Instructor reviewing team towing holds (Photo credits: Emily Plurkowski, Pete DeQuincy, Mills College)

 

Removing the victim from the area of danger, also known as extrication, happens in all incidents both non-emergency and critical. Whether it’s moving a submerged victim from the bottom of the pool to the surface, towing from the point of rescue to the wall, or expediting from water to land where EMS is staging; extrication is an essential skill all lifeguards perform.  The drills in this article focus on team extrication for critical incidents where the victim is unconscious and in need of immediate care.

 

KICKBACK DRILL: Pair up your lifeguards on the side of the pool, one as rescuer and one as victim. The victim will be on the rescue tube presenting as an unconscious victim. OBJECTIVE: Rescuers must tow their victim across the width of the pool and back as quickly and safely as possible. TIMING GOAL: 20-60 seconds depending on the width of the pool.

Towing a victim, provides the lifeguard an opportunity to build endurance and proficiency

Towing a victim in water is a challenging skill especially if the victim is unconscious. Often lifeguards hold the victim’s shoulders under the armpits with two hands. This hold only allows the lifeguard to do a flutter, inverted breaststroke, or an eggbeater kick to move the victim to safety. Consider using one arm hold and swimming the victim in whenever possible, or utilizing multiple rescuers.

Repeat this drill using three different kicks: flutter, inverted breaststroke, or eggbeater. This will help each lifeguard determine which kick is most effective and quickest.

 

TEAM TOWING DRILL: Focuses on 2 or more lifeguards working together to move a victim. Start in the shallow end of the pool where the water is waist deep. Group the lifeguards into pods of three, with 2 rescuers and 1 victim. Have the rescuers position themselves on opposite sides of the victim’s shoulders. Have the rescuers reach over the victim’s shoulders grasping the rescue tube and pinching the arm between the rescuer’s body and the rescue tube. Rescuers should face each other, standing in a ready position, as if they were a mirror reflection. OBJECTIVE: Move the victim across to the other side of the pool as quickly and safely as possible. TIMING GOAL: 15-30 seconds to complete the objective.

The lifeguards will quickly find that running/wading through the water is hard to do. Repeat this drill until all the pods complete the objective within the designated time. Once achieved, switch roles, so that each lifeguard gets to be a rescuer. Variations of the Team Towing Drill:

  • Mid-depth towing, water level is neck deep or slightly higher (add up to 10 seconds)
  • Deep water towing (add up to 10 seconds)
  • 3-ON-1 Rescuer towing (no time added)

3-on-1 team towing variation

 

TWO-PERSON REMOVAL WITH A BACKBOARD PROCEDURE REVIEW: Two-person removal from the water with a backboard is one of the main ways lifeguards extricate non-spinal victims from the water, however it is often not practiced enough. Extrication from the water with a backboard is a complex skill. Here are 11 common errors that occur during extrication:

  • Poor communication regarding which side of the rescuer the backboard should be placed
  • Lack of consistent arm crossing by the rescuer holding the victim
  • Backboard is not slid down along the side of the wall
  • Backboard is allowed to list to one side during placement of the victim
  • Failure of the rescuer to use their foot to stabilize the backboard
  • Unequal holds by the rescuers when pulling the backboard and victim out of the water
  • Too steep an angle on the backboard when pulling it from the water
  • Dropping, rather than lowering the backboard down on land
  • Not having a clear runway for the backboard to be placed
  • Only practicing victim removal on in-service training days focusing on spinal emergencies
  • Allowing the rescue tube and/or strap to get entangled with the victim or the backboard

Provide an opportunity to review (10 minutes at most); you'll better results during the extrication drills

Before starting the Extrication drill, break your lifeguards into pods of three, 2 rescuers and 1 victim, and have them review 2-person removal for at least 10 minutes, repeating the procedure, until none of the mistakes listed above occur. Decide which side the backboard should be place on the rescuer at your facility, and make that a standard. This will help to expedite the victim removal, eliminate the delay caused by the rescuers deciding, and synchronize the staff. Remember, this will dictate how the deck rescuer will cross their arms while holding the victim (their top hand needs to be on the side of the backboard).

 

EXTRICATION DRILL: Start with the primary rescuer on the side of the pool with the victim, and the secondary rescuer on the deck with the backboard. OBJECTIVE: Have the victim on the deck using the two-person removal with a backboard technique as quickly and safely as possible. TIMING GOAL: 20 seconds to achieve the objective. Move to the variations, once the entire group has accomplished the timing goal with every lifeguard getting to participate in the different rescuer positions. Variations of the Extrication Drill:

  • Same drill with timing goals of 15 seconds
  • Rescuer and victim 10 feet away from side of the pool (20 seconds)
  • Backboard 30 feet away (20 seconds)
  • Both rescuers in the water with victim at the side of the pool, backboard 30 feet away (25 seconds)
  • Both rescuers in the water with victim 10 feet away from side of pool, backboard 30 feet away (30 seconds)
  • Same drill ending with rescuers on deck with gloves on (20 seconds)
  • Same drill starting with equipment in its usual location and secondary rescuer in a lifeguard chair or other station (30 seconds)
  • Same drill ending with rescuers and victim on deck, primary assessment done, rescue breathing in process, having delivered 3 rescue breaths to complete the objective (40 seconds)

A third lifeguard can be used to speed the extrication and stabilize the victim

 

DEEP WATER SUBMERGED EXTRICATION DRILL: Requires 2 rescuers and 1 victim. Victim will be submerged on the bottom. Both rescuers will retrieve the victim. Primary rescuer will grasp victim from behind while secondary rescuer will plant their feet firmly on the bottom and grasp the primary rescuer. The objective of the secondary rescuer is to give the primary rescuer and victim a boost to the surface. OBJECTIVE: Get the victim and rescuers to the surface as quickly and safely.  TIMING GOAL: 10 seconds to complete the objective. 

Just a quick reminder: Extrication is a team effort skill that requires constant training. It is rare that EMS, Police or Fire personnel will physically get in the water to assist the lifeguard staff in extrication of the victim due to the extenuating demands of the critical incident. Getting the victim into EMS or Fire hands quickly depends on you and your lifeguard staff. And remember: Train hard, and train often.

 

Multiple rescuers can be used for deep water submersions. The Primary rescuer (in red) makes contact with the victim, while the secondary rescuer (in white) makes contact with the primary rescuer and pushes off the bottom. Remember the objective is to get the victim to the surface as quickly and safely as possible.

ALL IN THE TIMING

Extrication 1-Hour Training Curriculum (12 lifeguards)

 

Briefing/Suit up: 5 minutes

 

Kickback Drill: all three kicks, lifeguards paired up, 10 minutes

 

Team Towing Drill: shallow water, and either mid-depth or deep, 10 minutes

 

Two-person removal with a backboard procedure review: 10 minutes

 

Extrication Drill: initial drill with 3 variations: 15 minutes

 

Deep Water Submerged Extrication Drill: 5 minutes

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Tags: Aquatics, drills, education, in-service, lifeguarding, safety, teamwork, training, water

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