Sequences Flashcards
Aquatic emergency care general sequence acronyms (in order)
WRS HMIR and B WLEFT for alertness and ABCs TT BPSL FAMM
Get to ABCs as quickly as possible if you notice they cannot respond. Spinal holds do not matter if they are not breathing. So constantly check for breathing while doing everything.
Attract attention so that bystanders can help. Call medical services as soon as you notice someone is less conscious or not breathing, or if they might have an injury that makes moving them risky (spinal, dislocated knee, hazardous environment). Always get a first aid kit and AED with the help of a bystander if you are suspecting these might be needed.
If alone with non-breathing child, do two cycles of CPR before calling for help yourself a distance away. When possible use your cell phone on speaker phone and don’t interrupt CPR.
HMIR
Hazards
Mechanism of Injury
Immobilze
Remove
WLEFT
What happened Location Eyes Fingers Time/Date
ABCs
Airway
Breathing
Circulation
TT
Treatment
Temperature
BPSL
Breathing rate
Pulse rate
Skin condition
Light
FAMM
Food/drink
Allergies
Medications
Medical History
Sample = signs and symptoms, allergies, medications, past (medical history), last meal, events leading up to situation
Hazards
Are there hazards ?
No fire, no wire, no glass, no gas, no drugs, no thugs, look up, look down, look all around, and sniff.
If there are hazards, later you will either:
- remove the casualty from the hazard if safe enough to do so,
- move the casualty if they are able to move safely enough
- call 911 to have the proper trained authorities respond if the situation is too dangerous to enter
Mechanism of Injury
Look out for head injury, or pelvis injury, or seizure!
Common causes of spinal injuries :
- diving head-first into shallow water and hitting the bottom
- being thrown into the water
- diving into a sandbar
- making agressive contact in water polo
- falls
- severe head injuries
- car accidents
- bicycle accidents
Imobilize
If they are in the water and may have hit their head or pelvis, or anything indicating a spinal, you need to imobilize through either a vice grip (deep or shallow), the Canadian (deep if someone else will enter the water soon), or the Reverse Canadian (shallow). Remember to not create ripples as you approach. If they are having a seizure, you will need to help them keep their head out of water but not try to stop the movement.
Spinal rescue from deep water
If in the deep water, Canadian is the easiest to turn them face up and swim (bring your arm over them to initiate the hold, then turn them). Some people are fine with doing a vice grip here as well. Reverse Canadian would not work in deep water.
Canadian (use only if you are moving them to the shallow end) : You will need to wait to have someone else bring the spinal board into the water on the shallow end, and then have them take over the hold of the casualty’s arms with two hands from on top to allow the spinal board to make contact with the casualty’s back. At minimum you would need someone else in the water with you to perform this rescue, so make sure the other person can stand in shallow water.
Vice grip : This can be used but should personally be your second choice due to it being more difficult as a deep water rescue. Use vice grip when the other person will be staying out of the water or if you are alone (They will sit on the board beaver tail and then use a trapezius squeeze to hold them)
Spinal rescue from shallow water
If in the shallow water, you will use vice grip or Reverse Canadian. Whichever you choose will determine how the board will be placed.
Vice grip : Use vice grip when the other person will be staying out of the water or if you are alone (They will sit on the board beaver tail and then use a trapezius squeeze to hold them)
Reverse Canadian: Use when the other person will bring the spinal board into the water. The Reverse Canadian starts with your far arm reaching underneath the water to grab their far arm, pushing both their arms into their ears, and then turning. You will end up holding their arms from on top.
Strap order for spinal boards
Change to trapezius squeeze if the second person is out of water. Change to holding from above version of Canadian if second person is in water and you are in the shallow end. This way the board can fit under.
- chest strap
- hip strap
- change person holding head in place (now it will be a vice grip around the board regardless of other holds chosen)
- head strap with L-shaped things
- all other straps
- bring hands in on top of body (don’t let them dangle)
- remove (head-first, only lift slightly since you do not want to have the board leave the tiles on the deck; the person in the water can lift more)
Remove
If they are a spinal, follow the strap order and then lift out if you have at least two rescuers.
If they are unconscious but not a suspected spinal, dive or jump in, push their head down as you surface, arching their head back once you reach the surface and hold them by the head in a control carry. Have a bystander help you to secure them against the wall as you hop out. Then the bystander can help you on one side while you lift from the other side if they are too big for you to lift them alone. If they are smaller than you, take them out by yourself by grabing underneath their arm-pits with the bend of your elbows and clasping your own hands together.
If they are conscious and close to an exit, use a pika carry (hug around their waist) and eggbeater them to the edge. If you must travel a long distance, have flotation and allow them to hold onto it while you tug the flotation. It is best if you have the flotation around the victim. (In bronze medallion, we would have done a tow here, but as a lifeguard, we are okay with closer contact and do not necessarily need to follow the ladder approach.) Keep in mind that conscious victims prefer to have their head and shoulders out where possible.
You can use a spinal board to remove someone if you have two people. The first person turns them into the board that is placed straight down by the second person. The person on the board will grab the opposite handle to where they are standing and then catch the arm of the turned person that is closest to them. The other person will mirror this so that both researchers arms are crossing to hold the board with their outer arm holding the other arm of the swimmer.
WRS
Whistle
Radio
Shout
