Category: General Aquatics

Does Hands Only CPR Work for Drowning Victims

Does Hands Only CPR Work for Drowning Victims

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Hands-only CPR may not be as effective for drowning victims compared to traditional CPR, which includes both chest compressions and rescue breaths. When someone has drowned, there’s often a lack of oxygen in their system, which requires both oxygenation through rescue breaths and circulation through chest compressions.

Here’s why traditional CPR is typically recommended for drowning victims:

  1. Oxygenation: Drowning victims often have depleted oxygen levels in their bloodstream. Rescue breaths deliver oxygen directly to the lungs, helping to replenish oxygen levels and support vital functions.
  2. Clearing Airways: Drowning victims may have water in their airways, which can obstruct breathing. Rescue breaths help clear the airway and facilitate breathing, improving the effectiveness of CPR.
  3. Circulation: While chest compressions are crucial for maintaining blood circulation, they are more effective when combined with rescue breaths. Oxygenated blood circulated through compressions helps deliver oxygen to vital organs, including the brain.
  4. Special Considerations: Children who have drowned or experienced a near-drowning incident may particularly benefit from traditional CPR, as their smaller airways and faster metabolism require prompt oxygenation and circulation.

In summary, while hands-only CPR is effective for certain scenarios like sudden cardiac arrest in adults, traditional CPR, including both chest compressions and rescue breaths, is typically recommended for drowning victims to maximize the chances of survival and recovery.

In-Water Ventilations

In-Water Ventilations

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Quickly providing care to a victim who is in respiratory or cardiac arrest is very important. Allowing too much time to pass before care is provided can make the difference if a victim survives respiratory and cardiac arrest.  As a result, we have included in a skill to provide ventilations in the water prior to removing a victim.  This is included based on guidelines from the 2011 United States Lifeguard Standards Coalition and advocated by many lifeguard programs.

With that stated, the 2011 USLSC clearly states the survival rate is increased in open water settings.  The studies cited advocating in-water ventilations were conducted in open-water settings where victims were minutes away from shore.  No research has been shown (or done that we can find) to show in-water ventilations improves outcomes for drowning victims in swimming pools.  If a facility is operating within the standard of care and has sufficient staff trained to properly remove a victim from the water, we cannot see the time spent providing in-water ventilations vs removing a victim and providing care to have a meaningful improved outcome.  This makes the skill unnecessary in a pool setting.  Care can certainly be provided more effectively on land-especially for CPR and airway management. 

A more updated review of in-water ventilations, as well as, other resuscitation interventions for drownings, have found the efficacy of in-water ventilations to be inconclusive.  In fact, the study most cited by advocates of the skill from Brazil “was assessed as providing very low certainty evidence.”

This skill is optional for the certified course, but is included to allow aquatics managers to use the skill for in-service training if they decide it is necessary.  We certainly understand the need for this skill in an open water environment.  However, without corroborating research, this may not be the case in a swimming pool or water park facility-assuming the facility is operating at a high level and has adequate staff trained on how to remove a victim from the water.

Advice for Treating Burns

Advice for Treating Burns

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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

How to Create a First Aid Kit for your Facility

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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?

When should Rescuers Switch Positions During CPR?

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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

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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

Good Samaritan Laws

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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

Sample Program Bad Weather/Cancellation Policy

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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)

Recreational Water Illnesses (RWI)

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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

Lifeguarding Children Who Can’t Swim

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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