Swim Goggles in Lifeguard Training

Last Full Review: American Red Cross Scientific Advisory Council Answer, 2012
Last Update: 2021

Swim goggles were designed, and have historically been used, to prevent water from entering the eyes and causing irritation. They were not originally designed to protect the eyes from trauma.

Should participants in Red Cross Lifeguarding courses be allowed to use swim goggles?

 

 

 

Evidence Summary

A 2012 American Red Cross Scientific Advisory Council Answer, updated in 2021, describes case reports of ocular trauma related to the use of swim goggles (Paula et al. 2016, 860; Morgan et al. 2008, 1218; Wakely et al. 2004, 1600). An evidence-based literature search was performed to support the safety recommendation that swim goggles should not be worn when submerging below a depth of 5 feet (1.5 meters). The ophthalmological evidence revealed the potential for serious eye injury from barotrauma that is increased when a swim participant wearing goggles is submerged to a depth of 5 feet (1.5 meters) or more and cannot equalize the pressure through the nose.

Research reaffirms, based on ophthalmological evidence-based research and established field-based guidelines, that swim google use should be limited to the prerequisite 300-yard swim and noncontact surface swimming practice activities during lifeguard training classes. Goggles should not be used for submerging below 5 feet (1.5 meters) of depth or during evaluative criterion course activities.

The potential for serious injury is greatly increased when the swim goggle is in contact with an external object, which focuses impact to the area around the eye to a much smaller surface area.

 

Insights and Implications

In order to prevent drownings, it is important that swimmers can perform basic water competency activities (e.g., safe water entry/exit, breath control, flotation, movement on the front and on the back, change of position or orientation) without and with goggles during potential drowning incidents. Lifeguarding instructors and water safety instructors should familiarize themselves with the safe and appropriate use of swim goggles during American Red Cross classes and avoid their use in unsafe conditions, such as during diving or submersion (Best practice statement).

 

Appropriate Water Temperatures for Aquatic Instructional Programs

Last Full Review: American Red Cross Scientific Advisory Council, 2018
Last Update: 2021

Water temperature is a major factor in participant comfort and overall success of an American Red Cross Aquatic Instruction program. Water that is too cold can lead to chilling and discomfort and result in limiting the time spent on necessary practice.

What water temperature ranges are recommended for aquatic instruction?

 

 

Evidence Summary

A 2018 American Red Cross Scientific Advisory Council scientific review (American Red Cross Scientific Advisory Council 2018), updated in 2021, evaluated indoor pool water temperature ranges recommended by the Aquatic Exercise Association (Aquatic Exercise Association 2020) and USA Swimming (USA Swimming 2017) during aquatic instructional programs. The review sought to identify significant variables that affect thermoregulation and to provide more guidance where temperature extremes are the norm or program types and structure vary widely.

The American Red Cross Scientific Advisory Council scientific reviews note that because direct measurement of the hypothalamic temperature is not possible, other temperature measurement techniques were used in the studies. The variety of methods of temperature measurements made it difficult to compare research results. Additional differences in study methodology further complicate the comparison of findings and interpretation of results.

Findings in the scientific reviews from multiple studies regarding general responses to water immersion in temperatures ranging from 59° F to 91.4° F (15° C to 33° C) include:

• There is a direct relationship between water temperature and the length of time a person can be comfortably immersed, with the duration of comfortable immersion decreasing as temperature decreases.
• The metabolic rate increases as the temperature of the water decreases.
• The range of water temperatures in which a person can attain thermal balance can be extended by reducing the total surface area exposed to the water by exercise.
• Head submersion increases the cooling rate of the body.
• If water temperature and duration of immersion are controlled, some factors that act in concert to extend or reduce thermal comfort include surface area-to-mass ratio, subcutaneous fat thickness, age, rest versus exercise and level of fitness.
• The type and intensity of exercise in the water affects the cooling rate of the body.
• The ability of the arms to retain heat is lower than that of the legs, due to the higher surface area-to-mass ratio.
• There is a direct, nonlinear relationship between percent of body fat (% BF) and critical water temperature (persons with greater % BF have a lower critical water temperature, and therefore can remain longer in the water with less cold stress).
• Exercise performance, such as swimming, is affected by water temperature extremes.

The American Red Cross Scientific Advisory Council scientific reviews conclude that the range of water temperatures needed to optimize participant comfort and overall success of any aquatic instructional program varies with factors—including but not limited to—participant age, type of activity, intensity and planned immersion time. Suggested water temperatures for indoor pools with controlled humidity and air temperature are provided, as well as considerations for mitigation of heat loss in colder-than-recommended water and monitoring participants for hypothermia.

 

Insights and Implications

Water temperature is a major factor in participant comfort and overall success of any aquatic instructional program. Water that is too cold can lead to chilling and discomfort and result in limiting time spent on necessary practice. In contrast, water that is too hot can lead to overheating, discomfort and limiting the time spent on necessary practice. Overall, evidence from the 2018 review suggests that for each person there is a water temperature range in which they are most comfortable at rest and at different levels of exercise intensity. Most importantly, aquatic instructors should be able to recognize when a participant needs to end an in- or out-of-water session because of the early onset of temperature related issues, regardless of water temperature.

 

Retention of CPR Skills After Training

Last Full Review: American Red Cross Scientific Advisory Council 2009
Last Update: 2022

Bystander cardiopulmonary resuscitation (CPR) is associated with increased rates of survival following cardiac arrest. Past reviews have shown skill decay within 3 months of training and recommendations have been made for retraining at 1 to 2 years.

Is there new evidence to suggest an ideal period for refreshing CPR skills after initial training?

 

 

 

Evidence Summary

A 2022 triennial review (American Red Cross Scientific Advisory Council 2022) of an American Red Cross Scientific Advisory Council scientific review aimed to look for evidence to determine how long after training or retraining in CPR is the ability retained to perform effective CPR. Studies of CPR skill retention that were identified are heterogeneous due to the many types of training, the multiple modes of teaching and the varying levels of trainees. Many forms of primary instruction were equally associated with CPR performance degradation, and no form of primary instruction was shown to be superior in preventing degradation of skills. The authors of the review note that given the heterogeneity of the published research and the lack of standardized testing of skill retention, it is difficult to say with certainty what the optimal retraining schedule should be. However, more frequent refresher intervals are suggested and may be accomplished by establishing periodic personalized scheduling of performance training and assessment in the clinical environments, or through spaced learning with initial training (See Infographic: Retention of CPR Skills After Training).

Insights and Implications

There continues to be insufficient evidence to recommend the optimum interval or method for CPR for the Professional Rescuers skills retraining for lifeguards. The American Red Cross Lifeguarding Participant Manual (American Red Cross 2024) recommends a benchmark for facility operations that facility management would provide regular opportunities for lifeguards to practice multiple-rescuer response techniques, including two-rescuer CPR and multiple-rescuer team response skills.