Most drownings are preventable. However, the cold-hard reality is that 19 percent of drowning deaths in the US involving children occur in swimming pools with certified lifeguards present — including in camps and camp-like programs (USA Management, 2018). Further, many drownings that occur at guarded facilities go unrecognized by the lifeguards, and the incidents are brought to their attention by facility patrons. The bottom line is that drowning can happen anywhere there is water.

Singularly, the most important job of a lifeguard (and aquatics instructional staff) is the close and constant supervision of participants in or on the water to keep them safe. Lifeguards monitor the aquatic environment, supervise participants, inform and educate them about the consequences of injury-producing behavior, and enforce rules and regulations to prevent injuries. They are also, of course, expected to perform rescues and provide immediate first aid and CPR. But to do so, they must first identify persons who are in distress in the water; if they don’t see them, they can’t save them.

To identify individuals in distress (as well as recognizing when participants exhibit behaviors that may put them at risk of ending up in distress) lifeguards must consistently implement effective surveillance/scanning strategies. As such, participant surveillance is the critical key to preventing aquatic injury. The significance of participant surveillance is emphasized by understanding how people drown. Many assume that drowning individuals are easy to identify because they exhibit obvious signs of distress. Instead, people tend to drown quietly and quickly. They usually struggle to keep their mouth above the surface of the water to breathe. Struggling to stay afloat and possibly suffocating, they are rarely able to call out or wave their arms and can submerge in as little as 20 to 60 seconds (Center for Disease Control and Prevention, National Center for Injury Prevention and Control, 2001). Drowning begins as soon as a person loses consciousness. For the average person, the brain begins to die after about three minutes of oxygen deprivation. The longer a lifeguard takes to recognize there is a problem directly equates to more time before rescue takes place, increasing the odds of permanent brain disability or death.

Focus on Prevention

Unless a situation in which a person who is in danger or distress is recognized, an effective response to prevent death or injury is impossible. By vigilantly watching those in the water, lifeguards can observe behaviors and hazards that can be stopped or modified to prevent injury and death, and they can promptly respond if rescue efforts are needed. As participant surveillance and other accident prevention skills are critical, facility operators should emphasize prevention rather than rescue as the primary method to reduce drownings. Examples of skills in preventing aquatics accidents include being able to quickly identify when participants are struggling in the water, recognize signs of drowning, maintain vigilant observation, and recognize and respond to potential hazards before they become an issue, etc.

However, an inherent challenge of which operators should be aware is that most skills learned and practiced in a lifeguard training course are typically heavily focused on rescue — and may include very little practice in participant surveillance or other accident prevention topics. To be clear, there is no intent herein to negate the importance of in-water and other life-saving rescue skills. They are absolutely critical! Rather, the intent is to help operators equally focus on the development and practice of accident-prevention skills — like participant surveillance — reducing the need for in-water rescue.

How Do Operators Help Lifeguards Improve?

First, remember that “certified” isn’t the same as “qualified.” At the end of the day, the expectation is that the program/facility operator will provide the additional training and fill the gaps in knowledge required once the lifeguard is hired — and before they are placed in the lifeguard stand. While certification serves as a foundation, it is up to the camp to provide additional training, mentoring, and skills development to build lifeguards with a full range of competent abilities. A good analogy is to think of your lifeguards as teenagers learning to drive. They are taught a certain amount in the classroom and a certain amount in behind-the-wheel training — and then are given a learners/provisional permit so they can continue to get more hands-on experience in a real-world setting. Think of lifeguard certification as a learner’s permit, not a “license to lifeguard.”

Building a Prevention Mindset

With much of the emphasis in training focused on rescue skills when reacting to an emergency, a critical component for on-site training is in helping aquatics staff develop a risk management mindset, understanding that accident prevention is proactive, and accident response is reactive. While always being rescue-ready to quickly react in an emergency is crucial, lifeguards also need a clear understanding of their responsibilities in prevention, training in executing accident prevention activities/strategies (such as scanning), and opportunities to practice the guarding of lives in ways that are efficient, engaged, and active. Again, this can’t be said enough: Rescue should never be the primary method to reduce or prevent drownings.

Improving Participant Surveillance

The high rate of victims first being identified by other participants rather than by the lifeguard indicates that proactive supervision and scanning are not regularly being practiced. To help illustrate this point: In 2001, Ellis & Associates conducted more than 500 submerged manikin tests in 90 different pools in the US. Less than 10 percent of the lifeguards were able to spot the submerged manikin within ten seconds of its placement on the pool bottom. In 14 percent of the tests, lifeguards took over three minutes to spot the manikin. It took an average of one minute and 14 seconds for lifeguards to spot the submerged manikin (Jeff Ellis & Associates, Inc., 2018).

These failures are, in part, because participant surveillance (sometimes referred to as “scanning”) is a highly complex skill. There is often a false assumption that if a lifeguard can see, they can scan. Scanning requires both peripheral and focal vision, excellence in attention, vigilant use of short-term memory, use of cognitive-thinking processes, and a high level of awareness of critical signals that may require the lifeguard’s attention.

Training for lifeguards to help improve these skills can be broken down into three buckets. How to:

1. Recognize potential victims
2. Conduct surveillance/scanning
3. Improve vigilance

How to Recognize Potential Victims

As lifeguards must be able to recognize the visual and behavior cues that identify those most at risk of potentially becoming a victim, pre-duty on-site training should include how to assess participant swimming skills — such as body position, stamina, breath control, comfort in the water, etc. — as well as common behaviors of nonswimmers and those in distress. Unless they are also trained as swimming instructors and/or have been intentional in observing specific behaviors of real-life, real-time swimmers, it is unreasonable to expect inexperienced lifeguards to be able to recognize/assess swimming ability (or assume they understand just because they themselves can swim).

Ideally, training should include exercises in observing actual patrons to identify specific behaviors of swimmers and nonswimmers, including common behaviors of someone in distress. As applicable, also include common challenges encountered at your facility or with the specific clientele served. Additional training must also be provided if including lifeguards in evaluating participant swimming ability, such as for assigning campers to swimming areas/levels.

How to Conduct Surveillance/Scanning

Training should include hands-on practice of effective surveillance/scanning strategies, specifically to identify and practice how lifeguards are expected to watch participants in the water, such as:

• Identify, review, and practice the scanning techniques they are expected to use
• Effective strategies to avoid inattentional blindness, which occurs when people fail to notice stimuli appearing in front of their eyes while they are preoccupied with another visual task
• Where lifeguards are positioned and areas of responsibility
• Times of day/circumstances when lifeguard position should change and why
• Proper rotation between stations
• How camp keeps track of participants (i.e., how to conduct a buddy check)
• Common problems encountered/areas that are difficult to guard because of the nature of activities, body of water, clientele, facility, etc.
• How to deal with environmental hazards: sun glare, water clarity, weather conditions, etc.

To be most effective, require that lifeguards practice scanning with supervision and feedback. This can be done in a variety of ways, such as using side-by-side observation, “shadowing” an experienced lifeguard, skills practice one-on-one with another experienced guard, mock-scenarios, etc.

Improving Vigilance

A critical component of effective surveillance is the ability of the lifeguard to stay alert, focused, and to maintain a high level of attention. To be efficient, lifeguards must be mentally sharp. Surveillance requires the use of short-term memory, cognitive thinking processes, and a high level of awareness. The health and wellness of the lifeguard is also a significant contributor to vigilance. Staff who are fatigued, sleep-deprived, hungry, hungover, hot, or dehydrated are not going to be at their peak level of mental (or physical) performance. Further, many environmental factors influence vigilance, including noise, heat/cold, humidity, and time of day. Any one or combination of these factors may confound a lifeguard’s ability to maintain vigilance. To help counter factors that may negatively influence attention, training should include discussion of topics such as:

• How to interact properly with patrons while on duty, without becoming distracted or interrupting effective surveillance
• How the lifeguard can reduce other distractions, as they greatly affect the scanning process and decrease lifeguard performance
• Strategies for staying alert while guarding; preventing “zoning out”
• Lifeguard health and wellness; developing healthy habits that support performance
• Expectations around getting enough sleep emphasizing the need for lifeguards to obtain a full night’s sleep before assuming lifeguard duties
• Review policies around alcohol and recreational drug use
• What to do if they don’t feel like they are “at 100 percent”
• Any responsibilities for providing their own sun protection, water bottle, snacks, etc.

In addition to pre-duty training, participant supervision skills and accident-prevention strategies, along with hands-on practice of rescue skills, should also be included in ongoing on-site training.

Is Your Camp/Organization Following Best Practices?

Are your policies and procedures based on the most current best practices in aquatics risk management? Just as experience and expertise vary in different organizations, so do methods and standards. It’s not uncommon for operating procedures to have been accepted based on historical adherence (we do it that way because we have always done it that way).

For example, are lifeguards positioned based on best practices and current research in how humans process their field of vision? Or because that’s where the maintenance staff put the lifeguard chair? Best practices should be followed — but best practices must first be determined. Lifeguarding and aquatics management has evolved over the last several years — including research in human behavior applied to how it impacts lifeguard effectiveness. To help ensure your camp is putting an emphasis on prevention as well as using the latest research and science in aquatics management, it might be time for your organization to review policies and procedures.

Keep in mind that policies should be promoting best practices in effective participant surveillance and other accident-prevention skills. Unfortunately, sometimes facility operators inadvertently create situations that negatively impact a lifeguard’s ability to do their job effectively.

For example, in resident camps it’s not uncommon for lifeguards to also have overnight duties in the supervision of campers — which can negatively impact the amount and/or quality of sleep. This can result in tired, inattentive lifeguards who are not going to be at peak performance in terms of vigilance. Is overnight supervision of campers really where you want to put your lifeguard’s energy?

Other topic areas common to camps where operators may be inadvertently creating situations that negatively impact lifeguards include the number of lifeguards on duty, where lifeguards are positioned in relation to participants, the number of participants in an activity/area, time lifeguards are on duty, duties that are beyond the scope of what they were trained to do (such as supervising boating activities/watercraft rescue), and assigning duties that intrude/distract their attention from proper, ongoing observation of those in the water.

When reviewing policies, identify those factors that distract lifeguards from vigilant supervision of participants. Does your camp assign duties that would distract their attention from proper, ongoing observation of individuals in the water? Can you change any practices to reduce potential lifeguard distraction? For example, can other staff (such as camp counselors) take on the responsibility for managing any behavior on deck, such as running, so that lifeguards can focus on participants in the water?

Policies and procedures around accident-prevention topics should be specific to the types of aquatics activities offered at your camp/program, the types of aquatics facilities and equipment used, and the clientele served. As applicable, consider:

• What scanning techniques are staff trained to use to identify patrons in need of assistance? Are these techniques based on the most current science?
• Identify external factors that positively influence vigilance among lifeguards. How will staff be trained in these?
• Where are lifeguards positioned? Do positions move throughout the day to account for sun glare and water conditions? Who makes these decisions?
• How long should a lifeguard be assigned to continually watch the water before interruption of duty? Is this time based on current science or on “how we have always done it”?
• How many lifeguards are on duty? What determines this number?
• As distractions greatly affect the scanning process and decrease lifeguard performance, how can they be reduced by the camp?
• Policies for alcohol and recreational drug use
• What policies are in place for the proximity of lifeguards to participants? For example, for “floating” or watercraft guards, how close are they to be to participants? Does your camp have a 30-second, 10/20, or 10/30 rule?
• What are the rules? Does your camp allow underwater, breath-holding games?
• Do you allow horseplay? Are staff held to the same standards as campers?
• What steps do you take to make sure lifeguards get enough sleep?
• If outdoors, are you providing adequate protection from the heat and sun, such as sunscreen, hats, sunglasses, and umbrellas? What about hydration?

Note: Examples of accident-prevention topics to consider including during on-site, pre-duty, and in-service training are not intended to be comprehensive for every camp/facility. In-house training should be specific to the types of aquatics activities offered at your camp/program, the types of aquatics facilities and equipment used, and the clientele served.

Resources for More Information

United States Lifeguard Standards Coalition American Red Cross United States Lifesaving Association American Camp Association Centers for Disease Control YMCA of the USA American Academy of Pediatrics

References

Centers for Disease Control and Prevention & National Center for Injury Prevention and Control. (2001). Lifeguard effectiveness: A report of the working group. CDC. Retrieved from cdc.gov/homeandrecreationalsafety/pubs/lifeguardreport-a.pdf

Jeff Ellis & Associates. (2018). Industry leading international aquatic safety & risk management consulting. Retrieved from jellis.com

USA Management. (2018). Water safety. Retrieved from usamanagement.com/water-safety-facts