Water Safety Instructor Skills Evaluation Worksheet

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1 Water Safety Instructor Skills Evaluation Worksheet Water Safety Instructor Trainer: Water Safety Skills Strokes Instructor Emergency Response (IER) Skills Evaluation Date: Evaluation Location: Water Safety Instructor Trainer s Signature: Candidates Names and Red Cross ID# (where applicable) Eggbeater/Tread Water 3 min Feet-/Head-First Surface Dives with Underwater Swim 2m Throwing Assist without a Line Throwing Assist with a Line Reaching Assist with Rescue Equipment Disorienting Entries Stride Entry Standing Shallow Dive Front Crawl 100m Back Crawl 100m Elementary Back Stroke 50m Breast Stroke 50m Sidestroke 25m Recognition of Struggling Swimmer Assistive Carry from Deep Water Assistive Removal of a Conscious Person from Deep Water Walking Assist Rescue of Submerged Person Heart Attacks Scrapes Bleeding Muscle Cramps Nosebleeds Seizures Diabetic Emergencies Hyperventilation Asthma Suspected Head and Spine Injury Universal Sign for Choking Choking Rescue, Mild and Severe Airway Obstruction, Conscious Person Rescue Breathing, Adult and Child Complications of Rescue Breathing Complete (C) Incomplete (IC) Page 1 of 7

2 WATER SAFETY SKILLS EGGBEATER/TREAD WATER 3 MIN Eggbeater Sits in water with back straight Flexes hips so that thighs are nearly parallel to surface Rotates legs in circle, alternating leg actions Keeps hands/forearms out of water Tread Water Keeps body in vertical position Keeps head out of water Maximizes efficiency by minimizing movement FEET-/HEAD-FIRST SURFACE DIVES WITH UNDERWATER SWIM 2M Feet-First Surface Dive Demonstrates Self-Safety by checking depth and condition of water Presses down with arms, performing any power kick (e.g., scissor, whip, eggbeater) to provide upward body lift, then uses upward arm press to assist vertical descent, keeping legs together and hands at sides Once head submerges, presses palms upward with arms outstretched to assist descent Where site permits, descends 2m Swims 2m underwater Returns to surface with arm extended above head Head-First Surface Dive Demonstrates Self-Safety by checking depth and condition of water Pikes at waist or tucks into vertical descent, keeping body streamlined, with legs together Where site permits, descends 2m Swims 2m underwater Returns to surface with arm extended above head THROWING ASSIST WITHOUT A LINE Throws aid to a distressed conscious swimmer 5 10m away Identifies characteristics of a good throwing assist (e.g., buoyant, accessible, easy to throw, not easily blown away, easy to hold) Identifies 3 examples of a good throwing assist (e.g., ring buoy with or without a line, PFD/lifejacket, kickboard) THROWING ASSIST WITH A LINE Demonstrates throwing a line to a distressed conscious swimmer at least 3m away: 1. Calls for help and speaks clearly to distressed swimmer while maintaining eye contact 2. Places feet shoulder-width apart, with line secured under front foot 3. Faces swimmer and throws assist 4. Gets into stable position (lying down) before swimmer grabs assist 5. Smoothly pulls swimmer to nearest point of safety Explains reasons for not going into water during a rescue and avoiding direct contact NOTE: Assist must land within 1 arm length behind or to the side of distressed swimmer. REACHING ASSIST WITH RESCUE EQUIPMENT Identifies characteristics of a good reaching assist (e.g., buoyant, light, easy to hold) Gives 4 examples of a good reaching assist (e.g., kickboard, paddle, ring buoy, inner tube) Demonstrates safe reaching assists to distressed swimmer: 1. Gets into stable position (lying down on angle) 2. Speaks clearly and continuously, maintaining eye contact 3. Pulls swimmer to nearest point of safety, keeping reaching assist between self and swimmer at all times Explains reasons for not going into water during a rescue and avoiding direct contact; identifies need for further training DISORIENTING ENTRIES Experiments with disorientation through a variety of deepwater entries (e.g., front roll, side roll, jumping in and turning a somersault) STRIDE ENTRY Demonstrates Self-Safety Enters water with legs in stride or whip kick position Leans forward slightly during entry to increase surface resistance and presses down with outstretched arms Keeps head above water at all times STANDING SHALLOW DIVE Keeps head up until entry Enters water in a streamlined manner, keeping arms/hands extended in front of head Uses proper order of entry: hands, head, trunk, legs, and feet Dives within maximum depth of 1m Glides to surface maintaining streamlined body position Page 2 of 7

3 STROKES FRONT CRAWL 100M Maintains near-horizontal body position Does not sway hips/body Flutter kicks from hips Flicks ankles with each kick Recovers arms above water in controlled alternate manner Extends hand entry in front of head in line with shoulders Catches water with hands at full extension point to initiate pull Performs a bent arm pull to shoulder Extends push past hips Breathes to the side in a rhythmic pattern, either bilateral or unilateral, exhaling underwater Coordinates breathing with alternate arm recovery above water BACK CRAWL 100M Maintains near-horizontal streamlined body position Rolls body as 1 unit (shoulders, hips, and toes) Maintains neutral head position with chin tucked slightly toward chest Does not sway hips Flutter kicks at surface of water and continuously from hips Keeps knees below surface of water Flicks ankles with each kick Recovers arms straight and high above water in alternating motion Turns hands palms outward before entry Does not pause arms Hands enter and catch water at 11:00 and 1:00 positions Slightly bends elbows as arms pull to hips and push to legs As body roll finishes, turns hands toward feet with rigid hands and forearms (like a paddle), bends elbows and pushes water with palms toward feet Coordinates body roll with arm recovery Breathes in a relaxed manner ELEMENTARY BACK STROKE 50M Maintains near-horizontal back glide position, face above surface of water at all times Keeps back, hips, and thighs nearly straight, just below surface of water Recovers legs symmetrically by bending knees (knees slightly apart) and dropping heels toward bottom Leads movement with heels, drawing a circle (kick can be wide or narrow) and pushing water with insides of feet Flexes feet as heels drop and legs move Whips feet and lower legs back to glide position with streamlined legs and feet Straightens legs as they come together Points toes during glide Slides hands slowly up sides of body Reaches arms outward at head height, with fingers leading and elbows remaining bent Presses hands and forearms symmetrically, with palms facing toward feet, and pushes water in large scull toward feet Accelerates arms through power phase Keeps hands and arms at side during glide Initiates sequence with hands, with arms and legs finishing close together for glide Glides until momentum slows (2 3 seconds) BREAST STROKE 50M Keeps body/head at or near surface of water Recovers legs symmetrically by bending knees (knees slightly apart) and pulling heels toward buttocks Leads movement with feet, keeping ankles slightly wider than knees, drawing a circle (kick can be wide or narrow) Whips flexed feet and lower legs back to glide position Accelerates legs through power phase Recovers arms forward to full extension, with palms together With extended arms, sculls hands outward slightly wider than shoulders in single motion Bends elbows and sculls forearms and hands downward and toward shoulders Sweeps palms together under chin Accelerates arms through power phase Timing: pull, breathe, kick, glide Initiates exhale during glide phase Glides until body is streamlined SIDESTROKE 25M Aligns body and head in horizontal side glide position Recovers legs slowly and together by pulling knees toward chest Extends 1 leg forward with foot flexed and 1 leg back with toes pointed, similar to scissor action Squeezes legs together until ankles touch and toes are pointed (propulsion phase) Recovers trailing arm, close to body, to meet leading hand at chest Recovers leading arm back to side glide position In side glide position, pulls leading arm to chest Pushes water toward feet with trailing arm, finishing in a side glide position (NOTE: Hands come in together and move away at same time.) Begins pull with lead arm as trailing arm recovers to chest and legs initiate recovery position Pushes to side glide position with trailing arm as lead arm recovers to forward position and legs squeeze together for propulsion Page 3 of 7

4 INSTRUCTOR EMERGENCY RESPONSE (IER) SKILLS RECOGNITION OF STRUGGLING SWIMMER Demonstrates ability to recognize and simulate 4 different types of struggling swimmers: 1. Distressed swimmer: swimmer s body position can be horizontal, vertical, or diagonal, depending on how he is trying to support himself; distress is obvious on swimmer s face; arms may be flailing up and down as he tries to rise in water to breathe rather than trying to swim forward 2. Weak/tired swimmer: swimmer may be facing an apparent point of safety, edge, or shore, and may be able to call or wave for help 3. Injured swimmer: swimmer may be holding affected area of body and may be able to call or wave for help 4. Unconscious swimmer: swimmer may be horizontal or vertical, face down, face up, or submerged ASSISTIVE CARRY FROM DEEP WATER 1. Recognizes distressed swimmer (in deep water) and signals to lifeguards/instructors about leaving station 2. Chooses appropriate rescue equipment and entry into water 3. Keeps rescue equipment between self and distressed swimmer 4. Reaches across rescue equipment and grasps swimmer at armpit to help him maintain balance; ensures swimmer s head does not drop below water ASSISTIVE REMOVAL OF A CONSCIOUS PERSON FROM DEEP WATER 1. Maintains communication and eye contact with person 2. Maintains physical contact and support of person 3. Assesses environmental conditions, such as water depth, waves, weather, height of deck ledge, ladders, and ensures person s head does not drop below water 4. Holds person firmly and assists person out of water (can be assisted by another person or Instructor/lifeguard) 5. Uses legs rather than back to do lifting work WALKING ASSIST 1. Performs an assistive carry to shallow end 2. Places one of person s arms around own neck and across shoulder 3. Grasps wrist of person s arm that is across own shoulder 4. Wraps free arm around person s back or waist to provide support 5. Holds person firmly and assists person in walking out of water RESCUE OF SUBMERGED PERSON NOTE: This skill must be performed with an Instructor or lifeguard. 1. Recognizes drowning person and signals to Instructors/ lifeguards about leaving station 2. Chooses appropriate rescue equipment and entry into water 3. Performs a feet-first surface dive, and positions self behind person 4. Reaches one arm under person s armpits (right arm to right side or left arm to left side) 5. Uses free arm to pull self and person to surface 6. Once at surface, grasps and positions rescue equipment and ensures person s face is fully out of water 7. Holds person in face-up position on rescue equipment with person s face fully out of water 8. Returns person to nearest point of safety HEART ATTACKS Identifies what to look for with a heart attack: squeezing chest pain; problems breathing; abdominal or back pain (more common in women); cold, sweaty skin; skin that is bluish or paler than normal; nausea and vomiting; jaw pain; denial Demonstrates how to care for a heart attack: 1. Has person rest comfortably 2. Assists person in taking his medications, such as ASA and nitroglycerin (if person has it), after checking Five Rights of Medication* (nitroglycerin comes as a spray or pill and is sprayed or placed under tongue) 3. Ensures person s ABCs are present 4. Performs a secondary survey and treats any non-lifethreatening conditions 5. Provides continual care until EMS personnel arrive SCRAPES Identifies what to look for with scrapes: person s skin is rubbed or scraped away; pain; possible bleeding, which is usually minimal and easily controlled Demonstrates how to care for scrapes: 1. If gloves (preferably non-latex) are not available, uses some other kind of barrier between hand and wound; if possible, has injured person use own hand 2. If there is bleeding, puts direct pressure on wound until it stops 3. Washes wound thoroughly with soap and clean water 4. If possible, rinses wound for 5 minutes with clean, running tap water 5. If an antibiotic ointment or cream is available, puts it on wound as recommended by a pharmacist after checking Five Rights of Medication*; asks person if she has a sensitivity to any antibiotics, such as penicillin; if so, does not apply ointment 6. Covers wound with a sterile non-stick dressing and/or bandage 7. Watches for signs of infection Page 4 of 7

5 BLEEDING Identifies what to look for with bleeding: arterial bleeding is bright red, often rapid and profuse, and is life-threatening; venous bleeding is dark red or maroon and flows steadily; capillary bleeding is most common, is usually dark red, oozes steadily, and clots easily. For deadly bleeding, calls EMS/9-1-1 Demonstrates how to care for bleeding: 1. If gloves (preferably non-latex) are not available, uses some other kind of barrier between hand and wound; if possible, has injured person use own hand 2. Puts direct pressure on wound until bleeding stops 3. Washes wound thoroughly with soap and clean water 4. If possible, rinses wound for 5 minutes with clean, running tap water 5. If an antibiotic ointment or cream is available, puts it on wound as recommended by a pharmacist after checking Five Rights of Medication*; asks person if she has a sensitivity to any antibiotics, such as penicillin; if so, does not apply ointment 6. Covers wound with a sterile non-stick dressing and/or bandage 7. Watches for signs of infection MUSCLE CRAMPS Identifies what to look for with cramps: pain that can be caused by heavy exercise or by staying in same position for too long Demonstrates how to care for cramps: > Has person rest > Has person stretch and massage area with cramp > Has person change position of area with cramp NOSEBLEEDS Identifies what to look for with nosebleeds: blood coming out of nostril(s) Demonstrates how to care for nosebleeds: 1. If gloves (preferably non-latex) are not available, uses some other kind of barrier between hand and blood 2. Has person sit with head slightly forward while pinching nostrils for minutes 3. Once bleeding is controlled, tells person to avoid rubbing, blowing, or picking nose because this could restart bleeding 4. If bleeding was caused by an object in nose and object is easy to grasp, gently pulls it out (without feeling around inside nostril with finger); if there is an object in nose that cannot be removed easily, tells person to seek medical attention 5. If nosebleed was caused by a severe head injury, does not pinch nose 6. If person loses consciousness, places her in recovery position to allow blood to drain from nose 7. Provides continual care SEIZURES Identifies what to look for with a seizure: before a seizure, person may hallucinate and see, hear, taste, or smell something that doesn t actually exist; person may feel an urgency to get to safety; during a seizure, person may appear to be daydreaming; may experience uncontrollable muscle movements, eyes rolling upward, back into head, and have drool or foam in mouth Demonstrates how to care for a person during a seizure: 1. Never puts anything in person s mouth 2. Allows person to move without restraint 3. Protects person from injury by moving furniture, protecting person s head with blankets, keeping other dangers away from person Demonstrates how to care for a person after a seizure: 1. Ensures person s ABCs are present 2. Performs a secondary survey and treats any non-lifethreatening conditions: Makes sure there aren t any fluids in person s mouth Places person in recovery position Keeps person comfortable and warm 3. Provides continual care DIABETIC EMERGENCIES Identifies what to look for with diabetic emergencies: changes in level of consciousness; changes in behaviour, such as confusion or aggression; rapid breathing; cool, sweaty skin; skin that is paler than normal; appearance of intoxication; feeling and looking ill Demonstrates how to care for diabetic emergencies: 1. Ensures person s ABCs are present 2. Performs a secondary survey and treats any non-lifethreatening conditions: If person is conscious (and person knows it is a diabetic emergency): > Offers person a sugary drink such as orange or apple juice > If person s condition improves, recommends he eat a complete meal If person is unconscious: > Performs a secondary survey and places person in recovery position > Provides continual care until EMS personnel arrive HYPERVENTILATION Identifies what to look for with hyperventilation: shallow, rapid breathing; a feeling of not getting enough air or suffocating; fear, anxiety, or confusion; dizziness; numbness or tingling in fingers and toes Demonstrates how to care for hyperventilation: 1. Tells person to relax and breathe slowly; reassures person (which is often enough to stop hyperventilation) 2. Performs a secondary survey and treats any non-lifethreatening conditions 3. Provides continual care until EMS personnel arrive Page 5 of 7

6 ASTHMA Identifies what to look for with asthma: wheezing when exhaling; gasping for air or inability to catch one s breath; being upset; chest tightening or tingling in hands and feet Demonstrates how to care for asthma: 1. Moves person into a well-ventilated area, away from the environment if this is what caused attack Helps person get into a comfortable position Calms person to help slow down his breathing 2. Helps person to take any prescribed medication for his condition 3. Ensures person s ABCs are present 4. Performs a secondary survey and treats any non-lifethreatening conditions 5. Provides continual care SUSPECTED HEAD AND SPINE INJURY Identifies what to look for with a suspected head and spine injury: witnesses impact with bottom/wall/deck/diving board or another swimmer; changes in level of consciousness and behaviour; severe pain or pressure in head, neck, or back; numbness, tingling, or loss of feeling in any body part; weakness or inability to use a leg or arm; shock; unequal pupil size; unusual bumps on head, neck, or back; blood or clear fluid coming from ears or nose; heavy bleeding from head, neck, or back; seizures; difficulty breathing or seeing properly; nausea or vomiting; persistent headache; dizziness, disorientation, and/or loss of balance; bruising of head (especially around eyes and behind ears); drowsiness; unusually positioned neck or back; loss of bladder or bowel control Demonstrates one of the following: NOTE: Person is breathing in shallow water; removal from water is not required Vice Grip Technique Face-Up Person 1. Approaches person from side 2. With body at about shoulder depth in water, places one forearm along length of person s breastbone and other forearm along person s spine 3. Uses hands to gently hold person s head and neck in line with body 4. Places one hand on person s cheekbones (keeping nose and mouth clear) and other hand on back of head, being careful not to place pressure on or touch front or back of neck 5. Squeezes forearms together, clamping person s chest and back 6. Continues to support person s head and neck 7. Holds person so person s face is fully out of water until help arrives 8. Checks for consciousness and for breathing 9. Continues with Emergency Procedure steps Vice Grip Technique Face-Down Person 1. Approaches person from side 2. With body at about shoulder depth in water, places one forearm along length of person s breastbone and other forearm along person s spine 3. Uses hands to gently hold person s head and neck in line with body 4. Places one hand on person s cheekbones (keeping nose and mouth clear) and other hand on back of head, being careful not to place pressure on or touch front or back of neck 5. Squeezes forearms together, clamping person s chest and back 6. Continues to support person s head and neck while starting to slowly glide person forward 7. Turns person over while submerging under person and continuing forward movement 8. Rolls under person while turning person over, avoiding twisting person s body 9. Holds person so person s face is fully out of water until help arrives 10. Checks for consciousness and for breathing 11. Continues with Emergency Procedure steps Extended Arm Grip Technique Face-Up Person 1. Approaches person and stands beside person s head, then lowers own body until water level is at neck 2. Grasps person s arms midway between shoulder and elbow (grasps person s right arm with right hand and person s left arm with left hand) 3. Places thumbs on inside of person s arms, and then gently moves arms up alongside person s head 4. Slowly and carefully squeezes person s arms against person s head to help hold head in line with body; does not move person any more than necessary 5. Ensures person s face is fully out of water 6. Positions person s head close to crook of own arm, with person s head in line with body 7. Holds person in this position until help arrives 8. Checks for consciousness and for breathing 9. Continues with Emergency Procedure steps Extended Arm Grip Technique Face-Down Person 1. Approaches person from side 2. Grasps person s arms midway between shoulder and elbow (grasps person s right arm with right hand and person s left arm with left hand) 3. Gently moves person s arms up alongside person s head 4. Slowly and carefully squeezes person s arms against person s head to help hold head in line with body 5. Places thumbs on person s head, if possible 6. Slowly glides person forward to keep body straight and at surface 7. Continues moving slowly and pushes person s closest arm underwater while pulling person s other arm across surface toward self 8. Turns person until face up and ensures person s face is fully out of water Page 6 of 7

7 9. Positions person s head close to crook of own arm, with person s head in line with body 10. Holds person in this position until help arrives 11. Checks for consciousness and for breathing 12. Continues with Emergency Procedure steps UNIVERSAL SIGN FOR CHOKING Demonstrates universal sign for choking: one or both hands clutching throat Identifies what to look for with choking: inability to speak, cough, or breathe; change in face colour (e.g., bluish or paler than normal); look of panic with wide eyes; high-pitched noises CHOKING RESCUE, MILD AND SEVERE AIRWAY OBSTRUCTION, CONSCIOUS PERSON Recognizes person with an airway obstruction Demonstrates how to care for mild and severe airway obstruction for a conscious person: 1. Checks scene for danger 2. If it is safe to do so, checks person 3. Shouts for help 4. Determines if choking is mild or severe by asking Are you choking? If person can speak, cough, or breathe, it is mild choking: Encourages person to continue coughing and does not interfere; obstruction might clear itself 5. If person is unable to speak, cough, or breathe or is making high-pitched noises, it is severe choking: Stands (or kneels for a small child) behind person and wraps one arm diagonally across person s chest Bends person forward at waist until person s upper airway is at least parallel to ground With heel of other hand, delivers 5 firm back blows between shoulder blades 6. If object has not been dislodged, makes a fist and places it just above person s belly button Places other hand over fist and pulls sharply in and up, doing 5 abdominal thrusts Continues cycle of 5 firm back blows and 5 abdominal thrusts until object comes out or person begins to breathe or cough or becomes unconscious RESCUE BREATHING, ADULT AND CHILD Demonstrates how to perform rescue breathing for an adult and child: 1. Ensures no further danger and checks scene 2. If it is safe to do so, checks person s level of consciousness (tap and shout) 3. If unresponsive, shouts for help and tells bystander to call EMS/ Rolls person onto back (if necessary) and opens airway using head-tilt/chin-lift 5. Checks for breathing (look, listen, and feel for 5 10 seconds) 6. If there isn t normal breathing, simulates 2 one-second rescue breaths (tight seal, nose pinched) Adult: Performs rescue breathing at a rate of 1 breath every 5 6 seconds Child: Performs rescue breathing as for adult, demonstrating modifications: > Opens airway gently, breathes at a rate of 1 breath every 3 5 seconds or 12 20/minute > Expels less air; each breath should last 1 second COMPLICATIONS OF RESCUE BREATHING Simulates rescue breathing for a child and adult Recognizes 2 types of complications (distended stomach and vomiting), and shows how to respond: 1. Distended stomach: decreases amount of air expelled during breaths 2. Vomiting: protects head, rolls person onto side, wipes mouth clean, repositions person on back, opens airway, and continues rescue breathing * Five Rights of Medication 1. Right person: Make sure the person getting the medication is the one whose name is on the label of the medicine container. 2. Right medication: Read the label when you are getting the medication. 3. Right amount: Use an accurately marked measuring container (if applicable). 4. Right time: Give the medication at the right time. 5. Right method: Read the directions carefully. NOTE: Over-the-counter medications won t have the person s name on them. Page 7 of 7

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