CPR training is an essential component of any comprehensive
lifeguard training program. However, even with quality
comprehensive initial training, research indicates that CPR skills
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
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
When using scenarios, here are some ways to “keep it
- 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
- 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
- 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
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
- 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
- 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
- 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).