CPR training is an essential component of any comprehensive lifeguard training program. However, even with quality comprehensive initial training, research indicates that CPR skills decline quickly.

Especially in situations where the skills may be used infrequently, such as in a pool or waterfront situation, it can be assumed that skills will decline. The good news is that research also shows regular refresher training helps to keep these skills sharp.

Before lifeguards take to the stand, managers should confirm that they have good CPR skills. There should be a multi-pronged approach to maintain lifeguards’ skills for caring for breathing and cardiac emergencies.

Lifeguards must be confident — and correct — in the nuts and bolts of the skills. The order of the steps as well as the details, such as depth and rate of compressions and ratios of compressions to breaths, should be drilled into your lifeguards until it becomes instinctive.

But lifeguards also must be able  to effectively integrate the performance of CPR into the bigger picture of a water rescue — and be able to sustain the effort until additional trained responders are available to assist and/or take over. This includes making good decisions, being physically competent, using appropriate equipment and working together as a lifeguard team.

When using scenarios, here are some ways to “keep it real”:

  • Let scenarios play out — do not interrupt and make corrections. Instead, let guards figure it out. Give them the opportunity to struggle through and help each other, but be sure to discuss it afterward. Then let them try it again with the solutions.
  • Keep equipment where it is normally kept during operating hours. Will lifeguards know where to find it under stress? Require them to use personal protective equipment, such as disposable gloves and resuscitation masks, when giving care. Do not allow them to simulate.
  • When setting up scenarios, be sure to consider the many things that could happen; don’t always make it a drowning scenario. Think about a witnessed sudden collapse in the locker room, a choking child at the concession stand, or someone who is showing signs of a stroke in the parking lot.

A word of warning: If doing scenarios during operating hours when patrons are present, make sure they understand this is a training exercise.

Here are ideas to integrate CPR into your in-service training program:

  • Test knowledge with quizzes on breathing and cardiac emergencies. Make it more fun by setting up game show-style contests. For example, establish categories for different situations and assign points for each question, based on level of difficulty. The champion is the lifeguard with the most points. 
  • Hand Off: Form a group of about six lifeguards in a circle. Hand an infant manikin to one of the guards, who is to state the first step in CPR. The guard then hands the manikin to another guard in the circle, who states the next step. As the facilitator, indicate the victim’s condition as necessary to keep the circle going. Continue the circle until care steps come to a logical conclusion.
  • Shout It Out: Have all lifeguards tread water in a circle. Establish a scenario in which CPR is the appropriate care. Point to lifeguards, one at a time, and have each tell the next care step in the proper order.
  • During an in-service training session that is being held on another topic, pre-arrange for someone to collapse, as if experiencing sudden cardiac arrest. This provides an element of surprise for the lifeguards.
  • Tap Out: Set up a team CPR scenario in which three lifeguards are responding. While the team is performing CPR, select another guard to replace one of the responding guards, who must step in and continue the care steps that person was providing.
  • Need Help? Begin a rescue scenario that requires CPR being performed by a single lifeguard. Throughout the scenario, introduce new team members and additional equipment that becomes available at different points to assist with the rescue.
  • Complications and Realism: Set up a team CPR scenario with one lifeguard acting as the victim. Throughout the scenario, introduce complications and distractions. Distractions could include loud music as it might be played over the facility’s speaker system, or bystanders who are coming close to interfering with the responders. Some complications could include using whipped cream for frothing and vegetable soup for vomit. The “victim” could also hold his or her breath or simulate agonal gasps so that lifeguards can provide care for the conditions they see instead of reacting only to prompts. 
  • CPR Endurance. Establish teams of three — one primary lifeguard, one assisting lifeguard and one victim. Have as many groups as can safely go at once to complete a rescue of a submerged victim. Once out of the water, substitute the “victim” for a manikin, and have the guards perform CPR for nine minutes (or the average EMS response time at your facility).