Lifeguarding Manual

300 Pages·2012·41.768 MB·English

by  American Red Cross

Lifeguarding
Lifeguarding
Thank You for Participating in the American Red Cross
Lifeguarding Program
Your path to becoming a great lifeguard starts with Red Cross training. The important Manual
skills you learn in this course will help you act with speed and confidence in
emergency situations both in and out of the water. Your manual covers:
Water Rescue Skills • Surveillance and Recognition • First Aid • Breathing
Emergencies • Cardiac Emergencies and CPR • AED • and More.
Red Cross Lifeguarding emphasizes teamwork and prevention to help patrons stay
safe. Plus, convenient online refreshers supplement your in-service training to help
l
keep your knowledge and skills sharp. Visit redcross.org to learn about this and other i
f
e
training programs.
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u
a
The Red Cross Lifeguarding program is approved by the American Red Cross r
d
Scientific Advisory Council, and reflects the latest evidence-based science from:
i
n
• 2010 Consensus on Science for CPR and Emergency g
Cardiovascular Care (ECC).

• 2010 Guidelines for First Aid.

• 2011 United States Lifeguard Standards Coalition Report.

M
The American Red Cross Scientific Advisory Council is a panel of nationally
a
recognized experts in emergency medicine, sports medicine, emergency medical n
u
services (EMS), emergency preparedness, disaster mobilization and other public a
l
health and safety fields. The Council helps assure that courses, training materials
and products incorporate the latest scientific and technical information.
Each year the American Red Cross shelters, feeds and provides emotional support
to victims of disasters and teaches lifesaving skills to more than 15 million people.
The Red Cross supplies nearly half of the nation’s blood, provides international
humanitarian aid, supports military members and their families, teaches swimming
and water safety to more than 2 million people and trains nearly 300,000 lifeguards.
Stock No. 655735
Scan this code with your
smartphone to access free
redcross.org skill refreshers, or visit
redcross.org/LGrefresher.
LG_cover-PM.indd 1 12/16/11 10:15 AM
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 this book reflect the standard of knowledge and accepted
emergency practices in the United States at the time this book was published. It is the reader’s responsibility
to stay informed of changes in emergency care procedures.
PLEASE READ THE FOLLOWING TERMS AND CONDITIONS BEFORE AGREEING TO ACCESS
AND DOWNLOAD THE AMERICAN RED CROSS MATERIALS. BY DOWNLOADING THE
MATERIALS, YOU HEREBY AGREE TO BE BOUND BY THE TERMS AND CONDITIONS.
The downloadable electronic materials, 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, subject to the following restrictions:
■■ The recipient is prohibited from selling electronic versions of the materials.
■■ The recipient is prohibited from revising, altering, adapting, or modifying 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 and putting them on their own website
without Red Cross permission.
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 American National Red Cross. All rights reserved.
The Red Cross emblem, American Red Cross® and the American Red Cross logo are trademarks of
The American National Red Cross and protected by various national statutes.
The Boy Scouts of America Corporate Trademark and "PREPARED . FOR LIFE." are trademarks or registered trademarks
of the Boy Scouts of America in the United States and/or other countries.
All rights reserved. Used with Permission.
Published by Krames StayWell Strategic Partnerships Division
Printed in the United States of America
ISBN: 978-1-58480-487-1
Scan this code with your
smartphone to access
free skill refreshers, or visit
redcross.org/LGrefresher.
aCknoWlEDgMEnTS iii
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.
This manual reflects the 2010 Consensus on Science for CPR and emergency
Cardiovascular Care and the guidelines 2010 for First Aid. These treatment
recommendations and related training guidelines have been reviewed by the American
Red Cross Scientific Advisory Council, a panel of nationally recognized experts in fields
that include emergency medicine, occupational health, sports medicine, school and public
health, emergency medical services (eMS), 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.
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 also provided guidance
and review:
David Markenson, MD, FaaP, EMT-P Francesco a. Pia, PhD
Chair, American Red Cross Scientific Advisory Council Member, American Red Cross Scientific Advisory Council
Chief, Pediatric emergency Medicine Water Safety Films, Inc.
Maria Fareri Children’s hospital President, Pia Consulting Services
Westchester Medical Center Larchmont, New York
Valhalla, New York
S. Robert Seitz, M.Ed., Rn, nREMT-P
Peter Wernicki, MD Member, American Red Cross Scientific Advisory Council
Aquatics Chair, American Red Cross Scientific University of Pittsburgh
Advisory Council Center for emergency Medicine
Sports Medicine Orthopedic Surgeon Pittsburgh, Pennsylvania
International Lifesaving Federation Medical Committee
Past Chair The Sounding Board for this edition included:
U.S. Lifesaving Association
Medical Advisor Joyce a. Bathke
Vero Beach, Florida Chief Administrative Officer
American Red Cross St. Louis Area Chapter
Roy R. Fielding St. Louis, Missouri
Member, American Red Cross Scientific Advisory Council
University of North Carolina—Charlotte, department David W. Bell, PhD
of Kinesiology National Aquatic Committee
Coordinator, exercise Science/director of Aquatics National health and Safety Committee
Charlotte, North Carolina Boy Scouts of America
Ponca City, Oklahoma
Terri lees
Member, American Red Cross Scientific Advisory Council Pete DeQuincy
Aquatic Supervisor Aquatic Supervisor
North Kansas City Community Center east Bay Regional Park district
North Kansas City, Missouri Oakland, California
iv Lifeguarding Manual
Shawn DeRosa, JD, EMT-B Darwin Delappa
Manger of Aquatic Facilities and Safety Officer for director of Water Safety
Intercollegiate Athletics New York State Parks and Recreation
The Pennsylvania State University Queensbury, New York
University Park, Pennsylvania
luiz a. Morizot-leite
Scott E. gerding Captain, Ocean Rescue Lifeguard, Miami-dade
Sales Manager Fire Rescue department
Mid-east division Miami-dade County, Florida
American Red Cross
Columbus, Ohio Robert E. ogoreuc
Assistant Professor
Juliene R. Hefter Slippery Rock University
deputy director Slippery Rock, Pennsylvania
Wisconsin Park & Recreation Association
Owner, Safety First Aquatics, LLC William J. Frazier
greendale, Wisconsin Aquatic Operations Manager
Massanutten Resort
Carolyn Hollingsworth–Pofok Mcgaheysville, Virginia
director of Recreation and events
Millcreek MetroParks lee Hovis
Canfield, Ohio director of Recreation Operations
Nocatee Waterpark Recreation
William a.J. kirkner, JD Ponte Vedra Beach, Florida
Aquatics director
JCC of greater Baltimore Danial llanas
Reisterstown, Maryland director of Support Services
Busch entertainment Corporation
Joetta R. Jensen San Antonio, Texas
Assistant Professor and director of Aquatics
hampton University Scott Mersinger
hampton, Virginia Aquatics director
Lost Rios Waterpark
Rhonda Mickelson Wisconsin dells, Wisconsin
director of Standards
American Camp Association The following individuals provided external review:
estes Park, Colorado
alex antoniou
Edwin Pounds director of educational Programs
Aquatics Manager National Swimming Pool Foundation
City of Pearland Colorado Springs, Colorado
Pearland, Texas
Jerome H. Modell, MD., D Sc (Hon.)
Clayton D. Shuck emeritus Professor of Anesthesiology
deputy Manager of Recreation Courtesy Professor of Psychiatry
South Suburban Parks and Recreation Courtesy Professor of Large Animal Clinical Sciences
Centennial, Colorado Colleges of Medicine & Veterinary Medicine, University
of Florida
Thomas C. Werts gainesville, Florida
President
Aquatics Safety Consulting
The American Red Cross thanks Jorge L. Olaves h., ed S,
Kissimmee, Florida
Florida A&M University, for his contributions to this manual.
The following individuals participated as Waterfront
and Waterpark Working group members:
adam abajian
Recreation Program Manager/Lakefront Operations
City of evanston
evanston, Illinois
PREFaCE v
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.
vi Lifeguarding Manual
ConTEnTS
ChApteR 1 ChApteR 2
The Professional Lifeguard Facility Safety
Introduction ________________________________________ 2 Rescue equipment _________________________________ 12
Responsibilities of a Professional Lifeguard ______________ 2 Facility Safety Checks _______________________________ 15
Characteristics of a Professional Lifeguard ______________ 3 Weather Conditions ________________________________ 25
decision Making ____________________________________ 6 Rules and Regulations ______________________________ 27
Legal Considerations ________________________________ 6 Management and Safety _____________________________ 30
Continuing Your Training ______________________________ 8 Wrap-Up __________________________________________ 32
Being Part of the Team _______________________________ 9
Wrap-Up __________________________________________ 10
ChApteR 3 ChApteR 4
Surveillance and Recognition Injury Prevention
An Overview of the Process of drowning _______________ 34 how Injuries happen ________________________________ 53
effective Surveillance _______________________________ 34 Injury-Prevention Strategies __________________________ 53
Wrap-Up __________________________________________ 49 effective guarding—Injury Prevention Challenges ________ 56
Wrap-Up __________________________________________ 70
ChApteR 5 ChApteR 6
Emergency Action Plans Water Rescue Skills
Types of emergency Action Plans _____________________ 72 general Procedures for a Water emergency ____________ 88
Implementing an emergency Action Plan _______________ 76 Train to the Standard, Meet the Objective ______________ 90
emergencies Outside of Your Zone ___________________ 85 Rescue Skills ______________________________________ 90
Wrap-Up __________________________________________ 86 Additional Rescue Skills for Waterfronts _______________ 94
Special Situations for Waterfronts _____________________ 95
When Things do Not go as Practiced ________________100
Wrap-Up _________________________________________102
ChApteR 7 ChApteR 8
Before Providing Care Breathing Emergencies
and Victim Assessment
Recognizing and Caring for Breathing emergencies _____160
Bloodborne Pathogens _____________________________132 giving Ventilations _________________________________163
how Pathogens Spread ____________________________133 Airway Obstruction ________________________________169
Preventing the Spread of Bloodborne Pathogens _______135 emergency Oxygen ________________________________ 172
If You Are exposed ________________________________140 Oxygen delivery devices ___________________________ 175
general Procedures for Injury or Sudden Illness on Land ___140 Suctioning _______________________________________180
Wrap-Up _________________________________________ 147 Wrap-Up _________________________________________180
ConTEnTS vii
ChApteR 9
Cardiac Emergencies
Cardiac Chain of Survival ___________________________194
heart Attack ______________________________________194
Cardiac Arrest ____________________________________196
CPR ____________________________________________196
Aeds ____________________________________________198
Multiple-Rescuer Response _________________________203
Wrap-Up _________________________________________206
ChApteR 10
First Aid
Responding to Injuries and Illnesses __________________215
Secondary Assessment ____________________________216
Sudden Illness ____________________________________ 217
Skin and Soft Tissue Injuries ________________________220
Bites and Stings __________________________________228
Poisoning ________________________________________232
heat-Related Illnesses and Cold-Related emergencies __233
Injuries to Muscles, Bones and Joints _________________235
emergency Childbirth ______________________________ 237
Wrap-Up ________________________________________238
ChApteR 11
Caring for Head, Neck and Spinal Injuries
Causes of head, Neck and Spinal Injuries _____________ 247
Caring for head, Neck and Spinal Injuries _____________248
Wrap-Up ________________________________________ 257
glossary _________________________________________ 273
References _______________________________________280
Index ____________________________________________285
viii Lifeguarding Manual
SKILL SheetS
ƒ Rotations—ground-Level Station ______________________ 50 ƒ Recovery Positions ________________________________154
ƒ Rotations—elevated Station __________________________ 51 ƒ Moving a Victim
ƒ entries c■ Non-emergency Moves
c■ Slide-In entry __________________________________ 103 ●■ Walking Assist ______________________________156
c■ Stride Jump ___________________________________ 103 ●■ Two-Person Seat Carry _______________________156
c■ Compact Jump ________________________________104 c■ emergency Moves
c■ Run-and-Swim entry ____________________________ 105 ●■ Pack-Strap Carry ____________________________ 157
ƒ Assists ●■ Clothes drag _______________________________158
c■ Simple Assist __________________________________106 ●■ Ankle drag _________________________________158
c■ Reaching Assist from the deck ___________________106 ƒ giving Ventilations _________________________________ 181
ƒ Rescues at or Near the Surface of the Water ƒ giving Ventilations Using a Bag-Valve-Mask Resuscitator—
c■ Active Victim Front Rescue ______________________ 107 Two Rescuers ____________________________________ 182
c■ Active Victim Rear Rescue _______________________108 ƒ Conscious Choking—Adult and Child _________________184
c■ Passive Victim Rear Rescue ______________________109 ƒ Conscious Choking—Infant __________________________186
ƒ Multiple-Victim Rescue _____________________________ 111 ƒ Unconscious Choking ______________________________ 187
ƒ Rescuing a Submerged Victim ƒ Assembling the Oxygen System _____________________189
c■ Submerged Victim in Shallow Water_______________ 112 ƒ Administering emergency Oxygen ___________________190
c■ Feet-First Surface dive __________________________ 113 ƒ Using a Manual Suctioning device ___________________ 191
c■ head-First Surface dive _________________________ 114 ƒ One-Rescuer CPR ________________________________ 207
c■ Submerged Victim in deep Water _________________ 116 ƒ Two-Rescuer CPR—Adult and Child __________________208
ƒ Removal from Water
ƒ Two-Rescuer CPR—Infant ___________________________ 210
c■ Two-Person Removal from the Water
ƒ Using an Aed ____________________________________ 212
Using a Backboard _____________________________ 118
ƒ Secondary Assessment—Using SAMPLe to Take a
c■ Walking Assist _________________________________ 120
Brief history ______________________________________239
c■ Beach drag ___________________________________ 120
ƒ Checking a Conscious Person ______________________240
c■ Front-and-Back Carry ___________________________ 121
ƒ Using a Rescue Board ƒ Controlling external Bleeding ________________________ 242
ƒ Splinting
c■ Approaching a Victim on a Rescue Board __________ 122
c■ Arm Injuries ___________________________________ 243
c■ Rescuing an Active Victim with a Rescue Board _____ 123
c■ Leg Injuries ____________________________________244
c■ Rescuing a Passive Victim with a Rescue Board ____ 124
ƒ Using Watercraft for Rescues c■ Foot Injuries ___________________________________244
c■ Rib and Breastbone Injuries ______________________ 245
c■ Using a Square Stern Rowboat for Rescues ________ 126
c■ Using a Motorized Watercraft for Rescues _________ 127 c■ hand and Finger Injuries ________________________ 245
c■ Using a Kayak for Rescues ______________________ 127 ƒ head Splint—Face-Up Victim at or Near the Surface ____258
ƒ When Things do Not go as Practiced ƒ head Splint—Face-down Victim at or Near the Surface ___259
c■ Front head-hold escape ________________________ 128 ƒ head Splint—Submerged Victim _____________________260
c■ Rear head-hold escape _________________________ 128 ƒ head Splint—Face-down in extremely Shallow Water ___ 261
c■ In-Water Ventilations ____________________________ 129 ƒ Spinal Backboarding Procedure—Shallow Water _______ 262
c■ Quick Removal from Shallow Water for a Small Victim 130 ƒ Spinal Backboarding Procedure—deep Water _________ 265
ƒ Removing disposable gloves _______________________148 ƒ Spinal Injury—Removal from the Water on a Backboard __ 267
ƒ Using a Resuscitation Mask ƒ Spinal Backboarding Procedure and Removal
c■ head-Tilt/Chin-Lift ______________________________149 from Water—Speed Slide ___________________________268
c■ Jaw-Thrust (With head extension) Maneuver ________150 ƒ Caring for a Standing Victim Who has a Suspected
c■ Jaw-Thrust (Without head extension) Maneuver _____150 head, Neck or Spinal Injury on Land _________________269
ƒ Primary Assessment—Adult _________________________ 151 ƒ Manual Stabilization for a head, Neck or Spinal Injury
ƒ Primary Assessment—Child and Infant ________________ 152 on Land _________________________________________ 272
1
The Professional
Lifeguard
r
e
t
L
p
ifeguarding can be a rewarding job. Being a lifeguard is:
a
■■ Dynamic. each day on the job presents you with
h
new situations.
C
■■ Challenging. You need to make quick
judgments to do the job well.
■■ Important. You may need to
respond to an emergency at
any moment.
■■ Inspiring. With the
knowledge, skills and
attitude you acquire through
your lifeguard training, you
can save a life.
this chapter describes the
characteristics, responsibilities
and rewards of being a
professional lifeguard.
It also discusses
the importance of
maintaining lifeguarding
knowledge and skills. ■■