THEPOWER OFWATER. February THE SCARED STRAIGHT OF AQUATICS Thursday, February 7, 2013, 4:30 p.m. - 6:00 p.m. Session 1307 Gerald Dworkin

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1 THE SCARED STRAIGHT OF AQUATICS Thursday, February 7, 2013, 4:30 p.m. - 6:00 p.m. Session 1307 Gerald Dworkin 1 Gerald M. Dworkin Consultant, Aquatics Safety & Water Rescue Lifesaving Resources, LLC Developed for Club Managers Association of America (2013) THEPOWER OFWATER THE POWER OF WATER SHOULD NEVER BE UNDERESTIMATED - ITS BEAUTY, STRENGTH OR FORCE. LIFE CANNOT EXIST WITHOUT WATER. IT EMPOWERS US AND COMMANDS RESPECT. BE READY FORIT! 1

2 1. Anything that can happen will happen When it does, it will happen at the least opportune time. 5 EMERGENCY RESPONSE PLAN THUNDER& LIGHTNING STORMS Recognize the Danger Evacuate all Patrons & Staff Return Procedures Policy Development 6 2

3 RULE OF NUMBERS Frequency : Probability The more patrons who use your facility increases the probability of a significant incident. Each day you operate without a significant incident brings you one day closer to when the incident will occur. 7 DROWNING th leading cause of unintentional injury deaths. 2 nd leading cause of unintentional injury deaths for children 1 14 years of age. 3 rd leading cause of death for children 0 4 years of age times more people suffer brain damage than death from submersion incidents. Minorities drown at a rate 2x greater than whites. Males drown at a rate 4x greater than females. 8 6,000 7,000 drownings annually. 3,500 during recreational swimming activities. 90% in open water. 50% -67% are alcohol or drug-related in guarded facilities. 9 3

4 PEDIATRIC SUBMERSIONS Second leading cause of unintentional death nationwide. Leading contributing factor: Lack or lapse in adult supervision Young children are attracted to water and have little concept of the dangers associated with water. action of children around water is unpredictable. The 10 BIG HEAD / LITTLE BODY SYNDROME. Nearly half of the victims were out of sight less than 5 minutes prior to the incident. Drowning is a silent death. 64% of the victims were not expected to be in or near the swimming pool prior to the incident. 11 WATER CRISES Distress Swimmer Can support self in water by swimming or floating. Can keep head out of water to breathe. Can call out for help. Can wave for help. Drowning Victim Cannot support self in water by swimming or floating. Cannot keep head out of water to breathe. Cannot call out for help. Cannot wave for help. 12 4

5 INSTINCTIVE DROWNING RESPONSE Head is tilted back in attempt to breathe. Vertical position in the water. Arms are extended laterally. Victims don t call out for help. Victims don t wave for help. Appear to be playing in the water. Struggle for seconds. 13 THE DROWNING PROCESS Struggle (20 60 seconds) Ingest & aspirate water into stomach & airway Laryngospasm Hypoxia Unconsciousness (Aspirate water into lungs) Respiratory arrest Cardiac arrest 14 TYPES OF DROWNING Wet drowning Dry drowning Laryngeal drowning Mammalian diving reflex Shallow water blackout (hyperventilation) Silent (passive) drowning Long QT Syndrome Torso Reflex 15 5

6 P R M FACTORS Prevention Recognition Management 16 PREVENTION Establish & enforce rules & regulations Strategic positioning of lifeguard stations Remove or warn of hazards Prohibit or safeguard risks Vigilant surveillance & supervision 17 RECOGNITION Incidents Potential for Incidents Hazards Risks 18 6

7 MANAGEMENT Potential for incidents Hazards Risks Incidents Rescue Emergency patient care Rescue equipment Personal protective equipment (PPE) 19 R I D FACTORS Recognition Intrusion Distraction 20 A SERIES OFEVENTS 21 7

8 THREAT ASSESSMENT& HRD FACTORS Hazard + Risk = Danger Hazards Remove Warn Risks Prohibit Safeguard 22 VIRGINIA GRAHAM BAKER(VGB) ACT 23 LEGAL RESPONSIBILITY& LIABILITY Duty to Act Good Samaritan Laws Consent Abandonment Records & Reports Negligence 24 8

9 NEGLIGENCE 1. Duty to Plaintiff 2. Breach Duty 3. Injury or Loss 4. Direct Correlation of Breach to Injury/Loss 25 RULES, REGULATIONS& EEC FACTORS Establish Enforce Consequences 26 LAYERS OF PROTECTION Supervision Isolation fencing Self-closing, self-latching & self-locking gates Gates open outward, away from the pool Pool cover Pool alarm Passive monitoring Lifeline Depth line Depth markers Telephone 27 9

10 WEAR IT! 30 10

11 PFD TYPES 31 SURVEILLANCE PROTOCOLS 30-second Rule 10/20 Rule 10 x10 Reaction Rule Rotation Zone of Responsibility (ZOR) Sunglasses 32 SUNGLASSES Protection from ultraviolet rays during sunlight. Protection from powerful light because when eyes receive extra light, it closes the iris causing the lifeguard to squint. Protection from glare because water can reflect a great deal of light and conceal objects. Eradicate light frequencies that can blur vision or reduce contrast

12 POLARIZED SUNGLASSES From the moment of reflection, light becomes polarized and forms visual noise blinding glare that interferes with the real image. Polarized lenses enhance visual acuity, color, contrast and comfort. Tinted lenses only reduce light transmittance they do not block blinding glare. 34 USLA POSITION ON PATRON SURVEILLANCE Lifeguards assigned to supervise an aquatic area shall not be subject to dutiesthat would distract or intrude their attention from proper observation of persons in the waterfront area, or that prevent immediate assistance to persons in the water. Specifically, lifeguards assigned to water shall not be assigned to any public safety! surveillance duties other than 35 OPERATIONAL PROTOCOLS Standard Operating Procedures (SOPs) Emergency Action Plans (EAPs) Emergency Response Plans (ERPs) Incident Command (IC)& Incident Action Plans (IAPs) Missing Person vs. Missing Bather Credible Witness 36 12

13 LIFEGUARD QUALIFICATIONS Certification vs. Qualification Screening Pre-Service Training Standard Operating Procedures (SOPs) Surveillance Protocols, Victim Recognition & Zones of Responsibility Emergency Action Plans (EAPs) Emergency Response Plans (ERPs) & Emergency Drills Incident Command (IC) & Incident Action Plans (IAPs) Rescue & PPE Equipment RESPONSIBILITY OF AUTHORITY HAVING JURISDICTION(AHJ) Conduct Threat Assessment Determine Level of Operational Capability Required Plan for the Incident Train for the Incident Acquire the Resources Required to Safety & Effectively Manage the Incident 38 A B C RESCUE Primary Response Cover-up Response Secondary Response 39 13

14 FACILITY-USE GUIDELINES Accountability Supervision Within Arm s Reach Lifejackets 40 SPINAL IMMOBILIZATION PROTOCOLS The lack of neurological deficit does not rule out injury. It just means the injury is not yet apparent. If the Mechanism of Injury (MOI) is sufficient to have caused a spinal injury, then assume the injury exists. Emergency Care Protocols Standing take-down Shallow water Deep water Land 41 PATIENT ASSESSMENT A = Airway B = Breathing C = Circulation D = Disability E = Examination M = Mechanism of Injury 42 14

15 BSI PROTOCOLS Universal Precautions Personal Protective Equipment (PPE) Vaccine Preventable Hepatitis Hepatitis B Vaccine Hepatitis A Vaccine Hapatitis A/B Vaccine 43 MANAGEMENT OF HYPOXIA Positive Pressure Ventilation (PPV) Personal resuscitation mask (PRM) Personal resuscitation shield (PRS) Bag-Valve-Mask (BVM) resuscitator Oxygen Administration Airway Management Suction 44 BASIC LIFE SUPPORT Chain of Survival Access CPR AED Advanced Life Support (ALS) CPR: Life Saving or Life Sustaining? 30:2 ratio AED Protocols 45 15

16 AED PROTOCOLS Automated External Defibrillator High & Dry Verbal Commands I m Clear! You re Clear! Everyone s Clear! 46 PRINCIPLES Rule of Numbers PRM Factors RID Factors Threat Assessment & HRD Factors Suction Entrapment & VGB Act Legal Responsibility & Liability Factors Rules, Regulations & EEC Factors Layers of Protection (LOP) Surveillance Protocols Standard Operating Procedures (SOPs) Facility-Use Guidelines (FUG) Emergency Action Plans (EAPs) Emergency Response Plans (ERPs) Incident Command (IC) & Incident Action Plans (IAPs) Spinal Injury Management & Mechanism of Injury (MOI) Body Substance Isolation (BSI) Protocols Rescue Priorities Management of Hypoxia (MOH) Positive Pressure Ventilation (PPV) Protocols CPR Protocols AED Protocols 47 Lifesaving Resources, LLC Gerald M. Dworkin gerald@lifesaving.com 48 16