It is common enough for lifeguards to provide first aid to members of the public or staff. Mostly, these occur as walk-ins and can be easily treated with a band-aid, sting kill, or cold pack. However, the public does injure themselves with slips, trips, or falls that can lead to sprains, strains, contusions, dislocations, and breaks. While these treatments might not be as serious as rescue breathing or CPR, your lifeguards still need to develop proficiency in providing care, which could be for the immediate injury and/or the patron’s overall well being.
In addressing musculoskeletal injuries, let’s review a few areas that your lifeguards might need to address when providing care.
Environmental: Not all injured patrons will walk into the first-aid station. Lifeguards will need to travel with first aid gear in hand. Especially in open water, when lifeguards arrive on the scene, the environment could be inhospitable: rocky ledge; sandy, uneven, or slippery surfaces; full sun exposure; confined spaces; in water or even moving water. Lifeguards must assess whether they can safely and effectively provide initial care where the injured person was found or if they need to extricate the patron to a safer location first.
Cleaning the injured area: Not all injuries are clean and visible. The injured patron may be covered in sand, mud, or debris that obscures the injury site or effects the patron’s overall well-being. Lifeguards might need to clean the area around the injury – or even clean the patron – before providing care.
Multiple injuries: Patrons may have multiple injuries that need treatment. Once the musculoskeletal injury has been addressed, lifeguards should treat all other injuries and provide the appropriate care. Example: Immobilize a potentially fractured forearm, treat for shock, move the injured patron from direct sun, and clean and bandage additional cuts.
Delayed response from EMS: In case Fire and EMS are delayed in their arrival, lifeguards should be proficient in splinting an injured limb and provide ongoing care. Example: What do lifeguards do with an injured patron who receives care beyond a single rotation?
All of these factors should be incorporated into your drills, to make them realistic. With that in mind, the following drills will help prepare your lifeguarding team for these situations.
EXTRICATE AND CARE DRILL: Lifeguards form three-person teams – two will be the rescuers, one will be the injured patron. Have first aid supplies on hand. The injured patron is in the water. The instructor will identify the limb that is injured.
Objective: Lifeguards arrive on scene to the injured patron. It is determined that the patron needs to be moved or extricated to a safe and stable location before care is given. Then immobilization and care are provided.
Timing goal: 2 minutes.
Perform the drill in the following areas:
- In a pool, lazy river or wave pool
- Shallow surf
- Hillside/ledge
- Within a single occupancy bathroom stall
Once the lifeguards are proficient in extrication and care, add the following:
- Extended response time, lifeguards need to perform a full patient assessment
- Extended response time, lifeguards must treat for shock
- Extended response time, lifeguards splint the injury
- Reduce to only one rescuer providing care
CLEAN AND CARE DRILL: Lifeguards form three-person teams – two as the rescuers, one as the injured patron. First-aid supplies should be present. The instructor identifies the injured limb and what material or debris is obscuring the injury
Objective: After arriving on the scene, the lifeguards determine that the injury site must be cleaned before care can be provided. After cleaning the injury site, the team can provide immobilization and care.
Timing goal: 4 minutes.
Once the injury has been immobilized and treated, provide appropriate care for the following:
- The patron has sunscreen in their eyes and can’t see
- The patron is covered with dirt or mud from a fall
- The patron has a bloody area on their person due to the injury (non-life threatening)
Once the lifeguards are proficient in providing care, add the following:
- Extended response time, lifeguards need to perform a full patient assessment
- Extended response time, lifeguards must treat for shock
- Extended response time, lifeguards splint the injury
- Reduce to only one rescuer providing care
MULTIPLE INJURIES DRILL: Lifeguards form three-person teams – two will be the rescuers, one will be the injured patron. Have first aid supplies at the scene. The instructor identifies the injured limb and additional injuries.
Objective: The lifeguards arrive on the scene to an injured patron. It is determined that the patron has multiple injuries, at least one being musculoskeletal. The lifeguards need to provide care to all injuries.
Timing goal: 4 minutes.
Once the injury has been immobilized and cared for, utilize one of these options for the other injury:
- The patron has potential multiple fractures
- The patron may have a fractured rib
- Multiple cuts or road rash from a fall
- A minor burn from a barbeque
- A bloody nose
- The patron is diabetic and beginning to feel lightheaded
- The known asthmatic is beginning to experience shortness of breath
Once the lifeguards are proficient in providing care, add the following:
- Extended response time, lifeguards must perform a full patient assessment
- Extended response time, lifeguards must treat the patron for shock
- Extended response time, lifeguards splint the injury
- Reduce to only one rescuer providing care
- Multiple injured patrons
MISTAKES TO LOOK FOR
As the trainer, your critical eye is needed to make sure participants don’t make mistakes that could delay or compromise care. Here are some errors you might see:
- Lifeguards don’t take universal precautions
- They fail to request additional help
- They do not immobilize the injured area
- They fail to identify additional injuries
As the trainer, remind your lifeguards that they need to treat all injuries and be thorough in their assessments of the injured patrons. Remember less talk and more skill repetition. Good luck and keep training.