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Chapter 3 Patron Surveillance

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Chapter 3 Patron Surveillance Chapter 3 Patron Surveillance A lifeguard’s primary responsibility is to en- sure patron safety and protect lives. A pri- mary tool to accomplish this function is pa- tron surveillance—keeping a close watch over the people in the facility. Lifeguards will spend most of their time on patron sur- veillance. To do this effectively, they must be alert and attentive at all times, supervis- ing patrons continuously. 28 Lifeguarding EFFECTIVE SURVEILLANCE Distressed Swimmer For a variety of reasons, such as exhaustion, cramp or With effective surveillance, lifeguards can recognize be- sudden illness, a swimmer can become distressed. A dis- haviors or situations that might lead to life-threatening tressed swimmer makes little or no forward progress and emergencies, such as drownings or injuries to the head, may be unable to reach safety without a lifeguard’s assis- neck or back, and then act to modify the behavior or tance. control the situation. Effective surveillance has several Distressed swimmers can be recognized by the way elements: they try to support themselves in the water. They might ● Victim recognition float or use swimming skills, such as sculling or treading ● Effective scanning water. If a safety line or other floating object is nearby, a ● Lifeguard stations distressed swimmer may grab and cling to it for support. ● Area of responsibility Depending on the method used for support, the dis- tressed swimmer’s body might be horizontal, vertical or The previous chapter focused on eliminating haz- diagonal (Fig. 3-2). ardous situations. This chapter concentrates on recogniz- The distressed swimmer usually has enough control of ing patrons who either need, or might soon need, assis- the arms and legs to keep his or her face out of the water tance. to continue breathing and call for help. In most cases, a distressed swimmer is also able to wave for help. He or Victim Recognition she can use the legs and one arm for support, while rais- When conducting surveillance, lifeguards should look for ing the other arm to wave for assistance. The distressed behavior that indicates a patron needs immediate assis- swimmer generally has the ability to reach for a rescue tance. Lifeguards are better able to identify these behav- device. iors because they are universal responses that indicate a As conditions such as fatigue, cold or sudden illness patron is in trouble in the water. Deciding that a patron is continue to affect the distressed swimmer, he or she is in trouble must be based on his or her behavior, not on less and less able to support him or herself in the water. physical characteristics or appearance, such as age or As this occurs, the victim’s mouth moves closer to the ethnic or racial background. surface of the water, and anxiety increases. If a dis- It is important to understand the behaviors that a vic- tressed swimmer is not rescued, he or she may become tim shows when in distress or drowning. Table 3-1 com- an active drowning victim. pares the behaviors of a swimmer with those of a dis- tressed swimmer, an active drowning victim and a Active Drowning Victim passive drowning victim. Notice differences in— Active drowning victims have distinctive arm and body ● Breathing. positions. They try to keep their mouths above the sur- ● Arm and leg action. face of the water (Fig. 3-3). This universal behavior is ● Body position. called the instinctive drowning response (Pia, 1974). This ● Body propulsion or locomotion (movement) through means that all active drowning victims have the same be- the water. haviors. An active drowning victim— ● Struggles to keep the face above water in an effort Understanding these behaviors enables a lifeguard to to breathe. If unable to do this, he or she begins to recognize quickly when someone needs help. Quick ac- suffocate. tion can mean the difference between life and death for a ● Has arms extended to the side, pressing down for distressed or drowning victim. support. ● Has a vertical body position in the water with no Swimmer supporting kick. Depending on his or her proficiency with the stroke, a ● Might continue to struggle underwater. swimmer’s arms and legs work in a coordinated and ● Might eventually lose consciousness and stop moving. effective way. The body position is nearly horizontal, and there is some breath control. The person is able An active drowning victim is struggling to breathe. His to make recognizable progress through the water or her mouth repeatedly sinks below the surface and (Fig. 3-1). Note that a person with a physical disability reappears. While the mouth is below the surface, the (such as the loss of a leg) might have to modify a stroke, drowning victim keeps it closed to avoid swallowing wa- but that person’s unique swimming style can soon be ter. When the mouth is above the surface, the drowning recognized. victim quickly exhales and then tries to inhale before the Patron Surveillance 29 TABLE 3-1 BEHAVIORS OF DISTRESSED SWIMMERS AND DROWNING VICTIMS COMPARED TO SWIMMERS Fig. 3-1 Fig. 3-2 Fig. 3-3 Fig. 3-4 Distressed Active Drowning Passive Drowing Swimmer Swimmer Victim Victim Breathing Rhythmic Can continue Struggles to Not breathing breathing breathing and breathe; cannot might call for help call out for help Arm and Relatively Floating, sculling Arms to sides al- None Leg Action coordinated or treading water; ternately moving might wave for up and pressing help down; no sup- porting kick Body Horizontal Horizontal, verti- Vertical Horizontal or ver- Position cal or diagonal, tical; face-down, depending on face-up or sub- means of support merged Locomotion Recognizable Little or no for- None; has only 20 None ward progress; to 60 seconds be- less and less able fore submerging to support self mouth goes below the surface again. While the victim is Passive Drowning Victim gasping for air, he or she also might take water into the A victim might progress from active to passive drowning mouth. Although some people believe active drowning or suddenly slip under water without a struggle. Passive victims can call out for help, this is not the case. They drowning victims might float face-down at or near the can barely take in enough air to breathe, so there is no surface or might sink to the bottom (Fig. 3-4). A passive air left over to call out for help. drowning can result from a variety of conditions that can Active drowning victims do not make any forward lead to a loss of consciousness, including— progress in the water. All of the person’s energy is de- ● A heart attack or stroke. voted to keeping the mouth above the surface of the wa- ● A seizure. ter, and the person is unable to reach for a rescue de- ● A head injury. vice. The active drowning victim usually stays at the ● A heat-related illness. surface for only 20 to 60 seconds. The victim may con- ● Hypothermia. tinue to struggle underwater but eventually loses con- ● Hyperventilation. sciousness and stops moving. ● Use of alcohol and other drugs. 30 Lifeguarding Once a victim submerges and loses consciousness, victim. Table 3-2 lists the signs and symptoms for these water can enter the trachea (windpipe). This may cause a conditions. spasm of the vocal cords (laryngospasm), which blocks Heat-related Illness. A heat-related illness occurs the airway to keep fluid or food out of the airway. Water when a person’s inner core temperature rises above its might get into the lungs after submersion or loss of con- normal temperature of 98.6° F (37° C) to 102.6° F (39° C) or sciousness. Anyone who is submerged or floating face- higher. The victim becomes weak and dizzy, and might down and motionless for 30 seconds should be consid- become confused or lose consciousness. See Chapter 9 ered a passive drowning victim. Lifeguards should check for the signs and symptoms and care for heat-related the victim’s condition immediately. If the victim is con- emergencies. scious and was just holding his or her breath, the patron For facilities with a spa, exposure to hot water can needs to be directed to stop doing so. make it difficult for a person to get out. It is important for Heart Attack, Stroke, Seizure and Head Injury. A per- lifeguards to monitor patrons as they use spas and hot son who has suffered a heart attack, stroke, seizure or tubs and to advise them not to stay in the water too long. head injury might feel dizzy or faint or be temporarily par- Also, advise pregnant women, adults with cardiac or cir- alyzed. These conditions cause great difficulty in swim- culatory problems and parents or guardians of young ming or even walking in the water. The person might also children about the risk hot water can pose to their health. suddenly stop swimming and become a passive drowning Since many health clubs and recreation departments with TABLE 3-2 SIGNS AND SYMPTOMS OF A HEART ATTACK, STROKE, SEIZURE AND HEAD INJURY Heart Attack Stroke Seizure Head Injury Signs and ● Persistent ● Sudden weak- ● Confusion, ● Swollen or Symptoms chest pain or ness or numb- dizziness or bruised areas pressure (a pri- ness to the disorientation ● Unconscious- mary signal of face, arm or ● Difficulty ness a heart attack) leg; usually to breathing ● Confusion or that lasts one side ● Body might loss of memory longer than 3 to ● Difficulty with stiffen ● Severe pain or 5 minutes, or speech or ● Convulsions pressure in the goes away and vision followed by— head comes back ● Severe head- Ⅲ Relaxed ● Profuse or ex- ● Chest pain ache state ternal bleeding spreading to ● Confusion, Ⅲ Fatigue and of the head the shoulders, dizziness or confusion neck, jaw or disorientation Ⅲ Headache arms ● Shortness of breath or trou- ble breathing ● Nausea or vomiting ● Dizziness, light- headedness or fainting ● Pale, ashen (grayish) or bluish skin ● Sweating ● Denial of signals Patron Surveillance 31 swimming pools now include spas, it is important to be Fig.
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