Lifeguarding
Welcome!





Introductions
Policies and Procedures
Course Outline
Lifeguarding
Standard Precautions
Purpose

To teach lifeguard candidates the knowledge and
skills needed to prevent and respond to aquatic
emergencies.

The course content and activities prepare lifeguard
candidates to prevent drownings and injuries and to
recognize and respond quickly and effectively to
emergencies.
The Professional Lifeguard and
Injury Prevention
Lesson 1
Lifeguarding

Lifeguarding is—
 Dynamic!
 Challenging!
 Important!
 Inspiring!
What were the different places shown in
the video segment where you might
lifeguard?
What types of decisions might a
lifeguard need to make?
How did you decide to take this class?
Did you flip a coin?
The FIND Model
F
I
N
D
=
=
=
=
Figure out the problem
Identify possible solutions
Name the pros and cons of each solution
Decide which solution is best
Legal Considerations





Duty to act
Standard of care
Negligence
Good Samaritan laws
Consent




Refusal of care
Abandonment
Confidentiality
Documentation
The Lifeguard Team

Whenever another lifeguard is on duty with you,
you are part of a lifeguard team.

The aquatic safety team is a network of people who
prevent, prepare for, respond to and assist in an
emergency at an aquatic facility.
Facility Management and
Professionalism

How does management support lifeguard
professionalism?



By providing a policies and procedures manual
By conducting an orientation and regular in-service
trainings
By providing opportunities for recognition and career
development
Preventing Injuries—Patron Safety

Risk management involves identifying dangerous
conditions or behaviors that can cause injuries and
then taking steps to minimize or eliminate them.

Injury-prevention strategies
 Communication with patrons
 Facility safety checks
 Patron surveillance
Communication

Communication as an injury-prevention strategy
requires lifeguards to—
 Inform patrons about the potential for injury.
 Educate patrons about inappropriate behavior.
 Enforce rules and regulations.
How are patrons informed of a
potential injury at an aquatic facility?
Rules and Regulations

Lifeguards need to understand the rules and
regulations of the facility where they work.

Rules do not keep patrons from having fun, but are
for everyone’s health and safety.
Preventing a Patron from Engaging in
Risky Behavior
1. Get the patron’s attention, for example, by blowing
your whistle, and then saying, “Excuse me, but
what you are doing is dangerous.”
2. Explain the hazard or danger.
3. Explain a safe alternative behavior or activity.
Enforcing Rules and Regulations

Enforcing rules helps prevent injuries and
encourages safe patron behavior.

When enforcing rules, always be consistent and fair.

When enforcing rules, explaining the rule is usually
enough.

Asking a patron to leave the facility should always
be the last resort.
Safety Checks

Safety checks are conducted—
 Before opening the facility.
 During daily operations.
 At closing.

Use the facility’s safety checklist when performing a
safety check.

What are the general areas and equipment to
inspect during a safety check?
Weather Conditions

Lightning and thunderstorms happen more often in
the summertime.

Follow your facility’s emergency action plan (EAP)
for severe weather.
Management is responsible for—






Creating, reviewing and revising a facility’s policies
and procedures, rules and regulations and EAPs as
needed.
Warning staff about actual and potential dangers.
Addressing unsafe or dangerous conditions.
Complying with local, state and federal regulations
for facility operations and employment.
Maintaining records on the facility and its
employees.
Assisting after an emergency.
What’s Next?



Break
In-Water Skill Session
 Slide-In Entry
 Stride Jump
 Compact Jump
 Front Crawl Approach
 Breaststroke Approach
Assignments
Patron Surveillance and
Emergency Preparation
Lesson 2
Patron Surveillance



A lifeguard’s primary responsibility is to ensure
patron safety and protect lives.
The primary tool to accomplish that function is
patron surveillance.
Effective surveillance has several elements,
including—




Victim recognition.
Effective scanning.
Lifeguard stations.
Area of responsibility.
Effective Scanning

Scanning is a visual technique for watching patrons
in the water.

What does effective scanning require?
Lifeguard Stations

Patron surveillance is performed in a lifeguard chair
or by standing on the deck or in the water.

The location of your lifeguard station must enable
you to see your entire area of responsibility.

You might have to move your lifeguard stand or
change your position during the day.
How do periodic rotations from one
station to another, along with breaks,
help keep you alert and decrease fatigue?
Area of Responsibility

Your supervisor will establish the area of
responsibility for patron surveillance.

Areas of responsibility can include—



Zone coverage.
Total coverage.
Back-up coverage.
The RID Factor

Most drownings at supervised swim areas happen
when neither lifeguards nor patrons notice that a
victim has slipped below the surface.

RID



Recognition
Intrusion
Distraction
Patron Surveillance at Play Structures

Consider the following elements when conducting
patron surveillance at play structures:






Pay close attention to nonswimmers or weak swimmers.
Do not let a play structure become overcrowded.
Watch that patrons return to the surface after dropping
into the water from a drop-off slide.
Pay close attention to children playing in sprays and
fountains.
Pay close attention to patrons in moving water.
Keep play safe and orderly.
Emergency Action Plans (EAPs)

EAPs are detailed plans describing everyone’s
responsibilities in an emergency and should be in
the facility’s policies and procedures manual.

EAPs should be practiced regularly during
orientation and in-service training sessions.
What are the steps of an EAP?
What’s Next?


Break
In-Water Activity





Safety Tour of the Facility
Lifeguard Rotation
Victim Recognition
Putting It All Together
Assignments
Rescue Skills, Part 1
Lesson 3
General Procedures for Water
Emergencies






Assess the victim’s condition.
Safely enter the water, if needed.
Perform an appropriate rescue.
Move the victim to safety.
Remove the victim from the water.
Provide emergency care as needed.
What’s Next


Break
In-Water Skill Session









Simple Assist
Extension Assist from the Deck
Reaching Assist with Equipment
Throwing Assist
Swimming Extension Rescue
Active Drowning Victim Rear Rescue
Passive Drowning Victim Rear Rescue
Two-Person Removal from the Water Using a
Backboard
Assignments
Before Providing Care and
Rescue Skills, Part 2
Lesson 4
As a professional rescuer, what
responsibilities do you have related to
providing care?
What standard precautions should you
follow to prevent the spread of
bloodborne pathogens
while providing care?
Standard Precautions

What are universal precautions?

What are standard precautions?

The risk of getting a disease while performing CPR
is extremely low, but practicing standard precautions
reduces the risk even further.
Resuscitation Masks

What is a resuscitation mask?

Benefits of using a resuscitation mask:





A seal is created over both the victim’s mouth and nose.
Air can be delivered to the victim more quickly through
both the mouth and nose.
The device can be connected to emergency oxygen if it
has an oxygen inlet, thus increasing the oxygen
concentration the victim receives.
It protects against disease transmission when giving
rescue breaths.
Characteristics of a resuscitation mask
General Procedures in an Emergency

What general procedures should you follow in an
emergency?

The general procedures are—




Size up the scene.
Perform an initial assessment.
Summon EMS personnel, by calling 9-1-1 or the
local emergency number.
Perform a secondary assessment.
Initial Assessment

Purpose: To identify life-threatening conditions.

Includes checking the victim for―




Consciousness.
Signs of life (movement and breathing).
A pulse.
Severe bleeding.
Moving a Victim

It is important not to move a victim unless it is
necessary.

When should you move a victim?

What are some considerations when moving a victim?
Moving a Victim (cont.)

There are six ways to move a victim:






Clothes drag
Two-person seat carry
Walking assist
Pack-strap carry
Blanket drag
Foot drag
What’s Next?

Break

In-Water Skill Session

Passive Submerged Victim Rescue—Shallow Water

Multiple-Victim Rescue
Feet-First Surface Dive
Submerged Victim Rescue—Deep Water
Front and Rear Head-Hold Escapes



Assignments
Breathing and Cardiac Emergencies
Lesson 5
Breathing Emergencies

What is a breathing emergency?

Some reasons they occur:






Drowning
Nonfatal submersion injuries
Obstructed airway
Injury to head, chest, lungs
or abdomen
Respiratory conditions
Heart attack







Coronary heart disease
Allergic reactions
Electrocution
Shock
Poisoning
Drugs
Emotional distress
Respiratory Distress

Signs and symptoms:








Slow or rapid breathing
Unusually deep or shallow breathing
Shortness of breath or noisy breathing
Dizziness, drowsiness or light-headedness
Changes in the level of consciousness
Increased heart rate
Chest pain or discomfort
Flushed, pale, ashen or bluish skin
Respiratory Distress (cont.)

Signs and symptoms (cont.):






Unusually moist or cool skin
Gasping for breath
Wheezing, gurgling or high-pitched noises
Inability to speak in full sentences
Tingling in hands, feet or lips
What care should be given to a victim in respiratory
distress?
Rescue Breathing




Perform rescue breathing for a victim who has a
pulse, but is not moving or breathing. To determine
if a victim is not moving or breathing, perform an
initial assessment.
For an adult, give 1 rescue breath about every
5 seconds.
For a child and infant, give 1 rescue breath about
every 3 seconds.
Each rescue breath should last about 1 second and
make the chest clearly rise.
Bag-Valve-Mask Resuscitator

What is a bag-valve-mask resuscitator (BVM)?

A BVM reduces the risk of disease transmission and
increases the level of oxygen being delivered to a
victim.
Using a BVM—Two Rescuers

1.
2.
3.
4.
Rescuer 1 performs an initial assessment while Rescuer 2
assembles the BVM.
Rescuer 1 seals the mask and opens the airway.
Rescuer 2 begins ventilations.
Look for movement and recheck for breathing and a pulse
about every 2 minutes.
Airway Obstruction

What is an airway obstruction?

Steps for a conscious choking victim:




Size up the scene and ask the victim, “Are you choking?”
Identify yourself and ask if you may help.
If the victim is coughing forcefully, tell him or her to
continue coughing.
If the victim cannot cough, speak or breathe, summon
EMS personnel. Begin back blows and abdominal thrusts
for an adult or child or back blows and chest thrusts for an
infant.
Airway Obstruction (cont.)

Steps for an unconscious choking victim:




Size up the scene and approach the victim.
Look for movement, check for breathing and give
2 rescue breaths. If the rescue breaths do not make the
chest clearly rise, reposition the airway and attempt the
rescue breaths again.
If the rescue breaths still do not make the chest clearly
rise, begin chest thrusts for an adult, child or infant.
Give 5 chest thrusts, look for a foreign object and then
give 2 rescue breaths.
You are responding to a call in the locker
room in which a patron collapsed from
cardiac arrest.
What four steps need to be taken to
improve this victim’s chances of
survival?
The Cardiac Chain of Survival
1.
2.
3.
4.
Early recognition of the emergency and early
access to EMS
Early cardiopulmonary resuscitation
Early defibrillation
Early advanced medical care
Signs and Symptoms of a Heart Attack

Persistent chest discomfort, pain or pressure that
lasts longer than 3 to 5 minutes or goes away and
comes back

Chest discomfort, pain or pressure that spreads to
the shoulder, neck, jaw or arms

Trouble breathing

Nausea or vomiting
Signs and Symptoms of a Heart
Attack (cont.)

Dizziness, light-headedness, loss of consciousness
or fainting

Pale or ashen skin

Sweating—face may be moist or person may be
sweating profusely

Denial of signs and symptoms
Care for a Heart Attack

Immediately summon EMS personnel.

Have the victim stop what he or she is doing and rest.

Loosen any tight or uncomfortable clothing.

Closely monitor the victim until EMS personnel arrive and
take over.

Notice any changes in the victim’s appearance or
behavior.

Comfort the victim.
Care for a Heart Attack (cont.)

If medically appropriate and local protocols or
medical direction permit, give aspirin if the victim
can swallow and has no known contraindications.

Assist the victim with his or her prescribed
medication and give emergency oxygen, if it is
available and you are trained to do so.

Be prepared to perform CPR or use an AED.
Cardiac Arrest

What is it and when does it occur?

Signs and symptoms:




Unconsciousness
No movement or breathing
No pulse
Care:


Early CPR
Early defibrillation
CPR

Combination of rescue breaths and chest
compressions

Circulates blood that contains oxygen to vital organs,
increasing the victim’s chance of survival until EMS
personnel arrive

Must be performed on a firm, flat surface

Increases the likelihood that successful defibrillation
can be delivered to a victim of sudden cardiac arrest,
especially if more than 4 minutes have elapsed since
the victim’s collapse
Wrap-Up

Rescue breathing

Conscious and unconscious choking

CPR

Assignments
Two-Rescuer CPR and AED
Lesson 6
Two-Rescuer CPR

What is the job of the first rescuer?

What is the job of the second rescuer?

To signal for a position change, the second rescuer
calls “change” instead of “30” (for an adult) and
“15” (for a child or infant).
Introduction to AEDs

Most cardiac arrests occur away from the hospital.

Early CPR can help a cardiac arrest victim.

An electrical shock (defibrillation) is needed to
correct the problem. The sooner the shock is
administered, the greater the victim’s chance of
survival.

Early defibrillation is the third step in the Cardiac
Chain of Survival.
When the Heart Stops

Disease or injury can disrupt the heart’s electrical
system.

V-fib and V-tach are two of the most common
treatable abnormal heart rhythms.

Defibrillation is intended to disrupt the abnormal
activity of the heart.

Cardiac arrest can also occur in children.
Using an AED
1.
2.
3.
4.
5.
Turn on the AED.
Wipe the victim’s chest dry.
Attach the pads (use pediatric pads for children).
Plug the connector into the AED, if necessary.
Make sure no one, including you, is touching the
victim.
6. Push the “analyze” button, if necessary.
7. If a shock is advised, push the “shock” button.
What precautions should you take
when using an AED?
First Aid
Lesson 7
Secondary Assessment

Perform a secondary assessment after you have
determined there are no life-threatening conditions.

Perform a head-to-toe examination for an adult and
a toe-to-head examination for a child or infant.

Use SAMPLE to take a brief history.
SAMPLE
S
A
M
P
L
E
=
=
=
=
=
=
Signs and Symptoms
Allergies
Medications
Pertinent Past Medical History
Last Oral Intake
Events Leading Up to the Incident
Sudden Illness

Follow the general procedures for sudden injury or
illness on land.

Common sudden illnesses include—







Diabetic emergency.
Seizure in the water.
Stroke.
Fainting.
Poisoning.
Insect stings.
Snake and spider bites.
Wounds

An injury to the body’s soft tissue is called a wound.

Closed wounds occur beneath the surface of the
skin.

Four types of open wounds are—




Abrasions.
Punctures.
Avulsions.
Lacerations.

Internal versus external bleeding.

Burns are a type of soft tissue injury.
Shock

Any serious injury or illness can result in shock.

Signs and symptoms of shock include—






Restlessness or irritability.
Altered levels of consciousness.
Pale or ashen, cool, moist skin.
Rapid breathing and pulse.
Nausea or vomiting.
Excessive thirst.
To minimize the effects of shock—







Make sure that EMS personnel have been summoned.
Monitor the victim’s ABCs.
Control any external bleeding.
Keep the victim from getting chilled or overheated.
Have the victim lie down and elevate the legs about 12 inches
if a head, neck or back injury or broken bones in the hips or
legs are not suspected.
Comfort and reassure the victim until EMS personnel arrive
and take over.
Administer emergency oxygen, if available and trained to do
so.
What conditions could lead to a
heat-related emergency at
an aquatic facility?
Heat-Related Emergencies

Heat Cramps—Least severe of heat-related
emergencies

Heat Exhaustion—Early indicator that the body’s
cooling system is getting overwhelmed

Heat Stroke—A life-threatening condition
On a very warm day,
a lifeguard who is on surveillance duty
calls the lifeguard supervisor to her
lifeguard chair and complains that she
has a headache, is nauseous and is
sweating heavily.
What heat-related condition could
she be experiencing?
What care should be provided?
What is the difference between
frostbite and hypothermia?
Cold-Related Emergency

A victim suffering from frostbite experiences a loss
of feeling and sensation in the affected area.

The victim’s skin color can appear waxy, cold to the
touch or discolored (flushed, white, yellow or blue).

It does not have to be extremely cold for someone
to suffer a cold-related emergency, especially if the
person is wet or if it is windy.
What’s Next?

First Aid Scenarios

Assignments
Injuries to Muscles, Bones and Joints
and Caring for Head, Neck and
Back Injuries, Part 1
Lesson 8
Injuries to Muscles, Bones and Joints

Four types of injuries:




Fractures
Dislocations
Sprains
Strains
Caring for Head, Neck and Back
Injuries on Land

If you suspect that a victim has a head, neck or back
injury, tell him or her not to nod or shake his or her
head but to say yes or no.

To care for injuries to a head, neck or back on land—




Use personal protective equipment.
Minimize movement of the victim’s head, neck and back
by placing your hands on both sides of the victim’s head.
Have the victim remain in the position that you found him
or her until EMS personnel arrive and take over.
Monitor the victim’s ABCs.
Head, Neck and Back Injuries in the
Water

The care you provide depends on—





The victim’s condition.
The location of the victim.
The availability of help.
Your facility’s specific procedures.
The air and water temperature.
General Rescue Procedures
1.
2.
3.
4.
5.
6.
7.
8.
Activate the facility’s EAP.
Assess the victim’s condition.
Safely enter the water.
Perform an appropriate rescue.
Move the victim to shallow water whenever possible.
Check for consciousness and for signs of life.
Remove the victim from the water.
Provide emergency care as needed.
What’s Next?

Break

In-Water Skills Session




Manual In-Line Stabilization Techniques―Shallow
Water
Manual In-Line Stabilization Techniques―Deep Water
In-Line Stabilization—Submerged Victim
Assignments
Caring for Head, Neck and
Back Injuries, Part 2
Lesson 9
Using a Backboard

After stabilizing the victim’s head and neck with
either the head splint technique or the head and
chin support, secure the victim on a backboard.

Backboards come in different shapes and sizes.

Backboards vary in materials, the number and size
of handholds and buoyancy.
What’s Next?

Break

Review of Manual In-Line Stabilization Techniques

In-Water Skill Session



Using a Backboard in Shallow Water
Using a Backboard in Deep Water
Assignments