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Ellis & Associates, Inc INTERNATIONAL LIFEGUARD Training Program Manual 5th Edition Meets ECC, MAHC, and OSHA Guidelines Ellis & Associates, Inc. 5979 Vineland Rd. Suite 105 Orlando, FL 32819 www.jellis.com 800-742-8720 Copyright © 2020 by Ellis & Associates, Inc. All rights reserved. Unless otherwise indicated in writing by Ellis & Associates, the recipient of this manual is granted the limited right to download, print, photocopy, and use the electronic materials to fulfill Ellis & Associates lifeguard courses, subject to the following restrictions: • The recipient is prohibited from downloading the materials for use on their own website. • The recipient cannot sell electronic versions of the materials. • The recipient cannot revise, alter, adapt, or modify the materials. • The recipient cannot create derivative works incorporating, in part or in whole, any content of the materials. For permission requests, write to Ellis & Associates, addressed “Attention: Permissions Coordinator,” at the address above. Disclaimer: The procedures and protocols presented in this manual and the course are based on the most current recommendations of responsible medical sources, including the International Liaison Committee on Resuscitation (ILCOR) Consensus Guidelines for CPR, Emergency Cardiovascular Care (ECC) and First Aid, the Occupational Safety and Health Administration (OSHA) standards 1910.151, and the Model Aquatic Health Code (MAHC). The materials have been reviewed by internal and external field experts and verified to be consistent with the most current guidelines and standards. Ellis & Associates, however, make no guarantee as to, and assume no responsibility for, the correctness, sufficiency, or completeness of such recommendations or information. Additional procedures may be required under particular circumstances. Ellis & Associates disclaims all liability for damages of any kind arising from the use of, reference to, reliance on, or performance based on such information. ISBN 978-0-9961108-7-7 Library of Congress Cataloging-in-Publication Data Not Available at Time of Printing Unless otherwise indicated on the Credits Page, all photographs and illustrations are copyright protected by Ellis & Associates. CONTENTS Acknowledgements i Welcome ii Continuing Education iv Part One: Professionalism and Safety Chapter 1 Introduction to Lifeguarding 1 • Why Lifeguards? 2 • History of Lifeguarding 2 • Drowning: A Global Crisis 3 • Ellis and Associates Lifeguards 4 • Get the Most From Your E&A Lifeguard Training 5 • On-Going Training 7 • Primary Responsibilities of Lifeguards 8 • Secondary Responsibilities of Lifeguards 9 • Being Held Accountable 11 • Legal Concepts That Apply to Lifeguards 12 • Standard of Care 14 • Lifeguard Liability 14 • For Your Review 16 Chapter 2 Professional Image and Action 17 • Lifeguard Appearance and Behavior 18 • Lifeguard Uniform 20 • Lifeguard Equipment 20 • Positive Guest Interactions 23 • Rule Enforcement 24 • For Your Review 26 Chapter 3 Environmental Safety 27 • General Environmental Safety 28 • Weather Conditions 28 • Hydration 31 • Chemical Safety 31 • Recreational Waterborne Illnesses 33 • For Your Review 35 Chapter 4 Preventing Disease Transmission 36 • Bloodborne and Airborne Pathogens 37 • How Diseases are Transmitted 39 • OSHA Protection Standards 39 • Disease Prevention Practices 40 • If an Exposure Occurs 43 • For Your Review 45 Chapter 5 Guest Safety 46 • Health Codes, Laws and Standards 47 • Rule Enforcement 48 • Shallow Water Blackout 49 • Secondary Drowning 50 • Life Jackets 50 • For Your Review 52 Part Two: Vigilance and Teamwork Chapter 6 Zone Protection 53 • The 10/20 Protection Standard 54 • Lifeguard Zones 54 • Zone Documentation and Training 56 • For Your Review 57 Chapter 7 Surveillance 58 • Introduction 59 • Recognizing a Guest in Distress 59 • Recognizing Risk Factors 60 • The Drowning Process 61 • Proactive Scanning Strategies 63 • For Your Review 66 Chapter 8 Maintaining Vigilance 67 • Vigilance 68 • Lifeguard Station Rotations 68 • Challenges to Vigilance 71 • Avoiding Distractions 73 • Improving Performance 74 • For Your Review 76 Chapter 9 The Emergency Action Plan (EAP) 77 • Emergency Action Plans 78 • Multiple Rescuer Facilities 79 • Single Rescuer Facilities 79 • Communication Devices and Standards 80 • Contacting EMS 85 • For Your Review 86 Part Three: Providing Quality Basic Life Support (BLS) Chapter 10 Basic Life Support: Respiratory Emergencies 87 • The Respiratory System 88 • Causes of Respiratory Emergencies 88 • Respiratory Distress 89 • Respiratory Arrest 89 • Scene Survey 90 • Primary Check 90 • Secondary Check 91 • Rescue Breathing 91 • Special Situations 94 • Airway Obstruction (Choking) 95 • For Your Review 98 Chapter 11 Basic Life Support: Cardiac Emergencies 99 • The Circulatory System 100 • Cardiovascular Disease 100 • Cardiac Arrest 101 • Cardiopulmonary Resuscitation (CPR) 102 • Automated External Defibrillation (AED) 107 • For Your Review 112 Chapter 12 Supplemental Oxygen Support 114 • Drowning and the Need for Supplemental Oxygen 115 • Supplemental Oxygen Systems (SOS) 115 • Supplemental Oxygen Delivery Devices 117 • Care and Maintenance of Supplemental Oxygen Systems 121 • For Your Review 123 Part Four: First Responder Care Chapter 13 Caring for Injuries 124 • Introduction 125 • Scene Safety 125 • Assessing Injured Guests 125 • Wounds 126 • External Bleeding 127 • Internal Bleeding 129 • Burns 130 • Head Injuries 132 • Spinal Injuries 137 • Pelvic and Hip Injuries 138 • Chest Injuries 138 • Abdomen Injuries 139 • Joint, Bone, and Muscle Injuries 140 • Shock 142 • Emergency Moves 143 • Triage 144 • For Your Review 145 Chapter 14 Caring for Sudden Illnesses 147 • Allergic Reactions 148 • Breathing Emergencies 151 • Cold Emergencies 152 • Diabetic Emergencies 153 • Drug Emergencies 154 • Fainting 157 • Heart Attack 158 • Heat Emergencies 158 • Poisoning 160 • Pregnancy Complications 167 • Seizure 167 • Stroke 168 • For Your Review 172 Part Five: Water Rescues Chapter 15 Water Rescues for Responsive Guests 174 • Introduction 175 • Assists 175 • Water Entries 176 • Approach Strokes 177 • General Water Rescue Procedures 178 • Responsive Guests on the Surface 179 • Responsive Guests Beneath the Surface 181 • Challenging Rescue Situations 183 • For Your Review 185 Chapter 16 Water Rescues for Unresponsive Guests 186 • Unresponsive Guests in Distress 187 • Unresponsive Guest Rescues 187 • Caring for an Unresponsive Guest in the Water 191 • Rapid Extrication of an Unresponsive Guest 192 • Care After Extrication 194 • For Your Review 196 Chapter 17 Suspected Spinal Injuries 197 • About the Spine 198 • Recognizing Spinal Injuries 198 • Caring for Spinal Injuries in the Water 199 • Backboarding and Extrication 204 • Special Situations 208 • For Your Review 209 Part Six: Open Water Lifeguarding Chapter 18 Open Water Lifeguarding 210 • Introduction to Open Water Lifeguarding 211 • The Designated Swimming Area 211 • Managing Guest Safety 213 • Equipment for Open Water Lifeguarding 215 • Open Water Rescues 217 • Missing Guest Search 220 • For Your Review 222 Appendices Appendix A Sample First Aid Kit 224 Appendix B Sample BBP Exposure Control Plan 225 Index 231 i ACKNOWLEDGEMENTS In Memory of Louise Priest This edition of the International Lifeguard Training Program is dedicated to Louise Priest, a tireless aquatics educator, author, and leader. Louise held leadership positions with the American Red Cross NHQ, Ellis & Associates, and the Council for the National Cooperation in Aquatics. Louise was one of those select few “larger than life” individuals who put others ahead of herself, exemplifying the very best of humankind. While she will be missed, her legacy remains infinitely timeless. Contributors Many individuals, agencies, and organizations contributed to the tasks of designing, advising, writing, editing, reviewing, piloting, and producing this 5th edition of the International Lifeguard Training Program manual Jeff Ellis & Associates and Jeff Ellis Management National Staff Benjamin Strong Jennifer Barber Luke Martinez Darlene Reese-Sittig Jeremy Stiles Melanie Woods Dr. Larry Newell Jerica Cyr Richard Carroll Dr. Peter Goldberg Joe Stefanyak Steve Miller Jeffrey Ellis Juan Richards Travis Reed Jem Hughes Landon Reed Vinson Needler External Contributors Cedar Fair / Cedar Point, OH Katherine Martinez, KP Facilitation, CO City of Tempe Parks and Recreation, AZ Oakland County Parks, MI Erin Clancy, Stanfordville, NY Oostman Aquatics Safety Consulting, Inc, MA Deric Clinton, YMCA of Delaware Barbara Phillips, Tell a Story Creative, FL Brandon Cook, Online Design Club, FL Plainfield Township, MI Englewood Parks and Recreation, CO Jose Salazar, Loudoun County Fire & EMS, VA Megan Hartman, Great Wolf Lodge Resorts Ryan Phillips, Safety Skills Training Keith Herrmann, Aurora University, IL Six Flags America, MD Highlands Ranch Community Association, CO Village of Grayslake Aquatic Center, IL Hilton Anatole Dallas, TX Water Safety Products, Inc. FL Nick Licastro, Great Wolf Lodge Resorts Waukegan Park District, IL ii WELCOME Introduction Congratulations on your decision to become an Ellis & Associates (E&A) lifeguard. Following successful completion of your course, you will join a select group of aquatic professionals who apply proven state-of-the- art aquatic injury prevention practices to reduce the number of emergency incidents, and when necessary, to respond rapidly and effectively to any emergency. As a result of E&A’s emphasis on prevention, professionalism, accountability, and
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