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Unformatted text preview: INTERNATIONAL LIFEGUARD
Training Program Manual
5th Edition Meets ECC, MAHC, and OSHA Guidelines Ellis & Associates, Inc.
5979 Vineland Rd. Suite 105
Orlando, FL 32819
800-742-8720 Copyright © 2020 by Ellis & Associates, Inc.
All rights reserved.
Unless otherwise indicated in writing by Ellis & Associates, the recipient of this manual is granted the limited
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subject to the following restrictions:
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The procedures and protocols presented in this manual and the course are based on the most current
recommendations of responsible medical sources, including the International Liaison Committee on Resuscitation
(ILCOR) Consensus Guidelines for CPR, Emergency Cardiovascular Care (ECC) and First Aid, the Occupational Safety
and Health Administration (OSHA) standards 1910.151, and the Model Aquatic Health Code (MAHC).
The materials have been reviewed by internal and external field experts and verified to be consistent with the most
current guidelines and standards. Ellis & Associates, however, make no guarantee as to, and assume no responsibility
for, the correctness, sufficiency, or completeness of such recommendations or information. Additional procedures
may be required under particular circumstances. Ellis & Associates disclaims all liability for damages of any kind
arising from the use of, reference to, reliance on, or performance based on such information.
Library of Congress Cataloging-in-Publication Data Not Available at Time of Printing
Unless otherwise indicated on the Credits Page, all photographs and illustrations are copyright protected by
Ellis & Associates. CONTENTS
Continuing Education iv Part One: Professionalism and Safety
Chapter 1 Introduction to Lifeguarding 1 • Why Lifeguards? 2 • History of Lifeguarding 2 • Drowning: A Global Crisis 3 • Ellis and Associates Lifeguards 4 • Get the Most From Your E&A Lifeguard Training 5 • On-Going Training 7 • Primary Responsibilities of Lifeguards 8 • Secondary Responsibilities of Lifeguards 9 • Being Held Accountable 11 • Legal Concepts That Apply to Lifeguards 12 • Standard of Care 14 • Lifeguard Liability 14 • For Your Review 16 Chapter 2 Professional Image and Action 17 • Lifeguard Appearance and Behavior 18 • Lifeguard Uniform 20 • Lifeguard Equipment 20 • Positive Guest Interactions 23 • Rule Enforcement 24 • For Your Review 26 Chapter 3 Environmental Safety 27 • General Environmental Safety 28 • Weather Conditions 28 • Hydration 31 • Chemical Safety 31 • Recreational Waterborne Illnesses 33 • For Your Review 35 Chapter 4 Preventing Disease Transmission 36 • Bloodborne and Airborne Pathogens 37 • How Diseases are Transmitted 39 • OSHA Protection Standards 39 • Disease Prevention Practices 40 • If an Exposure Occurs 43 • For Your Review 45 Chapter 5 Guest Safety 46 • Health Codes, Laws and Standards 47 • Rule Enforcement 48 • Shallow Water Blackout 49 • Secondary Drowning 50 • Life Jackets 50 • For Your Review 52 Part Two: Vigilance and Teamwork
Chapter 6 Zone Protection 53 • The 10/20 Protection Standard 54 • Lifeguard Zones 54 • Zone Documentation and Training 56 • For Your Review 57 Chapter 7 Surveillance 58 • Introduction 59 • Recognizing a Guest in Distress 59 • Recognizing Risk Factors 60 • The Drowning Process 61 • Proactive Scanning Strategies 63 • For Your Review 66 Chapter 8 Maintaining Vigilance 67 • Vigilance 68 • Lifeguard Station Rotations 68 • Challenges to Vigilance 71 • Avoiding Distractions 73 • Improving Performance 74 • For Your Review 76 Chapter 9 The Emergency Action Plan (EAP) 77 • Emergency Action Plans 78 • Multiple Rescuer Facilities 79 • Single Rescuer Facilities 79 • Communication Devices and Standards 80 • Contacting EMS 85 • For Your Review 86 Part Three: Providing Quality Basic Life Support (BLS)
Chapter 10 Basic Life Support: Respiratory Emergencies 87 • The Respiratory System 88 • Causes of Respiratory Emergencies 88 • Respiratory Distress 89 • Respiratory Arrest 89 • Scene Survey 90 • Primary Check 90 • Secondary Check 91 • Rescue Breathing 91
• Special Situations 94 • Airway Obstruction (Choking) 95 • For Your Review 98 Chapter 11 Basic Life Support: Cardiac Emergencies 99 • The Circulatory System 100 • Cardiovascular Disease 100 • Cardiac Arrest 101 • Cardiopulmonary Resuscitation (CPR) 102 • Automated External Defibrillation (AED) 107 • For Your Review 112 Chapter 12 Supplemental Oxygen Support 114 • Drowning and the Need for Supplemental Oxygen 115 • Supplemental Oxygen Systems (SOS) 115 • Supplemental Oxygen Delivery Devices 117 • Care and Maintenance of Supplemental Oxygen Systems 121 • For Your Review 123 Part Four: First Responder Care
Chapter 13 Caring for Injuries 124
• Introduction 125 • Scene Safety 125 • Assessing Injured Guests 125 • Wounds 126 • External Bleeding 127 • Internal Bleeding 129 • Burns 130
• Head Injuries 132 • Spinal Injuries 137 • Pelvic and Hip Injuries 138 • Chest Injuries 138 • Abdomen Injuries 139 • Joint, Bone, and Muscle Injuries 140 • Shock 142 • Emergency Moves 143 • Triage 144
• For Your Review Chapter 14 Caring for Sudden Illnesses 145 147 • Allergic Reactions 148 • Breathing Emergencies 151 • Cold Emergencies 152 • Diabetic Emergencies 153 • Drug Emergencies 154 • Fainting 157 • Heart Attack 158 • Heat Emergencies 158 • Poisoning 160 • Pregnancy Complications 167 • Seizure 167 • Stroke 168 • For Your Review 172 Part Five: Water Rescues
Chapter 15 Water Rescues for Responsive Guests • Introduction 174
175 • Assists 175
• Water Entries 176 • Approach Strokes 177 • General Water Rescue Procedures 178 • Responsive Guests on the Surface 179 • Responsive Guests Beneath the Surface 181 • Challenging Rescue Situations 183 • For Your Review 185 Chapter 16 Water Rescues for Unresponsive Guests 186 • Unresponsive Guests in Distress 187 • Unresponsive Guest Rescues 187 • Caring for an Unresponsive Guest in the Water 191 • Rapid Extrication of an Unresponsive Guest 192 • Care After Extrication 194 • For Your Review 196 Chapter 17 Suspected Spinal Injuries 197 • About the Spine 198 • Recognizing Spinal Injuries 198 • Caring for Spinal Injuries in the Water 199 • Backboarding and Extrication 204 • Special Situations 208 • For Your Review 209 Part Six: Open Water Lifeguarding
Chapter 18 Open Water Lifeguarding • Introduction to Open Water Lifeguarding 210
211 • The Designated Swimming Area 211
• Managing Guest Safety 213 • Equipment for Open Water Lifeguarding 215 • Open Water Rescues 217 • Missing Guest Search 220 • For Your Review 222 Appendices
Appendix A Sample First Aid Kit Appendix B Sample BBP Exposure Control Plan 224
225 Index 231 i ACKNOWLEDGEMENTS
In Memory of Louise Priest
This edition of the International Lifeguard Training Program is dedicated to Louise Priest, a tireless aquatics
educator, author, and leader. Louise held leadership positions with the American Red Cross NHQ, Ellis &
Associates, and the Council for the National Cooperation in Aquatics. Louise was one of those select few
“larger than life” individuals who put others ahead of herself, exemplifying the very best of humankind. While
she will be missed, her legacy remains infinitely timeless. Contributors
Many individuals, agencies, and organizations contributed to the tasks of designing, advising, writing, editing,
reviewing, piloting, and producing this 5th edition of the International Lifeguard Training Program manual Jeff Ellis & Associates and Jeff Ellis Management National Staff
Dr. Larry Newell
Dr. Peter Goldberg
Jem Hughes Jennifer Barber
Landon Reed Luke Martinez
Vinson Needler External Contributors
Cedar Fair / Cedar Point, OH
City of Tempe Parks and Recreation, AZ
Erin Clancy, Stanfordville, NY
Deric Clinton, YMCA of Delaware
Brandon Cook, Online Design Club, FL
Englewood Parks and Recreation, CO
Megan Hartman, Great Wolf Lodge Resorts
Keith Herrmann, Aurora University, IL
Highlands Ranch Community Association, CO
Hilton Anatole Dallas, TX
Nick Licastro, Great Wolf Lodge Resorts Katherine Martinez, KP Facilitation, CO
Oakland County Parks, MI
Oostman Aquatics Safety Consulting, Inc, MA
Barbara Phillips, Tell a Story Creative, FL
Plainfield Township, MI
Jose Salazar, Loudoun County Fire & EMS, VA
Ryan Phillips, Safety Skills Training
Six Flags America, MD
Village of Grayslake Aquatic Center, IL
Water Safety Products, Inc. FL
Waukegan Park District, IL ii WELCOME
Congratulations on your decision to become an Ellis & Associates (E&A) lifeguard. Following successful
completion of your course, you will join a select group of aquatic professionals who apply proven state-of-theart aquatic injury prevention practices to reduce the number of emergency incidents, and when necessary, to
respond rapidly and effectively to any emergency. As a result of E&A’s emphasis on prevention, professionalism,
accountability, and proactive risk management, our safety record is unsurpassed in the aquatic industry. E&A - A History of Leadership and Innovation
In 1983 our program was created to address waterpark safety issues. Due to the great demand for this quality
program, it quickly expanded to pools, open-water environments, and resorts. Over a period spanning four
decades, E&A has been credited for revolutionizing the safety standards of the aquatic recreational and
amusement industry. Here are but a few E&A industry “firsts”:
• Elevating professional lifeguard standards through operational safety audits for lifeguard accountability
• Developing, implementing, and advocating for industry benchmarks and proactive risk management
standards such as our 10/20 Protection™ and 10/3 Protection™ standards, Vigilance Awareness Training®
(VAT®), and Zone Validation® system
• Developing equipment-based rescues that are safer and more effective than body contact rescues
• Incorporating bloodborne pathogens training into lifeguard training classes
• Introducing supplemental oxygen support (SOS), resuscitation masks, bag valve masks, manual suction devices,
and automated external defibrillators (AEDs) to enhance resuscitation efforts provided by aquatic staff to enhance
lifeguard resuscitation efforts
• Establishing a national database for aquatic injuries and injury prevention
• Offering the first blended e-learning lifeguarding program in the world Our Educational Philosophy
The emphasis of our lifeguarding curriculum is on preventing aquatic emergencies by consistently monitoring
guests, enforcing rules, and identifying and correcting potential dangers. Should an emergency occur our
lifeguards are prepared to work individually and as members of a team to respond rapidly and professionally.
We do not focus on executing textbook-perfect rescues, as such situations seldom occur in real-life. It is more
important for lifeguards to think critically, rationally, and overcome adverse rescue situations.
To achieve these learning outcomes E&A lifeguard candidates are immersed in the job of the lifeguard while
completing the course. They participate in hands-on lifeguarding activities including proactively scanning zones
as apprentice lifeguards. Through the design and delivery of our curriculum lifeguards exit our program with the
necessary knowledge, skills, and attitude to conduct themselves professionally and confidently. iii CONTINUING EDUCATION
Continuing education is a broad term used to recognize forms of post-secondary school learning activities often
associated with job training, maintaining professional certification/licensure, and personal enrichment courses.
Ellis & Associates is pleased to be able to provide Continuing Education Units (CEUs) to those who desire such
upon successful completion of our courses. Health care specialists, aquatic/recreation leaders, educators,
childcare providers, and other professionals can attain CEUs through our approved courses.
As an International Association of Continuing Education (IACET) Accredited Provider, Ellis & Associates offers
CEUs for its programs that qualify under the ANSI/IACET Standard. This prestigious accreditation demonstrates
our commitment to provide high-quality lifelong learning and high standards for all of our programs. We are
proud of our education programs, which reach aquatic safety, supervisory, and healthcare professionals each
year, helping to broaden their skills so that they remain on the cutting edge of education. 1 Introduction to Lifeguarding Chapter 1 INTRODUCTION TO
After reading this chapter and completing the related course work,
you should be able to:
• Understand the global problem of drowning
• Explain how lifeguards can help address the drowning problem
• Describe how to be a preventive lifeguard
• List responsibilities of a lifeguard
• Understand legal terms related to lifeguarding
• Relate lifeguard accountability to the standard of care
• Define lifeguard liability Chapter Overview
→ Why Lifeguards? (pg 2)
→ History of Lifeguarding (pg 2)
→ Drowning: A Global Crisis (pg 3)
→ Ellis and Associates Lifeguards (pg 4)
→ Get the Most From Your E&A Lifeguard Training (pg 5)
→ On-Going Training (pg 7)
→ Primary Responsibilities of Lifeguards (pg 8)
→ Secondary Responsibilities of Lifeguards (pg 9)
→ Being Held Accountable (pg 11)
→ Legal Concepts That Apply to Lifeguards (pg 12)
→ Standard of Care (pg 14)
→ Lifeguard Liability (pg 14)
→ For Your Review (pg 16) Introduction to Lifeguarding 2 Why Lifeguards?
Around the world, people of all ages happily swim in aquatic facilities, resort and hotel pools, and on beaches
without worry knowing that lifeguards are on duty providing pro-active surveillance. Facility guests put
their trust and safety in the hands of these well-trained individuals capable of performing water rescues and
emergency care including CPR. If a guest becomes fatigued, injured or at risk for other reasons, the lifeguard
enters the water and helps return the guest to safety. This is the responsibility you agree to take on as an Ellis
and Associates (E&A) trained lifeguard. History Of Lifeguarding
Some of the earliest, documented cases of lifeguarding can be traced to the 1700s. These early lifeguarding
efforts were primarily designed to aid those serving in battle or traveling the waterways. Comprised of military
and coast guard personnel, these early lifeguards were dedicated to eliminating or minimizing loss of life and
providing rescue and recovery services.
The first of these organizations was China’s Chinkiang Association for the Saving of Life, which offered money
and prizes for significant rescues.
Towards the mid-1800s, swimming became a popular pastime and recreational activity. In the United States,
oceanfront hotels and resorts began to dot the landscape in places like Atlantic City, New Jersey, The emerging
railroads would transport thousands of people to Atlantic City during the summer months to enjoy the beaches.
This brought an increased risk for drowning and other incidents. Demand for swimmer protection grew.
In 1855, a town in New Jersey took the first steps towards providing swimmer protection with the first
volunteer lifeguard team for beach patrol called the “Constables of the surf.” The Constables were police
officers tasked with responding to any beach emergency involving swimmers in the water. In the early 1900s
California instituted its first beach lifeguards (Fig 1.1).
Through the years, efforts to protect facility guests continued as more and more organizations looked to
ensure safety, developing training protocols, innovative rescue operations, and improved teaching materials
to better prepare lifeguards for the important task of preventing drownings. Today’s professional lifeguard is
better trained, and more equipped than ever before to protect lives in and around the water (Fig 1.2). 3 Introduction to Lifeguarding Figure 1.1 The lifeguarding profession has a decorated history. Figure 1.2 Today’s professional lifeguards Drowning: A Global Crisis
Drowning is the third leading cause of unintentional injury and death worldwide. It is the fifth cause of
death globally for children ages one-14 years old, impacting an estimated 360,000 children annually. Death
by drowning occurs in all regions of the world and in all types of economies. Deaths are especially prevalent
in lower and middle-income countries, regions of Africa, and in the Western Pacific and Southeast Asia,
accounting for half of the world’s drownings.
Higher risks for drowning include a number of additional factors:
• Alcohol use near the water
• Medical conditions such as seizure disorders
• Tourists unfamiliar with local features and risks
• Unsupervised and unattended children
The main risk factors for drowning involve:
• Lack of swimming ability
• Lack of barriers to prevent unsupervised access
• Children unsupervised
• Failure to wear life jackets
• Alcohol use
• Seizure disorders U.S. Statistics on Drowning
Drowning is a significant problem in the United States, ranking fifth among the causes of unintentional injury
deaths. Everyday about ten people die from unintentional drowning. About one in five people who die from
drowning are children 14 years of age or younger. For every child who dies from drowning, another five
receive emergency department care for serious, nonfatal submersion injuries. 4 Introduction to Lifeguarding Did You Know?
• Worldwide drowning is the third leading cause of unintentional injury death.
• In the U.S. more than 3600 people die from unintentional drowning annually; about two in 10 are
children 14 years old and younger. Ellis & Associates (E&A) Lifeguards
Having a lifeguard is the only consistently proven
means of preventing drownings and other tragic
incidents, in and around water. The best lifeguards
are those who are highly trained, professional, and
most of all, accountable (Figure 1.3).
In 1983, Ellis & Associates was founded to create the
best lifeguards in the aquatic industry to meet the needs
of an emerging industry - water parks. E&A lifeguards
have a mission to prevent submersion incidents and
potential loss of life and are held accountable to a high
standard of care. As an E&A trained lifeguard, your goal
is zero drownings annually. Figure 1.3 Professional lifeguards are highly trained and accountable for their actions. E&A’s International Lifeguard Training Program (ILTP®) stresses values that include safety, consistency, and integrity.
• Safety - Guests and employees of aquatics facilities trust you with their personal safety. You are
responsible for providing a safe environment for them and yourself. To accomplish this, you must proactively identify and manage risk.
• Consistency - To uphold the E&A Standard, you will consistently represent the E&A Philosophy and
effectively meet the skill and knowledge competencies of this program.
• Integrity - Being an E&A lifeguard requires a passion for aquatic safety. You will sincerely care about the
lives and well-being of those you protect. You will feel a sense of commitment and hold yourself personally
accountable to the swimmers you protect, the E&A training program, and your fellow lifeguards.
As a result of our collective emphasis on lifeguard professionalism, prevention, accountability, and
proactive risk management, E&A’s safety record is unmatch...
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- Fall '17
- Wind, Lifeguard, Drowning