The Power of the Secondary Lifeguard

[Pete DeQuincy]

Instructor reviewing how to assist the primary lifeguard. (Photo credits: Emily Plurkowski, Mills College)

My boss referred me to a quote from Aristotle, “The whole is greater than the sum of its parts.” One could view that the lifeguard team is based off of this quote, and that each team member believes in a shared set of rules:

• Rule 1: The lifeguard team consists of public servants who strive to ensure that everyone that visits their aquatic facility returns home safe and uninjured.
• Rule 2: Every lifeguard team member has value, based on their competencies.
• Rule 3: The lifeguard team trains in preparation for the worst; knowing that complacency kills.

Within the lifeguard team the primary lifeguard initiates the rescue, as the secondary lifeguard provide support. They must be quick, alert and foresee any possible gaps within the rescue operation. The challenge for the secondary lifeguard is how to participate in the critical incident without impeding the primary lifeguard, while enhancing the quality, speed, and delivery of patient care. The drills in this article focus on proper assistance and effective insertion of the secondary lifeguard.

BVM ROTATION DRILL (3 or more lifeguards, preferably 6+): Start with BVM fully assembled. All lifeguards stand in a line near the training station. All lifeguards have gloves which should be used when working on the patient.

A lifeguard will start in the primary position (Position A) behind the patient’s head (cephalic position) providing airway management with the mask portion of the BVM. Another lifeguard will be in the secondary position (Position B), to the side of the patient (lateral position), gripping the bag of the BVM with both hands. During ventilations, a tertiary lifeguard will glove up and prepare to step in.

After the third ventilation, the tertiary lifeguard will take over in Position A with airway management and the lifeguard that was in Position A will take Position B bagging the patient. The lifeguard that was in Position B de-gloves, and steps to rear of the line. OBJECTIVE: Each lifeguard will perform primary and secondary positions during ventilations with the BVM. They will each perform 3 successful ventilations consecutively for adult rescue breathing. TIMING GOAL: 20-25 seconds for each pair to complete 3 ventilations.

Lifeguards need to be ready to step into the BVM Rotation Drill

The drill ends when the initial lifeguard in Position B completes the objective in Position A. Each lifeguard should be proficient in both the primary and secondary role before moving to the variations.
BVM rotation drill variations:

• BVM is packaged and must be assembled by the primary and secondary lifeguards at the start of each rotation. Provide 3 BVM’s. (same timing)
• An additional BVM is packaged and must be assembled by the tertiary lifeguard prior to stepping into the primary position. BVM must be assembled within the time of 3 ventilations. Newly assembled BVM is used for the ventilations. Provide 3 BVM’s. (same timing)
• BVM is packaged and must be assembled by the primary and secondary lifeguards at the start of each rotation. BVM is intentionally packaged without a mask. Lifeguard must use personal pocket mask as BVM mask replacement. Provide 3 BVM’s. (same timing)

 

RECOGNITION DRILL: Secondary lifeguard starts in the break room or office. Primary lifeguard is in the water with a victim. OBJECTIVE: Once the EAP is activated, the secondary lifeguard must be in the vacant lifeguard station in the ready position as quickly and safely as possible. TIMING GOAL: 10-15 seconds to complete the objective.

Once proficient, add to the drill that once the secondary lifeguard is in the vacant lifeguard station, they need to locate the primary lifeguard, assess and verbally identify the situation. (Same timing):

• Primary lifeguard doesn’t need additional assistance, no action taken.
• Primary lifeguard needs assistance in water.
• Secondary lifeguard identifies that this is a critical incident, upgrades EAP for additional assistance and prepares emergency equipment.

 

Entry Assistance Drill variation: towing position (Photo credit, Jean E. Brink Swimming Pool, Pacifica)

ENTRY ASSISTANCE DRILL: This drill follows the Recognition Drill with the secondary lifeguard in the break room. These drills start when the primary lifeguard activates the EAP. OBJECTIVE and TIMING GOAL: Listed with each variation.

1. Once the secondary lifeguard identifies that assistance is needed in the water, upgrades EAP, enters the water and assists. Objective: secondary makes physical contact with primary. (30 seconds)
2. Victim is face down on water surface, unconscious. Primary lifeguard should have the victim rolled over before the secondary lifeguard makes contact. Secondary lifeguard assists in placing victim into a towing position. Objective: both lifeguards and rescue tube(s) are in the proper position. (20 seconds)
3. Victim is submerged. Objective: secondary lifeguard must reach the primary lifeguard before or just as the victim reaches the surface. (20 seconds)
4. Start with variation 3, add: Primary lifeguard assesses victim, while secondary supports. Primary announces, “Victim is not breathing, but has a pulse.” Two breathes are given, and victim begins to breathe. Objective: both lifeguards and rescue tubes are in the proper position. (35 seconds)

 

PREPPING EMERGENCY EQUIPMENT DRILL: These drills start with the activation of the EAP, primary lifeguard is towing in an unconscious victim. Each of these variations should be practiced. OBJECTIVE and TIMING GOAL: Listed with each variation.

1. Secondary lifeguard must upgrade EAP, bring backboard and be ready for extrication before primary lifeguard has reached the side of pool. (10 seconds or the time it takes to get the victim to the wall)
2. Secondary lifeguard must upgrade EAP, bring backboard, along with AED, and be ready for extrication before primary lifeguard has victim to side of pool. Gloves must be on. (15 seconds or the time it takes to get the victim to the wall)
3. Secondary lifeguard must upgrade EAP, bring backboard, along with AED and BVM, and be ready for extrication before primary lifeguard has victim to side of pool. BVM is assembled and gloves are on. (15 seconds or the time it takes to get the victim to the wall)

 

Push yourself and take training serious. Hierarchy within the lifeguard team is determined by competency

Remember: although most lifeguard skills are demonstrated, taught, and assessed on the ability of the single lifeguard, this does not mean that those skills should only be done by a single lifeguard. Push yourself and your lifeguard team. You might enjoy it.

 
Secondary Lifeguard 1-Hour Training Curriculum (12 lifeguards)

Briefing: 5 minutes

BVM Rotation Drill (2 groups of 6): 5 minutes

BVM Variations: (any 1) 5 minutes

Suit up: 5 minutes

Recognition Drill: 10 minutes

Entry Assistance Drill: 15 minutes

Prepping Emergency Equipment Drill: 10 minutes

 

Debrief/Break-down: 5 minutes

[Henry]

Great post Pete. Really enjoy your contributions.

[Jim Wheeler]

Another fantastic Blog Pete, thanks for sharing your passion and drills!