At a recent risk management workshop, representatives of the American Red Cross (Greg Stockton), Ellis and Associates (Larry Newell), and the YMCA (Laura Slane) staffed a panel to discuss current aquatic issues. A summary of their comments and information follows. In planning for hiring aquatic staff for 2000, this information will provide an important backdrop to needs and concerns.
Drowning is the second leading cause of death in youth aged one to nineteen. There are, on average, 1,500 deaths a year in this age group due to drowning. The drowning rates for males are four times those for females. The drowning rates for African Americans are two times (females) to four times (males) those for Caucasians. 40 percent of all drownings occur on Saturdays and Sundays. 66 percent occur between May and August.
The average drowning victim is a young male, six to ten years of age, who is a weak swimmer or nonswimmer. In many instances, this victim is left temporarily unattended and is found submerged or face down. In 1997, there were 2,300 drownings in the United States. Five to seven hundred of these drownings, on average, occur in guarded waterfronts (or pools). While few of them occur in camps, safeguards are important.
Survivors are found and rescued in less than two minutes on average. If they have been submersed up to one minute, their chance for recovery is excellent. If submersed two minutes, recovery is generally good. Three minutes, recovery chances are fair. Four minutes, recovery chances are poor. If you are still doing CPR when EMS arrives, there is only a 10 percent survival rate. If EMS is still doing CPR when they transport, there is only a 5 percent survival rate.
Near Drownings are also expensive psychologically, physically, and financially. For every drowning that occurs, four times as many persons are taken to a hospital and require admittance for treatment. On average, it costs $75-80,000 to treat a near-drowning victim in this hospital . . . that is physical treatment only and does not include the additional costs to deal with psychological trauma.
For every drowning that occurs, anywhere from eight to twenty times as many persons are taken to an emergency room for treatment.
Lifeguards tend to be young, and their maturity level is difficult to determine upon hiring. A near-drowning or drowning changes forever the perspective of guards on duty at the time. But this is a learning that comes after the fact. New lifeguards want to do a good job, but they lack the experience to know how. Experienced guards who have not dealt with a drowning or near-drowning can become complacent.
It is critical that there be in-service training to help keep guards vigilant in their responsibility. Lifeguards don’t always handle things well in their first few minutes of action, but the survival rates mentioned earlier in this article demonstrate the importance of quick action since the first few minutes are critical.
Training for guards needs to focus on attentiveness, positioning to constantly be scanning the area, ease of identification of nonswimmers, and preparedness to handle rescues.
There must be systems in place to access equipment. Where are the reaching poles? Where is the backboard? Where are masks kept? Do guards always have a rescue tube with them? How is the next level of emergency care accessed? Is there a phone at the lake? How does a guard summon the nurse or EMS? Time is critical!
There must also be systems in place to manage the facility. How is supervision handled? When are guards rotated? What training is provided? How frequently do you verify the skills of participants?
Facility Design for Safety Consciousness
Many lifeguard chairs are now designed with padded foot rests to make standing easier. Many new commercial and municipal pools that serve thousands of guests daily are now designed with underwater cameras and on-deck cameras. When guards rotate away from the pool, they may switch to watching monitors whose cameras are scanning the facility.
Automatic External Defibrillators (AEDs) can help re-start the heart, but they are not the answer to drownings. You still need persons trained in CPR to do rescue breathing. AEDs are not currently the standard of care in camps. The standard is well-trained lifeguards whose skills are kept up to date, whose work is supervised, and whose abilities are verified.
Ellis and Associates is now preparing a new book on In-Service Training of Lifeguards. It should be ready by March of 2000. It will include update information and training materials on conditioning, rescues, infectious disease, and other important topics.
What To Do Right Now
First, review accidents and incidents that may have occurred in the past several years at your aquatic facilities. Learn what was happening, who was involved, what might have been done to prevent the situation, time of day, day of week, and staff on duty (number and qualifications).
Develop procedures for next year that address the issues raised in this analysis. Consider what your backup is to staff on duty. How can they access additional help? How can they get immediate assistance in case of an emergency. If only one or two staff members are on duty, and all are involved in the rescue, how do they obtain help?
The thinking and planning you do now can help you hire and train a stronger staff to help provide an even more safety-conscious group to supervise aquatic activities.
Originally published in the 1999 Fall issue of The CampLine.