International Journal of Aquatic Research and Education Volume 13 Number 1 Article 2 7-8-2020 Portuguese Lifeguards Performance in Aquatic Rescue: An Exploratory Study Olga G. Marques Ph.D. University of Coimbra; Faculty of Sport Sciences and Physical Education, [email protected] José Palacios-Aguilar Ph.D Faculty of Sport Sciences and Physivcal Education, University of A Coruña, Spain, [email protected] Henrique G. Melo Mcs. Portuguese Navy, [email protected] Nuno G. Leitão Portuguese Navy, [email protected] Lucia P. Castillo MSc. Graduate in Marine Science, University of Vigo Follow this and additional works at: https://scholarworks.bgsu.edu/ijare See P nextart of page the forExer additionalcise Physiology authors Commons , Exercise Science Commons, Health and Physical Education Commons, Leisure Studies Commons, Outdoor Education Commons, Public Health Commons, Sports Sciences Commons, and the Sports Studies Commons Recommended Citation Marques, Olga G. Ph.D.; Palacios-Aguilar, José Ph.D; Melo, Henrique G. Mcs.; Leitão, Nuno G.; Castillo, Lucia P. MSc.; Szpilman, David M.D; and Rama, Luís Ph.D. (2020) "Portuguese Lifeguards Performance in Aquatic Rescue: An Exploratory Study," International Journal of Aquatic Research and Education: Vol. 13 : No. 1 , Article 2. DOI: https://doi.org/10.25035/ijare.13.01.02 Available at: https://scholarworks.bgsu.edu/ijare/vol13/iss1/2 This Research Article is brought to you for free and open access by the Journals at ScholarWorks@BGSU. It has been accepted for inclusion in International Journal of Aquatic Research and Education by an authorized editor of ScholarWorks@BGSU. Portuguese Lifeguards Performance in Aquatic Rescue: An Exploratory Study Cover Page Footnote The authors acknowledge and thank the lifeguards who participated in this study. Authors Olga G. Marques Ph.D., José Palacios-Aguilar Ph.D, Henrique G. Melo Mcs., Nuno G. Leitão, Lucia P. Castillo MSc., David Szpilman M.D, and Luís Rama Ph.D. This research article is available in International Journal of Aquatic Research and Education: https://scholarworks.bgsu.edu/ijare/vol13/iss1/2 Marques et al.: Lifeguard Performance in Aquatic Rescue Abstract The objective of the study was to compare the performance of Portuguese lifeguards in two trials of simulated rescue at the beach within a regular continuous workday. Additionally, the study aimed to analyse the influence of experience and initial course syllabus on the rescue performance. A total of 86 Portuguese lifeguards (LG) participated in this study, 69 males and 17 females. The two simulated drowning occurrences were planned to occur at 50 meters from the coastline between 9.00h am and 18.00h pm. The weather conditions, the characteristics of the beach, wave amplitude were also controlled. The results were analysed through descriptive and comparative tests and pairwise comparisons. The rescue was performed in less than 6 minutes by 91.9% of the subjects, 5.8% between and 6-10 min and only 2.3% exceeded 10 minutes. No significant differences (p>0.05) were found on the total rescue time between trials and the number of ventilations. The number of training sessions at the beach during the lifesaving course was negatively correlated with a faster rescue trial (r= -0.218; p=0.004). The majority of the Portuguese LG in this study demonstrated the readiness required to conduct a full rescue in less than 6 minutes. O objetivo do estudo foi comparar o desempenho dos nadadores-salvadores (NS) portugueses em dois ensaios de resgate simulado na praia em um dia de trabalho contínuo e regular. Além disso, o estudo teve como objetivo analisar a influência da experiência e do currículo inicial do curso no desempenho do resgate. Um total de 86 NS portugueses participaram neste estudo, 69 homens e 17 mulheres. As duas ocorrências simuladas de afogamento foram planeadas para ocorrer a 50 metros da costa, entre 9h e 18h. As condições climáticas, as características da praia, a amplitude da onda também foi controlada. Os resultados foram analisados através de testes descritivos e comparativos e comparações aos pares. O resgate foi realizado em menos de 6 minutos por 91,9% dos sujeitos, 5,8% entre 6 e 10 minutos e apenas 2,3% excederam os 10 minutos. Não foram encontradas diferenças significativas (p> 0,05) no tempo total de resgate entre os ensaios e o número de ventilações. O número de sessões de treino na praia durante o curso de nadador-salvador foi correlacionado com um teste de resgate mais rápido (r = -0, 218; p = 0,004). A maioria dos NS portugueses neste estudo demonstrou a prontidão necessária para realizar um resgate completo em menos de 6 minutos. Keywords: rescue, CPR, lifeguards, drowning prevention, Introduction It is estimated that in Portugal there are 106 kilometers of supervised bathing areas and 315 kilometers of unguarded bathing areas. Available data from the Portuguese lifesaving authority, Instituto de Socorros a Náufragos (ISN), indicates that the rate of drowning mortality during summer seasons has lowered in recent years according to the Autoridade Maritima Nacional (AMN, 2016). During the seven summer bathing seasons between the years 2008-2014 a total of 25 people died on patrolled beaches. The highest number of drowning deaths was between 2008 and 2011 with 6 deaths. On unguarded beaches for the identical time period there were Published by ScholarWorks@BGSU, 2020 1 International Journal of Aquatic Research and Education, Vol. 13, No. 1 [2020], Art. 2 a total of 92 deaths. Before 2014 trained and paid lifeguards (LG) were not a recognised profession. In 2015 a governmental regulation implemented and recognized LG training as a profession, increasing the responsibility of each LG to be technically, physically, and psychologically ready to safeguard human life in every aquatic environment recognized as proper bathing places (Law n.o 88/2012, 30 March, 2012). Portuguese law establishes that to be recognised as a lifeguard, an individual must be approved by completing the lifeguard course and certificated by the ISN. Briefly, the lifeguard's responsibilities and duties are to inform, prevent, help, and provide essential life support under any circumstances in official bathing areas, in public swimming pools, and other places where aquatic activities occur under mandatory surveillance (Law n.o 68/2014, 29th August, 2014). During drownings, a faster rescue is correlated with a better outcome. It is assumed that a 56% risk of severe neurological injury when a person has been submerged between 6 and 10 minutes (Szpilman, Bierens, Handley, & Orlowski, 2012). Facing an unconscious drowning victim, the possibility to reverse the situation could increase three times if the lifeguard applies the first breaths in the water while holding the victim (Szpilman et al., 2012). So, it is of paramount importance that lifeguards are well acquainted with rescue procedures and are well trained to apply the rescue algorithm by starting the ventilation in the water, reducing the time of hypoxia, and restoring oxygen levels. When this is accomplished, it may be the difference between life and death. Usually on an unconscious drowning victim, ventilation is restored after the first breaths. If not, the lifeguard should tow the person to a safe and dry place to start CPR immediately (Fitz-Clarke, 2017). The rescue algorithm adopted by Portuguese authorities (School of Maritime Authority, 2011) comprised three main components: recognition, planning, and action. During the recognition phase, the lifeguard facing an emergency should warn other lifeguards and the local lifesaving authorities. Afterwards, the LG should assemble the equipment quickly and must locate and check the number of victims. In this phase, the lifeguard must also evaluate the sea and environmental conditions. In the planning phase, the lifeguard must select the appropriate rescue method (e.g., reach, throw, wade, row, swim, tow) according to the available and appropriate equipment (e.g., float torpedo, rescue belt, rescue board, rescue stick, reel with rescue belt, circular floater). In the third and final action phase, the lifeguard must enter into the water with the rescue equipment, approach the victim using the appropriate swimming technique, address the situation from a safe distance (approximately 4 to 5 meters), and evaluate the victim’s state of consciousness. If the victim is conscious, the lifeguard should https://scholarworks.bgsu.edu/ijare/vol13/iss1/2 DOI: https://doi.org/10.25035/ijare.13.01.02 2 Marques et al.: Lifeguard Performance in Aquatic Rescue communicate with him, transmitting confidence and calm, and then rescue him to a safe location. As soon as possible the victim must be "delivered" to health care personnel, and then the LG should write the rescue report. If the victim is unconscious, the lifeguard should ask for help and begin the airway permeabilization, applying five ventilations and transport him as soon as possible to a safe place where the cardiopulmonary resuscitation compressions should start. The objective of the study was to compare the performance efficacy in two simulated rescue interventions within a regular, continuous workday of Portuguese lifeguards at the beach. Additionally, we aimed to analyse the influence of other variables, namely the experience, the syllabus content of the initial course, and the mandatory number of training sessions at the beach and the environmental conditions at the moment of the simulated rescue. The respect for the security signals was estimated through the comparison between green and yellow flag conditions. Method Study Sample This study was conducted on 18 beaches of Portugal (north, middle, and south), including the Portuguese Atlantic islands. Eighty-six lifeguards (69 males and 17 females), ages between 18 and 38 years working on the Portuguese maritime beaches, volunteered to participate in the study. Anthropometrics, age, body composition, the experience of the lifeguards, and physical activity level as well as volunteers who simulated drowning victims, were taken into account (Table 1).