptic fit.
Cardiopulmonary Resuscitation (CPR)
Involves providing chest compressions and ventilations that help circulate blood and oxygen to vital organs throughout the body. - If you conduct your primary check and confirm that the guest is unresponsive, not breathing, and pulseless, begin CPR starting with chest compressions. - Make sure your EAP is activated in order to get an Automated External Defibrillator (AED) and Emergency Medical Services (EMS) professionals called to the scene as soon as possible.
Water Chemistry
It impacts the water clarity for you to safely see your zone, but it can also affect whether or not contaminants like bacteria from recreational water borne illnesses are able to live and grow in the water. - A Certified Pool Operator (CPO) or an Aquatic Facility Operator (AFO) will handle the responsibility of managing the facility's water chemistry, adjusting chemicals, and maintaining the filtration system.
Guest Safety During Station Rotations (pg. 70: Table 8.1)
It is important that the 10/20 Protection Standard is maintained during lifeguard station rotations. Follow these steps during rotations: 1. The incoming lifeguard conducts a Proactive Bottom Scan confirming the zone is clear of any guests in distress and communicates this information to the on-duty lifeguard 2. Equipment, such as the rescue tube, is exchanged (if necessary) 3. The incoming lifeguard assumes the on-duty position and both lifeguards watch the zone 4. The outgoing lifeguard conducts a Proactive Bottom Scan and communicates "all is okay"" before leaving 5. The new on-duty lifeguard is in control of the lifeguard station until the next lifeguard rotation
Jaw thrust With Head Tilt
Jaw thrust with head tilt is commonly used to open the airway when spinal injury is not suspected. (1) Position yourself at the top of the guest's head. (2) Place your index and middle fingers of both hands behind the angle of the guest's jaw, and your thumbs on the cheekbones. (3) Lift the jaw with your fingers and tilt the head back. (4) Adults require more head tilt than children or infants. > Do not hyperextend the neck of a child or infant, as this could cause narrowing of the trachea.
Proactive Scanning Strategies
Knowing your zone and what drowning looks like will help you to prevent drowning.
L.U.D
Left uterine displacement
Life Jacket Inspections
Life jackets should be inspected daily for normal wear and tear and cleanliness. - Damaged life jackets should be removed. - Look for holes, tears, and broken buckles or clips - Life jackets should be stored in a place that allows them to dry out when not in use yet still be visible for guests - Remove life jackets if there is a smell of mildew, or signs of water logging
Operational Drills (this is how one is audited)
Lifeguard evaluations that can include the use of people, manikins or silhouette dolls to monitor your vigilance. Some drills may also involve scenarios where rescue skills are performed. As an E&A lifeguard, you should embrace all opportunities to both improve and demonstrate your lifeguarding abilities.
Accountable (pg. 11-12)
Lifeguards can be held accountable through performance evaluations that include audits. As an E&A lifeguard you are accountable to: (1) Facility guests (2) Your employer (3) Yourself
Rain
Light rain can have an impact on your ability to fully see and protect your assigned zone. - Rain falls on the surface of the water in your pool, it creates a mild agitation, decreasing the visibility of the water below the surface.
Hypoxia
Low oxygen saturation of the body, not enough oxygen in the blood.
Original Equipment Manufacturers Operations and Maintenance Manual (pg. 48)
Manual that comes from the builder of the attraction. Provides direction on how to... - operate, maintain, and repair the attraction - when to dispatch riders on the slide, how riders should participate on the slide, and what information should be placed on signage to describe the ride
M.A.H.C
Model Aquatic Health Code: A voluntary guidance document based on science and best practices that helps local and state authorities and aquatics facilities to provide healthy and safe swimming and other water activities.
Water Quality in Natural Body of Water Facilities
Natural body water facilities can be affected by algae blooms and pollutants such as runoff from heavy storms, industrial waste, oil spills, wildlife waste, fertilizer, pesticides, boating waste, and littering.
Are inflatable swim aids reliable flotation devices?
No. Use of inflatable swim aids such as water wings, these are not reliable flotation devices and are not U.S. Coast Guard approved. - Request that they wear a life jacket as this is an established safety practice.
Supplemental Responders
Non-lifeguard team members trained to assist lifeguards in emergency response. - Smaller facilities may have only one lifeguard with additional staff trained.
O.S.H.A
Occupational Safety and Health Administration
Lifeguard Station Rotations
Occurs when one lifeguard assumes the responsibilities from another lifeguard. - Your supervisor will determine a rotation schedule - Rotation period has and increased risk for guests due to its potential impact on lifeguard vigilance When rotating lifeguard stations, you will: • Ensure that the 10/20 Protection Standard is always maintained • Avoid distractions that may prevent you from recognizing a guest in distress • Be ready to react to any guest situation • Perform a proactive bottom scan of your zone
O.P.I.M
Other Possibly Infectious Material
Sun
Overexposure to the sun is a preventable environmental risk. Negative Effects: sunburn, dehydration, fatigue, heat-related injuries and long-term damage to skin such as skin cancer Preventing Negative Effects: • Work in a shaded area or under an umbrella • Wear a hat/visor • Wear sunglasses with polarized lenses • Wear a shirt as part of your uniform • Apply sunscreen with an SPF broad factor of 30 frequently to all exposed skin
Personal Protective Equipment (P.P.E)
PPE prevents blood and OPIM from coming into contact with your exposed skin or mucous membranes while you provide care. Examples of P.P.E's • Breathing devices • Suction devices • Medical exam gloves • Face masks • Gowns • Eye protection
How to preform Chest Compressions and Ventilations (pg. 106: Table 11.1)
Part 1: Chest Compressions Chest compressions are the most important part of high-quality CPR, and require you to: • Position the guest on his/her back on a hard surface • Compress on the center of the chest • Push fast (at a rate of 100-120 compressions per minute) • Push deep (at least 2 inches for an adult or child)(2/3 the way down on their chest) • Push rhythmically • Allow for complete recoil of the chest • Minimize interruptions Part 2: Ventilations Ventilations are the second part of CPR. Ventilations should be given over 1 second duration and be enough to make the chest rise. They are given every 30 compressions.
Multiple-Rescuer CPR (pg. 106: Table 11.1)
Performing CPR as part of a team enables rescuers to change positions when one tires during chest compressions. - This should be done about every two minutes to ensure that compression depth and rate are maintained at an optimal level. How To: (1) One rescuer provides chest compressions and the second rescuer provides ventilations (2) On an adult, the compression to ventilation ratio remains the same as one-rescuer CPR which is 30:2 (3) On a child or infant, the compression to ventilation ratio changes to 15:2 (4) On an infant, the rescuer providing compressions should use two thumbs to compress the chest, while encircling the infant's chest with both hands
P.P.E
Personal Protection Equipment
Pregnancy and CPR
Placing a woman in the later stage of pregnancy flat on her back can result in the weight of the fetus compromising blood flow in and out of the heart. You can correct this by carefully moving the fetus toward the left side of the abdomen, a technique known as left uterine displacement (LUD). Hold the fetus in this position while chest compressions are provided by other responders.
Automated External Defibrillator (AED)
Portable electronic device applied to a guest in cardiac arrest. It can analyze the heart rhythm and deliver an electric shock, known as Defibrillation, to the heart of a guest to correct ventricular fibrillation or ventricular tachycardia. - The goal of defibrillation is to reestablish a viable heart rhythm by shutting down the heart (asystole), enabling the heart to restart with normal electrical and mechanical function - records data such as the number of shocks delivered, changes in the ECG, the date, and the time of use
Scanning
Proactively searching your entire assigned zone every 10 seconds for guests in distress, looking at all depths of the water including the bottom, middle and surface area.
Company Procedures (pg. 48)
Procedures are developed based on codes, laws, and standards. - A company with multiple beaches, pools, water parks and resorts will likely want all its properties to operate consistently.
R.W.I
Recreational waterborne illnesses: - Spread to humans when they swallow, breath or come in contact with contaminated water. -Typical signs: Skin rashes, ear aches, and diarrhea. Some cases, however, can result in pneumonia, neurological damage, and even death.
Preventive Lifeguarding
Remain alert and work to prevent emergencies. As a lifeguard, people rely on you to prevent catastrophic incidents. This job requires your undivided attention.
The Respiratory System
Responsible for delivering oxygen to the lungs during inhalation and removing waste products, such as carbon dioxide, during exhalation. - This process is needed to sustain life - Interruption in this process caused by conditions such as choking, suffocation, or drowning, can result in death within minutes
How to Checking Responsiveness, Breathing, and Pulse:
Responsiveness: - If the guest is motionless, Tap the shoulder of the guest and shout, "Are you OK?" > If the guest does not respond, he or she is said to be unresponsive. If the guest is unresponsive, make sure 9-1-1 has been called. Breathing: Open The Airway - Open the airway and quickly visualize the chest > looking for movement (rising and falling) that would indicate breathing. Pulse: - At the same time, check the carotid pulse > In the neck of an adult or a child (anyone over the age of one year). For infants, check the brachial pulse in the inside of the upper arm > Use your index and middle fingers to locate the Adam's apple. Slide your fingers toward you, into the groove at the side of the neck. > Press down and feel for a pulse for up to 10 seconds. - If the guest is unresponsive, not breathing (or only has occasional gasps), but has a pulse, the guest is in respiratory arrest and needs rescue breathing. - If the guest is unresponsive, not breathing (or only has occasional agonal gasps), and no pulse, the guest is in cardiac arrest and needs cardiopulmonary resuscitation (CPR).
Station Rotations
Rotations necessary to provide lifeguards with a break from constant scanning
Rule Enforcement
Rules are established to prevent potential risks and injury. Remember to keep the conversation with a guest positive. An example of this would be stating "Please walk" instead of "No running!"
Go To Lifeguard Scanning Triangle (pg. 65)
Scan all volumes of water from bottom u to the surface.
Maintaining Vigilance Within Your Zone
Scanning your area constantly means searching the water in a manner that allows you to view all depths of the water every 10 seconds.
Secondary Duties
Secondary duties must not take away from your primary responsibility. Examples of secondary duties include: • Teaching a swim lesson • Coaching a swim team • Leading a special event, such as a birthday party • Taking attendance • Retrieving or putting away equipment • Adjusting or moving lane lines • Checking pool chemistry • Documenting facility records, logs and reports • Completing opening or closing attraction inspections • Conducting a water fitness class • Cleaning the facility • Working in admissions and cash handling • Passing out tubes or rafts for an attraction • Assisting guests with life jackets - secondary duties should not be done while you are at a duty station protecting your zone
Respiratory Distress
Signs and symptoms of respiratory distress include: • Labored breathing (Straining to breathe) • Noisy breathing (Wheezing, gurgling or high-pitched sounds) • Unusually slow or fast breathing • Unusually deep or shallow breathing • Irregular breathing • Gasping for breath • Inability to speak in full sentences • Restlessness, anxiety, and confusion • Changes in level of consciousness • Flushed, pale, or bluish (cyanotic) skin • Chest pain or discomfort • Tingling sensations
Facility Signs
Signs that communicate information and rules to guests. - can be in digital, illustrated or print format - typically posted at the entrance of the facility and near the attractions entrance - become familiar with content on these signs Examples: • Safety information including water temperature, chemistry, weather • Facility rules, policies and operating hours • Life jacket information • Attraction restrictions including height, weight, swimming requirements • Guest education such as safe swimming guidelines, lifeguard training notifications
Avoiding Distractions
Social and technology distractions can greatly impair your ability to remain vigilant. Be positive and friendly, yet remain on task and vigilant.
What is a guest in distress? G.I.D
Someone who needs immediate assistance. The guest will either be actively drowning or passively drowning. Guests can drown in three areas: • On the surface • Below the surface, within arm's reach • Below the surface, beyond arm's reach
Recognizing [a guest in distress] Risk Factors (pg. 61)
Statistics helps us understand who the higher risk guests are, pool locations where a higher number of rescues are made, and time of day and holidays when a greater frequency of water rescues occur. - Unattended children under age 14 - Weak or non-swimmers not wearing a life jacket or wearing it improperly - Adults under the influence of alcohol or other drugs - - Guests with medical conditions prone to sudden illness
Hydration
Staying hydrated keeps lifeguards alert and vigilant.
Scene Survey
Surveys provide valuable information such as: • What may have happened • The general type of problem that resulted such as a sudden illness or an injury • The number of guests involved • If the area is safe for you to approach and to provide care. Unsafe areas include situations such as live electric wires, fire, smoke, toxic chemical exposure, and areas with active assailants If the scene is unsafe, try to make it safe without endangering your life. There are two types of Surveys: (1) Primary Check (2) Secondary Check
Increasing Odds of Surviving Cardiac Arrest
The "Chain of Survival" is a concept based on a series of actions that must occur for a guest to have the best chance to survive cardiac arrest. The strength of the chain is dependent upon all the links: • Early recognition and access to EMS through an emergency number (e.g. 9-1-1) • Early CPR by those first on the scene • Early defibrillation, often using an AED • Early advanced care by paramedics and hospital professionals • Effective post resuscitative care
Creating Lifeguard Zones
The 10/20 Protection standard is the basis for deciding how large a zone can be and how many lifeguard stations are needed to staff the entire attraction. - Your supervisor is responsible for making sure you understand your zones and maintain the 10/20 Protection standard: the Zone Validation® system is used to determine if a alone meet sthe 10/20 protection standard. - You should notify your supervisor if you are unable to view your assigned zone so that an adjustment can be made.
The Circulatory System
The circulatory system is made up of the heart and blood vessels. This system delivers oxygen and nutrients throughout the body and removes waste products such as carbon dioxide. The heart muscle is unique in that it creates its own electrical impulses automatically. - An organ the size of a guests fist. - The two chambers on the right side of the heart are the right atrium (upper chamber) and right ventricle (lower chamber). These chambers receive oxygen-poor venous blood from the body and pump it to the lungs, where the waste products are removed, and oxygen is picked up and returned to the left side of the heart. - The two chambers on the left side of the heart are the left atrium (upper chamber) and left ventricle (lower chamber). These chambers accept the oxygen-rich blood and pump it out to all parts of the body through the arteries.
Standard of Care
The degree of care that a responsible person is expected to provide to prevent further harm and/ or manage the injury or illness for a guest in need. In your case, the standard of care considers the practices of what equally qualified lifeguards would have done if placed in the same or similar circumstance.
How the Heimlich Maneuver Works
The diaphragm is the largest muscle aiding breathing. When your hands are positioned just above the navel, they lie just below the diaphragm. When you pull inward and upward, the diaphragm is moved upward. This action forces air out of the lungs under pressure, which is often adequate to dislodge an object in a conscious choking adult or child.
Using an AED
The initial care for a guest in cardiac arrest involves giving CPR until a defibrillator is available. (1) turn the device on and follow the prompts (2) Prepare the guest's chest. > This involves removing clothing, drying the chest if damp, and shaving any excessive hair where the electrodes will be placed: AED will have a kit to prepare the body with inside.
Rescue Breathing
The process of manually providing oxygen to the lungs of a guest in respiratory arrest by giving ventilations using your own breath, or by an artificial means, such as the use of a bag-valve-mask (BVM).
Local State Swimming Pool Codes and Regulations (pg. 48)
The regulations are enforced by the local Health Department. These regulations typically list the type of lifeguard training requirements needed to work in a facility, facility design elements and equipment, how to handle bio-spills and RWIs, and acceptable water chemistry requirements for operation.
Laryngeal spasm (laryngospasm)
The sudden spasm of the larynx resulting in the closure of the larynx, meaning the epiglottis is sealed and the guest cannot breath. No breath = No oxygen = Potential death. - This spasm is a protective mechanism to keep water out of the airway. Unfortunately, it keeps oxygen out as well.
Risk Factors for Cardiovascular Disease
There are 8 risk factors commonly associated with cardiovascular disease. Five risk factors that can be controlled are: • High cholesterol - Total cholesterol level is a measure of all the cholesterol in the blood, including LDL (bad) cholesterol and HDL (good) cholesterol. • High blood pressure - Blood pressure (BP) increases with each heartbeat and decreases when the heart relaxes. Blood pressure constantly changes as a result of exercise, stress, or sleep. > For adults at rest, BP for adults should normally be less than 120/80 mm Hg (120 systolic and 80 diastolic) • Overweight - Body Mass Index (BMI) is a method used to determine if a guest is overweight. Although BMI correlates with the amount of body fat, it does not directly measure body fat. Some people, such as athletes, may have a BMI that identifies them as being overweight even though they do not have excess body fat. • Smoking - Smoking is a major cause of heart disease. A guest's risk of heart disease and heart attack greatly increases with the number of cigarettes smoked. People who smoke are two to four times more likely to suffer heart disease. • Diabetes - Adults with diabetes are two to four times more likely to have cardiovascular disease than adults without diabetes. People with diabetes often have other risk factors that contribute to their risk for developing cardiovascular disease. Risk factors that cannot be controlled are: • Gender - Coronary heart disease claims men and women in nearly equal numbers each year • Heredity - Certain inherited heart conditions can affect the physical structure of the heart and interfere with its ability to pump blood to the rest of the body. Hereditary electrical disturbances (dysrhythmias) can result in a heartbeat that is wrong and sometimes sudden death • Age - As people age, the risks of cardiovascular disease increase
AED Special Considerations
There are four special considerations to be aware of when using an AED: • Medication patches (nitroglycerin patches explode/light on fire) • Children and infants • Water • Implanted devices
Causes of Respiratory Emergencies?
There are numerous causes of respiratory emergencies which can result in respiratory distress or respiratory arrest. These include: • Airway obstruction (Choking) • Inhaling smoke or other toxic substances • Aspiration (Breathing in stomach contents when vomiting) • Asthma • Lung infections such as pneumonia • Near drowning • Suffocation • Chest trauma • Opioid (narcotic) overdose • Electrocution • Heart attack • Cardiac arrest
How Diseases Are Transmitted
There are three conditions that must be met for disease transmission to occur: • The pathogen must be present in adequate quantity to cause disease • A person must be susceptible to the pathogen • The pathogen must enter the body through an opening such as the eyes, nose, mouth, skin cuts, abrasions, bites, or needlestick puncture
Shallow Water Blackout
This blackout results from reduced oxygen supplied to the brain. An underwater "faint" due to the lack of oxygen to the brain brought on by holding one's breath for long periods of time. - Breathing is normally triggered by the elevation of carbon dioxide (CO2). Hyperventilating before submerging reduces the automatic response to breathe. - As oxygen (O2) is depleted, the guest can suddenly faint without feeling the need to breathe.
Improving Performance
This course is just the beginning of your lifeguard training. - your facility supervisor will typically continue your training with additional learning drills - drills are designed to keep you alert, increase your ability to recognize guests in distress - on-going training is designed to make sure you are accountable and at a test-ready level
OSHA's standards require that your employer protect you when you are doing your job.
This includes: • Identifying duties that you will perform that fall within the protection offered by the standards • Establishing an Exposure Control Plan that includes protective measures to follow to minimize the chance of disease transmission • Seeking your input into engineering and work practice controls • Offering access to the Hepatitis B vaccination • Creating a system of recordkeeping that tracks required training and exposure incidents • Creating protocols to follow in the event of an exposure incident • Implementing a schedule for cleaning and decontaminating the workplace • Implementing a system to identify and properly dispose of soiled material • Ensuring confidentiality of your medical records and any exposure incidents
Thunderstorms
Thunderstorms are dangerous and considered a weather-related emergency. Thunder and lightning, typically accompanied by heavy rain or hail, are more frequent in the summer months or in warmer climates. - Once it is determined that your facility needs to shut down, you must work quickly and safely to move guests to a secure and safe location
Hyperventilate
To breathe rapidly and deeply; to breathe beyond normal or what is necessary. Can cause a Shallow Water Blackout or someone to pass out even outside of a pool. - If you believe that the guest may pass out outside of the water, have them breath into a PAPER bag. The CO2 will trigger their brain and normalize their Oxygen levels.
How to care for a guest experiencing respiratory distress:
To care for a guest experiencing respiratory distress: • Help the guest rest in a position that makes breathing easier. This is often a seated position • Comfort and reassure the guest • Call 9-1-1 • Assist the guest with his or her prescribed medications, such as an inhaler • Administer emergency supplemental oxygen if available • Keep the guest's airway clear
Proper Hand Washing
To properly wash your hands after removing medical exam gloves: 1. Wet your hands with warm water. 2. Apply soap. 3. Rub your hands vigorously for at least 15 seconds, covering all surfaces. 4. Rinse with warm water. 5. Dry thoroughly
Jaw Thrust Without Head Tilt
Use this method when a spinal injury is suspected. - In this case it would be unwise to tilt the head back, as this might cause further damage to the spine. (1) Position yourself at the top of the guest's head. (2) Place your index and middle fingers of both hands behind the angle of the guest's jaw, and your thumbs on the cheekbone (3) Lift the jaw with your fingers but do not tilt the head back This will displace the tongue enough so that rescue breathing will be successful.
Radio Codes
Used to transmit information so that only persons working in your facility can understand what is being discussed. - Often site-specific - Special terms or phrases may be used during an emergency to distribute information quickly
Providing Ventilations (pg. 94: Table 10.1)
Using Resuscitation Mask: (1) After you have opened their airway, provide rescue breathing using the resuscitation mask. (2) The mask must be seated properly on the guest's face (3) Use one of the jaw thrust techniques, hold the mask securely to the face with your thumbs. Using BVM: (1) One rescuer holds the mask securely to the face and maintains an open airway. (2) The second rescuer squeezes the bag to provide ventilations. - A two-rescuer skill that even experienced providers need to frequently practice to maintain proficiency - The BVM provides a higher concentration of oxygen than a resuscitation mask alone. - When connected to an oxygen cylinder, the BVM provides the highest concentration of oxygen possible during rescue breathing BOTH: - The ventilation itself should last 1 second. - Time in between the ventilations are generally 3-5 seconds for a child or infant and every 4-6 seconds for an adult. > Children and infants do not need the same volume as adults. > Each ventilation should be enough to make the chest rise. - If a breathing tube is present a bag-valve-mask (BVM) can be attached directly to the tube. If Ventilation Does Not Work (chest does not rise when providing ventilations): - Reposition the head and mask and reattempt your ventilation - It is likely the guest has an airway obstruction that needs to be cleared.
Rescue Breathing: What Really Matters?
Ventilations must be provided in a manner that does not over inflate the lungs or end up with air in the stomach. Breathing too rapidly (hyperventilation) or forcefully can damage the lungs of a young child or infant. It can also cause distention of the abdomen that can result in vomiting, inability of the lungs to fully inflate, and a decrease in the amount of blood that returns to the heart.
Audit
Verify that lifeguards are still maintaining their test-ready commitment to their lifeguard training.
Tornados
Watch - A tornado watch means that tornadoes are possible. Tornado watches are issued long before a storm potentially reaches the area where the tornado may touch down. Warning - A tornado warning means that a tornado has touched down.
Weather Conditions
Weather is an environmental risk that lifeguards are exposed to while working. Weather is unpredictable and can change quickly. Weather-related emergencies that you are likely to face include: • Sun exposure • Rain • Thunderstorms • High wind • Tornados • Other unique conditions
Multiple Rescuer Facilities
Whatever their designation, all responders should know their roles in every situation. - When your EAP is activated, working as a team will provide the most effective response in emergency situations. - Duties vary based on whether you are the primary responder or secondary responder.
Activating EMS
When a 9-1-1 call is placed, an emergency call taker (dispatcher) will request information from you: • Whether you need police, fire or medical assistance • Your name • The phone number from which you are calling • The location of the emergency and accessibility • The problem you are experiencing Answer the questions and do not hang up before the dispatcher indicates you can do so. The dispatcher is likely trained to provide pre-arrival instructions to assist you with life-saving steps if needed until EMS personnel arrive and take over.
Respiratory Arrest
When a guest is no longer breathing. This process prevents the delivery of oxygen to the body, most importantly to the brain, causing loss of consciousness - Can result from prolonged respiratory distress, or as a result of cardiac arrest - Can also exist when breathing is ineffective, such as agonal breathing - Immediate care for respiratory arrest is to provide rescue breathing
Dysrhythmias
When the normal electrical activity of the heart is interrupted; an electrical disturbance. - Can be discovered on an electrocardiogram (ECG) There are Two of the most common life-threatening dysrhythmias: (1) ventricular tachycardia (V-tach) (2) ventricular fibrillation (V-fib)
Whistle
Worn around your neck and used to get a guests attention, and has a second tone used to activate an EAP.
Hip Pack
Worn around your waist and can be accessed on land or in the water. Inside: resuscitation mask and non-latex gloves.
Emergency Action Plans
Written procedures to practice and follow when there is an emergency. Outlines a course of action that will help you, your supervisors, and other staff to work as a cohesive team to manage different emergency situations in the best way possible. - there are different plans for different types of emergencies. - you are often a primary responder in an emergency The responding lifeguard, your initial communication of a problem notifies others who put the steps of the EAP into motion.
Proactively Scanning
You are actively searching the water, often physically moving to see everything, and adjusting your body posture to search through all depths of water in the zone. - When working in an elevated location you may need to physically adjust your body position and head/eye movements so that you can clearly see along the walls and edges in your zone Proactive scanning is... • Concentrating on your zone • Observing guests • Searching all depths of water • Searching the extreme areas • Physically moving to see all activity in your zone • Using a searching pattern(s) • Facing your zone with your body when roving • Actively using strategies to minimize distractions
Single Rescuer Facilities
You are the only lifeguard on deck at any time, responsible for recognizing and responding to any guest in distress. - If there is a guest who needs assistance, you will render care. - If you need assistance, request help from supplemental responders who are trained to do so. - The lifeguard will be looked upon as the lead responder - Practice working with your facility supplemental responders so that you are comfortable as the lead responder
Other types of Water Contaminants
You may be responsible for cleaning up these types of bio spills when they occur in or around their water. - Cleaning up vomit and or blood is like cleaning up a well-formed accidental fecal release.
Ho do you follow an EAP?
You will work to achieve a successful outcome by: • Rapidly recognizing a guest in distress • Promptly providing a rescue and in-water care • Moving a guest (extricating) from an area of danger when necessary • Providing effective care on land while awaiting the arrival of Emergency Medical Services (EMS) personnel after being summoned
Know Your Zone
Your Zone Should: • Be able to be scanned within 10 seconds • Be designed to reach the furthest point within 20 seconds • Be diagrammed to clearly show the entire area of responsibility • Clearly show any overlap with any adjacent zones • Identify unique physical characteristics of the zone • Consider factors that impact the 10/20 Protection Standard • Indicate if lifeguard stations are stationary or roving
Lifeguard Uniform
Your employer will provide the specifics on the standard lifeguard uniform for your facility. Lifeguard uniforms might include items such as: • Bathing suit/shorts or trunks • Shirt • Hat/visor • Polarized sunglasses
Social Distractions
Your eyes must remain on the water as you constantly scan. Tell them when you will be on break, when your shift ends, or other times when you will be available to talk. - you need to respond to guests without compromising the 10/20 Protection Standard. - keep the conversation brief and continue scanning your zone.
Special Attraction Rules and Restrictions
Your facility has operational rules for the safe use of the attraction by guests, including water slides, treehouse structures, diving boards, and surfing attractions. Examples: Rules can refer to... - size and weight of the guests - rider configuration Examples of restrictions include: • No weak swimmers in deep water • Children and weak swimmers must wear a life jacket • No swimmers in the lazy river without a tube
Communication Devices And Standards
Your facility will have a communication process in place that allows you to activate your EAP and quickly share pertinent information. Knowing your communication program will help you: • Contact EMS • Effectively communicate with others while on duty • Understand what is expected of you by others • Receive assistance from other lifeguards and non-lifeguard staff
Fecal Incidents in Your Facility (pg. 33)
Your facility will have a protocol outlined for handling accidental fecal release (AFRs) incidents. - your facility should provide training on how to respond to AFRs - The Centers for Disease Control (CDC) and Model Aquatic Health Code (MAHC) provide guidance on the proper way to handle AFRs and maintain healthy swimming facilities
Rule Enforcement
Your job is to know those rules, enforce them consistently, and follow them responsibly. - follow the rules yourself - know all the rules of your facility Some of the more common rules found in aquatic facilities include: • Proper swimwear required in pool • Walk, no running • No diving • Obey lifeguards at all times • No glass on the pool deck • Supervise children at all times • Please shower before entering the water
General Environmental Safety
Your personal safety must come first. If you are not safe, you will not be able to aid others when needed. Practicing safe behaviors can help minimize environmental risk factors in your work place. Potential Risk-Factors: > sun-exposure > dehydration > weather-related incidents > exposure to chemicals
A.E.D
automated external defibrillation
E.C.G
electrocardiogram
What is a lifeguard's primary duty?
guest safety: emergencies require you to recognize and respond to a guest in distress is!
Agonal Breathing
irregular, gasping breaths that are shallow therefore are ineffective in proving oxygen to the lungs.
Respiratory Arrest
permanent cessation of breathing (unless there is medical intervention)
pH
potential Hydrogen: - measured on a scale that runs from 0 to 14. - 7 is neutral, meaning there is a balance between acidity and alkalinity. - pH is above 7, the water is more basic (alkaline) - Below 7 the water is more acidic. - The optimum pH for pool water is typically at or near 7.4.
Cardiac Arrest
sudden, unexpected stoppage of heart action, often leading to sudden cardiac death
C.A.R.E
• Confident in your ability to maintain a test-ready skill level by enhancing your development through ongoing training participation. • Attentive to your Zone of Protection Area while on duty, anticipating and preventing potential issues (weak swimmers, crowded conditions, surface glare). • Responsive when faced with an emergency that requires you to quickly assess a situation and determine the best course of action. • Empathetic by placing yourself in the guest's position, understanding their needs and emotions.
What types of documentation could you be required to take? (documentation is a secondary responsibility of a lifeguard)
• Daily sign-in sheets • Facility inspection checklists • Attendance records • Lifeguard rotation logs • Facility maintenance records • Equipment inspection forms • Rescue reports • Incident and witness reports • Daily work schedules • Water chemistry logs • Weather condition reports • In-service training records • Attraction downtime records
D.E.A.L
• De-escalate the situation - Start with a clear understanding of the guest's concern. • Evaluate alternatives - Examine the options available to help with the guest's concern. • Act quickly - Based on the information you gather, and after considering your options, take action to improve the situation. • Look at outcomes - Evaluate how effective your action was afterward.
Signs of Secondary Drowning:
• Difficulty breathing • Persistent coughing • Froth (foam/fluid) from the nose or mouth • Choking as if drinking water that "went down the wrong tube" • Diminished consciousness • Anxiety • Extreme fatigue • Pale/bluish/gray lips and fingers • Chest pain • Vomiting
Guidelines for using PPE to prevent infection include:
• Follow Standard Precautions when using PPE • Avoid handling items such as radios when wearing soiled gloves • Do not eat, drink or touch your mouth, nose or eyes when giving care • Change gloves before providing care to additional guests • Wear protective coverings to avoid blood splatter from serious bleeding
Shelter During Thunderstorms
• If outside, take shelter in a building, completely enclosed structure, or hardtop vehicle • Protect yourself from lightning - avoid shelter areas that are not fully enclosed • Once guests are secure indoors, advise them to stay clear of metal objects, plumbing and even land lines. All three can conduct electricity from a direct lightning strike • Check with the National Weather Service or National Oceanic and Atmospheric Administration (NOAA) for additional information about lightning safety
Facility Type
• Indoor aquatic facilities have air ventilation systems designed to heat and circulate air in the facility to maximize guest comfort. These systems create a warm, climate-controlled environment with elevated air temperature and higher humidity levels. • Outdoor facilities are likely to experience greater changes in air temperature and humidity. These facilities are also impacted by wind, rain, and direct sunlight.
L.E.A.D
• Listen - to guests' concerns about rules without interrupting them • Empathize - with guests regarding how they may feel • Apologize - for any misunderstanding about rules on their behalf • Discuss - the rule, and provide guests with options if available
Examples of the codes, laws, and standards that provide safe operating guidance:
• Model Aquatic Health Code • Local or State Swimming Pool Codes and Regulations • American Society for Testing and Standards (now ASTM International) • Manufacturer Manuals
Challenges To Vigilance (pg. 72: Table 8.2)
• Monotony (boredom) • Environmental conditions • Glare on the water • Attraction features • Facility attendance extremes • Facility programming • Water turbidity (windiness)
Whats are some other emergency related telephone numbers that you should know and keep posted near a phone?
• Non-emergency local police department • Poison control (in the United States, 800-222-1222; for international numbers, visit http://apps.who.int/poisoncentres/) • Local hazardous material response
When to Stop CPR
• The guest begins showing signs of normal breathing or responsiveness • You are too exhausted to continue • You are replaced by another rescuer • The scene is no longer safe • Responding EMS assumes responsibility for the guest
What are some common pieces of information that may be included in your EAP?
• Type of emergency • Emergency Medical Services (EMS) • Responding team leader (person ultimately in charge) • Expected actions by personnel responding (supervisors, lifeguards, other staff) • Location of equipment and description of how it will be brought to the scene • Means for maintaining safety and control of remaining guests • Transfer of care to EMS personnel • Local authorities notified including public health department • Reporting including incident report, rescue report, medical services form • Witness statements • Media crisis plan including media designated location, facility spokesperson and statement • Debriefing and counseling services Every facility operates differently.
Lifeguards have a Right to Know About Chemicals
• What hazardous chemicals are in their facility • Where the chemicals are stored in the facility • How to properly store the chemicals • The risks and dangers of each chemical • How to protect themselves from the chemical • What Personal Protective Equipment (PPE) is needed when using the chemicals • How to handle the chemicals • How to handle exposure and what treatment is needed • Where the Safety Data Sheets (SDS) are located
What will the dispatcher ask you?
• Your name • Name of the facility • The facility address • Where the guest is located within the facility • Information on the emergency: o What happened o When it happened o The guest's condition o The care that is being provided Do not hang up until the dispatcher tells you it is okay to hang up. The dispatcher can provide additional instructions for care if needed.