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Unformatted text preview: Lifeguarding Manual American Red Cross Lifeguarding MANUAL The following organizations provided review of the materials and/or support American Red Cross Lifeguarding: This manual is part of the American Red Cross Lifeguarding program. By itself, it does not constitute complete and comprehensive training. Visit redcross.org to learn more about this program. The emergency care procedures outlined in the program materials reflect the standard of knowledge and accepted emergency practices in the United States at the time this manual was published. It is the reader’s responsibility to stay informed of changes in emergency care procedures. The care steps outlined within this manual are consistent with the 2015 International Liaison Committee on Resuscitation (ILCOR) Consensus on Science and Treatment Recommendations (CoSTR). The treatment recommendations and related training guidelines have been developed by The American National Red Cross Scientific Advisory Council (SAC), a panel of nationally recognized experts in fields that include emergency medicine, emergency medical services (EMS), nursing, occupational health, sports medicine, school and public health, aquatics, emergency preparedness and disaster mobilization. This manual also reflects the United States Lifeguarding Standards: A Review and Report of the United States Lifeguard Standards Coalition, a collaborative effort of the American Red Cross, the United States Lifesaving Association and the YMCA of the USA. PLEASE READ THE FOLLOWING TERMS AND CONDITIONS (the or these “Terms and Conditions”) BEFORE AGREEING TO ACCESS, USE OR DOWNLOAD THE FOLLOWING THE AMERICAN NATIONAL RED CROSS MATERIALS. BY PURCHASING, DOWNLOADING, OR OTHERWISE USING OR ACCESSING THE MATERIALS, YOU ACKNOWLEDGE AND HEREBY AGREE TO BE LEGALLY BOUND BY BOTH THESE TERMS AND CONDITIONS AND THE AMERICAN NATIONAL RED CROSS TERMS OF USE (AVAILABLE AT . redcross.org/terms-of-use). YOU AGREE THAT THE INCLUDED COURSE MATERIALS ARE PROVIDED “AS IS” AND WITHOUT WARRANTIES OF ANY KIND, AND THAT ANY ACCESS TO OR USE OF THESE COURSE MATERIALS IS AT YOUR OWN RISK. The following materials (including downloadable electronic materials, as applicable) including all content, graphics, images and logos, are copyrighted by, and the exclusive property of, The American National Red Cross (“Red Cross”). Unless otherwise indicated in writing by the Red Cross, the Red Cross grants you (“Recipient”) the limited right to download, print, photocopy and use the electronic materials only for use in conjunction with teaching or preparing to teach a Red Cross course by individuals or entities expressly authorized by the Red Cross, subject to the following restrictions: • The Recipient is prohibited from creating new electronic versions of the materials; • The Recipient is prohibited from revising, altering, adapting or modifying the materials, which includes removing, altering or covering any copyright notices, Red Cross marks, logos, or other proprietary notices placed or embedded in the materials; • The Recipient is prohibited from creating any derivative works incorporating, in part or in whole, the content of the materials; • The Recipient is prohibited from downloading the materials, or any part of the materials, and putting them on Recipient’s own website or any other third party website without advance written permission of the Red Cross; • The Recipient is prohibited from removing these Terms and Conditions in otherwise-permitted copies, and is likewise prohibited from making any additional representations or warranties relating to the materials. Any rights not expressly granted herein are reserved by the Red Cross. The Red Cross does not permit its materials to be reproduced or published without advance written permission from the Red Cross. To request permission to reproduce or publish Red Cross materials, please submit your written request to The American National Red Cross. © 2012, 2016 by The American National Red Cross. ALL RIGHTS RESERVED. The Red Cross emblem, American Red Cross® and the American Red Cross name and logo are registered trademarks of The American National Red Cross and protected by various national statutes. The Boy Scouts of America corporate logo is a registered trademark of the Boy Scouts of America in the United States and/or other countries. All rights reserved. Used with permission. Printed in the United States of America ISBN: 978-0-9983745-0-5 ACKNOWLEDGMENTS This manual is dedicated to the thousands of employees and volunteers of the American Red Cross who contribute their time and talent to supporting and teaching lifesaving skills worldwide and to the thousands of course participants and other readers who have decided to be prepared to take action when an emergency strikes. Many individuals shared in the development and revision process in various supportive, technical and creative ways. The American Red Cross Lifeguarding Manual was developed through the dedication of both employees and volunteers. Their commitment to excellence made this manual possible. The following members of the American Red Cross Scientific Advisory Council provided guidance and review of the American Red Cross Lifeguarding Manual: David Markenson, MD, MBA, FCCM, FAAP, FACEP, EMT-P Chair, American Red Cross Scientific Advisory Council Chief Medical Officer, Sky Ridge Medical Center Denver, Colorado Peter G. Wernicki, MD, FAAOS Aquatics Chair, American Red Cross Scientific Advisory Council Sports Medicine Orthopedic Surgeon Assistant Clinical Professor, Florida State School of Medicine Chair, International Lifesaving Federation Medical Committee U.S. Lifesaving Association Medical Advisor Vero Beach, Florida Joshua M. Tobin, MD Member, American Red Cross Scientific Advisory Council Director, Trauma Anesthesiology Keck School of Medicine at USC Los Angeles, California The following members of the American Red Cross Scientific Advisory Council provide support and guidance on American Red Cross Swimming and Water Safety programs: Angela Beale, PhD Louise Kublick, BS Stephen Langendorfer, PhD William D. Ramos, PhD For more information on the Scientific Advisory Council, visit redcross.org/science. The American Red Cross thanks: Francesco (Frank) Pia, PhD, Emeritus Member of the Scientific Advisory Council, Alex Antoniou, PhD, Chief Marketing and Information Officer, National Swimming Pool Foundation and Jerome H. Modell, MD, Emeritus Professor of Anesthesiology, Colleges of Medicine and Veterinary Medicine, University of Florida, for their contributions to this manual. Roy Fielding, MS Member, American Red Cross Scientific Advisory Council Senior Lecturer, Department of Kinesiology University of North Carolina at Charlotte Charlotte, North Carolina Teresa (Terri) Lees, MS Member, American Red Cross Scientific Advisory Council Owner, Lees Therapeutic Solutions Talees LLC Wichita, Kansas Linda Quan, MD, FAAP Vice Chair, American Red Cross Scientific Advisory Council Pediatric Emergency Physician Seattle Children’s Hospital Professor of Pediatrics at the University of Washington School of Medicine Seattle, Washington ACKNOWLE DG M E NTS | III The panel of volunteer subject matter experts for this edition include: Joshua D. Aldama Operations Manager Aquatica San Antonio, SeaWorld Parks & Entertainment San Antonio, Texas Algreatus Batton, AFO Assistant Aquatics Operations Manager City of Charlottesville Parks and Recreation Charlottesville, Virginia John Raby President Minnesota Safety Services, LLC Excelsior, Minnesota Billy Sassi Aquatics Manager Tucson Parks and Recreation Department Tucson, Arizona Sean E. Sepela Aquatic Operations Manager Freedom Aquatic & Fitness Center George Mason University Manassas, Virginia David W. Bell, PhD National Aquatics Task Force Boy Scouts of America Ponca City, Oklahoma Ginny Templeton, MA Associate Director of Operations Associated Students Inc., California State Polytechnic University Pomona, California Branden Burns Aquatics Coordinator Twinsburg Parks and Recreation Twinsburg, Ohio Jason D. Vitulli Aquatic Program Coordinator Town of Hempstead Hempstead, New York Pete DeQuincy Aquatics Manager East Bay Regional Park District Oakland, California Brenda J. Ward Lecturer, Department of Kinesiology University of North Carolina at Charlotte Charlotte, North Carolina Mary Franklin Volunteer Instructor Trainer Educator American Red Cross Knoxville, Tennessee Christopher R. Whipple, AqP Manager of Lifeguards University of Maryland College Park, Maryland Cory Hilderbrand Aquatics Supervisor City of Irvine Irvine, California Karen M. Jenovese Owner, Swim New Hampshire LLC Concord, New Hampshire Dan Jones Division Head of Aquatics and Beaches City of Norfolk, Virginia William A.J. Kirkner, JD Senior Director, Aquatics Facilities and Programs JCC of Greater Baltimore Owings Mills, Maryland Daniel Llanas Director of Operations Aquatica San Antonio SeaWorld Parks & Entertainment San Antonio, Texas IV | ACKNOWLE DG M E NTS LIFEGUARDING CONTENT DIRECTION Stephanie Shook, CPRP Senior Manager, Instructor Engagement and Quality Assurance Lifeguarding Content Director American Red Cross The American Red Cross team for this edition included: Catherine Barry National Director, Aquatics Jonathan Epstein Senior Director, Science and Content Development Connie Harvey National Director, Centennial Initiatives Matthew Haynes Product Manager, Aquatics Nichole Steffens Product Manager, Aquatics PREFACE This manual is for lifeguards, whom the American Red Cross profoundly thanks for their commitment to safeguarding the lives of children and adults who enjoy aquatic facilities. As the number of community pools and waterparks grows nationwide, participation in aquatic activities is also growing. With this growth comes the need for even more lifeguards. To protect this growing number of participants, lifeguards must receive proper and effective training. Lifeguards also need to maintain their skills to ensure their ability to work effectively with others as a part of a lifeguard team. Participation in frequent and ongoing training is essential. Lifeguards must be able to recognize hazardous situations to prevent injury. They must be able to supervise swimmers, minimize dangers, educate facility users about safety, enforce rules and regulations, provide assistance and perform rescues. Being a lifeguard carries a significant professional responsibility, but lifeguarding also offers opportunities for personal growth. Experience as a lifeguard can help one develop professional and leadership skills that will last a lifetime—through college, career and family. There are a half million American Red Cross-trained lifeguards working at swimming pools, waterparks and waterfronts across our country. Every day on the job, these lifeguards are part of a critical force for good—ensuring the safety of patrons and protecting lives. LI FEG UAR DI NG CONTE NT DI R ECTION | PR E FACE | V CONTENTS CHAPTER 1 CHAPTER 4 The Professional Lifeguard Injury Prevention Introduction ................................................................ 3 Responsibilities of a Professional Lifeguard ........ 3 Characteristics of a Professional Lifeguard ......... 4 Decision-Making ....................................................... 8 Legal Considerations ............................................... 8 Continuing Your Training........................................ 10 Being Part of the Team ..........................................13 Lifeguards as Water Safety Advocates ..............15 Wrap-Up ...................................................................17 How Injuries Happen ..............................................91 Injury Prevention Strategies ..................................91 Effective Guarding—Injury Prevention Challenges.............................................95 Special Considerations for Guarding Aquatic Attractions................................................. 105 Wrap-Up .................................................................. 112 CHAPTER 2 Facility Safety Rescue Equipment..................................................25 Facility Safety Checks ............................................30 Weather Conditions ...............................................40 Rules and Regulations ...........................................43 Management and Safety ........................................46 Wrap-Up ...................................................................48 CHAPTER 3 Surveillance and Recognition An Overview of the Process of Drowning ..........57 Effective Surveillance .............................................58 Wrap-Up ...................................................................79 VI | CHAPTER 5 Emergency Action Plans Types of Emergency Action Plans......................119 Implementing an Emergency Action Plan .........125 Emergencies Outside of Your Zone ................... 135 Wrap-Up ..................................................................136 CHAPTER 6 Water Rescue Skills General Procedures for a Water Emergency .....145 Train to the Standard, Meet the Objective .......147 Rescue Skills .........................................................147 Additional Rescue Skills for Waterfronts ..........153 Special Situations at Waterfronts ..................... 155 When Things Do Not Go As Practiced............ 161 Wrap-Up ................................................................ 163 CHAPTER 7 CHAPTER 10 Before Providing Care And Victim Assessment First Aid Bloodborne Pathogens ....................................... 203 How Pathogens Spread ..................................... 204 Preventing the Spread of Bloodborne Pathogens .............................................................. 206 If You Are Exposed................................................ 2 11 General Procedures for Injury or Sudden Illness on Land...................................................... 2 11 Wrap-Up ................................................................ 218 CHAPTER 8 Breathing Emergencies Recognizing and Caring for Breathing Emergencies ......................................................... 233 Giving Ventilations ............................................... 237 Airway Obstruction .............................................. 245 Emergency Oxygen.............................................. 248 Oxygen Delivery Devices .................................... 250 Suctioning ............................................................. 253 Wrap-Up ................................................................ 254 CHAPTER 9 Cardiac Emergencies Cardiac Chain of Survival ................................... 273 Heart Attack .......................................................... 274 Cardiac Arrest ...................................................... 275 CPR ........................................................................ 275 AEDs ...................................................................... 278 Multiple-Rescuer Response ............................... 283 Wrap-Up ............................................................... 284 Responding to Injuries and Illnesses ................ 303 Secondary Assessment ...................................... 304 Sudden Illness ...................................................... 305 Skin and Soft Tissue Injuries ............................. 309 Bites and Stings ................................................... 319 Poisoning ............................................................... 322 Heat-Related Illnesses and Cold-Related Emergencies ......................................................... 323 Injuries to Muscles, Bones and Joints .............. 325 Emergency Childbirth.......................................... 327 Wrap-Up ................................................................ 328 CHAPTER 11 Caring For Head, Neck And Spinal Injuries Causes of Head, Neck and Spinal Injuries ...... 341 Caring for Head, Neck and Spinal Injuries ...... 342 Wrap-Up ................................................................ 351 Glossary................................................................. 373 References ............................................................ 381 Special Thanks ..................................................... 386 Index ....................................................................... 387 | VII SKILL SHEETS • ROTATIONS .............................................................87 o Ground-Level Station ............................................87 o Elevated Station .....................................................88 • ENTRIES ................................................................ 169 o Slide-In Entry ........................................................ 169 o Stride Jump........................................................... 169 o Compact Jump..................................................... 170 o Run-and-Swim Entry .......................................... 170 • ASSISTS ................................................................. 171 o Simple Assist ....................................................... 171 o Reaching Assist ................................................... 172 • RESCUES AT OR NEAR THE SURFACE OF THE WATER ................................................... 173 o Active Victim Front Rescue ............................... 173 o Active Victim Rear Rescue ................................ 174 o Passive Victim Front Rescue ............................ 175 o Passive Victim Rear Rescue ............................. 176 o Passive Victim at or Near the Surface in Water ≤ 3’, Face-Up ...........................................177 o Passive Victim at or Near the Surface in Water ≤ 3’, Face-Down......................................178 Multiple-Victim Rescue ...................................... 179 • RESCUING A SUBMERGED VICTIM ......... 180 o Passive Submerged Victim–Shallow Water 180 o Feet-First Surface Dive ...................................... 181 o o Head-First Surface Dive .................................... 182 o Rescuing a Submerged Victim in Deep Water ..................................................................... 183 • REMOVAL FROM THE WATER ...................... 185 o Extrication Using a Backboard at the Pool Edge ............................................................. 185 o Extrication Using a Backboard at the Steps . 187 Extrication Using a Backboard in Zero Depth............................................................ 188 o Extrication Using a Backboard–Steep Steps and/or Moving Water ..............................189 o VIII | o Walking Assist ..................................................... 190 o Beach Drag........................................................... 190 Quick Removal for a Small Victim ................... 191 o • USING A RESCUE BOARD ............................ 192 o Approaching the Victim...................................... 192 o Rescuing a Distressed Swimmer or Active Victim...................................................................... 193 o Rescuing a Passive Victim ................................ 194 • USING WATERCRAFT FOR RESCUES ..... 196 o Rescue with a Non-Motorized Water Craft–Square Stern Rowboat .......................... 196 o Rescue with a Non-Motorized Water Craft–Kayak .......................................................... 197 o Rescue with a Motorized Water Craft ............ 197 • WHEN THINGS DO NOT GO AS PRACTICED .......................................................... 198 o Front Head-Hold Escape .................................. 198 o Rear Head-Hold Escape ................................... 198 o In-Water Ventilations .......................................... 199 • REMOVING DISPOSABLE GLOVES .......... 223 • USING A RESUSCITATION MASK ............... 224 o Head-Tilt/Chin-Lift ......................................
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