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Speaking of Aquatic Supervisors: What’s a Pool Monitor?

It wouldn’t surprise me at all if “pool monitor” is a new term to some. It is a type of swimming pool supervisor used almost exclusively in the homeowner association (HOA) market to provide some supervision without taking on the liability and extra costs of posting lifeguards. To understand how this works, we have to look at a law that is rather common in state regulations for swimming pool operation.

Many state laws call for a sign to be posted at swimming pools that do not require lifeguard services (e.g., hotel/motel pools, homeowner association pools, etc.). Perhaps you have seen such a sign posted:

Massachusetts-No-Lifeguard-Duty-Sign-S-7754Signs like this limit the liability of pool operators when lifeguard services are not required by state law. This is really a notice to swimmers and parents that children cannot swim without adult supervision and, in the case of this sign, that adults should not swim alone.

Pool monitors are the result of HOAs “playing both sides against the middle”: to have the protection of a “No Lifeguard on Duty” sign while providing cheaper “nonlifeguard” supervision at their swimming pools. This is fine except that these HOAs often blur the distinction between pool monitors and lifeguards to the extent that a mixed message is sent to families who cannot tell whether the “lifeguard” protocol or the “no lifeguard” protocol is in effect. The problem is further complicated when the HOA owners/management retain control of pool operation instead of deferring to specialists in aquatic safety.

I took a quick look at the laws in several states and could not find any provision for a “pool monitor.” Either lifeguard services are required or the sign is posted. Period. That being said, here are some ways for HOAs to avoid confusing their membership who are just trying to cool off and have fun in the sun:

  • Pool monitors should not be dressed in lifeguard-like uniforms, carry rescue tubes, sit in lifeguard stations, or otherwise look and behave like lifeguards.
  • Pool monitors should not make swimming rescues with or without equipment. Nonlifeguards should make reaching, throwing, boating, and wading assists only.
  • No Lifeguard on Duty signs should be displayed prominently throughout the facility and handouts should be given to all participants to clarify the policy.
  • Pool monitors should have clearly defined duties and “continuous supervision,” “scanning,” “rule enforcement,” “performing rescues,” etc. should not be a part of their duties. Those are lifeguard tasks and, in situations where there are no lifeguards, these duties fall to the parents of children in the water. Pool monitors may be asked by management to help parents in supervising, rescuing, and caring for their children in and around the water.
  • Pool monitors should not be supervised by the HOA but rather be under the control and supervision of an aquatic specialist like the lifeguard company providing the pool monitors. HOA owners/managers generally lack the knowledge to make good decisions about aquatics, including but not limited to visibility, supervision and crowd control, activities in the area, staff duties, etc. and they may make political decisions that they later deny when a drowning or other tragic event goes badly in the pool and the time comes to deflect liability to the contracting agency who had no say in the decision that led to the accident.

No one has asked my opinion (at least not yet), but I would recommend that lifeguard agencies who provide services to HOAs negotiate carefully the roles that their staff will play at the facility where they will work. It is important to put everything in writing.

Above all, pool monitors either are not lifeguards and should not look or behave like lifeguards, or they should be called lifeguards and the “no lifeguard” signs should be removed when lifeguards are on duty.

Define Water Safety Supervisors Carefully

Supervision is an essential aspect of water safety. Parents and other guardians supervise their children, group leaders watch over their participants, and operators of swimming pools, beaches, and water parks hire lifeguards to scan swimming areas. All these types of supervision can be equally effective despite using different methods to ensure water safety.

Supervision by Parents/Guardians

Let’s start with parental supervision. Parents, guardians, babysitters only need to keep track of a few kids. Easy, right? Wrong! Children of all ages can quickly get in trouble. Small children often escape parental supervision and find themselves near the water unsupervised. Even when children are in the water under parental supervision, they can get into trouble with just one bad decision about diving, exploring deep water, etc. Here are some tips:

  1. Very young children need to be supervised at all times. They can reach the water and drown in the time it takes to answer the phone or flip a couple burgers.
  2. Use layers of protection to keep children safe. Contrary to what some swim schools might tell you, learning to swim at 3 months is not as important as constant adult supervision at the pool and in the home and barriers (e.g., fences, covers, locks, etc.) to water sources inside and outside the house. Other supplemental layers of protection include alarm systems, supervisor knowledge of water safety and CPR/first aid, and swimming lessons.
  3. When in the water with a young child, keep that child within arm’s reach at all times. Use a U.S. Coast Guard life jacket if necessary, but do not trust floaties, water wings, plastic rings, etc.
  4. For children old enough to read and understand rules, walk them around the pool and show them the posted rules and markers. Discuss why each rule is important. Be emphatic, not dramatic.
  5. When you are acting as a supervisor for your child, do not read, sun bathe, or visit with other adults. Keep eyes on your children at all times.
  6. Have children swim in a designated swimming area where lifeguards are on duty, but do not rely on lifeguards to watch your children. This is your responsibility.
  7. Watch for currents at beaches and rivers that can move children into dangerous water or out of your sight.
  8. Protect your children from the sun, the weather, and water contaminants.

Group Leader Supervision

Supervision by swimming instructors and coaches often goes unmentioned. The absurd conventional wisdom goes like this: “Since lifeguards cannot divide their attention between surveillance and a secondary task like teaching, it follows that instructors and coaches cannot teach and supervise their classes.” Right? Wrong!

The first responsibility of any instructor is to provide for the safety of all participants in their group. This is accomplished through supervision and otherwise accounting for participants in their class. The following tips apply to swimming instructors, WSIs, coaches, etc.:

  1. Obtain rescue and first aid/CPR training.
    1. If you swim well enough to get a lifeguarding certificate, do so. Some states consider a swimming instructor or coach with lifeguarding qualifications who supervises his/her group as providing lifeguard services.
    2. If you cannot swim well enough to be certified as a lifeguard, take a Red Cross Basic Water Rescue course, a Safety Training for Swim Coaches course, or equivalent with first aid and CPR.
  2. Dress appropriately for class. Be ready to enter the water or use equipment to make a rescue and to give care. Consider having oxygen, an automated external defibrillator (AED), a backboard, a first aid kit, reaching and throwing devices, a rescue tube, resuscitation mask, etc. accessible for your use. When in the water with your class, wear the rescue tube.
  3. Make sure the pool is free of hazards and ready to be used safely. If you cannot see the bottom, if broken glass is in the area, or if chemicals are out of balance, you cannot hold class in the water.
  4. Remove all pool covers from the pool before allowing participants in the water. Never hold class in a partly covered pool.
  5. Make sure your group is not too large to supervise. If it is, get help in the form of more staff or divide the group so that half the group is in the water and the other half is doing a land-based activity in the bleachers.
  6. Test all participants and decide where they can be in the facility. Remember that most skills can and should be taught in shallow water first.
  7. Position yourself so you can supervise the entire group. Even the strongest swimmers need your supervision.
  8. Teach corresponding water safety information with swimming and water-contact activities.
  9. Follow, don’t flout, the rules. They are appropriate for even the strongest swimmers.
  10. Take attendance before going in the water and again after class before leaving the pool area.
  11. Check the bottom of the pool before replacing pool covers or leaving the area at the end of class.
  12. Develop and practice an emergency action plan for your program.

Lifeguard Supervision

Lifeguards have specialized training to provide supervision of a swimming area. Since lifeguards provide surveillance of an entire area, they cannot focus attention on secondary tasks like swimming lessons, facility maintenance, cashier duties, etc. Tips for lifeguards include:

  1. Get proper training that includes lifeguarding, first aid/CPR, AED, and oxygen administration. Keep your training up-to-date and look for opportunities to take part in refreshers, staff training, etc.
  2. Have proper equipment on hand or accessible, including a rescue tube, a resuscitation mask, first aid equipment, backboard, etc.
  3. Come to work well rested, well hydrated, and mentally and physically ready to work.
  4. Position yourself where assigned or where you can keep constant surveillance of your entire area. Be mindful of blind spots, glare, and water conditions that affect your ability to see everything in your area.
  5. Program your mind with the victim characteristics, rule violation behaviors, hazardous conditions and practices, etc. so you will recognize them when you see them. Do not focus on scanning patterns or become distracted by the activities or people in the water. You have to see people and analyze activities, but do not become lost in the moment and forget to keep supervising.
  6. Scan appropriately and continuously. Perform visual sweeps of your assigned area, looking at the surface, middle, and bottom of the water, going from side to side, top to bottom, and point to point in your area.
  7. Inform, educate, and enforce safety rules in the area. Alert instructors of unsafe conditions or unsupervised participants.
  8. Activate the emergency action plan when your respond to an emergency and make a rescue in the most direct way. You have a duty to act appropriately in each situation.
  9. Take charge of emergency care until relieved by someone of equal or greater training.

All Supervision Is Good Supervision

Each of these supervisors uses different methods to get the job done. In some cases, the coverage of two or more supervisors may overlap and offer layers of protection. Remember all supervision is good supervision if it is adequately and continuously applied by the proper person.

Also remember that children can be taught swimming and water safety so that they can begin, as they grow older, to make good water safety decisions, thereby providing an extra layer of protection: a growing awareness of water hazards and self-reliance in the water.

 

School Instructor-Lifeguards

I was looking for state laws regarding “Swim at Your Own Risk” signs for another blog when I ran across the following article: Lack of School Lifeguards Prompts Questions.

In particular, I was taken aback by a statement by San-Diego–based water safety consultant Alison Osinski when she said: “We’re asking them to do two jobs at once – teach and lifeguard – and that’s impossible,” With all due respect to Ms. Osinski and those who share this conventional wisdom, I strongly disagree.

While lifeguards in a lifeguard station scanning an area of responsibility certainly should perform no other duties, including, but not limited to, teaching lessons, the same is not true for swimming instructors and coaches. Instructors and coaches have a primary duty to supervise their group and account for their participants at all times. Although this is accomplished by course planning, assessment of participant ability, class organization and management, instructor positioning relative to the class, the use of safety equipment and accountability checks, etc., these tactics and others are as effective as scanning, if not more so when focused on the group appropriately and consistently. In the absence of lifeguard service, these methods can provide comprehensive and adequate supervision of the group. If lifeguards are also stationed, their supervision of the pool area is secondary to the supervision, control, and accountability provided by the instructor/coach.

If the group is too large to be supervised by one instructor/coach, money should be spent to provide additional instructors so the group can be divided to provide effective supervision before money is spent on a stationed lifeguard. While being beneficial, lifeguard services for instructional programs are secondary supervisors.

Every time aquatic experts point to the absence of a stationed lifeguard as the root-cause of a drowning during swimming instruction, they miss the main point that a swimming instructor or coach must be taught how to be an effective supervisor of their group at all times first and foremost.

 

Personal Flotation Devices–What’s in a Name?

Centuries ago, William Shakespeare wrote in Romeo and Juliet: “What’s in a name? That which we call a life jacket by any other name would float as much.” Wait a second. That is not exactly what Shakespeare wrote, is it? However, the recent discussion started by Rebecca Wear Robinson’s blog about using the term life jacket made me think of Shakespeare’s immortal line: “That which we call a rose by any other name would smell as sweet.”

In a follow-up blog, Rebecca wrote that she was surprised by the controversy over a name to call wearable personal flotation devices (PFDs). While I applaud those attempting to be more technically accurate in defining life jackets and other PFDs, I also understand where Rebecca is coming from. She and many groups are working hard to simplify messages about water safety so people understand what to do to prevent drownings and respond to emergencies.

Yolk-type PDF (Type II)

Yolk-type PDF (Type II)

Life Jacket, PFD, and Back to Life Jacket Again

Having been in the water safety business for over 40 years, I remember teaching children about lifejackets in swimming classes. At that time, we used the orange yolk-type PFD because it was the least expensive and therefore the type purchased by aquatic departments to be available for lessons. We taught that lifejackets must be US Coast Guard approved, the correct size for thew wearer, and in good repair. (This is still good advice!)

Type I Lifejacket

Type I Lifejacket

I remember the day when the term personal flotation device or PFD was introduced to replace lifejacket. At the time, I remember being told that there were other devices that cannot be classified as lifejackets that should be a part of the discussion of buoyancy aids and devices. This discussion then included the 5 types of PFDs identified by the US Coast Guard.

Type I are off-shore life jackets designed to roll an unconscious wearer to a faceup position.

Type II are near-shore buoyant vests (see above) that provides less buoyancy than a Type I life jacket. Many Type II devices turn an unconscious victim face up.

Type III Flotation Aid

Type III Flotation Aid

Type III are flotation aids considered to be the most comfortable for recreation in and around the water. These devices should be used close to shore where quick rescue because they will not turn an unconscious victim face up. Type III devices are used for water skiing, jet skiing, tubing, fishing, hunting, water slide use, etc.

Life ring or ring buoy

Life Ring or Ring Buoy (Type IV)

Type IV are throwable devices that include the life ring, seat cushions found on boats and airplanes, etc. The use of the term PFDs probably became popular to include Type IV devices in discussions about life jackets and related devices.

Seat Cushions (Type IV)

Seat Cushions (Type IV)

Type V PFD

Type V PFD

Type V are restricted-use and special-use devices like work vests, deck suits, and hybrids (devices with some buoyancy that can be inflated when necessary to provide additional buoyant support). Some Type V devices have additional features, like insulation to prevent hypothermia.

The Central Message: Don’t Just Pack It, Wear Your Jacket

Here’s where Rebecca and groups like the US Coast Guard are coming from. Wear your life jacket, especially when you are a nonswimmer, boating, using recreational equipment on the water, or around cold water. The use of “life jacket” in this message is meant to simplify the message and be inclusive of the appropriate wearable device. (For links about life jackets, go to General Water Safety.)

Following this central message, it is OK to state: Life jackets should meet US Coast Guard or ISO BS EN 12402 standards, be appropriate for the activity (i.e., ask an expert), fit snugly yet comfortably, and be in good repair. there are several types of life jackets, including buoyant vests and flotation aids.

It is great to be as precise as possible when discussing the technical aspects of a subject, but remember that simply messages are easy to remember and save lives. For example, the message “stay with the boat” does not need to be qualified for the type of vessel. It is a general rule.

By the way, if I am ever on a cruise and the purser or cruise director hands me a Type III buoyancy aid in case of an emergency at sea, I’m getting off at the next port of call!

 

 

Scanning 101: Environmental Factors and Scanning (Part 3 of 3)

As a part of scanning preparation, lifeguards should be trained in the supervision challenges of the aquatic environment where they plan to work. Minimally, this training should include an orientation to the general and facility-specific characteristics of the aquatic environment, shadowing a seasoned lifeguard to learn effective supervision practices, and oversight on the job with periodic evaluation.

Adapting Scanning to the Environment

Sample beach zones

Sample beach zones

Different aquatic environments present unique surveillance challenges.

Open Water Environments

Oceans and waterfronts, for example, can have long shorelines with waves, currents, rising and falling murky water, and unseen obstructions. Scanning these areas may be limited to surveying the beach and surface of the water within an assigned zone.

Fortunately, most participants in open-water environments do less swimming and keep their heads above water much more than in swimming pools. In fact, the murkier and colder the water, the less time participants will be underwater and out of sight (unless snorkeling, etc.).

Waterparks

In contrast, waterparks have isolated catch pools and flumes; winding rivers of slowly moving water; play areas with sprays, fountains, and other obstructions; and wave pools with zero-depth entrances and crowded wave zones. With the exception of winding rivers and wave pools (usually handled with zone coverage), each of these areas is supervised by a single lifeguard who provides total coverage. In some cases, the lifeguard is positioned in a catch pool or next to the flumes of a speed slide to assist participants as they exit.

Swimming Pools

Swimming pools provide an environment that necessitates effective scanning. Hundreds of participants of differing abilities crowd into the water to enjoy various water-based activities (e.g., swimming, diving, water polo, cooling off and splashing around, etc.). When you factor in the slippery decks, shallow water, deep water, diving boards and play structures, adventurous preschoolers, underwater swimmers, etc., there are literally millions of ways for people to hurt themselves and others in a swimming pool. Through surveillance, rule enforcement, and emergency response, lifeguards prevent injuries and save many lives.

Zoned Total Coverage

Although some promote zone coverage for swimming pool surveillance, true zone coverage is really meant for environments where a single lifeguard cannot see from one end of the total swimming area to the other. The entire area must be divided with overlapping coverage so that the entire area is supervised.

Swimming pools small enough to use total coverage (i.e., a single lifeguard watching the entire pool) during times of low attendance should use a hybrid of zone and total coverage called zoned total coverage during times of high activity when two or more lifeguards are stationed.

Zoned total coverage

Zoned total coverage

Zoned total coverage is a surveillance strategy for swimming pools that combines the elements of classic zone coverage and total coverage. Assigned lifeguards survey the entire pool area or as much of it as they can see (total coverage) while focusing primary attention on the zone nearest them (zone coverage). This creates primary, secondary (overlapping areas) and tertiary areas of the pool to include in each scan.

In each primary zone, the assigned lifeguard actively enforces rules and responds to emergencies. In overlapping areas of primary zones (secondary zones), the assigned lifeguards provide the same level of surveillance but defer emergency response to the lifeguard that recognizes the emergency first and activates the emergency action plan.

The entire pool outside the primary and secondary zones should also be included in each lifeguard’s scan, but this is mainly to detect hazards the primary lifeguard cannot easily see. Rule violations can be enforced by any lifeguard, but emergencies detected outside the primary and secondary zones should be pointed out to the primary lifeguard for response.

Improving Environment-Specific Scanning

Some general techniques for improving lifeguard surveillance include adding lifeguards to reduce the area and/or number of individuals being supervised; repositioning lifeguard stations to be closer to the public and to minimize blind spots and glare; and designating the most appropriate rotation schedule.

  • Adding Lifeguards. Lifeguard can be assigned as a rover along the beach, throughout the waterpark, or around the perimeter of the swimming pool, wave pool, or winding river. In addition, lifeguard can be positioned opposite existing stations at a pool, in the surf zone in the ocean or a wave pool, or in a  boat at the outer edge of a waterfront swimming area.
  • Repositioning the Lifeguard Station. To improve visibility, lifeguard stations can be moved or lifeguards can patrol on foot.
  • The Most Appropriate Rotation Schedule. The right number of lifeguards must be deployed and rotated at an appropriate interval. Having too many or too few lifeguards deployed and/or keeping them in one station too long can lead to lapses in coverage.

Scanning 101: Attention Capture and Scanning (Part 2 of 3)

To be successful, scanning must result in the timely recognition of distressed and drowning victims as well as hazardous conditions and practices that require lifeguard response. In other words, scanning must lead to prompt and consistent attention capture and the correct analysis of each situation.

Bottom-Up Triggers vs. Top-Down Controls

One of the most debated issues in the study of visual attention has to do with the role played by bottom-up triggers and top-down controls in attention capture. In the context of lifeguard surveillance, top-down controls refer to the ability to select and focus on the criteria for attention capture during scanning. Bottom-up triggers refer to the capacity of certain attributes or behaviors to capture attention, irrespective of what the scanning lifeguard is focusing on or trying to find.

For example:

  • Top-down controls: When a lifeguard assumes a station, he or she should focus on the physical signs that indicate hazardous conditions, dangerous practices, and distressed and drowning victims. By keeping this focus, the lifeguard is in essence “programming” his or her senses to detect these signs.
  • Bottom-up triggers: While scanning an area of the pool, the lifeguard’s attention might be drawn away momentarily by the bright color of a swim suit or a skillful dive performed on the 1-meter diving board.

Let’s assume that both types of attention capture can and do occur during scanning. The most consistent and reliable method for scanning must be the one lifeguards can learn, control, and program their minds to look for: top-down controls. In other words, if the lifeguard understands potential hazards, the activities that lead to injury, and the behaviors of weak swimmers and distressed and drowning victims, these characteristics can lead from preattentive analysis to focused attention, reaction, and response.

In contrast, the lifeguard does not, by definition, control or program the mind for bottom-up mechanisms. These simply appear unexpectedly and, therefore, may or may not be detected during visual sweeps.

The Problem with Lifeguard Vigilant Testing

A great example of the inconsistency of bottom-up attention capture during scanning can be found in the results of so-called lifeguard vigilance testing. This testing uses a false trigger (e.g., a red shirt, red cap, floating object, or a submerged manikin or silhouette) to signal a mock rescue during an actual lifeguard shift. The lifeguard closest to the false trigger is timed from its appearance until the lifeguard recognizes it and responds, by activating the emergency action plan and entering the water to make the “rescue.”

In 2001, Ellis and Associates conducted more than 500 of these tests at 90 pools and waterparks across the United States. As reported in the 2002 article “Lifeguards Watch, but They Don’t Always See” by Joshua Brener and Michael Oostman, it took lifeguards, on average, one minute and 14 seconds to detect a manikin submerged in the pool. Brener and Oostman went on to use this average to draw the conclusion that lifeguards are not always vigilant on the job and that drowning would have occurred if the manikins had been real victims.

I strongly disagree with these conclusions. First, they are far from scientific. It is altogether possible that the lifeguards tested were doing a good job of scanning with proper top-down controls. Even though submerged manikins simulate a drowning victim, they do not look real and may be screened out during the preattentive feature recognition stage. If lifeguards are informed of vigilant testing in advance, they may be distracted from their primary responsibility to the extent they focus on finding the false trigger. And, if they are not informed of the test, their preattentive recognition of a false trigger (a fake victim) is likely to cause confusion, resulting in a delayed response.

Lifeguard vigilance testing is a bad idea because:

  • These bottom-up triggers (i.e., silhouettes, manikins, etc.) are not reliable attention capture mechanisms.
  • If lifeguards focus on these triggers, they interfere with what the lifeguard should really be looking for. This makes these tests an intrusion of a secondary task by management (i.e., a test/evaluation) while lifeguards are engaged in a primary duty (i.e., scanning the pool for real issues/victims). This violates the spirit, if not the letter, of Dr. Frank Pia’s RID Factor. Lifeguards that do better in vigilance testing may actually not be focused on the primary goal of surveillance.
  • These tests also put lifeguards and patrons at unnecessary risk from the staged rescue in less than controlled condition.  This must occur during a real rescue, but it cannot be justified for a mere test.

Using Top-Down–Control Scanning

Lifeguards can learn top-down–control scanning by:

  • Developing an understanding of what they are looking for as they scan. This includes:
    • Learning the safety rules for the swimming areas they supervise and why those rules are in place
    • Understanding how injuries occur and what characteristics make up common hazards
    • Visualizing the characteristics of distressed and drowning victims
  • Discussing with other lifeguards on their team how to enforce safety rules and handle common problems in each area
  • Focusing on these things as they scan

 

Scanning 101: Scanning Mechanics (Part 1 of 3)

Scanning is a surveillance technique used by lifeguards to actively supervise the public in an aquatic environment (e.g., beach, swimming pool, waterpark, etc.). To scan effectively, lifeguards must make broad, continuous visual sweeps of their area of responsibility for recognizing victims and identifying hazardous conditions and practices.

The Mechanics of Scanning

Girl Holding Her BreathProper scanning requires the use of the lifeguard’s entire field of vision. Each visual sweep must be broad, emphasizing the peripheral range both up and down and side to side. Utilized in many situations to detect important visual information not being focused on (such as while operating a motor vehicle), peripheral vision can be used by lifeguards to detect the characteristics of distressed and drowning victims as well as the unusual sights that indicate an emergency. Just like driving a car would be impossible without expanding one’s vision to the periphery, proper surveillance of a beach or swimming area cannot be effective without the information obtained using peripheral vision.

As the lifeguard performs each visual sweep in a scanning pattern, his or her head should move in a continuous circular pattern that cuts through the area of responsibility and traces its edges. This moves the lifeguard’s central vision through the area while his or her peripheral vision sweeps from bottom to top, front to back, and side to side, gathering patron information.

Scanning must be continuous, and the scanning pattern should be simple and repeatable. Gaps in scanning, elaborate scanning patterns, and mental activities designed to help the lifeguard stay alert (e.g., looking for patrons of certain ages, with certain hair colors, etc.) can actually become a distraction, interfering with the lifeguard’s capacity to identify real problems. This will be discussed in greater detail in part 2 of this blog.

If the lifeguard detects a problem, his or her central vision, which provides the greatest visual acuity, automatically shifts to the spot to analyze what is going on. This analysis occurs automatically, unconsciously, effortlessly, and early in the perceptual process, followed by focused attention and reaction by the lifeguard based on the situation and the lifeguard’s experience and training.

Making Scanning Meaningful

As lifeguards scan, they must keep in mind two important aspects:

  • The characteristics to be identified (e.g., victim behaviors, rule violations, hazards, etc.)
  • The points that define the boundaries of each scan. Point-to-point scanning refers to the length (front to back), width (side to side), and depth (bottom to top) of each scan. These points must be included in each visual sweep to avoid missing something important.

Maintaining focus on these aspects makes scanning complete and meaningful. Without this focus (or worse yet, if there is a competing focus such as needing to spot silhouettes at the bottom of the pool or to spell out a letter of the alphabet with each scan), the lifeguard is looking at the water without necessarily the correct purpose or scope.

Timing Each Scan

stopwatch1In lifeguarding, seconds count and scanning needs to be performed in a timely manner. For swimming pools and waterparks, Ellis and Associates International Aquatic Safety & Risk Management Consultants has long maintained the 10/20 Patron Protection Rule, which requires lifeguard recognition of a patron in trouble within 10 seconds followed by access to the victim in 20 seconds. The YMCA uses a similar rule called the 10/10 Reaction, shortening the response time to 10 seconds.

For beaches, the Australian Surf Lifesaving Association uses 30/120 (a 30-second recognition and a 120-second response).

Establishing a time factor for scanning is important so that the lifeguard can measure his or her own effectiveness. If a lifeguard cannot consistently complete a scan of his or her area of responsibility in the time frame established for recognition, he or she should report this to management immediately.

Common Errors Affecting Scanning

Lifeguards and lifeguard management often make the following errors that negatively impact lifeguard surveillance:

  • Faulty preparation for duty—Lifeguards sometimes come to work with too little sleep or mental preparation; they may even arrive intoxicated, high, or hung over.
  • Improper lifeguard positioning—Lifeguards who are improperly positioned cannot see their entire area due to blind spots, glare, etc.
  • Improper rotations/breaks—Rotations and breaks help lifeguards to stay alert. But excessive duty shifts in one station, excessive breaks, or even late rotations can contribute to lifeguard inattentiveness.
  • Effects of the sun—Without proper hydration and sun protection, lifeguards can become too “fried” to do their job.

Lifeguard Service in Instructional Settings

Recently, I read some very tragic news items involving school pool drownings. To read what I read, click the following:

Stories such as these cause us to reflect on the best way to keep our children safe and still provide needed swimming/water safety instruction. Often, the rote answer given by aquatic professionals, risk managers, attorneys, and others is what seems to be missing—a lifeguard on duty. To quote the American Red Cross, an authoritative source, from page 7 of its current Water Safety Instructor’s Manual:

An adequate number of lifeguards should be on-duty and conducting patron surveillance during all in-water sessions.

Despite all of this, a stationed lifeguard is not always the best solution. As aquatic professionals, we need to understand this so we do not miss the point when we train others, advise pool operators and school districts, talk to the media, or look for answers in the face of tragic events.

Supervision: Not Just from the Lifeguard Chair

During instructional activities, the swimming instructor or coach, not the lifeguard, is the primary supervisor of the class. The stationed lifeguard, if present, is a secondary layer of protection—a second set of eyes watching the pool. (If you doubt this, try an experiment: The next time you are teaching a group in the water, tell the lifeguard you are leaving your class in the water for 5 minutes while you go to make a phone call. See what happens!)

In contrast, even if the lifeguard isn’t present, primary supervision of the class is still there because of the instructor. In addition to being primary, instructor supervision is also more direct, specific, and proximal to the class. This means instructors can combine supervision and class management to ensure participant safety. To that end, instructors must:

  • Be prepared to make a rescue and to perform CPR/first aid
  • Account for every participant at all times
  • Use principles of class organization to keep participants safe, including:
    • Taking a position that enables you to watch the entire class at all times
    • Structure activities to minimize anticipated risks
    • Introduce and enforce pool/class rules that eliminate risky behaviors
    • Apply class and individual limits based on age, ability, water depth, class size, etc.
  • Integrate water safety into all swimming instruction

If an instructor cannot adequately supervise and control the class at all times, the class should not be in the water until it can be divided or until additional instructors can assist.

RECOMMENDATION #1: Correct any issues with primary supervision in instructional settings before calling for a lifeguard in a chair or other secondary solutions.

Single Lifeguards: “Fish Out of Water”

In addition to being a secondary supervisor, lifeguards hired alone (i.e., outside of a properly managed swimming pool) may lack the necessary infrastructure and support system to be effective. They are a bit like “fish out of water” because of the following:

  • Lifeguards should be screened and hired on the basis of meeting minimum standards required for the facility. Associations, schools districts, university recreation centers, private parties are more likely to hire individuals simply because they can produce certifications.
  • Lifeguards require training, including an orientation to the job and in-service training. Single lifeguards hired by uninitiated pool operators are likely to depend on the lifeguard’s initial Lifeguarding course to give the lifeguard all the training required.
  • Lifeguard training at the facility usually includes “shadowing” with an experienced lifeguard so the newbie learns how the pool area is supervised for consistency and facility-specific issues. In a single lifeguard environment, there is nobody to shadow.
  • The single lifeguard probably has to work without specific written procedures defining his/her role and authority, primary responsibilities, emergency response, etc.
  • Without direct supervision by a head lifeguard/aquatic supervisor, it is easy for a lifeguard to become complacent and undisciplined. They may stop suiting up, sitting in a designated place, continually scanning the pool area, etc.

Of course, these potential problems exist for the instructors as well. However, instructors have more to do in the pool area and should already be motivated to provide safe, effective instruction. It is much easier to expand their preparation to include safety, supervision in an aquatic environment, etc. than it would be to provide all the infrastructure required to manage one or more stationed lifeguards.

RECOMMENDATION #2: When hiring a single lifeguard to supplement supervision in instructional settings, make sure RECOMMENDATION #1 is in place and necessary lifeguard infrastructure is implemented and maintained.

Lifeguard Services Redefined

The issues I have addressed here (and probably budgetary concerns, etc.) have causes  some states to redefine lifeguard services to include supervision by swimming instructors with proper qualifications. For example, in California, Section 116028 of the California Health and Safety Code has the following:

…”Lifeguard services” includes the supervision of the safety of participants in water-contact activities by lifeguards who are providing swimming lessons, coaching or overseeing water-contact sports, or providing water safety instructions to participants when no other persons are using the facilities unless those persons are supervised by separate lifeguard services.

Michigan, a state where one of the referenced drownings took place, has a similar law as explained in Michigan Public Pool Safety Guidelines for Schools 2007:

…Public Act 368, R 325.2198, clearly specifies when a lifeguard must be on duty and the qualifications of that lifeguard. A lifeguard must be on duty:

  1. At swimming pools other than spas or wading pools.
  2. At pools owned and operated by governments, public corporations, or a school.
  3. If a pool has a water surface greater than 2,400 square feet.
  4. If a pool has a diving board(s).
  5. Whenever the pool is open for use.

 

There must be at least 1 lifeguard for every 75 swimmers…’.

This document goes on to describe the swimming instructor/lifeguard option:

…If a supervising instructor, teacher, or coach does not meet the requirements of Rule R 325.2198, listed above, then a separate lifeguard who meets the requirements must be present.

Questions often arise about the requirements of schools to provide lifeguards. Frequently there is only one staff person on duty during class/practice. This may lead some to think that lifeguards need not be present, but usually the coach or physical education teacher is not only a qualified instructor, but also a certified lifeguard.

There must be a lifeguard on duty whenever the pool is open for use, which includes physical education class, practice, and when the pool is being used by staff or by any group, regardless of the level of swimming competency.

Can the swim instructor or coach also act as the lifeguard if he/she meets the qualifications listed above?

The answer is yes, but it is important to reiterate that if a swim instructor or coach is acting as both the instructor and lifeguard, he/she must always keep in mind that he/she is a lifeguard first and foremost.

Why Swim Instructor Lifeguard Service Makes Sense

Since swimming instructors have an inherent obligation to provide supervision, it makes sense that laws defining lifeguard service would recognize this fact, especially in situations where hiring a stationed lifeguard is impractical, irrelevant, and/or out of budget (such as within a school district).

Lifeguard services provided by swimming instructors and coaches are different than that provided by stationed lifeguards, but it can be as effective if not more so.

RECOMMENDATION #3: Recommend/require swimming instructors and coaches to have training in lifeguarding, first aid, and CPR. Make sure their protocols include readiness, adequate supervision, effective class organization, etc.

What’s the Deal with CPR ABCs?

The “ABCs” of CPR have always referred to “airway, breathing, and circulation” or, to be more specific:

  • A: Open the airway and make sure it is clear
  • B: Check for breathing; if necessary, give 2 breaths
  • C: Check for signs of circulation (pulse); make sure there is no severe bleeding; give chest compressions in the absence of a pulse or other signs of life

In 2010, when CPR and first aid guidelines were last reviewed, these ABCs were in certain cases modified in an effort to increase the speed and effectiveness of CPR and related care. Understanding the new ABCs of CPR is key to understanding techniques like compression-only CPR and important priorities that make all the difference when seconds count.

CAB vs. ABC

The most significant change by far enacted by the Emergency Cardiac Care (ECC) Committee of the American Heart Association consists of rearranging the ABCs of CPR to CAB for patients of sudden cardiac arrest (SCA). CAB means (upon determining you have an unresponsive patient who suddenly collapsed):

  • C: Determine that there is no severe bleeding and begin 30 chest compressions immediately; if you are reluctant to give ventilations or do not have training in that skill, continue to give compressions to the patient until EMS personnel arrive
  • A: If you decide to give breaths, open the airway and make sure it is clear
  • B: Give 2 breaths followed by 30 more compressions

Why CAB Works

This change is designed to get compressions started as quickly as possible for victims that have oxygenated blood. Think about it. The patient was breathing until the moment of collapse. The heart stopped due to an electrical problem, not a lack of oxygen. Giving compressions immediately starts some oxygen-rich blood moving through the body, delivering oxygen to the brain and other vital organs. Taking time to give breaths delays the care this patient really needs.

According to the Sudden Cardiac Arrest Association, SCA is a leading cause of death in the United States, claiming more than 325,000 lives each year. During a sudden cardiac arrest, heart function ceases – abruptly and without warning. When this occurs, the heart is no longer able to pump blood to the rest of the body, and, in some 95 percent of victims, death occurs.

Why Compression-Only CPR Works

CAB is also explains why compression-only CPR works. Since the patient has oxygen in his/her system, performing compression immediately is a more critical care step. A recent study published in the New England Journal of Medicine showed no significant difference between the survival outcomes of patients given compression-only CPR and standard CPR. Compression-only CPR is easier to teach and to perform, especially by bystanders without protective devices learning CPR over the phone.

(For a hilarious American Heart Association public safety announcement starring Ken Jeong, go here.)

So, What About ABC?

Despite the ease and effectiveness of CAB and compression-only CPR for victims of SCA, the ABCs of CPR should still be followed for patients who are hypoxic (without oxygen). This includes the majority of infants and children and cases of respiratory problems that lead to cardiac arrest due to oxygen depletion.

Take a drowning victim for example. This begins as suffocation in water, but the heart usually keeps beating until the oxygen in the blood is used up. Then cardiac arrest occurs. This patient needs ventilations first and then compressions (standard ABC CPR). Giving compression first, or compressions only, to this patient may not be effective due to lack of oxygen in the bloodstream.

What About the “D”?

The “D” stands for defibrillation, administered using an automated external defibrillator (AED). Both patients may benefit from AED administration, which converts disorganized electrical activity in the heart to a normal rhythm. In other words, you can add a D to either ABC or CAB for a more comprehensive solution.

Come to think about it, “E” is for emergency medical services (EMS), which should already have been called (as soon as you know the patient is unconscious). So, now you have a complete chain of survival in both cases:

  • ABCDE for hypoxic patients and children
  • CABDE for adults who suddenly collapse (SCA) or children with known heart conditions