When it comes to providing an in-service training on rescues, active victim rescues usually take priority.
Let’s be honest: Training on active victims is fun. There’s a lot of splashing, yelling and overall action in the water. Lots of young lifeguards define themselves on their ability to make rescues.
However, it’s our proficiency and speed with passive victims that truly defines us. An active victim is most likely still on the surface, moving and struggling, whereas a passive victim has more than likely exhausted their energy and become unresponsive. The victim could be on the surface or submerged.
The priority of the lifeguard becomes stopping the drowning process, followed by extricating the victim. This in-service will focus on submerged victim rescues with extrication.
Rescuing a passive victim has its challenges. The victim’s body is limp, requiring the lifeguard to physically manage and secure the victim onto the rescue tube. The victim’s size, whether a small child or large adult, changes the effort needed to make the rescue from simple to dramatic. Start with rescues in shallow water, then move to mid-depth and, lastly, deep water.
Shallow water (3 to 5 feet deep) provides an optimal environment for lifeguards to build their proficiency before moving to mid-depth (5 to 9 feet deep) and deep water (9 feet plus). Shallow water provides a certain level of comfort and certainty. The shallow depth allows the lifeguard full access to the victim from the left, right, front, back, top and bottom positions. If the victim is floating on the surface, the lifeguard can maneuver around the victim with relative ease. Shallow water also provides the lifeguard easy access to air, allowing them to focus on developing rescue techniques without having to tread water and breathe. If the victim is submerged, shallow water provides a short distance if the lifeguard needs surface for air. And if something goes awry, both the lifeguard and the victim can stop the drill and stand up.
Lastly, shallow water allows the lifeguard to focus on making contact and securing the victim to the rescue tube. The lifeguard should be able to make safe and effective contact with the victim, whether floating on the surface, face-up or face-down, facing away or towards the lifeguard, and submerged facing away or towards the rescuer.
Securing the victim means the victim is placed on the rescue tube face-up, with their airway open, and the victim is in a stable position on the rescue tube. Stability is demonstrated by the lifeguard being able to release their hands from the victim and tube and the victim staying on the tube.
Why hands free? If the victim requires airway management before being removed from the water, the lifeguard should be able to reach for their fanny pack, be able to remove their pocket mask and use it on the victim. Remember, for a passive submerged victim in the water, securing the airway and providing ventilations if needed is the priority. If the victim is unresponsive but breathing, then maintain their airway, extricate and provide additional care.
PASSIVE VICTIM RESCUE, SHALLOW WATER DRILL: Have the victim 10 feet from the edge, face-up on the surface, facing away from the lifeguard. The depth of the water should be between 3½ to 4½ feet. Lifeguards should have at least one hand on the edge with the rescue tube strap on.
Objective: Lifeguards need to reach the victim and secure them onto the rescue tube. Once the victim is secured face-up, rescuers place their arms in the air, thus hands free.
Timing goal: 5-7 seconds to complete the objective. Once proficient, incorporate these variations:• Victim is face-down on the surface, facing away/facing the lifeguard (no change)
• Victim is face-down, submerged, facing away/facing the lifeguard (7-10 seconds)
SUBMERGED PASSIVE VICTIM RESCUE, MID-DEPTH/DEEP WATER DRILL: Have the victim 10 feet from the edge, face-up on the surface, facing away from the lifeguard. Mid-depth water should be 5 to 7 feet deep and deep water will be 8 to 12 feet. Lifeguards will start on the deck with the rescue tube strap on.
Objective: Lifeguards need to enter the water quickly and safely to reach the victim and secure them onto the rescue tube.
Timing goal: 5-10 seconds to complete the objective.
Submerged victims will be at least 1 to 3 feet underwater in a vertical position. Fully submerged victims will be horizontal on the bottom of the pool. NOTE: If either the lifeguard or victim is struggling with equalizing pressure while underwater, avoid the submerged drills.
Once proficient, incorporate these variations:• Victim is face-down on the surface facing away/facing the lifeguard (no change)
• Victim is face-down, submerged, facing away/facing the lifeguard (5-12 seconds)
• Victim is face-down, fully submerged, facing away/facing the lifeguard (10-12 seconds)
SHALLOW WATER/DEEP WATER SUBMERGED EXTRICATION DRILL: Requires at least two lifeguards (but can support more) and one victim. The victim will be submerged on the bottom.
Objective: Lifeguard(s) will bring the victim and extricate to the side, while secondary lifeguards will assist using the backboard to extricate.
Timing goal: 20-25 seconds to complete the objective. Same timing goal for all three depths.
MISTAKES TO LOOK FOR
As the trainer, your critical eye is needed to guide lifeguards and help them avoid mistakes that could cause delays or compromises to care.
Here are some errors that you might see:• Rescue tube placement on the back of the victim doesn’t support the victim.
• The victim slides off the rescue tube after placement.
• The backboard is allowed to list to one side during placement of the victim.
• Dropping, rather than lowering the backboard to the ground.
• Not having a clear runway for the backboard to be placed.
• Only practicing victim extrication on in-service training days that focus on spinal emergencies.
• Allowing the rescue tube to get entangled with the victim on the backboard.
As the trainer, to make the 30-minute in-service compact and effective, plan on using the best setting at your facility to run this in-service. Establish clear objectives, and transition quickly between drills.
Good luck and keep training.