I worked for a university that hosted a diverse range of activities. We offered collegiate swimming and diving, swim lessons for all ages, water polo, water exercise of every kind, kayaking and canoe classes, and even scuba certification. It was during a scuba class that I realized how deficient I was in preparing my guards for a scuba emergency.
My staff had been trained by several certifying agencies in water skills and first aid. I drilled them monthly on rescue techniques and included quizzes on facility-specific procedures. But no one had taught them what to do if a scuba diver was not moving on the bottom of the pool.
It’s extremely unlikely that a pool lifeguard will need to rescue a scuba diver, and it is almost impossible for a lifeguard to recognize the symptoms of a diver in distress on the pool bottom during normal scanning. However, if a scuba student comes to the surface and tells a lifeguard that the instructor isn’t moving, what does the lifeguard do? I decided to prepare my staff to rescue everyone who entered our pool, if needed.
I partnered with a local scuba shop that taught lessons at our facility, to come up with an emergency action plan. We needed to combine what divers know and do with what lifeguards know and do. In other words, we needed to train dive instructors and diving students what to expect from lifeguards during an emergency. Likewise, we had to teach the guards how to work with divers and dive gear. The dive shop, Coral Edge Adventures, brought in instructors to act as unresponsive divers. They brought in gear so the guards could understand the buttons and clips and practice on actual equipment. Then we worked on the rescues.
Getting on the same page
I needed a way to get the attention of everyone underwater. At the World Aquatic Health Conference in Indianapolis, I talked with Mike Hamer, aquatic supervisor at The Ohio State University. He suggested dropping a traffic cone into the water. This was an identifier for all divers to surface and seek further instructions. We kept traffic cones on our starting blocks. Perfect! This became our universal signal for scuba classes — see the red cone, come to the surface and await instructions.
Now the lifeguards needed to know what challenges arise from rescuing a scuba diver. A diver carries equipment not usually familiar to guards. Our local scuba shop brought in buoyancy compensation devices (BCDs) in all sizes along with regulators so the guards could try them on and become familiar with the straps, buckles, clips and hoses. This was the key. I can explain where and how all day, but for many of the guards touching, feeling and wearing the BCD made the difference between just hearing it and doing it.
Then we drilled and drilled. We shot video of a rescue and posted it to our lifeguard website. The guards had instant access to what is expected of them during a scuba-related emergency. Then I quizzed them on it. Here are the vital action steps that we learned:
1) Activate the facility’s emergency action plan.
2) Get the attention of all the divers and bring them to the surface (tap stainless steel with lane line wrench and drop the cone in the water).
3) The guard should approach the victim and perform a surface dive.
4) Check the diver for responsiveness.
5) The focus is to get that diver to the surface quickly. If the guard can reach under the diver’s right arm and hold the regulator in place, AND reach the low-pressure-inflator, great. If not, the LPI should take priority, leaving the regulator as-is.
6) Inflate the diver’s BCD, bringing the guard and diver to the surface.
7) At the surface, guards should ditch any weights or weight belts after making sure there is no one left beneath them.
8) Remove the victim’s scuba unit. Be sure to support the victim while the unit is removed.
9) Remove the victim using techniques similar to a passive victim removal.
Once on the surface, lifeguards must consider the additional equipment scuba divers wear. A special knife (called a line cutter, available at any dive shop or from Amazon) may be needed to cut away buckles and clips or cut open a wet suit to use an AED. Standard scissors may not be strong enough to cut through the material used in scuba equipment.
The lifeguards said it was the best in-service training they’d ever had. They always wondered what to do in this situation and now they are more comfortable guarding a scuba class. Some guards who had been trained in scuba asked if they could use the alternate air source of the unresponsive diver. Dr. Neal Pollock, research director at Divers Alert Network, advises against it. He cites bad air as a possible cause of the victim’s state and adds that there also is the possibility of pulmonary overexpansion injury of the rescuer, particularly if he or she has little experience with compressed gas diving. Additionally, Dr. Pollock believes a lifeguard should focus first on removing the diver’s weights over using the auto-inflator.
Not the end of it
Now this is not a comprehensive approach to lifeguard and scuba rescue. There are so many variations of equipment and rescue techniques that it's impossible to cover them all. But becoming familiar with basic scuba equipment and training will give guards the skills and confidence they need.
Scuba diving is fun and I encourage everyone to try it. The point of this article is to call attention to training your lifeguards to save everyone entering the pool. If you have a special activity in your pool, make sure the staff can handle an emergency during that activity. Make it part of in-service training. Have the staff actually do the activity to give them hands-on experience and feedback on the skills. Consult industry experts before trying the activity or implementing any rescue skills. Good luck, be safe!