Red Cross Best Practices Flashcards
Should an AED be used before CPR in cardiac arrest following drowning or should CPR be provided before using an AED?
Red Cross Guidelines and Best Practices
For adults, children or infants in cardiac arrest following a drowning event, begin cardiopulmonary resuscitation and initiate automated external defibrillator use as soon as one is available and where feasible and safe.
Is there evidence to support in-water resuscitation with ventilations only?
Red Cross Guidelines and Best Practices
In-water resuscitation with ventilations can be considered in cases where a responder has proper training in the in-water resuscitation technique and is comfortable performing it without causing an unsafe environment for the responder or the drowning person.
Though in-water resuscitation can be performed without the aid of additional equipment, floating and propelling equipment should be considered.
Insights and Implications
Because airway and respiratory pathophysiology, including systemic hypoxemia, are the most significant insults and primary cause of morbidity and mortality in the drowning process, the earlier an intervention can be applied to reverse the insult and the drowning process, the greater the chances should be for survival. However, the evidence to support in-water ventilation is limited, shows that it increases the time and difficulty of the rescue and it may lead to increased water aspiration by the drowning person. In-water ventilation is considered feasible in suitable water conditions by highly-trained rescue teams with water rescue equipment if the distance to shore warrants its use. Thus, it should only be considered if the responder has proper training, can provide in-water resuscitation without causing an unsafe environment and floating and propelling equipment can be used.
In-water ventilations while swimming or towing are not taught by Red Cross for multiple reasons, including:
Loss of a tight mask seal during the rescue process.
Difficulty maintaining an open airway while swimming.
Potential entry of water into the airway.
The relatively short distance to an extrication point in the pool environment.
The potential for delayed extrication and resuscitation on land.
What is the recommended first aid for exposure to pool chemicals?
Red Cross Guidelines and Best Practices
Following eye, skin or inhalation exposure to pool chemicals, the injured person should be removed from the source and taken to an area with fresh air. Contaminated materials (e.g., clothing, contact lenses) should be removed.
Irrigation of the exposed area should take place immediately with fresh water for at least 15 minutes.
When providing first aid for chemical eye injury, irrigation with normal saline, lactated ringer’s solution or a commercial eye wash solution is a reasonable alternative to water, when available immediately.
Following exposure to industrial chemicals, consider contacting a poison control center (i.e., the National Capital Poison Center, 1-800-222-1222) for additional specific guidance. Emergency medical services should be contacted for pool chemical exposure that is accompanied by respiratory distress.
While on surveillance duty, lifeguards are required to deliberately and actively scan their zone of responsibility. To be able to accomplish this task, what do lifeguards need to do?
Red Cross Guidelines and Best Practices
Surveillance should begin in the lifeguard’s assigned zone by scanning from point-to-point quickly, thoroughly and repeatedly.
Lifeguards should move their head and eyes and look directly at each area of the assigned zone and each person in the assigned zone.
Lifeguards should adjust body position or stand up as needed to gain better visibility.
With each scan of the assigned zone, the lifeguard should search:
- The entire volume of water, including the bottom, the middle and the surface.
- The areas under, around and directly in front of the lifeguard station.
- The areas around play features or other structures.
Each scan of the entire zone should be completed within 30 seconds.
Lifeguards should continue scanning the assigned zone throughout the entire time on the stand.
The use of virtual reality may be considered as an alternative instructional method to promote acquisition of effective surveillance and scanning skills.
How can lifeguards counteract vigilance decrement?
To be effective, a lifeguard must be vigilant (i.e., continuously mentally alert and attentive) while conducting surveillance. Being vigilant while on the lifeguard stand is a key component of effective surveillance. Maintaining the continuous concentration needed to remain vigilant while scanning is difficult and fatiguing. While conducting surveillance, a lifeguard’s ability to stay focused and pay attention declines, which is called vigilance decrement.
Red Cross Guidelines and Best Practices
Lifeguards should receive training to avoid inattention and distractions (e.g., talking to patrons, using cell phone, daydreaming) while on duty.
Lifeguards should receive training in simple ways to improve attention (e.g., getting enough rest, performing simple physical change of posture movements).
How can lifeguards counteract inattentional blindness?
Inattentional blindness occurs when a person completely misses something in their line of sight because they are focused on something else, and a new or different stimulus is unexpected. Effective surveillance requires attention, focus and concentration while on the lifeguard stand. Several distractions, such as by one’s own thoughts, may be present during this time that may lead a lifeguard to inadequately fulfill their current responsibilities.
The Red Cross offers suggestions for strategies to avoid inattentional blindness while conducting surveillance (American Red Cross Scientific Advisory Council 2023):
Maintain an active body posture.
Change position often.
Get enough rest before reporting for a lifeguard shift.
Stay hydrated.
Cool off during breaks.
Engage in some form of light exercise during breaks to keep energy up.
What does a non-swimmer or inexperienced swimmer look like?
Conducting surveillance is how a lifeguard fulfills their primary responsibility, which is to protect lives. With effective surveillance, a lifeguard can recognize behaviors or situations that might lead to life-threatening emergencies, such as drowning, and then quickly intervene to stop the behavior or change the situation. However, effective surveillance relies on knowing which situations and behaviors to look for.
Bobbing in or near water over their head.
Crawling hand-over-hand along a pool wall, toward deeper water.
Out of arms’ reach of a supervising adult.
Clinging to something or struggling to grab something to stay afloat.
Wearing a lifejacket improperly.
Using water wings or pool toys that creates a false sense of security. This could lead them to deeper water where they fall off of a pool toy setting up the potential for a drowning situation.
How long should a lifeguard be assigned to continually watch the water before interruption of this duty?
Red Cross Guidelines and Best Practices
To reduce vigilance decrement, lifeguards should have scheduled breaks from surveillance duty (e.g., a 10- to 15-minute break every hour).
