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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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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$! Rule'of'Numbers'! PRM'Factors'! RID'Factors'! Threat'Assessment'&'HRD'Factors'! Suction'Entrapment'&'VGB'Act'! Legal'Responsibility'&'Liability'
Factors'! Rules,'Regulations'&'EEC'Factors'! Layers'of'Protection'(LOP)'! Surveillance'Protocols'! Standard'Operating'Procedures'
(SOPs)'! FacilityUUse'Guidelines'(FUG)'
! Emergency'Action'Plans'(EAPs)'! Emergency'Response'Plans'(ERPs)'! Incident'Command'(IC)'&'Incident'
Action'Plans'(IAPs)'! Spinal'Injury'Management'&'
Mechanism'of'Injury'(MOI)'! Body'Substance'Isolation'(BSI)'
Protocols'! Rescue'Priorities'! Management'of'Hypoxia'(MOH)'! Positive'Pressure'Ventilation'(PPV)'
Protocols'! CPR'Protocols'! AED'Protocols'
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MURPHY’S$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!'
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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'swimming'or'floating.'
! Can'keep'head'out'of'water'to'breathe.'
! Can'call(out'for'help.'
! Can'wave(for'help.'
! Cannot'support(self'in'water'by'swimming'or'floating.'
! Cannot'keep'head'out'of'water'to'breathe.'
! Cannot'call(out'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'
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$''Establish(
'' ' 'Enforce(
'' ' ' 'Consequences(
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LAYERS$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'
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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.'
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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'
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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$RESCUE$'(Primary(Response'
'( (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$ASSESSMENT$'
A'''''='''''Airway''
B'''''='''''Breathing''
C'''''='''''Circulation''
D'''''='''''Disability''
E'''''='''''Examination''
M'''''='''''Mechanism'of'Injury'
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BSI$PROTOCOLS$
! Universal'Precautions'
! Personal'Protective'Equipment'(PPE)'
! Vaccine'Preventable'Hepatitis'! Hepatitis'B'Vaccine'! Hepatitis'A'Vaccine'! Hapatitis'A/B'Vaccine'
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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$INCIDENT$
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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'
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AED$PROTOCOLS$'
Automated'External'Defibrillator''
! High'&'Dry'
! Verbal'Commands'! I’m'Clear!'! You’re'Clear!'! Everyone’s'Clear!'
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HUNTINGTON$BEACH$AED$RESCUE$
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PRINCIPLES$! Rule'of'Numbers'! PRM'Factors'! RID'Factors'! Threat'Assessment'&'HRD'Factors'! Suction'Entrapment'&'VGB'Act'! Legal'Responsibility'&'Liability'
Factors'! Rules,'Regulations'&'EEC'Factors'! Layers'of'Protection'(LOP)'! Surveillance'Protocols'! Standard'Operating'Procedures'
(SOPs)'! FacilityUUse'Guidelines'(FUG)'
! Emergency'Action'Plans'(EAPs)'! Emergency'Response'Plans'(ERPs)'! Incident'Command'(IC)'&'Incident'
Action'Plans'(IAPs)'! Spinal'Injury'Management'&'
Mechanism'of'Injury'(MOI)'! Body'Substance'Isolation'(BSI)'
Protocols'! Rescue'Priorities'! Management'of'Hypoxia'(MOH)'! Positive'Pressure'Ventilation'(PPV)'
Protocols'! CPR'Protocols'! AED'Protocols'
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SAN$JOSE$NEARNDROWNING$INCIDENT$
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TOMORROW’S$LIFEGUARD$
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Lifesaving!Resources,!LLC!www.lifesaving.com!