1. 2/11/12$
Gerald'M.'Dworkin'
Consultant,'
Aquatics'Safety'&'Water'Rescue'
Lifesaving'Resources,'LLC'
www.lifesaving.com'
'
Developed(for(
National'Drowning'Prevention'Symposium'
(2012)'
'
'
!
!
THE!POWER!OF!WATER!
!
THE!POWER!OF!WATER!SHOULD!NEVER!BE!UNDERESTIMATED+
2!ITS!BEAUTY,!STRENGTH+OR!FORCE.!
!
LIFE!CANNOT!EXIST!WITHOUT!WATER.!
IT!EMPOWERS+US!AND!COMMANDS!RESPECT.!!
!
BE!READY+FOR!IT!!
!
!
www.lifesaving.com!
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26'
Gerald'M.'Dworkin'
Consultant,'
Aquatics'Safety'&'Water'Rescue'
Lifesaving'Resources,'LLC'
www.lifesaving.com'
'
Developed(for(
National'Drowning'Prevention'Symposium'
(2012)'
'
'
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PRINCIPLES$
! Rule'of'Numbers' ! Emergency'Action'Plans'(EAPs)'
! PRM'Factors' ! Emergency'Response'Plans'(ERPs)'
! RID'Factors' ! Incident'Command'(IC)'&'Incident'
! Threat'Assessment'&'HRD'Factors' Action'Plans'(IAPs)'
! Suction'Entrapment'&'VGB'Act' ! Spinal'Injury'Management'&'
! Legal'Responsibility'&'Liability'
Mechanism'of'Injury'(MOI)'
Factors' ! Body'Substance'Isolation'(BSI)'
! Rules,'Regulations'&'EEC'Factors' Protocols'
! Layers'of'Protection'(LOP)' ! Rescue'Priorities'
! Management'of'Hypoxia'(MOH)'
! Surveillance'Protocols'
! Standard'Operating'Procedures' ! Positive'Pressure'Ventilation'(PPV)'
Protocols'
(SOPs)'
! FacilityUUse'Guidelines'(FUG)' ! CPR'Protocols'
! AED'Protocols'
28'
MURPHY’S$LAWS$
1. Anything'that'can'happen'–'will'happen.'
2. When'it'does,'it'will'happen'at'the'least'opportune'time.'
3. Mother'Nature'is'a'Bitch!'
29'
1.''Anything'that'can'happen'–'will'happen.'
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2. When'it'does,'it'will'happen'at'the'least'opportune'time.'
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3.''Mother'Nature'is'a'Bitch!'
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EMERGENCY$RESPONSE$PLAN$
THUNDER$&$LIGHTNING$STORMS$
! Recognize(the'Danger'
! Evacuate(all'Patrons'&'Staff'
! Return(Procedures'
Policy'Development'
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RULE$OF$NUMBERS$
'
Frequency!:'Probability!
'
The'more'patrons'who'use'your'facility'increases'the'
probability'of'a'significant'incident.'
'
Each'day'you'operate'without'a'significant'incident'brings'
you'one'day'closer'to'when'the'incident'will'occur.'
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DROWNING$101$
! 7th'leading'cause'of'unintentional'injury'deaths.'
! 2nd'leading'cause'of'unintentional'injury'deaths'for'children(1(–(
14(years(of(age.'
! 3rd(leading(cause(of(death(for(children(0(–(4(years(of(age.(
! 6'–'10'times'more'people'suffer'brain'damage'than'death'from'
submersion'incidents.'
! Minorities'drown'at'a'rate'2x'greater'than'''''''''''''''''''''''''''
whites.'
! Males'drown'at'a'rate'4x'greater'than'females.'
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! 6,000'–'7,000'drownings'annually.'
! 3,500'during'recreational'swimming'activities.'
! 90%'in'open'water.'
! 50%'U'67%'are'alcohol'or'drugUrelated.'
! 100+'in'“guarded”'facilities.'
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PEDIATRIC$SUBMERSIONS$
! Second'leading'cause'of'unintentional'death'nationwide.'
! Leading'contributing'factor:'
Lack(or'lapse(in'adult(supervision(
'
! Young'children'are'attracted(to'water'and'have' '''
little'concept'of'the'dangers(associated'with'water.'' ''''
The'action'of'children'around'water'is''''''''''''
unpredictable.'
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! BIG'HEAD'/'LITTLE'BODY'SYNDROME.'
! Nearly'half'of'the'victims'were'out'of'sight' ' '''''
less'than'5'minutes'prior'to'the'incident.'
! Drowning'is'a'silent(death.'
! 64%'of'the'victims'were'not'expected'to'be' ' ''''''''
in'or'near'the'swimming'pool'prior'to'the' ''''''''
incident.'
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WATER$CRISES$
Distress'Swimmer' Drowning'Victim'
! Can'support(self'in'water'by' ! Cannot'support(self'in'water'
swimming'or'floating.' by'swimming'or'floating.'
! Can'keep'head'out'of'water' ! Cannot'keep'head'out'of'
to'breathe.' water'to'breathe.'
! Can'call(out'for'help.' ! Cannot'call(out'for'help.'
! Can'wave(for'help.' ! Cannot'wave(for'help.'
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INSTINCTIVE$DROWNING$RESPONSE$
! Head(is'tilted(back(in'attempt'to'breathe.'
! Vertical(position'in'the'water.'
! Arms(are'extended'laterally.'
! Victims'don’t(call(out'for'help.'
! Victims'don’t(wave(for'help.'
! Appear(to(be(playing(in(the(water.(
! Struggle'for'20'–'60'seconds.'
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THE$DROWNING$PROCESS$
! Struggle((20'–'60'seconds)'
! Ingest'&'aspirate'water'into'stomach'&'airway'
! Laryngospasm(
! Hypoxia(
! Unconsciousness'
! (Aspirate'water'into'lungs)'
! Respiratory(arrest(
! Cardiac(arrest(
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TYPES$OF$DROWNING$
! Wet'drowning'
! Dry'drowning'
! Laryngeal(drowning(
! Mammalian'diving'reflex'
! Shallow'water'blackout'(hyperventilation)'
! Silent'(passive)'drowning'
! Long'QT'Syndrome'
! Torso'Reflex'
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SECONDARY$DROWNING$INCIDENT$
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CHERRY$HILLS$WATERPARK$INCIDENT$
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P$R$M$FACTORS$
' 'Prevention(
'
' ' 'Recognition(
'
' ' ' 'Management(
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PREVENTION$
! Establish'&'enforce'rules(&'regulations(
! Strategic'positioning'of'lifeguard(stations(
! Remove'or'warn'of'hazards(
! Prohibit'or'safeguard'risks(
! Vigilant'surveillance(&'supervision(
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RECOGNITION$
! Incidents(
! Potential(for'Incidents'
! Hazards'
! Risks'
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MANAGEMENT$
! Potential(for'incidents'
! Hazards'
! Risks'
! Incidents(
! Rescue'
! Emergency'patient'care'
! Rescue'equipment'
! Personal'protective'equipment'(PPE)'
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LOUISIANA$SUBMERSION$INCIDENT$
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R$I$D$FACTORS$
'Recognition(
'
' ' 'Intrusion(
'
' ' ' 'Distraction(
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A$SERIES$OF$EVENTS$
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THREAT$ASSESSMENT$&$HRD$FACTORS$
Hazard''+''Risk''=''Danger'
'
Hazards'
! Remove'
! Warn'
Risks'
! Prohibit'
! Safeguard'
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VIRGINIA$GRAHAM$BAKER$(VGB)$ACT$
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http://www.lifesaving.com'
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LEGAL$RESPONSIBILITY$&$LIABILITY$
! Duty(to(Act(
! Good'Samaritan'Laws'
! Consent(
! Abandonment'
! Records(&(Reports(
! Negligence'
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NEGLIGENCE$
1. Duty(to'Plaintiff'
2. Breach(Duty'
3. Injury(or'Loss(
4. Direct'Correlation(of'Breach'to'Injury/Loss(
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COEUR$D’ALENE$INCIDENT$
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www.yonigottesman.com'
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RULES,$REGULATIONS$&$EEC$FACTORS$
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'Establish(
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' ' 'Enforce(
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' ' ' 'Consequences(
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LAYERS$OF$PROTECTION$
! Supervision(
! Isolation(fencing(
! SelfSclosing,(selfSlatching(&(selfSlocking(gates(
! Gates'open'outward,'away'from'the'pool'
! Pool'cover'
! Pool'alarm'
! Passive'monitoring'
! Lifeline(
! Depth(line(
! Depth'markers'
! Telephone(
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GOFF$V.$HAMLET$APARTMENTS$INCIDENT$
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http://www.lifesaving.com/poolUsafelyUdigitalUassets'
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PERSONAL$FLOTATION$DEVICES$(PFDS)$
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WEAR$IT!$
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PFD$TYPES$
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SURVEILLANCE$PROTOCOLS$
! 30Ssecond(Rule(
! 10/20(Rule(
! 10'x'10'Reaction'Rule'
! Rotation(
! Zone(of(Responsibility((ZOR)(
! Sunglasses'
80'
SUNGLASSES$
! Protection(from'ultraviolet(rays(during'sunlight.'
! Protection(from'powerful(light(because'when'eyes'receive'
extra'light,'it'closes'the'iris'causing'the'lifeguard'to'squint.'
! Protection(from'glare(because'water'can'reflect'a'great'
deal'of'light'and'conceal'objects.'
! Eradicate'light'frequencies'that'can'blur( ((((((((((((((
vision'or'reduce(contrast.'
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POLARIZED$SUNGLASSES$
! From'the'moment'of'reflection,'light'becomes'polarized'
and'forms'visual'noise'–'blinding(glare(that'interferes'with'
the'real'image.'
! Polarized'lenses'enhance(visual(acuity,(color,(contrast(and(
comfort.'
! Tinted(lenses(only'reduce'light'transmittance'–' ''''
they'do(not(block(blinding(glare.'
82'
USLA$POSITION$ON$
PATRON$SURVEILLANCE$
'
Lifeguards'assigned'to'supervise'an'aquatic'area'shall(not(be(
subject(to(duties'that'would'distract(or'intrude(their'
attention'from'proper'observation'of'persons'in'the'
waterfront'area,'or'that'prevent(immediate(assistance(to'
persons'in'the'water.'
'
Specifically,'lifeguards(assigned'to'water' ' ''
surveillance'shall(not(be(assigned(to(any( ((((((((((((((
duties(other(than(public(safety!'
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OPERATIONAL$PROTOCOLS$
! Standard'Operating'Procedures'(SOPs)'
! Emergency'Action'Plans'(EAPs)'
! Emergency'Response'Plans'(ERPs)'
! Incident'Command'(IC)'&'Incident'Action'Plans'(IAPs)'
! Missing'Person'vs.'Missing'Bather'
! Credible'Witness'
85'
LIFEGUARD$QUALIFICATIONS$
'
Certification'vs.(Qualification'
'
! Screening'
! PreUService'Training'
! Standard'Operating'Procedures'(SOPs)'
! Surveillance'Protocols,'Victim'Recognition'&'Zones'of'Responsibility'
! Emergency'Action'Plans'(EAPs)'
! Emergency'Response'Plans'(ERPs)'&' ' '''''' ''''''''
Emergency'Drills'
! Incident'Command'(IC)'&'Incident'Action' ' ''''''''''''''''''
Plans'(IAPs)'
! Rescue'&'PPE'Equipment'
RESPONSIBILITY$OF$
AUTHORITY$HAVING$JURISDICTION$(AHJ)$
! Conduct'Threat'Assessment'
! Determine'Level'of'Operational'Capability'Required'
! Plan(for'the'Incident'
! Train(for'the'Incident'
! Acquire'the'Resources(Required'to' ' '''''''''''''
Safety'&'Effectively'Manage(the'Incident'
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JAMIE$KENNEDY$EXPERIMENT$
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A$B$C$RESCUE$
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(Primary(Response'
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( (CoverSup(Response'
'
( ( (Secondary(Response'
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FACILITYNUSE$GUIDELINES$
! Accountability'
! Supervision'
! Within'Arm’s'Reach'
! Lifejackets'
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COMPETITION$DIVING$INCIDENT$
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WATER$ENTRIES$
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SPINAL$IMMOBILIZATION$PROTOCOLS$
The'lack'of'neurological'deficit'does'not'rule'out'injury.''It'just'
means'the'injury'is'not'yet'apparent.'
'
If'the'Mechanism'of'Injury'(MOI)'is'sufficient'to'have'caused'a'
spinal'injury,'then'assume'the'injury'exists.'
'
Emergency'Care'Protocols'
! Standing'takeUdown'
! Shallow'water'
! Deep'water'
! Land'
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DIVING$INCIDENT$
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PATIENT$ASSESSMENT$
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A'''''='''''Airway'
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B'''''='''''Breathing'
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C'''''='''''Circulation'
'
D'''''='''''Disability'
'
E'''''='''''Examination'
'
M'''''='''''Mechanism'of'Injury'
97'
BSI$PROTOCOLS$
! Universal'Precautions'
! Personal'Protective'Equipment'(PPE)'
! Vaccine'Preventable'Hepatitis'
! Hepatitis'B'Vaccine'
! Hepatitis'A'Vaccine'
! Hapatitis'A/B'Vaccine'
98'
MANAGEMENT$OF$HYPOXIA$
Positive'Pressure'Ventilation'(PPV)'
! Personal'resuscitation'mask'(PRM)'
! Personal'resuscitation'shield'(PRS)'
! BagUValveUMask'(BVM)'resuscitator'
Oxygen'Administration'
'
Airway'Management'
! Suction'
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MASSACHUSETTS$INCIDENT$
100'
BASIC$LIFE$SUPPORT$
Chain'of'Survival'
! Access'
! CPR'
! AED'
! Advanced'Life'Support'(ALS)'
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CPR:'Life'Saving'or'Life'Sustaining?'
! 30:2'ratio'
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AED'Protocols'
101'
AED$PROTOCOLS$
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Automated'External'Defibrillator'
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! High'&'Dry'
! Verbal'Commands'
! I’m'Clear!'
! You’re'Clear!'
! Everyone’s'Clear!'
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HUNTINGTON$BEACH$AED$RESCUE$
103'
PRINCIPLES$
! Rule'of'Numbers' ! Emergency'Action'Plans'(EAPs)'
! PRM'Factors' ! Emergency'Response'Plans'(ERPs)'
! RID'Factors' ! Incident'Command'(IC)'&'Incident'
! Threat'Assessment'&'HRD'Factors' Action'Plans'(IAPs)'
! Suction'Entrapment'&'VGB'Act' ! Spinal'Injury'Management'&'
! Legal'Responsibility'&'Liability'
Mechanism'of'Injury'(MOI)'
Factors' ! Body'Substance'Isolation'(BSI)'
! Rules,'Regulations'&'EEC'Factors' Protocols'
! Layers'of'Protection'(LOP)' ! Rescue'Priorities'
! Management'of'Hypoxia'(MOH)'
! Surveillance'Protocols'
! Standard'Operating'Procedures' ! Positive'Pressure'Ventilation'(PPV)'
Protocols'
(SOPs)'
! FacilityUUse'Guidelines'(FUG)' ! CPR'Protocols'
! AED'Protocols'
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SAN$JOSE$NEARNDROWNING$INCIDENT$
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TOMORROW’S$LIFEGUARD$
109'
Lifesaving!Resources,!LLC!
www.lifesaving.com!
Gerald!M.!Dworkin!
gerald@lifesaving.com'
110'
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