Lifeguarding and the Model Aquatic Health Code

NEHA

Lifeguarding and the Model Aquatic Health Code

Hello, everyone, and welcome to the presentation, "Lifeguarding and the Model Aquatic Health Code."

To ask questions about this presentation, please join the presenter in the Networking Lounge at the designated time listed on the agenda.

I would now like to introduce Roy Fielding, a Senior Lecturer at the University of North Carolina at Charlotte.

Thank you, everyone, for attending.I wanted to go through the lifeguarding and the Model Aquatic Health Code, and some of the information that was provided with this code in moving forward to the future of safer aquatics.

One of the things that the Model Aquatic Health Code – they had a vision.A number of folks got together back in the early 2000s – Michael Beach from CDC being one of them and Doug Sackett from the New York Health Department at that time and some folks from the National Swimming Pool Foundation -- to look at things that were taking place across the country.We had to remember that all the different states had different codes dealing with pools and that; and these folks had the vision and the thoughtfulness of looking at it and saying, "We should be better at this, and there should be consistent across the country in looking at the codes for swimming pools."

So they developed the Model Aquatic Health Code to gather in this information.One of the things with this vision was to take the mission on that was going to be collecting the information, assessing it, seeing if this was valid information, that it had science behind it or best practices, and then try and make our aquatic facilities as healthy and safe as possible looking at the Model Aquatic Health Code for guidance.

One of the things that we all know, and we need to remember as we go through is legislators, health departments and are not the true experts on swimming pools.They basically have checklists that they go by, and they rely on others to help develop their codes as they move forward in that.So this was one of the things that was kind of beneficial to the Model Aquatic Health Code in developing these different standards that different states could look at, possibly put into their health codes as they go through.I know at this time that some states, my understanding is, that they're taking in all the Model Aquatic Health Code and developing their new basis for their regulations for swimming pools.They're accepting it as whole.Some of the states are looking at it for parts of it that are going to fit into their situation.

The mission continued, again, to provide assistance to the aquatic industry in helping them look at the science and how they were going to build pools and how they were going to operate pools and have kind of the best situation moving forward as they were going through it.One of the things that people need to remember also, this Model Aquatic Health Code is a living document that is going to go on and on and on.As science comes forward, as new techniques come forward that are, I guess, rational and something that we could look at and say this would be a better situation to go into a code issue moving forward, the Model Aquatic Health Code is trying to do that research moving forward with that.

One of the things we looked at – again, I served as Vice Chair on two of the committees actually; one of them was on lifeguarding and bather supervision.We needed to look at it from the standpoint of how can we make lifeguards better at the job that they're doing; but we also needed to understand that some of the pools don't have lifeguards, probably will not have lifeguards, and we had to kind of have a long debate on which pools were going to be required to have lifeguards as we went through.

One of the things that we were trying to do is not upset the apple cart as far as the original and the existing situations in pools that are out there, but we're trying to give some guidance on this.So this was trying to design it for new construction.We were looking at pools that needed to have lifeguards were any pools deeper than five feet of depth; they allowed children under the age of 14 to be unsupervised; and one of the big things, and we're seeing a lot of this taking place that aquatic facilities have to be aware of, a lot of groups are using our pools now – whether it's daycare centers, whether it's sports groups.They're using it as kind of a group-type activity with very few supervisors but a lot of kids.This is where we're having a number of issues taking place with this, so that would have to be a lifeguarded pool.

Any pool that was wider than 30 feet – and the reason that this 30-foot was there is most people will have a ring buoy or some type of throwing device that has a rope on it that's either 50-feet long or one-and-a-half times the width of the pool.So it's fairly reasonable to expect somebody to be able to throw something at least 30 feet to get out there, so that was one of the configurations that we were looking at as well.

And then anything that has any type of wave-induced or any type of current going, any type of waterslide or landing area, and where the bathers enter from a height – like diving boards, drop slides, diving platforms and climbing walls.Again, we're trying to look at it from the standpoint that these pools need to have lifeguards as they move forward; and, again, we're going from a new construction standpoint with that.

Looking at qualified lifeguards – we needed to define who is going to be qualified as a lifeguard that can be accepted under this new code with the Model Aquatic Health Code.We had to look at training first.One of the things that we looked at was they needed to have these different aspects.So all lifeguard training needed to have hazard identification, emergency response, AED use, First Aid and CPR, and legal issues.So this would be in the training of the lifeguards themselves -- that they'd have to have at least this information defined out and put in place as far as the curriculum for the lifeguard moving forward.

Another thing would be a qualified lifeguard would have to have current certification, or certifications, depending upon what organization they're going through.So everything had to be current.

One of the key things, in my mind anyway, is meet all the preservice requirements.The pool, UNC Charlotte, that I've been operating for a number of years is 13 feet in depth.Well, I know in working with a number of agencies as far as the training is concerned, some of the lifeguard training might be done in only 7 to 10 feet of water.Well, we don't know if they can go to 13 feet of depth.So one of the preservice requirements that we would have to have at our pool would be to make sure the lifeguard could go down to the deepest part of the pool, recover a victim or simulated victim on the bottom, bring him to the surface before we could allow them to be a lifeguard at that facility.

So one of the key things out there that all aquatic facility operators should pay attention to is make sure your preservice requirements for lifeguard hire includes everything that they might have to do – any type of situation that they might have to get into.

Participating in continuing inservice training – again, this is one of the key things to make sure our lifeguards are going to be more current and are going to continue with the standards set forth by their training and their certifications.

The length of valid certification – one of the things that we debated back and forth because there have been different levels over the years as far as years that the certification was good for.One of them was basically the lifeguarding itself.In some people, it ranged from one year to three years; so we basically talked as a group and came to a consensus of two years as far as the lifeguarding part was concerned.

As far as the CPR, we looked at the research that out there; and there's really almost 40 studies that looked at CPR and the retention of the skill of CPR.And no one basically can go two years and still have good retention; in other words, it basically said that there was inadequate skill retention after a two-year break from training.But they also noted in some of the studies that were listed on this, they looked at doing some type of refresher within 6 to 12 months of the original certification.This showed that to be adequate as far as getting the retention in there.So we chose the one year and, again, backed by science, to move forward with that as far as retention of CPR skills.

A qualified lifeguard should be assessed in the preservice as we talked about before.Copies of certifications – we want to have these copies on hand at the aquatic facility in case there is any doubt.Also, people can put into calendars now when certain guards are going to be coming up for a need for recertification; so these things should be kept in place.

One of the things that we've run into – and very tragically in some places – where the lifeguard has worked during the summer; their certification ran out in mid-July; and at the end of the season, they're still guarding; and the management did not realize that the person's certification was lacking at that time.

Documentation of inservice training – one of the things that all of us have learned over the many years of doing this is that if you have an inservice training, you've got to document it; otherwise, it didn't happen.So documentation is one of the crucial things to make sure that the guards are going through the specific skills, you're documenting it -- what took place, who was there for the inservice, who was conducting the inservice, what were the actual skills presented in the inservice training -- and then have signatures, date, time, all that, placed into the documentation of the inservice.

One of the things I've encouraged in teaching pool operators in the past is encouraged them to get with their local EMS – whoever their EMS provider is – and have them visit the aquatic venue, have them sit down with the staff on what their responsibilities are going to be, and have that EMS provider basically be there to understand how to get into the facility as quickly as possible.If they did have to do some type of work with the gurney to haul a patient out, what would be the access that they would use?Get that done ahead of time, be prepared ahead of time for almost any situation that you might get in.

Other qualified skills, proficiencies – we want them to be able to demonstrate the knowledge and skill proficiencies that they had in their training course – as I talked about before, reaching the bottom of the maximum depth.To me, this is one that is very, very crucial.Tragically we've had some situations where lifeguards that were certified basically could not get to the victim in a pool that was deeper than what they had done in their training.That's why we do the pre-assessment.We want to make sure that these guards can do what they're supposed to do in the maximum depths that are at that facility.

Be able to recognize a victim – in some facilities, we'll have some type of eye test, basically a vision test, going on to make sure that people can see.There have been studies done on this that if a person even wearing corrective lenses or glasses, as a lifeguard they could see the victim.Once they were in the water, they could basically make a successful rescue if that was possible even though their glasses were not with them or anything like that.

Be able to reach the furthest zone or patron surveillance within 20 seconds.One of the things that is crucial when we start dealing with human lives is time.Time is of the essence.We want guards to get there as quickly as possible, to get to the victim.Again, we've used this 20 seconds as far as getting to the farthest area of the zones.Again, the committee that was dealing with this had a consensus that 20 seconds was a legitimate skill that they must have as they go through it.

Other qualifications and proficiencies that they would have beforehand in going through the inservice would be the water rescue skills, First Aid and CPR skills, execute emergency action plans.This is one thing that should be developed for all pools for as many situations as they can possibly come up with that they have an emergency action plan for it and how it's going to be staffed, how it's going to be executed, and how they're going to be, as far as a lifeguard, working with a safety team to make sure that they can execute the emergency action plan when necessary.

Emergency closure issues – the lifeguard should know what are the issues that we need to close the facility, to get people out of the water to get them to safety, whether it's a weather situation or whether it's some type of violence taking place near or in the aquatic venue.What are the closure issues that they need to get people out of the water to get them to safety as much as possible?

One of the things that came out from CDC a couple of years ago was dealing with any type of contamination.The lifeguards are probably going to be the frontline individuals that are going to be at the pool.They're going to be able to see if something is happening, whether there's someone bleeding near the pool near the pool or in the pool.If someone as vomited or there's a fecal accident in the pool, they need to know what's the protocol; what are we supposed to do?Is there a closure issue taking place?Do we need to get the people out of the water?What's taking place?

So they need to be trained and understand that facilities – and usually this is for almost all of us in the UnitedStates, we're using CDC guidelines to follow their recommendations as far as this type of contamination protocol in moving forward.

Preservice requirements – certificates shall be maintained at the facility.Policies and procedures, training specific to the venue – and this is one of the things, again.We have these lifeguarding classes that are very generic in nature, and we need to make sure when the lifeguard gets to a facility and they're getting ready to be hired or they have been hired that any type of moving forward as far as their inservice training and that, it's very specific to the venue itself.It shouldn't deviate really from their training; they should be using the same skills.But because of the venue being set up differently than what they had in their training, they need to understand what they should do as that first responder moving forward.

Demonstration of the safety team skills – again, we're talking about safety team now that can incorporate beyond the lifeguards.It could be a cashier; it could be a locker room attendant; it could be a maintenance personnel.All these people kind of play into the whole situation as far as being a safety team.This goes back to the emergency action plans.Who do you have as far as your responders that should be part of this safety team for your aquatic venue, and how are they going to react together and work together as a safety team?

Documentation of training – as we've talked about, whether it's inservice, preservice, there are documentations; there are certifications where they got certified.I would always keep records of who their trainer was as far as their lifeguard instructor.These are things that are crucial to make sure we've got very good staff at our aquatic venue.

Quality control – one of the things the Model Aquatic Health Code is look at the training agencies also.We have very good training agencies out there, and then we have some training agencies that might be a little bit on the periphery, that is more profit oriented than skill oriented.And we wanted to make sure that there was quality control built into both the instruction of the classes for the lifeguards that are taking this.

As you can see the first bullet, training agencies shall have a quality control system in place evaluating the lifeguard instructors, the ability to conduct courses.So having this, whether it's evaluations being turned in, some type of feedback to the agencies to look at the lifeguard and instructors that are providing these courses to make sure that the folks are doing a quality job in producing these lifeguards.

I had a situation once where a lifeguard instructor near us in Charlotte, North Carolina, was training people; and they never got out of five feet of depth of water.Well, this is totally against their training as far as the policies, as far as what they're supposed to be teaching in the first place.So we had to go in and basically look at all these individuals, retrain them if they wanted to be retrained; but we had to pull a lot of the certifications off these folks because the lifeguard instructor did not train them properly in the first place.We want to have quality individuals going out there as far as lifeguards.So all the protocols, all the things that are required by the agency, should be a part of their course in the first place.