NPLQ Presentation

Teaching Skills to Save LivesTeaching Skills to Save Lives

COURSE TRAINERCOURSE TRAINERStewart Hodsoll - EnglishStewart Hodsoll - English•14 years Pool & Beach Lifeguard Experience

•Worked in UK, Bahamas, Australia and UAE

•Qualifications include; NPLQ Australia, Ellis & Associates Special Facility Licence, RLSS UK NPLQ, RLSS UK NBLQ, RLSS UK Pool & Beach Lifeguard Trainer/ Assessor – Speciality endorsements in PWC Rescue, Rescue Paddle craft, O2 & AED & Surf Rescue

•UAE Representative for the Royal Lifesaving Society UK

•Organiser of the UAE National Lifeguard Championships

The Royal Lifesaving Society The Royal Lifesaving Society UKUK

• Formed in 1891 by Mr William HenryFormed in 1891 by Mr William Henry

• Purpose - to reduce the number of Purpose - to reduce the number of drowningsdrownings

• Granted Royal charter in 1924 by Granted Royal charter in 1924 by King George VKing George V

• RLSS UK – 51 BranchesRLSS UK – 51 Branches

• RLSS Worldwide – 53 CountriesRLSS Worldwide – 53 Countries

The National Pool Lifeguard AwardThe National Pool Lifeguard Award

• UNIT 1:UNIT 1: The Principles of Lifesaving & The Principles of Lifesaving & Swimming Pool SupervisionSwimming Pool Supervision

• Lifeguard theoryLifeguard theory• Water rescue skillsWater rescue skills• CPR knowledge and skillsCPR knowledge and skills• First Aid at Work knowledge and skillsFirst Aid at Work knowledge and skills

The National Pool Lifeguard AwardThe National Pool Lifeguard Award

• UNIT 2:UNIT 2: The Application of Supervision The Application of Supervision and and Rescue in a Swimming PoolRescue in a Swimming Pool

• The Lifeguard and the Law.The Lifeguard and the Law.

• The Swimming Pool and the role of the Lifeguard.The Swimming Pool and the role of the Lifeguard.

• Normal Operating Procedures. Normal Operating Procedures.

• Emergency Action Plan.Emergency Action Plan.

• Provision and Use of Play Equipment.Provision and Use of Play Equipment.

• Flumes, Waterslides and other water features.Flumes, Waterslides and other water features.

• Diving in PoolsDiving in Pools

Unsuccessful CandidatesUnsuccessful Candidates• Failure of one Element, may require Failure of one Element, may require

additional training followed by a additional training followed by a retake of that entire Element within retake of that entire Element within 28 days.28 days.

• Failure of more than one Element will Failure of more than one Element will result in total failure of the course, result in total failure of the course, this will require the candidate to this will require the candidate to undertake the Unit 1 course again.undertake the Unit 1 course again.

The Rules and The Rules and Regulation'sRegulation's

• MOBILE PHONES OFF or SWITCHED TO MOBILE PHONES OFF or SWITCHED TO SILENTSILENT

• Must follow guidelines laid down by the Must follow guidelines laid down by the Trainer Trainer

• AAll medical problems must be reported to ll medical problems must be reported to the Trainerthe Trainer

• Swimming to a depth of 1.5 metres may Swimming to a depth of 1.5 metres may cause ear damagecause ear damage

• No Jewellery (Including Watches) during No Jewellery (Including Watches) during practical water sessionspractical water sessions

Why become aWhy become a Lifeguard?Lifeguard?

• Keep fitKeep fit

• Have funHave fun

• Make good friendsMake good friends

• TravelTravel

• Learn lifesaving Learn lifesaving skillsskills

• SunSun

• It’s cool!It’s cool!

• The girls/ boys love The girls/ boys love it!it!

• To help/ teach To help/ teach peoplepeople

• MoneyMoney

• Accident Prevention and Water Safety Accident Prevention and Water Safety EducationEducation

The Main aims of a LifeguardThe Main aims of a Lifeguard

The Role of a LifeguardThe Role of a Lifeguard

• CCommunicatioommunicationn

• RRescue escue

• OObservationbservation

• FFirst Aid irst Aid

• TTeamworkeamwork

• SSupervisionupervision

PREVENTION

Hazards & Risk AssessmentsHazards & Risk Assessments

Hazard• Something that has the potential to cause harmSomething that has the potential to cause harm

Risk• The likelihood of that thing causing harmThe likelihood of that thing causing harm

Risk Assessments• Identifying hazards, measuring the risk Identifying hazards, measuring the risk

and putting in control measure to and putting in control measure to minimise chancesminimise chances

HazardsHazards

•People HazardsPeople Hazards

•Activity HazardsActivity Hazards

•Physical HazardsPhysical Hazards

•Lifeguard HazardsLifeguard Hazards

Lifeguards MUST be fully aware of the individual Hazards presented by the design of the pool, the users of the pool, what the

users are doing and the hazards created by themselves.

People HazardsPeople Hazards• Young Children not accompanied by Young Children not accompanied by

an Adultan Adult• Old Old • Special NeedsSpecial Needs• TimidTimid• Boisterous / Show off’sBoisterous / Show off’s• Weak Swimmers / Arm BandsWeak Swimmers / Arm Bands• Under the Influence of Alcohol or Under the Influence of Alcohol or

DrugsDrugs• Poor HealthPoor Health

Physical HazardsPhysical Hazards• High WallsHigh Walls• Slippery SurfacesSlippery Surfaces• Drain CoversDrain Covers• GutteringGuttering• Underwater Steps / Underwater Steps /

Step laddersStep ladders• FeaturesFeatures• Pool Design / SizePool Design / Size• DepthDepth• LightingLighting

Activity HazardsActivity Hazards

• Ducking Ducking

• Fighting / BullyingFighting / Bullying

• RunningRunning

• GymnasticsGymnastics

• Boisterous Games Boisterous Games

• Distance Swimming Distance Swimming Under Water Under Water (Hyperventilation)(Hyperventilation)

• Pushing in Pushing in • BombingBombing• Dangerous DivingDangerous Diving• Flippers / Fins / Face Flippers / Fins / Face

Masks / SnorkelsMasks / Snorkels

Lifeguard HazardsLifeguard Hazards• New Lifeguards New Lifeguards

• HorseplayHorseplay

• Poor Lifeguard Poor Lifeguard Position Position

• Swinging Whistle Swinging Whistle

• Trivial Chatting Trivial Chatting

• Back to the Pool Back to the Pool

• Untrained Untrained

• Attention WandersAttention Wanders• Other Whistle BlowingOther Whistle Blowing• Observation but not Observation but not

supervision or actionsupervision or action• Timid LifeguardsTimid Lifeguards

TASKTASK

In groups, take a close look at the pool facility. List down as many of the following as possible;

•POTENTIAL HAZARDS

•HOW DANGEROUS ARETHEY? (Low/Medium/High)

•HOW THEY COULD BE CONTROLLED

Supervision & ObservationSupervision & Observation

What’s the difference?What’s the difference?

• Observation = watching Observation = watching

• Supervision = watching & controllingSupervision = watching & controlling

10 = 10 = seconds for the Lifeguard to seconds for the Lifeguard to recognise a guest in distressrecognise a guest in distress

20 = 20 = seconds for the Lifeguard to seconds for the Lifeguard to reach reach the guest and begin to the guest and begin to help themhelp them

“ “ Lifeguard Vigilance Training”Lifeguard Vigilance Training”

PART 1PART 1

‘‘Disappearing Dummies’ Disappearing Dummies’

What Lifeguards Can’t see.What Lifeguards Can’t see.

Dr Tom GriffithsDr Tom Griffiths

ZoningZoning

Zoning helps Lifeguards to Zoning helps Lifeguards to understand where their areas of understand where their areas of direct responsibility are.direct responsibility are.

There are 3 standard types of zoning, There are 3 standard types of zoning, they are……they are……

Intensive ZoningIntensive Zoning

• The Lifeguard is responsible for a The Lifeguard is responsible for a specific area of water, or water specific area of water, or water feature……feature……

……for example…..for example…..

Diving pools, water slides, wave Diving pools, water slides, wave machine outletsmachine outlets

Extensive ZoningExtensive Zoning

Usually found in smaller, traditionally Usually found in smaller, traditionally designed pools.designed pools.

• Each Lifeguard is responsible for Each Lifeguard is responsible for scanning the entire pool areascanning the entire pool area

• Each pool is observed by more than Each pool is observed by more than one Lifeguardone Lifeguard

Combined ZoningCombined Zoning

• This system uses both the intensive & This system uses both the intensive & extensive system togetherextensive system together

Intensive + Extensive = COMBINEDIntensive + Extensive = COMBINED

The Lifeguard Team work together to The Lifeguard Team work together to cover ‘special areas’ and ‘regular cover ‘special areas’ and ‘regular areas’areas’

INTENSIVE ZONING

EXTENSIVE ZONING

What is it?What is it?

P – POOLP – POOL

S – SAFETYS – SAFETY

O – OPERATINGO – OPERATING

P – PROCEDURES P – PROCEDURES

P.S.O.PP.S.O.P

By LAW the activities in a pool and it’s By LAW the activities in a pool and it’s users MUST be managed by WRITTEN users MUST be managed by WRITTEN operating procedures.operating procedures.

These procedures MUST be;These procedures MUST be;

• Based on initial risk assessmentsBased on initial risk assessments

• Available to ALL employeesAvailable to ALL employees

• Understood AND followed by ALL staffUnderstood AND followed by ALL staff

P.S.O.PP.S.O.P

P.S.O.P’s are made up of TWO P.S.O.P’s are made up of TWO different sections. These are……different sections. These are……

• N.O.P – NORMAL OPERATING N.O.P – NORMAL OPERATING PROCEDUREPROCEDURE

• E.A.P – EMERGENCY ACTION PLANE.A.P – EMERGENCY ACTION PLAN

Normal Operating Normal Operating ProceduresProcedures

A set of instructions and information A set of instructions and information on what is needed to run a facility on on what is needed to run a facility on a regular day to day basisa regular day to day basis

Normal Operating Normal Operating ProceduresProcedures

• Lines of supervisionLines of supervision

• RotationsRotations

• Number of Number of lifeguardslifeguards

• UniformsUniforms

• EquipmentEquipment

etc….etcetc….etc

Types of things found in an NOP may Types of things found in an NOP may include;include;

• Pool depths & Pool depths & dimensionsdimensions

• Bather loadsBather loads

• A plan of the A plan of the buildingbuilding

• A list of hazards & A list of hazards & their control their control measuresmeasures

Emergency Action PlansEmergency Action Plans

A set of instructions and information A set of instructions and information on what to do in all foreseeable on what to do in all foreseeable emergency situationsemergency situations

Emergency Action PlansEmergency Action Plans

• EvacuationEvacuation• Casualty’s in the Casualty’s in the

waterwater• Serious injuriesSerious injuries• Structural failureStructural failure• Chemical spillagesChemical spillages

etc….etcetc….etc

Types of things found in an EAP may Types of things found in an EAP may include;include;

• Who calls the Who calls the emergency emergency servicesservices

• Types & locations Types & locations of emergency of emergency equipmentequipment

• OvercrowdingOvercrowding

• Lack of water Lack of water clarityclarity

The CHAIN of SurvivalThe CHAIN of Survival

A series of actions that should occur A series of actions that should occur to ensure a casualty has the best to ensure a casualty has the best chance of recoverychance of recovery

The CHAIN of SurvivalThe CHAIN of Survival

THETHE CHAIN OF SURVIVAL

1.1. Early Access – to get help!Early Access – to get help!

2.2. Early BASIC LIFE SUPPORT – to Early BASIC LIFE SUPPORT – to buy timebuy time

3.3. Early Defibrillation – to restart the Early Defibrillation – to restart the heartheart

4.4. Early ADVANCED LIFE SUPPORT – Early ADVANCED LIFE SUPPORT – to stabilise ( hospital)to stabilise ( hospital)

THE CHAIN OF SURVIVALTHE CHAIN OF SURVIVAL

• If one of the ‘links’ is broken the If one of the ‘links’ is broken the chain failschain fails

• If all links are completed the casualty If all links are completed the casualty has the BEST chance of recovery/ has the BEST chance of recovery/ survival.survival.

• This highlights the importance of This highlights the importance of calling for help EARLYcalling for help EARLY

PRACTICAL SESSIONPRACTICAL SESSION

• Casualty AssessmentCasualty Assessment

• Top to Toe surveyTop to Toe survey

• Recovery PositionRecovery Position

• Manikin IntroductionManikin Introduction

• CPR IntroductionCPR Introduction

Progressive RescueProgressive Rescue• Getting into the water should Getting into the water should

always always be as a be as a last resortlast resort.. When you When you enter enter the water you put yourself in a the water you put yourself in a lot lot more danger. PLUS you can no more danger. PLUS you can no longer longer retain your 10:20 scan.retain your 10:20 scan.

EVERYEVERY rescue is different so be rescue is different so be prepared and practice using prepared and practice using

rescue rescue equipment at your pool.equipment at your pool.

The Progressive Rescue The Progressive Rescue SequenceSequence• Talk Talk

• ReachReach

• ThrowThrow

- - - - - - - - - - - - - - - - - - - -

• WadeWade

• Swim with an aidSwim with an aid

• Swim and towSwim and tow

LEAST DANGEROUS

MOST DANGEROUS

Types of Rescue EquipmentTypes of Rescue Equipment

All types of rescue have advantages All types of rescue have advantages and disadvantages, these depend on:and disadvantages, these depend on:

• Type of casualtyType of casualty

• Number of casualtiesNumber of casualties

• LocationLocation

• SituationSituation

Types of Rescue EquipmentTypes of Rescue Equipment

• You!You!

• Rescue TubeRescue Tube

• Rescue Can/ Rescue Can/ Torpedo buoyTorpedo buoy

• Ring Buoy/ Perry Ring Buoy/ Perry BuoyBuoy

• Spine BoardSpine Board

• Shepherds HookShepherds Hook

• Reach PoleReach Pole

• Throw bagThrow bag

TASKTASK

Looking at the different types of equipment, working out the ADVANTAGES AND/OR DISADVANTAGES ( If there are any!) for the equipment .

Present your findings to the group.

Casualty RecognitionCasualty Recognition

Drowning non-swimmerDrowning non-swimmer

• Drowning non-swimmers struggle for Drowning non-swimmers struggle for a comparatively short time. It is this a comparatively short time. It is this shorter than expected period that shorter than expected period that contributes to many deaths.contributes to many deaths.

• Children commonly struggle for up to Children commonly struggle for up to 20 seconds.20 seconds.

• Adults commonly struggle for less Adults commonly struggle for less than one minute.than one minute.

• Drowning Non Drowning Non SwimmerSwimmer

• Distressed Weak Distressed Weak SwimmerSwimmer

• Injured SwimmerInjured Swimmer

• Unconscious SwimmerUnconscious Swimmer

Resuscitation & Resuscitation & How the body How the body

worksworks

Resuscitation InformationResuscitation Information• If a casualty’s brain has If a casualty’s brain has

not had oxygen for not had oxygen for more than 45 Seconds more than 45 Seconds the brain will begin to the brain will begin to die!die!

• The Most important The Most important part of our brains is the part of our brains is the central point, this is central point, this is what begins to die first.what begins to die first.

BACKGROUNDBACKGROUND

• Approximately 700,000 Approximately 700,000 cardiac arrests per year in cardiac arrests per year in EuropeEurope

• Survival to hospital Survival to hospital discharge presently discharge presently approximately 5-10%approximately 5-10%

• Bystander CPR vital Bystander CPR vital intervention before arrival intervention before arrival of emergency servicesof emergency services

• Early resuscitation and Early resuscitation and prompt defibrillation (within prompt defibrillation (within 1-2 minutes) can result in 1-2 minutes) can result in >60% survival>60% survival

Basic Anatomy (Air Route)Basic Anatomy (Air Route)• Air enters the Mouth and Air enters the Mouth and

Nose.Nose.• Pharynx - (Warms and Pharynx - (Warms and

Moistens the Air.Moistens the Air.• Larynx - Voice Box also Larynx - Voice Box also

Seals air route in the Seals air route in the event of drowning.event of drowning.

• Epiglottis - A Flap guides Epiglottis - A Flap guides food to oesophagus food to oesophagus (Stomach) or Air to the (Stomach) or Air to the Trachea.Trachea.

• Bronchus - Alveoli (Gas Bronchus - Alveoli (Gas Exchange)Exchange)

Respiration (Breathing)Respiration (Breathing)

• We breathe in “air”We breathe in “air”• 21% of this is oxygen (O2)21% of this is oxygen (O2)• The Body uses 5%The Body uses 5%• We breathe out 16%We breathe out 16%• O2 is exchanged for Carbon Dioxide O2 is exchanged for Carbon Dioxide

(CO2) in the lungs(CO2) in the lungs• Oxygen (O2) feeds the body.Oxygen (O2) feeds the body.

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call for EMS

30 chest compressions2 Rescue breaths

ADULT, CHILD & BABY CPR

Give 5 Rescue Breaths

APPROACH SAFELY!APPROACH SAFELY!

SceneScene

RescuerRescuer

VictimVictim

BystandersBystanders

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call EMS

30 chest compressions

2 rescue breaths

CHECK RESPONSECHECK RESPONSE

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 112

2 rescue breaths

Shake shoulders gently

Ask “Are you all right?”

If he responds

• Leave as you find him.

• Find out what is wrong.

• Reassess regularly.

CHECK RESPONSECHECK RESPONSE

SHOUT FOR HELPSHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call EMS

2 rescue breaths

OPEN AIRWAYOPEN AIRWAY

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 112

2 rescue breaths

CHECK BREATHINGCHECK BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call EMS

2 rescue breaths

CHECK BREATHINGCHECK BREATHING

• Look, listen and Look, listen and feel for NORMAL feel for NORMAL breathingbreathing

• Do not confuse Do not confuse agonal breathing agonal breathing with NORMAL with NORMAL breathingbreathing

AGONAL BREATHINGAGONAL BREATHING

• Occurs shortly after the Occurs shortly after the heart stops heart stops

in up to 40% of cardiac in up to 40% of cardiac arrestsarrests

• Described as barely, Described as barely, heavy, noisy or gasping heavy, noisy or gasping breathingbreathing

• Recognise as a sign of Recognise as a sign of cardiac arrestcardiac arrest

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call EMS

2 rescue breaths

CALL EMSCALL EMS

30 CHEST 30 CHEST COMPRESSIONSCOMPRESSIONS

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call EMS

2 rescue breaths

• Place the heel of one hand in the centre of the chest

• Place other hand on top

• Interlock fingers

• Compress the chest– Rate 100 min-1

– Depth 4-5 cm

– Equal compression : relaxation

• When possible change CPR operator every 2 min

CHEST COMPRESSIONSCHEST COMPRESSIONS

RESCUE BREATHSRESCUE BREATHS

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call EMS

2 rescue breaths

RESCUE BREATHSRESCUE BREATHS

• Pinch the nosePinch the nose

• Take a normal breathTake a normal breath

• Place lips over mouthPlace lips over mouth

• Blow until the chest Blow until the chest risesrises

• Take about 1 secondTake about 1 second

• Allow chest to fallAllow chest to fall

• RepeatRepeat

CONTINUE CPRCONTINUE CPR

3030 22

ONLY STOP ONLY STOP IFIF…………

1.You are too tired to continue2.The scene becomes unsafe and

you cannot move the casualty3.If the EMS staff take over4.If a team member/ trained member

of staff takes over5.If the casualty comes round (highly

un-likely!!)

ADULT ADULT RESUSCITATION – RESUSCITATION –

SUDDEN SUDDEN COLLAPSECOLLAPSE

Problems with Problems with ResuscitationResuscitation

• Broken RibsBroken Ribs - Continue - Continue CPR Breathing is more CPR Breathing is more importantimportant

• TracheotomyTracheotomy - Seal the - Seal the Mouth and nose and Mouth and nose and breath through the hole breath through the hole in the neck (Stoma)in the neck (Stoma)

• Air in StomachAir in Stomach - Extend - Extend the Neck Morethe Neck More

• Vomit -Vomit - Place the Place the Casualty into the Action Casualty into the Action for Vomit Positionfor Vomit Position

• Injury to Mouth or Injury to Mouth or NoseNose - Use a Mask or - Use a Mask or use the nose or mouthuse the nose or mouth

• Cold Casualties -Cold Casualties - Check Check Pulse for 1 MinutePulse for 1 Minute

• Not InflatingNot Inflating - Check for - Check for Obstruction and treat for Obstruction and treat for choking or Extend the choking or Extend the Neck with Babies check Neck with Babies check for over extensionfor over extension

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call for EMS

30 chest compressions2 rescue breaths

ADULT – DROWNING

Give 5 rescue breaths

ADULT ADULT RESUSCITATION – RESUSCITATION –

DROWNINGDROWNING

CPR ON CHILDRENCPR ON CHILDREN

AGES 1YR TO 8YRSAGES 1YR TO 8YRS

1.1.ASK PARENTS IF YOU ASK PARENTS IF YOU CAN HELPCAN HELP

2.2.BE MORE GENTLE THAN BE MORE GENTLE THAN ON AN ADULTON AN ADULT

3.3.MAKE YOUR RESCUE MAKE YOUR RESCUE BREATH SMALLERBREATH SMALLER

4.4.USE 1 HAND FOR USE 1 HAND FOR COMPRESSIONSCOMPRESSIONS

5.5.ONLY PRESS TO 1/3 OF ONLY PRESS TO 1/3 OF THE BODY DEPTHTHE BODY DEPTH

CHILD CHILD RESUSCITATION – RESUSCITATION – ALL SITUATIONSALL SITUATIONS

CPR ON INFANTSCPR ON INFANTS

AGES 0YR TO 1YRAGES 0YR TO 1YR

1.1.ASK PARENTS IF YOU ASK PARENTS IF YOU CAN HELPCAN HELP

2.2.BE BE VERYVERY GENTLE GENTLE3.3.MAKE YOUR RESCUE MAKE YOUR RESCUE

BREATH A ‘PUFF’BREATH A ‘PUFF’4.4.USE 2 FINGERS FOR USE 2 FINGERS FOR

COMPRESSIONSCOMPRESSIONS5.5.ONLY PRESS TO 1/3 OF ONLY PRESS TO 1/3 OF

THE BODY DEPTHTHE BODY DEPTH

INFANT INFANT RESUSCITATION – RESUSCITATION – ALL SITUATIONSALL SITUATIONS

The Recovery PositionThe Recovery Position

• If the casualty is breathing and has a If the casualty is breathing and has a regular heart rhythm but is regular heart rhythm but is unconscious…unconscious…

• Do a full Secondary Survey, then…Do a full Secondary Survey, then…

• Place the person in the Recovery Place the person in the Recovery position…position…

The Recovery Position

Communication

There are many forms of communication, that a Lifeguard might come across.

Name as many as you can…

VoiceWhistle

Megaphone

Walkie TalkieFlags

Alarms – Visual/ Audible

Body Language

Hand Signals

Mobile Phone

One Blast

Lifeguard Communications

Two Blasts

Three BlastsAttracts the attention of a Lifeguard

Indicates that emergency action is about to take place

Attracts the attention of a bather

One Long BlastIndicates the Pool should be cleared.

Pool AlarmPool Alarm•Pool Alarm Pool Alarm must be must be activated in activated in the event of a the event of a major incident.major incident.

CommunicationCommunication

Verbal Communications between lifeguards who are on pool duty should be kept to a minimum - Hazard reports only.

Lifeguard Communication - Lifeguard Communication - Hand SignalsHand Signals

Look There

StopOK - Understand

FIRST AIDFIRST AID

The Aims of First AidThe Aims of First Aid

•The Three ‘P’sThe Three ‘P’s•Preserve Preserve - The vital signs of the - The vital signs of the

Casualty and ultimately the life of Casualty and ultimately the life of the Casualtythe Casualty

•Prevent Prevent - Further Injury and - Further Injury and deteriorationdeterioration

•Promote Promote - Recovery of the Casualty- Recovery of the Casualty

First Aid ProcedureFirst Aid Procedure

• AssessAssess the situation, Is it the situation, Is it SAFE FOR YOUSAFE FOR YOU to Enter ! ! ! to Enter ! ! !

• DiagnoseDiagnose the Injuries, the Injuries, Priorities multiple injuries, Priorities multiple injuries, using the three ‘B’susing the three ‘B’s

• TreatTreat the injuries the injuries

• TransferTransfer the Casualties. the Casualties.

Assess the Assess the SituationSituation

•Look all around the areaLook all around the area•Check for GasCheck for Gas•Never attempt a rescue when Never attempt a rescue when

high voltage is the causehigh voltage is the cause•Never directly touch domestic Never directly touch domestic

cables if they have caused the cables if they have caused the injury.injury.

DiagnoseDiagnose• History

• Symptoms

• Signs

What happened ?

What Casualties tell you !

What is happening to the casualty ?

S.A.M.P.L.E QUESTIONSS.A.M.P.L.E QUESTIONS

• S – Signs & SymptomsS – Signs & Symptoms

• A – AllergiesA – Allergies

• M – MedicationM – Medication

• P – Previous HistoryP – Previous History

• L – Last Oral intakeL – Last Oral intake

• E – Events leading up toE – Events leading up to

The Four ‘B’sThe Four ‘B’s• BBreathingreathing

– Check for Airway, Breathing and signs of Check for Airway, Breathing and signs of Circulation.Circulation.

• BBleedingleeding– Check for signs of severe bleeding.Check for signs of severe bleeding.

• BBroken Bonesroken Bones– Check for fracturesCheck for fractures

• BBurnsurns– Check for burns.Check for burns.

Hygiene MeasuresHygiene Measures• Always wear Always wear

protective gloves and protective gloves and wash hands before wash hands before and after use.and after use.

• Aprons as uniform Aprons as uniform offers little protection. offers little protection.

• Never talk or cough Never talk or cough over a wound or over a wound or dressing.dressing.

• Clean and blood / Body Clean and blood / Body fluids with 1:10 fluids with 1:10 disinfectant.disinfectant.

• Dispose of any used Dispose of any used medical dressings in a medical dressings in a yellow bio-hazard bag and yellow bio-hazard bag and ensure bag is incinerated. ensure bag is incinerated.

• Needles should be Needles should be disposed of in a sharp disposed of in a sharp needle box.needle box.

Recording and After Recording and After CareCare

• Accident Form Accident Form • Staff Accident BookStaff Accident Book

– DetailedDetailed– AccurateAccurate– ClearClear

• Rescue Report FromRescue Report From• Witness Report FormsWitness Report Forms• Incident ReportIncident Report

Basic First Aid Basic First Aid TreatmentsTreatments

• AsphyxiaAsphyxia• BleedingBleeding• BurnsBurns• Heart AttackHeart Attack• Asthma AttackAsthma Attack• Epileptic FitEpileptic Fit• Diabetic AttackDiabetic Attack• Chest InjuryChest Injury• Eye InjuryEye Injury

• Electric ShockElectric Shock

• ShockShock

• FracturesFractures

• FaintingFainting

• UnconsciousnessUnconsciousness

• Sprains and Sprains and StrainsStrains

• PoisoningPoisoning

• Choking.Choking.

Causes of Causes of AsphyxiaAsphyxia

• DrowningDrowning

• Gas PoisoningGas Poisoning

• Severe bleedingSevere bleeding

• Chest injuryChest injury

• Deep unconsciousnessDeep unconsciousness

• Drug overdoseDrug overdose

• Electric shockElectric shock

• SuffocationSuffocation

DrowningDrowning

““Death by asphyxia caused Death by asphyxia caused by immersion in liquid”by immersion in liquid”

Wet DrowningWet Drowning

• Form of Asphyxia Form of Asphyxia insufficient oxygen insufficient oxygen reaches the blood.reaches the blood.

• Initial Stages of Initial Stages of Drowning.Drowning.Submerged water Submerged water enters mouth enters mouth automatically safety automatically safety mechanism closes mechanism closes Larynx (Apnea). Larynx (Apnea).

• WET DROWNING.WET DROWNING. Unconscious casualty Unconscious casualty larynx opens, water larynx opens, water will enter lungs.will enter lungs.

Dry DrowningDry Drowning

•Larynx Closes and remains closed.•Common in Children airway.•Treatment for Shock and Monitor A - B - C.

Secondary Drowning Secondary Drowning

• Small amount of Small amount of water in lungs water in lungs interfere with interfere with diffusion.diffusion.

• Delayed up to 72 Delayed up to 72 Hrs.Hrs.

• Medical attention for Medical attention for all near drowning all near drowning even if full recovery.even if full recovery.

HyperventilationHyperventilation

• Rapid, deep breathingRapid, deep breathing

• Some swimmers believe Some swimmers believe increases oxygen content.increases oxygen content.

• Reduces CO2 level in Reduces CO2 level in blood.blood.

• CO2 levels helps the brain CO2 levels helps the brain control breathing.control breathing.

• CO2 levels fall desire to CO2 levels fall desire to breath reduced. breath reduced.

• Physical activity Physical activity uses up oxygen uses up oxygen before CO2 level has before CO2 level has reached a point to reached a point to restore breathing.restore breathing.

• Runs out of oxygen Runs out of oxygen and looses and looses consciousness.consciousness.

BleedingBleedingTypes of woundsTypes of wounds

• Laceration – TearLaceration – Tear

• Abrasion – GrazeAbrasion – Graze

• Contusion – Bruise ( internal)Contusion – Bruise ( internal)

• PuncturePuncture

• Stab/ incised – knife or sharp edged Stab/ incised – knife or sharp edged objectobject

• Gunshot woundGunshot wound

Major BleedingMajor Bleeding

• Sit or lie the Sit or lie the casualty downcasualty down

• Scan the wound for Scan the wound for foreign bodiesforeign bodies

• Put some medical Put some medical gloves ongloves on

• Elevate the LimbElevate the Limb• Apply direct Apply direct

PressurePressure• Clean and Dress Clean and Dress

the woundthe wound..

Major Bleeding Foreign Major Bleeding Foreign BodyBody

• Lie or sit the Lie or sit the casualty downcasualty down

• Scan the woundScan the wound

• Put some medical Put some medical gloves ongloves on

• Apply pressure Apply pressure either side of the either side of the wound.wound.

• Place two Place two dressings dressings rolled up either rolled up either side of the side of the foreign body.foreign body.

• Apply pressure Apply pressure two both sides of two both sides of the foreign bodythe foreign body

• Bandage around Bandage around the foreign body.the foreign body.

““GRAB THE BLEEDER,GRAB THE BLEEDER,

RAISE THE BLEEDER,RAISE THE BLEEDER,

LAY THE BLEEDER DOWN”LAY THE BLEEDER DOWN”

Burns & ScaldsBurns & ScaldsCan be caused by….Can be caused by….

• Flames, contact with hot surfaces, frictionFlames, contact with hot surfaces, friction( Dry burn)( Dry burn)

• Steam, hot liquids ( Scald)Steam, hot liquids ( Scald)• Low/ high voltage currents, lightning Low/ high voltage currents, lightning

( Electrical burn) ( Electrical burn)• Chemicals ( fumes, gases, cleaning fluid)Chemicals ( fumes, gases, cleaning fluid)• Sun/ radiation ( Radiatation burn) Sun/ radiation ( Radiatation burn)

BurnsBurns• TreatmentTreatment• Alert the lifeguard teamAlert the lifeguard team• A casualty should be sent to hospital if:A casualty should be sent to hospital if:

– He or she is a childHe or she is a child– The burn is the full depth of the skin The burn is the full depth of the skin – Burns extend around a limbBurns extend around a limb– You are unsure about the extent of a burnYou are unsure about the extent of a burn– Burns cover the feet, hands, face or genitalsBurns cover the feet, hands, face or genitals– Burns cover an area greater than the size of the palm of the hand.Burns cover an area greater than the size of the palm of the hand.

• Immerse the affected area in very cold running water for at least Immerse the affected area in very cold running water for at least ten ten minutesminutes

• If the clothing is stuck to the burned area, don’t try to remove it.If the clothing is stuck to the burned area, don’t try to remove it.• Remove any rings, watches or jewelleryRemove any rings, watches or jewellery• Cover the burn with a clean, dry, sterile dressing with a lightly Cover the burn with a clean, dry, sterile dressing with a lightly

applied bandageapplied bandage• Treat for shockTreat for shock

ScaldsScalds• Submerge under Submerge under

water for ten minuteswater for ten minutes• Do not remove any Do not remove any

clothing that is stuck clothing that is stuck to the skin.to the skin.

• Do not burst any Do not burst any blistersblisters

• Remove Wrist Watch Remove Wrist Watch or Rings.or Rings.

Heart Attack Heart Attack (Symptoms and Signs)(Symptoms and Signs)

•Chest PainChest Pain•Tightness of Tightness of

ChestChest•Pain in the left Pain in the left

armarm•Pale clammy Pale clammy

skin.skin.

Heart Attack TreatmentHeart Attack Treatment

• Sit the Casualty Down in Sit the Casualty Down in a Semi-recumbent a Semi-recumbent Position.Position.

• Ask if they have any Ask if they have any medication ?medication ?

• Call for a Paramedic Call for a Paramedic Unit ! Unit !

• If they fall Unconscious If they fall Unconscious check A.B.Signs of Lifecheck A.B.Signs of Life

• Carry our full C.P.R.Carry our full C.P.R.

Heart Problem Heart Problem (Angina)(Angina)

•Possibly knows Possibly knows what's what's happeninghappening

•Similar Similar Symptoms and Symptoms and signs of Heat signs of Heat Attack.Attack.

FaintingFainting• Lack of Blood (Oxygen) to Lack of Blood (Oxygen) to

the Brain - Face Pale, Skin the Brain - Face Pale, Skin cold / Clammy, Shallow cold / Clammy, Shallow breathing. breathing.

• Treatment lay down the Treatment lay down the casualty and raise legscasualty and raise legs

• Place casualty into the Place casualty into the recovery position if recovery position if casualty does not come casualty does not come round.round.

ASTHMAASTHMA

The muscles of the air The muscles of the air passages go into spasm passages go into spasm and swell, making and swell, making breathing difficultbreathing difficult

CausesCauses

•AllergyAllergy

•A coldA cold

•Particular DrugsParticular Drugs

•Cigarette smokeCigarette smoke

•No obvious triggerNo obvious trigger

Signs & SymptomsSigns & Symptoms

• Difficulty in breathing outDifficulty in breathing out

• WheezingWheezing

• Difficulty in speakingDifficulty in speaking

• Grey/ blue tinge to lips ( cyanosis)Grey/ blue tinge to lips ( cyanosis)

• Distress/ anxietyDistress/ anxiety

• CoughCough

• ExhaustionExhaustion

TreatmentTreatment

• Calm and Re-assureCalm and Re-assure

• Give them their in-haler to useGive them their in-haler to use

• Ask to breathe slowly and deeplyAsk to breathe slowly and deeply

• Make them comfortableMake them comfortable

A mild asthma attack should ease in 3 A mild asthma attack should ease in 3 minsmins

CALL EMS IF………CALL EMS IF………

• If it is their first attackIf it is their first attack

• The inhaler has no effect after 5 The inhaler has no effect after 5 minutesminutes

• The casualty is getting worseThe casualty is getting worse

• Talking is difficultTalking is difficult

• The casualty is becoming exhaustedThe casualty is becoming exhausted

TreatmentTreatment

• Treat the causeTreat the cause• Lay the casualty downLay the casualty down• Calm/ re-assureCalm/ re-assure• Raise the legsRaise the legs• Loosen tight clothingLoosen tight clothing• Keep casualty warmKeep casualty warm• Call EMSCall EMS• Monitor vital signsMonitor vital signs

Electric ShockElectric Shock • Your Safety 1st.Your Safety 1st.

• Never Attempt a Never Attempt a Rescue when high Rescue when high Voltage is the cause Voltage is the cause (Sub Stations)(Sub Stations)

• Isolate the electrical Isolate the electrical Supply, turn of the Supply, turn of the switch using aswitch using a

non-conductive item.non-conductive item.

• Use a non-Use a non-Conductive Pole to Conductive Pole to remove any remove any electrical Applianceselectrical Appliances

• Check A.B.C if Check A.B.C if UnconsciousUnconscious

• Minor blister on Minor blister on Entry and ExitEntry and Exit

• Major internal BurnsMajor internal Burns

ShockShock

“ “ Failure of the circulatory Failure of the circulatory systems to supply blood to systems to supply blood to the vital organs”the vital organs”

CausesCauses

• Severe blood lossSevere blood loss

• DiarrhoeaDiarrhoea

• VomitingVomiting

• Severe burnsSevere burns

• Heart diseaseHeart disease

• InfectionInfection

• Low blood sugarLow blood sugar

• HypothermiaHypothermia

• Severe allergic Severe allergic reactionreaction

• Spinal cord injurySpinal cord injury

• TraumaTrauma

Signs & SymptomsSigns & Symptoms• Rapid pulseRapid pulse

• Pale, cold clammy Pale, cold clammy skinskin

• Grey/ blue skinGrey/ blue skin

• Weakness/ dizzinessWeakness/ dizziness

• NauseaNausea

• ThirstThirst

• Rapid/ shallow Rapid/ shallow breathingbreathing

• RestlessnessRestlessness

• AggressivenessAggressiveness

• Yawning/ gasping Yawning/ gasping for airfor air

Diabetes

Failure of the body to regulate blood sugar levels adequately

There are 2 major types of diabetes…….

•HYPER – Glycaemia HIGH blood sugar

•HYPO – Glycaemia LOW blood sugar

Signs & Symptoms of HYPO….• Pale

• Profuse Sweating

• Rapid Pulse

• Shallow breathing

• Fainting

• Unconsciousness

• Trembling

• Confusion

• Aggressive

• May appear to be drunk

Treatment of Hypoglycaemia

• If conscious give them a sweet drink

•Only give candy IF you think the person is capable of swallowing it

•Calm them/ re-assure them

•Make them comfortable

•Keep them warmIf they don’t improve call for help asap

Epilepsy

“Irregular electrical activity in the brain”

Minor FitMinor FitSymptoms and Symptoms and

SignsSigns• 1. Dazed Look1. Dazed Look

TreatmentTreatment• Allow to come out Allow to come out

of fit naturally.of fit naturally.

Major FitMajor FitSymptoms, Signs and StagesSymptoms, Signs and Stages1. Cry out1. Cry out

2. Rigid Body2. Rigid Body

3. Convulsions3. Convulsions

4. Sleep4. Sleep

TreatmentTreatment• Remove any ObstructionsRemove any Obstructions

• Support person so head remains above waterSupport person so head remains above water

• Recovery Position.Recovery Position.

• Send to HospitalSend to Hospital

FracturesFractures

TypesTypes

1.1. Closed – Skin is NOT brokenClosed – Skin is NOT broken

2.2. Open – bone is exposedOpen – bone is exposed

3.3. Complicated – bone has caused Complicated – bone has caused damage to other internal areasdamage to other internal areas

Treatment - CLOSEDTreatment - CLOSED

1.1. Immobilise – sling/ bandage/ splintImmobilise – sling/ bandage/ splint

2.2. Calm/ Re-assure casualtyCalm/ Re-assure casualty

3.3. Treat for signs of shockTreat for signs of shock

4.4. Monitor vital signsMonitor vital signs

5.5. Arrange for transport to hospitalArrange for transport to hospital

Treatment- OPENTreatment- OPEN

• ImmobiliseImmobilise

• Control bleedingControl bleeding

• Prevent infectionPrevent infection

• Calm/ Re-assure casualtyCalm/ Re-assure casualty

• Treat for signs of shockTreat for signs of shock

• Call EMSCall EMS

SPINAL INJURIESSPINAL INJURIES

Types of injuriesTypes of injuries

• Flexion – head is forced forwardsFlexion – head is forced forwards

• Extension – head is forced backwardsExtension – head is forced backwards

• Compression – spine is compactedCompression – spine is compacted

• Fracture – vertebrae fractureFracture – vertebrae fracture

• Dislocation – vertebrae are moved Dislocation – vertebrae are moved out of positionout of position

Signs & Symptoms• Pain

•Irregular shape

•Tenderness

•Loss of control of limbs

•Loss of sensation

•Loss of bladder/ bowel control

•Breathing difficulties

TreatmentTreatment

• Immobilise the affected areaImmobilise the affected area

• Calm/ re-assure the casualtyCalm/ re-assure the casualty

• Monitor vital signsMonitor vital signs

ShockShock

“ “ Failure of the circulatory Failure of the circulatory systems to supply blood to systems to supply blood to the vital organs”the vital organs”

CausesCauses

• Severe blood lossSevere blood loss

• DiarrhoeaDiarrhoea

• VomitingVomiting

• Severe burnsSevere burns

• Heart diseaseHeart disease

• InfectionInfection

• Low blood sugarLow blood sugar

• HypothermiaHypothermia

• Severe allergic Severe allergic reactionreaction

• Spinal cord injurySpinal cord injury

• TraumaTrauma

Signs & SymptomsSigns & Symptoms• Rapid pulseRapid pulse

• Pale, cold clammy Pale, cold clammy skinskin

• Grey/ blue skinGrey/ blue skin

• Weakness/ dizzinessWeakness/ dizziness

• NauseaNausea

• ThirstThirst

• Rapid/ shallow Rapid/ shallow breathingbreathing

• RestlessnessRestlessness

• AggressivenessAggressiveness

• Yawning/ gasping Yawning/ gasping for airfor air

TreatmentTreatment

• Treat the causeTreat the cause• Lay the casualty downLay the casualty down• Calm/ re-assureCalm/ re-assure• Raise the legsRaise the legs• Loosen tight clothingLoosen tight clothing• Keep casualty warmKeep casualty warm• Call EMSCall EMS• Monitor vital signsMonitor vital signs

FracturesFractures

TypesTypes

1.1. Closed – Skin is NOT brokenClosed – Skin is NOT broken

2.2. Open – bone is exposedOpen – bone is exposed

3.3. Complicated – bone has caused Complicated – bone has caused damage to other internal areasdamage to other internal areas

Treatment - CLOSEDTreatment - CLOSED

1.1. Immobilise – sling/ bandage/ splintImmobilise – sling/ bandage/ splint

2.2. Calm/ Re-assure casualtyCalm/ Re-assure casualty

3.3. Treat for signs of shockTreat for signs of shock

4.4. Monitor vital signsMonitor vital signs

5.5. Arrange for transport to hospitalArrange for transport to hospital

Treatment- OPENTreatment- OPEN

• ImmobiliseImmobilise

• Control bleedingControl bleeding

• Prevent infectionPrevent infection

• Calm/ Re-assure casualtyCalm/ Re-assure casualty

Heat Stroke/ Heat Heat Stroke/ Heat ExhaustionExhaustion

Heat ExhaustionHeat Exhaustion

Loss of salt and water from the body Loss of salt and water from the body through excess sweatingthrough excess sweating

Heat StrokeHeat Stroke

The failure of the ‘thermostat’ in the The failure of the ‘thermostat’ in the brain, which regulates body brain, which regulates body temperaturetemperature

Heat ExhaustionHeat Exhaustion

• Headache, dizziness, confusionHeadache, dizziness, confusion• Loss of appetite and nauseaLoss of appetite and nausea• SweatingSweating• Pale/ clammy skinPale/ clammy skin• CrampsCramps• Rapid, weak pulse & breathingRapid, weak pulse & breathing

TreatmentTreatment

• Shift to shade/ cool areaShift to shade/ cool area

• Give plenty of water – weak salt Give plenty of water – weak salt solution if possible/ weak sugary solution if possible/ weak sugary drinkdrink

• Lay the casualty downLay the casualty down

• Raise legsRaise legs

• Monitor vital signsMonitor vital signs

Heat StrokeHeat Stroke

• Headache dizziness and discomfortHeadache dizziness and discomfort

• Restlessness & confusionRestlessness & confusion

• Hot, flushed and DRY skinHot, flushed and DRY skin

• Rapid deterioration in level of responseRapid deterioration in level of response

• Full, bounding pulseFull, bounding pulse

• Body temperature above 40 degrees CBody temperature above 40 degrees C

TreatmentTreatment• Quickly move the casualty to a cool Quickly move the casualty to a cool

placeplace• Remove as much outer clothing as Remove as much outer clothing as

possiblepossible• Call EMSCall EMS• Cool the body by applying water until Cool the body by applying water until

temperature falls.temperature falls.• MonitorMonitor

HEAT STROKE IS A LIFE THREATENING ILLNESS

Sun BurnSun Burn

“ “ A burn caused by over A burn caused by over exposure to the sun”exposure to the sun”

• Red skinRed skin

• Pain in the area of the burnPain in the area of the burn

• Blistering of the area affectedBlistering of the area affected

TreatmentTreatment• Cover the casualty’s skin with light Cover the casualty’s skin with light

clothing or a towelclothing or a towel

• Cool the skin with water or by soaking Cool the skin with water or by soaking are in a cold bath for 10 minutesare in a cold bath for 10 minutes

• Encourage the casualty to have Encourage the casualty to have frequent sips of cold waterfrequent sips of cold water

• For mild burns, calamine lotion or after For mild burns, calamine lotion or after sun may helpsun may help

SHOCKSHOCK

““Failure of the circulatory Failure of the circulatory system to supply oxygen system to supply oxygen to the vital organs”to the vital organs”

Signs & SymptomsSigns & Symptoms• Rapid PulseRapid Pulse• Pale, cold, clammy Pale, cold, clammy

skinskin• Grey, blue skin Grey, blue skin

( cyanosis)( cyanosis)• Weakness/ dizzinessWeakness/ dizziness• Nausea/ vomitingNausea/ vomiting• ThirstThirst• Rapid, shallow Rapid, shallow

breathingbreathing

• RestlessnessRestlessness• AggressivenessAggressiveness• Yawning and Yawning and

gasping for airgasping for air• UnconsciousnessUnconsciousness

TreatmentTreatment

• Treat the causeTreat the cause

• Lay the casualty downLay the casualty down

• Calm/ Re-assureCalm/ Re-assure

• Raise and support legsRaise and support legs

• Loosen tight clothingLoosen tight clothing

• Keep the casualty warmKeep the casualty warm

• Call for EMSCall for EMS

DO NOTDO NOT• Eat, drink or smoke. ( If thirsty moisten Eat, drink or smoke. ( If thirsty moisten

lips with water)lips with water)

• Leave the casualty unattended, except Leave the casualty unattended, except to call for EMSto call for EMS

• Try to warm the casualty with a direct Try to warm the casualty with a direct heat sourceheat source

Remember…shock is LIFE THREATENINGRemember…shock is LIFE THREATENING

Anaphylactic Shock

“Potentially fatal MASSIVE allergic reaction”

Causes

• Insect Sting

•Food

•Animal

•Drug

Signs & Symptoms

• Shock

• Anxiety

• Swelling of the face and neck

• Blotchy Skin

• Puffiness around the eyes

• Impaired breathing

• Rapid Pulse

• Nausea

• Unconsciousness

Treatment

•Send to Hospital STRAIGHT AWAY

• If conscious get them to sit in a comfortable position

• If unconscious treat as normal

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