Advice for Treating Burns

Treating burns properly is essential to promote healing, reduce pain, and prevent infection. Here’s some of the best advice for treating burns:

  1. Cool the burn: Hold the burned area under cool (not cold) running water for at least 10 to 20 minutes, or until the pain subsides. Avoid using ice or very cold water, as this can further damage the skin.
  2. Remove tight clothing and jewelry: If clothing or jewelry is not stuck to the burn, remove it to prevent constriction and allow for proper cooling and healing.
  3. Protect the burn: Once the burn has been cooled, cover it with a sterile, non-adhesive dressing or clean cloth to protect it from friction and infection. Avoid using cotton balls or fluffy material, as these can stick to the wound.
  4. Avoid popping blisters: If blisters form, do not pop them. Blisters act as a natural barrier against infection. Popping them increases the risk of infection and delays healing.
  5. Use pain relief: Over-the-counter pain relievers like ibuprofen or acetaminophen can help reduce pain and inflammation associated with burns. Follow the recommended dosage instructions.
  6. Seek medical attention for severe burns: If the burn is severe (large, deep, or covering a sensitive area like the face, hands, feet, or genitals), or if it is accompanied by symptoms like fever, chills, or signs of infection, seek medical attention immediately.
  7. Do not use butter, oil, or toothpaste: Despite common misconceptions, these substances can actually trap heat and bacteria, worsening the burn and increasing the risk of infection.
  8. Stay hydrated: Drink plenty of water to help your body recover from the burn and maintain proper hydration levels.
  9. Follow up with a healthcare professional: If you have any concerns about the burn or if it’s not healing properly, consult a healthcare professional for further evaluation and treatment.

Remember, the severity of a burn can vary, so it’s important to assess each burn individually and seek appropriate medical care if necessary.

How to Create a First Aid Kit for your Facility

Creating a first aid kit for lifeguards involves assembling essential supplies to address common injuries and emergencies encountered in aquatic environments. It’s crucial to adhere to local regulations as they may specify specific requirements for lifeguard first aid kits. Here’s a general guideline:

  1. Waterproof Container: Choose a durable, waterproof container to hold all the first aid supplies. This ensures that the contents remain dry and accessible during emergencies.
  2. Personal Protective Equipment (PPE):
    • Disposable gloves
    • CPR mask with one-way valve
  3. Wound Care:
    • Sterile gauze pads of various sizes
    • Adhesive bandages (assorted sizes)
    • Sterile adhesive tape
    • Antiseptic wipes or solution for wound cleaning
    • Hydrogel or burn gel for minor burns
    • Sterile saline solution for irrigation
  4. Medications:
    • Aspirin or other pain relievers (check local regulations)
    • Antihistamines for allergic reactions
    • EpiPen (if permitted and necessary)
  5. Trauma Supplies:
    • Trauma shears
    • Triangular bandages for splinting or slings
    • Roller bandages for compression
    • Splinting materials (e.g., SAM splints)
    • Instant cold packs for sprains or strains
  6. Rescue Equipment:
    • Whistle for signaling
    • Lifeguard rescue tube or buoy
    • Backboard (if required by regulations)
    • AED (Automated External Defibrillator) if required and available
  7. Documentation:
    • First aid manual or guidebook
    • Incident report forms as per local regulations
    • Contact information for emergency services and medical facilities
  8. Water Safety Equipment:
    • Lifeguard fanny pack or belt pouch for easy access to essentials
    • Floatation devices (depending on the setting)
    • Reaching pole or rescue hook
  9. Sun Protection:
    • Sunscreen with a high SPF
    • Lip balm with SPF
  10. Hydration and Nutrition:
    • Bottled water or hydration packs
    • High-energy snacks (e.g., granola bars)

Ensure that all items are regularly checked and replenished, and that lifeguards are trained in first aid procedures. Additionally, consult with local authorities or regulatory bodies to ensure compliance with any specific regulations governing lifeguard first aid kits in your area.

When should Rescuers Switch Positions During CPR?

During CPR (Cardiopulmonary Resuscitation), it’s essential for rescuers to switch positions if they are performing the procedure for an extended period to ensure the effectiveness of the compressions and to prevent rescuer fatigue. Here are general guidelines for when and how often rescuers should switch positions:

  1. Time Interval for Switching: Rescuers should aim to switch positions every 2 minutes or after about 5 cycles of 30 compressions and 2 breaths, whichever comes first. This timing aligns with the recommended rate of compressions and allows for minimal interruption in chest compressions.
  2. Monitoring Rescuer Fatigue: It’s crucial to switch positions before the rescuer performing compressions becomes too fatigued to maintain effective compression depth and rate. Signs of fatigue can include slowing of compressions, decreased depth, or visible signs of physical strain.
  3. Quick Switch to Minimize Interruption: The switch between rescuers should be as quick and smooth as possible to minimize interruptions in chest compressions. Ideally, the switch should take less than 5 seconds to ensure continuous blood flow to the brain and other vital organs.
  4. Communication is Key: Before starting CPR, rescuers should agree on the signal or command for switching. Clear communication during the resuscitation effort is crucial to coordinate the switch and other aspects of care efficiently.
  5. Training and Practice: Regular CPR training and practice, including the switch maneuver, can help rescuers become more efficient and comfortable with the process, reducing the time needed to switch and ensuring the high quality of compressions throughout the resuscitation effort.

These guidelines are based on recommendations from organizations such as the American Heart Association (AHA) and are designed to maximize the effectiveness of CPR while ensuring the safety and endurance of the rescuers. It’s always important to stay updated with the latest CPR guidelines as they can evolve based on new research and consensus in the medical community.

Be sure to practice CPR during in-service training!

The Cardiac Chain of Survival

The Cardiac Chain of Survival is a series of critical actions that, when performed in sequence, significantly increase the likelihood of survival following a cardiac arrest. This concept is widely promoted by various health organizations, including the American Heart Association (AHA), as a guideline for both laypeople and medical professionals to follow during a cardiac emergency. The chain consists of the following links:

  1. Immediate Recognition and Activation of the Emergency Response System: This step involves recognizing the signs of a cardiac arrest, such as sudden collapse or unresponsiveness, and immediately calling emergency services (like 911 in the United States). Early recognition and calling for help are crucial to start the survival chain.
  2. Early Cardiopulmonary Resuscitation (CPR): Performing CPR promptly is critical because it helps maintain vital blood flow to the heart and brain until professional help arrives. Bystander CPR, especially if performed immediately, can double or triple a victim’s chance of survival.
  3. Rapid Defibrillation: This involves the use of an Automated External Defibrillator (AED) to deliver an electric shock to the heart. Defibrillation can restore a regular cardiac rhythm in a person who has suffered a cardiac arrest due to ventricular fibrillation or pulseless ventricular tachycardia.
  4. Effective Advanced Life Support: This step is provided by healthcare professionals and includes the advanced airway management, intravenous medications, and other interventions needed to support life and promote the restoration of a normal heart rhythm.
  5. Integrated Post-Cardiac Arrest Care: After the immediate emergency is over, the patient needs specialized care aimed at preserving brain function, managing other critical aspects of the patient’s health, and facilitating rehabilitation. This includes therapeutic hypothermia (cooling the body), controlled reoxygenation, and other measures to improve the patient’s recovery.

Understanding and implementing the Cardiac Chain of Survival can significantly impact survival.

CPR and understanding the chain of survival is part of any good lifeguard training course. Be sure to practice your CPR skills regularly so you can save a life! 

Good Samaritan Laws

States have implemented laws intended to protect people providing care to victims requiring emergency care.  These laws vary from state to state and we encourage you to evaluate your state’s Good Samaritan Law.  In general, the laws protect rescuers who act in good faith and provide care within the scope of their training.  For example, if you chose to amputate a victim’s finger that is stuck in a door, you may not be protected from liability since, as a lifeguard, you have not been trained to perform such a procedure.  Good Samaritan Laws may not protect someone who has a duty to act.  A complete list of Good Samaritan laws by state can be found here: http://www.cprinstructor.com/legal.htm

Sample Program Bad Weather/Cancellation Policy

The safety of your child(ren) is of the utmost importance to us.  We reserve the right to cancel swim lessons for any reason that puts the safety of your child(ren) at risk.

Inclement Weather:  In the case of thunderstorms or other inclement weather, we will place a notice on the website by 8:00 am the day of the lessons, as well, as update the Facebook page and voice mail greeting to announce the cancellation.

Mechanical or other issues:  We will make every effort to contact parents/guardians at the phone number provided in cases where swim lessons are cancelled for any reason other than weather. 

Make-Up Days: We have purposefully created two make-up days at the end of each two (2) week session in case a swim lesson was canceled.  The class will be made up during one of the make-up days. A refund will not be provided.

Sample Procedure for closing an indoor/outdoor pool during a lightning storm

  1. Designate a weather lookout that can monitor a weather radio, weather TV program or Internet weather information to obtain up to the minute local weather information.
  2. The pool should be cleared and bathers not allowed in the water if there is less than 30 seconds from when a flash of lightning is observed until when thunder is heard.
  3. Have customers collect their belongings and head for the locker rooms, or designated storm shelter
  4. We cannot control if customers chose to stay in the shelter.  If they chose to leave, they can do so of their own free will.
  5. The swimming pool will remain closed for thirty (30) minutes after the last thunder is heard.

Notes:

Use the Flash-To-Bang (F-B) method to determine a storm’s rough distance and speed. This technique measures the time from seeing lightning to hearing associated thunder. For each five seconds from F-B, lightning is one mile away. Thus, a F-B of 10 = 2 miles; 15 = 3 miles; 20 = 4 miles; etc. (16). 

Attached to the procedure should be a facility map with the designated storm shelters.

Recreational Water Illnesses (RWI)

Even though pools are required to be disinfected to prevent people from getting sick, there are bacteria resistant to chlorine.  Two examples are Cryptosporidium and Giardia.  Depending on the chlorine level of the pool, it can take days for chlorine to kill Cryptosporidium in pool water. Since the most common RWI are spread through diarrheal events, people that are ill should not participate in swimming activities.

Below is a table that shows various disinfection times based on a Chlorine level of 1ppm (parts per million):

Chlorine Disinfection Timetable
AgentDisinfectant Times for Fecal Contaminants in Chlorinated Water
E. coli 0157:H7
(Bacterium)
less than 1 minute
Hepatitis A
(Virus)
approximately 16 minutes
Giardia
(Parasite)
approximately 45 minutes
Cryptosporidium
(Parasite)
approximately 15,300 minutes (10.6 days)

Lifeguarding Children Who Can’t Swim

I took the family to the pool last week and watched a young girl, that did not know how to swim, have free run of the place.  She was wearing a NON Coast Guard approved personal flotation device (PFD).  Her dad had to save her more than once and there was no attempt by the lifeguards to redirect her to a safer vest.  The dad was not a great swimmer either and had a hard time keeping his daughter from hurting herself.

I was stunned at the lack of response by the aquatics staff.  If a family is choosing to use flotation devices for their children, lifeguards should never let children, who cannot swim, wear anything other than a Coast Guard approved PFD.

A good resource on how to select a PFD can be found here:

https://www.uscg.mil/hq/cg5/cg5214/pfdselection.asp

 

 

Who is watching the pool during rest breaks?

I have visited a few pools this summer.  One thing that always strikes me as odd is how often there is no lifeguard presence during rest breaks.  I firmly believe this is a HUGE mistake.  When customers are told the facility provides lifeguards, that means the whole time-not 45-50 minutes of an hour.

Over the past few weeks (during rest breaks), I have observed small children swimming on their own and people throwing each other into the pool.  All while there is no lifeguard on the pool deck to intervene.  A good practice is to have a supervisor observe the pool during rest breaks.

While on the topic, are rest breaks required?  The simple answer is not in most areas.  We cannot figure out where or how rest breaks started.  It is one of those things that are now legend and nobody can remember how rest breaks came to be.  Some reasons we have heard include:

  • Allow time for kids to use the restroom and prevent water borne illnesses
  • Gives small children time to rest
  • A chance for kids to re-hydrate and not drink the pool water
  • To give lifeguards a break
  • Present a time to put on sun screen.
  • So pools can sell concessions

Whatever the reason you choose to have rest breaks, a lifeguard still should be watching the pool at all times!

Lifeguard Stations

This week, I came across a pool that had a lifeguard station in the shallow end of the pool-even though there was an elevated station positioned perfectly for the lifeguard to see her entire coverage area.  The lifeguard had her back to the rest of the pool while observing about 20 people (mostly children).  The general use for an in-water lifeguard station is for catch pools at the bottom of water slides.  I have seen it used with other applications effectively, but this is not one of those times.  Let’s discuss a few reasons why:

  1. The lifeguard limited her visibility by being in the water instead of in an elevated station above the water.
  2. There was a portion of her area of responsibility she could not fully see (stairs used as an entrance and exit for the shallow end of the pool.
  3. Patrons regularly obstructed her view so she could not effectively scan her whole area.
  4. She would turn her back to half the area she was supposed to be watching while she paced.

All in all, it was a poor use of a lifeguard.

Below is an excerpt from the Lifeguard University Lifeguard Manual about lifeguard stations:

 

Lifeguard Stations

To provide proper surveillance, lifeguards MUST be able to see their entire area of responsibility.  There are different types of stations used to ensure that lifeguards can not only see their entire area, but also enforce rules and are able to engage patrons that need assistance.

Elevated Station    

Generally, an elevated station is the best way to maintain the best surveillance of pool patrons.  It provides a clear view of the area and allows a lifeguard to observe a large area.  A common mistake lifeguards make is forgetting to scan the area of the pool directly below their station.

Ground Station

Similar to an elevated station, a ground station is a set point for lifeguards to maintain patron surveillance.  A ground station does not allow the same range of visibility, but does allow lifeguards the ability to enforce rules and make assists easier.

Roving

A lifeguard may be assigned a roving station that allows the lifeguard to move between two or more fixed points.  It allows similar advantages as a ground station; with the added benefit of the lifeguard being able to move position based on the surveillance needs of the pool.

Notes:

 

  • A lifeguard should not have an area of responsibility greater than a 180-degree viewing area. In short, a lifeguard should not have to turn their body to observe their area or have to look behind them to scan.
  • It should take no more than 20 seconds for a lifeguard to reach a victim. Lifeguard stations should be planned accordingly.