HYDROTHERAPY POOL
Guidelines, Operating Procedures and Emergency Action Plan
The Chiltern School / Primary Site
HYDROTHERAPY POOLS – WHAT YOU NEED TO KNOW
A hydrotherapy pool is very different to an ordinary swimming pool. The water temperature is maintained at a higher rate (around 34oC) to stimulate circulation and relaxation; and to allow frail pupils, with poor temperature control, the opportunity to experience water activities. The air temperature is also controlled to avoid the ‘shiver’ effect and coldness when getting out. There is special filtration equipment and a water treatment unit to ensure the water is perfectly clean for these frail pupils.
In addition, there is sensory stimulation equipment (colour projector, music system etc.) to relax and reassure the pupil and to make the whole experience enjoyable. Because it is a dedicated facility, the numbers that use it at one time and the activities that are arranged, can be controlled and tailored to the needs of the group.
The physical structure of the pool, its high water and air temperatures and intermittently intensive use by diverse groups of pupils and staff, together produce potentially hazardous conditions. This document therefore describes the control and management systems that are in place, and must be adhered to, to minimise risk.
POOL MANAGEMENT
Kim Gibbs provide overall daily management of the hydrotherapy pool. They will maintain an accurate daily log of the running of the pool.
Responsibility for Health and Safety of all persons in the pool area is delegated to the designated person in charge of each session.
DESCRIPTION OF THE POOL
The Hydrotherapy Pool is of the deck-level type, this means the water is level with the surrounding floor. This makes for easy pool entry and exit, and facilitates the use of hoist and helps pool hygiene by promoting removal of surface water by way of a grated channel outside the pool.
The pool is 189” long x 147” wide and rectangular in plan. The water depth in the therapy area ranges from 4” to 32”. The change in depth is gradual over the length of the pool with no sudden steps or drops. No diving is allowed into the pool.
Access to the pool is by steps with handrails. There is also a manually operated poolside hoist that can lift a pupil in a chair and an electric hoist to get pupils in and out of the pool at either side.
Water filtration and disinfection is achieved by sand filters, automatic chlorination and a Prozone ozonator. Ozone is generated from air and then pumped through the water. It destroys algae, viruses, and bacteria on contact - with no harmful by-products. It also breaks down harmful chemicals and acts as a flocculent, causing dissolved solids to be suspended and easily removed by the water filtration process.
The emergencybutton is mounted on the wall of the pool. Assistance will be provided by school nurse, office staff and a member of the Senior Leadership Team.
Changing facilities are arranged close to the pool with shower unit and toilet. This last room is equipped with a height adjustable changing plinth and hoist. There is also a single WC. On the side of the pool there is one ‘open’ shower for rinsing off.
SAFETY
Users
Pupils using the pool require close supervision. Numbers of permitted users and the supervision required is detailed in Appendix 1 and must be adhered to at all times. All users should be aware of the contraindications to use of the pool as detailed below. If in doubt they should seek advice from the school nurse or Kim Gibbs before using the facility.
Contraindications to use of pool/spa
1. Medical conditions that contraindicate use of the pool are listed at Appendix 2.
2. Persons under the influence of drugs/alcohol are not permitted to enter the hydrotherapy facility.
3. Children are not permitted to use the pool or enter the hydrotherapy facility without supervision.
4. No one is allowed to use the pool alone. Persons needing to enter the facility for cleaning/maintenance, etc. and who will be alone should notify the site agent when they enter and leave the facility.
5. The maximum permitted time in the pool is 30 minutes, but each teacher should assess users to ensure they are not becoming overheated and ensure they cool down after therapy/use of the pool.
The increased temperatures cause the body to loose more fluid and salts than usual during exercise, so it is important to drink plenty of fluids after being in the pool or pool area. A drinking fountain is provided within the pool area. The high temperatures can cause muscle fatigue and increased tiredness. It is possible for strong swimmers and lively youngsters to overdo it, though the effects will only be realised an hour or so later – care should be taken. Sufficient time must be allowed for rest and recovery afterwards.
ACTIVITIES
Diving
Diving is prohibited
Running
Running is not permitted anywhere or for any reason within the hydrotherapy pool facility (this includes the reception area, changing rooms, store areas, poolside, ramps and steps). Users should be warned that the floor might be wet and slippery.
Jumping
Jumping into the pool from any side is not allowed.
PHYSICAL
Security
The Pool will be locked at all times when it is not in use. Please ensure that the chain is on the changing room side and door locked to main corridor.
Water Depth
Teachers are responsible for familiarising themselves with the water depth of the pool and the emergency call procedure.
Wet Surfaces
All wet surfaces are slippery and care should be taken particularly around the sides of the pool and between the pool/showers and changing areas.
Pool Steps
These should be used with care as they are difficult to judge and see through the water. Special care is needed with the bottom step.
Emergency Procedures
These are detailed as follows:
1. Emergency Action Plan (Procedure 1)
2. Accidental Generation of Chlorine Gas (Procedure 2)
3. Fire (Procedure 3)
4. Accident to bather/user (Procedure 4)
5. First Aid for incidents related to chemicals (Procedure 1)
Chemicals
Chemicals used in the treatment of pool water should never be mixed, other than via the chemical dosing system according to the manufacturers instructions. Chlorine liquid and dry acid produce a harmful gas called chlorine gas when mixed. The procedures for storage, handling, use and action in the event of an accident should be followed and are detailed later in this document.
Hygiene and Cleanliness in the Pool and Pool Area
Strict adherence to rules of cleanliness and hygiene in the pool area is essential to its efficiency. The pool is divided into a clean area, which is the area immediately around the pool, the pool itself, the showers on the poolside; and a dirty area, which is the entrance, changing rooms (including showers and toilets) and storage areas.
Footwear/Wheelchairs
Outside shoes can only be worn within the pool area if covered with over shoes. Otherwise, they should be removed. The wheels of the chair should be checked and as much dirt as possible cleaned off. ‘Dirty’ wheelchairs should not be taken into the clean area of the pool.
Poolsides
The pool sides should be cleaned daily with pool water, preferably at the end of the day when the pool is not in use. Propriety cleaning compounds should not be used where they may wash into the pool water system (e.g. close to the pool). Kim Gibbs willsupervise the day-to-day cleaning of pool sides and pool equipment.
Pool Water Changing and Inspection
For normal, regular cleaning, pools should be cleaned when full using a long-handled brush. Algal slime should not be allowed to develop, and small brown algal spots on the walls of the pool should be removed with a wire brush. Particular attention should be paid to cleaning the channels around the edge of the pool under the grating. Kim Gibbs is responsible for this.
Teachers should ensure the pool side is kept clear of debris at all times (plasters, cotton wool, sticking plaster, nappies, etc).
Pool equipment such as floats, shower chairs/trolleys and toys should be cleaned regularly with warm, soapy water.
At least annually, the pool hall walls, the floors around the pool, changing rooms, etc. will be given a thorough clean by a team of staff.
All staff should report any damage or build up of dirt, etc. they observe to Kim Gibbs.
Soiling
The pool should be evacuated & partly emptied if a bather releases an unformed stool into the pool. The pool should be thoroughly vacuumed, refilled and hyper-chlorinated as per manufacturer’s recommendations. After six hours running in this situation a backwash should be performed before bathers are allowed to use the pool again. Vacuuming equipment should be completely dismantled, cleaned and disinfected.
The pool does not require partial emptying in the event of a soiling accident that involves a formed stool. The stool should be removed with a leaf skimmer or other suitable container. When all bathers have left the pool, the chlorine level is increased to 5ppm in accordance with manufacturer’s instructions. After one hour the chlorine levels should be checked and if they have not exceeded recommended maximum levels, then the pool can continue to be used.
Occupational Health Problems for Pool Staff
Prolonged exposure to hydrotherapy pool conditions can cause problems to staff.
Poolside working
The warm water, high ambient air temperature and humidity of the pool hall can cause fatigue or lassitude. Staff should dress appropriately if working in the pool and maintain a high fluid intake.
Irritation of the eyes and upper respiratory tract can arise from the by-products of chlorine disinfections in the air. However, in a properly maintained and monitored pool this should not be a problem. Asthma sufferers may experience a mild exacerbation of their symptoms in this situation.
Due regard must always be given to the requirements of the Health and Safety at Work Act 1974 and the Control of Substances Hazardous to Health (COSHH) Regulations.
In the pool working
Dry Skin This may result from the degreasing effect of the disinfectant. Individual susceptibility varies considerably. Time in the pool should therefore be limited to no more than two sessions daily. Moisturising cream may be helpful after bathing.
Ear Infections Wetting of the ears may cause mild irritation to the external ear canal. Ensuring the ears are clear of wax and debris (that attract water into the ear) can help in preventing this. Hats and earplugs don’t help in keeping water out of the ear and can make things worse. If a lot of staff become affected by ear irritation/infection, this is a warning of a build up of organisms and should be investigated by taking samples of water. It is important users report any cases.
Skin Irritation and Rashes These are the most frequently reported health problems associated with hydrotherapy pools. Soggy or water-logged skin may cause itching. Those with pre-existing skin conditions may experience a worsening of their condition. Skin rashes due to chlorine are rare. If cases are increasing or are more than usual this may indicate an organism in the water that needs dealing with.
Pupil Hygiene and Safety
Prior to going in the pool, staff need to ensure that pupils:
ñ Are clean;
ñ Have emptied their bladder and bowels (particularly if incontinent);
ñ Are showered all over;
ñ Have a clean costume to wear;
In The Pool
Should a pupil need to empty their bladder or bowels, they should be removed from the pool immediately to do this and returned afterwards when comfortable.
Pupils known to be incontinent should wear ‘swimmers’ in the water.
After Pool Care
The after-pool care of pupils is important. Pupils should be encouraged to shower before dressing. It is important they are kept warm when leaving the pool and again when leaving the pool area. They should be encouraged to drink to replace fluid lost in the heat of the pool, etc. Please avoid taking vulnerable pupils into the cold air until their hair is dry and they have acclimatised their temperature. Swimwear and towels should be washed after each session.
APPENDIX 1
BATHING CAPACITY / SUPERVISION REQUIREMENTS
Pool
ñ Maximum number of bathers at any one time is 10.
ñ Minimum number is 1 however, that bather must have two other people poolside.
ñ If there are children anywhere in the facility, there must be at least 3 adults supervising them.
ñ There must be a teacher or physiotherapist on duty for all sessions in the pool, at all times. The adult undertaking the role of ‘spotter’ must be aware of their responsibilities. They must check that doors are unlocked and lock them at the end of the session.
ñ They should know where and how to operate the emergency call button.
ñ They must be prepared to enter the water to support a rescue if needed.
*******ALL USERS OF THE POOL DO SO AT THEIR OWN RISK******
APPENDIX 2
Contraindications to Hydrotherapy
Wound Infection
Skin Infection
Gastrointestinal Problems/Viruses
Recent CVA (less than three weeks)
Recent Pulmonary embolus