Lifeguarding Manual

Lifeguarding
Lifeguarding
INSTRUCTOR’S MANUAL
Lifeguarding
Stock No. 655736

American Red Cross
Lifeguarding
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This instructor’s manual is part of the American Red Cross Lifeguarding program.
Visit redcross.org to learn more about this program.
The emergency care procedures outlined in this book reflect the standard of knowledge
and accepted emergency practices in the United States at the time this book was published. It is the
reader’s responsibility to stay informed of changes in emergency care procedures.
PLEASE READ THE FOLLOWING TERMS AND CONDITIONS BEFORE AGREEING

TO ACCESS AND DOWNLOAD THE AMERICAN RED CROSS MATERIALS. BY
DOWNLOADING THE MATERIALS, YOU HEREBY AGREE TO BE BOUND BY THE
TERMS AND CONDITIONS.
The downloadable electronic materials, including all content, graphics, images, and
logos, are copyrighted by and the exclusive property of The American National Red Cross
(“Red Cross”). Unless otherwise indicated in writing by the Red Cross, the Red Cross
grants you (“recipient”) the limited right to download, print, photocopy and use the electronic
materials, subject to the following restrictions:
■■ The recipient is prohibited from selling electronic versions of the materials.

■■ The recipient is prohibited from revising, altering, adapting, or modifying the materials.
■■ The recipient is prohibited from creating any derivative works incorporating, in part or in
whole, the content of the materials.
■■ The recipient is prohibited from downloading the materials and putting them on their own
website without Red Cross permission.
Any rights not expressly granted herein are reserved by the Red Cross. The Red Cross does not
permit its materials to be reproduced or published without advance written permission from the
Red Cross. To request permission to reproduce or publish Red Cross materials, please submit your
written request to The American National Red Cross.
© 2012 American National Red Cross. ALL RIGHTS RESERVED.
The Red Cross emblem, American Red Cross® and the American Red Cross logo are trademarks of
The American National Red Cross and protected by various national statutes.
Published by Krames StayWell Strategic Partnerships Division.
Printed in the United States of America.
ISBN: 978-1-58480-488-8
ACKNOWLEDGMENTS
This manual is dedicated to the thousands of employees and volunteers of the American Red Cross who contribute
their time and talent to supporting and teaching lifesaving skills worldwide and to the thousands of course
participants and other readers who have decided to be prepared to take action when an emergency strikes.
This manual reflects the 2010 Consensus on Science for CPR and Emergency Cardiovascular Care and the
Guidelines 2010 for First Aid. These treatment recommendations and related training guidelines have been
reviewed by the American Red Cross Scientific Advisory Council, a panel of nationally recognized experts in fields
that include emergency medicine, occupational health, sports medicine, school and public health, emergency
medical services (EMS), aquatics, emergency preparedness and disaster mobilization. This manual also reflects the
United States Lifeguarding Standards: A Review and Report of the United States Lifeguard Standards Coalition, a
collaborative effort of the American Red Cross, the United States Lifesaving Association and the YMCA of the USA.
Many individuals shared in the development and revision process in various supportive, technical and creative
ways. The American Red Cross Lifeguarding Instructor’s Manual was developed through the dedication of both
employees and volunteers. Their commitment to excellence made this manual possible.
The American Red Cross team for this edition included:

Jean Erdtmann Mark Schraf
Senior Director Gina Gunn Senior Associate
Program Development and Sales Support Project Manager, Aquatics Sales Business Planning
Support
Kamenna Lee Sales Support Charles Snyder
Vice President Associate
Business Marketing Tom Heneghan Program Development
Senior Associate, Business Planning
Jennifer Deibert Business Planning Stephanie Shook, CPRP
Manager Senior Associate
Program Development Don Lauritzen Program Development
Senior Associate
Connie Harvey Operations John Thompson
Manager, Aquatics Program Senior Associate
Development Stephen Lynch Program Administration
Project Manager Senior Analyst
Retail Product Development and Distribution Joy Zukauskas
Kara L. Desmarais, MPA Senior Associate
Project Manager Stacey Ryan Divisional Support
Information Technology Director, Service Delivery
Division 6
Denise González Hensal
Business Analyst
Information Technology
The following individuals provided guidance and support:

Jack McMaster Steven Glockenmeier Don Vardell
President Vice President National Chair
Preparedness and Health and Safety Services Preparedness and Health and Safety Services Preparedness and Health and Safety Services
Acknowledgments iii
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The StayWell team for this edition included:
Nancy Monahan Ellen Beal Bryan Elrod
Senior Vice President Executive Director Senior Developmental Editor
Content and Delivery Platforms
Paula Batt Kate Plourde
Vice President David Cane Marketing Manager
Sales and Client Services Managing Editor
Shannon Bates
Reed Klanderud Danielle DiPalma Senior Production Manager
Vice President Senior Content Manager
Marketing and Communications Michelle Clark
Senior Graphic Designer
The following members of the American Red Cross Scientific Advisory Council also
provided guidance and review:
David Markenson, MD, FAAP, Roy R. Fielding Francesco A. Pia, PhD
EMT-P Member, American Red Cross Member, American Red Cross
Chair, American Red Cross Scientific Scientific Advisory Council Scientific Advisory Council
Advisory Council University of North Carolina—Charlotte Water Safety Films, Inc.
Chief, Pediatric Emergency Medicine Department of Kinesiology President, Pia Consulting Services
Maria Fareri Children’s Hospital Coordinator, Exercise Science/Director of Larchmont, New York
Westchester Medical Center Aquatics
Valhalla, New York Charlotte, North Carolina S. Robert Seitz, M.Ed., RN,
NREMT-P
Peter Wernicki, MD Terri Lees Member, American Red Cross
Aquatics Chair, American Red Cross Member, American Red Cross Scientific Advisory Council
Scientific Advisory Council Scientific Advisory Council University of Pittsburgh
Sports Medicine Orthopedic Surgeon Aquatic Supervisor Center for Emergency Medicine
International Lifesaving Federation Medical North Kansas City Community Center Pittsburgh, Pennsylvania
Committee Past Chair North Kansas City, Missouri
U.S. Lifesaving Association
Medical Advisor
Vero Beach, Florida
The Sounding Board for this edition included:

Joyce A. Bathke Scott E. Gerding Joetta R. Jensen
Chief Administrative Officer Sales Manager Assistant Professor and Director of
American Red Cross St. Louis Area Chapter Mid-East Division Aquatics
St. Louis, Missouri American Red Cross Hampton University
Columbus, Ohio Hampton, Virginia
David W. Bell, PhD
National Aquatic Committee Juliene R. Hefter Rhonda Mickelson
National Health and Safety Committee Deputy Director Director of Standards
Boy Scouts of America Wisconsin Park & Recreation Association American Camp Association
Ponca City, Oklahoma Owner, Safety First Aquatics, LLC Estes Park, Colorado
Greendale, Wisconsin
Pete DeQuincy Billy Pounds
Aquatic Supervisor Carolyn Hollingsworth-Pofok Aquatics Manager
East Bay Regional Park District Director of Recreation and Events City of Pearland
Oakland, California Millcreek MetroParks Pearland, Texas
Canfield, Ohio
Shawn DeRosa, JD, EMT-B Clayton D. Shuck
Manger of Aquatic Facilities and William A.J. Kirkner, JD Deputy Manager of Recreation
Safety Officer for Intercollegiate Aquatics Director South Suburban Parks and Recreation
Athletics JCC of Greater Baltimore Centennial, Colorado
The Pennsylvania State University Reisterstown, Maryland
University Park, Pennsylvania Thomas C. Werts
President
Aquatics Safety Consulting
Kissimmee, Florida
iv Lifeguarding Instructor’s Manual
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The following individuals participated as Waterpark and Waterfront Working Group
members:
Adam Abajian Robert E. Ogoreuc Danial Llanas
Recreation Program Manager/ Assistant Professor Director of Support Services
Lakefront Operations Slippery Rock University Busch Entertainment Corporation
City of Evanston Slippery Rock, Pennsylvania San Antonio, Texas
Evanston, Illinois
William J. Frazier Scott Mersinger
Darwin DeLappa Aquatic Operations Manager Aquatics Director
Director of Water Safety Massanutten Resort Lost Rios Waterpark
New York State Parks and Recreation McGaheysville, Virginia Wisconsin Dells, Wisconsin
Queensbury, New York
Lee Hovis
Luiz A. Morizot-Leite Director of Recreation Operations
Captain, Ocean Rescue Lifeguard, Nocatee Waterpark Recreation
Miami-Dade Ponte Vedra Beach, Florida
Fire Rescue Department
Miami-Dade County, Florida
The following individuals provided external review:

Alex Antoniou Jerome H. Modell, MD, D Sc The American Red Cross thanks Jorge
Director of Educational Programs (Hon.) L. Olaves H., Ed S, Florida A&M University,
National Swimming Pool Foundation Emeritus Professor of Anesthesiology for his contributions to this manual, as well
Colorado Springs, Colorado Courtesy Professor of Psychiatry as Pat Bennett and Lindsay O’Donnell for
Courtesy Professor of Large Animal Clinical their assistance in writing the instructor’s
Sciences manual and supplementary materials.
Colleges of Medicine & Veterinary Medicine
University of Florida
Gainesville, Florida
Acknowledgments v
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CONTENTS
SECTION A | ADMINISTRATION
CHAPTER 1 INTRODUCTION _____________________________________________________________ 1

Course Purpose _____________________________________________________________ 1
Course Objectives ___________________________________________________________ 1
Course Participants __________________________________________________________ 1
Instructor’s Responsibilities __________________________________________________ 2
CHAPTER 2 COURSE DESIGN____________________________________________________________ 3

Course Content _____________________________________________________________ 3
Participant Resources ________________________________________________________ 3
Lifeguarding Manual ______________________________________________________ 3
Instructor Resources _________________________________________________________ 3
Lifeguarding Instructor’s Manual _____________________________________________ 3
Video Segments___________________________________________________________ 4
Materials, Equipment and Supplies ___________________________________________ 5
Course Presentation _______________________________________________________ 5
Activity Worksheets ________________________________________________________ 6
Instructor’s Corner ________________________________________________________ 6
Additional Resources for Instructors and Participants ___________________________ 6
Training Equipment and Red Cross Retail Products _____________________________ 6
Additional Red Cross Courses ______________________________________________ 6
Refresher Program ________________________________________________________ 6
CHAPTER 3 SETTING UP AND RUNNING THIS COURSE ____________________________________ 7

Recommended Class Size ____________________________________________________ 7
Course Length ______________________________________________________________ 7
Classroom Space ____________________________________________________________ 7
Swimming Area ______________________________________________________________ 7
Setting Up and Running Skills Sessions ________________________________________ 8
Class Safety _________________________________________________________________ 9
Health Precautions for Course Participants ____________________________________ 10
Participants With Disabilities and Special Health Considerations _________________ 10
CHAPTER 4 REQUIREMENTS FOR SUCCESSFUL COURSE COMPLETION ____________________ 11

Criteria for Course Completion and Certification _______________________________ 11
Final Written Exams _________________________________________________________ 11
Final In-Water Skill Scenarios ________________________________________________ 11
Exam Security _____________________________________________________________ 12
Reporting Procedures _______________________________________________________ 12
Participant Course Evaluation ________________________________________________ 12
Contents vii
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Awarding Certificates _______________________________________________________ 12
Continuing Education Units for Professionals __________________________________ 12
SECTION B | THE LIFEGUARDING AND SHALLOW WATER

LIFEGUARDING COURSES
Lifeguarding Course Outline _________________________________________________ 13

Shallow Water Lifeguarding Course Outline ____________________________________ 19
Precourse Session _________________________________________________________ 26
LESSON 1: The Professional Lifeguard and Facility Safety _______________________ 32
LESSON 2: Facility Safety, Patron Surveillance and Injury Prevention _____________ 48
LESSON 3: Injury Prevention and Rescue Skills, Part 1 __________________________ 62
LESSON 4: Rescue Skills, Part 2 ______________________________________________ 72
LESSON 5: Before Providing Care, Victim Assessment and Breathing Emergencies 79
LESSON 6: Cardiac Emergencies and Using an Automated External Defibrillator___ 99
LESSON 7: First Aid ________________________________________________________ 114
LESSON 8: Head, Neck and Spinal Injuries in the Water ________________________ 133
LESSON 9: Final Written Exam and Final In-Water Skill Scenarios _______________ 141
Activity Worksheets ________________________________________________________ 145
ACTIVITY WORKSHEET 1.1—Reasons for the Rules _________________________ 145
ACTIVITY WORKSHEET 2.1—Guarding Special Attractions ___________________ 148
ACTIVITY WORKSHEET 3.1—Strategies for a Safe Group Visit ________________ 149
ACTIVITY WORKSHEET 6.1—Using an AED in Unique Situations—Fact or Fiction 150
SECTION C | WATERFRONT SKILLS
Module Outline ____________________________________________________________ 151

Waterfront Skills Module Lesson Plan ________________________________________ 154
SECTION D | WATERPARK SKILLS
Module Outline ____________________________________________________________ 175

Waterpark Skills Module Lesson Plan ________________________________________ 178
SECTION E | LIFEGUARDING FINAL WRITTEN EXAMS

Lifeguarding _______________________________________________________________ 191
SECTION 1—CPR/AED for the Professional Rescuer and First Aid,
Exams A and B _____________________________________________ 193
SECTION 2—Lifeguarding Skills Exams A and B _____________________________ 206
Shallow Water Lifeguarding _________________________________________________ 219
SECTION 2—Shallow Water Lifeguarding Skills Exams A and B ________________ 220
viii Lifeguarding Instructor’s Manual
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Waterfront Skills Module ____________________________________________________ 232
Waterfront Skills Module Exam, Exams A and B ______________________________ 233
Waterpark Skills Module ____________________________________________________ 239
Waterpark Skills Module Exam, Exams A and B _______________________________ 240
Final Written Exam Answer Sheets __________________________________________ 247
Index _____________________________________________________________________ 253
Final Written Exam Answer Keys
Contents ix
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SECTION A | ADMINISTRATION
CHAPTER 1
INTRODUCTION
This manual is intended to serve as a resource for should be familiar with the material in the American
instructors of the American Red Cross Lifeguarding Red Cross Lifeguarding Manual (Stock No. 655735)
program. The information and teaching strategies and in this instructor’s manual before you teach
it provides will help you to teach the program. You the course.
COURSE PURPOSE
The purpose of the American Red Cross Lifeguarding and respond to emergencies in aquatic facilities with
course is to provide entry-level lifeguard participants waterpark features.
with the knowledge and skills to prevent, recognize
The care steps outlined within this product are
and respond to aquatic emergencies and to provide
consistent with the Guidelines 2010 for First Aid and
care for breathing and cardiac emergencies, injuries
the 2010 Consensus on Science for Cardiopulmonary
and sudden illnesses until emergency medical services
Resuscitation and Emergency Cardiovascular
(EMS) personnel take over.
Care. This manual also reflects the United States
The purpose of the Shallow Water Lifeguarding course Lifeguarding Standards: A Review and Report of
is to learn the knowledge and skills needed to prevent the United States Lifeguard Standards Coalition, a
and to respond to aquatic emergencies in shallow water collaborative effort of the American Red Cross, the
up to 5 feet deep. The purpose of the Waterfront Skills United States Lifesaving Association and the YMCA of
module is to teach lifeguards the skills and knowledge the USA.
needed to prevent and respond to emergencies in
The course content and activities will prepare
nonsurf, open-water areas found at public parks,
participants to make appropriate decisions about
resorts, summer camps and campgrounds. The
the care to provide in an aquatic emergency and a
purpose of the Waterpark Skills module is to teach
medical emergency.
lifeguards the skills and knowledge needed to prevent
COURSE OBJECTIVES
It is your responsibility as an instructor to see listed at the beginning of each lesson in this
that participants meet the learning objectives instructor’s manual.
COURSE PARTICIPANTS
Many of the course participants will be in, or preparing instructors, swim coaches, public safety personnel,
for, positions that require a background in lifeguarding. adult youth leaders and the general public. Participants
Participants may include camp counselors, water safety may represent a broad range of backgrounds and
SECTION A | Administration 1
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differ in levels of education and experience. They may Prerequisites for each course or module are listed
be taking courses in the Lifeguarding program to in the Precourse Session in this instructor’s manual.
fulfill employment requirements, to complete Before having the participants break to change into
requirements for a major area of study or certification their swimsuits for the prerequisite swimming skills
or for personal satisfaction. evaluation, orient them to the locker rooms and the
pool area where they are to meet.
INSTRUCTOR RESPONSIBILITIES
Your responsibilities as a certified Red Cross instructor ■ Providing participants an opportunity to evaluate
include: the course.
■ Providing for the health and safety of participants ■ Adapting your teaching approach to match the
by always ensuring: experience and abilities of the participants,
| Manikins have been properly cleaned identifying participants who are having difficulty
according to “Recommendations on and developing effective strategies to help them
Manikin Decontamination,” which is meet course objectives.
available on Instructor’s Corner.
■ Supervising participants while they are practicing
| Other course equipment (medical and first aid
supplies) is clean and in good working order. course skills and providing timely, positive and
corrective feedback as they learn.
| Participants are aware of health
precautions and guidelines concerning ■ Evaluating participants as they perform skills,
the transmission of infectious diseases. focusing on critical performance steps as described
| All participants have the physical in the skill charts.
ability to perform the skills and know
to consult you if they have concerns ■ Administering and scoring the final written exams.
about their physical ability to do so. ■ Conducting courses in a manner consistent with
| The classroom, aquatic facility and all course design.
practice areas are free of hazards.
■ Submitting completed course records and reports
■ Being familiar with and knowing how to effectively to the Red Cross representative within 10 working
use program materials and training equipment. days from course completion.
■ Ensuring there are lifeguards on duty during ■ Being familiar with and informing participants of
the in-water skill sessions with the proper safety other Red Cross courses and programs.
equipment, and that the swimming area is the
■ Being prepared to answer participants’ questions
proper water quality.
or knowing where to find the answers.
■ Maintaining adequate supervision at all times
■ Providing a positive example by being neat in
during in-water skill sessions.
appearance and not practicing unhealthy behaviors
■ Foreseeing hazards and taking steps to eliminate or while conducting American Red Cross courses.
control them before participants arrive or step into
■ Identifying potential instructor candidates and
the water.
referring them to the appropriate Red Cross
■ Planning, coordinating and managing training with representatives.
the Red Cross, including advising the Red Cross in
■ Abiding by the obligations in the Instructor
advance of any classes you are scheduled to teach.
Agreement and Code of Conduct and, if applicable,
■ Informing participants about knowledge and skills the Authorized Provider Agreement.
evaluation procedures and course completion
■ Representing the Red Cross in a positive manner.
requirements.
■ Promoting volunteer opportunities available
■ Creating a non-threatening environment that is
through the Red Cross.
conducive to achieving the learning objectives.
■ Preparing participants to meet the course
objectives.
2 Lifeguarding Instructor’s Manual
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CHAPTER 2
COURSE DESIGN
COURSE CONTENT
The course is designed to be flexible in delivery. needs and interests of the participants as long as these
You should not modify course content, but you have participants can meet the course objectives. You may
flexibility to select teaching methods to meet the wish to emphasize certain aspects of the content.
PARTICIPANT RESOURCES
Lifeguarding Manual the course. The manual is available for purchase (Stock
No. 655735) or as a downloadable digital version, which
The manual has been designed to simplify learning and can be printed. Participants must have a Lifeguarding
understanding of the material. The manual reinforces Manual at the start of the course.
key points from the lecture portions of the course and
contains skill sheets. It also serves as a reference after Free electronic versions are available on redcross.org.
INSTRUCTOR RESOURCES
Lifeguarding Instructor’s Manual Lifeguarding/Shallow Water Lifeguarding Skills.
It also includes the final written exams for the
This instructor’s manual contains all the information Waterfront Skills and Waterpark Skills modules.
necessary to conduct the American Red Cross
Lifeguarding program. The manual is divided into The instructor’s manual can also be viewed online on
five parts—Section A: Administration, Section B: The Instructor’s Corner (redcross.org/instructorscorner).
Lifeguarding and Shallow Water Lifeguarding Courses, Lesson Plans
Section C: The Waterfront Skills Module, Section D: Several items in the lesson plans can help you conduct
The Waterpark Skills Module and Section E: Final the course. These include the following:
Written Exams, Answer Sheets and Answer Keys.
Lesson Objectives
■ Section A: Administration contains information
needed to conduct the course and provides a course The knowledge and skill objectives are presented at the
overview, explains how to set up and teach the beginning of each lesson.
course, gives requirements for successful course
Lecture Points
completion and describes what to do when the
course is completed. The lecture points summarize the critical material from
the lesson that is most important for the participants
■ Sections B–D include the course outline and the
to understand. They also represent the information
lesson plans to teach the Lifeguarding and Shallow
participants need to meet the objectives, successfully
Water Lifeguarding courses and the Waterfront
complete the skill sessions and pass the written exams.
Skills and Waterpark Skills modules. The lesson
plans provide the instructor with the primary Activities
points to be covered in each lesson and with
The activities that are part of the lesson plans
guidelines for classroom activities.
involve participants in guided discussion, viewing
■ Section E: Final Written Exams, Answer Sheets video segments and course presentations, activity
and Answer Keys includes the final written worksheets and scenarios. Most lessons contain at
exams for CPR/AED for the Professional Rescuer least one activity.
and First Aid and the final written exams for
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Where the lesson has an alternate activity, the Skills Assessment Tools
instructor should use these when conducting the
In addition to performing the steps listed in the
Shallow Water Lifeguarding course as they apply to
skill chart in the correct order, participants must
water less than 5 feet deep.
meet the criteria listed at the proficient level on the
skill assessment tools to be checked off for a skill.
Skill Drills
Assessment criteria that are general for the category of
Skill drills are used to help reinforce the skills learned skills, as well as specific to the skill, must be met.
up to that point in the lesson and require participants
to perform multiple skills in succession. Skill drills Scenarios
provide an immediate opportunity to put the “total
Scenarios help to reinforce learning by drawing on
picture” into practice.
participants’ skills and decision-making abilities in
various situations. They also are included as a review
Assignments
during which participants can recall and apply the
At the end of each lesson is an assignment for the next information learned in the course.
lesson.
Final Written Exams
Land-Based Skills Practice
Two exams, Section 1—CPR/AED for the Professional
In some of the land-based skill practice sessions, Rescuer and First Aid and Section 2—Lifeguarding
participants practice the skill on one another and/or on Skills are included in Section E of this manual. Two
manikins. Practice on a “real-life” victim is important to versions are available for each exam. Participants must
give participants experience in handling a real person. pass each exam with a minimum score of 80 percent
Skills that require mouth-to-mouth contact, such as as part of the requirements for receiving American Red
giving ventilations and performing CPR, however, are Cross course completion certificates.
practiced only on manikins. Suctioning and airway
Additional exams for the Waterfront Skills and
insertion also should be done only on manikins.
Waterpark Skills modules are also included in
Request that participants with special needs, including Section E of this manual.
medical conditions or physical disabilities, bring these
to your attention privately to determine if reasonable Video Segments
accommodations can be made while still accomplishing
The Lifeguarding DVD Set (Stock No. 655739) is
the course objectives.
designed specifically for use during the courses in the
Lifeguarding program. The video segments can also be
In-Water Skill Practice
viewed on Instructor’s Corner. Instructors are required
The in-water rescue skills performed in the to use the video segments because they contain model
Lifeguarding courses and modules have multiple demonstrations that combine real-life scenarios with
actions occurring simultaneously. If a skill is only studio-based skill segments to help ensure lesson
demonstrated from one side or angle, the secondary objectives are met. The course cannot be conducted if
actions may be missed and the total picture will the video segments are not available. A detailed menu
be incomplete. This is true for skills that involve of the Lifeguarding DVD Set and running times is
actions both above and below water. For example, in included on Instructor’s Corner.
demonstrating how to turn a victim face-up using the
head splint, participants may clearly see the rescuer’s Instructors can also use the Lifeguarding DVD Set
hand and arm position above the water, but may to teach the Administering Emergency Oxygen and
not notice the rescuer’s leg action. Since supporting Bloodborne Pathogens Training: Preventing Disease
the victim and avoiding unnecessary movement are Transmission courses and the asthma inhaler and
important when performing the rescue, the rescuer’s epinephrine auto-injector trainings.
underwater actions are significant elements in the
total skill.
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Materials, Equipment and Supplies if fewer backboards are available, additional
time may be required
Specific materials, equipment and supplies needed for
For each lesson, lifeguard candidates must have the
each lesson are included at the beginning of the lesson.
Lifeguarding Manual and should have a pencil or
Instructors should have the specific equipment needed
pen, a name tag, the activity worksheets, non-latex
for the lessons ready prior to the start of the lesson.
disposable gloves in multiple sizes and a resuscitation
■ For the course, instructors must have the following: mask (adult and pediatric). For the final lesson, each
| Newsprint and marker pens, easel or tape candidate should have a final written exam and answer
| Equipment for viewing the video segments sheet for the applicable course and/or module.
and/or the course presentation, including a
DVD player and monitor or LCD projector, Instructors must have American Red Cross
extension cord and grounded plug adaptor identification; the Lifeguarding Manual; the
if needed, Lifeguarding DVD Set and Lifeguarding Instructor’s Manual; a name tag; answer
the applicable course presentation
keys for the course and/or module exams; extra
| Diving bricks and a stopwatch or pace clock manikin lungs, airways and faces; Course Record and
| Rescue tubes (one for every two participants) Course Record Addendum; Participant Progress Log;
| Hip packs and extra pens or pencils.
■ For the Lessons 5, 6 and 9, each class must have
the following: Course Presentation
| Manikin decontamination supplies
Another resource for instructors is the Lifeguarding
including decontamination solution,
4-inch x 4-inch gauze pads, soap and course presentations. Similar to a PowerPoint
water, brush, basins or buckets, and any presentation, the course presentation is an in-class
accessories that may be recommended visual aid that is projected onto a screen or viewing
by the manufacturer of the manikin
area. Instructors click through the presentation slides
| Blankets or mats (one for every as they progress through the lessons.
two participants)
| Adult and infant manikins (one of each The course presentation is designed to include all
for every two participants) the visual information necessary to conduct the
| Child manikins are optional (one for every Lifeguarding courses. The course presentation
two participants) includes lecture points, video segments and
| Adult and pediatric bag-valve-mask selected skill sheets. Cross-references appear in
resuscitators
this manual to assist in teaching along with the
| AED training devices (one for every
course presentation.
two participants)
| Adult AED training pads (one set for each Before conducting the course, become familiar with the
training device) presentation software and test the display of the system
| Pediatric AED training pads (one set for to be used. It is recommended you have backup copies
each training device)
of the presentation in case technical difficulties occur.
| A towel
■ For the Lessons 7 and 8, each class must have the Course Presentation System Requirements:
following: ■ Adobe Reader 9
| External bleeding control materials ■ Flash Player 8, 9 for Windows and Mac
for each pair of participants, including ■ Flash Player 9 for Linux and Solaris
two 3-inch roller bandages and four
nonsterile dressings or gauze pads Equipment Requirements:
| Splinting materials for each pair of ■ Laptop/desktop computer
participants, including four triangular
■ Power source
bandages, one 3-inch roller bandage, a
blanket or pillow and a rigid splint such as a ■ Projector
magazine, cardboard or long and short boards
■ Projection screen/area
| Spinal immobilization materials
■ Computer speakers
| Backboards, each equipped with 3 straps
and head immobilizers (one backboard for The presentation is available to download on
every three participants is recommended); Instructor’s Corner. The presentation is saved in PDF
LGI_SecA_p001-012.indd 5 10/24/11 1:22 PM

format. To view the presentation, save the file to your ■ Administrative Terms and Procedures.
computer and double click on the PDF icon to open it. ■ Course Fact Sheets.
Additional directions for using the course presentation
■ Sample Letter to Lifeguarding course participants.
are available on Instructor’s Corner.
■ Course Record and Course Record Addendum.
Activity Worksheets ■ Americans with Disabilities Act (ADA) Resource
Guide.
The Lifeguarding program uses activity worksheets in
some of the lessons to help reinforce course material. ■ Lifeguarding DVD Menu and Run Times.
Activity worksheets for participants can be found at ■ Teaching Strategies.
the end of Section B. The activity worksheets should ■ Participant Progress Log.
be given to each participant during the appropriate
Additional resources on Instructor’s Corner:
lessons. Answers to the activity worksheets are
included in the appropriate lessons within the course. ■ Administrative forms and policies, including
the Instructor Agreement and Code of Conduct
Instructor’s Corner and the Manual of Administrative Policies and
Procedures (MAPP)
As an instructor, it is very important that you register
■ Information about other Red Cross training and
on Instructor’s Corner (redcross.org/instructorscorner)
and visit the site regularly for program information education programs
and updates. Once you have completed the brief ■ Frequently asked questions and expert answers to
registration process, you will have free access to many your technical questions
important resources for instructors. ■ Link to the Learning Center Web site
Lifeguarding program materials on Instructor’s Corner ■ Links to redcrossstore.org and shopstaywell.com
include: for training supplies and Red Cross retail products
ADDITIONAL RESOURCES FOR INSTRUCTORS

AND PARTICIPANTS
Training Equipment and Red Cross Refer participants to the Red Cross for more
Retail Products information about scheduled courses in their
community.
Equipment used during the course, such as CPR
breathing barriers, first aid kits and a wide range of Refresher Program
Red Cross retail products, are available through the
Red Cross or the Red Cross store at redcrossstore.org. CPR and AED knowledge and skills begin to decline
within as little as 3 months after training. That is why
Additional Red Cross Courses refreshers—a series of short, online learning exercises
and quizzes—are included in the Lifeguarding program.
A wide range of additional training opportunities in Refreshers help skills retention by giving participants
safety and preparedness are offered through the Red opportunities to test and reaffirm CPR, AED and
Cross. Additional Red Cross programs include: lifeguarding knowledge and skills learned in class. The
■ Swimming and Water Safety. goal of the refresher program is to keep the knowledge
and skills learned in class fresh in participants’ minds.
■ Babysitter’s Training.
Participants will receive an e-mail with the link to their
■ Family Caregiving. first refresher about 3 months after class. From then,
■ Nurse Assistant Training. they will receive additional refreshers throughout the
■ CPR/AED for Professional Rescuers and Health certification period. While participation in the refresher
Care Providers. program is voluntary, all participants are strongly
encouraged to complete the refreshers on schedule.
■ Wilderness and Remote First Aid.
LGI_SecA_p001-012.indd 6 10/12/11 11:12 AM

CHAPTER 3
SETTING UP AND RUNNING THIS COURSE
This chapter explains how to organize the American
Red Cross Lifeguarding program.
RECOMMENDED CLASS SIZE

The course outline and lesson plans have been effective practice and the safety of participants. If
developed for a class of approximately 10 participants. the class is too large, you may not be able to provide
If your class is larger, you probably will need to allow proper supervision or complete class activities in the
more time or have co-instructors or instructor aides allotted time. It is strongly recommended that you
help you. The amount of available equipment and have additional instructors help during skill practice
assistance from additional instructors may limit class sessions.
size. Personal supervision is necessary to ensure
COURSE LENGTH
The course length varies depending on which well as participant needs such as breaks, may increase
Lifeguarding course is taught. The Lifeguarding course course length.
is designed to be taught in approximately 25 hours,
Other factors that may influence lesson planning
20 minutes. The Shallow Water Attendant course is
include:
designed to be taught in approximately 24 hours. The
Waterfront Skills module will add 5 hours, 40 minutes ■ Classroom availability and layout.
to the core Lifeguarding course. The Waterpark Skills ■ Aquatic facility availability and layout.
module will add 3 hours, 40 minutes to the core
■ Equipment availability.
Lifeguarding course.
■ Number of participants.
You must carefully consider the issues of time when
■ Skill level of participants.
planning each class session. The lesson plans in this
■ Instructor experience.
instructor’s manual should be followed as closely as
possible, but facility constraints, specific instructor-to- ■ Number of instructors.
participant ratios, equipment-to-participant ratios, as
CLASSROOM SPACE
The lessons described in this instructor’s manual ventilated and have a comfortable temperature. If
require classroom space suitable for lecture, class the practice area is not carpeted, provide some knee
discussions, small group activities, DVD presentations protection, such as folded blankets or mats, for use
and skill practice sessions. The classroom should by participants or allow them to bring their own
provide a safe, comfortable and appropriate learning padding materials.
environment. The room should be well lit and well
SWIMMING AREA
A pool is recommended for skill practice, in-water ■ Prerequisite swimming skills evaluation
activities and skills evaluation. The pool must meet the ■ Submerged victim rescue (7-10 feet)
requirements needed to conduct the following:
LGI_SecA_p001-012.indd 7 12/13/11 2:27 PM

■ Caring for head, neck and spinal injuries in ■ Return to the surface and swim on the back to the
deep water starting point with both hands holding the object
■ Final In-Water Skill Scenarios 1-3 at the surface and the face remaining at or near the
surface or able to get a breath. Candidates should
When teaching the Lifeguarding course, if the pool has
not swim the distance underwater.
a maximum depth of 6 feet, an alternate timed event
can be used as part of the prerequisite swimming If a waterfront or waterpark facility is used for teaching
skills evaluation. All other class activities must be the Lifeguarding course, a swimming area should be
taught in water depth as described in the activity or chosen that is free from surf or obstructions and has
skill session directions. sufficient space and depth (7-10 feet) for skill practice,
in-water activities and skills evaluation. The facility
For pools with maximum water depth of 6 feet deep, must meet the same standards as listed above for
candidates should complete the following timed event swimming pools.
within 1 minute, 40 seconds.
To ensure consistency in course delivery, facilities must
■ Starting in the water, swim 20 yards. The face be used that meet the guidelines for conducting the
may be in or out of the water. Swim goggles are course activities. More than one facility can be used to
not allowed. accommodate the lesson plan activities.
■ Surface dive to a depth of 6 feet, swim 10 to 15 feet
along the bottom to retrieve a 10-pound object.
SETTING UP AND RUNNING SKILL SESSIONS

The instructions in the skills practice sessions are In some cases, this may not be possible, such as with
condensed for ease of use. However, during every an entry from a lifeguard stand. However, the more
skill practice session, circulate among groups to participants can see, the better they will conceptualize
monitor progress and provide assistance when a skill.
necessary. Lifeguards should practice the skills
until they are able to meet performance criteria. Training to the Standard but Testing
Observe each participant’s performance of the skill to the Objective
and provide corrective feedback using the skill
Instructors must focus on the successful completion of
charts and skill assessment tools. Record their
an objective as opposed to perfecting every individual
progress on the Participant Progress Log
skill. For example:
(redcross.org/instructorscorner).
■ A person with one arm may not be able to perform
Land-Based Skill Practice a front crawl or breaststroke approach. However,
he or she may be able to perform a modified
The skill sessions are conducted in one of two ways.
sidestroke to reach a victim in distress. If the
Some skills are learned via the Watch-Then-Practice
“objective” is for the lifeguard to reach a victim,
instructional method while others offer a choice of how
the person with one arm will fully satisfy that
the skill session is conducted (Practice-While-You-
objective even though he or she has not performed
Watch or Watch-Then-Practice). Skill charts and skill
a conventional approach stroke in the process.
assessment tools are located in the instructor’s manual
at the end of the lessons that include skill sessions. ■ A person may not be able to support the head and
neck in the standard way for manual stabilization,
In-Water Skill Practice but if the person is able to hold the victim’s head
stable, the objective is met.
Whenever possible, the skill should be demonstrated,
■ A person may not be able to perform either a
and then practiced, on land first. Demonstrations
compact jump or a stride jump perfectly and may
should be performed as slowly as possible without
have to modify the skill to enter the water in a safe
losing the integrity of the skill. Whenever possible,
way. It is not essential that a lifeguard enter the
skills should be demonstrated in exactly the same
water in a specific manner during a rescue, only
manner from the front, back and both sides. This allows
that he or she can do it safely.
participants to see all sides and angles of a sequence.
LGI_SecA_p001-012.indd 8 12/13/11 2:27 PM

In all these situations, the participant may continue on adjustments to training can be found in the
the course and still receive certification, since he Americans with Disabilities Act (ADA) Accommodation
or she is capable of performing the function of a Resource Guide found on Instructor’s Corner at
lifeguard during a rescue. Additional information www.redcross.org/instructorscorner.
CLASS SAFETY
As a Red Cross instructor, it is important for you to has a large number of participants, you will need
make the teaching environment as safe as possible. additional help.
Participants who feel they are at risk for injury or ■ Instructor Aides: Individuals who express an
illness may become distracted. These same feelings interest in becoming an instructor but do not, for
may also affect your ability to teach. There are several example, meet the minimum age, can participate
steps you can take to help increase class safety: as an instructor aide. Instructor aides must always
■ Instructor Preparation: Consider possible hazards be under the direct supervision of an instructor
and manage safety concerns before a course starts. and should never be left alone to supervise course
Often, you can foresee hazards and take steps to participants. Instructor aides may not evaluate
eliminate or control them long before participants or certify a participant’s skill performance.
arrive. An instructor aide must possess a basic-level
certificate(s) in the applicable program or course
■ Assisting Instructors and Co-Instructors: Assisting
for which he or she wishes to assist. Lifeguarding
instructors and co-instructors can help decrease
instructors can train instructor aide candidates.
risks by giving more supervision and reducing the
Contact the Red Cross to get further information
instructor-to-participant ratio. They also increase
about instructor aide training. In general, duties
participation and learning by providing more
and responsibilities of instructor aides include:
one-on-one attention to participants. When using
| Handling registration and record keeping.
assisting instructors or co-instructors, clearly
define their roles and responsibilities. Doing so will | Setting up classrooms and handing
out supplies.
help eliminate confusion and lapses in supervision.
| Assisting with equipment (e.g., setup,
Remember that you are ultimately responsible cleaning and distribution of materials).
for your participants’ safety. To determine your
| Helping participants with skill practice
staffing needs, consider the different ages and the or small group activities.
individual abilities of participants. If your course
HEALTH PRECAUTIONS FOR COURSE PARTICIPANTS

As a Red Cross instructor, one of your responsibilities is People with certain health conditions may be
to protect participants from health risks. The materials and hesitant to take part in the practice sessions. These
procedures for teaching these courses are designed to: could include a history of heart attack or other heart
conditions or respiratory problems. Suggest that these
■ Limit the risk of disease transmission.
participants check with their health care provider
■ Limit the risk of one participant injuring another before participating in practice sessions involving
when practicing with a partner. physical activity. Inform participants who take the
■ Limit the risk that the activity involved in skill course, but cannot demonstrate the skills taught in the
practice could cause injury or sudden illness. practice sessions, that they cannot receive an American
When possible, prospective participants should be Red Cross course completion certificate. Encourage
provided information about health requirements and them, however, to participate to whatever extent
safety before enrolling in the course. The Sample Letter possible. The Red Cross advocates that, whenever
to Lifeguarding Program Participants on Instructor’s possible, the instructor adjust participants’ activity
Corner is one way to communicate that information. levels as necessary to facilitate learning and help
Ask participants to talk with you before any practice participants meet course objectives.
session if they doubt they can participate.
LGI_SecA_p001-012.indd 9 12/13/11 2:27 PM

PARTICIPANTS WITH DISABILITIES AND SPECIAL
HEALTH CONSIDERATIONS
People with disabilities and other conditions may be Detailed guidance on these topics is included in the
able to perform first aid, CPR and other EMR skills. Health Precautions and Guidelines During Training
Some skills may need to be modified, but the result and the Americans with Disabilities Act (ADA)
is the same. Instructors should focus on the critical Resource Guide, both of which are available on
components of a skill that are needed to successfully Instructor’s Corner (redcross.org/instructorscorner).
meet the objective.
LGI_SecA_p001-012.indd 10 12/13/11 2:27 PM

CHAPTER 4
REQUIREMENTS FOR SUCCESSFUL
COURSE COMPLETION
CRITERIA FOR COURSE COMPLETION

AND CERTIFICATION
On successful completion of the Lifeguarding course, ■ Pass both the Section 1—CPR/AED for the
participants receive American Red Cross certificate Professional Rescuer and First Aid and Section 2—
for Lifeguarding/First Aid/CPR/AED. On successful Lifeguarding/Shallow Water Lifeguarding Skills
completion of the Shallow Water Lifeguarding course, final written exams with minimum grades of
participants receive an American Red Cross certificate 80 percent.
for Shallow Water Lifeguarding/First Aid/CPR/AED. Participants should be told of the requirements
To successfully complete the Lifeguarding/Shallow when they enroll for the course and again during the
Water Lifeguarding course, the participant must: course introduction. For successful completion of the
Waterfront Skills module, participants must pass the
■ Attend and participate in all class sessions. Waterfront Skills Final Written Exam as well. For
■ Demonstrate competency in all required skills successful completion of the Waterpark Skills module,
and activities. participants also must pass the Waterpark Skills Final
■ Demonstrate competency in all required final Written Exam.
rescue skill scenarios.
FINAL WRITTEN EXAMS

Two exams, Section 1—CPR/AED for the Professional Additional exams for the Waterfront Skills and
Rescuer and First Aid and Section 2—Lifeguarding/ Waterpark Skills modules are also included in Section
Shallow Water Lifeguarding Skills, are included in E of this manual. Participants must pass the exam
Section E of this manual. Two versions are available with a minimum score of 80 percent as part of the
for each exam. Participants must pass each exam requirement for receiving an American Red Cross
with a minimum score of 80 percent as part of the course completion certificate for the corresponding
requirements for receiving American Red Cross course module.
completion certificates.
FINAL IN-WATER SKILLS SCENARIO

Participant skills are evaluated and feedback given ■ Submerged Victim in Deep Water—
throughout the course. The purpose of the final in- Timed Response
water skills scenarios is to ensure that participants have Participants will have to demonstrate competency in
achieved a level of competency and retention of the the following areas for the Shallow Water Lifeguarding
skills learned in the course. course:
Participants will have to demonstrate competency in ■ Head, Neck or Spinal Injury in Shallow Water
the following areas for the Lifeguarding course:
■ Active Victim in Shallow Water
■ Head, Neck or Spinal Injury in Shallow Water ■ Submerged Victim in Shallow Water—
■ Active Victim in Deep Water Timed Response
LGI_SecA_p001-012.indd 11 12/27/11 10:05 AM

There are not separate final in-water skills scenarios Lifeguarding instructors are encouraged to use
for the Waterfront Skills module or the Waterpark additional instructors to help administer the final
Skills module. Participants must successfully complete skills evaluation.
the final in-water skills scenario as outlined in the
EXAM SECURITY
Exam security is your responsibility. It is not the exam and return it to the participant. This way, the
recommended that participants be allowed to see the participant can review any incorrect answers. Be sure to
written exam before it is distributed. As participants collect all answer sheets and exams before participants
hand in their answer sheets, you may quickly grade leave the class.
REPORTING PROCEDURES
You must submit a completed course record to the Red course records electronically through the Learning
Cross within 10 working days of course completion. Center (https://classes.redcross.org/Saba/Web/Main).
While the course record can be submitted in hard copy, Check with the Red Cross for procedures to submit
the Red Cross encourages instructors to submit their course records.
PARTICIPANT COURSE EVALUATION

Gaining feedback from participants is an important provide you with feedback concerning the course and
step in any evaluation process. Participants should its instruction and help the Red Cross maintain the
have an opportunity to tell you what they thought about high quality of the course. A copy of the evaluation
the course. Have participants complete evaluations form is available on Instructor’s Corner.
each time you teach this course. This information will
AWARDING CERTIFICATES
Discuss with the Red Cross the procedures for participants. If you receive certificates after the course
obtaining American Red Cross course completion is over, make arrangements to get them to participants.
certificates. Sign the certificates before giving them to
CONTINUING EDUCATION UNITS FOR PROFESSIONALS

Many course takers are professionals who need (Iacet.org). IACET’s Criteria for Quality Continuing
continuing education units to maintain a license and/ Education and Training Programs are the standards
or certification. The American Red Cross is approved as by which hundreds of organizations measure their
an authorized provider by the International Association educational offerings. For additional information,
of Continuing Education and Training (IACET) contact the Red Cross.
LGI_SecA_p001-012.indd 12 12/13/11 2:27 PM

SECTION B | THE LIFEGUARDING AND SHALLOW
WATER LIFEGUARDING COURSES
LIFEGUARDING COURSE OUTLINE
PRECOURSE SESSION
Activity Time
Introduction to the Precourse Session 10 minutes
Verification of Age Prerequisite 5 minutes
Prerequisite Swimming Skills Evaluation 40 minutes
Wrap-Up 5 minutes
Precourse Session, Total Time 60 minutes
LESSON 1—THE PROFESSIONAL LIFEGUARD AND

FACILITY SAFETY
Activity Time
Introduction to the Course 15 minutes
The Professional Lifeguard 15 minutes
Video: The Professional Lifeguard
Decision Making 5 minutes
Legal Considerations 10 minutes
Continuation of Training 10 minutes
Being Part of a Team 15 minutes
Facility Safety 10 minutes
Weather Conditions 5 minutes
Rules and Regulations 20 minutes
Entries and Approaches 10 minutes
Video: Entries and Approaches
In-Water Skill Session: Entries and Approaches 40 minutes
Skill: Slide-in Entry and Walking Approach
Skill: Slide-in Entry and Swimming Approach
SECTION B | The Lifeguarding and Shallow Water Lifeguarding Courses 13
LGI_SecB_p013-024.indd 13 1/6/12 3:25 PM

Skill: Stride Jump and Swimming Approach
Skill: Compact Jump and Swimming Approach
Putting It All Together 10 minutes
Lesson 1, Total Time 2 hours 45 minutes
LESSON 2—FACILITY SAFETY, PATRON SURVEILLANCE

AND INJURY PREVENTION
Activity Time
Management and Facility Safety 10 minutes
The Drowning Process 10 minutes
Effective Surveillance—Victim Recognition 10 minutes
Video: Surveillance
Effective Surveillance—Scanning 10 minutes
Video: Scanning
Effective Surveillance—Zones of Surveillance Responsibility 10 minutes
Video: Zones of Surveillance
Injury Prevention Strategies 15 minutes
Video: Injury Prevention
Guarding a Variety of Activities 10 minutes
Guarding Play Structures, Special Attractions and Water Slides 20 minutes
In-Water Skill Session: Review Skills, Victim Recognition and Lifeguard Rotation 45 minutes
LESSON 3—INJURY PREVENTION AND RESCUE SKILLS,

PART 1
Activity Time
Guarding for Organized Recreational Swim Groups 20 minutes
Emergency Action Plans 20 minutes
Video: Emergency Action Plans
Rescue Skills, Part 1: Distressed and Active Victim Rescues 10 minutes
Video: Water Rescue Skills—Rescues At or Near the Surface
In-Water Skill Session—Rescue Skills, Part 1 85 minutes
Skill: Reaching Assist from the Deck
Skill: Simple Assist
Skill: Active Victim Front Rescue
Skill: Active Victim Rear Rescue
Skill: Passive Victim Rear Rescue
Skill: Multiple Victim Rescue
LGI_SecB_p013-024.indd 14 11/21/11 11:30 AM

LESSON 4—RESCUE SKILLS, PART 2
Activity Time
Surveillance Activity I 10 minutes
Video: Review—Surveillance Activity I
Rescue Skills, Part 2: Submerged Victim Rescues 10 minutes
Video: Water Rescue Skills—Submerged Victim Rescues
In-Water Skill Session: Rescue Skills, Part 2 70 minutes
Skill: Submerged Passive Victim in Shallow Water
Skill: Feet-First Surface Dive in Deep Water
Skill: Head-First Surface Dive in Deep Water
Skill: Submerged Victim in Deep Water
Skill: Two-Person Removal from the Water Using a Backboard
LESSON 5—BEFORE PROVIDING CARE, VICTIM

ASSESSMENT AND BREATHING
EMERGENCIES
Activity Time
Standard Precautions 10 minutes
Video: Standard Precautions
Skill: Removing Disposable Gloves
General Procedures for an Emergency on Land 5 minutes
Performing a Primary Assessment 50 minutes
Video: Primary Assessment—Adult
Skill: Performing a Primary Assessment—Adult, Child and Infant
Video: Primary Assessment—Child and Infant
Skill: Using a Resuscitation Mask
Skill: Performing a Primary Assessment—Child or Infant
Moving a Victim 5 minutes
Recognizing and Caring for Breathing Emergencies 5 minutes
Giving Ventilations 15 minutes
Video: Giving Ventilations—Adult, Child and Infant
Skill: Giving Ventilations—Adult
Skill: Giving Ventilations—Child or Infant
Giving Ventilations Using a Bag-Valve-Mask Resuscitator 15 minutes
Video: Using a Bag-Valve-Mask Resuscitator—Two Rescuers
Skill: Giving Ventilations Using a BVM—Two Rescuers
Airway Obstruction 30 minutes
Video: Conscious Choking—Adult and Child
Skill: Conscious Choking—Adult and Child
LGI_SecB_p013-024.indd 15 10/12/11 11:53 AM

Video: Conscious Choking—Infant
Skill: Conscious Choking—Infant
Video: Unconscious Choking—Adult, Child and Infant
Skill: Unconscious Choking—Adult and Child
Skill: Unconscious Choking—Infant
In-Water Skill Session: Putting It All Together 30 minutes
LESSON 6—CARDIAC EMERGENCIES AND USING AN

AUTOMATED EXTERNAL DEFIBRILLATOR
Activity Time
Recognizing and Caring for a Heart Attack 15 minutes
Cardiac Arrest 5 minutes
Video: Heart Attack and the Cardiac Chain of Survival
CPR 40 minutes
Video: CPR—Adult and Child
Skill: CPR—Adult and Child
Video: CPR—Infant
Skill: CPR—Infant
Two-Rescuer CPR 15 minutes
Video: Two-Rescuer CPR—Adult and Child
Skill: Two-Rescuer CPR—Adult and Child
Video: Two-Rescuer CPR—Infant
Skill: Two-Rescuer CPR—Infant
When the Heart Stops and AEDs 5 minutes
Using an AED 15 minutes
Video: Using an AED
Skill: Using an AED
Video: Using an AED—CPR in Progress
AED Precautions and Maintenance 10 minutes
Putting It All Together: Multiple-Victim Response 5 minutes
Video: Putting It All Together: Multiple-Rescuer Response—CPR in Progress
LGI_SecB_p013-024.indd 16 10/21/11 2:45 PM

LESSON 7—FIRST AID
Activity Time
Review—Surveillance Activities 5 minutes
Video: Review—Surveillance Activity 2
Secondary Assessment 5 minutes
Sudden Illness 10 minutes
Video: Responding to Sudden Illnesses
Responding to Injuries 45 minutes
Video: Responding to Injuries
Skill: Controlling Bleeding
Skill: Splinting
Putting It All Together—First Aid Scenarios 20 minutes
Caring for Head, Neck and Spinal Injuries on Land 10 minutes
Video: Head, Neck and Spinal Injuries on Land
Skill: Caring for a Nonstanding Victim of a Suspected Head, Neck or
Spinal Injury on Land
Skill: Caring for a Standing Victim of a Suspected Head, Neck or
Back Injury on Land
When Things Do Not Go as Practiced 5 minutes
Video: When Things Do Not Go as Practiced
In-Water Skill Session: When Things Do Not Go as Practiced 30 minutes
In-Water Skill Session: Rescue Skill Review 30 minutes
LESSON 8—HEAD, NECK AND SPINAL INJURIES

IN THE WATER
Activity Time
Final Written Exam: Section 1—CPR/AED for the Professional
Rescuer and First Aid 40 minutes
Caring for Head, Neck and Spinal Injuries in the Water 10 minutes
Video: Head, Neck and Spinal Injuries in the Water
In-Water Skill Session: Head, Neck and Spinal Injuries 140 minutes
Skill: Head Splint—Face-Up Victim At or Near the Surface in Shallow Water
Skill: Head Splint—Face-Down Victim At or Near the Surface in Shallow Water
Skill: Head Splint—Submerged Victim in Shallow Water
Skill: Spinal Backboarding Procedure―Shallow Water
Skill: Head Splint—Face-Up and Face-Down Victim At or Near the Surface in
Deep Water
Skill: Head Splint—Submerged Victim in Deep Water
Skill: Spinal Backboarding Procedure—Deep Water
LGI_SecB_p013-024.indd 17 12/13/11 2:59 PM

LESSON 9—FINAL WRITTEN EXAM AND FINAL IN-WATER
SKILL SCENARIOS
Activity Time
Review of the Final Written Exam: Section 1—CPR for the

Professional Rescuer and First Aid 5 minutes
Final Written Exam: Section 2—Lifeguarding Skills 30 minutes
In-Water Skill Session: General Skills Review 30 minutes
Final In-Water Skill Scenarios 90 minutes
Skill: Final Scenario: Head, Neck or Spinal Injury in Shallow Water
Skill: Final Scenario: Active Victim in Deep Water
Skill: Final Scenario: Submerged Passive Victim in Deep Water—Team Response
Closing 5 minutes
TOTAL COURSE TIME 25 hours 20 minutes
LGI_SecB_p013-024.indd 18 12/13/11 2:59 PM

SHALLOW WATER LIFEGUARDING
COURSE OUTLINE
PRECOURSE SESSION
Activity Time
Introduction to the Precourse Session 10 minutes
Verification of Age Prerequisite 5 minutes
Prerequisite Swimming Skills Evaluation 40 minutes
Wrap-Up 5 minutes
Precourse Session, Total Time 60 minutes
LESSON 1—THE PROFESSIONAL LIFEGUARD AND

FACILITY SAFETY
Activity Time
Introduction to the Course 15 minutes
The Professional Lifeguard 15 minutes
Video: The Professional Lifeguard
Decision Making 5 minutes
Legal Considerations 10 minutes
Continuation of Training 10 minutes
Being Part of a Team 15 minutes
Facility Safety 10 minutes
Weather Conditions 5 minutes
Rules and Regulations 20 minutes
Entries and Approaches 10 minutes
Video: Entries and Approaches
In-Water Skill Session: Entries and Approaches 40 minutes
Skill: Slide-in Entry and Walking Approach
Skill: Slide-in Entry and Swimming Approach
Skill: Compact Jump and Swimming Approach
LGI_SecB_p013-024.indd 19 12/13/11 2:59 PM

LESSON 2—FACILITY SAFETY, PATRON SURVEILLANCE
Activity Time
Management and Facility Safety 10 minutes
The Drowning Process 10 minutes
Effective Surveillance—Victim Recognition 10 minutes
Video: Surveillance
Effective Surveillance—Scanning 10 minutes
Video: Scanning
Effective Surveillance—Zones of Surveillance Responsibility 10 minutes
Video: Zones of Surveillance
Injury Prevention Strategies 15 minutes
Video: Injury Prevention
Guarding a Variety of Activities 10 minutes
Guarding Play Structures, Special Attractions and Water Slides 20 minutes
In-Water Skill Session: Review Skills, Victim Recognition and Lifeguard Rotation 45 minutes
LESSON 3—INJURY PREVENTION AND RESCUE SKILLS,

PART 1
Activity Time
Guarding for Organized Recreational Swim Groups 20 minutes
Emergency Action Plans 20 minutes
Video: Emergency Action Plans
Rescue Skills, Part 1: Distressed and Active Victim Rescues 10 minutes
Video: Water Rescue Skills—Rescues At or Near the Surface
In-Water Skill Session—Rescue Skills, Part 1 85 minutes
Skill: Reaching Assist From the Deck
Skill: Simple Assist
Skill: Active Victim Front Rescue
Skill: Active Victim Rear Rescue
Skill: Multiple Victim Rescue
LGI_SecB_p013-024.indd 20 12/13/11 2:59 PM

LESSON 4—RESCUE SKILLS, PART 2
Activity Time
Surveillance Activity 1 10 minutes
Rescue Skills, Part 2: Submerged Victim Rescues 10 minutes
Video: Water Rescue Skills—Submerged Victim Rescues
In-Water Skill Session: Rescue Skills, Part 2 30 minutes
Skill: Submerged Passive Victim in Shallow Water
Skill: Two-Person Removal from the Water Using a Backboard
Lesson 4, Total Time 1 hour 35 minutes
LESSON 5—BEFORE PROVIDING CARE, VICTIM

ASSESSMENT AND BREATHING
EMERGENCIES
Activity Time
Standard Precautions 10 minutes
Video: Standard Precautions
Skill: Removing Disposable Gloves
General Procedures for an Emergency on Land 5 minutes
Performing a Primary Assessment 50 minutes
Video: Primary Assessment—Adult
Skill: Performing a Primary Assessment—Adult, Child and Infant
Video: Primary Assessment—Child and Infant
Skill: Using a Resuscitation Mask
Skill: Performing a Primary Assessment—Child or Infant
Moving a Victim 5 minutes
Recognizing and Caring for Breathing Emergencies 5 minutes
Giving Ventilations 15 minutes
Video: Giving Ventilations—Adult, Child and Infant
Skill: Giving Ventilations—Adult
Skill: Giving Ventilations—Child or Infant
Giving Ventilations Using a Bag-Valve-Mask Resuscitator 15 minutes
Video: Using a Bag-Valve-Mask Resuscitator—Two Rescuers
Skill: Giving Ventilations Using a BVM—Two Rescuers
Airway Obstruction 30 minutes
Video: Conscious Choking—Adult and Child
Skill: Conscious Choking—Adult and Child
Video: Conscious Choking—Infant
Skill: Conscious Choking—Infant
LGI_SecB_p013-024.indd 21 12/13/11 2:59 PM

Video: Unconscious Choking—Adult, Child and Infant
Skill: Unconscious Choking—Adult and Child
Skill: Unconscious Choking—Infant
LESSON 6—CARDIAC EMERGENCIES AND USING AN

Activity Time
Recognizing and Caring for a Heart Attack 15 minutes
Cardiac Arrest 5 minutes
Video: Heart Attack and the Cardiac Chain of Survival
CPR 40 minutes
Video: CPR—Adult and Child
Skill: CPR—Adult and Child
Video: CPR—Infant
Skill: CPR—Infant
Two-Rescuer CPR 15 minutes
Video: Two-Rescuer CPR—Adult and Child
Skill: Two-Rescuer CPR—Adult and Child
Video: Two-Rescuer CPR—Infant
Skill: Two-Rescuer CPR—Infant
When the Heart Stops and AEDs 5 minutes
Using an AED 15 minutes
Video: Using an AED
Skill: Using an AED
Video: Using an AED―CPR in Progress
AED Precautions and Maintenance 10 minutes
Putting It All Together: Multiple-Victim Response 5 minutes
Video: Putting It All Together: Multiple-Rescuer Response—CPR in Progress
LGI_SecB_p013-024.indd 22 12/13/11 2:59 PM

LESSON 7—FIRST AID
Activity Time
Review—Surveillance Activities 5 minutes
Secondary Assessment 5 minutes
Sudden Illness 10 minutes
Video: Responding to Sudden Illnesses
Responding to Injuries 45 minutes
Video: Responding to Injuries
Skill: Controlling Bleeding
Skill: Splinting
Putting It All Together—First Aid Scenarios 20 minutes
Caring for Head, Neck and Spinal Injuries on Land 10 minutes
Video: Head, Neck and Spinal Injuries on Land
Skill: Caring for a Nonstanding Victim of a Suspected Head,
Neck or Spinal Injury on Land
Skill: Caring for a Standing Victim of a Suspected Head,
Neck or Back Injury on Land
When Things Do Not Go as Practiced 5 minutes
Video: When Things Do Not Go as Practiced
In-Water Skill Session: When Things Do Not Go as Practiced 30 minutes
Skill: Front Head—Hold Escape in Shallow Water
Skill: Rear Head—Hold Escape in Shallow Water
Skill: In-Water Ventilations—Shallow Water
In-Water Skill Session: Rescue Skill Review 30 minutes
LESSON 8—HEAD, NECK AND SPINAL INJURIES

IN THE WATER
Activity Time
Final Written Final Exam: Section 1—CPR/AED for the Professional
Caring for Head, Neck and Spinal Injuries in the Water 10 minutes
Video: Head, Neck and Spinal Injuries in the Water
In-Water Skill Session: Head, Neck and Spinal Injuries 100 minutes
Skill: Head Splint—Face-Up Victim At or Near the Surface in Shallow Water
Skill: Head Splint—Face-Down Victim At or Near the Surface in Shallow Water
Skill: Head Splint—Submerged Victim in Shallow Water
Skill: Spinal Backboarding Procedure
LGI_SecB_p013-024.indd 23 12/13/11 2:59 PM

LESSON 9—FINAL WRITTEN EXAM AND FINAL IN-WATER
SKILL SCENARIOS
Activity Time
Review of the Final Written Exam: Section 1—CPR for the Professional
Final Written Exam: Section 2—Shallow Water Lifeguarding Skills 30 minutes
In-Water Skill Session: General Skills Review 30 minutes
Final In-Water Skill Scenarios 90 minutes
Skill: Final Scenario: Head, Neck or Spinal Injury in Shallow Water
Skill: Final Scenario: Active Victim in Deep Water
Skill: Final Scenario: Submerged Passive Victim in Deep Water―Team Response
Closing 5 minutes
TOTAL COURSE TIME 24 hours
LGI_SecB_p013-024.indd 24 12/13/11 2:59 PM

PRECOURSE SESSION
¡ Session Length: 1 hour
MATERIALS, EQUIPMENT AND SUPPLIES

■ A 10-pound object (a diving brick or weight; one for every five participants)
■ Stopwatch
■ Lifeguarding Precourse Skills Checklist (redcross.org/instructorscorner)
TOPIC: INTRODUCTION TO THE Time: 10 minutes

PRECOURSE SESSION
Activity ■ Welcome prospective participants and introduce yourself. Identify yourself as an
American Red Cross instructor. Briefly tell about your background in aquatics.
Include co-instructors and aides, if applicable.
■ Review facility policies, including emergency procedures. Give the locations of
restrooms, locker rooms, water fountains and details unique to your facility. Also,
identify the location of the automated external defibrillator (AED) and first aid kit.
■ Have participants briefly introduce themselves.
■ Explain the purpose of the Lifeguarding course is to teach the knowledge and skills
needed to help prevent and respond to aquatic emergencies. This includes land and
water rescue skills as well as first aid and CPR/AED.
■ For the Shallow Water Lifeguarding course, explain that the purpose of the course
is to teach the knowledge and skills needed to help prevent and respond to aquatic
emergencies in water up to 5 feet deep.
■ Explain to prospective participants that this precourse session is designed to evaluate

their swimming skills. Participants who successfully complete the precourse skills
evaluation should be able to participate in the Red Cross Lifeguarding course.
Instructor’s Note: Review the prerequisite skills only for the course and/or modules
you are teaching.
■ Review the prerequisite skills to be performed for their course and/or module:
| Lifeguarding course or Waterpark Skills module prerequisite skills:
1. Swim 300 yards continuously demonstrating breath control and rhythmic
breathing. Candidates may swim using the front crawl, breaststroke or a
combination of both but swimming on the back or side is not allowed. Swim
goggles may be used.
2. Tread water for 2 minutes using only the legs. Candidates should place their
hands under the armpits.
3. Complete a timed event within 1 minute, 40 seconds.
■ Starting in the water, swim 20 yards. The face may be in or out of the
water. Swim goggles are not allowed.
■ Surface dive, feet-first or head-first, to a depth of 7 to 10 feet to retrieve
a 10-pound object.
LGI_SecB_p025-031.indd 25 10/13/11 1:56 PM

■ Return to the surface and swim 20 yards on the back to return to the
starting point with both hands holding the object and keeping the face
at or near the surface so they are able to get a breath. Candidates should
not swim the distance under water.
■ Exit the water without using a ladder or steps.
| Waterfront Skills module prerequisite skills:
goggles are allowed.
■ Starting in the water, swim 20 yards. The face may be in or out of the
water. Swim goggles are not allowed.
■ Surface dive, feet-first or head-first, to a depth of 7 to 10 feet to retrieve
a 10-pound object.
■ Return to the surface and swim 20 yards to return to the starting point
with both hands holding the object and keeping the face at or near the
surface so they are able to get a breath. Candidates should not swim the
distance under water.
4. Swim 5 yards, submerge and retrieve three dive rings placed 5 yards apart in
4 to 7 feet of water, resurface and continue to swim another 5 yards to
complete the skill sequence.
| Shallow Water Lifeguarding course prerequisite skills:
goggles are allowed.
3. Complete a timed event within 50 seconds.
■ Starting in the water, swim 20 yards using the front crawl or
breaststroke. The face may be in or out of the water. Swim goggles are
not allowed.
■ Submerge to a depth of 4 to 5 feet to retrieve a 10-pound object.
■ Return to the surface and walk or swim 20 yards to return to the
starting point with both hands holding the object at the surface of the
water.
Instructor’s Notes:
■ When teaching the Lifeguarding course, if the maximum water depth is 6 feet, an
alternate timed event is permitted as described in the swimming skills evaluation
section below.
■ If a Waterfront Skills module is scheduled to immediately follow the Lifeguarding
course and all candidates are enrolled in both the Lifeguarding course and
Waterfront Skills module, you should conduct the precourse session for the
Waterfront Skills module instead of the Lifeguarding precourse session.
■ If the prerequisite evaluation for Waterfront Lifeguarding is not completed at
this time, then it must be completed as a precourse session for the Waterfront
Skills module.
LGI_SecB_p025-031.indd 26 10/12/11 12:38 PM

TOPIC: VERIFICATION OF AGE Time: 5 minutes
PREREQUISITE
Activity ■ Tell prospective participants that to participate in any Red Cross Lifeguarding course
or module they must be at least 15 years of age on or before the final scheduled
session of this course.
■ Verify the eligibility of participants to participate in the course by checking their
proof of age, which can be a driver’s license, state identification, birth certificate or
passport.
■ If an individual does not meet the age requirements for course participation,
suggest that he or she enroll in the next available Lifeguarding course once the age
requirement is met.
■ Orient them to the locker rooms and the pool area where they are to meet for the
prerequisite swimming skills evaluation.
TOPIC: PREREQUISITE SWIMMING SKILLS Time: 40 minutes

EVALUATION
Instructor’s Note: Have participants perform the prerequisite skills only for the
course and/or module you are teaching.
Activity ■ Explain to prospective participants that they must successfully complete three
swimming prerequisites to continue in the Lifeguarding course.
■ Refer to the Skill Assessment Chart to evaluate performance of each prospective
participant. Record completion of each skill on the Lifeguarding Precourse Skills
Checklist.
Lifeguarding Course and Waterpark Skills Module

Prerequisite 1— ■ Explain to prospective participants that they must perform a 300-yard continuous
300-Yard Swim swim using the front crawl, breaststroke or a combination of both. Swimming on the
back or side is not permitted. Swim goggles are allowed.
Prerequisite 2— ■ Explain to prospective participants that they must tread water for 2 minutes without
Tread Water support and without stopping. When treading, only the legs can be used. Candidates
should place their hands under the armpits. The head must remain above the surface
of the water.
Prerequisite 3— ■ Arrange the swim distance of 20 yards and place a 10-pound object at a depth of 7 to
Timed Event 10 feet.
■ Explain that goggles are not allowed for this event.
■ Evaluate each prospective participant on the following skill to be performed within
1 minute and 40 seconds.
| Starting in the water, swim 20 yards. The face may be in or out of the water.
| Surface dive, feet-first or head-first, to a depth of 7 to 10 feet to retrieve a
10-pound object.
| Return to the surface and swim 20 yards to return to the starting point with both
hands holding the object and keeping the face at or near the surface so they are
able to get a breath. The participants should not swim the distance under water.
| Exit the water without using a ladder or steps.
LGI_SecB_p025-031.indd 27 10/12/11 12:38 PM

Waterfront Skills Module
of the water.
Timed Event 10 feet.
■ Evaluate each participant on the following skill to be performed within 1 minute and
40 seconds.
| Starting in the water, swim 20 yards using the front crawl or breaststroke. The
face may be in or out of the water.
| Surface dive, feet-first or head-first, to a depth of 7 to 10 feet to retrieve a 10-
pound object.
| Return to the surface and swim 20 yards to return to the starting point with
both hands holding the object and keeping the face at or near the surface so they
are able to get a breath. The participants should not swim the distance under
water.
Prerequisite 4— ■ Arrange the swim distance area, placing three dive rings 5 yards apart in 4 to 7 feet
Underwater of water.
Swim ■ Explain that goggles are not allowed for this event.
■ Evaluate each participant on the following skill.
| Submerge, swim under water and retrieve three dive rings placed 5 yards apart
in 4 to 7 feet of water.
| Return to the surface after picking up all three dive rings and continue to swim
another 5 yards to complete the skill sequence.
Shallow Water Lifeguarding Course

of the water.
Timed Event 5 feet.
■ Evaluate each participant on the following skill to be performed within 50 seconds.
| Starting in the water, swim 20 yards using the front crawl or breaststroke or a
combination of both. The face may be in or out of the water.
| Submerge to a depth of 4 to 5 feet to retrieve a 10-pound object.
LGI_SecB_p025-031.indd 28 12/13/11 3:00 PM

| Return to the surface and walk or swim 20 yards to return to the starting point
with both hands holding the object at the surface of the water.
■ For pools with maximum water depth of 6 feet deep, candidates should complete the
following alternate timed event:
| Starting in the water, swim at the surface for 20 yards. The face may be in or out
of the water. Swim goggles are not allowed.
| Surface dive to a depth of 6 feet, swim 10 to 15 feet along the bottom and
retrieve a 10-pound object.
| Return to the surface and swim on the back to the starting point with both
hands holding the object at the surface and the face remaining at or near
the surface or able to get a breath. Candidates should not swim the
distance underwater.
Instructor’s Note: When determining a participant’s ability to pass the prerequisite

swimming skills evaluation and successfully participate in the course, the instructor
must evaluate the individual’s overall performance. The prerequisite swimming skills
evaluation is designed to assess the individual’s strength, endurance and comfort in the
water. The individual should not be judged on stroke mechanics, but rather on his or
her overall demonstration of swimming strength, endurance, comfort in the water and
ability to meet the time requirements.
If a candidate is not successful on the first attempt, he or she has only one opportunity
to reattempt the prerequisites after sufficient rest. If the candidate does not successfully
perform the prerequisites, ask him or her to see the instructor after class to schedule a
retest to take place before the first scheduled class session, time permitting.
TOPIC: WRAP-UP Time: 5 minutes
■ Respond to participants’ questions.

■ Provide participants with information on the first class session, including the time
of the class and location. Review the full course schedule and basic course outline,
including test dates.
■ Provide participants who have passed the precourse evaluation with a copy of the
American Red Cross Lifeguarding Manual. All participants must have a copy of
the manual—digital or print—for use during the course. Instruct participants to
read Chapter 1, The Professional Lifeguard, and Chapter 2, Facility Safety, in the
Lifeguarding Manual before the first class session.
Counseling After the Precourse Session

■ On an individual basis, after the precourse session has ended, advise each
participant who did not meet the prerequisites that:
| Entry into the Red Cross Lifeguarding course is strictly limited to those who
meet the minimum age requirement and have successfully completed the
prerequisite swimming skills evaluation.
| Failure to have attained the appropriate skill level could pose a safety threat to
themselves and to others in the class.
■ Suggest appropriate developmental training opportunities and explain the specific
skills that the individual needs to improve to be eligible to take the Lifeguarding
course in the future.
■ Direct individuals to contact the local Red Cross chapter for more information.
LGI_SecB_p025-031.indd 29 10/13/11 1:56 PM

SKILL ASSESSMENT TOOL
Participants must meet the criteria listed at the proficient level to be checked off as passing the prerequisite skill
evaluation.
SKILL ASSESSMENT TOOL: LIFEGUARDING AND SHALLOW WATER

LIFEGUARDING COURSES AND WATERFRONT AND WATERPARK SKILLS
MODULES PREREQUISITES
Criteria Proficient Not Proficient
Continuous swim ■ Swims designated distance ■ Cannot swim designated

continuously using front crawl, distance continuously
breaststroke or a combination of ■ Swims on the back or side
both without stopping to rest
■ Stops to rest during a turn at
■ Demonstrates comfort in deep a wall
water
■ Stops swimming, stands on
■ Swims with face in the water the bottom or clings to rope,
and demonstrates breath lane line or other support
control (slight hesitation during
■ Refuses to swim in deep water
breathing acceptable)
■ Swims with head or face out of
■ Maintains body position that is
the water
nearly horizontal to the surface
■ Does not demonstrate breath
■ Uses above-water arm recovery
control or rhythmic breathing
for the front crawl
■ Body position is near vertical
■ Leg action contributes to
forward momentum ■ Uses underwater arm recovery
for the front crawl
■ No leg action or leg action that
does not contribute to forward
momentum
Tread water ■ Treads water for 2 minutes ■ Unable to tread water for
■ Body position is near vertical 2 minutes
■ Head remains above the surface ■ Body position is near
horizontal—prone or supine
■ Uses legs only
■ Stands on the bottom or clings
to rope, lane line or other
support
■ Swims rather than treads
■ Mouth sinks below the surface
■ Uses arms while treading
LGI_SecB_p025-031.indd 30 10/12/11 12:38 PM

Timed event ■ Completes the prerequisite ■ Does not complete the
event within the designated prerequisite event within the
time designated time
■ Submerges and retrieves a 10- ■ Does not submerge far enough
pound object to reach the 10-pound object
■ Swims back to the side, holding ■ Does not locate the 10-pound
the object in both hands while object
keeping the face at or near the ■ Does not lift the 10-pound
surface of the water (Note: object and return to the
Shallow Water Lifeguarding surface
candidates can swim or walk)
■ Returns to the side holding the
■ Exits the water without using object in one hand
ladder or stairs
■ Returns to the side
underwater with the object
and without taking a breath
■ Unable to exit the water
without ladder or stairs
Waterfront Skill Module Only ■ Swims 5 yards ■ Walks along the bottom
Underwater swim event ■ Submerges, swims and retrieves ■ Does not submerge enough to
three dive rings reach the dive ring(s)
■ Swims to the side with three ■ Surfaces before retrieving all
dive rings three dive rings
■ Does not retrieve all three dive
rings
■ Does not swim back with three
dive rings
LGI_SecB_p025-031.indd 31 10/12/11 12:38 PM

LESSON 1
THE PROFESSIONAL LIFEGUARD AND
FACILITY SAFETY
¡ Session Length: 2 hours, 45 minutes
LESSON OBJECTIVES
After completing this lesson, participants will be able to:
■ Describe the characteristics and responsibilities of a professional lifeguard.
■ Define certain legal considerations and apply them to situations that might be encountered in lifeguarding.
■ Describe ongoing training for lifeguards.
■ Describe what it means to work as part of a lifeguard and safety team.
■ Describe the role lifeguards play in ensuring facility safety.
■ Identify how to ensure the safety of patrons when weather conditions create safety concerns.
■ Explain the reasons for common rules and regulations at aquatic facilities.
■ Demonstrate how to safely and effectively enter the water and approach a victim.
ADDITIONAL MATERIALS, EQUIPMENT AND SUPPLIES

■ Activity Worksheet 1.1—Reasons for the Rules
TOPIC: INTRODUCTION TO THE COURSE Time: 15 minutes
Welcome and Introduction to the Course

Activity ■ Welcome participants and introduce yourself, including your background in aquatics
and certification as an American Red Cross instructor. Include co-instructors and
aides if applicable.
■ Have participants introduce themselves.
■ Review facility policies and procedures, and give locations of restrooms, water
fountains, break areas and details unique to your facility. Also, point out where the
exits are located as well as where the automated external defibrillators (AEDs) are
located.
■ Review the course schedule and basic outline, including written exam dates.
■ Explain to participants that the primary purpose of the Lifeguarding course is
to learn the knowledge and skills needed to prevent and to respond to aquatic
emergencies. The course content and activities prepare participants to recognize and
respond quickly and effectively to emergencies and prevent drowning and injuries.
■ When conducting the Shallow Water Lifeguarding course, explain to participants

that the primary purpose of the course is to learn the knowledge and skills needed to
prevent and to respond to aquatic emergencies in shallow water up to 5 feet deep.
■ Explain the requirements for successful completion of the course:

| Attend and participate in all class sessions.
| Demonstrate competency in all required skills and activities.
| Demonstrate competency in all required final rescue skill scenarios.
LGI_SecB_p032-047.indd 32 11/2/11 9:30 AM

| Correctly answer at least 80 percent of the questions in each of the two sections
of the final written exam.
■ Explain that upon successful completion of the Lifeguarding course, each participant
will receive an American Red Cross Universal Certificate for Lifeguarding/First Aid/
CPR/AED, which is valid for 2 years.
■ Explain that upon successful completion of the Shallow Water Lifeguarding course,
each participant will receive an American Red Cross Universal Certificate for Shallow
Water Lifeguarding (up to 5 feet)/First Aid/CPR/AED, which is valid for 2 years.
■ Explain the ground rules for the course.

| Participants must demonstrate a professional attitude and mature behavior,
including, but not limited to:
● Being prepared for all class activities, including appropriate swimwear
for all in-water skill sessions.
● Completing reading assignments.
● Behaving appropriately during activities.
● Making an effort to improve skills during practice sessions.
● Treating others with respect.
● Following all pool safety rules and any additional safety precautions as
explained throughout the course.
● Demonstrating respect for the facility and equipment used in the course.
| Ask participants to turn off or silence cell phones and refrain from using
electronic devices during all class sessions, with the exception of accessing
digital course materials.
| Explain that participants should secure any items of value or avoid bringing
them to class if possible.
TOPIC: THE PROFESSIONAL LIFEGUARD Time: 15 minutes

PRESENTATION: THE PROFESSIONAL LIFEGUARD
Video Segment ■ Explain to participants that as they begin their training as lifeguards it is important
to understand that they:
| Must take responsibility to help protect the lives of people in a variety of
aquatic activities.
| Must maintain a high level of knowledge and skills for being a professional
rescuer.
| Will have the legal responsibility to act in an emergency.
| Will need to develop skills for effective communication with the public.
| Must be willing to be a leader as well as a good team member.
| Will need to demonstrate maturity, professionalism and competence in
specialized rescue techniques.
■ Explain to participants that the following video segment will introduce them to the
professional aspects of lifeguarding.
■ Show the video segment, “The Professional Lifeguard.”
■ Answer participants’ questions about the video segment.
LESSON 1 | The Professional Lifeguard and Facility Safety 33
LGI_SecB_p032-047.indd 33 10/21/11 2:47 PM

Guided ■ Ask participants: What characteristics of a professional lifeguard were
Discussion discussed or illustrated in the video segment?
Answers: Responses should include the following:
| Knowledgeable
| Able to perform appropriate skills
| Reliable
| Mature
| Courteous and consistent
| Positive
| Professional
| Healthy and fit
■ Ask participants: What behaviors would demonstrate a lack of
professionalism?
| Leaving lifeguard station while on surveillance duty
| Using mobile phones or other electronic devices while on duty
| Slouching posture
| Talking with others while on surveillance duty
| Eating while on surveillance duty
■ Your primary responsibility as a lifeguard is to help ensure patron safety
and protect lives.
■ Ask participants: What are some tasks that should be the lifeguard’s
primary responsibility?
| Monitoring activities in and near the water through patron surveillance
| Preventing injuries by minimizing or eliminating hazardous situations or
behaviors
| Enforcing facility rules and regulations and educating patrons about them
| Recognizing and responding quickly and effectively to all emergencies
| Administering first aid and CPR or using an AED in an emergency
and, if trained, administering emergency oxygen when necessary
| Working as a team with other lifeguards, facility staff and management
■ Ask participants: What are some examples of secondary tasks that a
lifeguard might be asked to perform while not responsible for primary
responsibilities?
| Testing pool water chemistry
| Assisting patrons (e.g., conducting safety orientations, administering swim
tests and fitting life jackets)
| Cleaning or performing maintenance
| Completing records and reports
| Performing opening duties, closing duties or facility safety checks and
inspections.
■ Ask participants: What are the different places shown in the video where a
person might work as a lifeguard?
| Swimming pools
| Multi-attraction aquatic facilities
LGI_SecB_p032-047.indd 34 10/12/11 2:29 PM

| Waterfronts with nonsurf swimming areas
| Waterparks
■ Shallow Water Lifeguarding is available for lifeguards who plan to work
at shallow water facilities only with a water depth not to exceed 5 feet
deep.
■ Additional training, such as the Waterfront Skills or Waterpark Skills
modules, are required for work in some of the environments
shown in the video.
| Lifeguards who plan to work in a waterpark or waterfront setting
should complete the appropriate additional module to be equipped
with the additional skills needed.
| The prerequisites for the Waterpark Skills module are the same as
for the Lifeguarding course.
| The Waterfront Skills module includes additional
prerequisites that must be completed prior to participating in the
module.
TOPIC: DECISION MAKING Time: 5 minutes

PRESENTATION: DECISION MAKING
Lecture ■ Decision making is an important component of lifeguarding. In an

emergency, such as a situation requiring a water rescue or performing
CPR, your facility should have established emergency action plans
(EAPs) that enable you to act quickly.
■ In a non-emergency situation, such as working with your manager or
deciding how to address inappropriate patron behaviors, you can take
more time in deciding how best to respond.
TOPIC: LEGAL CONSIDERATIONS Time: 10 minutes

PRESENTATION: LEGAL CONSIDERATIONS
Guided ■ Refer participants to Chapter 1, The Professional Lifeguard, in the Lifeguarding

Discussion Manual to answer the questions in the guided discussion activity and to apply the
legal considerations to the scenario.
■ As a lifeguard, you need to understand the legal principles involved in
being a professional rescuer.
Scenario: You are the lifeguard on duty when you see a young boy running on the
deck.
■ You have a duty to act to prevent injuries. What should you do to prevent
the child from slipping and falling?
Answer: Tell the child to walk on the deck and explain that he could get hurt by
slipping and falling.
■ If you had not tried to stop the child from running and then the child got
hurt, what legal principle could be a problem for you?
Answer: Negligence. Lifeguards have a duty to help prevent patron behaviors that
place them at risk of injury.
LGI_SecB_p032-047.indd 35 10/21/11 2:47 PM

Scenario (cont.): After you warn the child about the dangers, he once again runs and
now slips and falls on the deck. His knee is bleeding and he complains that it hurts. His
mother arrives on the scene.
■ What must you do before you can provide care for this child?
Answer: Ask the mother for her consent to allow you to help the child.
■ What should be stated when asking for consent?
| State your name.
| State your level of training.
| Ask the mother if you may help her son.
| Explain to the mother what you think may be wrong.
| Explain what you plan to do to provide care (clean the wound, apply ice, etc.).
Scenario (cont.): The child is very frightened so the mother takes the child in her
arms and refuses the lifeguard’s offer to care for the child’s injury.
■ How should you respond to the mother at this point since she has
refused care?
| You should explain why he needs care.
| You should let the mother know that you are there to help if she changes her
mind.
■ What should you do if the mother continues to refuse care for her son?
Answer: You must document any refusal of care. Someone else, such as another
lifeguard, should witness the person’s refusal of care and sign the incident report as
a witness to the refusal of care. If the person who refuses is willing, have him or her
sign the report as well.
Scenario (cont.): The mother decides to allow you to care for the child’s injury
after all.
■ If you failed to provide the proper care or provided care that was beyond
your level of training, and as a result, the boy suffers further injury, what
legal principle could be a problem for you?
Answer: Negligence.
Scenario (cont.): You are treating the injury and realize it is time for your shift
to end.
■ What legal problem could come about if you stop caring for the young
boy?
Answer: Abandonment, which is a type of negligence.
TOPIC: CONTINUATION OF TRAINING Time: 10 minutes

PRESENTATION: CONTINUATION OF TRAINING
Lecture ■ Successfully completing the Lifeguarding course does not guarantee

and Guided employment. You can expect that employers will require their own
evaluation of your swimming and rescue skills before deciding whether
Discussion to hire you as a lifeguard.
■ The skills learned in the Lifeguarding course need to be practiced
frequently.
■ Ask participants: What do you think should be included in an orientation
session for new lifeguards at a facility?
LGI_SecB_p032-047.indd 36 10/21/11 2:47 PM

| Features of the facility that might differ from the place where the lifeguard was
trained
| Job responsibilities
| Facility operations
| Management’s expectations
| Facility rules that need to be enforced
■ Annual or preseason orientation and training often occurs prior to
the summer season since summer typically the busiest season for
aquatic facilities. This training should include a review of knowledge
and skills for:
| Lifeguarding.
| CPR/AED.
| First aid.
| Facility-specific protocols.
■ Facility management also must provide training to meet government
requirements for occupational safety, including yearly bloodborne
pathogen training.
■ A policies and procedures manual provides you with important
information, including:
| Administrative policies and procedures, such as job descriptions.
| Personnel policies and guidelines, such as uniform requirements,
scheduling information and job performance evaluation procedures.
| Standard operating procedures, such as facility rules and
emergency procedures.
■ In-service training should take place on a regular basis at the facility
where you work. It is designed to help you maintain your knowledge
and skills at a professional level. It also provides an opportunity for
lifeguards to practice working as a team in emergencies.
■ It is a best practice of many well-managed facilities that lifeguards
participate in a minimum of 4 hours of in-service training each month.
■ Topics that might be covered during in-service training include:
| Surveillance and recognition.
| Water and land rescue skills.
| Emergency response drills.
| Decision-making protocols.
| Facility rules and regulations.
| Customer service.
| Records and reports.
| Physical conditioning.
■ Periodic lifeguard evaluations may be performed by your employer or
through a contracted agency, such as the Red Cross, or a combination
of both. The evaluations may be announced or unannounced and may
include observation of lifeguards performing patron surveillance,
skills evaluations and a check of the aquatic facility related to
lifeguard operations.
■ Facilities also may offer lifeguards the opportunity to pursue further
training for other jobs in the area of aquatics as well as preparation for a
full-time career. For example:
| The Red Cross Lifeguarding Instructor course, for ages 17 and up,
provides training for teaching Lifeguarding courses.
LGI_SecB_p032-047.indd 37 10/12/11 2:29 PM

| The Red Cross Lifeguard Management course provides training for
head lifeguards and managers of an aquatic facility.
| The Red Cross Water Safety Instructor course, for ages 16 and up,
provides training for teaching Red Cross swim lessons and water
safety courses.
| Various organizations offer pool operator training for those that will
be responsible for the actual mechanical and chemical operations of
the pool.
TOPIC: BEING PART OF A TEAM Time: 15 minutes

PRESENTATION: BEING PART OF A TEAM
Human Knot Team-Building Activity

Activity ■ Divide the class into teams of six to eight people. Have each team move to a location
that allows them to stand shoulder to shoulder in a small circle.
■ Instruct members of each team to form a human pretzel by having each person
extend the left hand across the circle and grasp the left hand of someone else not
directly next to him or her. Then have each person extend his or her right hand
across the circle and grasp the right hand of another, different person.
■ Inform the teams that their task is to unravel their interlocking arms without letting
go of anyone’s hands and without causing injury. If group members break the chain,
they must repair the break the way it was or start over.
■ Stop the activity after about 8 minutes if the group is unsuccessful at making the
circle without breaking the chain of hands. It is sometimes impossible to get to a
single circle.
Guided ■ Ask participants the following:

Discussion | How did it feel to be successful or unsuccessful?
| What strategy did your team use to complete the task?
| Who were the leaders in this activity?
| Did the team reach consensus on a plan of action or take action
without a plan?
| How well did your team communicate during this activity?
| If you could do it again, what would you change?
■ Just as in the human-knot activity, the lifeguard team must communicate
and work together effectively when responding to emergencies.
■ Effective communication, trust, mutual respect, commitment and
cooperation are crucial elements for working effectively as a team.
■ Ask participants: In your job as a lifeguard, aside from being a team
player while responding to emergencies, what can you do as an
individual to have a positive effect on the team?
| Arriving to work on time
| Rotating stations on time
| Attending in-service trainings
| Enforcing safety rules in a consistent manner
| Communicating clearly while treating others with respect
| Being prepared by maintaining knowledge, skills and physical fitness
| Completing secondary responsibilities in a timely and acceptable fashion
LGI_SecB_p032-047.indd 38 10/21/11 2:47 PM

■ As lifeguards, you should be given an EAP that guides the actions of
lifeguards and other team members in emergencies. The EAP describes
what needs to be done and who does it in the event of an emergency.
EAPs are discussed in more detail later in the course.
■ The lifeguard team is part of the broader facility safety team.
| The safety team includes management and maintenance staff who
provide assistance in maintaining a safe environment and providing
emergency care.
| Local emergency response personnel also are part of the safety team.
TOPIC: FACILITY SAFETY Time: 10 minutes

PRESENTATION: FACILITY SAFETY
Lecture ■ Aquatic facilities must have the appropriate rescue equipment available
and Guided and in proper working order at all times for emergency response.
Discussion ■ As a lifeguard, you must always wear or carry certain equipment so
that it is instantly available in an emergency, including a rescue tube,
resuscitation mask and gloves. You also must have a whistle to signal
an emergency.
Activity ■ Ask a volunteer to come forward to demonstrate how to wear the rescue tube while in
an elevated lifeguard station and a ground-level station.
| The demonstration should include the following:
● Keep the strap of the rescue tube over the shoulder and neck.
● Hold or gather the excess line to keep it from getting caught in the chair or
other equipment when you move or start a rescue.
● Hold the rescue tube across the thighs in an elevated station.
● Hold the rescue tube across the stomach when standing.
■ Ask participants: Why should you wear the hip pack at all times, whether or
not you are on surveillance duty?
Answer: To be prepared to respond to an emergency at all times, whether or not
performing surveillance duty.
■ Explain that the type of rescue equipment, such as backboards, can vary among
facilities and they will need to be trained to use the specific pieces of equipment at
the facility where they will be employed.
■ Explain that rescue equipment can be expensive to purchase and maintain and
should be treated respectfully.
Activity ■ Explain to participants that one of their most important responsibilities as a

lifeguard will be to help ensure that the aquatic facility is safe.
■ Lead participants through the following scenarios to review what they should do
during a facility safety check when an issue or problem is found.
Scenario 1: You are conducting an opening facility safety check and you find a loose
bolt on a pool ladder.
■ Ask participants: What should you do?
| Document and report the loose bolt to management staff, identifying the
specific ladder and bolt.
| Fix the problem by seeing that the bolt is tightened properly before the facility
is opened.
| If the bolt cannot be tightened, block off the ladder so that it cannot be used
until it is repaired.
LGI_SecB_p032-047.indd 39 10/21/11 2:47 PM

Scenario 2: You are on duty conducting patron surveillance and a patron reports to
you that someone spilled shampoo in the locker room and the floor is very slippery.
■ Ask participants: What should you do?
| Thank the patron for bringing it to your attention.
| Clarify the specific location.
| Signal for assistance from another staff member who is not performing patron
surveillance so they can take care of it.
■ Remind participants that facility safety checks are a secondary responsibility and
must not be done while performing patron surveillance.
■ Explain that if during your surveillance you observe problems with equipment or
other problems are rported to you, you should notify a member of the safety team, a
lifeguard supervisor or another lifeguard who is not performing surveillance.
TOPIC: WEATHER CONDITIONS Time: 5 minutes

PRESENTATION: WEATHER CONDITIONS
Lecture ■ Weather affects the safety of swimmers both outdoors and indoors.
■ Facility management should monitor weather alerts using a weather
radio or other electronic communications. Management should keep
lifeguards informed when there are severe weather alerts, and lifeguards
should keep management informed when they see indications of
severe weather.
■ You will need to know and follow facility procedures to clear patrons
from the water and deck before an impending storm.
■ If thunder or lightning occur:
| Clear everyone from the water at the first sound of thunder or first
sight of lightning.
● If you are in an elevated station, get down immediately.
● Move everyone to a safe area free from contact with water,
plumbing or electrical circuits.
● For outdoor facilities, move everyone inside, if possible.
| Keep patrons and staff out of showers and locker rooms during
a thunderstorm as water and metal can conduct electricity.
| Do not use a telephone connected to a landline except in an
emergency.
| Keep everyone away from windows and metal objects.
| Watch for more storms and monitor weather reports on a radio or
TV broadcast, weather radio or website.
| The National Lightning Safety Institute recommends waiting
30 minutes after the last lightning sighting or sound of thunder
before resuming activities.
■ If caught outside in a thunderstorm and there is not enough time to
reach a safe building:
| Keep away from tall trees standing alone and any tall structures.
| Keep away from water and metal objects.
| Keep as low to the ground as possible but do not lie on the ground:
squat or crouch with the knees drawn up, both feet together and
hands off the ground.
LGI_SecB_p032-047.indd 40 10/21/11 2:47 PM

■ Other weather conditions, such as fog, wind or heavy rain, also may
cause safety concerns. Clear the pool or waterfront if visibility is
impaired by waves or increased turbidity.
■ In the event of a power failure, you should clear the pool because
circulation and filtration of pool water will not be possible. If weather
conditions cause safety concerns, you also should clear the deck.
TOPIC: RULES AND REGULATIONS Time: 20 minutes

PRESENTATION: RULES AND REGULATIONS
Activity ■ Explain that each aquatic facility establishes its own set of rules and regulations.
Some are required by the state or local health department, whereas others are
determined by the facility itself. Lifeguards must know and enforce all facility rules.
■ Explain that rules are communicated to patrons by signage as well as verbally when
lifeguards enforce the rules.
■ Divide the class into small groups. Distribute Activity Worksheet 1.1—Reasons for the
Rules. Assign each group different sections of the worksheet.
■ Refer participants to Chapter 2, Facility Safety, in the Lifeguarding Manual for
information to help them with this activity. Explain that there are five common rules
for each category or type of facility or attraction. These are not the “most important”
rules, but rather common rules. The intent of this activity is to provide a wide range
of rules so that participants gain an understanding of the rationale for different types
of rules.
■ Allow approximately 5 minutes for groups to discuss the reasoning behind the
assigned rules.
■ Reassemble the class and call on group leaders to share their answers.
Activity Worksheet 1.1—Reasons for the Rules

Aquatic Facilities—General Reason
1. Swim only when a lifeguard is on duty. There are inherent risks in aquatic environments,
and lifeguards are trained to respond to aquatic
emergencies. Statistics indicate that survival
rates after emergencies are higher in areas where
lifeguards are present.
2. No running, pushing or rough play. Running, pushing and rough play can result in
injuries, especially in an aquatic environment
with slippery surfaces, such as the tile deck of an
indoor pool.
3. Dive only in designated areas. Diving head-first in shallow water can result in head,
neck and spinal injuries.
4. No diving in shallow water (water up to 5 feet Diving head-first in shallow water can result in head,
deep). neck and spinal injuries.
5. No glass containers in the pool area and locker Broken glass poses several dangers, including
rooms. bleeding injuries and exposure to infectious
body fluids.
6. No alcoholic beverages or other drug use allowed. The use of alcohol and drugs can impair a patron’s
judgment, balance and motor skills.
LGI_SecB_p032-047.indd 41 12/13/11 3:04 PM

Waterfront Facilities
1. No playing or swimming under piers, rafts, Lifeguards cannot see under these structures. Patrons
platforms or play structures. may surface quickly and injure themselves on these
structures without the lifeguard observing them.
2. No running and diving head-first into shallow Diving head-first in shallow water or under a
water. breaking wave can result in a head, neck or
spinal injury.
3. No fishing near swimming areas. Fishing hooks and tackle left in swimming areas can
present a risk of injury.
4. No umbrellas at the waterline. Beach umbrellas positioned close to the shoreline may
obstruct the view of the lifeguard.
5. No swimming in unauthorized areas. Unauthorized areas are not protected by lifeguards,

and may have hidden hazards, such as drop-offs or
underwater obstructions. Watercraft could be present
in unauthorized areas, posing a danger to swimmers.
Waterpark Facilities, including Winding Rivers and Waterslides

1. Designated age, height or weight requirements for Age, height or weight requirements are designated
using an attraction to help ensure that patrons can safely enjoy the
attraction. For example, some attractions require a
certain minimum weight for it to function properly,
whereas others are designed only for persons with the
small build of young children.
2. Enter and exit the winding river only at Entrance and exit areas typically are recessed from
designated places. the winding river, creating an area where the water
current is minimized and patrons can enter and exit
without interfering with patrons in the main current.
3. Stay in tubes at all times. Stray tubes obstruct a lifeguard’s view of patrons
who are not riding on tubes. Lifeguards are trained
to suspect problems when tubes are floating
without riders.
4. No metal objects, locker keys, jewelry, metal These items can cause injury to the person riding the
snaps/zippers, eyewear or watches, including metal waterslide. Sharp objects also can scratch or gouge
rivets, buttons or fasteners on swimsuits or shorts. the waterslide, causing rough edges that then could
hurt others using the slide.
5. No running, stopping, standing, kneeling, rotating These behaviors can cause a patron to become more
or tumbling on the slides. disoriented when riding in the slide or entering the
catch pool, creating the potential for injury.
Diving Areas
1. Patrons must demonstrate their swimming ability Anyone swimming in deep water should be competent,
before entering deep water. comfortable and able to swim to the side of the pool
from any spot in the deep area.
2. Only one patron on the diving board at a time. By maintaining orderly use of the diving board, such
as allowing only one patron on the diving board itself
and one patron on the ladder at a time, lifeguards
help to create a safer environment. Patrons can get
restless waiting in line, which can result in rough play
on either the ladder or the diving board; a patron
could slip on either the board or ladder, causing injury
to him- or herself or others. Allowing multiple patrons
on a diving board also may affect its spring, which
may result in injury for the patron using the diving
board.
LGI_SecB_p032-047.indd 42 10/12/11 2:29 PM

3. Only one bounce allowed on the diving board. Multiple bounces on the diving board can impact
balance or body control and can result in a patron
slipping on the board, possibly hitting the diving
board on the way in.
4. Dive or jump forward, straight out from the The areas to each side of the diving board must
diving board. remain clear to prevent injury. Jumping to the side
could result in striking the side of the pool or colliding
with another patron.
5. Swim immediately to the closest ladder or wall. Clearing the area immediately allows the next patron
to use the diving board without danger to the patron
in the water.
Spas, Hot Tubs and Therapy Pools

1. Shower with soap and water before entering the The temperature of the hot tub creates an
water. environment where germs can thrive. Washing with
soap and water can help keep the hot tub clean and
safe for all.
2. People with certain medical conditions are not High temperatures can stress a person’s circulatory
allowed to use the spa or hot tub. and energy systems and also can cause problems for
some neurological conditions.
3. Pregnant women and young children should seek The potential for hyperthermia is a danger for
their doctor’s approval before using a spa or hot tub. pregnant women and young children because they are
less able to tolerate heat.
4. Do not allow anyone to sit or play near the drain or The suction has the potential for entrapment (i.e.,
suction fittings. holding a patron to the drain).
5. Limit time in the spa to 10 minutes. Patrons then A prolonged stay in the hot tub can cause the internal
may shower, cool down and return briefly. body temperature to elevate to a range that can result
in nausea, dizziness, fainting or hyperthermia.
TOPIC: ENTRIES AND APPROACHES Time: 10 minutes

PRESENTATION: ENTRIES AND APPROACHES
Video Segment ■ Explain that the video segment will illustrate skills for entering the water and
approaching a victim, which will be practiced in the pool.
■ Refer participants to the skills sheets in Chapter 6, Water Rescue Skills, in the
Lifeguarding Manual.
■ Show the video segment, “Entries and Approaches.”
IN-WATER SKILL SESSION: ENTRIES AND Time: 40 minutes

APPROACHES
PRESENTATION: NEXT STEPS
Skill Practice ■ Explain to participants that during the water rescue skill sessions you will
demonstrate skills and guide them through practice.
■ For each skill, be sure to review key points from the text and video, including
instructions on how to perform each skill and reminders about when each entry or
approach is appropriate.
LGI_SecB_p032-047.indd 43 10/21/11 2:47 PM

■ Explain that every rescue should begin by activating the EAP. Participants should
simulate this during each practice session.
■ Explain that the signals used to activate the EAP may vary among facilities. Define
the method that will be used in skill sessions, including the following:
| Announce the activation of the EAP with a loud signal either mimicking a whistle
or making a verbal announcement.
| Point to the victim that is in need of help.
■ Lead them through the following skills using a rescue tube:
| Slide-in entry and walking approach
● Especially useful in shallow water, crowded pools or when a victim with a
head, neck or spinal injury is close to the side of the pool
| Slide-in entry and swimming approach
● Especially useful in shallow water, crowded pools or when a victim with a
head, neck or spinal injury is close to the side of the pool
| Stride jump and swimming approach
● When you are less than 3 feet above the water and the water is at least
5 feet deep
| Compact jump and swimming approach
● When you are more than 3 feet above the water and the water is at least
5 feet deep
● Jump from the deck into the water.
■ When conducting the Shallow Water Lifeguarding course, omit the stride jump and
swimming approach. The compact jump should be performed when the lifeguard is 3
feet or less above the water.
■ Remind participants that if the tube slips out or if they need to swim a longer
distance, let the tube trail behind. They should reposition the tube as appropriate
before making contact with the victim.
■ Observe each participant’s performance of the skill several times and provide
corrective feedback.
■ Participants should practice the skills several times. Time permitting, participants
should practice the skills until they are able to meet performance criteria.
Participants who cannot meet the performance criteria should be counseled to
practice outside of class times if possible.
■ Observe each participant’s performance of the skill and provide corrective feedback.
Skill Drill— ■ Explain to participants that they now are going to practice the entry and approach
Entries and skills to make decisions as to when it is appropriate to use the different entries and
approaches and build fitness.
Approaches
■ Keep participants moving throughout these activities to develop conditioning for
speed and endurance:
| Have participants simulate activating the EAP, perform a designated entry
and then swim an approach stroke with a rescue tube as fast as they can for a
significant distance, 25 yards if possible, climb out without using the ladder
and walk quickly back to the starting point. Repeat until participants have done
this several times, sometimes swimming the approach stroke with the rescue
tube under their armpits and sometimes with the rescue tube trailing behind.
| Continue to follow the skill drill using the same pattern but give
participants a scenario and let them decide what entry to use, such as:
● The water is murky and they cannot see the bottom. Slide-in entry
● They are guarding on the deck and the water is 4-feet deep. Compact jump
LGI_SecB_p032-047.indd 44 10/13/11 2:01 PM

● The pool is crowded and swimmers are directly in front of them.
Slide-in entry
● They are in an elevated lifeguard station that is 4 feet above the level of the
water and the water is 7-feet deep. Compact jump
● They are in an elevated guard chair that is not suitable for a jump so they
must climb down to enter the water. The chair could be situated in a shallow
water area or not secured adequately to allow the lifeguard to jump from it.
Simulate stepping down from the stand and perform a compact jump or
slide-in entry
● They suspect a spinal injury close to the edge of the pool. Slide-in entry
● They are guarding a deep water area on the deck and suspect a spinal injury
at the far side of the pool. Compact jump, stride jump or slide-in entry
PUTTING IT ALL TOGETHER Time: 10 minutes
Activity ■ Gather participants in the deep end to tread water. Explain that you are going to lead
them through three scenarios. Have participants tread water with both hands in the
air if they agree with the lifeguard’s actions.
■ For the Shallow Water Lifeguarding course, have participants gather at one end
of the pool. Explain that you are going to lead them through three scenarios. Have
participants perform a breaststroke rescue approach using a rescue tube if they agree
with the lifeguard’s actions.
■ For each scenario, ask several participants to share their reasons for agreeing or
disagreeing.
■ In between each scenario, allow participants an opportunity to rest while you
facilitate a brief review of the lifeguard’s actions. Then have participants tread water
again while presenting the next scenario.
Scenario 1: You are lifeguarding when your friend comes to the pool to swim with
her little brother. The friend stops to talk to you about last night’s soccer game. You
talk with your friend for several minutes, believing that you are demonstrating
professionalism in this situation because you are being friendly with a customer. Do
you agree or disagree with the lifeguard’s actions?
■ Ask participants about the importance of providing undivided attention to the
job, the perception of other customers who may have observed this behavior
and suggestions for how the lifeguard could have handled this situation more
professionally. Review other aspects of professionalism that should be demonstrated
by a lifeguard.
Scenario 2: You are lifeguarding and there are only two people in the pool, a father
and his child. Although you still need to inventory the first aid supplies and the father
and child are in shallow water, you decide that your primary responsibility is to watch
the swimmers to make sure they are safe. Do you agree or disagree with the lifeguard’s
actions?
■ Ask participants about the primary and secondary responsibilities of a lifeguard and
how to accomplish the inventory of the first aid supplies, such as completing it at a
later time or having another lifeguard do it.
LGI_SecB_p032-047.indd 45 10/13/11 2:01 PM

Scenario 3: You are at work getting ready for your lifeguard shift when another
lifeguard comments on the in-service reminder posted on the bulletin board that states
that the focus of the in-service will be customer service. You state that you do not need
to go because you already know how to make customers happy by letting them do what
they want. Do you agree or disagree with the lifeguard’s actions?
■ Ask participants about the importance of enforcing rules as well as other types of
ongoing training needed by lifeguards. Discuss what constitutes good customer
service. Is it just making customers happy? Emphasize that in-service training allows
lifeguards to be part of the solution to problems since they can share and discuss
customers’ complaints. The team of lifeguards and management personnel then can
develop strategies to resolve the issues.
ASSIGNMENT
■ Read Chapter 2, Facility Safety, Chapter 3, Surveillance and Recognition, and
Chapter 4, Injury Prevention, in their Lifeguarding Manual before the next class
session.
SKILL CHARTS AND ASSESSMENT TOOLS

In addition to performing the steps listed in the skill chart in the correct order, participants must meet the criteria
listed at the proficient level to be checked off for this skill.
ENTRIES
SKILL CHART: SLIDE-IN ENTRY
1. Sit down on the edge facing the water. Place the rescue tube next to you or in the water.
2. Lower your body into the water feet-first.
3. Retrieve the rescue tube.
4. Place the rescue tube across your chest with the tube under your armpits, focus on the victim and begin the
approach.
SKILL CHART: STRIDE JUMP (Lifeguarding Course only)
1. Squeeze the rescue tube high against your chest with the tube under your armpits.
2. Hold the excess line to keep the line from getting caught on something when jumping into the water.
3. Leap into the water with one leg forward and the other leg back.
4. Lean slightly forward, with your chest ahead of your hips, and focus on the victim when you enter the water.
5. Squeeze or scissor your legs together right after they make contact with the water for upward thrust.
6. Focus on the victim and begin the approach.
SKILL CHART: COMPACT JUMP
1. Squeeze the rescue tube high against your chest with the tube under your armpits.
2. Hold the excess line to keep it from getting caught on the lifeguard chair or other equipment when jumping
into the water.
3. Jump out and away from the lifeguard chair, pool deck or pier. In a wave pool, time the jump to land on the
crest (top) of a wave.
4. Bend your knees and keep your feet together and flat to absorb the shock if you hit the bottom. Do not point
your toes or keep your legs straight or stiff.
5. Let the buoyancy of the rescue tube bring you back to the surface.
6. Focus on the victim when surfacing and begin the approach.
LGI_SecB_p032-047.indd 46 10/12/11 2:29 PM

SKILL ASSESSMENT TOOL: ENTRIES
Equipment is properly positioned ■ Control of the rescue tube ■ Contact with the rescue tube
for the appropriate entry maintained not maintained
■ Tube held securely to the chest ■ Tube not held securely to the
for the compact jump and stride chest for the compact jump
jump and stride jump
■ Excess line held to keep it from ■ Excess line not held
getting caught on the lifeguard
stand or other equipment
Appropriate entry is selected for the Entry is safe for the rescuer, victim Entry causes a safety hazard
situation and surrounding persons
Focus on the victim is maintained Upon entering (or resurfacing after a Fails to look toward the victim or
compact jump), focus on the victim site where the victim was last seen
or the site where the victim was last
seen is maintained
RESCUE APPROACHES
SKILL CHART: WALKING APPROACH
1. Walk to the victim.

2. Hold the rescue tube at your side and walk quickly toward the victim.
3. If necessary, position the tube in front of you before contacting the victim.
SKILL CHART: SWIMMING APPROACH
1. Swim to the victim using a modified front crawl or breaststroke.

2. Keep the rescue tube under your armpits or torso and swim toward the victim with your head up, keeping the
rescue tube in control at all times.
3. For longer distances, or if the rescue tube slips out from under your arms or torso while you are swimming, let
the tube trail behind.
4. If necessary, reposition the rescue tube in front of you before contacting the victim.
SKILL ASSESSMENT TOOL: APPROACHES
Approaches victim safely and Effective propulsion used for safe ■ No effective propulsion
quickly approach ■ Approach causes a safety
hazard
Focus on the victim is maintained Focus on the victim or the site Fails to look toward the victim or
where the victim was last seen is site where the victim was last seen
maintained
Equipment is properly positioned ■ Control of rescue tube is ■ Fails to maintain contact with
for the appropriate approach maintained during approach the rescue tube
■ Tube is strapped on during ■ Does not strap on tube during
approach approach
■ Tube remains in position or is ■ Tube is not in position for the
repositioned as needed before selected rescue before contact
contact with victim with victim
LGI_SecB_p032-047.indd 47 12/13/11 3:05 PM

LESSON 2
FACILITY SAFETY, PATRON SURVEILLANCE
LESSON OBJECTIVES
■ Describe the role that facility management plays in facility safety.
■ Describe the drowning process.
■ Identify the behaviors of a swimmer, distressed swimmer, and an active and a passive victim.
■ Identify and define elements of effective surveillance.
■ Explain proper scanning techniques and identify tactics to overcome scanning challenges.
■ Identify various types of zones of surveillance.
■ Explain how communication with patrons plays a role in preventing injuries.
■ Explain patron surveillance techniques for various activities.
■ Explain patron surveillance techniques for facilities with special attractions.
■ Explain and demonstrate lifeguard rotations.
■ Demonstrate how to perform effective surveillance including scanning, victim recognition and
lifeguard rotations.

■ Activity Worksheet 2.1—Guarding Special Attractions
■ Diving brick(s)
■ Stopwatch or pace clock
TOPIC: MANAGEMENT AND Time: 10 minutes

FACILITY SAFETY
PRESENTATION: MANAGEMENT AND FACILITY SAFETY
Lecture ■ As a lifeguard, your job is to follow and enforce your facility’s rules and
regulations. The job of your facility’s management team is to ensure
that the facility is in compliance with the law and to make sure you are
enforcing facility rules correctly.
■ Management is responsible for:
| Creating, reviewing and revising facility policies and procedures,
rules and regulations and emergency action plans (EAPs) as needed.
| Addressing unsafe conditions.
| Complying with federal, state and local laws and regulations for
facility operations and employment.
| Maintaining records regarding the facility and its employees.
| Assisting after an emergency.
■ Ask participants: What can you do, as a lifeguard, to assist management in
addressing unsafe conditions?
Answer: Report any unsafe conditions and take action to limit use of an unsafe
area or help correct the unsafe conditions.
LGI_SecB_p048-061.indd 48 12/13/11 3:11 PM

■ Federal, state and local regulations affect the operation of aquatic
facilities. Your employer should inform you as to regulations that affect
your facility, such as:
| Lifeguard certification requirements.
| Facility design and safety features.
| Pool capacities.
| Staff training requirements and lifeguard competencies.
| Ratio of lifeguards to patrons.
| Water sanitation procedures.
| First aid equipment and supplies.
| Lifeguarding equipment.
| Diving depths.
■ Federal and state labor laws affect which tasks lifeguards younger
than 18 years may perform, including the hours they may work. These
regulations generally are more stringent for 15-year-old lifeguards than
for 16- and 17-year-old lifeguards.
■ The Occupational Safety and Health Administration (OSHA) established
regulations designed to keep employees safe while on the job.
■ The purpose of the Hazard Communication Standard is to inform
and protect employees from exposure to hazardous chemicals in the
workplace.
■ Each chemical has an information sheet called a Material Safety Data
Sheet (MSDS), which describes special precautions to take when storing
or using the chemical in addition to safety precautions needed when
cleaning up chemical spills. The MSDS also explains what to do should
you come into contact with the chemical.
■ These documents must be easy to find and use. Be sure to know where
MSDSs are kept and how to find the information.
■ Employees have a right to know:
| Which hazardous chemicals are in the facility.
| Where those chemicals are stored in the facility.
| The specific dangers of those chemicals.
| How to identify chemical hazards in the facility.
| How to protect themselves and others from being exposed to
hazardous chemicals.
| What to do if they or others are exposed to such hazards.
■ The Bloodborne Pathogens Standard is an OSHA regulation designed to
reduce the risk of disease transmission while on the job. Your employer
must provide an exposure control plan to help protect employees from
being exposed to disease-causing bacteria and viruses, called bloodborne
pathogens, and instruct employees about what to do if an exposure
occurs.
LESSON 2 | Facility Safety, Patron Surveillance and Injury Prevention 49
LGI_SecB_p048-061.indd 49 10/21/11 2:52 PM

TOPIC: THE DROWNING PROCESS Time: 10 minutes
PRESENTATION: THE DROWNING PROCESS
Lecture ■ Your primary responsibility as a lifeguard is to help ensure patron safety

and protect lives.
■ You will spend most of your time on patron surveillance—keeping a close
watch over the people in the facility and intervening when necessary.
■ For effective patron surveillance, you must understand the drowning
process and be alert and attentive at all times.
■ Drowning is a continuum of events that begins when a victim’s airway
becomes submerged under the surface of the water. The process can be
stopped, but if not, it will end in death.
■ The process of drowning begins when water enters the victim’s airway.
| This causes involuntary breath holding and then laryngospasm (a
sudden closure of the larynx or windpipe). When this occurs, air
cannot reach the lungs. During this time, the victim is unable to
breathe but may swallow large quantities of water into the stomach.
| As oxygen levels are reduced, the laryngospasm begins to subside and
the victim may gasp for air but instead inhales water into the lungs.
■ Due to inadequate oxygen to body tissues, the victim may suffer cardiac
arrest. This can occur in as little as 3 minutes after submerging. Brain
damage or death can occur in as little as 4 to 6 minutes.
■ Many intervening variables can affect the outcome, including underlying
medical conditions of the victim, and the time until advanced medical
care intervenes.
■ In general giving ventilations often will resuscitate the victim if they are
given within 1½ to 2 minutes of submerging .
■ When you are providing care, an unconscious victim may have isolated
or infrequent gasping in the absence of other breathing, called agonal
gasps.
| Agonal gasps can occur even after the heart has stopped beating.
| Normal, effective breathing is regular, quiet and effortless. Agonal
gasps are not breathing—care for the victim as though he or she
is not breathing at all by giving ventilations or providing CPR.
■ Ask participants: What does this understanding of the drowning process
mean for you as a lifeguard?
| Practice preventive lifeguarding and enforce rules to keep patrons safe.
| Stay alert to recognize when a patron is drowning.
| Respond with urgency.
| Get the victim’s airway out of the water and provide care for a breathing
emergency as quickly as possible.
| If a victim is in cardiac arrest, begin CPR as quickly as possible.
| Practice emergency care skills frequently to be ready to respond quickly and
with confidence.
■ To give a victim the greatest chance for normal survival, you must
recognize when a person needs help or is in danger of drowning. The
sooner the drowning process is stopped by getting the victim’s airway
out of the water, opening the airway and providing resuscitation
(ventilations or CPR), the better is the chance for survival without
permanent brain damage.
LGI_SecB_p048-061.indd 50 10/21/11 2:52 PM

TOPIC: EFFECTIVE SURVEILLANCE— Time: 10 minutes
VICTIM RECOGNITION
PRESENTATION: EFFECTIVE SURVEILLANCE—VICTIM RECOGNITION
Video Segment ■ Tell participants: Effective surveillance involves not only recognizing
behaviors or situations that might lead to life-threatening emergencies,
such as drowning or injuries to the head, neck or spine, but also taking
effective action to modify the behavior or control the situation.
■ Explain that swimmers and nonswimmers, adults and children, all can become
victims very quickly.
■ Show the video segment, “Surveillance.”
Guided ■ Ask participants: What are some situations that could lead to trouble for a
Discussion weak or nonswimmer?
| Bobbing in or near water over his or her head
| Hand-over-hand wall crawling
| Being beyond arm’s reach of a supervising adult, even if wearing inflatable
water wings or swim rings
| Clinging to something or struggling to grab something to stay afloat
| Wearing a life jacket improperly
■ Ask participants: What are some situations that could lead to trouble for a
swimmer?
| Breath-holding or swimming underwater for an extended period after
hyperventilating
| Participating in a high-risk/high-impact activity, such as diving
| Experiencing a medical emergency, such as a sudden illness
■ Refer participants to Table 3-1: Behaviors of Distressed Swimmers and Drowning
Victims in the Lifeguarding Manual.
■ Ask participants: What are the characteristics of a distressed swimmer?
| Able to keep his or her face out of the water
| Able to call for help
| Able to wave for help
| Horizontal, vertical or diagonal body position, depending on what the person is
using for support
| Floating, sculling or treading water
■ Ask participants: What instinctive drowning response behaviors would you
see in a drowning victim who is struggling at or near the surface?
| Cannot call out for help/his or her efforts are on getting a breath
| Struggles to keep the face above water in an effort to breathe
| Has arms extended to the side or in front, pressing down for support
| Has a vertical body position in the water with no supporting kick
| Might continue to struggle underwater
| Might eventually lose consciousness and stop moving
LGI_SecB_p048-061.indd 51 10/21/11 2:52 PM

■ Ask participants: In some cases, what might a very small child look like
when in trouble in the water?
| Appears to be doing the “doggy paddle” but is not making forward progress
| In a horizontal position at the surface but not able to raise the face up out of the
water
| Underwater, struggling to get to the surface
■ Ask participants: What are some conditions that could lead to a patron
becoming a drowning victim who appears to be unconscious?
| Lack of timely rescue of an active victim
| Heart attack or stroke
| Seizure
| Head injury
| Heat-related illness
| Hypothermia (below-normal body temperature)
| Hyperventilation and prolonged underwater breath-holding activities
| Use of alcohol and other drugs

SCANNING
PRESENTATION: EFFECTIVE SURVEILLANCE—SCANNING
Video Segment ■ Explain that effective surveillance also includes scanning, a visual technique for
deliberately observing patron behaviors and actively looking for signals that someone
in the water needs help.
■ Show the video segment, “Scanning.”
Guided ■ Ask participants: What are some important factors for effective scanning?
Discussion Answers: Responses should include:
| Know what to look for to determine if a victim is in trouble in the water.
| Deliberately and actively observe swimmer’s behavior.
| Scan the entire volume of water: bottom, middle and surface.
| Move your eyes and head while scanning and look directly at the patron’s body
movements.
| Maintain an active, rescue-ready posture.
■ Refer participants to Table 3-2: Scanning Challenges in the Lifeguarding Manual to
see some of the challenges for effective scanning.
■ Tell participants that you will present some challenges for scanning and they are to
provide you with what tactics could help to overcome the challenge.
LGI_SecB_p048-061.indd 52 10/21/11 2:53 PM

Challenge Tactic
Monotony ■ Stay fully engaged in what you are seeing—do not let your attention drift.
■ Change body position and posture periodically.
■ Sit upright and slightly forward.
■ Rotate stations.
Fatigue ■ Request additional lifeguard coverage.

■ Keep hydrated, cool off and get out of the sun when on break.
■ Exercise during one of your breaks.
Distraction ■ Stay focused on patron surveillance.

■ Do not daydream, have conversations with co-workers or patrons or watch events
outside of your area.
■ Keep patron activities safe and orderly. Signal for an additional lifeguard or
supervisor if assistance is needed.
Blind spots ■ Adjust your location or body position or stand up.

■ Check all potential blind spots: under the stand, at play features or any part of the
zone.
Glare (from the ■ Use polarized sunglasses.

sun or overhead ■ Change body position—stand up and look around and through glare spots.
lighting)
■ Reposition your lifeguard station with permission of your supervisor.
Water movement ■ Adjust your body position.

and surface ■ Be aware of the normal appearance of the bottom of the pool; know the appearance
distortion of the of drains, colored tiles or painted depth markings.
water
■ Scan the bottom carefully.
Murky water ■ Adjust your location or body position.

■ Stay alert for high-risk activities.
■ Signal for additional assistance to get extra coverage for the area.
Heavy patron ■ Stand up frequently.

loads ■ Signal for additional assistance to get extra coverage for your area.
Low patron loads ■ Change body position and posture frequently.

■ Change to a ground-level station, if appropriate.
Hot air ■ Use fans to cool the surrounding air in an indoor setting.
temperature ■ Stay in the shade; use umbrellas.
■ Cool off by getting wet during your break.
■ Rotate more frequently.
■ Stay in cooler areas during breaks.
■ Stay hydrated by drinking plenty of water.
LGI_SecB_p048-061.indd 53 10/21/11 2:53 PM

ZONES OF SURVEILLANCE
RESPONSIBILITY
PRESENTATION: EFFECTIVE SURVEILLANCE—ZONES OF
SURVEILLANCE RESPONSIBILITY
Video Segment ■ Explain that another element of effective surveillance involves the assignment of
zones of surveillance responsibility. The video segment will introduce participants
to various types of zone coverage, including zone coverage, total coverage and
emergency back-up coverage in various types of facilities.
■ Show the video segment, “Zones of Surveillance.”
Guided ■ Ask participants: What should you do if the number of patrons increases in
Discussion your zone and you feel unable to adequately provide surveillance?
Answer: Signal for assistance for another lifeguard to help cover the zone.
■ Ask participants: You are seated in an elevated lifeguard station and there
is a glare on the surface of the water making it difficult for you to see.
What should you do?
Answer: While maintaining surveillance, get down from the chair and adjust your
position so you can see all areas of your zone or reposition your lifeguard station
with permission from your supervisor.
■ Ask participants: A group of preschool-aged children enter your zone. They
are all weak swimmers. Although there are not many children, you feel
that you are not able to watch the area adequately. What should you do?
Answer: Signal for assistance for another lifeguard to help cover the zone.
TOPIC: INJURY PREVENTION Time: 15 minutes

STRATEGIES
PRESENTATION: INJURY PREVENTION STRATEGIES
Lecture ■ Aquatic injury prevention is part of your facility’s risk management

program.
■ Risk management involves identifying dangerous conditions or
behaviors that can cause injuries and then taking steps to minimize
or eliminate them. Even though lifeguarding requires performing
emergency rescues, one of your goals is preventive lifeguarding, trying to
make sure emergencies do not happen in the first place.
■ Ask participants: What are some examples of life-threatening conditions?
| Unconsciousness
| Breathing and cardiac emergencies
| Severe bleeding
| Drowning
■ Ask participants: What could be some causes of non-life-threatening
conditions?
| Diving in shallow water could result in a spinal injury.
| Slipping and falling on the deck could result in wounds, fractures, dislocations,
joint sprains or muscle strains.
LGI_SecB_p048-061.indd 54 10/21/11 2:53 PM

| Exposure to sun could result in sunburn.
| Exposure to heat could result in dehydration.
■ It is important to understand how injuries occur so you can help prevent
them. As a lifeguard you need to:
| Increase your awareness of risks and hazards.
| Help patrons avoid risky behavior.
| Help develop a safety-conscious attitude at your facility.
Lecture ■ Communicating with patrons is an important injury-prevention strategy.

and Guided It requires you to inform and educate patrons about inappropriate
behavior and the potential for injury. Communication also includes
Discussion enforcing rules and regulations.
■ Facilities use a variety of strategies to inform patrons of potential risks.
| Signs are displayed listing the rules. Universal symbols may be used
on signs in place of or in addition to words. For example, an
illustration of a person diving with a circle around it and a line
through it is a universal symbol for “No Diving.”
| Patrons may be given printed material listing rules when entering
the facility or as part of membership.
| As a lifeguard, you also are a part of the communication strategy
since it is your job to inform patrons of the possible consequences
if they are not following the rules.
■ Ask participants: What information do patrons need to know concerning
risky behaviors?
| Why the behavior is dangerous
| Possible consequences of the risky behavior
| Safe options
■ Ask participants: How can you politely get a patron’s attention?
| Blowing a whistle
| Saying, “Excuse me,” to the patron
| Using a visual signal, such as a nod of the head or a hand signal, if you have
the attention of the patron
■ Your whistle is a communication tool to get the attention of patrons. It
also is a communication tool that can be used to activate the EAP.
■ Your facility’s EAP should specify a certain number and type of whistle
blasts to indicate certain emergency situations. For example, one long,
loud blast might signal to clear the pool, whereas three loud, short blasts
might signal a water rescue.
■ You will need to practice using your whistle blowing so you can blow it
loud enough to be heard above the surrounding noise and others can
distinguish which specific signal you are trying to communicate.
■ Use your whistle cautiously since it might be ignored by staff and patrons
if you use it too frequently.
Video Segment ■ Explain to participants that the following video segment will provide them with some
and Guided strategies to use to help keep their facility safe.
Discussion ■ Show the video segment, “Injury Prevention.”
■ Pause the video for discussion of the thunder scenario—rule enforcement and
customer service.
■ Ask participants: What did the lifeguard do to protect patrons when
thunder was heard?
LGI_SecB_p048-061.indd 55 11/21/11 11:33 AM

| Cleared the pool.
| Got down from the guard chair once the zone was cleared to get the patron’s
attention rather than just continue to blow the whistle.
■ Ask participants: What strategies did the lifeguard use to try to get the
resistant man to understand the importance of clearing the pool?
| Spoke with the man, explaining that thunder had been heard in the area.
| Used a rescue tube to get the attention of the man and stop him at the wall.
| Explained that the need to exit the pool was a safety issue.
| Requested help from management.
| Explained firmly that if he did not comply with the request the consequence
could be that he could lose his membership at the pool.
TOPIC: GUARDING A VARIETY OF Time: 10 minutes

ACTIVITIES
PRESENTATION: GUARDING A VARIETY OF ACTIVITIES
Lecture ■ Ask participants: What types of activities might take place when you are
and Guided lifeguarding?
Discussion Answers: Responses should include the following:
| Open or recreational swimming
| Water exercise, such as water walking and lap swimming
| Instructional classes, such as swim lessons, water therapy, water exercise
and SCUBA lessons
| Team practices, such as swim team, water polo or synchronized swimming
| Competitive events, such as swim meets and triathlons.
| Special events such as movie nights, pool parties and after-hours rentals.
■ Open or recreational swimming typically involves patrons of various
ages and swimming abilities. Challenges in guarding recreational
swimming are numerous, and may include:
| Young children who are not adequately supervised.
| Patrons engaging in risky behaviors in or out of the water.
| A child who has wandered off from parents or caretakers.
| Nonswimmers who have ventured into water that is too deep.
| A patron that suffers a sudden illness.
■ When guarding for organized activities, it is helpful to understand
the unique aspects and risks of the activity. Questions that need to be
answered for effective guarding include:
| What things could go wrong that are unique about this activity?
| What is the swimming ability or comfort level in the water of patrons
involved in this activity?
| Are there any unique challenges or obstacles to recognizing an
emergency, approaching a victim or performing a rescue?
| Do participants have any medical conditions that increase the
chances for sudden illness or injury due to the nature of the activity?
LGI_SecB_p048-061.indd 56 12/13/11 3:11 PM

■ Instructional classes have the benefit of additional supervision by
trained personnel, including instructors for swim lessons, lifeguarding
or fitness classes and coaches for competitive sports, such as swimming
and diving, water polo or synchronized swimming.
■ Facility management should consider instructors or coaches to be part of
the safety team and provide them with training to help ensure the safety
of participants.
■ Instructors and coaches are responsible for the safety of their classes or
teams but this does not in any way relieve you of your responsibilities.
You are expected to recognize inappropriate behavior that could lead to
injury and emergencies. You still must scan every person in the water
and enforce rules for participants and instructional staff, perform
rescues and provide first aid as appropriate.
■ Ask participants: What might be some unique risks of participants in a
water exercise class for older adults?
| Participants may have risks associated with exercise such as over-exertion
and possibly heat illness.
| Participants may have risks associated with medical problems such as
hypertension, diabetes or arthritis.
| Participants may be using water exercise or therapy to rehabilitate from
surgery or injury and may have less balance or stamina.
■ Ask participants: What might be some unique risks of participants in swim
lessons?
| Participants who do not know how to swim may be unaware of dangers and
slip into water that is too deep for them.
| Participants may not follow the instructions of the instructor and attempt
to leave the class.
| Participants may attempt skills that are too difficult for them in an effort to
please the instructor or the parent or to impress peers.
| Participants may have fears that overcome their ability to react in an
emergency situation. A participant might suddenly panic when discovering
that he or she is in deep water.
■ Participants in competitive aquatic sports, such as swimming and diving,
water polo or synchronized swimming, or participants in open water
swimming events, such as triathlons, typically are skilled swimmers but
are not exempt from potentially needing assistance, particularly after
suffering sudden illness or injury. Some participants may be novice
swimmers who could become tired when swimming longer distances.
■ Ask participants: What might be some unique risks of participants in
competitive sports?
| Swimmers may have exercise-related risks from overexertion or dehydration
during practice or a competition, such as a triathlon.
| Injuries can occur in overcrowded lap lanes during practice or warm-ups for
a competition, from being hit by a ball during water polo, or from being hit by
the springboard when diving.
| Swimmers may hyperventilate when trying to swim longer distances without
breathing.
LGI_SecB_p048-061.indd 57 10/21/11 2:53 PM

TOPIC: GUARDING SPECIAL Time: 20 minutes
ATTRACTIONS
PRESENTATION: GUARDING SPECIAL ATTRACTIONS
Lecture ■ Many facilities have special attractions that create challenges for
lifeguarding, such as:
| Water-play areas specifically for young children.
| Play structures, such as sprays, fountains and dumping buckets;
floating obstacle courses; inflatable play structures or sports
structures for volleyball or basketball.
| Special rides and attractions, such as bowl slides, multiperson raft
rides, uphill water coasters, high-speed water slides; or other
attractions including diving platforms, cable swings, and hand-over-
hand rope, nets and rings.
| Water slides, including open and enclosed slides, drop slides and
speed slides.
| Winding rivers.
| Wave pools.
Activity ■ Divide the participants into small groups and provide each group with Activity
Worksheet 2.1—Guarding Special Attractions.
■ Refer participants to Chapter 4, Injury Prevention, in the Lifeguarding Manual for
information to help them with this activity.
■ Instruct groups to list unique concerns for guarding each of the special attractions
listed on the worksheet or assign specific topics to individual groups.
■ Allow up to 5 minutes for the group work. Circulate among groups to monitor
progress and provide assistance when necessary.
■ Reassemble the class and call on group leaders to share their answers to
the questions.
Activity Worksheet 2.1—Guarding Special Attractions

■ Areas Specifically for Young Children
| Enforce height and age requirements since older children may be too large for some structures or
too rough for young children.
| Ask adults to actively supervise their children.
| Watch out for young children using the pool as a toilet.
| Watch children for sunburn or signs of overexposure to cold or heat.
■ Play Structures
| Do not let a play structure become overcrowded.
| Do not allow patrons to swim underneath structures.
| Watch that patrons return to the surface after dropping into the water.
| Pay close attention to children playing in and around sprays, fountains and interactive water-play
structures. Excited children may run and fall and be injured.
| Pay close attention to patrons in moving water. They might lose their balance and be unable to stand
up again.
| Watch for overcrowding and horseplay on floating structures.
| Keep play safe and orderly.
LGI_SecB_p048-061.indd 58 12/13/11 3:11 PM

■ Special Rides and Attractions
| Watch patrons as they enter and exit an attraction. Dispatch patrons safely on a ride at set intervals.
| Carefully watch both the water below and the activities overhead.
| Keep patrons in view as long as possible.
| Ensure that patrons who fall off a structure return to the surface.
| Be aware of any special risks.
| Enforce rules for safe behaviors allowed on the attraction.
■ Water Slides
| Check that patrons are tall enough to use the slide.
| Instruct riders how to ride down the slide and make sure they are in the correct position.
| Help riders with the equipment.
| Confirm that the riders are ready to go and signal them to start.
| If assisting riders to take off, use tube handles when available. Avoid pushing or pulling riders by their
shoulders, arms or legs.
| Dispatch next riders at the proper intervals.
| Signal the lifeguard at the bottom when a rider has been dispatched. If the lifeguard at the bottom can
be seen, you can use a hand signal or a whistle.
| Watch for riders who stop, slow down, stand up or form a chain.
| Watch for riders who lose their mat, tube or raft or have trouble getting down the slide.
| Watch for riders who hit their heads on the side of the slide.
| Observe all riders exit the slide into the catch pool.
| Assist riders who appear off balance or get caught under water in the strong downward flow of water
in the catch pool.
| Ensure that riders do not cross in front of any slide when getting out of the runout or catch pool.
| Help riders, if needed, from the runout or catch pool.
| Signal the lifeguard at the top when each rider has moved out of the catch pool or runout and it is clear
to send the next rider.
■ Winding Rivers
| Ensure that patrons enter and exit at designated locations.
| Watch for inexperienced swimmers falling off their inner tubes or inflatable rafts.
| Watch carefully for, and correct, risky behavior.
■ Wave Pools
| Ensure that patrons enter only in the shallow end.
| When the waves are on, stand up to get a better view of patrons.
| Watch for swimmers who get knocked over by the waves or carried into deeper water by the
undercurrent.
| Do not let patrons dive into the waves.
| Keep the areas around ladders and railings clear so that patrons can exit from the pool quickly.
| Keep other swimmers out of the pool during special activities, such as surfing.
| Before performing an emergency rescue, turn the waves off using the emergency stop button.
LGI_SecB_p048-061.indd 59 10/21/11 2:53 PM

IN-WATER SKILL SESSION: REVIEW SKILLS, Time: 45 minutes
VICTIM RECOGNITION AND LIFEGUARD
ROTATION
Skill Review
Activity ■ Explain to participants that they are going to participate in a review session for
entries and approaches.
■ Lead a brief review discussion of the entries they learned in Lesson 1, asking
participants when they would use them and why.
| Slide-in entry
| Stride jump
| Compact jump
■ Have participants practice each of the entries, including approach strokes
several times.
■ Clearly observe each participant’s performance of the skill and provide corrective
feedback.
Effective Scanning and Lifeguard Rotations

Activity ■ Explain to participants that they are going to participate in an activity to experience
effective scanning and lifeguard rotations.
■ Two participants will be positioned on deck as lifeguards, equipped with rescue
tubes and hip packs. The remaining participants will be in the water as if it were a
recreational swim time.
■ Assign each participant a number and record it with their name to avoid calling the
number of one of those playing the lifeguard role. When their number is called, they
will know it is their turn to play the role of either a distressed swimmer, an active
victim or a passive victim. The victim should not react immediately but should allow
the lifeguards some time to scan the pool before presenting them with the challenge
of victim recognition.
■ Assign zones of coverage for the lifeguards. When a victim is recognized, the
lifeguard should activate (or simulate) the EAP, point to the victim and state what
type of victim they observe.
■ Place an extra rescue tube and hip pack on the deck for the incoming lifeguard. Explain
that the participant who was the victim will exit the water, put on a rescue tube and
hip pack and rotate into the position of one of the lifeguards. The lifeguard who is
being replaced will rotate to the position of the other lifeguard; afterward, he or she
will place the rescue tube and hip pack on the deck and enter the water to join the
recreational swim group. Follow the same pattern of rotation throughout the activity.
■ Remind participants that they need to follow rotation procedures that maintain
patron surveillance.
| Each lifeguard should carry his or her own rescue tube during the rotation.
| The incoming lifeguard should be aware of the patrons and activity level of the
zone and begin scanning while walking toward the station, checking all areas of
the water from the surface to the bottom.
| The outgoing lifeguard should inform the incoming lifeguard of any situations
that need special attention. The exchange of information should be brief, and
patron surveillance must be maintained throughout the entire rotation.
| Once in position, with the rescue tube strapped on, the incoming lifeguard
makes any adjustments needed, such as removing shoes or adjusting an
umbrella, before confirming to the outgoing lifeguard that he or she “owns the
zone.” The outgoing lifeguard should continue scanning as he or she is walking
toward the next station.
LGI_SecB_p048-061.indd 60 12/13/11 3:11 PM

■ Begin the activity with the lifeguards that have been assigned to be on deck. Call out
a number that has been assigned to one of the participants that is in the water.
■ Provide guidance as needed for both victim recognition and for the lifeguard rotation.
■ Continue the activity until everyone has had the opportunity to play the role of a
lifeguard.
Activity ■ Gather participants and explain that they will be participating in two activities to
challenge their physical fitness, entries and approaches.
Activity 1: Round ■ Have participants form a circle in deep water and begin treading.
Robin Brick Drill ■ Hand one participant a brick and have him or her tread water while holding the
brick at the surface of the water with both hands for 20 seconds. At your signal,
have him or her pass it to the person on the right. Participants who are not currently
supporting the brick will alternate between treading water by kicking only, then
using their arms and legs each time you signal.
■ Anyone who drops the brick must retrieve it.
■ Continue this activity for about 7 to 10 minutes.
■ You can vary this activity adding additional items to the circle, such as another brick
and a tennis ball.
■ For the Shallow Water Lifeguarding course, place three bricks on the bottom of
the shallow end of the pool, starting at the edge of the pool; there should be 5 feet
between each brick.
■ At your signal, have participants swim under water to the first brick, pick up the
brick and stand up, bringing the brick to the surface of the water.
■ After placing the brick back on the bottom of the pool, have participants swim to the
next brick and repeat the drill.
■ Continue this activity until every participant has retrieved all three bricks two times.
Activity 2: ■ Explain to participants that this is a swimming relay activity to practice entries and
Rescue Tube approach strokes combined with speed.
Relay ■ Divide the group into two or more teams with an equal number of participants.
■ Each team member, wearing a hip pack, must either do a stride jump or compact
jump into the water and swim to the other side using a modified front crawl or
breaststroke while keeping the rescue tube under his or her armpits.
■ For the Shallow Water Lifeguarding course, participants should use the compact
jump to enter the water.
■ When each team member reaches the other end of the pool, he or she should hand
off the rescue tube and hip pack to the next person in line. The next person in line
performs a stride jump or compact jump into the water and swims with the rescue
tube back to the starting point.
■ Continue this process until each team member has participated or continue for about
7 to 10 minutes.
■ You can vary this activity by changing the type of entry, approach stroke or letting the
tube trail behind.
ASSIGNMENT
■ Review Chapter 4, Injury Prevention, and Chapter 5, Emergency Action Plans, in the
Lifeguarding Manual before the next class session.
LGI_SecB_p048-061.indd 61 10/21/11 2:53 PM

LESSON 3
INJURY PREVENTION AND RESCUE SKILLS,
PART 1
LESSON OBJECTIVES
■ Explain patron surveillance techniques for organized groups.
■ Explain the purpose and general procedures of an emergency action plan (EAP).
■ Demonstrate how to safely and effectively assist a distressed swimmer, rescue an active and passive victim
and rescue multiple victims.
■ Demonstrate the ability to implement an EAP and perform a rescue.

■ Activity Worksheet 3.1—Strategies for a Safe Group Visit
TOPIC: GUARDING FOR ORGANIZED Time: 20 minutes

RECREATIONAL SWIM GROUPS
PRESENTATION: GUARDING FOR ORGANIZED RECREATIONAL SWIM GROUPS
Lecture ■ Organized groups, such as day care groups, camps and youth
organizations, may visit your facility. These groups may be a part of your
organization or may be outside groups.
■ Groups should be accompanied by leaders, such as camp counselors or
chaperones.
■ Groups may reserve the entire facility for a specific activity.
■ Facility management can contribute to the safety of groups by putting in
place strategies such as:
| Gathering important information as part of the booking procedure
when the group schedules their visit.
| Ensuring a safety orientation with all members of the visiting group
to explain the rules and expectations.
| Developing a classification system based on swimming ability that
easily identifies patron swim levels, such as using color-coded wrist
bands or swim caps.
| Designating the swimming areas based on ability and intended use.
| Orienting the group as to the design of the swimming area, including
water depth, and identifying where groups may swim.
| Using an identification system for group leaders or adult chaperones,
such as laminated lanyard or a brightly colored baseball cap or
T-shirt.
| Pairing swimmers of like ability as buddies to watch one another.
| Implementing periodic buddy checks so that leaders can identify and
account for all of their group members.
LGI_SecB_p062-071.indd 62 10/21/11 2:53 PM

Activity ■ Assign participants to small groups and assign each group one of the scenarios in
Activity Worksheet 3.1—Strategies for a Safe Group Visit to each group. Give groups
5 minutes to develop a list of strategies for a safe group visit.
■ Have each group present their strategies to the class.
■ Upon completion, discuss any considerations for group visits that were not
addressed.
Activity Worksheet 3.1—Strategies for a Safe Group Visit

■ Scenario 1: You are guarding multiple activities using the pool in addition to an organized group of 30
preschool-aged children with four group leaders. In general, what should you ensure and be aware of while
guarding the activity?
| Ensure that swimming areas are clearly marked according to their predetermined swimming abilities.
| Ensure that patrons stay in the sections appropriate for their swimming abilities. Be aware that weak
or nonswimmers, excited to be together enjoying a recreational activity, may attempt to venture into
areas that are beyond their swimming ability.
| Provide U.S. Coast Guard-approved life jackets for weak or nonswimmers.
| Know how to identify group leaders or chaperones.
| Ensure that chaperones are actively supervising the members of their group and that the appropriate
swimmer-to-chaperone ratio is being met. If it appears that they are not doing so, alert your facility’s
manager.
| Signal for additional lifeguard coverage, such as a roving lifeguard, if you feel you cannot effectively
guard your zone. You may need to do this at the beginning of the swim time while the group gets
adjusted to the facility’s rules or if large groups are concentrated in one area.
■ Scenario 2: You are tasked with giving a quick safety orientation to a camp group that will be using the
diving boards. Group members took the facility swim test, and all are approved to swim in deep water. List
some common rules that you will review for the safe use of the diving boards and briefly describe how you
would cover the information.
Answers: Responses should include:
| Only one person on the diving board at a time.
| Only one person on the ladder at a time.
| Look before diving or jumping to make sure the diving area is clear.
| Only one bounce allowed on the diving board.
| Dive or jump forward and straight out from the diving board.
| Swim immediately to the closest ladder or wall.
| Start by asking what the group members already know about the diving area rules to gauge their level
of understanding and then explain any rules that the group did not understand.
Note to instructors teaching the Shallow Water Lifeguarding course: While shallow water lifeguards
may not work in a deep-water environment, this scenario can still be used in the Shallow Water Lifeguarding
course so participants can understand common rules for all areas of swimming facilities.
■ Scenario 3: You will be working a private rental at your facility for families with children of all ages from
your local athletic association. You will be doing a safety orientation for the group. Who will you be instructing
during the orientation and what items will you be sure to cover?
| The safety orientation will be given to all members of the group, including the adults. It should cover the
following:
● General aquatic safety rules
● Swimming area sections
● Water depths
LESSON 3 | Injury Prevention and Rescue Skills, Part 1 63
LGI_SecB_p062-071.indd 63 12/19/11 10:07 AM

● Features or play structures
● Equipment
● How to use approved floatation devices
● Rule signage locations
● Operational information, such as buddy checks or breaks
TOPIC: EMERGENCY ACTION PLANS Time: 20 minutes

PRESENTATION: EMERGENCY ACTION PLANS
Video Segment ■ Explain to participants that the importance of activating an EAP already has been
discussed as a part of performing a rescue. In this lesson, they will learn more details
about EAPs.
■ Show the video segment, “Emergency Action Plans.”
■ Explain that a new hire orientation should include their assigned responsibilities in
the facility’s EAP. Regular in-service training and simulation drills to practice EAP
procedures also should occur throughout their employment.
Lecture ■ Ask participants: What is the purpose of an EAP?

and Guided Answer: The purpose of an EAP is to describe everyone’s responsibility in an
Discussion emergency.
■ During orientation, in-service training and in simulation drills, you will
learn and practice your assigned EAP responsibilities.
■ Aquatic facilities often have a general plan for water or land rescues, as
well as additional plans designed to address specific situations, such as
an active victim, a passive victim, a spinal injury, a missing person or an
injury or illness. Activate your facility’s EAP whenever you recognize an
emergency.
■ Refer participants to Chapter 5, Emergency Action Plans, in the Lifeguarding
Manual and discuss the sample EAP flow charts.
■ In a water emergency, the rescuing lifeguard should:
| Signal: Activate the EAP
| Rescue: Perform an appropriate rescue by following the general
procedures for a water emergency.
| Care: Provide emergency care as needed
| Report, advise and release: Complete a report of the incident and
advise the victim as to precautions they should take to prevent the
situation from occurring again. If the victim is a minor, he or she
should be released to the appropriate person. Gather information
that is needed from the victim and complete the report after
releasing the victim.
■ During the emergency, assisting lifeguards or other members of the
safety team should:
| Provide back-up surveillance coverage or clear the area.
| Assist with the rescue and emergency care if needed.
| Summon EMS personnel if needed.
| Bring additional rescue equipment if needed.
| Assist with crowd control.
| Meet and direct EMS personnel.
LGI_SecB_p062-071.indd 64 10/21/11 2:53 PM

■ Ask participants: What other situations at a facility may require
different EAPs?
| Evacuations
| The need to shelter in place
| Severe weather
| Chemical spills or leaks
| Power failures
| Violence
■ Ask participants: What information should be communicated when calling
9-1-1 or the local emergency number?
| Identify yourself.
| Explain the situation briefly (e.g., unconscious child pulled from the water).
| Explain the purpose of the call (e.g., need an ambulance, need police).
| Give the location.
| Answer questions to the best of your knowledge.
| Do not hang up until the emergency medical services (EMS) call-taker tells
you to do so.
■ Ask participants: Outside of the immediate aquatic area, where might you
be needed in an emergency?
| Locker rooms
| Concession areas
| Entrance or lobby areas
| Adjacent recreational facilities, such as exercise facilities or playgrounds
| Mechanical rooms
| Parking lots
TOPIC: RESCUE SKILLS, PART 1— Time: 10 minutes

RESCUES AT OR NEAR
THE SURFACE
PRESENTATION: WATER RESCUE SKILLS—RESCUES AT OR NEAR THE SURFACE
Video Segment ■ Explain to participants that the following video segment will provide
demonstrations of the first set of rescue skills they will learn for distressed and
active victims.
■ Refer participants to the skill sheets in Chapter 6, Water Rescue Skills, in the
■ Show the video segment, “Water Rescue Skills—Rescues At or Near the Surface.”
LGI_SecB_p062-071.indd 65 10/21/11 2:53 PM

IN-WATER SKILL SESSION—RESCUE Time: 1 hour, 25 minutes
SKILLS, PART 1
Skill Practice ■ Explain to participants that during water rescue skill sessions you will demonstrate
skills and guide them through practice.
■ Pair up participants and explain that they will take turns as a victim and rescuer for
each skill. For the multiple victim rescuer, reassign participants into groups of three.
■ For each skill, organize participants so that they can clearly see and hear. Be sure
to provide any instructions related to their position in the water or how they should
behave as victims.
■ Lead them through the following skills for victims at or near the surface:
| Reaching assist from the deck
● Lifeguards: on the edge of the deck
● Victims: about 3 feet from the edge of the pool; distressed swimmer
| Simple assist
● Lifeguards: standing in shallow water
● Victims: standing in shallow water; losing balance
| Active victim front rescue
● Lifeguards: in the water
● Victims: at least 10 yards from the edge of the pool facing the lifeguard;
struggling in deep water
| Active victim rear rescue
● Victims: at least 10 yards from the edge of the pool facing away from the
lifeguard; struggling in deep water
| Passive victim rear rescue
● Victims: in deep water, passive
| Multiple victim rescue
● Lifeguards: lifeguard in the water
● Victims: Two victims per rescuer in deep water. When playing the role of the
victims they should face each other, one victim holding securely to the other
victim.
■ For the Shallow Water Lifeguarding course, practice the simple assist and reaching
as noted above.
■ For the active victim front rescue, active victim rear rescue and multiple victim
rescue, practice in water up to 5 feet deep.
■ For the passive victim rear rescue, the victim should be at or near the surface of the
water.
Skill Drill— ■ Explain to participants that they are going to participate in an activity to practice
Active Victim recognizing a victim, simulating activating the EAP, entering the water, approaching
a victim, performing a rescue and returning the victim safely to the side of the pool.
Rescues This is designed to allow participants to practice rescuing a variety of victims in rapid
succession.
LGI_SecB_p062-071.indd 66 10/21/11 2:53 PM

■ Divide the class in half and assign one group as lifeguards and the other group as
victims. Line up lifeguards stationed on the deck, one per victim in the water:
VICTIMS X X X X X
LIFEGUARDS O O O O O
■ Explain that when you say, “Go!” (all victims and lifeguards will go at the same time):
| The victims will simulate an active victim facing the lifeguard.
| The lifeguards will simulate the EAP signal, enter the water, rescue the victim
and return the victim to a point of safety at the wall where the rescuer started
the rescue.
| Lifeguards exit the water and the victims will return to their same spot in the
water to be victims again.
| Once out of the water and standing in front of their victims again, have each
lifeguard move one spot down so they are stationed in front of the next victim
in line. Have the last rescuer in line move to the first position so that each
lifeguard has a new victim in front of them. On your instruction to go, lifeguards
will repeat the front active victim rescue with the new victim.
■ Continue until all lifeguards have rotated down the line to rescue each victim and
they are back in front of the victim they started with.
■ Repeat the drill with the victim facing away from the rescuer.
■ After the lifeguards have performed both types of active victim rescues on each
victim in the line, switch the groups—the victim group becomes the lifeguard group
and the lifeguard group becomes the victim group—and repeat the activity.
Activity ■ Explain to participants that they are going to participate in an activity to practice an
EAP for an active victim or distressed swimmer.
■ Assign one lifeguard who is performing patron surveillance and one back-up
lifeguard who is not on surveillance duty. Assign the zone and have the lifeguard go
to the lifeguard station and have the back-up lifeguard go to an area on the deck
where he or she can see the lifeguard station.
■ Explain to participants that upon recognizing a victim, the lifeguard will:
| Activate the EAP.
| Enter the water using the appropriate entry.
| Perform the appropriate rescue.
| Bring the victim to a point of safety at the side of the pool.
■ Explain to participants that when the EAP signal is activated, the back-up lifeguard
will get a rescue tube, go to the lifeguard station and assume coverage of the zone.
■ Gather the rest of the group so that the lifeguards cannot hear. Assign someone to
simulate a victim (active or distressed) after a prearranged signal from you, such as a
head nod.
■ Begin the activity by allowing the swimmers to swim and play until you give the
signal and the drowning simulation begins.
■ Once the rescue is complete, gather the group and discuss how it went and what the
next steps of the EAP would be.
■ Repeat the activity until all participants have had the opportunity to be a lifeguard or
back-up lifeguard.
ASSIGNMENT
Review Chapter 5, Emergency Action Plans, in the Lifeguarding Manual.
LGI_SecB_p062-071.indd 67 12/13/11 3:15 PM

listed at the proficient level to be checked off for this skill. Assessment criteria that are general for the category of
skills, as well as specific to, the skill must be met.
ASSISTS
SKILL CHART: REACHING ASSIST FROM THE DECK
1. Extend the tube to the victim, keeping your body weight on your back foot and crouching to avoid being
pulled into the water.
| Remove the rescue strap from your shoulder if necessary to reach the victim and hold the shoulder strap
in one hand and extend the tube to the victim with the other hand.
2 Tell the victim to grab the rescue tube.
3. Slowly pull the victim to safety.
SKILL CHART: SIMPLE ASSIST
1. Approach the person who needs help while keeping the rescue tube between you and that person.
2. Reach across the tube and grasp the person at the armpit to help the person maintain his or her balance.
| If the person is under water, grasp under the person’s armpits with both hands and help him or her
stand up.
3. Assist the person to the exit point, if necessary.
SKILL ASSESSMENT TOOL: ASSISTS
Communicates with the victim Victim is reassured and told what No attempted verbal
to do communication with the victim
Maintains balance Assumes a sturdy posture and stable Stumbles, falls or knocks victim
footing under the water
Equipment is properly positioned Control of the rescue tube is Rescue tube is not kept between
for the assist maintained between victim and victim and rescuer
rescuer
Maintains support until victim is ■ Supports the victim so that the ■ Victim’s mouth or nose is
safe mouth and nose are above water under water
■ Assists the victim to a safe ■ Lets go of victim without
position ensuring that the victim is at a
position of safety
■ Does not assist the victim out
of the water if needed
RESCUES AT OR NEAR THE SURFACE
SKILL CHART: ACTIVE VICTIM FRONT RESCUE
1. Approach the victim from the front.

2. As you near the victim, grab the rescue tube from under your arms with both hands and begin to push the
tube out in front of you. Continue kicking to maintain momentum.
3. Thrust the rescue tube slightly under water and into the victim’s chest, keeping the tube between you and the
victim. Encourage the victim to grab the rescue tube and hold onto it.
4. Keep kicking, fully extend your arms and move the victim to a safe exit point. Change direction, if needed.
LGI_SecB_p062-071.indd 68 12/27/11 10:08 AM

SKILL CHART: ACTIVE VICTIM REAR RESCUE
1. Approach the victim from behind with the rescue tube across your chest.
2. With both arms, reach under the victim’s armpits and grasp the shoulders firmly. Tell the victim that you are
there to help and continue to reassure the victim throughout the rescue.
3. Using your chest, squeeze the rescue tube between your chest and the victim’s back.
4. Keep your head to one side to avoid being hit by the victim’s head if it moves backwards.
5. Lean back and pull the victim onto the rescue tube.
6. Use the rescue tube to support the victim so the victim’s mouth and nose are out of the water.
7. Tow the victim to a safe exit point.
SKILL CHART: PASSIVE VICTIM REAR RESCUE
1. Approach a face-down victim from behind with the rescue tube across your chest.
2. With both arms, reach under the victim’s armpits and grasp the shoulders firmly. You may be high on the
victim’s back when doing this.
3. Using your chest, squeeze the rescue tube between your chest and the victim’s back.
4. Keep your head to one side to avoid being hit by the victim’s head if it moves backwards.
5. Roll the victim over by dipping your shoulder and rolling onto your back so that the victim is face-up on top
of the rescue tube. Keep the victim’s mouth and nose out of the water. Place the tube under the victim below
the shoulders so that the victim’s head naturally falls back to an open-airway position.
6. Tow the victim to a safe exit point. For greater distances, use one hand to stroke. For example, reach your
right arm over the victim’s right shoulder and grasp the rescue tube. Then use the left hand to stroke.
7. Remove the victim from the water, assess the victim’s condition and provide appropriate care.
SKILL ASSESSMENT TOOLS: RESCUES AT OR NEAR THE SURFACE
Equipment is properly positioned ■ Rescue tube is kept between the ■ Rescue tube is not maintained
for the appropriate rescue lifeguard and the victim between the victim and the
■ Rescue tube is positioned to rescuer
support the victim at the surface ■ The victim is not supported by
of the water the rescue tube
Victim’s mouth and nose above Victim’s mouth and nose are Victim’s mouth or nose is under
water maintained above water water
Tows the victim to a safe exit point Victim is towed to a safe exit point ■ Unable to tow the victim to a
using the rescue tube to support the safe exit point
victim ■ Victim is not supported by the
rescue tube
■ Releases contact with the
victim
LGI_SecB_p062-071.indd 69 1/6/12 8:14 AM

ACTIVE VICTIM FRONT RESCUE
Rescue tube is placed to provide ■ Rescue tube is slightly ■ Rescue tube is thrust above
support for the victim and safety for submerged and thrust into the victim’s armpits or in the
the rescuer victim’s chest to provide support stomach area and does not
■ Lifeguard’s arms are extended provide support
with elbows locked ■ Lifeguard’s arms are not fully
extended
Move the victim to a safe exit point Forward momentum and kick are ■ Little to no forward movement
used to move the victim to a safe ■ Unable to move the victim to a
exit point safe exit point
ACTIVE VICTIM REAR RESCUE
Lifeguard squeezes the rescue tube Rescue tube remains in place and is ■ Rescue tube slips out and is
against the victim’s back to provide repositioned if it slips out not supporting the victim at
support for the victim and safety for the surface
the rescuer ■ Is not successful in
repositioning the rescue tube
PASSIVE VICTIM REAR RESCUE
Maintain head in an open airway Rescue tube is placed under the Victim’s head is tilted forward
position at the surface victim’s back so that the victim’s (chin toward chest)
head falls back to an open airway
position
Turn the victim to a face-up ■ Rescue tube is squeezed ■ Rescue tube is not maintained
position between rescuer’s chest and between the victim and the
victim’s back rescuer
■ Leans back to pull victim ■ Unable to reposition the tube
face-up if it slips out
■ Unable to pull victim to a
face-up position
LGI_SecB_p062-071.indd 70 10/12/11 3:10 PM

MULTIPLE-VICTIM RESCUE
SKILL CHART: MULTIPLE-VICTIM RESCUE
If you are the only one rescuing two victims who are clutching each other:
1. Approach one victim from behind.
2. With both arms, reach under the victim’s armpits and grasp the shoulders. Squeeze the rescue tube between
your chest and the victim’s back, keeping your head to one side of the victim’s head.
3. Use the rescue tube to support both victims with their mouths out of the water. Talk to the victims to help
reassure them.
4. Support both victims until other lifeguards arrive or the victims become calm enough to move to a safe exit.
SKILL ASSESSMENT TOOLS: MULTIPLE VICTIM RESCUE
Equipment is properly positioned ■ Rescue tube is kept between the ■ Rescue tube is not maintained
for the appropriate rescue lifeguard and the victim between the victim and the
■ Rescue tube positioned to rescuer
support the victim at the surface ■ Victim is not supported by the
of the water rescue tube
Victim’s mouth and nose above Victim’s mouth and nose are Mouth or nose are under water
water maintained above water
Tows the victim to safety Victim is towed to safety using the ■ Unable to tow the victim to
rescue tube to support the victim safety
■ Victim is not supported by the
rescue tube
■ Releases contact with the
victim
Rescue tube is placed to provide Maintains firm hold of one victim Both victims are not supported
support for victims and safety for and rescue tube effectively supports
rescuer both victims’ heads above water
LGI_SecB_p062-071.indd 71 10/21/11 2:53 PM

LESSON 4
RESCUE SKILLS, PART 2
¡ Shallow Water Lifeguarding Session Length: 1 hour, 35 minutes
LESSON OBJECTIVES
■ Demonstrate how to safely and effectively rescue a submerged victim in shallow or deep water.
■ Demonstrate how to safely and effectively perform feet-first and head-first surface dives.
(Lifeguarding course only)
■ Demonstrate how to safely and effectively perform a two-person removal of a victim from the water using
a backboard.
TOPIC: SURVEILLANCE ACTIVITY I Time: 10 minutes

PRESENTATION: REVIEW—SURVEILLANCE ACTIVITY
Video Segment ■ Explain that this activity provides an opportunity to practice their surveillance skills.
and Activity ■ Show the video segment, “Review—Surveillance Activity I.”
■ Lead a discussion of what they see in each segment.
| Are there any hazards that could cause an injury?
| Are there any patrons who would be of special concern?
| Are there any rules being broken that could lead to an injury or
emergency situation?
| Are there any distracting situations for the lifeguard?
TOPIC: RESCUE SKILLS, PART 2: Time: 10 minutes

SUBMERGED VICTIM RESCUES
PRESENTATION: WATER RESCUE SKILLS—SUBMERGED VICTIM RESCUES
Video Segment ■ Explain to participants that the following video segment will cover rescue skills for
passive victims.
■ Refer participants to the skill sheets in Chapter 6, Water Rescue Skills, in the
■ Show the video segment, “Water Rescue Skills—Submerged Victim Rescues.”
LGI_SecB_p072-078.indd 72 10/21/11 2:55 PM

IN-WATER SKILL SESSION: RESCUE Time: 1 hour, 10 minutes
SKILLS, PART 2
Shallow Water Lifeguarding Time: 30 minutes
Safety Tips: For practicing rescues of victims submerged in deep water:

■ Instruct participants that if they experience difficulty when playing the role of a
victim, they should signal “let go” to the lifeguard by a predetermined signal, such
as a tap or gentle pinch.
■ Explain that ear and sinus squeeze can be uncomfortable and for those with
congestion, it can be painful or even cause damage to the ear. In this course, when
practicing rescues of submerged victims, participants are required only to go to a
depth of 7 to 10 feet. However, when hired to work at a facility with deeper water,
they would be expected to be able to go all the way to the bottom.
■ For the Shallow Water Lifeguarding course, participants are required only to go to
a maximum depth of 5 feet.
■ Explain that swim goggles may not be used for rescues of submerged victims since
they have no mechanism for pressure relief, which could result in injury to the eyes
when swimming in deeper water. They will be expected to open their eyes under
water to perform rescues.
Skill Practice ■ Explain to participants that during the water rescue skill sessions you will
demonstrate skills and guide them through practice.
■ Pair up participants and explain that they will take turns as victim and rescuer
for each skill. For the two-person removal from the water using a backboard skill,
participants should form groups of three.
■ For each skill, organize participants so that they can clearly see and hear. Be sure
to provide any instructions related to their position in the water or how they should
behave as victims.
■ Explain to them that for each rescue skill, they should begin by simulating the
activation of the emergency action plan (EAP) (except when learning the surface
dives).
■ Lead them through the following skills for submerged victims:
| Submerged passive victim in shallow water
● Victims: at least 10 yards from the edge of the pool submerged in shallow
water; passive
| Feet-first surface dive in deep water
| Head-first surface dive in deep water
| Submerged victim in deep water
● Victims: at least 10 yards from the edge of the pool submerged in deep
water; passive
LESSON 4 | Rescue Skills, Part 2 73
LGI_SecB_p072-078.indd 73 10/21/11 2:55 PM

■ For the Shallow Water Lifeguarding course, omit the feet-first and head-first
surface dives and the submerged victim in deep water rescue unless necessary to
get to the bottom.
| Two-person removal from the water using a backboard

● Lifeguard 1: bringing victim to the edge of the pool after a passive victim
rescue
● Lifeguard 2: on deck with backboard
● Victim: passive
| Observe each participant’s performance of the skill and provide corrective
feedback
Skill Drill ■ Assemble the participants on the deck and explain they will be practicing team
rescues for a submerged passive victim in deep water, removing the victim from the
water on a backboard and preparing to provide care by putting on disposable gloves.
Part 1 ■ Explain that they will be practicing how to put on gloves in a wet environment. They
will learn the method for glove removal in lesson 5.
■ Explain that putting on gloves with wet hands can be challenging.
■ Lead them through the skill of putting on gloves with wet hands. One method is to
dip the glove in the pool and fill with water and insert your hand in the glove.
■ Participants should practice the skill until they are comfortable doing it quickly.
■ For the Shallow Water Lifeguarding course, have teams practice rescues for a
submerged passive victim in shallow water, removing the victim from the water on a
backboard and preparing to provide care by putting on disposable gloves.
■ Participants will complete part 1 as it is described above. For part 2, the victim
will submerge to the bottom in shallow water at the same time as the rescuer. The
rescuing lifeguard will rescue a victim who is submerged in shallow water and
passive.
Part 2 ■ Divide the participants into groups of four and assign one rescuing lifeguard, one
victim and two assisting lifeguards for each group. Have each lifeguard wear a hip
pack with gloves inside.
■ Explain for each group:
| The rescuing lifeguard will simulate activating the EAP and enter the water.
| The victim will submerge to the bottom in deep water at the same time as the
rescuer. The rescuing lifeguard will rescue a victim who is submerged in deep
water and passive.
| While the rescuing lifeguard supports the victim at the edge, the two assisting
lifeguards will bring the backboard and then will remove the victim from the
water, demonstrating team communication skills between all three lifeguards.
| Once removed from the water, the victim will remain passive on the backboard
until all three lifeguards have put on their gloves.
■ Repeat the drill until each person in the group has performed as a rescuing lifeguard
and an assisting lifeguard at least once.
LGI_SecB_p072-078.indd 74 10/13/11 2:23 PM

ASSIGNMENT
■ Read Chapter 7, Before Providing Care and Victim Assessment, and Chapter 8,
Breathing Emergencies, in the Lifeguarding Manual before the next class session.

skills, as well as specific to the skill, must be met.
SUBMERGED VICTIMS
SKILL CHART: PASSIVE SUBMERGED VICTIM IN SHALLOW WATER
1. Swim or quickly walk to the victim’s side. Let go of the rescue tube but keep the strap around your shoulders.
2. Submerge and reach down to grab the victim under the armpits.
3. Simultaneously, pick up the victim, move forward and roll the victim face-up upon surfacing.
4. Grab the rescue tube and position it under the victim’s shoulders. The victim’s head should naturally fall back
into an open-airway position. If an assisting lifeguard is there with the backboard, skip this step and proceed
to remove the victim from the water.
5. Move the victim to a safe exit point, remove the victim from the water, assess the victim’s condition and
provide appropriate care.
SKILL CHART: SUBMERGED VICTIM IN DEEP WATER
(LIFEGUARDING COURSE ONLY)
1. Release the rescue tube, perform a feet-first surface dive and position yourself behind the victim.
2. Reach one of your arms under the victim’s arm (your right arm under their right arm or your left arm under
their left arm) and across the victim’s chest. Hold firmly onto the victim’s opposite side.
3. Once you have hold of the victim, reach up with your free hand and grasp the towline. Pull it down and feed
the line to the hand that is holding the victim. Keep feeding the towline this way until nearing the surface.
4. As you surface, tilt the victim back so he or she is face-up. Grasp and position the rescue tube so it is squeezed
between your chest and the victim’s back. For a passive victim, place the tube below the victim’s shoulders so
the victim’s head naturally falls back into an open-airway position. A victim may begin to struggle, requiring
you to grasp tighter.
5. Reach under the victim’s armpits and grasp the shoulders.
6. Tow the victim to a safe exit point. Remove the victim from the water, assess the victim’s condition and
provide appropriate care.
Note: As you descend into deep water, be sure to equalize pressure early and often. If you are unable to equalize
pressure, return to the surface.
SKILL ASSESSMENT TOOL: SUBMERGED VICTIM RESCUES
Equipment is properly positioned Rescue tube is positioned under the ■ Victim slides off tube
to provide support for the victim victim’s back and is supporting the ■ Victim’s head submerges
upon rolling over or surfacing victim at the surface
Victim is face-up upon surfacing Victim is quickly brought to a ■ Victim is face-down

face-up position ■ Unable to turn victim to
a face-up position upon
surfacing
Victim’s mouth and nose are above Victim’s mouth and nose are Victim’s mouth or nose is under
water. maintained above water. water.
LGI_SecB_p072-078.indd 75 10/13/11 8:48 AM

Maintain head in an open airway Rescue tube is placed under the Victim’s head is tilted forward
position at the surface victim’s back so that the victim’s (chin toward chest)
head falls back to an open airway
position
Tow the victim to safety Victim is towed to a safe exit point ■ Unable to make progress in
using the rescue tube to support the the water to move the victim
victim to a safe exit point
■ Victim is not supported by the
rescue tube and slips off or
submerges
SUBMERGED PASSIVE VICTIM IN SHALLOW WATER
Equipment is properly positioned Rescue strap is around the shoulder ■ Tries to submerge with the
to start the rescue of the rescuer rescue tube
■ Rescue tube strap is not worn
over the shoulder
Victim brought to the surface ■ Submerges to grasp victim ■ Unable to submerge

■ Maintains grasp of the victim ■ Does not make contact with
and brings to the surface victim
■ Drops victim
■ Unable to return to the surface
with victim
SUBMERGED VICTIM IN DEEP WATER (LIFEGUARDING COURSE ONLY)
Equipment is properly positioned ■ Rescuer releases rescue tube so ■ Tries to submerge with the
appropriate to the rescue it remains at the surface rescue tube
■ Rescue tube strap is worn ■ Loses contact with the rescue
around the shoulder tube strap—not worn around
■ For water deeper than the tube the shoulder or not held
strap length, strap is removed ■ Unable to grasp rescue tube
from the shoulder and held once returned to the surface to
place under the victim’s back
Victim brought to the surface ■ Submerges to grasp the victim ■ Unable to submerge
■ Maintains grasp of the victim ■ Cannot grasp the victim
and brings to the surface ■ Does not make contact with
■ Rescue tube placed under the the victim
victim’s back upon surfacing ■ Drops the victim
■ Unable to return to the surface
with the victim
■ Unable to grasp or place
rescue tube under the victim
upon surfacing
SURFACE DIVES
SKILL CHART: FEET-FIRST SURFACE DIVE (LIFEGUARDING COURSE ONLY)
1. Swim to a point near and above the victim. Release the rescue tube but keep the strap around your shoulders.
2. Position your body vertically, then at the same time press both hands down to your sides and kick strongly to
raise your body out of the water.
3. Take a breath then let your body sink under water as you begin to extend your arms outward with palms
upward pushing against the water to help you move downward. Keep your legs straight and together with toes
pointed. Tuck your chin and turn your face to look down toward the bottom.
LGI_SecB_p072-078.indd 76 10/13/11 8:48 AM

4. As downward momentum slows, repeat the motion of extending your arms outward and sweeping your hands
and arms upward and overhead to go deeper.
5. Repeat this arm movement until deep enough to reach the victim.
If you must swim under water, such as for a deep-water line search, also perform these steps:
1. When deep enough, tuck your body and roll to a horizontal position.
2. Extend your arms and legs and swim under water.
SKILL CHART: HEAD-FIRST SURFACE DIVE (LIFEGUARDING COURSE ONLY)
1. Swim to a point near the victim and release the rescue tube.
2. Gain momentum using a swimming stroke.
3. Take a breath, sweep your arms backwards to your thighs and turn them palms-down.
4. Tuck your chin to your chest and flex at the hip sharply while your arms reach downward toward the bottom.
5. Lift your legs upward, straight and together so that their weight above the water helps the descent. Get in a
fully extended, streamlined body position that is almost vertical.
6. If you need to go deeper, such as in a diving well, do a simultaneous arm pull with both arms to go deeper,
then level out and swim forward under water.
Tip: If the depth of the water is unknown or the water is murky, hold one or both arms extended over the head
toward the bottom or use a feet-first surface dive.
SKILL ASSESSMENT TOOL: SURFACE DIVES
Submerge to appropriate depth Submerges to appropriate depth Unable to submerge to appropriate

depth
Look toward bottom while Face is looking down toward bottom Face is looking forward or upward
descending while descending while descending
FEET-FIRST SURFACE DIVE (LIFEGUARDING COURSE ONLY)
Body descends feet-first in a ■ Legs are held together ■ Legs are apart and impede
streamlined position ■ Arms are fully extended descent
overhead ■ Arm positioning impedes
descent
HEAD-FIRST SURFACE DIVE (LIFEGUARDING COURSE ONLY)
Body descends head-first in a ■ Legs are held together and lifted ■ Legs are apart
streamlined position upward toward the surface to ■ Body is not nearly vertical
aide descent during descent
■ Arms reach downward toward ■ Arms are not in front reaching
the bottom downward
REMOVAL FROM THE WATER
SKILL CHART: TWO-PERSON REMOVAL FROM THE WATER USING A BACKBOARD
1. The primary lifeguard brings the victim to the side and turns him or her to face the wall. Another lifeguard
brings a backboard with the head immobilizer and the straps removed, if possible.
2. The assisting lifeguard on land crosses his or her own hands to grab the victim’s wrists and pulls the victim up
slightly to keep the head above the water and away from the wall. Support the victim’s head so that the head
does not fall forward.
LGI_SecB_p072-078.indd 77 10/13/11 8:48 AM

3. The primary lifeguard ensures that the victim’s face is out of the water and then climbs out of the water,
removes the rescue tube and gets the backboard.
4. The primary lifeguard guides the backboard, foot-end first, down into the water along the wall next to the
victim. The second lifeguard immediately begins to turn the victim onto the backboard. Each lifeguard then
quickly grasps one of the victim’s wrists and one of the handholds of the backboard.
5. When the primary lifeguard gives the signal, both lifeguards pull the backboard and victim onto land,
until the underside of the board is safely away from the edge. (Remember to lift with the legs and not with
the back.) The lifeguards step backward and then carefully lower the backboard onto the ground. If other
lifeguards or additional help is available, they can provide assistance by pulling or pushing the backboard.
6. Lifeguards provide immediate and appropriate care based on the victim’s condition. Continue care until
emergency medical services (EMS) personnel arrive and assume control over the victim’s care.
Tips:
■ It may be easier to submerge the board initially if the board is angled, foot-end first, toward the wall.
■ As soon as the board is submerged, turn the victim onto the board then allow the board to float up beneath
the victim.
■ Once the board is submerged, the second lifeguard can help to stabilize the board against the wall, placing
his or her foot against the backboard, if necessary.
SKILL ASSESSMENT TOOL: TWO-PERSON REMOVAL FROM THE WATER USING
A BACKBOARD
Victim is brought to a position Victim is facing the side of the pool ■ Victim is not facing the side of
facing the side of the pool with the with head tipped back, out of the the pool
head out of the water water ■ Victim’s head is leaning
forward
■ Victim’s face is in the water
Lifeguards communicate with each Lifeguard(s) communicates what, Lifeguards cannot proceed with
other how and/or when actions happen removing the victim from the
water
Victim’s head remains above the Victim’s mouth and nose are Victim’s mouth or nose is in the
surface of the water maintained out of the water water
Assisting lifeguard(s) maintains Assisting lifeguard(s) maintains grip Assisting lifeguard(s) loses grip of
contact with the victim of the victim’s wrists the victim
Backboard is submerged into Backboard is submerged along the ■ Unable to submerge the
position wall next to the victim backboard
■ Backboard cannot be placed
under the victim
Victim is placed onto the board ■ Victim is turned onto backboard ■ Unable to place victim on the
■ Each lifeguard grasps one of backboard
the victim’s wrists and has a ■ Loses contact with backboard
handhold of the backboard or victim
Victim is pulled out on the ■ Lifeguards pull the backboard ■ Unable to remove the
backboard in a safe manner for and victim onto land backboard and the victim
rescuers and victim ■ Backboard is carefully lowered ■ Victim’s body is hanging off
to the ground the board, which may cause
injury
■ Backboard is dropped on land
Lifeguard(s) move into position to Lifeguard(s) open the victim’s Lifeguard(s) does not open the
start a primary assessment of the airway victim’s airway
victim
LGI_SecB_p072-078.indd 78 10/13/11 8:48 AM

LESSON 5
BEFORE PROVIDING CARE, VICTIM
ASSESSMENT AND BREATHING EMERGENCIES
LESSON OBJECTIVES
■ Describe what standard precautions to take to prevent disease transmission when providing care.
■ Demonstrate proper removal of disposable gloves.
■ Describe the general procedures for injury or sudden illness on land.
■ Identify items of concern when conducting a scene size-up.
■ Demonstrate how to perform a primary assessment and place a victim in the H.A.IN.E.S. recovery position.
■ Identify victim conditions that indicate the need to summon emergency medical services (EMS) personnel.
■ Understand how to safely and effectively move a victim on land.
■ Demonstrate how to use a resuscitation mask.
■ Recognize and care for a breathing emergency.
■ Demonstrate how to safely and effectively give ventilations.
■ Demonstrate how to safely and effectively use a bag-valve-mask (BVM) resuscitator with two rescuers.
■ Demonstrate how to safely and effectively care for an obstructed airway for a conscious and an unconscious
victim.
■ Demonstrate the ability to work as a team to implement an EAP, perform a rescue and perform emergency
care.

■ Manikins (one adult and one infant manikin per two participants, child manikins optional)
■ Pediatric resuscitation masks (one per participant)
■ Bag-valve-mask (BVM) resuscitators (one per two participants)
■ Decontamination supplies
TOPIC: STANDARD PRECAUTIONS Time: 10 minutes

PRESENTATION: STANDARD PRECAUTIONS
Video Segment ■ Remind participants that they have already discussed disease transmission related to
safety and explain that in this lesson they will learn more about the specific diseases
of concern and how they are transmitted.
■ Show the video segment, “Standard Precautions.”
■ Answer participants’ questions about the segment.
■ Ask participants: What are the diseases that are of primary concern for you
as a lifeguard?
| Hepatitis B
| Hepatitis C
| HIV
LESSON 5 | Before Providing Care, Victim Assessment and Breathing Emergencies 79
LGI_SecB_p079-098.indd 79 10/21/11 2:56 PM

Removing Disposable Gloves
Skill Practice ■ Provide all participants with disposable non-latex gloves.
■ Explain that participants will have many opportunities to practice glove removal
since they will be following these procedures each time they remove gloves
throughout the remainder of this course.
■ Lead participants through the skill of Removing Disposable Gloves.
Lecture ■ Facility management should abide by Occupational Safety and Health

Administration (OSHA) requirements regarding job-related exposure to
bloodborne pathogens, which are designed to protect you from disease
transmission.
■ You should participate in annual bloodborne pathogens training to
learn and review the procedures that protect you from exposure at your
worksite.
■ Standard precautions are safety measures that combine universal
precautions and body substance isolation (BSI) precautions by assuming
that all body fluids may be infectious.
■ Standard precautions can be applied through the use of:
| Personal protective equipment (PPE), such as non-latex disposable
gloves and a resuscitation mask.
| Good hand hygiene, which includes washing your hands thoroughly
after removing gloves or after any direct or indirect contact with
body fluids.
| Engineering controls, such as the use of biohazard bags to dispose of
items that may be contaminated with body fluids.
| Work practice controls, such as using the proper procedure for
removing disposable gloves that protect you from exposure to body
fluids.
| Proper steps for cleaning equipment that will be re-used following an
incident involving body fluids.
| Spill clean-up procedures, such as cleaning up blood spills from the
pool deck.
TOPIC: GENERAL PROCEDURES FOR Time: 5 minutes

AN EMERGENCY ON LAND
PRESENTATION: GENERAL PROCEDURES FOR AN EMERGENCY ON LAND
Lecture ■ If someone is suddenly injured or becomes ill, activate the facility’s

emergency action plan (EAP) for an emergency on land and follow these
general procedures.
| Size up the scene to:
● Check for hazards that could present a danger to you or the
victim.
● Determine what caused the injury or the nature of the illness.
● Determine the number of victims to prioritize care.
● Determine what additional help may be needed.
● Put on the appropriate PPE.
| Perform a primary assessment to determine life-threatening
conditions.
● Be sure to obtain consent if the victim is conscious.
LGI_SecB_p079-098.indd 80 10/21/11 2:56 PM

| Summon emergency medical services (EMS), if needed.
| Perform a secondary assessment if no life-threatening conditions
are found.
| Provide care for the conditions found.
| Complete follow-up reports, advise the victim, if warranted, and
release the victim.
Scene Size-Up
Guided ■ Tell participants that the first step in the general procedures is the scene size-up. A
Discussion scene size-up is the careful and systematic approach of a scene to get a full picture of
the emergency situation.
■ Ask participants: Using your senses, what information can you gather
about the scene of an emergency?
| Sight: Hazardous conditions, number of victims, number of bystanders
| Smell: Odors that might suggest chemical release, intoxication, diabetic
emergency or burning objects
| Hearing: Unusual sounds, cries for help, splashing
■ Ask participants: Why else is a scene size-up necessary?
| To ensure scene safety for the rescuers, the victims and any bystanders
| To identify necessary PPE
| To determine the mechanism of injury or nature of the illness
| To determine the number of victims
| To identify what additional help may be required
TOPIC: PERFORMING A PRIMARY Time: 50 minutes

ASSESSMENT
PRESENTATION: PERFORMING A PRIMARY ASSESSMENT
Lecture ■ A primary assessment is done to identify any life-threatening conditions.

■ The steps for a primary assessment include the following:
| Check the victim for responsiveness.
| Open the victim’s airway and check for breathing and a pulse.
● If the victim is alert and speaking, the airway is open.
● If the victim is unconscious and you do not suspect a head, neck
or spinal injury, use the head-tilt/chin-lift technique to open the
airway. If you suspect a head, neck or spinal injury, use the jaw-
thrust (without head extension) maneuver to open the airway.
● Agonal gasps, which are irregular, gasping or shallow breaths,
may occur. These gasps are not considered normal breathing. If
you detect agonal gasps, care for the victim as though he or she is
not breathing.
● Check for a carotid pulse in an adult and a child. Check for a
brachial pulse in an infant.
● For a child or an infant, give 2 initial ventilations if the victim is
not breathing. For an adult, give 2 initial ventilations only if he or
she is not breathing because of drowning or another respiratory
cause.
| Scan for severe bleeding.
LGI_SecB_p079-098.indd 81 10/21/11 2:56 PM

■ In general, if a person is unconscious but breathing, leave that person
in a face-up position and maintain an open airway, especially if there
is a suspected spinal injury. However, if you are alone and must leave
the person (e.g., to call for help), or you cannot maintain an open and
clear airway because of fluids or vomit, place the person in a modified
high arm in endangered spine (H.A.IN.E.S.) recovery position. Do this
whether or not a spinal injury is suspected.
Performing a Primary Assessment—Adult

Video Segment ■ Explain to participants that the video segment demonstrates the procedures used
for a primary assessment for an adult to identify life-threatening conditions. These
procedures also are followed for any victim of a witnessed sudden collapse.
■ Show the video segment, “Primary Assessment—Adult.”
Skill Practice ■ Ask participants to take their participant’s manual and disposable gloves to the
practice area.
■ Ask participants to find a partner. One person will be the responder while the other
person will be the injured or ill person, then they will switch roles.
■ Guide participants through the steps listed on the Performing a Primary
Assessment—Adult skill chart. Once participants have completed the primary
assessment, have them practice the modified H.A.IN.E.S. recovery position.
Guide them through the steps listed on the Modified H.A.IN.E.S. Recovery Position
skill chart.
■ Be sure to point out any common errors, such as failing to size up the scene, failing
to determine consciousness, failing to follow standard precautions, improperly
opening the airway, checking an inappropriate pulse site or pressing the pulse site
too hard.
Performing a Primary Assessment—Child and Infant

Video Segment ■ Explain to participants that there are some differences in technique in the primary
assessment for children and infants. Remind them that for children and infants
as well as for any victim of a drowning or another respiratory cause, the primary
assessment also includes giving 2 ventilations.
■ Explain that since the skill for this age victim includes giving ventilations, this
segment covers the primary assessment skill as well as how to give ventilations using
a resuscitation mask. It shows how to use the resuscitation mask from different
positions and for different situations.
■ Show the video segment, “Primary Assessment—Child and Infant.”
■ Ask participants: What are the differences to be aware of when performing
a primary assessment on a child versus an infant?
| The position of the head should be slightly past the neutral position for a child
and in the neutral position for an infant.
| For an infant, feel for the brachial pulse on the inside of the upper arm,
between the elbow and the shoulder.
■ Ask participants: In what circumstances do you give 2 ventilations when
performing a primary assessment?
| For a child or infant that is not responsive and not breathing
| For an adult victim of a drowning or other respiratory cause
LGI_SecB_p079-098.indd 82 12/13/11 3:18 PM

Using a Resuscitation Mask
Skill Practice ■ Ask participants to bring their participant’s manual, disposable gloves and
resuscitation masks to the practice area.
■ Using a manikin, guide participants through the three methods for giving
ventilations using each of the following methods:
| Head-tilt/chin-lift technique
| Jaw-thrust (with head extension) maneuver
| Jaw-thrust (without head extension) maneuver
■ Be sure to point out any common errors, such as improperly opening the airway, not
obtaining a seal with the resuscitation mask, or not making the chest rise and fall.
Primary Assessment—Child or Infant

Skill Practice ■ Using a manikin, guide participants through the steps listed on the Primary
Assessment—Child and Infant skill chart.
■ Once participants have completed the primary assessment, have them practice the
modified H.A.IN.E.S. recovery position. Guide participants through the steps listed
on the Modified H.A.IN.E.S. Recovery Position skill chart.
■ Observe each participant’s performance of the skills and provide corrective feedback.
Summoning EMS Personnel

Lecture ■ Summon EMS personnel for any of the following conditions:
| Unconsciousness or altered level of consciousness (LOC)
| Breathing problems
| Chest pain, discomfort or pressure lasting more than a few minutes
or that goes away and comes back or that radiates to the shoulder,
arm, neck, jaw, stomach or back
| Persistent abdominal pain or pressure
| No pulse
| Severe external bleeding (bleeding that spurts or gushes steadily
from a wound)
| Vomiting blood or passing blood
| Severe (critical) burns
| Suspected poisoning
| Seizures on land, unless the person is known to have periodic
seizures
| Stroke
| Painful, swollen, deformed areas or an open fracture
| Victim’s physical condition is unclear or is worsening
■ Ask participants: What other conditions that may occur in the aquatic
environment might require summoning EMS personnel?
| Any victim recovered from underwater who may have inhaled water
| Seizures in the water
| Suspected or obvious injuries to the head, neck or spine
LGI_SecB_p079-098.indd 83 10/13/11 10:11 AM

TOPIC: MOVING A VICTIM Time: 5 minutes
PRESENTATION: MOVING A VICTIM
Lecture ■ Moving a victim needlessly or improperly can lead to further pain and
injury.
■ Ask participants: What factors should be considered when deciding
whether or not to move a victim?
| You are faced with immediate danger.
| You need to get to other victims who have more serious injuries or illnesses.
| It is necessary to provide appropriate care (e.g., moving a victim to the top or
bottom of a flight of stairs to perform CPR).
■ If you must leave a scene to ensure your personal safety, you should
make reasonable attempts to move the victim to safety as well.
■ Ask participants: If the decision is made to move a victim, what factors
should be considered in deciding what method to use?
| The victim’s height and weight
| Your physical strength
| Obstacles, such as stairs and narrow passages
| The distance to be moved
| Whether others are available to assist
| The victim’s condition
| Whether aids to transport are readily available
TOPIC: RECOGNIZING AND CARING FOR Time: 5 minutes

BREATHING EMERGENCIES
PRESENTATION: RECOGNIZING AND CARING FOR BREATHING EMERGENCIES
Guided ■ In a breathing emergency, a person’s breathing can become so impaired

Discussion that life is threatened. As a lifeguard, it is important for you to know how
to recognize and care for these emergencies.
■ Hypoxia is a condition in which insufficient oxygen reaches the cells.
■ Ask participants: What are possible causes of hypoxia?
| Obstructed airway
| Shock
| Inadequate breathing
| Fatal and nonfatal drowning
| Strangulation
| Choking
| Suffocation
| Cardiac arrest
| Head trauma
| Carbon monoxide poisoning
| Anaphylactic shock
LGI_SecB_p079-098.indd 84 10/21/11 2:56 PM

■ There are two types of breathing (also referred to as respiratory)
emergencies:
| Respiratory distress is a condition in which breathing becomes
difficult.
| Respiratory arrest is a condition in which breathing stops.
■ Respiratory distress may lead to respiratory arrest.
■ Ask participants: What signs and symptoms might indicate that a person is
experiencing respiratory distress?
| Slow or rapid breathing
| Unusually deep or shallow breathing
| Shortness of breath or noisy breathing
| Dizziness, drowsiness or light-headedness
| Changes in level of consciousness
| Increased heart rate
| Chest pain or discomfort
| Skin that is flushed, pale, ashen or bluish
| Unusually moist or cool skin
| Gasping for breath
| Wheezing, gurgling or high-pitched noises
| Inability to speak in full sentences
| Tingling in the hands, feet or lips
| Apprehensive or fearful feelings
■ Caring for respiratory distress includes:
| Maintaining an open airway.
| Summoning EMS personnel.
| Helping the victim to rest in a comfortable position that makes
breathing easier.
| Reassuring and comforting the victim.
| Assisting the victim with taking any of his or her prescribed
medication.
| Keeping the victim from getting chilled or overheated.
| Administering emergency oxygen, if it is available and you are
trained to do so.
■ Someone with asthma or emphysema who is in respiratory distress may
try to do pursed-lip breathing.
■ To assist with this, have the person assume a position of comfort. After
he or she inhales, have the person slowly exhale through the lips, pursed
as though blowing out candles.
■ The use of emergency oxygen can help a conscious person who is in
respiratory distress or may be used for an unconscious victim who is not
breathing. Additional American Red Cross training is available to teach
you how to administer emergency oxygen.
■ Refer participants to Chapter 8, Breathing Emergencies, in the Lifeguarding
Manual. Point out the sidebars on asthma and anaphylaxis. Explain that if they will
be required to administer epinephrine, they may need to undergo additional training
conducted at their facility.
Instructor’s Note: Training information and skill sheets for the administration
of epinephrine and for the administration of inhalers can be found on
redcross.org/instructorscorner.
LGI_SecB_p079-098.indd 85 10/21/11 2:56 PM

TOPIC: GIVING VENTILATIONS Time: 15 minutes
PRESENTATION: GIVING VENTILATIONS—ADULT, CHILD AND INFANT
Giving Ventilations—Adult
Skill Practice ■ Choose either the practice-while-you-watch or watch-then-practice method for this
skill practice.
■ Be sure to point out any common errors, such as tilting the head too far back, failing
to reassess for breathing and pulse, not leaving the victim in a face-up position with
return of breathing, not obtaining a seal with the resuscitation mask or using an
improperly sized mask for the victim.
Practice-While-You-Watch
| Ask participants to take their disposable gloves and resuscitation masks to the
practice area.
| Explain to the participants that, for this skill, they will follow along with and
practice the steps for giving ventilations as they are guided by the video.
| Show the video segment, “Giving Ventilations—Adult, Child and Infant.”
| Do not interrupt this skill session to lecture or communicate anything other than
guidance related to skill practice. In general, answering questions should occur
after the video segment (and skill session) has ended.
Watch-Then-Practice
| Tell participants that, for this skill, they will watch the video segment without
practicing until you pause it, even though the narration may say to follow along.
| Show the video segment, “Giving Ventilations—Adult, Child and Infant.”
practice area.
| Guide participants through the steps of the skill.
Giving Ventilations—Child or Infant

Skill Practice Instructor’s Notes: Participants need only demonstrate how to provide ventilations
for either a child or infant and be able to point out the differences for the other, such as
how far to tilt the head or using a pediatric resuscitation mask for a child.
■ Guide participants through the steps of the skill.
■ Point out any common errors for giving ventilations, such as tilting the head too far
back, failing to recheck for breathing and a pulse, giving ventilations that are too
hard or too fast, not properly sealing the resuscitation mask or using an improperly
sized mask for the victim.
LGI_SecB_p079-098.indd 86 11/21/11 11:39 AM

TOPIC: GIVING VENTILATIONS USING Time: 15 minutes
A BAG-VALVE-MASK
RESUSCITATOR
PRESENTATION: GIVING VENTILATIONS USING A BVM—TWO RESCUERS
Activity ■ Briefly show participants a BVM and point out the three parts—bag, valve and
mask— demonstrating how squeezing the bag opens the one-way valve, forcing air
into the lungs, and how releasing the bag closes the valve, allowing environmental air
to refill it.
■ Emphasize the need for two rescuers: one to position and seal the mask and one to
squeeze the bag.
Video Segment ■ Explain to participants that the video segment demonstrates how to use a BVM.
■ Show the video segment, “Using a Bag-Valve-Mask Resuscitator—Two Rescuers.”
Giving Ventilations Using a Bag-Valve-Mask Resuscitator—Two Rescuers

Skill Practice ■ Divide participants into pairs and guide them through the steps listed on the Giving
Ventilations Using a Bag-Valve-Mask Resuscitator—Two Rescuers skill chart.
■ Point out any common errors for giving ventilations using a BVM, such as not
maintaining a seal with the resuscitation mask, not squeezing the bag hard enough or
squeezing the bag too hard.
TOPIC: AIRWAY OBSTRUCTION Time: 30 minutes
PRESENTATION: AIRWAY OBSTRUCTION
Conscious Choking—Adult and Child

Video Segment ■ Explain to participants that the video segment will demonstrate how to care for a
conscious choking adult or child.
■ Show the video segment, “Conscious Choking—Adult and Child.”
Lecture ■ The most common cause of respiratory emergencies is airway

obstruction.
■ Mechanical obstructions result from a foreign body lodged in the airway,
generally food or other small objects.
■ Anatomical obstructions are caused mostly by the tongue. When a
person becomes unconscious, the tongue loses muscle tone and falls
back, blocking the airway.
■ The universal sign for choking in a conscious person is clutching the
throat.
■ Encourage coughing as long as the person can cough forcefully.
■ If the person cannot cough, speak, cry or breathe, immediate action is
needed.
Skill Practice ■ Divide participants into two lines facing the same direction or have them partner and
arrange each pair so you can see all groups. Designate victims and lifeguards.
LGI_SecB_p079-098.indd 87 12/13/11 3:18 PM

■ Instruct participants not to give actual back blows or abdominal thrusts to their
partners.
■ Guide them through the steps listed on the Conscious Choking—Adult and Child skill
chart.
■ Have participants change roles and repeat the guided skill practice.
■ Point out any common errors, such as failing to obtain the victim’s consent,
performing abdominal thrusts before back blows, positioning the hands improperly
or not using the thumb side of the fist to give abdominal thrusts.
■ Participants only need to demonstrate how to care for either a conscious choking
adult or a child and be able to point out the differences for the other, such as kneeling
if the victim is shorter.
■ Remind participants that if a conscious choking victim is too large to reach around
or if the victim is obviously pregnant or known to be pregnant, back blows and chest
thrusts are used.
Conscious Choking—Infant
Video Segment ■ Explain that the video segment will demonstrate how to care for a conscious choking
infant.
■ Show the video segment, “Conscious Choking—Infant.”
Skill Practice ■ Ask participants to return to the practice area.

■ Divide participants into pairs and guide them through the steps listed on the
Conscious Choking—Infant skill chart.
■ Have each participant practice clearing the airway of a conscious choking infant on a
manikin while the other participants use their skill sheets to give feedback.
■ Follow the same steps as in the previous skill session:
| Have participants practice the skill.
| Observe each participant’s performance of the skill and provide
| Point out any errors, such as not keeping the infant’s head lower than the chest,
not supporting the head and neck securely when turning the infant, not placing
the fingers correctly for chest thrusts or the hand for back blows.
Unconscious Choking—Adult and Child

Lecture ■ A drowning victim may likely present a complication with an obstructed
airway.
■ If there is a white or pink froth in and around the victim’s mouth, wipe it
away and proceed with care.
■ If there is vomit or heavy mucus, use chest compressions to try to clear
the obstruction.
■ More advanced skills, such as suctioning and the use of airway adjuncts,
may help to clear an obstructed airway. These methods require
additional training.
Video Segment ■ Explain that the video segment demonstrates how to clear an obstruction from the
airway for an unconscious choking adult, child and infant
■ Show the video segment, “Unconscious Choking—Adult, Child and Infant.”
Skill Practice ■ Ask participants to take their disposable gloves and resuscitation masks to the
practice area.
■ Divide participants into pairs and guide them through the steps listed on the
Unconscious Choking—Adult and Child skill chart.
LGI_SecB_p079-098.indd 88 10/21/11 2:56 PM

■ Have each participant practice clearing the airway of an unconscious choking
adult or child on a manikin while the other participants use their skill sheets to
give feedback.
■ Point out any common errors, such as using abdominal thrusts instead of chest
thrusts, failing to check the mouth for an object, compressing too little or too much,
failing to give ventilations or using the wrong finger to clear the object from
the mouth.
■ Participants only need to demonstrate care for an airway obstruction for either an
unconscious adult or child and be able to point out the differences, such as how far to
tilt the head and how deep to compress the chest.
Unconscious Choking—Infant
Skill Practice ■ Guide participants through the steps listed on the Unconscious Choking—Infant
skill chart.
■ Follow the same steps as in the previous skill session:
| Observe each participant’s performance of the skill and provide
| Point out any common errors for caring for an unconscious choking infant, such
as not keeping the infant’s head lower than the chest, not supporting the head
and neck securely when turning the infant, not placing the fingers correctly for
chest thrusts or the hand for back blows, or failing to give ventilations.
IN-WATER SKILL SESSION: PUTTING IT Time: 30 minutes

ALL TOGETHER
Skill Drill ■ Assemble the participants on the pool deck and explain they will be practicing team
rescues for a submerged passive victim in deep water, removing the victim from the
water on a backboard, doing a primary assessment and caring for a victim who is not
breathing but has a pulse.
■ For the Shallow Water Lifeguarding course, participants will practice rescuing a
submerged passive victim in shallow water.
■ Divide the participants into groups of three and assign one rescuing lifeguard, one
assisting lifeguard and one victim for each group. Have each lifeguard wear a hip
pack containing gloves and a resuscitation mask.
■ Have a manikin available to substitute into the drill once the primary assessment is
complete.
■ Explain that for each group:
| The rescuing lifeguard will simulate activating the EAP and enter the water.
| The victim will get into position and submerge as the rescuing lifeguard gets
near. The rescuing lifeguard will perform a submerged passive victim rescue.
| The assisting lifeguard will bring the backboard and assist the rescuing lifeguard
in removing the victim from the water, demonstrating team communication
skills between the lifeguards.
| Once removed from the water, the lifeguards should do a primary assessment on
the victim (simulating breaths) and then provide care for a victim who is not
breathing but has a pulse on the manikin. The lifeguards should give ventilations
using a BVM.
LGI_SecB_p079-098.indd 89 10/21/11 2:56 PM

and an assisting lifeguard.
ASSIGNMENT
■ Read Chapter 9, Cardiac Emergencies, in the Lifeguarding Manual before the next
class session.

REMOVING DISPOSABLE GLOVES
SKILL CHART: REMOVING DISPOSABLE GLOVES
1. Pinch the glove.

| Pinch the palm side of one glove near your wrist.
| Carefully pull the glove off so that it is inside out.
2. Slip two fingers under the glove.
| Hold the glove in the palm of your gloved hand.
| Slip two fingers under the glove at the wrist of the remaining gloved hand.
3. Pull the glove off.
| Pull the glove until it comes off, inside out.
| The first glove should end up inside the glove you just removed.
4. Dispose of gloves and wash hands.
| Dispose of gloves and other PPE in a proper biohazard container.
| Wash your hands thoroughly with soap and running water, if available. Otherwise, rub hands thoroughly
with an alcohol-based sanitizer if hands are not visibly soiled.
SKILL ASSESSMENT TOOL: REMOVING DISOSABLE GLOVES
Removes gloves Bare skin does not come into contact Bare skin comes into contact with
with outside surface of gloves outside surface of glove(s)
PRIMARY ASSESSMENT
SKILL CHART: PRIMARY ASSESSMENT—ADULT
Size up the scene for safety and then:

1. Check for responsiveness.
| Tap the shoulder and ask, “Are you okay?”
2. If no response, summon EMS personnel.
| If the victim is face-down, roll the victim onto his or her back while supporting the head, neck and back.
3. Open the airway and quickly check for breathing and a pulse for no more than 10 seconds.
| To open the airway:
● From the side, use the head-tilt/chin-lift technique.
● From above the victim’s head, use the jaw-thrust (with head extension) maneuver.
● If a head, neck or spinal injury is suspected, use the jaw-thrust (without head extension) maneuver.
LGI_SecB_p079-098.indd 90 10/13/11 10:11 AM

| Look, listen and feel for breathing.
| Feel for a carotid pulse by placing two fingers in the middle of the victim’s throat and then sliding them
into the groove at the side of the neck closest to you. Press lightly.
Note: For a breathing emergency (e.g., drowning, hypoxia), give 2 ventilations before scanning for severe
bleeding. If at any time the chest does not rise, the airway might be blocked. Provide care for an unconscious
choking victim.
4. Quickly scan for severe bleeding.
5. Provide care as needed.
| If no breathing or pulse, perform CPR.
| If no breathing but there is a pulse, give 1 ventilation about every 5 seconds.
| If there is severe bleeding and the victim is breathing, provide first aid care for the bleeding.
| If unconscious but breathing, leave the victim in a face-up position. Place in a modified H.A.IN.E.S.
recovery position only if you:
● Are alone and must leave the victim (e.g., to call for help).
● Cannot maintain an open and clear airway because of fluids or vomit.
SKILL CHART: PRIMARY ASSESSMENT—CHILD AND INFANT
Size up the scene for safety and then:

1. Check for responsiveness.
| For a child, tap the shoulder and shout, “Are you okay?”
| For an infant, tap the shoulder or flick the underside of the foot and shout.
2. If no response, summon EMS personnel.
| If the victim is face-down, roll the victim onto his or her back while supporting the head, neck and back.
3. Open the airway and check for breathing and a pulse for no more than 10 seconds.
| To open the airway:
● From the side, use the head-tilt/chin-lift technique.
● From above the victim’s head, use the jaw-thrust (with head extension) maneuver.
● If you suspect a head, neck or spinal injury, use the jaw-thrust (without head extension) maneuver.
| Look, listen and feel for breathing.
| Check for a pulse.
● For a child, feel for a carotid pulse by placing two fingers in the middle of the victim’s throat
and then sliding them into the groove at the side of the neck closest to you. Press in lightly.
● For an infant, feel for the brachial pulse on the inside of the upper arm between the infant’s elbow
and shoulder. Press lightly.
Note: If you witnessed a child or an infant suddenly collapse, skip Step 4.
4. If no breathing, give 2 ventilations. Each ventilation should last about 1 second and make the chest clearly rise.
| The chest should fall before the next ventilation is given.
Note: If at any time the chest does not rise during Step 4, the airway might be blocked. Provide care for an
unconscious choking victim.
5. Quickly scan for severe bleeding.

6. Provide care as needed.
| If no breathing or pulse, perform CPR.
| If no breathing but there is a pulse, give 1 ventilation about every 3 seconds.
| If there is severe bleeding and the victim is breathing, provide first aid care for the bleeding.
| If unconscious but breathing, leave the victim in a face-up position. Place in a modified H.A.IN.E.S
recovery position only if you:
● Are alone and have to leave the victim (e.g., to call for help).
● Cannot maintain an open and clear airway because of fluids or vomit.
LGI_SecB_p079-098.indd 91 11/2/11 9:32 AM

SKILL ASSESSMENT TOOL: PRIMARY ASSESSMENT—ADULT, CHILD AND INFANT
Open the airway ■ Tilts head back so that jaw line ■ Tilts head back so that jaw line
is at an angle of 80° to 100° to is at an angle less than 80° or
the floor greater than 100° to the floor
■ Maintains open airway ■ Does not maintain an open
throughout primary assessment airway throughout primary
assessment
Feel for a pulse ■ For adult or child, feels for ■ Feels for pulse in incorrect
carotid pulse location
■ For infant, feels for brachial ■ Feels for a pulse for less than 5
pulse or more than 10 seconds
■ Feels for a pulse for more than
5, but no more than 10 seconds
Give ventilations (child or infant, or ■ Gives 2 ventilations that make ■ Gives 2 ventilations that do
in cases of a breathing emergency the chest clearly rise and last not make the chest clearly rise
[e.g., drowning or hypoxia] in an about 1 second each and last 2 or more seconds
adult) ■ Allows the chest to fall between each
ventilations ■ Does not allow chest to fall
between ventilations
LGI_SecB_p079-098.indd 92 10/13/11 10:11 AM

RECOVERY POSITIONS
SKILL CHART: FACE-UP POSITION
If unconscious but breathing, leave the victim in a face-up position.

SKILL CHART: MODIFIED H.A.IN.E.S. RECOVERY POSITION
1. Kneel at the victim’s side.

2. Roll the victim away from you.
| Reach across the victim’s body, lift up the arm farthest from you and place it next to the head with the
palm facing up.
| Take the person’s arm closest to you and place it next to his or her side.
| Grasp the leg farthest from you and bend it up.
| Using your hand that is closest to the victim’s head, cup the base of the victim’s skull in the palm of your
hand and carefully slide your forearm under the victim’s shoulder closest to you. Do not lift or push the
head or neck.
| Place your other hand under the arm and hip closest to you.
| Using a smooth motion, roll the victim away from you by lifting with your hand and forearm. Keep the
victim’s head in contact with his or her extended arm and be sure to support the head and neck with
your hand.
| Stop all movement when the victim is on his or her side.
3. Place the top leg on the other so that both knees are in a bent position.
4. Make sure the arm on top is in line with the upper body.
| If you must leave the person to get help, place the hand of the upper arm palm side down with the fingers
under the armpit of the extended lower arm.
SKILL CHART: INFANT RECOVERY POSITION (ALTERNATE)
1. Carefully position the infant face-down along your forearm.

2. Support the infant’s head and neck with your other hand while keeping the infant’s mouth and nose clear.
SKILL ASSESSMENT TOOL: RECOVERY POSITIONS
Face-Up Position
Maintain an open airway Victim is breathing, lying face-up Head is not tilted back in an open
and head is tilted in an open airway airway position
position
H.A.IN.E.S Recovery Position
Maintain an open airway Rolls victim onto side Victim is vomiting but left lying
face-up
Support head, neck and spine Rolls victim in a smooth motion Lifts or pushes the head or neck
until on his or her side
Infant (Alternate)
Maintain an open airway Mouth and nose are clear Infant’s mouth or nose is blocked
by forearm or hand
Support head and neck ■ Infant face-down along the Infant’s head or body is sideways
rescuer’s forearm or dangling from forearm
■ Head and neck supported by
other hand
LGI_SecB_p079-098.indd 93 10/13/11 2:24 PM

USING A RESUSCITATION MASK
SKILL CHART: HEAD-TILT/CHIN-LIFT TECHNIQUE
1. Kneel to the side of the victim’s head.

2. Position the mask.
| Place the rim of the mask between the victim’s lower lip and chin.
| Lower the mask until it covers the victim’s mouth and nose.
3. Seal the mask.
| Place the thumb and fingers of one hand around the top of the mask.
| Place the thumb of your other hand on the bottom of the mask and slide your first two fingers onto the
bony part of the victim’s chin.
| Press downward on the mask with your top hand and the thumb of your lower hand to seal the top and
bottom of the mask.
4. Tilt the victim’s head back and lift the chin to open the airway.
5. Blow into the mask.
| Each ventilation should last about 1 second and make the chest clearly rise. The chest should fall before
the next ventilation is given.
SKILL CHART: JAW-THRUST (WITH HEAD EXTENSION) MANEUVER

| Kneel above the victim’s head.
| Place the rim of the mask between the lower lip and chin.
| Lower the resuscitation mask until it covers the victim’s mouth and nose.
2. To seal the mask and open the airway:
| Using the elbows for support, place your thumbs and index fingers along each side of the resuscitation
mask to create a “C.”
| Slide your 3rd, 4th and 5th fingers into position to create an “E” on both sides of the victim’s jawbone.
| Hold the mask in place while you tilt the head back and lift the jaw into the mask.
| Each ventilation should last about 1 second and make the chest clearly rise. The chest should fall
before the next ventilation is given.
SKILL CHART: JAW-THRUST (WITHOUT HEAD EXTENSION) MANEUVER

| Kneel above the victim’s head.
| Place the rim of the mask between the lower lip and chin.
| Lower the resuscitation mask until it covers the victim’s mouth and nose
2. To seal the mask and open the airway:
| Place your thumbs and index fingers along each side of the resuscitation mask to create a “C.”
| Without moving or tilting the head back, lift the lower jaw up with your fingers along the jawbone to seal
the mask to the face.
| Each ventilation should last about 1 second and make the chest clearly rise. The chest should fall
before the next ventilation is given.
LGI_SecB_p079-098.indd 94 11/2/11 1:29 PM

SKILL ASSESSMENT TOOL: USING A RESUSCITATION MASK
Open the airway:

■ Head-tilt/chin-lift or jaw Tilts the head back so that the jaw Tilts head back so that jaw line is
thrust (with head extension) line is at an angle of 80° to 100° to at an angle less than 80° or greater
maneuver the floor than 100° to the floor
■ Jaw thrust (without head Lifts the victim’s jaw to open the Tilts the victim’s head back
extension) maneuver airway
Give ventilations Gives ventilations that make the ■ Ventilations do not make the
chest clearly rise and last about 1 chest clearly rise
second each ■ Ventilation lasts 2 or more
seconds
GIVING VENTILATIONS USING A BAG-VALVE-MASK RESUSCITATOR
SKILL CHART: GIVING VENTILATIONS USING A BAG-VALVE-MASK

RESUSCITATOR—TWO RESCUERS
1. Rescuer 1 kneels behind the victim’s head and positions the mask over the victim’s mouth and nose.
2. Rescuer 1 seals the mask.
3. Rescuer 1 opens the airway using the jaw-thrust (with head extension) maneuver.
| Using the elbows for support, place your thumbs and index fingers along each side of the resuscitation
mask to create a “C.”
| Hold the mask in place while you tilt the head back and lift the jaw into the mask.
4. Rescuer 2 gives ventilations.
| Squeeze the bag slowly with both hands.
| For an adult, give 1 ventilation about every 5 seconds.
| For a child or infant, give 1 ventilation about every 3 seconds.
| Each ventilation should last about 1 second and make the chest clearly rise. The chest should fall before
the next breath is given.
5. Rescuer 2 rechecks for breathing and a pulse about every 2 minutes.
| Remove the mask and look, listen and feel for breathing and a pulse for no more than 10 seconds.
SKILL ASSESSMENT TOOL: GIVING VENTILATIONS USING A BVM—TWO
RESCUERS
Open airway Performs a jaw-thrust (with head ■ Tilts the head from the side
extension) maneuver ■ Unable to open the airway
Deliver the appropriate volume of Squeezes the bag to give ventilations Victim’s chest does not rise
air with each ventilation that make the chest clearly rise
LGI_SecB_p079-098.indd 95 11/2/11 9:32 AM

Give ventilations at the correct ratio Adult ratio: Squeezes the bag to give ■ Gives ventilations too slow or
for the victim 1 ventilation about every 5 seconds too fast:
| Less than 1 ventilation
every 3 seconds
| Greater than 1 ventilation
every 7 seconds
Child or Infant ratio: Squeezes the ■ Gives ventilations too slow or

bag to give 1 ventilation about every too fast:
3 seconds | Less than 1 ventilation
every second
| Greater than 1 ventilation
every 5 seconds
AIRWAY OBSTRUCTION
SKILL CHART: CONSCIOUS CHOKING—ADULT AND CHILD
If the victim cannot cough, speak or breathe:

1. Give 5 back blows.
| Position yourself slightly behind the victim.
| Place one arm diagonally across the victim’s chest and bend the victim forward at the waist. The victim’s
upper airway should be at least parallel to the ground.
| Firmly strike the victim between the shoulder blades with the heel of your hand.
| Each thrust should be a distinct attempt to dislodge the object.
2. Give 5 abdominal thrusts.
| Stand behind the victim.
| For a child, stand or kneel behind the child, depending on the child’s size. Use less force on a child than
you would on an adult.
| Place the thumb side of your fist against the middle of the abdomen, just above the navel.
| Grab your fist and give quick, upward thrusts.
| Each thrust should be a distinct attempt to dislodge the object.
SKILL CHART: CONSCIOUS CHOKING—INFANT
If the victim cannot cough, speak or breathe:

1. Carefully position the infant face-down along your forearm.
| Support the infant’s head and neck with your hand.
| Lower the infant onto your thigh, keeping the infant’s head lower than his or her chest.
2. Give 5 back blows.
| Give back blows with the heel of your hand between the infant’s shoulder blades.
| Each back blow should be a distinct attempt to dislodge the object.
3. Position the infant face-up along your forearm.
| Position the infant between both of your forearms, supporting the infant’s head and neck.
| Turn the infant face-up.
| Lower the infant onto your thigh with the infant’s head lower than his or her chest.
4. Give 5 chest thrusts.
| Put two or three fingers on the center of the chest just below the nipple line and compress the chest about
1½ inches.
| Each chest thrust should be a distinct attempt to dislodge the object.
LGI_SecB_p079-098.indd 96 10/13/11 10:11 AM

SKILL ASSESSMENT TOOL: CONSCIOUS CHOKING—ADULT OR CHILD
Bend the person forward at the Positions person with upper Positions person with upper
waist for back blows airway (person’s head and neck) airway (person’s head and neck)
parallel to the ground or angled angled upward
slightly downward
Give 5 back blows ■ Strikes the back with heel of one ■ Strikes the back with closed
hand hand
■ Strikes the center of the back ■ Strikes the back with palm
between shoulder blades ■ Strikes the back more than 2
■ Each back blow is a separate inches from the center of both
and distinct attempt to dislodge shoulder blades
the object ■ Each back blow is not a
separate and distinct attempt
to dislodge the object
Give 5 abdominal thrusts ■ Places fist within 2 inches of ■ Places fist more than 2 inches
navel from navel
■ Places fist 1 inch or more away ■ Places fist less than 1
from lower tip of breastbone inch from the lower tip of
■ Each abdominal thrust is a breastbone (too close to
separate and distinct attempt to breastbone)
dislodge the object ■ Each abdominal thrust is not a
separate and distinct attempt
to dislodge the object
SKILL ASSESSMENT TOOL: CONSCIOUS CHOKING—INFANT
Keep the head lower than the chest Positions infant with upper airway Positions infant with upper airway
(infant’s head and neck) angled (infant’s head and neck) parallel to
downward, lower than chest ground or angled upward
Support the head and neck securely Places thumb and fingers on ■ Places thumb on front of
infant’s jaw infant’s neck
■ Places fingers on front of
infant’s neck
Maintain firm support Holds infant securely ■ Drops infant

■ Loses control of infant
Give back blows ■ Strikes the back with the heel of ■ Strikes the back with a
one hand closed hand
■ Strikes the center of the back ■ Strikes the back with a palm
between the shoulder blades ■ Strikes the back more than 1
inch from the center of both
shoulder blades
Give chest thrusts ■ Places fingers in line with ■ Places fingers perpendicular to
the breastbone (not across/ breastbone
perpendicular to the ■ Places fingers outside center
breastbone) of chest
■ Places fingers in center of chest ■ Places fingers more than 1
not more than 1 inch below inch below nipple line
nipple line
■ Places fingers more than 1
inch above nipple line
LGI_SecB_p079-098.indd 97 10/13/11 10:11 AM

UNCONSCIOUS CHOKING
SKILL CHART: UNCONSCIOUS CHOKING
If at any time the chest does not rise:

1. Re-tilt the head and give another ventilation.
2. If the chest still does not clearly rise, give 30 chest compressions.
| Place the heel of one hand on the center of the chest.
| Place the other hand on top of the first hand and compress the chest 30 times.
| For an adult, compress the chest at least 2 inches.
| For a child, compress the chest about 2 inches.
| Compress at a rate of about 100 compressions per minute.
3. Look for an object inside the mouth.
| Grasp the tongue and lower jaw between your thumb and fingers and lift the jaw.
4. If you see an object, remove it.
| Slide your finger along the inside of the victim’s cheek using a hooking motion to sweep the object out.
5. Give 2 ventilations.
| Replace the resuscitation mask and give 2 ventilations.
SKILL ASSESSMENT TOOL: UNCONSCIOUS CHOKING—ADULT, CHILD AND
INFANT
Responds to the chest not rising Re-tilts the head and attempts ■ Does not re-tilt the head
another ventilation ■ Continues to attempt
ventilations without the chest
rising
Compress the chest Compresses the chest 30 times Does not compress the chest
Look inside the mouth and remove Grasps the tongue and lower jaw ■ Does not open mouth
an object if seen between the thumb and fingers and ■ Does not look in mouth
lifts the jaw.
■ Does not remove an object
Re-attempt 2 ventilations After compressions or removing an Does not attempt ventilations that
object, re-attempts 2 ventilations make the chest clearly rise and
that make the chest clearly rise and lasts 2 seconds or more
that last about 1 second each
LGI_SecB_p079-098.indd 98 11/2/11 9:32 AM

LESSON 6
CARDIAC EMERGENCIES AND USING AN
LESSON OBJECTIVES
■ Identify the four links in the Cardiac Chain of Survival and identify the importance of each.
■ Recognize the signs of a heart attack.
■ Identify the steps for caring for a victim of a heart attack.
■ Identify signs and symptoms of cardiac arrest.
■ Demonstrate how to safely and effectively perform one-rescuer CPR and two-rescuer CPR.
■ Demonstrate how to use an automated external defibrillator (AED).
■ Identify precautions for using an AED.

■ Activity Worksheet 6.1—Using an AED in Unique Situations—Fact or Fiction
■ Manikins (one adult and one infant manikin per two participants, child manikins optional)
■ Pediatric resuscitation masks (one per participant)
■ Automated external defibrillator (AED) training devices (one per two participants)
■ AED training pads (one set of adult and one set of pediatric training pads per two participants)
■ Stopwatch or pace clock
■ Additional items for scenarios:
{ Two hip packs
{ Adult and pediatric bag-valve-mask (BVM) resuscitators
TOPIC: RECOGNIZING AND CARING Time: 15 minutes

FOR A HEART ATTACK
PRESENTATION: RECOGNIZING AND CARING FOR A HEART ATTACK
Video Segment ■ Explain to participants that the video segment will provide important information to
help them recognize and provide care for a victim experiencing a heart attack.
■ Show the video segment, “Heart Attack and the Cardiac Chain of Survival.”
Lecture ■ Present the following scenario: A patron walking on the pool deck suddenly
and Guided collapses.
Discussion ■ Ask participants: What four links in the Cardiac Chain of Survival are
necessary to improve this victim’s chance for survival?
| Early recognition and early access to the emergency medical services (EMS)
system
| Early cardiopulmonary resuscitation (CPR)
LESSON 6 | Cardiac Emergencies and Using an Automated External Defibrillator 99
LGI_SecB_p099-113.indd 99 10/21/11 2:58 PM

| Early defibrillation
| Early advanced medical care
■ Present the following scenario: You are on duty at a first aid station when an
adult male patron comes to you for help. He is sweating profusely and is
having trouble breathing. He is complaining of pain in his chest and arm
that comes and goes.
■ Ask participants: What condition does he appear to be experiencing?
Answer: Heart attack
■ Ask participants: What care should you provide for a victim possibly having
a heart attack?
| Take immediate action and summon EMS personnel.
| Have the victim stop any activity and rest in a comfortable position.
| Loosen any tight or uncomfortable clothing on the victim.
| Closely monitor the victim until EMS personnel take over, noting any changes
in appearance or behavior.
| Comfort the victim.
| Assist the victim with prescribed medication, such as nitroglycerin, and
administer emergency oxygen, if available and trained to do so.
| Be prepared to perform CPR and use an AED.
| Ask questions to get information that relates to the victim’s condition, such as
what happened, whether he has any medical conditions or is taking any
medications or when was the last time he had anything to eat or drink.
■ Aspirin can help the victim of a heart attack if taken soon after the
symptoms begin.
■ If your facility allows you to dispense aspirin, you will need to follow
procedures to assess if a victim of a heart attack should be given aspirin.
TOPIC: CARDIAC ARREST Time: 5 minutes

PRESENTATION: CARDIAC ARREST
Lecture ■ Cardiac arrest is a life-threatening situation in which the heart stops

and Guided beating or beats too irregularly or too weakly to circulate blood
effectively.
Discussion
■ Heart attack, electrocution, respiratory arrest, drowning or other
conditions may cause cardiac arrest.
■ Signs of cardiac arrest include:
| Sudden collapse.
| Unconsciousness.
| Absence of breathing.
| Absence of a pulse.
■ Ask participants: What is the difference between a heart attack and cardiac
arrest?
| A heart attack occurs when the heart muscle experiences a loss of oxygenated
blood.
| Cardiac arrest occurs when the heart stops beating or the heart is beating too
irregularly or too weakly to circulate blood effectively. The victim is
unconscious, is not breathing and does not have a pulse. A heart attack may
cause cardiac arrest.
LGI_SecB_p099-113.indd 100 10/21/11 2:58 PM

TOPIC: CPR Time: 40 minutes
PRESENTATION: CPR
Lecture ■ CPR is a combination of chest compressions and ventilations to circulate

and Guided blood that contains oxygen to the brain and other vital organs of a
person whose heart and breathing have stopped. CPR should be
Discussion performed on a firm, flat surface.
■ CPR is used in combination with an AED according to local protocols
until EMS personnel take over.
■ Ask participants: How can you make sure that your chest compressions are
effective?
| Placing the victim on a firm, flat surface
| Correctly positioning the hands
| Compressing the chest in a straight-down manner to the proper depth
| Performing compressions at the proper rate
| Making sure the chest recoils fully between each compression
| Minimizing interruptions in CPR
■ Once started, do not stop CPR except in one of these situations:
| You notice an obvious sign of life, such as breathing.
| An AED is available and ready to use.
| Another trained responder takes over.
| EMS personnel take over.
| You are too exhausted to continue.
| The scene becomes unsafe.
■ Ask participants: What should you do if, at any time, you notice breathing?
Answer: Stop CPR and continue to monitor the victim’s condition. Be prepared to
resume care if necessary.
■ Even with the best of preparation and effort, complications can arise,
including broken ribs, separation of cartilage, vomiting, frothing at the
mouth and chaos at the scene. Despite your best efforts to provide
quality care, not all victims of cardiac arrest survive.
■ Even so, you can and should continue to provide care.
CPR—Adult and Child

Skill Practice ■ Choose either the practice-while-you-watch or watch-then-practice method for this
skill practice.
■ Participants need only demonstrate adult CPR and be able to point out how one
differs from performing CPR on a child, such as compressing the chest to a depth less
than that for an adult.
■ Be sure to point out any common errors, such as compressions that are too shallow
or too deep, interrupting compressions for too long or too frequently, incorrect hand
position, failure to allow full recoil after each compression or inappropriate rate
(speed) of compressions.
LGI_SecB_p099-113.indd 101 10/21/11 2:58 PM

Practice-While-You-Watch
practice area.
| Explain to the participants that, for this skill, they will follow along with and
practice the steps for performing CPR as they are guided by the video segment.
| Show the video segment, “CPR—Adult and Child.”
| Do not interrupt this skill session to lecture or communicate anything other than
guidance related to skill practice. In general, answering questions should occur
after the video segment (and skill session) has ended.
Watch-Then-Practice
| Tell participants that, for this segment, they will watch the video segment
without practicing until you pause it, even though the narration may say to
follow along.
| Show the video segment, “CPR—Adult and Child.”
practice area.
| Guide participants through the steps of the skill and evaluate completion of the
skill using the skill chart.
CPR—Infant
Video Segment ■ If using the Practice-While-You-Watch method, move to the skill practice and show
the video segment as you conduct the skill practice.
■ Explain to participants that the video segment will demonstrate the procedures for
one-rescuer CPR for an infant.
■ Show the video segment, “CPR—Infant.”
Skill Practice ■ Follow the same steps as in the previous skill practice:
| Observe and evaluate each participant’s performance of the skill.
| Point out any common errors, such as compressions that are too shallow or too
deep, interrupting compressions for too long or too frequently, incorrect hand
position and failure to allow full recoil after each compression or inappropriate
rate (speed) of compressions.
TOPIC: TWO-RESCUER CPR Time: 15 minutes
PRESENTATION: TWO-RESCUER CPR
Two-Rescuer CPR—Adult and Child

Lecture ■ Two-rescuer CPR is used when two rescuers arrive on the scene at
the same time or when one rescuer arrives on the scene when CPR is
in progress.
■ In two-rescuer CPR, one rescuer gives ventilations while the other
performs chest compressions.
■ Rescuers switch positions about every 2 minutes.
■ When CPR is in progress by one rescuer and a second rescuer arrives,
the second rescuer should confirm whether EMS personnel have been
summoned. If not, the second rescuer does so before getting the AED or
assisting with care.
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Video Segment ■ Explain to participants that the video segment will demonstrate the procedures for
Two-Rescuer CPR for an adult or child.
■ Show the video segment, “Two-Rescuer CPR—Adult and Child.”
Skill Practice ■ Pair up participants and, using a manikin and a resuscitation mask, conduct the
skill practice.
■ Participants only need to demonstrate either adult two-rescuer CPR or child two-
rescuer CPR and be able to point out how one differs from the other, such as depth of
compressions and ratio of compressions to ventilations.
■ Observe and evaluate each participant’s performance of the skill.
■ Point out any common errors, such as compressions that are too shallow or at an
inappropriate rate, compressing and ventilating at the same time, failing to call for a
position change or using an incorrect cycle of compressions and ventilations.
Two Rescuer CPR—Infant

Two-Rescuer CPR for an infant.
■ Show the video segment, “Two-Rescuer CPR—Infant.”
Skill Practice ■ Pair up participants and, using a manikin and a resuscitation mask, conduct the skill
practice.
■ Observe and evaluate each participant’s performance of the skill.
■ Point out any common errors, such as compressions that are too shallow or at an
inappropriate rate, compressing and ventilating at the same time, failing to call for a
position change or using an incorrect cycle of compressions and ventilations.
TOPIC: WHEN THE HEART STOPS Time: 5 minutes

AND AEDs
PRESENTATION: WHEN THE HEART STOPS AND AEDS
Lecture ■ Any damage to the heart muscle from disease or injury can disrupt the
heart’s electrical system.
■ The two most common treatable abnormal rhythms associated with
sudden cardiac arrest are ventricular fibrillation (V-fib) and ventricular
tachycardia (V-tach).
■ With V-fib, the ventricles quiver without any organized rhythm, the
electrical impulses fire at random, creating chaos, and the heart is
unable to pump and circulate blood.
■ V-tach occurs when an abnormal electrical impulse originates in the
ventricles instead of at the sinoatrial (SA) node. The impulse fires
rapidly, preventing the chambers from filling, and the heart is not able to
pump effectively.
■ AEDs are portable electronic devices that analyze the heart’s rhythm and
provide an electrical shock.
■ Defibrillation is the delivery of an electrical shock that may help
re-establish an effective rhythm.
■ Each minute that CPR and defibrillation are delayed, the victim’s chance
for survival is reduced by about 10 percent.
LGI_SecB_p099-113.indd 103 10/21/11 2:58 PM

TOPIC: USING AN AED Time: 15 minutes
PRESENTATION: USING AN AED
Lecture Points ■ When cardiac arrest occurs, use an AED as soon as it is ready to use.
■ If the AED advises that a shock is needed, follow protocols to provide
1 shock followed by about 2 minutes of CPR.
■ If CPR is in progress, do not interrupt chest compressions until the AED
is turned on, the AED pads are applied and the AED is ready to analyze
the heart rhythm.
■ AEDs may be equipped with pediatric AED pads; however, pediatric pads
are appropriate only for use on infants and children up to 8 years of age
or weighing less than 55 pounds.
| If pediatric-specific equipment is not available and local protocols
allow, you can use an AED designed for adults.
| If the AED pads risk touching each other because of the smaller chest
size, use the anterior (front)/posterior (back) method of pad
placement.
using an AED.
■ Show the video segment, “Using an AED.”
Skill Practice ■ Using manikins, resuscitation masks and training AEDs with the appropriately sized
AED training pads, have participants work in pairs with their Using an AED skill
sheets to lead each other as they practice the skill.
■ Participants only need to demonstrate how to use an AED on either an adult, a child
or an infant and be able to point out the differences in the use of an AED for the
other two age groups.
■ Be sure to point out any common errors, such as not wiping the victim’s chest, using
pediatric AED pads on an adult or failing to resume CPR after delivery of a shock.
Using an AED—CPR in Progress

Lecture Points ■ When one rescuer is on the scene, that rescuer begins CPR and instructs
someone to summon EMS personnel and obtain the AED, if one is
available.
■ When the second rescuer arrives, that rescuer prepares the AED for use
while the first rescuer continues CPR.
■ If at any time either rescuer notices an obvious sign of life, such as
breathing, he or she should stop CPR and monitor the victim’s condition
and administer emergency oxygen, if it is available and you are trained
to do so.
Video ■ Show the video segment, “Using an AED—CPR in Progress.”

LGI_SecB_p099-113.indd 104 10/21/11 2:58 PM

TOPIC: AED PRECAUTIONS AND AED Time: 10 minutes
MAINTENANCE
PRESENTATION: AED PRECAUTIONS AND AED MAINTENANCE
Lecture ■ Ask participants: What are the general precautions to take when using an
and Guided AED?
Discussion Answer: Responses should include the following:
| Do not use alcohol to wipe the victim’s chest dry.
| Do not use an AED and/or pads designed for adults on an infant or child
younger than 8 years of age or weighing less than 55 pounds, unless pediatric
pads specific to the device are not available.
| Do not use pediatric AED pads on an adult older than 8 years of age or
weighing more than 55 pounds.
| Do not touch the victim while the AED is analyzing.
| Before shocking a victim with an AED, make sure that no one is touching or is
in contact with the victim or any resuscitation equipment.
| Do not touch the victim while the device is defibrillating.
| Do not administer defibrillation to someone when around flammable or
combustible materials.
| Do not use an AED in a moving vehicle.
| Do not use an AED on a victim who is in contact with water.
| Do not use an AED on a victim wearing a nitroglycerin patch or other patch on
the chest.
| Do not use a mobile phone or radio within 6 feet of an AED.
■ Ask participants: What precautions would you take when using an AED
around water?
| Remove the victim from freestanding water.
| Make sure there are no puddles of water around the rescuer, victim and AED.
| Remove the victim’s wet clothing.
| Dry the victim’s chest.
| Keep the victim as dry as possible.
| Shelter the victim from the rain (if raining).
■ AEDs require minimal maintenance; however, responders should be
familiar with the various visual and audible prompts to warn of
malfunction or low battery.
■ Read the operator’s manual thoroughly.
■ Periodically check equipment; have a fully charged backup battery and
properly sealed, unexpired and correct AED pads available; replace all
used accessories; and make sure the machine is in proper working order
before placing it back in service.
Activity ■ Divide the participants into small groups and provide each group with Activity
Worksheet 6.1—Using an AED in Unique Situations—Fact or Fiction.
■ Refer participants to Chapter 9, Cardiac Emergencies, for information to help them
with this activity. Circulate among the groups to monitor progress and provide
assistance when necessary.
■ Instruct groups to indicate if each statement is fact or fiction and provide a rationale
for their answer along with any other important information regarding the
statement.
■ Allow up to 5 minutes for the group work. Re-assemble the class and call on group
leaders to share their answer to the questions; offer corrections when needed.
LGI_SecB_p099-113.indd 105 10/21/11 2:58 PM

Activity Worksheet 6.1—Using an AED in Unique Situations—
Fact or Fiction
Fact Fiction 1. It is safe to use an AED in rain or snow.
It is safe to use AEDs in all weather conditions. However, if possible, move the victim
to a shelter to protect him or her from rain or snow.
■ If the victim is lying in water, move him or her to a relatively dry area. Be sure
there are no puddles of water around you, the victim or the AED.
■ Remove the victim’s wet clothing and wipe the chest dry before placing the AED
pads.
■ Do not delay defibrillation when taking steps to provide for a dry environment.
■ Check the manufacturer’s instructions for specific information about the AED you
will be using.
Fact Fiction 2. An AED cannot be used on a pregnant woman.
Defibrillation shocks transfer no significant electrical current to the fetus. Local

protocols and medical direction should be followed.
Fact Fiction 3. If someone has chest hair, you should shave it before using the AED.
Because the time to delivery of the first shock is critical, and chest hair rarely interferes
with pad adhesion, press firmly on the pads to attach them to the victim’s chest. If you
get the “Check pads” message, remove the first set of AED pads, shave the victim’s chest
and attach new pads to the victim’s chest.
Fact Fiction 4. If a victim has a body piercing or is wearing jewelry, you should remove
the item before using an AED.
Jewelry and body piercings do not need to be removed when you use an AED.
However, do not place the AED pads directly over metallic jewelry or body piercings.
Fact Fiction 5. Never shock someone who has an implantable cardioverter-

defibrillator (ICD) or pacemaker device.
If the implanted device is visible, or you know that the victim has one, do not place the
AED pads directly over the device.
Fact Fiction 6. If you see a transdermal medication patch you should use a gloved hand
to remove it.
Avoid wasting time trying to identify patches. Since you might absorb nitroglycerin or
other medications, remove any patch you see on the victim’s chest with a gloved hand.
Fact Fiction 7. Never shock a person who is suffering from traumatic injuries.
If a victim is in cardiac arrest resulting from traumatic injuries, you may still use
an AED.
Fact Fiction 8. Never shock a victim on a metal surface.
It is safe to deliver a shock to a victim in cardiac arrest on a metal surface. Care should
be taken that AED pads do not contact the conductive (metal) surface and that no one
is touching the victim when the shock button is pushed.
Fact Fiction 9. Never shock a victim suffering from hypothermia.
During your primary assessment of a victim suffering from hypothermia, you may
have to check for breathing and a pulse for up to 30 to 45 seconds. If the victim is not
breathing and does not have a pulse, begin CPR until an AED becomes available,
according to local protocols.
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PUTTING IT ALL TOGETHER: Time: 5 minutes
MULTIPLE-RESCUER RESPONSE
PRESENTATION: MULTIPLE-RESCUER RESPONSE
Video Segment ■ Explain to participants that the video segment will demonstrate the procedures for a
multiple-rescuer response with CPR in progress.
■ Show the video segment, “Putting It All Together: Multiple-Rescuer Response—CPR
in Progress.”
IN-WATER SKILL SESSION: Time: 40 minutes

PUTTING IT ALL TOGETHER
Skill Drill—Timed Response

■ Assemble the participants on the deck and explain they will be practicing rescuing a
submerged passive victim in deep water, removing the victim from the water on a
backboard, performing a primary assessment and caring for a victim who is not
breathing and does not have a pulse.
■ Note to instructor: because this person is a drowning victim, lifeguards will have to
give 2 ventilations as part of their primary assessment.
■ For the Shallow Water Lifeguarding course, participants will practice rescuing a
backboard, performing a primary assessment and caring for a victim who is not
breathing and does not have a pulse.
■ Explain that this is a timed scenario, with 2 minutes allotted for the water rescue and
removal of the victim from the water, followed by 3 minutes of one-rescuer CPR.
■ Divide the participants in groups of three and assign one rescuing lifeguard, one
assisting lifeguard to help with removal from the water, one victim and one manikin
for each group.
| The rescuing lifeguard, wearing a hip pack containing gloves, will simulate
activating the EAP and enter the water. Once the EAP has been activated, the
stopwatch must be started.
| The victim will get into position about 30 feet from the edge and submerge as the
rescuing lifeguard gets near. The rescuing lifeguard will perform a submerged
passive victim rescue.
in removing the victim from the water, demonstrating team communication
skills between the lifeguards.
| Once removed from the water, the rescuing lifeguard will do a primary
assessment on the victim, then switch to a manikin and provide one-person CPR
for 3 minutes. Once the rescuer begins CPR, the stopwatch must be started.
■ Inform each participant of his or her time and provide feedback for improvement, as
necessary.
LGI_SecB_p099-113.indd 107 10/21/11 2:58 PM

Skill Drill—Multiple-Rescuer Response
■ Assemble the participants on the deck and explain that they will now put their
multiple-rescuer response skills into practice.
■ Divide participants into groups of five: four lifeguards and one victim.
■ Conduct the scenarios and ensure that lifeguards provide care according to the Flow
Chart: Example of a Multiple-Rescuer Response in Chapter 9.
■ Have a manikin available to substitute into the scenario once the primary assessment
is complete.
| Four lifeguards will be equipped with hip packs containing their gloves and
resuscitation masks.
| One victim will get into position and submerge as the rescuing lifeguard
approaches. The rescuing lifeguard will perform a submerged passive victim
rescue.
| Two assisting lifeguards will assist with removal from the water.
| Another assisting lifeguard will provide the supplemental equipment (BVM and
AED).
| Once the victim is removed from the water, the lifeguards should communicate
as a team and perform a primary assessment on the victim (simulating
ventilations) and then provide care for a victim who is not breathing and does
not have a pulse on the manikin.
■ Repeat the drill three times ensuring each person in the group has rotated to
different roles at least once. Be sure to change the situations slightly each time so
that lifeguards are required to practice their decision-making skills each time. For
example, at one time you could state the victim is vomiting; another time, the initial
breaths do not make the chest rise. The intent is for participants to apply what they
are learning through the class; it is not intended to make it complicated or
convoluted.
ASSIGNMENT
■ Read Chapter 10, First Aid, and Chapter 11, Caring for Head, Neck and Spinal
Injuries, in the Lifeguarding Manual.

ONE-RESCUER CPR
SKILL CHART: ONE-RESCUER CPR—ADULT, CHILD AND INFANT
If the victim is not breathing and has no pulse:

1. Give 30 chest compressions.
| Push hard, push fast.
● Compress the chest at least 2 inches for an adult, about 2 inches for a child and about 1½ inches for
an infant at a rate of at least 100 per minute.
● Let the chest rise completely before pushing down again.
| For an adult or a child:
● Place the heel of one hand on the center of the chest with the other hand on top.
● Keep your arms as straight as possible and shoulders directly over your hands.
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| For an infant:
● Place one hand on the infant’s forehead.
● Place two or three fingers on the center of the chest just below the nipple line (toward the infant’s
feet).
2. Give 2 ventilations.
3. Perform cycles of 30 compressions and 2 ventilations.
Do not stop CPR except in one of the following situations:

■ You see an obvious sign of life, such as breathing.
■ An AED is ready to use.
■ Another trained responder takes over.
■ More advanced medical personnel take over.
■ You are too exhausted to continue.
■ The scene becomes unsafe.
SKILL ASSESSMENT TOOL: CPR—ADULT OR CHILD
Victim is on a flat, firm surface If necessary, moves victim to a flat, Attempts CPR on a soft surface
firm surface
ADULT:
Compress chest at least 2 inches Compresses the chest straight down Compresses the chest less than
deep for an adult at least 2 inches for at least 24 of the 2 inches for 7 or more times per
30 compressions 30 compressions
CHILD:
Compress chest about 2 inches Compresses the chest straight down Compresses the chest less than
deep for a child about 1¾ inches for at least 24 of 1¾ inches for 7 or more times per
the 30 compressions 30 compressions
Let chest rise completely before Compresses and fully releases the Pauses while compressing or
pushing down again chest without pausing or taking releasing the chest for 7 or more
hands off chest for 24 of the times per 30 compressions
30 compressions
Compress chest at a rate of at least Compresses center of the chest Compresses the chest less than 24
100 times per minute 24–36 times in about 18 seconds or more than 36 times in about
(30 compressions in about 18 seconds
18 seconds)
Give ventilations Gives 2 ventilations that make the Gives 2 ventilations that do not
chest clearly rise and that last about make the chest clearly rise and
1 second each that last 2 or more seconds each
Return to compressions Gives ventilations and returns Gives ventilations and returns to
to chest compressions within compressions but takes 7 or more
3–6 seconds seconds
SKILL ASSESSMENT TOOL: CPR—INFANT
Victim is on a flat, firm surface If necessary, moves victim to a flat, Attempts CPR on a soft surface
firm surface
Compress chest about 1½ inches Compresses the chest straight down Compresses the chest less than
deep for an infant at least 1¼ inches for at least 24 of 1¼ inches for 7 or more times per
the 30 compressions 30 compressions
Let chest rise completely before Compresses and releases the chest Pauses while compressing or
pushing down again without pausing for 24 of the releasing the chest for 7 or more
30 compressions times per 30 compressions
LGI_SecB_p099-113.indd 109 10/13/11 10:48 AM

Compress chest at a rate of at Compresses center of the chest Compresses the chest less than 24
least 100 times per minute 24–36 times in about 18 seconds or more than 36 times in about
(30 compressions in about 18 seconds
18 seconds)
Give ventilations Gives 2 ventilations that make the Gives 2 ventilations that do not
chest clearly rise and that last about make the chest clearly rise and
1 second each that last 2 or more seconds each
Return to compressions Gives ventilations and returns to Gives ventilations and returns to
chest compressions within compressions but takes 7 or
3–6 seconds more seconds
TWO-RESCUER CPR
SKILL CHART: TWO-RESCUER CPR—ADULT AND CHILD

1. Rescuer 2 finds the correct hand position to give chest compressions.
| Place two hands on the center of the chest.
2. Rescuer 2 gives chest compressions.
● Compress the chest at least 2 inches for an adult and about 2 inches for a child at a rate of at least
100 per minute.
3. Rescuer 1 gives 2 ventilations.
4. Perform about 2 minutes of compressions and ventilations.
| Adult: Perform cycles of 30 compressions and 2 ventilations.
| Child: Perform cycles of 15 compressions and 2 ventilations.
5. Rescuers change positions about every 2 minutes.
| Rescuer 2 calls for a position change by using the word “change” at the end of the last compression cycle:
● For an adult, use the word “Change” in place of saying “30.”
● For a child, use the word “Change” in place of saying “15.”
| Rescuer 1 gives 2 ventilations.
| Rescuer 2 quickly moves to the victim’s head with his or her own mask.
| Rescuer 1 quickly moves into position at the victim’s chest and locates correct hand position on the chest.
| Changing positions should take less than 5 seconds.
6. Rescuer 1 begins chest compressions.
| Continue cycles of compressions and ventilations.
SKILL CHART: TWO-RESCUER CPR—INFANT

1. Rescuer 2 finds the correct hand position to give chest compressions.
| Use the two-thumbs-encircling technique on the infant’s chest.
● Place thumbs next to each other on the center of the chest just below the nipple line.
● Place both hands underneath the infant’s back and support the infant’s back with your fingers.
● Ensure that your hands do not compress or squeeze the side of the ribs.
| If available, a towel or padding can be placed under the infant’s shoulders to help maintain the head in
the neutral position.
2. Rescuer 2 gives chest compressions.
● Compress the chest about 1½ inches for an infant at a rate of at least 100 per minute.
LGI_SecB_p099-113.indd 110 10/13/11 10:48 AM

3. Rescuer 1 gives 2 ventilations.
4. Perform about 2 minutes of compressions and ventilations.
| Perform cycles of 15 compressions and 2 ventilations.
5. Rescuers change positions about every 2 minutes.
| Rescuer 2 calls for a position change by using the word “change” in place of saying “15” at the end of the
last compression cycle.
| Rescuer 1 gives 2 ventilations.
| Rescuer 2 quickly moves to the victim’s head with his or her own mask.
| Rescuer 1 quickly moves into position at the victim’s chest and locates correct hand position on the chest.
| Changing positions should take less than 5 seconds.
6. Rescuer 1 begins chest compressions.
| Continue cycles of compressions and ventilations.
Do not stop CPR except in one of the following situations:
■ You see an obvious sign of life, such as breathing.
■ An AED is ready to use.
■ Another trained responder takes over.
■ EMS personnel take over.
■ You are too exhausted to continue.
■ The scene becomes unsafe.
SKILL ASSESSMENT TOOL: TWO-RESCUER CPR—ADULT, CHILD AND INFANT
Change positions Changes positions in 5–7 seconds Changes positions but takes more
than 7 seconds
Compress the chest and give ADULT: ADULT:

ventilations at the appropriate rate Cycles consist of 30 compressions Cycles consist of less or more
and 2 ventilations than 30 compressions and
CHILD AND INFANT: 2 ventilations
Cycles consist of 15 compressions CHILD AND INFANT:
and 2 ventilations Cycles consist of less or more than
15 compressions and 2 ventilations
AED
SKILL CHART: USING AN AED

1. Turn on the AED and follow the voice and/or visual prompts.
2. Wipe the victim’s bare chest dry.
Tip: Remove any medication patches with a gloved hand.

3. Attach the AED pads to the victim’s bare, dry chest.
| Place one pad on the victim’s upper right chest and the other pad on the left side of the chest.
● For a child or an infant: Use pediatric AED pads, if available. If the pads risk touching each other,
place one pad in the middle of the child’s chest and the other pad on the child’s back, between the
shoulder blades.
4. Plug in the connector, if necessary.
5. Stand clear.
| Make sure no one, including you, is touching the victim.
| Say, “Everyone, stand clear!”
LGI_SecB_p099-113.indd 111 10/13/11 10:48 AM

6. Analyze the heart rhythm.
| Push the “Analyze” button, if necessary. Let the AED analyze the heart rhythm.
7. Deliver a shock or perform CPR based on the AED recommendation.
| If a shock is advised:
● Make sure no one, including you, is touching the victim.
● Say, “Everyone, stand clear!”
● Deliver the shock by pushing the “Shock” button, if necessary.
● After delivering the shock, perform about 2 minutes of CPR.
● Continue to follow the prompts of the AED.
| If no shock is advised:
● Perform about 2 minutes of CPR.
● Continue to follow the prompts of the AED.
SKILL ASSESSMENT TOOL: USING AN AED—ADULT, CHILD OR INFANT
Attach AED pads to bare chest Places one pad on the upper right ■ Places one pad on the upper
chest and one on the left side of the left chest
chest ■ Places one pad on the lower
right side of the chest
■ Places one or more pads on a
location other than the chest
Make sure that pads do not touch ■ Places pads on the chest so that ■ Places pads on the chest, but
(child or infant) they are separated from each pads touch each other
other ■ Places the center of one pad
■ Places one pad in the middle of more than 2 inches from the
the chest and one on the back center of the chest
centered between the shoulder ■ Places the center of one pad
blades more than 2 inches from the
■ Places pads so that the heart is center of both shoulder blades
between the two pads
Make sure that no one is touching ■ Says, “Everyone, stand clear!” ■ Does not say, “Everyone, stand
the victim before pushing the “Analyze” clear!”
button, if necessary ■ Pushes the “Analyze” button if
■ Says, “Everyone stand clear!” necessary, before saying,
before pushing the “Shock” “Everyone, stand clear!”
button, if necessary ■ Pushes the “Shock” button, if
necessary, before saying,
“Everyone, stand clear!”
After delivering the shock, or if no Returns to chest compressions Returns to chest compressions
shock is advised, perform about 2 within 5 seconds after 6 or more seconds
minutes of CPR
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FLOW CHART
EXAMPLE OF A MULTIPLE-RESCUER RESPONSE
Instructor’s Note: This example assumes that the EAP has been activated, EMS personnel have been called
and a primary assessment has been done. The victim is not breathing and has no pulse. Additional rescuers are
coming in to support the efforts of the initial rescuers and are bringing equipment.
1. The initial rescuers begin two-rescuer CPR.
| Rescuers 1 and 2 perform two-rescuer CPR.
| Rescuer 1 gives ventilations while Rescuer 2 gives chest compressions.
2. An additional rescuer arrives with the AED. CPR continues until the AED pads are placed on the victim and it
is ready to begin analyzing.
| Rescuer 3:
● Turns on the AED and follows the prompts.
● Attaches the pads to the victim’s bare chest.
● Plugs in the connector, if necessary.
● Says, “Everyone, stand clear!”
● Pushes the “Analyze” button, if necessary.
● If a shock is advised, delivers the shock by pressing the “Shock” button, if necessary.
3. After the shock or if no shock is advised, Rescuers 1, 2 and 3 perform about 2 minutes of CPR.
4. An additional rescuer arrives with the BVM and assists with care.
| Rescuer 4 assembles the BVM, if necessary. Administer emergency oxygen if trained to do so.
| Rescuer 1 places and seals the mask of the BVM and maintains an open airway.
| Rescuer 4 provides ventilations by squeezing the bag.
| Rescuer 2 performs compressions.
● If the victim vomits:
■ Rescuers quickly roll the victim onto the side.
■ After vomiting stops, a rescuer on the side of the victim clears the victim’s mouth using a finger
sweep and suction, if necessary.
■ Turn the victim onto the back and continue providing care.
● If ventilations do not make the chest clearly rise:
■ Rescuer 1 re-tilts the head.
■ Rescuer 3 attempts 1 ventilation.
● If ventilation attempt still does not make the chest clearly rise:
■ Rescuer 2 gives 30 chest compressions.
■ Rescuer 3 looks inside the mouth and removes any visible large debris from the mouth using a
finger sweep and suction, if necessary.
| Rescuer 4 replaces the mask.
| Rescuer 1 opens the airway and seals the mask.
| Rescuer 4 provides ventilations.
| Rescuer 2 performs compressions.
LGI_SecB_p099-113.indd 113 10/24/11 1:28 PM

LESSON 7
FIRST AID
LESSON OBJECTIVES
■ Demonstrate how to perform a secondary assessment.
■ Identify how to recognize and care for a victim of sudden illness, injuries and shock.
■ Demonstrate how to control external bleeding.
■ Identify how to recognize and care for a victim of poisoning, heat-related illnesses and cold-related
emergencies.
■ Demonstrate how to immobilize muscle, bone and joint injuries.
■ Demonstrate the ability to work as a team to implement an EAP, perform a secondary assessment and provide
first aid care.
■ Identify possible causes of head, neck or spinal injuries on land.
■ Identify signs and symptoms of head, neck or spinal injuries.
■ Demonstrate how to care for victims with head, neck or spinal injuries on land.
■ Demonstrate how to perform front and rear head-hold escapes.
■ Demonstrate how to give in-water ventilations.
■ Demonstrate how to perform a quick removal of a victim from the water.

■ Non-latex disposable gloves (one pair per participant)
■ Backboards, each equipped with 3 straps and head immobilizers (one backboard for every three participants
is recommended; if fewer backboards are available, additional time may be required)
■ Dressing and bandages (one per every two participants)
TOPIC: REVIEW—SURVEILLANCE Time: 5 minutes

ACTIVITIES
PRESENTATION: REVIEW—SURVEILLANCE ACTIVITIES
Video Segment ■ Explain that you will be giving them an opportunity to see how their surveillance
skills should be used to detect an emergency situation. Explain that they should
watch each video segment and note the problems they see developing.
■ Show the video segment, “Review—Surveillance Activity 2.”
■ Lead a discussion of what they see in each segment.
| Are there any hazards that could cause an injury?
| Does it appear that all the required equipment is available for the
lifeguard?
| Are there any patrons who could be of special concern?
| Are there any rules being broken that could lead to an injury or
emergency situation?
| Are there any customer service issues to be addressed?
| Are there any distracting situations for the lifeguard?
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TOPIC: SECONDARY ASSESSMENT Time: 5 minutes
PRESENTATION: SECONDARY ASSESSMENT
Guided ■ After you have completed a primary assessment and determined that
Discussion there are no life-threatening conditions, perform a secondary
assessment to determine if there are any additional non-life-threatening
conditions that would require you to provide care.
■ Ask participants: What information should you check for when using
SAMPLE to take a brief history related to the injury or illness?
| S = Signs and symptoms
| A = Allergies
| M = Medications
| P = Pertinent past medical history
| L = Last oral intake
| E = Events leading up to the incident
■ Ask participants: What should be included when performing a
secondary assessment?
| Visually inspect the person’s body looking carefully for any bleeding, cuts,
bruises and obvious deformities.
| Look for a medical identification (ID) tag, necklace or bracelet on the person’s
wrist, neck or ankle.
| Check the person’s ability to move body parts. Caution the person to not move
any parts if he or she experiences discomfort or pain. If the person is unable to
move a body part or is experiencing dizziness or pain on movement:
● Help the person rest in a comfortable position.
● Keep the person from getting chilled or overheated.
● Reassure the person.
● Determine whether to summon emergency medical services (EMS)
personnel.
● Continue to watch for changes in the level of consciousness (LOC) and
breathing.
LESSON 7 | First Aid 115
LGI_SecB_p114-132.indd 115 11/2/11 9:33 AM

TOPIC: SUDDEN ILLNESSES Time: 10 minutes
PRESENTATION: SUDDEN ILLNESSES
Video Segment ■ Explain to participants that the video segment will provide important information
regarding sudden illnesses.
■ Show the video segment, “Responding to Sudden Illnesses.”
Lecture ■ In most cases, it is not necessary to know the cause or type of sudden
illness because the care that you provide will be the same with few
exceptions.
■ What are the general steps to take to care for a sudden illness?
Answer: Responses should include the following:
| Care for any life-threatening conditions first.
| Monitor the victim’s condition and watch for changes in LOC.
| Keep the victim comfortable and reassure him or her.
| Keep the victim from getting chilled or overheated.
| Do not give the victim anything to eat or drink unless the victim is fully
conscious and is not in shock.
| Care for any other problems that develop, such as vomiting.
■ If you think something is wrong, check the victim and look for a medical
ID bracelet or necklace. Do not be afraid to ask questions.
■ Remember that the victim’s condition may worsen rapidly if care is
not provided.
TOPIC: RESPONDING TO INJURIES Time: 45 minutes

PRESENTATION: RESPONDING TO INJURIES
regarding injuries.
■ Show the video segment, “Responding to Injuries.”
Controlling Bleeding
Lecture ■ An injury to soft tissue, such as the skin, fat, or muscle, is called
a wound.
■ The first aid supplies needed to care for most wounds should be carried
in the lifeguard’s hip pack.
■ Closed wounds occur beneath the surface of the skin.
■ Internal bleeding may occur when the skin’s surface is not broken and
damage to soft tissue and blood vessels happens below the surface of
the skin.
■ The four main types of open wounds are abrasion, laceration, avulsion
and puncture.
Skill Practice ■ Pair up participants. One participant will be the lifeguard and the other will be the
victim; they will switch roles for the second scenario.
■ Provide each participant with a pair of non-latex disposable gloves.
LGI_SecB_p114-132.indd 116 11/2/11 9:33 AM

■ Provide a bandage and dressing for each pair of the participants.
■ Guide participants through the steps listed on the Controlling External Bleeding skill
sheet in Chapter 10, First Aid, in the Lifeguarding Manual.
■ Have participants switch roles and repeat the skill practice.
■ Clearly observe each participant’s performance and provide corrective feedback.
Shock
Lecture ■ Any serious injury or illness can cause the condition known as shock.
■ Shock is a natural reaction by the body. It usually signals that the victim’s
condition is serious.
■ Signs and symptoms of shock include:
| Restlessness or irritability.
| Altered LOC.
| Pale or ashen, cool, moist skin.
| Nausea or vomiting.
| Rapid breathing and pulse.
| Excessive thirst.
■ To minimize the effects of shock:
| Make sure that EMS personnel have been summoned.
| Monitor the victim’s condition and watch for changes in LOC.
| Control any external bleeding.
| Keep the victim from getting chilled or overheated.
| Have the victim lie flat on his or her back.
| Cover the victim with a blanket to prevent loss of body heat. Do not
overheat the victim—your goal is to maintain a normal body
temperature.
| Comfort and reassure the victim until EMS personnel take over.
| Administer emergency oxygen, if available and trained to do so.
■ Do not give food or drink to a victim of shock, even if the victim asks for
them.
Common Injuries
Activity ■ Explain that Chapter 10, First Aid, of the Lifeguarding Manual is a resource for first
aid care for many specific types of injuries.
■ Divide the participants into small groups. Assign each group one of the following
types of injury:
| Nosebleeds
| Mouth and Teeth Injuries (No Head, Neck or Spinal Injury Suspected)
| Knocked-Out Tooth
| Animal or Human Bites
| Insect Stings
| Burns
■ Ask participants to research and report their findings to the class as to what care
should be provided for their assigned type of injury.
■ Allow up to 3 to 5 minutes for the group work. Circulate among groups to monitor
progress and provide assistance when necessary.
■ Re-assemble the class and call on group leaders to share the group’s findings.
LGI_SecB_p114-132.indd 117 10/13/11 11:38 AM

Injury or Illness Care Steps
Nosebleeds ■ Have the victim sit leaning slightly forward to prevent swallowing or choking on
the blood.
■ Pinch the nostrils together for about 5 to 10 minutes or until the bleeding stops.
■ After the bleeding stops, have the victim avoid rubbing, blowing or picking the nose.
■ Medical attention is needed if the bleeding persists or recurs or if the victim says the
nosebleed was a result of high blood pressure.
■ If the victim loses consciousness, place the victim on his or her side to allow blood to
drain from the nose. Summon EMS personnel immediately.
Mouth and Teeth ■ Rinse the victim’s mouth with cold tap water, if available.
Injuries (No ■ Have the victim lean slightly forward or place the victim on his or her side to
Head, Neck or prevent the victim from swallowing the blood, which could cause nausea
Spinal Injury
or vomiting.
Suspected)
■ Apply a dressing.
Knocked-Out ■ Rinse the victim’s mouth with cold tap water, if available.
Tooth ■ Have the victim bite down on a rolled sterile dressing in the space left by the tooth
(or teeth).
■ Save any displaced teeth.
■ Carefully pick up the tooth by the crown (white part), not the root.
■ Rinse off the root of the tooth in water if it is dirty. Do not scrub it or remove any
attached tissue fragments.
■ Place the tooth in milk. If milk is not available, place the tooth in clean water and
keep it with the victim.
■ Advise the victim to get to a dentist with the tooth as soon as possible.
Animal or Human ■ Summon EMS personnel if the wound bleeds severely or if the animal is suspected
Bites to have rabies.
■ For severe bleeding, control the bleeding first. Do not clean the wound. It will be
properly cleaned at the hospital.
■ If the bleeding is minor:
| Wash the wound with large amounts of clean water.
| Control the bleeding.
| Cover with a sterile bandage.
Burns ■ Stop the burning by removing the person from the source of the burn.
■ Cool the burned area with large amounts of cold tap water at least until pain is
relieved.
■ Cover the burned area loosely with a sterile dressing.
■ Take steps to minimize shock, such as by keeping the victim from getting chilled or
overheated.
■ Comfort and reassure the victim.
LGI_SecB_p114-132.indd 118 12/13/11 3:49 PM

Poisoning
Lecture ■ To determine how to care for a victim of poisoning:
| Call Poison Control Center at 1-800-222-1222.
| Refer to the Material Safety Data Sheet (MSDS) for information
regarding the poisonous substances used at your facility if exposure
to one of these is believed to be the cause.
| If the victim was exposed to a chemical poison at your facility and is
showing signs of life-threatening conditions, send the MSDS with the
victim to the doctor or the hospital.
■ To care for a victim of an inhaled poison:
| Size-up the scene to be sure it is safe for you to help the victim.
| Summon EMS personnel.
| Move the victim to fresh air.
| Care for life-threatening conditions.
| Monitor the victim’s condition and watch for changes in the LOC.
| If conscious, keep the victim comfortable.
■ To care for a victim of an absorbed poison:
| Remove exposed clothing and jewelry and immediately rinse the
exposed area thoroughly with water for 20 minutes, using a shower
or garden hose if possible.
| If a rash or wet blisters develop, advise the victim to see his or her
health care provider.
| If the condition spreads to large areas of the body or face, have the
victim seek medical attention.
Heat-Related Illnesses
Guided ■ Ask participants: What is the least serious type of heat-related illness?
Discussion Answer: Heat cramps
■ Ask participants: What are some signs that a person has progressed to the
stage of heat exhaustion?
| Cool, moist, pale, ashen or flushed skin
| Headache, nausea, dizziness
| Weakness, exhaustion
| Heavy sweating
■ Ask participants: What care should be provided for a person experiencing
heat stroke?
| Summon EMS personnel.
| Move the victim to a cool place.
| Loosen tight clothing and remove perspiration-soaked clothing.
| Cool the victim by spraying with cool water or applying cool, wet towels to the
skin.
| Fan the victim.
| Encourage the victim to drink small amounts of a commercial sports drink,
milk or water if the victim is conscious and able to swallow.
LGI_SecB_p114-132.indd 119 12/15/11 2:36 PM

Cold-Related Emergencies
Lecture ■ It does not have to be very cold for someone to suffer a cold-related
emergency. Cold water, air temperature and windy conditions can
contribute to hypothermia.
■ The victim’s skin color may appear waxy, cold to the touch or discolored
(flushed, white, yellow or blue).
■ It is important to dry off the victim. Remove wet clothing and warm the
victim gradually.
■ The victim’s heart rate may be slowed. If the victim is unconscious and
you are performing a primary assessment, check for a pulse for 30 to
45 seconds.
Injuries to Muscles, Bones and Joints

Guided ■ Ask participants: What are the four types of injuries that can occur to
Discussion muscles, bones and joints?
| Fracture—A complete break, a chip or a crack in a bone. Fractures can be open
or closed.
| Dislocation—Displacement of a bone away from its normal position at a joint.
| Sprain—Tearing of ligaments at a joint.
| Strain—Stretching and tearing of muscles or tendons.
Splinting
Skill Practice ■ Refer participants to the skill sheet in Chapter 10, First Aid, in the Lifeguarding
Manual and have them bring their book to the practice area.
■ Pair up participants and provide each participant with a pair of disposable gloves.
■ For every pair of participants you will need:
| Two triangular bandages for the arm injury skill.
| Four triangular bandages for the leg injury skill.
| Three triangular bandages and one large towel or blanket for the foot injury skill.
■ Guide participants through the steps listed on the skill sheet for an arm injury and
either the leg or the foot injury.
■ Have participants switch roles and repeat the skills.
■ Observe each participant’s performance and provide corrective feedback.
TOPIC: PUTTING IT ALL TOGETHER— Time: 20 minutes

FIRST AID SCENARIOS
PRESENTATION: FIRST AID SCENARIOS
Activity ■ Tell participants that they will now participate in two first aid scenarios that will
require them to perform a secondary assessment.
■ Explain that they will work in groups of three for each scenario. Some of the
scenarios require one lifeguard, a child victim and a parent whereas others assume
that two lifeguards are providing care to one victim.
■ Assign the scenarios randomly, such as through a drawing. A total of six scenarios
are provided. It is acceptable for more than one group to complete the same scenario.
■ Allow a few minutes for those playing the role of victim to review the signs and
symptoms of the condition assigned using the Lifeguarding Manual.
■ Explain that lifeguards should perform a secondary assessment and provide care for
the conditions found.
LGI_SecB_p114-132.indd 120 12/13/11 3:49 PM

■ Be sure to have the appropriate equipment and supplies available for use in the
scenarios, including personal protective equipment (PPE) and first aid supplies.
■ After they have completed two scenarios, re-assemble the group and discuss the
activity. Each group should:
| Explain the scenario.
| Describe initial steps taken, such as calling for backup coverage, if necessary.
| Describe the injury or illness, including signs and symptoms.
| Explain the care steps provided, including summoning EMS personnel, if
appropriate.
| Explain any follow-up instructions given to the victim.
Scenario 1: You are on duty lifeguarding at an outdoor pool. A child comes to you saying that she was
just in the concession area eating a snack when she was stung by a bee. Her parent is swimming laps
in the adult lap swim lane.
Initial Steps ■ Signal to obtain backup coverage for your zone.
■ Get the attention of the child’s parent and obtain consent.
■ Ask if the child has a known allergy to bee stings.
Signs and Symptoms ■ Pain

■ Redness or swelling
■ Possible presence of a stinger
■ Signals of an allergic reaction:
| Rash or hives
| Feeling of tightness in the chest and throat
| Shortness of breath
| Swelling of the face, neck or tongue
Care Steps ■ Examine the sting site to see if the stinger is in the skin. If it is still present,
remove the stinger by scraping it away with the edge of a plastic card, such as a
credit card.
■ Wash the wound with soap and water.
■ Cover the site with a dressing and keep the wound clean.
■ Apply a cold pack to the site to reduce pain and swelling.
■ Watch the victim for signals of an allergic reaction.
■ Monitor the victim’s condition and look for changes in LOC.
■ Keep the victim comfortable.
■ Summon EMS personnel for any life-threatening conditions, such as a
breathing emergency.
Follow-Up ■ Have the child remain in the first aid area for a few minutes and watch the child for
signs of an allergic reaction.
■ Tell the child and parent to alert a lifeguard or other staff member if symptoms get
worse.
Scenario 2: You are on break when an adult tells you that his friend is not feeling well and needs
help. The patron tells you that he is wearing a diabetic ID bracelet.

Initial Steps ■ Obtain consent from the patron who is not feeling well.
Signs and Symptoms ■ The patron told you he is not feeling well and his medical ID bracelet tells you of
the condition.
LGI_SecB_p114-132.indd 121 12/13/11 3:49 PM

Care Steps ■ If the person is conscious and can safely swallow fluids or food, give him sugar.
Give glucose paste, tablets or sugar in liquid form (e.g., 12 oz of orange juice), milk
or nondiet soft drink, or table sugar, either dry or dissolved in a glass of water.
■ Summon EMS personnel if:
| The person is unconscious or about to lose consciousness.
| The person is conscious but unable to swallow.
| The person does not feel better within about 5 minutes after taking the sugar.
| A sugar source cannot be found immediately. Do not spend time looking for it.
Follow-Up ■ Ask the patron to remain there until he clearly feels better, at least 5 minutes.
■ Tell the person to alert a lifeguard or staff member if symptoms recur.
Scenario 3: You are on a break in the lifeguard room. Through the window, you notice a patron on
the deck who appears to be having a seizure.
Initial Steps ■ Activate the EAP.
Signs and Symptoms ■ May last 1 to 3 minutes and can produce a wide range of signs and symptoms
■ May lose consciousness and fall
■ May become rigid and then experience sudden, uncontrollable muscular
convulsions lasting several minutes
■ Breathing may become irregular and even stop temporarily
Care Steps ■ Protect the person from injury by moving nearby objects away from the person.
■ Position the person on his or her side, if possible, after the seizure passes so that
fluids (saliva, blood, vomit) can drain from the mouth.
■ Check to see if the person was injured during the seizure.
Follow-Up ■ Stay with the person until he or she is fully conscious and aware of his or her
surroundings.
■ Offer to let the person remain in a first aid area to rest.
Scenario 4: You are hosing down a section of the deck as part of your secondary responsibilities. A
regular patron approaches and tries to ask you a question. Her speech seems impaired and you
cannot understand what she is saying.

■ Obtain consent if able to do so.
Signs and Symptoms ■ Sudden change in how the body is working or feeling, such as sudden weakness or
numbness of the face, an arm or a leg; often only on one side of the body
■ Difficulty with speech (trouble speaking and being understood and difficulty
understanding others)
■ Blurred or dimmed vision
■ Sudden, severe headache; dizziness; or confusion
■ Loss of balance or coordination
■ Trouble walking
■ Ringing in the ears
LGI_SecB_p114-132.indd 122 12/13/11 3:49 PM

Care Steps ■ Summon EMS personnel immediately.
■ Think FAST:
| Face—Ask the person to smile. This will show if there is drooping or weakness
in the muscles on one side of the face. Does one side of the face droop?
| Arm—Ask the person to raise both arms to find out if there is weakness in the
limbs. Does one arm drift downward?
| Speech—Ask the person to speak a simple sentence to listen for slurred or
distorted speech. Example: “The sky is blue.” Can the victim repeat the sentence
correctly?
| Time—Note the time that the signs and symptoms began and summon EMS
personnel immediately.
Follow-Up ■ Comfort and reassure the person until EMS personnel arrive.
■ Collect any of the person’s belongings and give to EMS.
Scenario 5: You are on duty as a lifeguard. Your guard station is on the deck at the shallow end of the
pool. An adult is exiting the pool using the ladder, then slips and hits his mouth on the railing. When
you approach the victim, you notice that he is missing a tooth, which he holding in his hand, and
bleeding from the mouth.
Signs and Symptoms ■ Tooth is missing and he has it in his possession

■ Bleeding from the area
Care Steps ■ Rinse the victim’s mouth with cold tap water, if available.
■ Have the victim bite down on a rolled sterile dressing in the space left by the tooth.
■ Save the displaced tooth.
■ Carefully pick up the tooth by the crown (white part), not the root.
■ Rinse off the root of the tooth in water if it is dirty. Do not scrub it or remove any
attached tissue fragments.
■ Place the tooth in milk. If milk is not available, place the tooth in clean water and
keep it with the victim.
Follow-Up ■ Advise the victim to get to a dentist with the tooth as soon as possible.
Scenario 6: You are on break when a concession worker comes to you and tells you help is needed.
Another concession worker has been burned by hot oil from the popcorn machine.
Initial Steps ■ Obtain consent.
Signs and Symptoms ■ Burned area on an arm and hand—red skin with blisters beginning to form
Care Steps ■ Stop the burning by removing the person from the source of the burn.
■ Cool the burned area with large amounts of cold tap water at least until pain is
relieved.
■ Cover the burned area loosely with a sterile dressing.
■ Take steps to minimize shock, such as by keeping the victim from getting chilled or
overheated.
■ Comfort and reassure the victim.
Follow-Up ■ Advise the person to follow up with a doctor.
LGI_SecB_p114-132.indd 123 12/13/11 3:49 PM

TOPIC: CARING FOR HEAD, NECK AND Time: 10 minutes
SPINAL INJURIES ON LAND
PRESENTATION: CARING FOR HEAD, NECK AND SPINAL INJURIES ON LAND
Guided ■ When deciding whether a person may have a head, neck or spinal injury,
Discussion first think about what caused the injury.
■ Head, neck or spinal injuries can happen on land or in the water.
■ In aquatic environments, examples of injuries on land include:
| Tripping or falling on a pool deck.
| Slipping in a locker room.
| Falling from greater than a standing height
| Falling off pool features, such as a diving board ladder.
■ Ask participants: What signs and symptoms might indicate a possible head,
neck or spinal injury?
| Unusual bumps, bruises or depressions on the head, neck or back
| Heavy external bleeding of the head, neck or back
| Bruising of the head, especially around the eyes and behind the ears
| Blood or other fluids in the ears or nose
| Seizures
| Changes in level of consciousness
| Impaired breathing or vision
| Nausea or vomiting
| Partial or complete loss of movement of any body area
| Loss of balance
| Victim holds the head, neck or back
| Behavior resembling intoxication
| Severe pain or pressure in the head, neck or back
| Back pain, weakness, tingling or loss of sensation in the hands, fingers, feet or toes
| Persistent headache
Video Segment ■ Explain to participants that the video segment demonstrates backboarding a victim
of a spinal injury on land.
■ Show the video segment, “Head, Neck and Spinal Injuries on Land.”
Skill Practice— ■ Explain to participants that during the skill session you will demonstrate skills and
On Land guide them through practice.
■ Pair up participants for the first skill and explain that they will take turns as victim
and lifeguard. For the second skill, divide participants into groups of four—three are
in the role of lifeguards and one as a victim.
■ For each skill, organize them so that they can clearly see and hear. Be sure to provide
any instructions related to their position in the water or how they should behave as
victims.
■ Lead them through the following skills:
| Caring for a nonstanding victim
| Caring for a standing victim
■ Participants should practice the skills until they are able to meet performance criteria.
LGI_SecB_p114-132.indd 124 12/15/11 2:38 PM

TOPIC: WHEN THINGS DO NOT GO Time: 5 minutes
AS PRACTICED
PRESENTATION: WHEN THINGS DO NOT GO AS PRACTICED
regarding the techniques to use when things do not go as practiced. The skills in this
video will be practiced later in the water. They include:
| Front and rear head-hold escapes.
| Quick removal from shallow water for a small victim.
| In-water ventilations.
■ Refer participants to the skill sheets in Chapter 6, Rescue Skills, in the Lifeguarding
Manual.
■ Show the video segment, “When Things Do Not Go as Practiced.”
IN-WATER SKILL SESSION—WHEN THINGS Time: 30 minutes

DO NOT GO AS PRACTICED
Activity ■ Explain to participants that during the skill session you will demonstrate skills and
guide them through practice.
■ Pair up participants and explain that they will take turns as a victim and a rescuer for
each skill.
■ For each skill, organize them so that they can clearly see and hear. Be sure to provide
any instructions related to their position in the water or how they should behave as
victims.
| Front head-hold escape
● Lifeguards: deep water, facing victim
● Victims: deep water
| Rear head-hold escape
● Lifeguards: deep water, back to victim
● Victims: deep water
| In-water ventilations—shallow water
● Lifeguards: standing in shallow water
● Victims: passive
| In-water ventilations—deep water
● Lifeguards: treading in deep water
● Victims: passive
■ For the Shallow Water Lifeguarding course, participants will practice the front and
rear head-hold escapes in shallow water.
■ Omit the in-water ventilations—deep water when teaching the Shallow Water
■ Participants should practice the skills until they are able to meet performance
criteria.
LGI_SecB_p114-132.indd 125 12/15/11 2:38 PM

IN-WATER SKILL SESSION—RESCUE Time: 30 minutes
SKILLS REVIEW
Activity ■ Designate three stations for review skills and divide participants into three groups.
Count off participants as “ones” and “twos” so that you can easily assign roles at each
station and for each skill practice.
■ Participants will practice the rescues as many times as possible in about a 5-minute
period.
■ Rotate groups every 5 to 7 minutes.
■ Observe participants and provide feedback.
■ Stations:
| Shallow Water
● Simple Assist for a Distressed Swimmer
● Submerged Passive Victim
● Reaching Assist from the Deck for a Distressed Swimmer
| Deep Water
● Active Victim on the Surface—Front Approach
● Passive Victim on the Surface—Rear Approach
| Deep Water
● Two-Person Removal Using a Backboard
■ For the Shallow Water Lifeguarding course, designate three stations for review skills
and divide participants into three groups.
■ Participants will practice the rescues as many times as possible in about a 5-minute
period.
■ Rotate groups every 5 to 7 minutes.
■ Stations:
| Passive Victim
● Passive Victim on the Surface—Rear Approach
● Two-Person Removal Using a Backboard
| Distressed Swimmer
● Simple Assist for a Distressed Swimmer
● Reaching Assist from the Deck for a Distressed Swimmer
| Active Victim
● Active Victim on the Surface—Front Approach
● Active Victim on the Surface—Rear Approach
● Multiple Active Victim Rescue
ASSIGNMENT
■ Remind participants to prepare for the final written exam on CPR/AED and first aid
by reviewing Chapters 7 through 10.
■ Read Chapter 11, Caring for Head, Neck and Spinal Injuries, of the Lifeguarding
Manual before the next class session.
LGI_SecB_p114-132.indd 126 12/15/11 2:38 PM

SECONDARY ASSESSMENT
SKILL CHART: USING SAMPLE TO TAKE A BRIEF MEDICAL HISTORY
Take a brief history using SAMPLE:

1. Signs and symptoms:
| What happened?
| Where do you feel any pain or discomfort?
| Do you have any numbness or loss of sensation? If so, where?
2. Allergies:
| Do you have any allergies, such as to medications or food? If so, what type of reactions have you
experienced when you were exposed?
3. Medications:
| Do you have any medical conditions or are you taking any medications? If so, what conditions do you
have or what medications are you taking?
| Have you taken any medications in the past 12 hours?
4. Pertinent past medical history:
| Have you recently been ill?
| Do you have any medical conditions?
| Have you experienced any recent falls, accidents or blows to the head?
| Have you had surgery, been in a traumatic accident or had a medical emergency?
5. Last oral intake:
| When did you last eat or drink?
| What did you last eat or drink?
6. Events leading up to the incident:
| What were you doing before the incident occurred?
| What were you doing when the incident occurred?
SKILL CHART: CHECKING A CONSCIOUS PERSON
1. Check the head.

| Look at the scalp, face, ears, eyes, nose and mouth for cuts, bumps, bruises and depressions.
| Note if the victim has any changes in the level of consciousness, such as dizziness, or feels light-headed.
2. Check skin appearance and temperature.
| Feel the victim’s forehead with the back of your hand and note if the skin is cold or hot.
| Look at the coloring of the victim’s face and lips.
| Look at the victim’s skin and note if the skin is moist or dry or if it is red, pale, flushed or ashen.
3. Check the neck.
| Ask the victim to move his or her head from side to side if there is no discomfort and if an injury to the
neck is not suspected.
| Note pain, discomfort or inability to move.
4. Check the shoulders.
| Ask the victim to shrug his or her shoulders.
LGI_SecB_p114-132.indd 127 12/15/11 3:08 PM

5. Check the chest and abdomen.
| Ask the victim to take a deep breath and blow air out.
| Listen for difficulty or changes in breathing.
| Ask the victim if he or she is experiencing pain during breathing.
6. Check the arms.
| Check one arm at a time.
| Ask the victim to move his or her hand and fingers and to bend the arm.
7. Check the legs.
| Check one leg at a time.
| Ask the victim to move his or her foot and toes and to bend the leg.
8. Provide care for any conditions found.
9. Have the victim rest in a comfortable position if he or she can move all body parts without pain or discomfort
and has no other apparent signs or symptoms of injury or illness. Continue to watch for changes in
consciousness and breathing.
SKILL ASSESSMENT TOOL: USING SAMPLE TO TAKE A BRIEF MEDICAL HISTORY
Ask questions to determine a brief Gathers information about what ■ Does not ask any questions
history happened, possible signs and ■ Does not ask questions about
symptoms or brief medical history what happened, possible signs
and symptoms or brief
medical history
Checking a Conscious Person
Check for signs and symptoms of Visual inspection from head to toe ■ Does not perform an
injuries or sudden illnesses looking carefully for any bleeding, assessment
cuts, bruises and obvious ■ Does not recognize obvious
deformities signs or symptoms
Check for medical conditions that Visual inspection looking for a Does not look for medical ID tag,
may need to be considered medical ID tag, necklace or bracelet necklace or bracelet
Monitor the person’s condition Watches for changes in Does not look at victim
consciousness or breathing
CONTROLLING EXTERNAL BLEEDING
SKILL CHART: CONTROLLING EXTERNAL BLEEDING
To control external bleeding:

1. Cover the wound with a dressing, such as a sterile gauze pad.
2. Apply direct pressure firmly against the wound until bleeding stops.
3. Cover the dressing with a roller bandage and secure it directly over the wound.
4. Check for circulation beyond the injury (check for pulse, skin temperature and feeling).
If the bleeding does not stop:

■ Apply additional dressings and bandages on top of the first ones and continue to apply direct pressure.
■ Take steps to minimize shock.
■ Summon EMS personnel.
■ Follow local protocols when considering other methods of bleeding control, such as applying a tourniquet.
LGI_SecB_p114-132.indd 128 12/13/11 3:49 PM

SKILL ASSESSMENT TOOL: CONTROLLING EXTERNAL BLEEDING
Use personal protective equipment Puts on disposable gloves before ■ Does not put on disposable
covering wound gloves
■ Puts on disposable gloves after
covering wound
Cover the wound with a (sterile) ■ Places dressing over wound ■ Places dressing away from
dressing and apply direct pressure ■ Applies pressure to wound wound area
until bleeding stops ■ Does not apply pressure
■ Secures dressing in place with
roller gauze ■ Uses pressure points instead
of direct pressure
■ Roller gauze does not stay in
place
Apply additional dressings and ■ Adds additional dressings to ■ Removes initial dressing
more direct pressure (if bleeding initial dressing ■ Does not add additional
does not stop) ■ Applies pressure to wound dressings
■ Does not apply pressure
SPLINTING
SKILL CHART: ARM INJURIES
1. Leave the arm in the position in which it was found or in the position in which the victim is holding it.
2. Place a triangular bandage under the injured arm and over the uninjured shoulder to form a sling.
3. Tie the ends of the sling at the side of the neck. Place gauze pads under the knots to make it more comfortable
for the victim.
4. Secure the arm to the chest with a folded triangular bandage.
SKILL CHART: LEG INJURIES
1. Place several folded triangular bandages above and below the injured body area.
2. Place the uninjured leg next to the injured leg.
3. Tie triangular bandages securely with knots.
SKILL CHART: FOOT INJURIES
1. Place several folded triangular bandages above and below the injured area.
2. Gently wrap a soft object (pillow or folded blanket) around the injured area.
3. Tie bandages securely with knots.
SKILL CHART: RIB AND BREASTBONE INJURIES
1. Place a pillow or folded towel between the victim’s injured ribs and arm.
2. Bind the arm to the body to help support the injured area.
SKILL CHART: HAND AND FINGER INJURIES
1. For a hand injury, place a bulky dressing in the palm of the victim’s hand and wrap with a roller bandage.
2. For a possible fractured or dislocated finger, tape the injured finger to the finger next to it.
SKILL ASSESSMENT TOOL: SPLINTING
Immobilize the injured part Secures splint with sufficient Secures splint with insufficient
tension to prevent injured part from tension—injured part can move
moving more than 1 inch from more than 1 inch from splinted
splinted position position
LGI_SecB_p114-132.indd 129 12/13/11 3:49 PM

Ensure the splint is not too tight ■ Secures splint without causing ■ Secures splint causing skin to
(except for a sling) skin to discolor or become cool discolor
to touch or creating a tingling ■ Secures splint causing skin to
sensation beyond the injury become cool to the touch
■ Checks pulse, skin temperature ■ Secures splint creating a
and feeling tingling sensation beyond the
injury
■ Does not check pulse, skin
temperature and feeling
CARING FOR HEAD, NECK OR SPINAL INJURY ON LAND
SKILL CHART: CARING FOR A STANDING VICTIM WHO HAS A SUSPECTED HEAD,
NECK OR SPINAL INJURY ON LAND
1. Lifeguard 1 approaches the victim from the front and performs manual stabilization of the victim’s head and
neck by placing one hand on each side of the head.
2. Lifeguard 2 retrieves a backboard and places it against the victim’s back, being careful not to disturb
stabilization of the victim’s head. Lifeguard 3 helps to position the backboard so that it is centered behind
the victim.
3. While Lifeguard 3 holds the backboard, Lifeguard 2 secures the victim to the backboard by placing and
securing straps across the victim’s chest, under the armpits, and across the hips and thighs. Lifeguard 2
rechecks the straps to be sure that they are secure, then secures the victim’s head to the backboard using a
head immobilizer and strap across the victim’s forehead.
4. The lifeguards at the victim’s side each place their inside hands underneath the victim’s armpit, in between
the victim’s arm and torso, and grasp the backboard at a handhold at the victim’s armpit level or higher.
5. When the victim is secured to the board, the other lifeguard grasps the top. Lifeguard 1 informs the victim
that they will lower him or her to the ground. When ready, signal to the other two lifeguards to begin. While
lowering the victim, the lifeguards at the victim’s sides should walk forward and bend at the knees to avoid
back injury.
If the position of head immobilizer cannot be adjusted to the height of a victim, consider one of
the following options:
■ Place the blocks on either side of the victim’s head flush against the backboard. Place an additional strap
across the victim’s forehead.
| If this is not possible, have another lifeguard provide manual stabilization from the head of the board. At
the beginning, this lifeguard stands behind the board and reaches around to provide stabilization. As the
board is lowered, this lifeguard steps back, while maintaining stabilization, until the board is on the
ground.
■ If the victim is taller than the backboard, place an object, such as a folded blanket or towel, under the foot of
the backboard so that the victim’s head does not extend beyond the end of the board.
SKILL CHART: MANUAL STABILIZATION FOR A NONSTANDING VICTIM OF A

HEAD, NECK OR SPINAL INJURY ON LAND
1. Minimize movement by placing your hands on both sides of the victim’s head.
2. Support the head in the position found.
| Do not align the head and neck with the spine if the head is sharply turned to one side, there is pain on
movement or if you feel any resistance when attempting to align the head and neck with the spine.
3. Maintain an open airway.
4. Keep the victim from getting chilled or overheated.
Note: Gently position the victim’s head in line with the body if you cannot maintain an open airway.
LGI_SecB_p114-132.indd 130 12/19/11 10:10 AM

SKILL ASSESSMENT TOOL: CARING FOR A STANDING VICTIM WHO HAS A
SUSPECTED HEAD, NECK OR SPINAL INJURY ON LAND
Maintain stabilization Primary lifeguard maintains ■ Loss of stabilization during the

stabilization while backboard is rescue
being positioned ■ Loss of contact with the victim
■ Lack of communication
between lifeguards as needed
Position the backboard behind the ■ Backboard is placed to support ■ Victim’s head is not supported
victim the victim’s head, neck and body against the backboard
■ Backboard is against the ■ Victim is not aligned and
victim’s body against the backboard
Secure straps ■ Strapping begins with chest ■ Strapping is done in some

strap, then the strap over the other order
hips and then the strap over the ■ Hands are not strapped inside
thighs the strap
■ Hip strap is placed across the ■ Straps are loose and victim
hips with the hands secured can easily fall
underneath the strap
■ Straps are tight and once all ■ Straps are not re-checked for
straps are secured, they are re- tightness
checked ■ Straps are not tightened if
loose
Immobilize the victim’s head ■ Head immobilizer is placed to ■ Head immobilizer is not used
(Options described on page 130 are immobilize the victim’s head ■ Head immobilizer is placed
permitted if the head immobilizer ■ Head strap is secured across the and moves victim’s head or
cannot be adjusted to the height of victim’s forehead neck
the victim.)
■ No strap is used across the
victim’s forehead
Lower the victim to the ground ■ Lifeguards communicate what, ■ No verbal communication
how or when actions happen ■ Communication does not
■ Backboard is lowered carefully result in effective actions
to the ground ■ Backboard is dropped
■ Victim falls
SKILL ASSESSMENT TOOL: MANUAL STABILIZATION FOR A NONSTANDING
VICTIM OF A HEAD, NECK OR SPINAL INJURY ON LAND
Stabilize the victim’s head ■ Places one hand on each side of ■ Places only one hand on the
the victim’s head and applies side of victim’s head
gentle pressure ■ Does not stabilize the head
■ Victim’s head remains in the ■ Moves the victim’s head in line
position found with body
LGI_SecB_p114-132.indd 131 12/15/11 2:36 PM

WHEN THINGS DO NOT GO AS PRACTICED
SKILL CHART: FRONT HEAD-HOLD ESCAPE
1. As soon as the victim grabs hold, take a quick breath, tuck your chin down, turn your head to either side, raise
your shoulders and submerge with the victim.
2. Once under water, grasp the victim’s elbows or the undersides of the victim’s arms just above the elbows.
Forcefully push up and away. Keep your chin tucked, your arms fully extended and your shoulders raised
until you are free.
3. Quickly swim under water, out of the victim’s reach. Surface and reposition the rescue tube and try the rescue
again.
SKILL CHART: REAR HEAD-HOLD ESCAPE
1. Take a quick breath, tuck your chin down, turn your head to either side, raise your shoulders and submerge
with the victim.
2. Once under water, grasp the victim’s elbows or the undersides of the victim’s arms just above the elbows.
Forcefully push up and away while twisting your head and shoulders. Keep your chin tucked, your arms fully
extended and your shoulders raised until you are free.
3. Quickly swim under water out of the victim’s reach. Surface and reposition the rescue tube and try the rescue
again.
SKILL ASSESSMENT TOOL: ESCAPES
Lifeguard releases the victim’s hold Lifeguard presses victim’s arms up Does not release the victim’s hold
and pushes victim away
Lifeguard swims away to safety Lifeguards swims under water to a Victim grabs rescuer again
safe distance from the victim
Lifeguard re-attempts the rescue Lifeguard repositions the rescue Does not re-attempt a rescue
tube and attempts to rescue the
victim again
IN-WATER VENTILATIONS
SKILL CHART: IN-WATER VENTILATIONS
1. Ensure that the rescue tube is placed under the victim so the victim’s head naturally falls back to an open-
airway position.
2. From behind the victim’s head, position the resuscitation mask, seal the mask and open the airway.
3. Give ventilations.
4. Remove the victim from the water as soon as conditions allow, then immediately resume providing care.
Instructor’s note: Remind participants not to give ventilations but rather to simulate ventilations on
their partner.
SKILL ASSESSMENT TOOL: IN-WATER VENTILATIONS
Open the airway Performs a jaw-thrust maneuver Does not open the airway by using
a jaw-thrust maneuver
Seal mask and give Properly seals mask and simulates ■ Mask is not properly sealed
simulated ventilations ventilations ■ Simulated ventilations are
not given
LGI_SecB_p114-132.indd 132 12/19/11 10:10 AM

LESSON 8
HEAD, NECK AND SPINAL
INJURIES IN THE WATER
¡ Shallow Water Lifeguarding Session Length: 2 hours, 30 minutes
LESSON OBJECTIVES
■ Demonstrate how to care for victims with head, neck and spinal injuries in shallow and deep water.
■ Demonstrate how to care for victims with head, neck and spinal injuries in shallow water only.
(Shallow Water Lifeguarding)

■ Final Written Exam: Section 1, Exams A and B, and answer sheets (one for each participant)
■ Answer keys for Final Written Exam: Section 1
■ Non-latex disposable gloves (one pair per participant)
■ Rescue tubes (one for every three participants)
■ Backboards, each equipped with 3 straps and head immobilizers (one backboard for every three participants
is recommended; if fewer backboards are available, additional time may be required)
FINAL WRITTEM EXAM: SECTION 1— Time: 40 minutes

CPR/AED FOR THE PROFESSIONAL
RESCUER AND FIRST AID
Activity ■ Tell participants that they will now take Section 1 of the final written exam on the
information covered in Lessons 5, 6 and 7. They may not use their manual or notes to
find the answers.
■ Hand out an exam and answer sheet to each participant. Tell participants to write
only on the answer sheet and mark answers clearly.
■ Tell participants to come to you or raise their hands when they have finished the
exam or if they have questions.
■ Once exams are completed, collect all exams and answer sheets. Before the next
lesson, grade the exam using the answer key.
■ At the beginning of Lesson 9, hand back the exam and review it with participants.
Make arrangements for those participants who score less than 80 percent to review
the material and retake the opposite version of the exam.
LESSON 8 | Head, Neck and Spinal Injuries in the Water 133
LGI_SecB_p133-140.indd 133 12/14/11 8:13 AM

TOPIC: CARING FOR HEAD, NECK AND Time: 10 minutes
SPINAL INJURIES IN THE WATER
PRESENTATION: CARING FOR HEAD, NECK AND SPINAL INJURIES IN THE WATER
Video Segment ■ Show the video segment, “Head, Neck and Spinal Injuries in the Water.”
Lecture ■ Head, neck or spinal injuries often are caused by high-impact/high-risk

activities. In aquatic environments, examples of these activities include:
| Entering head-first into shallow water.
| Entering the water from a height, such as a diving board, water slide,
an embankment, cliff or tower.
| Striking a submerged or floating object.
| Receiving a blow to the head.
| Colliding with another swimmer.
| Striking the water with high impact, such as falling while water
skiing or surfing.
■ When a head, neck or spinal injury is suspected, the goal is to
minimize movement.
■ If you suspect a head, neck or spinal injury, tell the victim to say “yes” or
“no” in response to your questions instead of nodding or shaking his or
her head.
■ Whether on land or in the water, care for life-threatening conditions is
the number one priority. If a spinal injury is suspected and the victim is
not breathing, remove the nonbreathing victim from the water and
resuscitate him or her by the fastest means available. Do not delay
removal from the water by strapping the victim to the board or using a
head immobilizer device.
■ If the victim is in the water and is breathing, immobilize him or her using
a backboard equipped with straps and a head-immobilizer device. This
needs to be done quickly but carefully.
■ The type of care that you provide to a victim with an injury to the head,
neck or spine depends on:
| The victim’s condition, including whether he or she is conscious and
breathing.
| The location of the victim (shallow or deep water, at the surface of
the water, submerged or not in the water).
| The availability of additional help, such as other lifeguards,
bystanders, fire fighters, police or emergency medical services (EMS)
personnel.
| The facility’s specific procedures.
| The air and water temperature.
Team Spinal Backboarding

Lecture ■ Team spinal backboarding requires communication by all lifeguards
involved and an understanding of each person’s role in the process.
■ A minimum of two lifeguards is needed to place and secure a victim on a
backboard, but additional lifeguards also should help, if available.
■ Throughout the backboarding process, you or another lifeguard must
maintain stabilization of the victim’s head and neck.
LGI_SecB_p133-140.indd 134 12/14/11 8:13 AM

■ Rescue tubes can be used to aid in flotation of the backboard. Additional
lifeguards also can assist in keeping the board afloat.
■ Communication with the victim also is important. Let the victim know
what you are doing and reassure him or her along the way. Instruct the
victim to avoid moving his or her head, such as by nodding, when
communicating with you.
■ Once the victim is secured onto the backboard, remove the victim from
the water.
■ After the victim is out of the water, assess his or her condition and
provide the appropriate care. Place a towel or blanket on the victim to
keep him or her warm if needed.
IN-WATER SKILL SESSION: Time: 2 hours, 20 minutes

HEAD, NECK AND
Shallow Water Lifeguarding Time: 1 hour, 40 minutes
SPINAL INJURIES
Shallow Water guide them through practice.
■ For the first three skills, pair up participants and explain that they will take turns as
victim and rescuer for each skill. For the shallow water backboarding procedure,
divide participants into groups of three—two are in the role of lifeguard and one as a
victim. Each group should practice the backboarding procedure at least two times so
that all participants have the opportunity be in the role of lifeguard.
■ For each skill, organize participants so that they can clearly see and hear. Be sure to
provide any instructions related to their position in the water or how they should
behave as victims.
■ Lead them through the following shallow water skills:
| Head splint—face-up victim at or near the surface in shallow water
● Lifeguards: in shallow water
● Victims: face-up in shallow water, responsive
| Head splint—face-down victim at or near the surface in shallow water
● Victims: face-down in shallow water, responsive once face-up at surface
| Head splint—submerged victim in shallow water
● Victims: submerged in shallow water, responsive once face-up at surface
| Spinal backboarding procedure
● Victims: face-down in shallow water, responsive once face-up at surface
■ Participants should practice the skills until they are able to meet
performance criteria.
Deep Water guide them through practice.
■ For the first two skills, pair up participants and explain that they will take turns as
victim and rescuer for each skill. For the deep water backboarding procedure, divide
participants into groups of five—four are in the role of lifeguard and one as a victim.
Each group should practice the backboarding procedure at least two times so that all
participants have the opportunity to be in the role of lifeguard.
LGI_SecB_p133-140.indd 135 12/14/11 8:13 AM

■ Reinforce to them that the mechanics of the skills are essentially the same in deep
water as in shallow water. The skills are more challenging, however, because lifeguards
are unable to stand to accomplish the skills. Rescue tubes can provide support to
lifeguards as well as the victim. Additional lifeguards also can provide assistance.
■ Prior to the spinal backboarding procedure, remind participants that backboards,
straps and head immobilizers may vary at different facilities. When employed as a
lifeguard, they should expect to be trained on the use of the backboard as part of a
new employee orientation and in-service training.
■ Ask participants: What are the steps they will use to secure a victim to a
backboard?
| Position the backboard under the victim.
| Secure the chest strap high into the armpits.
| Secure the hip strap with the hands also secured in the strap.
| Secure the strap across the thighs.
| Place the head blocks next to the head.
| Secure the head blocks with the head strap.
behave as victims.
■ For the Shallow Water Lifeguarding course, omit the skill practice in deep water.
■ However, before giving participants the assignment for the next lesson, ask
participants, What are the steps you will use to secure a victim to a
backboard?
| Position the backboard under the victim.
| Secure the chest strap high into the armpits.
| Secure the hip strap with the hands also secured in the strap.
| Secure the strap across the thighs.
| Place the head blocks next to the head.
| Secure the head blocks with the head strap.
■ Lead them through the following deep water skills:

| Head splint—face-down victim at or near the surface in deep water
● Lifeguards: in deep water
● Victims: face-down in deep water, responsive once face-up at surface
| Head splint—submerged victim in deep water
● Victims: submerged in deep water, responsive once face-up at surface
| Spinal backboarding procedure
● Victims: face-down in deep water, responsive once face-up at surface
■ Participants should practice the skills until they are able to meet performance criteria.
ASSIGNMENT
■ Remind participants to prepare for the final written exam on lifeguarding skills by
reviewing Chapters 1 to 6 and Chapter 11 of the Lifeguarding Manual before the next
class session.
LGI_SecB_p133-140.indd 136 12/14/11 8:13 AM

IN-LINE STABILIZATION—IN-WATER
SKILL CHART: HEAD SPLINT—FACE-UP VICTIM AT OR NEAR THE SURFACE
1. Approach the victim’s head from behind or stand behind the victim’s head.
| In shallow water, lower your body so that the water level is at your neck.
| In deep water, use the rescue tube under both of your arms for support.
2. Grasp the victim’s arms midway between his or her shoulder and elbow. Grasp the victim’s right arm with
your right hand and the victim’s left arm with your left hand. Gently move the victim’s arms up alongside the
head. Position yourself to the victim’s side while trapping the victim’s head with his or her arms.
3. Slowly and carefully squeeze the victim’s arms against his or her head to help hold the head in line with the
body. Do not move the victim any more than necessary.
4. Position the victim’s head close to the crook of your arm, with the head in line with the body.
5. Check for consciousness and breathing.
| If the victim is not breathing, immediately remove the victim from the water using a technique, such as
the two-person-removal-from-the-water, and provide resuscitative care. Do not delay removal from the
water by strapping the victim in or using the head immobilizer.
| If the victim is breathing, hold the victim with the head in line with the body and move toward safety
until the backboard arrives. In deep water, move the victim to shallow water, if possible.
6. Continuously monitor for consciousness and breathing. If at any time the victim stops breathing, immediately
remove the victim from the water and then provide appropriate care.
SKILL CHART: HEAD SPLINT—FACE-DOWN VICTIM AT OR NEAR THE SURFACE
1. Approach the victim from the side.

2. Grasp the victim’s arms midway between the shoulder and elbow. Grasp the victim’s right arm with your right
hand and the victim’s left arm with your left hand. Gently move the victim’s arms up alongside the head.
3. Squeeze the victim’s arms against his or her head to help hold the head in line with the body.
4. Glide the victim slowly forward.
| In shallow water, lower your body to shoulder depth before gliding the victim forward.
| Continue moving slowly and turn the victim until he or she is face-up. To do this, push the victim’s arm
that is closest to you under the water while pulling the victim’s other arm across the surface toward you.
5. Position the victim’s head in the crook of your arm, with the head in line with the body.
water by strapping the victim in or using the head immobilizer device.
LGI_SecB_p133-140.indd 137 12/14/11 8:13 AM

SKILL CHART: HEAD SPLINT—SUBMERGED VICTIM
1. Approach the victim from the side. In deep water, release the rescue tube if the victim is more than an arm’s
reach beneath the surface.
2. Grasp the victim’s arms midway between the shoulder and elbow. Grasp the victim’s right arm with your right
hand and the victim’s left arm with your left hand. Gently move the victim’s arms up alongside the head.
3. Squeeze the victim’s arms against his or her head to help hold the head in line with the body.
4. Turn the victim face-up while bringing the victim to the surface at an angle. To turn the victim face-up, push
the victim’s arm that is closest to you down and away from you while pulling the victim’s other arm toward
you. The victim should be face-up just before reaching the surface or at the surface.
5. Position the victim’s head close to the crook of your arm, with the head in line with the body. Another
lifeguard can place a rescue tube under your armpits to help support you and the victim.
water by strapping the victim in or using the head immobilizer device.
Note: If the victim is submerged but face-up, approach the victim from behind and follow the same steps for a
Face-Up Victim At or Near the Surface while you bring the victim to the surface.
SKILL ASSESSMENT TOOL: HEAD SPLINT—IN-LINE STABILIZATION FOR A VICTIM
IN THE WATER
Provide in-line stabilization ■ Moves victim’s arms to a secure ■ Does not move victim’s arms
position against the victim’s against the victim’s head or
head maintain pressure
■ Equal pressure on both arms is ■ One arm is pressed against
maintained throughout rescue head and one is not
Victim’s face remains out of the ■ Victim’s face does not submerge ■ Victim’s face submerges under
water ■ Mouth and nose are above water water
■ Victim’s mouth or nose is
under water
Move victim to a safe location to ■ Moves victim to shallow water if ■ Does not move to shallow
prepare for backboarding safe and possible water to stand up if it is safe
■ If rescue involves moving water, and possible
moves victim to a sheltered area ■ Remains in moving water
when access to a sheltered
area is possible
SPINAL BACKBOARDING AND REMOVAL FROM WATER
SKILL CHART: SPINAL BACKBOARDING PROCEDURE—SHALLOW WATER
1. The first lifeguard (primary rescuer) provides in-line stabilization until another lifeguard arrives with the
backboard.
2. The assisting lifeguard removes the head-immobilizer device, enters the water, submerges the backboard and
positions the board under the victim so that it extends slightly beyond the victim’s head. The victim’s head
should be centered on the backboard’s head space.
3. While an assisting lifeguard raises the backboard into place, the primary rescuer moves the elbow that is
under the victim toward the top of the backboard while continuing to apply pressure on both of the victim’s
arms, using the victim’s arms as a splint.
LGI_SecB_p133-140.indd 138 12/27/11 10:12 AM

4. Once the backboard is in place, an assisting lifeguard then stabilizes the victim by placing one hand and arm
on the victim’s chin and chest, the other hand and arm under the backboard. The primary rescuer then
releases his or her grip on the victim’s arms.
5. The primary rescuer lowers the victim’s arms, moves behind the victim’s head and places the rescue tube
under the head of the backboard to aid in flotation of the board.
6. The primary rescuer balances the backboard on the rescue tube with his or her forearms and stabilizes the
victim’s head by placing his or her hands along each side of the victim’s head.
7. An assisting lifeguard secures the victim on the backboard with a minimum of three straps: across the victim’s
chest, hips and thighs. Secure the straps in the following order:
| Strap high across the chest and under the victim’s armpits. This helps to prevent the victim from sliding
on the backboard during the removal.
| Strap across the hips with the victim’s arms and hands secured under the straps.
| Strap across the thighs.
| Recheck straps to be sure that they are secure.
8. The rescuers secure the victim’s head to the backboard using a head immobilizer and a strap across the
victim’s forehead.
9. If not done already, bring the victim to the side of the pool.
SKILL CHART: SPINAL BACKBOARDING PROCEDURE—DEEP WATER
(LIFEGUARDING COURSE ONLY)
1. The first lifeguard (primary rescuer) provides in-line stabilization. If the victim is face-down, the primary
rescuer turns the victim into a face-up position. If necessary, an assisting lifeguard retrieves the primary
rescuer’s rescue tube and inserts it under the primary rescuer’s armpits.
2. The primary rescuer moves the victim to the side, if possible, toward a corner. An assisting lifeguard places a
rescue tube under the victim’s knees to raise the legs. This makes it easier to place the backboard under the
victim.
3. An assisting lifeguard places the backboard under the victim while the primary rescuer maintains
stabilization.
4. As an assisting lifeguard raises the backboard into place, the primary rescuer moves the elbow that is under
the victim toward the top of the backboard while continuing to apply pressure on both of the victim’s arms.
An assisting lifeguard stabilizes the victim with one hand and arm on the victim’s chin and chest, and the
other hand and arm under the backboard.
5. Once the backboard is in place, the primary rescuer then lowers the victim’s arms, moves behind the victim’s
head and places a rescue tube under the head of the backboard. The primary rescuer balances the board on
the rescue tube with his or her forearms and stabilizes the victim’s head by placing his or her hands along
each side of the victim’s head. The assisting rescuer moves to the foot of the board and removes the rescue
tube under the victim’s knees by sliding the rescue tube toward him or herself.
6. An assisting lifeguard secures the victim on the backboard by placing straps at least across the victim’s chest,
hips and thighs. After all the straps have been checked and properly secured, the rescuers secure the victim’s
head using a head immobilizer and a strap across the victim’s forehead.
SKILL CHART: SPINAL INJURY REMOVAL FROM THE WATER ON A BACKBOARD
1. Once the victim is properly secured to the backboard, position the backboard with the head end by the side of
the pool and the foot end straight out into the water.
2. With one lifeguard at each side, lift the head of the backboard slightly and place it on the edge. Use one or two
rescue tubes if needed to support the foot end of the board.
3. One lifeguard gets out of the pool while the other maintains control of the backboard. Once out of the water,
the lifeguard on land grasps the head of the backboard while the other gets out of the water.
4. Together the lifeguards stand and step backward, pulling the backboard and sliding it up over the edge and
out of and away from the water. If available, an assisting lifeguard remains in the water to help push the
board.
5. If available, additional lifeguards can help to guide and remove the backboard out of the water and onto land,
then begin to assess the victim’s condition and provide the appropriate care.
LGI_SecB_p133-140.indd 139 12/27/11 10:12 AM

SKILL ASSESSMENT TOOL: SPINAL BACKBOARDING PROCEDURE

Maintain in-line stabilization ■ Primary lifeguard maintains ■ Loss of in-line stabilization
in-line stabilization while during the rescue
backboard is being positioned. ■ Loss of contact with the victim
■ Assisting lifeguard maintains ■ Lifeguards do not
in-line stabilization while victim communicate as needed when
is being strapped to the board switching
and while head immobilizers
are being secured.
under water
Position the victim on the ■ Backboard is raised to support ■ Victim’s head is not aligned on
backboard the victim’s head with the head the backboard’s head space
aligned with the backboard’s ■ Victim is not aligned and on
head space the backboard.
■ Victim’s body is on the
backboard
thighs the strap
■ Hip strap is placed across the ■ Straps are loose so that victim
hips with the victim’s hands can easily slide
secured underneath the strap
■ Straps are not rechecked for
■ Straps are tight, and once all tightness
straps are secured, they are
■ Straps are not tightened if
rechecked
discovered to be loose
immobilize the victim’s head ■ Head immobilizer is placed
■ Head strap is secured across the but moves victim’s head or
victim’s forehead neck
victim’s forehead
SPINAL INJURY REMOVAL FROM THE WATER ON A BACKBOARD
Lifeguards communicate as a team Lifeguards communicate what, how ■ No verbal communication

to remove the victim from the water or when actions happen ■ Communication does not
result in effective actions
under water
Lifeguards remove the backboard ■ Backboard removed from the ■ Backboard is lifted in the air,
and victim from the water water by sliding it along the edge causing the victim to move or
■ Backboard held steady during slide
removal ■ Backboard is near vertical, and
victim is slipping or moving
■ Backboard is jerking or
rocking from side to side
LGI_SecB_p133-140.indd 140 12/14/11 8:13 AM

LESSON 9
FINAL WRITTEN EXAM AND FINAL
IN-WATER SKILL SCENARIOS
LESSON OBJECTIVES
■ Demonstrate how to care for a victim with a head, neck or spinal injury in shallow water.
■ Demonstrate how to rescue an active victim in deep water.
■ Demonstrate how to rescue a submerged passive victim in deep water and provide care.
■ Demonstrate how to rescue an active victim in shallow water. (Shallow Water Lifeguarding only)
■ Demonstrate how to rescue a submerged passive victim in shallow water and provide care.
(Shallow Water Lifeguarding only)

■ Final Written Exam: Section 2, Exams A and B, and answer sheets (one for each participant)
■ Answer keys for Final Written Exam: Section 2
■ Backboards (one for each test group and at least one for practice)
■ Adult manikins (at least two so they can be rotated and decontaminated)
■ Towel (to dry the manikin when using the AED training device)
■ Bag-valve-mask resuscitator (BVM) (one for each test group; one for practice)
■ AED training devices (one for each test group)
■ AED training pads (one set for each AED training device)
TOPIC: REVIEW OF FINAL WRITTEN Time: 5 minutes

EXAM: SECTION 1—CPR/AED
FOR THE PROFESSIONAL
Activity ■ Return the final written exam and answer sheets for Section 1—CPR/AED for the
Professional Rescuer and First Aid to participants for them to review.
■ Answer participants’ questions about the exam.
■ Make arrangements for those participants who need to retake the exam.
■ Collect the exams and answer sheets.
LESSON 9 | Final Written Exam and Final In-Water Skill Scenarios 141
LGI_SecB_p141-144.indd 141 10/13/11 11:55 AM

FINAL WRITTEM EXAM: SECTION 2— Time: 30 minutes
LIFEGUARDING SKILLS
Activity ■ Tell participants that they will now take Section 2 of the final written exam on the
information covered in Lessons 1 through 4 and Lesson 8. They may not use their
manual or notes to find the answers.
■ If teaching the Shallow Water Lifeguarding course, hand out Final Written Exam:
Section 2—Shallow Water Lifeguarding Skills and answer sheet to each participant.
■ Tell participants to come to you or raise their hand when they have finished the exam
or if they have questions.
■ Hand back the exam and review it with participants. Collect all exams, as the exam is
a standard exam that participants should not be allowed to keep. Make arrangements
for those participants who score less than 80 percent to review the material and
retake the opposite version of the exam.
TOPIC: IN-WATER SKILL SESSION: Time: 30 minutes

GENERAL SKILLS REVIEW
Activity ■ This time is allotted for general skills review to meet the needs of each class. As the
instructor, you should set up and facilitate a session to help participants practice
skills before the final skill scenarios.
■ If teaching the Shallow Water Lifeguarding course, pre-assign the groups for the
Skills Scenario 3: Submerged Passive Victim in Shallow Water Timed Response.
FINAL IN-WATER SKILL SCENARIOS Time: 1 hour, 30 minutes
Activity ■ Tell participants that there are three skill scenarios.

■ All skills must be performed according to the proficiency requirements to meet the
objective of the skills.
■ Each participant has only two opportunities to complete each scenario
successfully.
■ If a participant does not successfully complete a scenario during the first attempt,
options include:
| Reattempting the scenario during the normal lesson after a brief consultation on
the corrective actions needed to complete the scenario successfully.
| If additional practice is needed and time and resources permit, asking the
participant to see you after class to schedule a re-evaluation of the unsuccessful
scenarios at a later time.
■ To set up each scenario:
| Assign one participant to simulate drowning victim behaviors as instructed.
| Instruct the rescuing lifeguard to simulate activating an emergency action plan
(EAP) and perform the appropriate rescue based on the type of victim observed.
LGI_SecB_p141-144.indd 142 12/15/11 2:29 PM

| Provide each rescuing lifeguard a rescue tube and hip pack containing non-latex
disposable gloves and a resuscitation mask.
| Have a manikin available to substitute into the scenario for a passive victim once
the primary assessment is complete.
Final Scenario 1: Head, Neck or Spinal Injury in Shallow Water

Instructor’s Note: This scenario does not include immobilizing the victim on a
backboard or removal from the water.
■ Assign a primary lifeguard to a ground-level station for a shallow water zone.
■ Assign a participant to be a victim of a suspected head, neck or spinal injury in
shallow water and face-down at the surface. The victim will be responsive when
turned face-up.
■ Begin the scenario by prompting the victim to simulate a spinal injury victim in
shallow water.
■ Repeat the scenario until each participant has performed in-line stabilization for a
spinal injury in shallow water.
Final Scenario 2: Active Victim in Deep Water

Instructor’s Note: The lifeguard must use the appropriate active victim rescue
depending on the direction the active victim is facing. This scenario does not include
removal from the water.
■ Assign a primary lifeguard to an elevated or ground-level station for a deep water
zone.
■ Assign a victim to role-play an active victim in deep water facing any direction he or
she chooses.
■ Begin the scenario by prompting the victim to begin simulating an active victim.
■ Repeat the scenario until each participant has performed an active victim rescue.
■ For the Shallow Water Lifeguarding course, follow the directions for the Active
Victim in Deep Water with the exception of having the lifeguard and victim stationed
in shallow water.
Final Scenario 3: Submerged Passive Victim in Deep Water—Timed

Response
■ Explain to participants that this is a timed scenario, with 2 minutes allotted for the
water rescue and removal of the victim from the water (with an assisting lifeguard
who will bring the backboard), followed by 3 minutes of one-rescuer CPR.
Note:
assisting lifeguard to help with removal from the water, one victim and one
manikin for each group.
■ Tell the victim to get into position about 30 feet from the edge and submerge as the
rescuing lifeguard gets near.
■ Start the stopwatch once the EAP has been activated, and again once the rescuer
begins CPR.
■ Repeat the drill until each person in the group has performed as a rescuing
lifeguard.
■ For the Shallow Water Lifeguarding course, follow the directions for the Submerged
Passive Victim in Shallow Water—Timed Response with the exception of having the
lifeguard and victim stationed in shallow water.
LESSON 9 | Final Written Exam and Final In-Water Skill Scenarios 143
LGI_SecB_p141-144.indd 143 10/13/11 11:55 AM

TOPIC: CLOSING Time: 5 minutes
Activity ■ Thank all participants for attending the course.

■ Congratulate participants on successful completion.
■ Explain that they will receive a certificate that indicates Lifeguarding/First Aid and
CPR/AED for Lifeguard, all valid for 2 years.
■ For the Shallow Water Lifeguarding course, explain that participants will receive a
certificate that indicates Shallow Water Lifeguarding (up to 5 ft)/First Aid and CPR/
AED for Lifeguard, all valid for 2 years.
■ Make arrangements to retest any participants who did not pass the final written
exam(s) or scenario(s).
LGI_SecB_p141-144.indd 144 10/13/11 11:55 AM

Activity Worksheet 1.1—Reasons for the Rules
Aquatic Facilities—General Reason
1. Swim only when a lifeguard is on duty.
2. No running, pushing or rough play.
3. Dive only in designated areas.
4. No diving in shallow water (water up to 5 feet

deep).
5. No glass containers in the pool area and locker

rooms.
6. No alcoholic beverages or other drug use allowed.
Waterfront Facilities
1. No playing or swimming under piers, rafts,
platforms or play structures.
2. No running and diving head-first into shallow

water.
3. No fishing near swimming areas.
4. No umbrellas at the waterline.
ACTIVITY WORKSHEET 1.1 | Reasons for the Rules 145
LGI_SecB_Wrksht_p145-150.indd 145 10/13/11 11:56 AM

5. No swimming in unauthorized areas.
Waterpark Facilities, Including Winding Rivers and Waterslides

1. Designated age, height or weight requirements for
using an attraction.
2. Enter and exit the winding river only at designated

places.
3. Stay in tubes at all times.
4. No metal objects, locker keys, jewelry, metal

snaps/zippers, eyewear or watches, including metal
rivets, buttons or fasteners on swimsuits or shorts.
5. No running, stopping, standing, kneeling, rotating

or tumbling on the slides.
Diving Areas
1. Patrons must demonstrate their swimming ability
before entering deep water.
2. Only one patron on the diving board at a time.
3. Only one bounce allowed on the diving board.
4. Dive or jump forward, straight out from the diving

board.
5. Swim immediately to the closest ladder or wall.

Spas, Hot Tubs and Therapy Pools
1. Shower with soap and water before entering the
water.
2. People with certain medical conditions are not

allowed to use the spa or hot tub.
3. Pregnant women and young children should seek

their doctor’s approval before using a spa or hot tub.
4. Do not allow anyone to sit or play near the drain or

suction fittings.
5. Limit time in the spa to 10 minutes. Patrons then

may shower, cool down and return briefly.
ACTIVITY WORKSHEET 1.1 | Reasons for the Rules 147

Activity Worksheet 2.1—Guarding Special Attractions
Attractions Issues for Guarding the Special Attraction
Areas Specifically for Young Children
Play Structures
Special Rides and Attractions
Water Slides
Winding Rivers
Wave Pools

Activity Worksheet 3.1—Strategies for a Safe Group Visit
Scenarios Guarding Strategies
Scenario 1: You are guarding multiple activities
using the pool in addition to an organized group of
30 preschool-aged children with four group leaders. In
general, what should you ensure and be aware of while
guarding the activity?
Scenario 2: You are tasked with giving a quick safety

orientation to a camp group that will be using the
diving boards. Group members took the facility swim
test, and all are approved to swim in deep water. List
some common rules that you will review for the safe
use of the diving boards and briefly describe how you
would cover the information.
Scenario 3: You will be working a private rental

at your facility for families with children of all ages
from your local athletic association. You will be doing
a safety orientation for the group. Who will you be
instructing during the orientation and what items will
you be sure to cover?
ACTIVITY WORKSHEET 3.1 | Strategies for a Safe Group Visit 149

Activity Worksheet 6.1—Using an AED in Unique Situations—
Fact or Fiction
Fact Fiction 1. It is safe to use an AED in rain or snow.
Fact Fiction 2. An AED cannot be used on a pregnant woman.
Fact Fiction 3. If someone has chest hair, you should shave it before using the AED.
Fact Fiction 4. If a victim has a body piercing or is wearing jewelry, you should remove
the item before using an AED.
Fact Fiction 5. Never shock someone who has an implantable cardioverter-

defibrillator (ICD) or pacemaker device.
Fact Fiction 6. If you see a transdermal medication patch you should use a gloved hand
to remove it.
Fact Fiction 7. Never shock a person who is suffering from traumatic injuries.
Fact Fiction 8. Never shock a victim on a metal surface.
Fact Fiction 9. Never shock a victim suffering from hypothermia.

SECTION C | WATERFRONT SKILLS
MODULE OUTLINE
Activity Time
Introduction to the Waterfront Skills Module 10 minutes
Verification of Certification Prerequisite 5 minutes
Verification of Swimming Skills 40 minutes
Unique Aspects of Waterfront Lifeguarding 45 minutes
Waterfront Rescue Skills 10 minutes
Video: Waterfront Rescue Skills
In-Water Skill Session: Waterfront Rescue Skills 180 minutes
Skill: Run-and-Swim Entry
Skill: Walking Assist
Skill: Beach Drag
Skill: Front-and-Back Carry
Skill: Head Splint—Face-Down in Extremely Shallow Water
Skill: Searching Shallow-Water Areas
Skill: Entering the Water While Wearing Mask and Fins
Skill: Feet-First Surface Dive with Mask and Fins
Skill: Head-First Surface Dive with Mask and Fins
Skill: Searching Deep-Water Areas
Skill: Approaching a Victim on a Rescue Board
Skill: Rescuing an Active Victim with a Rescue Board in Deep Water
Skill: Rescuing a Passive Victim with a Rescue Board in Deep Water
Final Written Exam: Waterfront Skills Module 25 minutes
Closing 5 minutes
Total Time 5 hours 40 minutes
SECTION C | Waterfront Skills Module 151
LGI_SecC_p151-174.indd 151 11/2/11 1:35 PM

WATERFRONT SKILLS MODULE
MODULE NOTES
The purpose of the Waterfront Skills module is to teach lifeguards the knowledge and skills needed to prevent
and respond to emergencies in nonsurf, open-water areas found at public parks, resorts, summer camps
and campgrounds.
MODULE PREREQUISITES
■ Age Prerequisite: Candidates must be 15 years old by the last day of the module.
■ Certification Prerequisite: Candidates must have a current American Red Cross Lifeguarding/First Aid/CPR/AED.
■ Skill Prerequisites: Candidates must successfully complete the following:
1. Swim 550 yards continuously in a prone position demonstrating breath control and rhythmic breathing.
Swimming on the back is not allowed. Swim goggles are allowed.
2. Tread water for 2 minutes using only the legs. Candidates should place their hands under the armpits.
● Starting in the water, swim 20 yards using front crawl or breaststroke. The face may be in or out of
the water. Swim goggles are not allowed.
● Surface dive, feet-first or head-first, to a depth of 7 to 10 feet to retrieve a 10-pound object.
● Return to the surface and swim 20 yards to return to the starting point with both hands holding the
object and keeping the face at or near the surface so they are able to get a breath. Candidates should
not swim the distance under water.
● Exit the water without using a ladder or steps.
4. Swim 5 yards, submerge and retrieve three dive rings placed 5 yards apart in 4 to 7 feet of water,
resurface, and swim 5 yards to the side of the pool.
■ If conducting this module immediately following a full or review Lifeguarding, it is recommended that
participants perform the prerequisites for the Waterfront Skills module at the start of the Lifeguarding course.
If the prerequisite evaluation for Waterfront Skills module is not completed at this time, then it must be
completed as a precourse session for the Waterfront Skills module.
MODULE LENGTH
This module is designed to be taught in approximately 5 hours, 40 minutes, which includes the minimum time
needed for conducting the prerequisites, presenting information, practicing skills and conducting written exams.
This estimate is based on:
■ Ten participants per instructor.

■ The recommended equipment needed to conduct the module. If working with a limited amount of equipment,
build additional practice time into the module.
CLASS SIZE
It is recommended that there be one instructor for every 10 participants. If the class has more than 10
participants, you should have a co-instructor or aide or extend the class length.
LGI_SecC_p151-174.indd 152 11/21/11 11:36 AM

FACILITY REQUIREMENTS
Classroom space should be equipped with the ability to show video segments. The swimming area must be free of
surf and obstructions and meet requirements to perform skills. A zero-depth or gradual sloping area is ideal for
practicing entry and exit skills; however, shallow water can be used. An extreme shallow water area is required for
practicing care for spinal injuries.

■ Waterfront Skills Module Course Presentations
■ Waterfront Skills segment on the Lifeguarding DVD Set
■ DVD player and monitor
■ A 10-pound object (a diving brick or weight; one for every five participants)
■ Stopwatch
■ Three diving rings
■ Masks, assorted sizes, one per participant
■ Fins, assorted sizes, one pair per participant
■ Rescue board (one for every five participants)
■ Waterfront Skills Checklist
■ Copies of Waterfront Skills Written Exams (exams A and B) and answer sheets (one for each participant)
■ Answer keys for Waterfront Skills Written Exams
TESTING AND CERTIFICATES

■ To receive the module completion certificate for American Red Cross Waterfront Skills, the participant must:
| Correctly answer at least 80 percent of the questions of the written exam.
■ Upon successful completion of the module, participants will receive an American Red Cross certificate
indicating Waterfront Skills that is valid for no more than 2 years. The Waterfront Skills certificate is only
valid when accompanied by a current Lifeguarding/First Aid/CPR/AED certificate.
■ Skills in the module include the following:
| Run-and-swim entry
| Walking assist
| Beach drag
| Front-and-back carry
| Head splint—face-down in extremely shallow water
| Searching shallow-water areas
| Proper use of mask and fins
| Feet-first surface dive with mask and fins
| Head-first surface dive with mask and fins
| Searching deep-water areas
| Approaching a victim on a rescue board
| Rescuing an active victim with a rescue board
| Rescuing a passive victim with a rescue board
LGI_SecC_p151-174.indd 153 10/13/11 12:29 PM

WATERFRONT SKILLS MODULE LESSON PLAN
LESSON OBJECTIVES
■ Describe the unique aspects of waterfront lifeguarding.
■ Demonstrate how to perform the waterfront rescue skills safely and effectively.

and certification as a Red Cross instructor. Include co-instructors and aides if
applicable.
identify the location of the AED and first aid kit.
■ Explain that the purpose of the Waterfront Skills module is to teach lifeguards the
skills and knowledge needed to prevent and respond to emergencies in nonsurf,
open-water areas found at public parks, resorts, summer camps and campgrounds.
■ Explain the requirements to pass the module:
| Correctly answer at least 80 percent of the questions in the written exam.
■ Explain that upon successful completion of the module, participants will receive an
American Red Cross certificate indicating Waterfront Skills that is valid for no more
than 2 years. The Waterfront Skills certificate is only valid when accompanied by a
current Lifeguarding/First Aid/CPR/AED certificate.
■ If a Waterfront Skills module is immediately following the Lifeguarding course and
all candidates are enrolled in both the Lifeguarding course and Waterfront Skills
module, the precourse session for the Waterfront Skills module should have been
used instead of the Lifeguarding precourse session. If this is the case, then it is not
necessary to repeat the Waterfront Skills swimming prerequisites. If the prerequisite
evaluation for Waterfront Skills was not completed during the Lifeguarding
precourse session, then it must be completed at this time.
■ Explain to participants that they must successfully complete the swimming
prerequisites to verify swimming ability to continue in the Red Cross Waterfront
Skills module:
breathing. Candidates must demonstrate the ability to swim both the front crawl
and breaststroke. Swimming on the back or side is not allowed. Swim goggles are
allowed.
● Starting in the water, swim 20 yards using front crawl or breaststroke. The
face may be in or out of the water for this. Swim goggles are not allowed.
● Surface dive, feet-first or head-first, to a depth of 7 to 10 feet to retrieve a
10-pound object.
LGI_SecC_p151-174.indd 154 10/13/11 12:29 PM

● Return to the surface and swim 20 yards to return to the starting point with
both hands holding the object.
4. Swim 5 yards, submerge and retrieve three dive rings placed 5 yards apart in 4 to
7 feet of water, resurface, and swim 5 yards to the side of the pool.
TOPIC: VERIFICATION OF Time: 5 minutes

CERTIFICATION PREREQUISITE
Activity ■ Check the eligibility of participants to participate in the module by checking their
American Red Cross Lifeguarding/First Aid/CPR/AED certification.

SWIMMING SKILLS
Activity ■ Explain to prospective participants that they must successfully complete four
swimming prerequisites to continue in the Waterfront Skills module.
participant. Record completion of each skill on the Waterfront Skills Checklist.
Waterfront Skills
Activity 1—550-Yard Swim
■ Explain to prospective participants that they must perform a 550-yard continuous
swim using the front crawl, breaststroke or a combination of both. Swimming on the
Activity 2—Tread Water

■ Explain to prospective participants that they must tread water for 2 minutes without
support and without stopping. When treading, only the legs can be used. Candidates
of the water.
Activity 3—Timed Event

■ Arrange the swim distance of 20 yards and place a 10-pound object at a depth of 7 to
10 feet.
■ Explain that swim goggles are not allowed for this event.
■ Evaluate each prospective participant on the following skill to be performed within
1 minute and 40 seconds.
| Starting in the water, swim 20 yards using the front crawl or breaststroke. The
face may be in or out of the water.
| Surface dive, feet-first or head-first, to a depth of 7 to 10 feet to retrieve a
10-pound object.
LGI_SecC_p151-174.indd 155 12/14/11 8:31 AM

Activity 4—Underwater Swim Event
■ Arrange the swim distance area, placing three dive rings 5 yards apart in 4 to 7 feet
of water.
■ Explain that swim goggles are not allowed for this event.
■ Evaluate each participant on the following skill.
| Submerge, swim under water and retrieve three dive rings placed 5 yards apart
in 4 to 7 feet of water.
| Return to the surface after picking up all three dive rings and continue to swim
another 5 yards to complete the skill sequence.
Instructor’s Note: If any participant is unable to complete the verification of
swimming ability, he or she is not eligible to continue in the Waterfront Skills module.
Privately advise any participant who did not successfully demonstrate the skills that he
or she may not continue.
TOPIC: UNIQUE ASPECTS OF Time: 45 minutes

WATERFRONT LIFEGUARDING
PRESENTATION: UNIQUE ASPECTS OF WATERFRONT LIFEGUARDING
Lecture ■ The Waterfront Skills module builds on the knowledge and skills learned
and Guided in the Lifeguarding course. Because many aquatic facilities now have a
variety of features and attractions, much of the knowledge and skills
Discussion were covered in that course.
■ The purpose of the Waterfront Skills module is to teach lifeguards the
knowledge and skills needed to prevent and respond to emergencies in
nonsurf, open-water areas found at public parks, resorts, summer
camps and campgrounds.
■ Remember, your primary responsibility is to help ensure patron safety
and protect lives. The main tool used to accomplish this is patron
surveillance—keeping a close watch over the people in the facility and
intervening when necessary.
■ Ask participants: What are the elements of effective surveillance?
| Recognition of dangerous behaviors
| Victim recognition
| Effective scanning
| Zone of surveillance responsibility
| Lifeguard stations
■ When considering the unique challenges for lifeguarding at a waterfront,
consider what is unique to waterfront facilities:
| Underwater hazards, including plant and marine life.
| Physical structures, such as piers and docks.
| Changing water conditions.
| Water quality.
LGI_SecC_p151-174.indd 156 10/21/11 3:01 PM

Facility Safety
Lecture ■ Ask participants: What underwater hazards might present concerns for
and Guided waterfront facility safety?
| Holes in the swimming area.
| Sudden drop-offs.
| Submerged objects, such as rocks, tree stumps and underwater plants.
| Bottom conditions (sand, rock, silt, weeds and mud).
| Slope of the bottom and water depth.
| Shells and barnacles.
| Broken glass or other sharp objects.
| Marine life.
■ You should check for and, if possible, remove underwater hazards. If
hazards cannot be removed, swimming areas should be positioned away
from them. Floating buoys can be used to mark underwater hazards to
warn patrons of their danger.
■ Physical structures in the water, such as piers or docks, are often used
for different activities.
■ Ask participants: What precautions should be taken with physical
structures?
| Ensure that floating piers, docks and rafts are anchored securely.
| Adjust attachment points between floating sections to minimize hazards.
| Be aware of and take steps to eliminate blind spots (obstructed views) caused
by physical structures.
| Ensure that patrons dive only in designated areas. Check the water depth daily.
Be aware of bottom and tidal changes before allowing head-first entries.
| Prohibit swimming in fishing areas around piers or docks or adjacent to boat
activity.
■ Many factors can influence water conditions, which in turn can affect
patron safety including:
| Water depth and currents.
| Water quality.
| Debris or cloudiness in the water.
| Water temperature.
LGI_SecC_p151-174.indd 157 10/13/11 12:29 PM

■ Ask participants: What occurrences might cause changes in water depth
and water currents?
| A dam that releases water, causing the water depth above the dam to drop and
the river depth below the dam to rise.
| Heavy rainfall that makes a lake or river rise, or a long, dry period that makes
it too shallow for diving.
| Tidal changes.
| A seiche in a large lake. The danger from a seiche comes from rapidly rising
and falling lake levels and can sweep people off piers and breakwaters and pull
swimmers far away from shore.
| Sand bars that can move and shift from season to season or from heavy rain
that produces strong currents. These changes in the waterfront floor can create
unexpected drops or new shallow-water features.
■ Ask participants: What might cause concerns with water quality?
| Insufficient flow may lead to stagnant water and compromise water quality.
| Pollutants, such as waste and storm water runoff.
| Periods during and after heavy rain.
■ When dealing with changing water conditions:
| Warn patrons of hazards by using signs, buoys and safety
announcements.
| Check for objects that may have washed into the area.
| Check for changes in bottom conditions, water depth and water
quality.
| Alert patrons to cold water, and watch for potential signs of
hypothermia.
| Check and document scheduled high and low tides in the daily log
each morning before opening, and plan for depth changes.
■ Ask participants: What aspects of a facility safety check may be unique to a
waterfront facility?
| Bottom is free of hazards.
| Shoreline is free of sharp objects, broken glass, rocks, litter and
wildlife droppings.
| Sand in front of and around lifeguard stands is clear of objects.
| Docks and piers are stable—no protruding nails, rotting wood or weak or
frayed anchor lines.
| Rescue craft, such as rescue boards, rowboats and kayaks, are in proper
operating condition and contain appropriate rescue equipment.
| Communication devices, such as phones, two-way radios, air horns and
megaphones, are in good working order.
LGI_SecC_p151-174.indd 158 10/13/11 12:29 PM

■ Ask participants: What rules might a waterfront facility adopt that would
be specific to safety at waterfronts?
| No playing or swimming under structures, such as docks, piers, rafts,
platforms or play structures.
| No boats, sailboards, or personal water craft in swimming areas.
| No running or diving head-first into shallow water.
| No fishing near swimming areas.
| No umbrellas at the waterline (umbrellas present a surveillance obstruction).
| No swimming in unauthorized areas.
Additional Facility Safety Concerns at Waterfronts
Lecture ■ Additional safety concerns at waterfront facilities can include cold water
and rip currents.
■ Body heat can be lost much faster in cold water than in cold air.
■ Be aware of signs and symptoms of hypothermia in swimmers, which
can occur in situations, such as:
| In the spring and early summer, when water temperatures are
cooler.
| After rain.
| Extended periods of time in cooler water, cooler temperatures and/
or windy conditions.
| Sudden immersion in cold water.
■ To perform a rescue in cold water, remove a victim from the water as
quickly as possible. Because you will also be affected by cold water, you
should attempt the rescue without entering the water.
| You can extend a rescue tube to reach the victim, but the victim
might not be able to maintain a hold on the equipment due to the
cold.
| If you must enter the water as a last resort, take a rescue tube and try
to keep your head out of the water while swimming.
| When the victim is out of the water, assess his or her condition.
Victims who have been submerged in cold water may still be alive
even with:
● A decreased or undetectable pulse rate.
● No detectable breathing.
● Bluish skin that is cold to the touch.
● Muscle rigidity.
| Begin giving ventilations or CPR, as needed, and provide first aid for
hypothermia as soon as possible. If not done so already, summon
emergency medical services personnel immediately. The sooner the
victim receives advanced medical care, the better the chances are for
survival.
■ If you are lifeguarding at a facility where sudden immersion in cold
water is possible, you should receive specialized training in cold water
rescue.
■ Another potential safety concern at some waterfront facilities are rip
currents.
■ A rip current is a strong channel of water that flows seaward beginning
near the shore and often extending well beyond the breakers. They are
often associated with underwater features, such as sand bars, and also
commonly occur near physical structures, such as piers, groins and
natural outcroppings.
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■ According to the National Weather Service, common indicators of a rip
current include:
| A channel of churning, choppy water,
| An area having a noticeable difference in water color.
| A line of foam, seaweed or debris moving steadily away from shore.
| A break in the incoming wave pattern.
■ Although these are good indicators, they are not always present.
Consequently, it is not always possible even for an experienced lifeguard
or surfer to spot a rip current.
■ All swimmers should swim near a lifeguard—this includes other
lifeguards and experienced swimmers.
■ On many beaches, color coded flags are flown to indicate the presence of
hazardous surf and rip currents. Anytime you see a red or double red
flag stay out of the water; use extreme caution when there is a yellow
flag.
■ If caught in a rip current:
| Do not panic.
| Never attempt to swim against the current—fighting the current will
cause you to become exhausted and possibly drown.
| Allow the current to take you away from shore.
| Once the current weakens, swim parallel to the beach then back to
shore at an angle. Try to swim in the direction of least resistance to
the current.
| If you are too exhausted to swim to shore, signal by calling and
waving for help.
■ If you are lifeguarding on a waterfront where there is the possibility of
rip currents, it is critical to receive specialized training in the specific
conditions and hazards that exist in your area and to learn how to
identify rip currents and to help someone who is caught in them.
Patron Surveillance
Lecture ■ Waterfront activities vary and can include swimming, boating, water
skiing, sailing, canoeing, as well as use of personal watercraft and
SCUBA diving.
■ Patron surveillance at a waterfront can be challenging due to water
conditions that can cause visibility to be difficult.
■ The swimming area should have a buffer zone of no boating buoys. In
addition to watching your zone of surveillance, you may need to warn
people on boats, personal watercraft or water skiers to stay out of the No
Boating area.
■ Ask participants: What unique challenges for effective scanning might you
experience at a waterfront facility?
| Blind spots underneath or around structures, such as docks, piers and floating
rafts.
| Water movement (i.e., waves).
| Murky water.
■ When a drowning victim submerges at a waterfront, you may not be able
to see the location of the victim as you approach. A sighting or a cross-
bearing is used to keep track of where the victim went underwater.
LGI_SecC_p151-174.indd 160 10/13/11 12:29 PM

■ If a person is reported as missing in or near the water, or you have
attempted and are unable to locate a victim after submersion, a search is
necessary.
■ In many waterfront facilities, additional lifeguards are stationed to
watch swimmers from a watercraft, typically patrolling the outer edge of
a swimming area. Often, someone in trouble in the water can be reached
more quickly from watercraft than from a lifeguard station on the shore.
■ In a small, calm area, a rescue board, kayak or flat-bottom rowboat
might be used while conducting patron surveillance. In rough water,
rowboats might be used. Powerboats, inflatable boats and personal
watercraft also can be used as rescue watercraft.
■ If stationed on watercraft in water with a current, you might have to row
or paddle to stay in position. Some watercrafts use a special anchor line
with a quick release for making a rescue. In some larger watercraft, one
lifeguard maintains the craft’s position while a second watches the
swimming area.
■ Make sure you are well trained in operating the facility’s watercraft
before using it for surveillance or to make a rescue. Use caution with
motorized watercraft to avoid injuring swimmers or damaging lifelines
when crossing into the swimming area to make a rescue.
■ Most states require that boat operators pass a boating education course.
In motorized craft, operators must have a state-approved boating
education certificate.
■ For personal watercraft, operators should have additional training in the
operation and use as a rescue craft.
Injury Prevention
Lecture ■ Organizations, such as day cares or youth camps, may bring groups to
waterfront facilities for recreation. These groups may be based out of
your facility and swim regularly or visit one or more times as a field trip.
■ Group leaders, chaperones or camp counselors may assist with
discipline but do not take the place of lifeguards.
■ Some youth camps operate their own waterfront facilities. Youth camps
may implement additional layers of safety precautions. These additional
layers are not a replacement for continuous scanning of your area.
■ Additional supervision may be provided by camp staff that have been
trained to serve as spotters or lookouts. These staff members should
never take the place of lifeguards.
■ Swim tests may be used to identify the swimming ability of both campers
and staff and assign them to designated swimming areas.
■ Buddy systems with buddy boards and buddy checks may be used to help
account for swimmers by having buddies look out for one another.
| Buddies are paired according to swimming ability as much as
possible. If buddies do not have similar swimming skills, they should
remain in the swimming area that is suitable for the weakest
swimmer’s ability. Buddies are to stay together and be responsible
for each other, informing a lifeguard at any time that their buddy is
in trouble or missing.
| Buddy checks are used to account for all swimmers and to teach
buddies to continuously monitor their partners. Buddy checks are
often set for specific timed intervals. A lifeguard, lookout or
supervisor gives a pre-arranged signal, such as a whistle blast. The
buddies grasp each other’s hands, raise their arms over their heads
and hold still while the staff confirms that everyone has a buddy and
is accounted for.
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| Buddy boards provide a system of checking campers in and out of the
water.
● A lifeguard or other staff member is stationed at the buddy board
to make sure the tags are placed correctly and that no one enters
or leaves the swimming area without moving their tags
appropriately.
● Each swimmer has a tag that may designate swimming ability,
camp group or the name of the individual camper.
● The buddy board has an “in” area and an “out” area. The “in”
area may be divided according to specific sections of the
swimming area. Before buddies enter the water they hang their
tags next to each other on the board in the designated area for
where they will be in the water.
● When buddy checks are done, a count of people in the water is
verified with the number of tags on the buddy board.
● If buddies move to another swimming area or leave the
swimming area they are to change their tags on the buddy board
accordingly.
■ In general, when guarding groups, you should:
| Ensure that swimming areas are clearly marked and determined by
swimming abilities.
| Ensure that patrons stay in the sections appropriate for their
swimming abilities.
| Provide U.S. Coast Guard-approved life jackets for weak or
nonswimmers.
| Ensure that chaperones are actively supervising the members of
their group and that the appropriate swimmer-to-chaperone ratio is
being met.
| Signal for additional lifeguard coverage, such as a roving lifeguard, if
you feel you cannot effectively guard your zone.
Emergency Action Plans

Lecture ■ Ask participants: What communication systems might lifeguards use at a
waterfront facility?
| Two-way radios
| Whistles
| Hand signals or signals using rescue equipment
| Public address systems
| Telephones
| Flags
| Horns
| Megaphones
| Electronic devices (buttons or switches) that must be triggered
■ Be sure you understand the methods of communication used at your
facility.
■ Include communication systems in daily facility safety checks, including
battery charge for battery-operated equipment.
■ EAPs may include additional steps because of the environment, weather,
the size of the waterfront and its surroundings and possibly a longer
response time for EMS personnel.
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■ It is important to understand the role played by other members of the
safety team including camp staff, which may include medical personnel,
park rangers, as well as maintenance and security personnel.
■ Refer participants to Chapter 5: Emergency Action Plans in the Lifeguarding
Manual to review the sample missing person procedure.
TOPIC: WATERFRONT RESCUE SKILLS Time: 10 minutes

PRESENTATION: WATERFRONT RESCUE SKILLS
Video Segment ■ Explain that the video segment will demonstrate skills for rescues at waterfronts.
■ Show the video segment, “Waterfront Rescue Skills.”
IN–WATER SKILL SESSION: WATERFRONT Time: 3 hours

RESCUE SKILLS
Entries, Assists guide them through practice.
and Head, Neck ■ For each skill, organize participants so that they can clearly see and hear. Be sure to
and Spinal Injury
behave as victims.
■ Pair up participants and explain that they will take turns as victim and rescuer for
each skill.
| For the run-and-swim entry, have participants line up along the edge of a zero-
depth area or simulated shoreline and have them perform the run-and-swim
entry. If simulating this skill, have participants perform the skill on dry land in a
suitable area with a dry surface that is free of obstructions or have the
participants perform the entry in a shallow water area.
| For the beach drag and front-and-back carry, reorganize participants into groups
of three and have them perform the skills as a team of two lifeguards.
■ Remind participants to simulate activating the emergency action plan before
entering the water.
● Lifeguards: on the edge of a zero-depth area
| Walking assist
● Victims: in shallow water about 5 yards from the edge of the zero-depth
area, distressed swimmer
| Beach drag—one person and two person
● Victims: in shallow water about 5 yards from the edge of the zero-depth
area, face-up passive victim
● Victims: in shallow water about 5 yards from the edge of the zero-depth area
or simulated shoreline, face-up passive victim
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● Victims: face down in extremely shallow water, approximately one foot deep
criteria.
Skill Practice— ■ Organize participants into a group and lead them through the skill of searching a
Searches and shallow water area. Be sure to cover how to shift the line or turn.
Using Masks ■ Next, explain that the next several skills deal with rescues in deep water.
and Fins ■ Explain that as they descend into deep water, water pressure increases and presses
against the empty spaces in your skull, especially those inside the ears. This can
cause pain or even injury. To relieve this pressure, they need to equalize the pressure
by forcing more air into the empty spaces so that the air pressure matches the water
pressure. Explain that they should equalize early and often.
■ Guide them through the steps of equalizing by simulating the following:
1. Place your thumb and finger on your nose.
2. Pinch your nose and keep your mouth shut. Try to exhale gently through your
nose until the pressure is relieved.
3. Repeat this as needed to relieve ear pressure. If your ears hurt, do not attempt to
go deeper until successfully equalizing the pressure.
■ Have each participant put on a mask and ensure that it properly fits. To check that it
properly fits, have them:
1. Place the mask against his or her face without using the strap.
2. Inhale slightly through the nose to create a slight suction inside the mask. This
suction should keep the mask in pace without being held.
3. Adjust the strap so the mask is comfortable. The mask should be placed on the
crown of the head for a proper fit.
4. Try to mask in the water. Make adjustments as needed.
■ Guide them through the steps of equalizing while wearing a mask by simulating the
following:
1. Place your thumb on finger on the nosepiece of the mask.
2. Pinch your nose and keep your mouth shut. Try to exhale gently through your
nose until the pressure is relieved.
3. When descending, the increased water pressure will cause the mask to squeeze
your face. To relieve the squeezing, exhale a small amount of air through your
nose into the mask.
■ Have each participant put on a pair of fins then practice swimming with fins. Have
them practice the following:
| Use a modified flutter kick: the kicking action is deeper and slower, with a little
more knee bend than the usual flutter kick.
| Swim with the legs only; keep the arms relaxed at the side.
■ Lead participants through the following skills:
| Entering the water while wearing mask and fins
| Feet-first surface dive with mask and fins
| Head-first surface dive with mask and fins
■ Organize participants into a group and lead them through the skill of searching a
deep water area.
criteria.
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Skill Practice— ■ Lead participants through the following skills using a rescue board.
Using a Rescue ■ Approaching a victim on a rescue board
Board | Lifeguards: on edge of zero-depth, going out to deep water
| Victims: on the surface in deep water, active victim
■ Rescuing an active victim with a rescue board
| Lifeguards: on the rescue board in deep water
| Victims: on the surface in deep water, active victim
■ Rescuing a passive victim with a rescue board
| Lifeguards: on the rescue board in deep water
| Victims: on the surface in deep water, passive victim
criteria.

■ Assemble the participants on the shoreline and explain they will be practicing
rescuing a submerged passive victim in shallow water, removing the victim from the
water, doing a primary assessment and caring for a victim who is not breathing and
does not have a pulse.
■ Explain that the goal of this water rescue and removal of the victim from the water is
to be completed within 2 minutes. Timing starts once the lifeguard simulates the
EAP. One-rescuer CPR should be performed for 3 minutes.
for each group. Explain that for each group:
| The rescuing lifeguard, wearing a hip pack with gloves inside, will simulate
| The victim will get into position about 30 feet from the rescuer and submerge as
the rescuing lifeguard gets near. The rescuing lifeguard will perform a
submerged passive victim rescue.
| The assisting lifeguard will assist the rescuing lifeguard in removing the victim
from the water demonstrating team communication skills between the
lifeguards.
| Once removed from the water, the rescuing lifeguard will perform a primary
LGI_SecC_p151-174.indd 165 11/2/11 1:35 PM

FINAL WRITTEM EXAM: Time: 25 minutes
■ Tell participants that they will now take a final written exam on the information
covered in the module. They may not use their manual or notes to find the answers.
■ Hand back the exam and review it with participants. Collect all exams as the exam is
for those participants who score less than 80 percent to review the material and re-
take the opposite version of the exam.
■ Thank all participants for attending the course.

■ Explain that they will receive an American Red Cross certificate indicating
Waterfront Skills that is valid for no more than 2 years. The Waterfront Skills
certificate is only valid when accompanied by a current Lifeguarding/First Aid/CPR/
AED certificate.
exam(s).

ENTRIES
SKILL CHART: RUN-AND-SWIM ENTRY
1. Hold the rescue tube and the excess line and run into the water, lifting your knees high to avoid falling. Swing
your legs wide as you run.
2. When you can no longer run, either put the rescue tube across your chest and lean forward or drop the tube to
the side and start swimming, letting the rescue tube trail behind. Do not dive or plunge head-first into the
water; this could cause a serious head, neck or spinal injury.
SKILL ASSESSMENT TOOL: RUN-AND-SWIM ENTRY
Properly positions equipment for ■ Control of the rescue tube is ■ Contact with the rescue tube
the entry maintained not maintained
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Uses appropriate entry for the Entry is safe for the rescuer, victim Entry causes a safety hazard
Maintains balance while running in Lifts knees high to step over the ■ Fails to lifts knees high enough
the water water to step over the water
■ Loses balance when entering
the water
■ Dives forward when entering
the water
Begins swimming when no longer Leans forward into water with head Does not keep head up while
able to run up to begin swimming swimming toward victim
Maintains focus on the victim Upon entering, focus on the victim Fails to look toward the victim or
or the site where the victim was last site where the victim was last seen
seen is maintained
SKILL CHART: WALKING ASSIST
1. Place one of the victim’s arms around your neck and across your shoulder.
2. Grasp the wrist of the arm that is across your shoulder. Wrap your free arm around the victim’s back or waist
to provide support.
3. Hold the victim firmly and assist him or her in walking out of the water.
4. Have the victim sit or lie down while you monitor his or her condition.
SKILL ASSESSMENT TOOL: WALKING ASSIST
General Criteria Proficient Not Proficient
to do communication with victim
Maintains balance Assumes a sturdy posture and stable Stumbles, falls or knocks victim
Assists victim with balance and ■ Holds victim’s hand securely ■ Fails to hold victim’s hand
bearing weight to walk out of water with arm across shoulders to securely with arm across
bear weight. shoulders
■ Supports victim across the back ■ Fails to support victim’s
for balance and stability. weight
■ Fails to provide balance and
stability to victim while exiting
the water
SKILL CHART: BEACH DRAG
1. Stand behind the victim and grasp him or her under the armpits, supporting the victim’s head as much as
possible with your forearms. Let the rescue tube trail behind, being careful not to trip on the tube or line. If
another lifeguard is available to assist, each of you should grasp the victim under an armpit and support the
head.
2. Walk backward and drag the victim to the shore. Use your legs and not your back.
3. Remove the victim completely from the water then assess his or her condition and provide appropriate care.
LGI_SecC_p151-174.indd 167 10/13/11 12:29 PM

SKILL ASSESSMENT TOOL: BEACH DRAG
Securely holds victim Grasps victim securely under the Does not grasps victim securely
armpits under the armpits
Supports victim’s head Forearms held close together to ■ Fails to attempt to support
support victim’s head if possible victim’s head between
forearms
■ Forearms are positioned so
victim’s head falls back
Keeps victim’s head above the Mouth and nose of victim Mouth or nose of victim is in the
SKILL CHART: FRONT-AND-BACK CARRY
1. From behind the victim, one lifeguard reaches under the victim’s armpits. This lifeguard grasps the victim’s
right wrist with his or her right hand and the victim’s left wrist with his or her left hand. Then the lifeguard
crosses the victim’s arms across the victim’s chest.
2. The second lifeguard stands between the victim’s legs, facing the victim’s feet. This lifeguard bends down and
grasps the victim under the knees. On signal, both lifeguards lift the victim and carry him or her out of the
water while walking forward.
SKILL ASSESSMENT TOOL: FRONT-AND-BACK CARRY
Securely holds victim ■ Lifeguard 1 grasps victim ■ Lifeguards fail to support

securely under the armpits victim under the armpits or
■ Lifeguard 1 grasps wrists knees
■ Lifeguard 2 grasps victim ■ Victim is dropped
securely under the knees
SUSPECTED SPINAL INJURIES
SKILL CHART: HEAD SPLINT—FACE-DOWN IN EXTREMELY SHALLOW WATER
1. Approach the victim from the side. Grasp the victim’s right arm with your right hand and the victim’s left arm
with your left hand, trapping the victim’s head between his or her arms.
2. After the victim’s head is trapped between his or her arms, begin to roll the victim toward you.
3. While rolling the victim, step from the victim’s side toward the victim’s head and begin to turn the victim face-up.
4. Lower your arm on the victim’s side that is closest to you so that the victim’s arms go over the top of your arm
as you step toward the victim’s head. Maintain arm pressure against the victim’s head, since your hand rotates
during this maneuver. You are now positioned above and behind the victim’s head.
| If the victim is not breathing, immediately remove the victim from the water and give the appropriate
care.
| If the victim is breathing, hold the victim in this position. Place a towel or blanket on the victim to keep
him or her from getting chilled.
remove the victim from the water then provide appropriate care.
Note: If unable to keep the victim from getting chilled and there are enough assisting lifeguards, follow the care
steps for Spinal Backboarding Procedure and Removal from Water—Speed Slide.
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SKILL ASSESSMENT TOOL: HEAD SPLINT—FACE-DOWN IN EXTREMELY SHALLOW
WATER
Provides in-line stabilization ■ Moves victim’s arms to a secure ■ Does not move victim’s arms
Keep victim’s face out of the water ■ Victim’s face does not submerge ■ Victim’s face submerges under
■ Mouth and nose are above water water
under water
Moves victim to a safe location to ■ If victim’s condition is life- ■ Does not move victim to a safe
prepare for backboarding threatening, moves victim out of location
water quickly to perform care as ■ Fails to check victim’s
needed condition
■ If victim is conscious, monitors
victim’s condition
■ Follows facility procedures for
backboarding
IN-WATER SEARCHES
SKILL CHART: SEARCHING SHALLOW-WATER AREAS
1. Have a lifeguard oversee the search.

2. Ask adult volunteers and staff to link their arms and hold hands to form a line in the water. The shortest
person should be in the shallowest water, and the tallest person should be in water no more than chest deep.
3. Have the whole line slowly move together across the area, starting where the missing person was last seen.
4. As the line moves forward, have searchers sweep their feet across the bottom with each step. If there is a
current, walk downstream.
SKILL ASSESSMENT TOOL: SEARCHING SHALLOW-WATER AREAS
Lead lifeguard organizes search Communication is clear so searchers Lifeguards cannot proceed with
know what to do and function as a removing the victim from the
team. water
Bottom of shallow-water area ■ Line moves slowly to allow time ■ Lifeguards move too quickly
searched thoroughly to sweep their feet across the or become out of line
bottom. ■ Lifeguards fail to sweep the
■ If the search does not result in bottom with their feet
finding the victim, the line ■ Lifeguards do not move to
searches the area again moving search at a different angle if
at a different angle. victim not found
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ENTRIES WITH MASK AND FINS
SKILL CHART: ENTERING THE WATER WITH MASK AND FINS
1. Put one hand over the mask to hold it in place, keeping your elbow close to your chest.
2. Make sure no swimmers or other objects are below.
3. Step out with a long stride over the water, but do not lean forward. While entering the water, the fins will slow
your downward motion.
4. Swim keeping the arms at the side and face in the water or hold your arms out in front to protect your head.
SKILL ASSESSMENT TOOL: ENTERING THE WATER WITH MASKS AND FINS
Holds mask place Holds the mask against the face with ■ Fails to hold mask in place
elbow tucked by side ■ Mask slips off from face when
entering
Enters water feet-first, vertical with Stands upright while stepping out in ■ Does not enter water in a
legs in a stride position a stride position while entering the vertical position
water ■ Does not use stride position to
enter water
SURFACE DIVES WITH MASK AND FINS
SKILL CHART: FEET-FIRST SURFACE DIVE WITH MASK AND FINS
1. Swim to a point near the victim. Release the rescue tube but keep the strap around your shoulders.
2. Position your body vertically, then at the same time press both hands down to your sides and kick strongly to
raise your body out of the water.
3. Take a breath then let your body sink underwater as you begin to extend your arms outward with palms
upward pushing against the water to help you move downward. Keep your legs straight and together with toes
pointed. Tuck your chin and turn your face to look down toward the bottom.
4. As downward momentum slows, repeat the motion of extending your arms outward and sweeping your hands
and arms upward and overhead to go deeper.
5. Repeat this arm movement until deep enough to reach the victim.
If you must swim underwater, such as for a deep-water line search, also perform these steps:
6. When deep enough, tuck your body and roll to a horizontal position.
7. Extend your arms and legs and swim underwater.
Note: As you descend into deep water, be sure to equalize pressure early and often. If you are unable to
equalize pressure, return to the surface.
SKILL CHART: HEAD-FIRST SURFACE DIVE WITH MASK AND FINS
1. Swim to a point near the victim and release the rescue tube.
2. Gain momentum using a swimming stroke.
3. Take a breath, sweep your arms backwards to your thighs and turn them palms down.
4. Tuck your chin to your chest and flex at the hip sharply while your arms reach downward toward the bottom.
5. Lift your legs upward, straight and together so that their weight above the water helps the descent. Get in a
fully extended, streamlined body position that is almost vertical.
6. If you need to go deeper, such as for a deep-water line search, do a simultaneous arm pull with both arms to
go deeper, then level out and swim forward underwater.
Note: As you descend into deep water, be sure to equalize pressure early and often. If you are unable to
equalize pressure, return to the surface.
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SKILL ASSESSMENT TOOL: SURFACE DIVES WITH MASK AND FINS
Submerges to appropriate depth Submerges to appropriate depth Unable to submerge to appropriate

depth
Feet-First Surface Dive with Mask and Fins
Kick and arm press to raise out of Kick and arm press are effective at Ineffective kick or arm pull results
the water lifting the shoulders and upper chest in inability to lift shoulders and
out of the water upper chest out of water
Body descends feet-first in a ■ Legs are held together ■ Legs are apart and impede
streamlined position ■ Arms are fully extended descent
overhead ■ Arm positioning impedes
descent
Head-First Surface Dive with Mask and Fins
Head position directs upper body Chin is tucked to lower head into the Does not tuck chin on descent
down into the water water
Arms assist in pulling body into Arms pull to hips then toward Does not use an arm pull to
head-first position tucked head to pull head deeper into descend
the water.
Legs rise out of the water From either a tuck or pike position, ■ Fails to use either a tuck or
legs are lifted out of the water pike position
■ Fails to lift legs out of water
Body descends head-first in a ■ Legs are held together and lifted ■ Legs are apart
streamlined position upward toward the surface to ■ Body is not nearly vertical
aid descent during descent
■ Arms reach downward toward ■ Arms are not in front reaching
the bottom downward
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SEARCHES
SKILL CHART: SEARCHING DEEP-WATER AREAS

1. Wearing masks and fins, several lifeguards form a straight line an arm’s length from each other.
2. One lifeguard should serve as the safety lookout above the water level on a dock, pier, raft or watercraft with
rescue equipment in case a searcher gets in trouble or the missing person is found.
3. On command from the lead lifeguard, all lifeguards do the same type of surface dive (feet-first or head-first) to
the bottom and swim forward a predetermined number of strokes—usually three. If the water is murky,
searchers check the bottom by sweeping their hands back and forth in front of them, making sure to cover the
entire area. To keep the water from becoming cloudier, try to avoid disturbing silt and dirt on the bottom. Do
not miss any areas on the bottom when diving and resurfacing.
4. Lifeguards return to the surface as straight up as possible.
5. The lead lifeguard accounts for all searchers, reforms the line at the position of the person farthest back and
backs up the line one body length. On command, the team dives again.
6. Lifeguards repeat this procedure until the victim is found or the entire area has been searched.
7. If the missing person is not found, lifeguards expand the search to nearby areas. Consider whether currents
may have moved the victim.
8. Lifeguards continue to search until the person is found, emergency personnel take over or the search has been
called off by officials.
9. If a lifeguard finds the victim, the lifeguard should bring the victim up by grasping the victim under the
armpits and returning to the surface. Swim the victim to safety, keeping the victim on his or her back, with his
or her face out of the water. A lifeguard with equipment should take over to maintain an open airway while
moving the victim to safety. Remove the victim from the water, assess the victim’s condition and provide
appropriate care.
SKILL ASSESSMENT TOOL: SEARCHING DEEP WATER AREAS
Lead lifeguard organizes the search Communication is clear so searchers Unclear communication by lead
know what to do and function as a lifeguard, delaying search
team
Bottom of deep-water area ■ Searchers use masks and fins to ■ Searchers fails to reach
thoroughly searched surface dive to get to the bottom appropriate depth or fail to
■ Lead lifeguard re-positions the descend quickly or in a
line after each surface dive to streamlined position
make sure the area is covered ■ Lifeguards move too quickly or
thoroughly become out of line
■ Lifeguards fail to sweep the
bottom with their hands
■ Lifeguards do not move to a
different angle if victim not
found
Safety of searchers is monitored ■ Lifeguard stationed as a look-out Lead lifeguard fails to verify that all
observes searchers for safety other lifeguards return to surface
concerns
■ Lead lifeguard verifies that all are
OK after each surface dive.
LGI_SecC_p151-174.indd 172 10/13/11 12:29 PM

USING A RESCUE BOARD
SKILL CHART: APPROACHING A VICTIM ON A RESCUE BOARD

1. Hold onto the sides about mid-board when entering the water.
2. When the water is knee-deep, lay the rescue board on the water and push it forward. Climb on just behind the
middle and lie down in the prone position. For better balance, place a foot on either side of the rescue board in
the water.
3. Paddle with the front of the board toward the victim, using either a front-crawl or a butterfly arm stroke. To
change to a kneeling position, which may provide better visibility in some situations, paddle a few strokes first.
4. Continue paddling with your head up and the victim in your sight until you reach the victim. Place your foot
into the water to help steer if necessary.
SKILL ASSESSMENT TOOL: APPROACHING A VICTIM ON A RESCUE BOARD
Uses quick approach Uses rescue board proficiently with ■ Fails to reach victim quickly
balance and speed ■ Slips off rescue board
Focus on the victim is maintained ■ Upon entering, focus on the Fails to look toward the victim or
during approach victim or the site where the site where the victim was last seen
victim was last seen is
maintained
■ Holds head up while paddling on
rescue board to keep victim in
sight
Properly positions board for the Aims the board to a spot beside Fails to place board in proper
rescue when reaching victim victim position beside victim
SKILL CHART: RESCUING AN ACTIVE VICTIM WITH A RESCUE BOARD
1. Approach the victim from the side so that the side of the rescue board is next to the victim.
2. Grasp the victim’s wrist and slide off the rescue board on the opposite side.
3. Help the victim reach his or her arms across the rescue board. Encourage the victim to relax while you kick to
turn the board toward shore.
4. Hold the rescue board stable and help the victim onto the board.
5. Tell the victim to lie on his or her stomach facing the front of the board.
6. Carefully climb onto the board from the back with your chest between the victim’s legs. Be careful not to tip the
rescue board, and keep your legs in the water for stability.
7. Paddle the rescue board to shore.
8. Slide off the board and help the victim off the board and onto shore with a walking assist.
SKILL ASSESSMENT TOOL: RESCUING AN ACTIVE VICTIM WITH A RESCUE
BOARD
Makes contact with victim Grasps victim’s wrist while sliding off Grasps victim’s arm or shoulder
the board on the opposite side
Communicates with victim Reassures victim and gives direction No attempted verbal
as to how to get on the rescue board communication with the victim
Climbs onto board from the back ■ Gets on back of board and brings Unable to climb on board to return
board to a safe exit point to safe exit point
■ Removes victim from the water
LGI_SecC_p151-174.indd 173 10/13/11 12:29 PM

SKILL CHART: RESCUING A PASSIVE VICTIM WITH A RESCUE BOARD
To rescue someone who is unconscious or cannot hold or climb onto the rescue board:
1. Approach the victim from the side. Position the rescue board so that the victim is slightly forward of the middle
of the rescue board.
2. Grasp the victim’s hand or wrist and slide off the board on the opposite side, flipping the rescue board over
toward you. Hold the victim’s arm across the board with the victim’s chest and armpits against the far edge of
the board.
3. Grasp the far edge of the rescue board with the other hand.
4. Kneel on the edge of the rescue board using your own body weight to flip the board toward you again. Catch
the victim’s head as the rescue board comes down.
5. Position the victim lying down lengthwise in the middle of the rescue board with the victim’s head toward the
front of the rescue board.
6. Kick to turn the board toward shore. Carefully climb onto the board from the back with your chest between the
victim’s legs. Be careful not to tip the rescue board, and keep your legs in the water for stability.
7. Paddle the rescue board to shore.
8. Help the victim to safety with the beach drag or other removal technique.
SKILL ASSESSMENT TOOL: RESCUING A PASSIVE VICTIM WITH A RESCUE
BOARD
Makes contact with victim Grasps victim’s wrist while sliding off ■ Grasps victim’s arm or shoulder
the board on the opposite side. ■ Releases contact with the
victim
Positions victim so mouth and nose Uses technique of flipping rescue ■ Victim’s mouth and nose are in
are above water board to get victim onto the board the water
with his or her face out of the water. ■ Fails to place victim on board
Climbs onto board from the back ■ Gets on back of board and brings Unable to climb on board to return
and returns to safe exit point board to a safe exit point to safe exit point
■ Removes victim from water
LGI_SecC_p151-174.indd 174 10/13/11 12:29 PM

SECTION D | WATERPARK SKILLS
MODULE OUTLINE
Activity Time
Introduction to the Waterpark Skills Module 10 minutes
Verification of Certification Prerequisite 5 minutes
Verification of Swimming Skills 20 minutes
Unique Aspects of Waterpark Lifeguarding 35 minutes
Waterpark Rescue Skills 10 minutes
Video: Waterpark Rescue Skills
In-Water Skill Session: Waterpark Rescue Skills 90 minutes
Skill: Run-and-Swim Entry
Skill: Walking Assist
Skill: Beach Drag
Skill: Front-and-Back Carry
Skill: Head Splint—Face-down in Extremely Shallow Water
Skill: Head Splint—Moving Water (winding river or catch pool)
Skill: Suspected Spinal Injury—Moving Water: Speed Slide Runout
Final Written Exam: Waterpark Skills Module 25 minutes
Closing 5 minutes
Total Time 3 hours 40 minutes
SECTION D | Waterpark Skills Module 175
LGI_SecD_p175-190.indd 175 1/6/12 3:36 PM

WATERPARK SKILLS MODULE
MODULE NOTES
The purpose of the Waterpark Skills module is to teach lifeguards the knowledge and skills needed to prevent and
respond to emergencies in aquatic facilities with waterpark features.
MODULE PREREQUISITES
■ Age Prerequisite: Candidates must be 15 years old by the last day of the module.
■ Certification Prerequisite: Candidates must possess and present a current American Red Cross Lifeguarding/
First Aid/CPR/AED.
■ Skill prerequisites: Candidates must successfully complete the following:
| Swim 300 yards continuously demonstrating breath control and rhythmic breathing. Candidates must
demonstrate the ability to swim both the front crawl and breaststroke. Swimming on the back or side
is not allowed. Swim goggles may be used.
| Tread water for 2 minutes using only the legs. Candidates should place their hands under the armpits.
| Complete a timed event within 1 minute, 40 seconds.
● Starting in the water, swim 20 yards. The face may be in or out of the water. Swim goggles are
not allowed.
● Surface dive, feet-first or head-first, to a depth of at least 5 feet (but no more than 10 feet) to
retrieve a 10-pound object.
● Return to the surface and swim 20 yards on the back to return to the starting point with both hands
holding the object and keeping the face at or near the surface so they are able to get a breath.
Candidates should not swim the distance under water.
■ If conducting this module immediately following a full or review Lifeguarding course, the skill prerequisites
do not need to be repeated as part of this module.
MODULE LENGTH
This module is designed to be taught in approximately 3 hours, 40 minutes, which includes the minimum time
needed for conducting prerequisites, presenting information, practicing skills and conducting written exams. This
estimate is based on:
■ Ten participants per instructor.

■ The recommended equipment needed to conduct the module. If working with a limited amount of equipment,
build additional practice time into the module.
CLASS SIZE
It is recommended that there be 1 instructor for every 10 participants. If the class has more than 10 participants,
you should have a co-instructor or aide or extend the class length.
LGI_SecD_p175-190.indd 176 12/14/11 8:36 AM

FACILITY REQUIREMENTS
Classroom space should be equipped with the ability to show video segments. The swimming area meet
requirements to perform skills. A zero-depth area is ideal for practicing entry and exit skills; however, shallow
water can be used. An extreme shallow water area as well as moving water are required, such as a winding river or
water slide with a catch pool, for practicing care for spinal injuries. A speed slide runout is preferred for practicing
backboarding in the confined space; however, this can be practiced/simulated on land.

■ Waterpark Skills Module Course Presentations
■ Waterpark Skills segment on the Lifeguarding DVD Set
■ DVD player and monitor
■ A 10-pound object (a diving brick or weight; one for every five participants)
■ Stopwatch
■ Waterpark Skills Checklist
■ Copies of Waterpark Skills Final Written Exam (exams A and B) and answer sheets (one for each participant)
■ Answer keys for Waterpark Skills Final Written Exam
TESTING AND CERTIFICATES

■ To receive the module completion certificate for American Red Cross Waterpark Skills, the participant must:
| Correctly answer at least 80 percent of the questions of the written exam.
■ Upon successful completion of the module, participants receive an American Red Cross certificate indicating
Waterpark Skills that is valid for no more than 2 years. The Waterpark Skills certificate is only valid when
accompanied by a current Lifeguarding/First Aid/CPR/AED certificate.
■ Skills in this module include the following:
| Walking assist
| Beach drag
| Suspected spinal injury:
● In-line stabilization: Head splint—face-down in extremely shallow water
● In-line stabilization: Head splint—face-up in moving water (winding river or catch pool)
● Backboarding and removal from the water: Speed slide
LGI_SecD_p175-190.indd 177 11/21/11 11:38 AM

WATERPARK SKILLS MODULE LESSON PLAN
LESSON OBJECTIVES
■ Describe the unique aspects of waterpark lifeguarding.
■ Demonstrate how to perform the waterpark rescue skills safely and effectively.

and certification as a Red Cross instructor. Include co-instructors and aides if
applicable.
identify the location of the AED and first aid kit.
■ Explain that the purpose of the Waterpark Skills module is to teach lifeguards the
skills and knowledge needed to prevent and respond to emergencies in aquatic
facilities with waterpark features.
■ Explain the requirements to pass the module:
| Correctly answer at least 80 percent of the questions in the written exam.
■ Explain that upon successful completion of the module, participants receive an
American Red Cross certificate indicating Waterpark Skills that is valid for no more
than 2 years. The Waterpark Skills certificate is only valid when accompanied by a
current Lifeguarding/First Aid/CPR/AED certificate.
■ Explain to participants that they must successfully complete the swimming
prerequisites to verify swimming ability to continue in the Red Cross Waterpark
Skills module.
breathing. Candidates must demonstrate the ability to swim both the front crawl
and breaststroke. Swimming on the back or side is not allowed. Swim goggles
may be used.
● Starting in the water, swim 20 yards. The face may be in or out of the water.
Swim goggles are not allowed.
● Surface dive, feet-first or head-first, to a depth of at least 5 feet (but no more
than 10 feet) to retrieve a 10-pound object.
● Return to the surface and swim 20 yards on the back to return to the
starting point with both hands holding the object and keeping the face at or
near the surface so they are able to get a breath. Candidates should not swim
the distance under water.
■ If conducting this module in conjunction with a Lifeguarding review course or
challenge, it is not necessary to repeat these prerequisites.
LGI_SecD_p175-190.indd 178 10/13/11 12:41 PM

CERTIFICATION PREREQUISITE
Activity ■ Check the eligibility of participants to participate in the module by checking their
American Red Cross Lifeguarding/First Aid/CPR/AED certification.
TOPIC: VERIFICATION OF SWIMMING Time: 20 minutes

SKILLS
Activity ■ Explain to prospective participants that they must successfully complete three
swimming prerequisites to continue in the Waterpark Skills module.
participant. Record completion of each skill on the Waterpark Skills Checklist.
Waterpark Skills
Activity 1—300-Yard Swim
■ Explain to prospective participants that they must perform a 300-yard continuous
swim using the front crawl and breaststroke. Swimming on the back or side is not
permitted. Swim goggles are allowed.
Activity 2—Tread Water

■ Explain to prospective participants that they must tread water for 2 minutes without
support and without stopping. When treading, only the legs can be used. Candidates
of the water.
Activity 3—Timed Event

■ Arrange the swim distance of 20 yards and place a 10-pound object at a depth of 7 to
10 feet.
■ Evaluate each prospective participant on the following skill to be performed within 1
minute and 40 seconds.
| Surface dive, feet-first or head-first, to a depth of at least 5 feet (but no more
than 10 feet) to retrieve a 10-pound object.
Instructor’s Note: If any participant is unable to complete the verification of
swimming ability, he or she is not eligible to continue in the Waterpark Skills module.
Privately advise any participant who did not successfully demonstrate the skills that he
or she may not continue.
LGI_SecD_p175-190.indd 179 11/21/11 11:39 AM

TOPIC: UNIQUE ASPECTS OF Time: 35 minutes
WATERPARK LIFEGUARDING
PRESENTATION: UNIQUE ASPECTS OF WATERPARK LIFEGUARDING
Lecture ■ The Waterpark Skills module builds on the knowledge and skills learned
and Guided in the Lifeguarding course. Because many aquatic facilities now have a
variety of features and attractions, much of the knowledge and skills
Discussion were covered in that course.
■ Remember, your primary responsibility is to help ensure patron safety
and protect lives. The main tool used to accomplish this is patron
surveillance—keeping a close watch over the people in the facility and
intervening when necessary.
■ Ask participants: What are the elements of effective surveillance?
| Recognition of dangerous behaviors
| Victim recognition
| Effective scanning
| Zone of surveillance responsibility
| Lifeguard stations
■ The purpose of the Waterpark Skills module is to teach lifeguards the
knowledge and skills needed to prevent and respond to emergencies in
aquatic facilities with waterpark features.
■ When considering the unique challenges for lifeguarding at a waterpark,
consider what is unique to waterpark facilities, such as:
| Variety and number of attractions and features.
| Where and how lifeguards are positioned, especially related to the
various attractions and features.
| Patrons’ familiarity with the facility (i.e., they are often first time
visitors).
| Water depth and movement throughout the facility.
Facility Safety
Lecture ■ Ask participants: What types of features might you encounter when
and Guided working at a waterpark?
| Play areas for young children.
| Play structures, such as lily pads and rope swings.
| Water slides with and without rafts, drop slides, “toilet bowl/tornado” slides,
speed slides, free-fall slides.
| Winding rivers.
| Wave pools.
| Wave rides.
■ Facilities should follow the manufacturer’s guidelines for installation,
safe inspection, maintenance, operations and use of its various
attractions and features.
■ Ask participants: Even if an attraction or feature has been inspected during
the facility safety check, what types of problems may develop that you
should stay alert for?
| Loose or rusted bolts.
| Cracks.
LGI_SecD_p175-190.indd 180 10/21/11 3:02 PM

| Broken or missing pieces.
| Frayed, loose or mildewed safety nets.
| Unusual noises.
| Increased frequency of injury to patrons.
■ At waterparks, rules and regulations should be posted, but they may also
be played over a public address system as recorded messages. Rules may
vary based on the type of attractions available.
| For example, U.S. Coast Guard-approved life jackets may be required
on certain attractions but not allowed on others.
■ Waterparks should have signage at every attraction stating the water
depth, height or age requirements and how to use the attraction safely.
This is to prevent patrons from finding themselves in water that is
deeper or shallower than they expected.
| For example, some pools at the end of a slide are shallow so patrons
can stand up, but others are very deep. Without signage to warn
them, patrons may expect a shallow catch pool and be surprised to
find themselves in deep water.
■ Additional rules for each attraction typically cover:
| The minimum or maximum number of people allowed on an
attraction or a tube at a time.
| The maximum height or age requirements in some areas designated
for small children for safety reasons.
| The minimum patron height or weight requirements for using an
attraction.
■ Ask participants: What are some common rules for safety in winding
rivers?
| Enter and exit the winding river only at designated places.
| No jumping or diving into the water. No people on shoulders.
| Stay in tubes at all times, if tubes are used.
| No walking or swimming in the winding river if tubes are used.
| Only one properly fitted life jacket per patron.
| No stacking of tubes or life jackets.
| No forming chains of tubes or life jackets.
| Only one patron allowed per tube, except for an adult holding a small child.
The child must be wearing a U.S. Coast Guard-approved life jacket in case the
adult tips over.
■ Ask participants: What are some common rules for safety in water slides?
| Enter, ride and exit the slide feet-first.
| No stopping in the slide.
| No running, standing, kneeling, rotating or spinning on the slides.
| No metal objects, locker keys, jewelry, metal snaps/zippers, eyewear or
watches, including metal rivets, buttons or fasteners on swimsuits or shorts.
| No aqua socks or aqua shoes.
| No eyeglasses, sunglasses or goggles.
| Keep hands and feet inside the slide.
LGI_SecD_p175-190.indd 181 10/13/11 12:41 PM

■ There are other rules for specific equipment and structures. These rules
depend on the facility and may include:
| One person at a time on a ladder or attraction.
| Do not sit or hang on lifelines or lane lines.
| Do not climb on lifeguard stands or towers.
| Starting blocks may be used only by swim team members in
scheduled practices, competitions and instruction when supervised
by a certified coach or instructor.
Injury Prevention
Lecture ■ As part of patron surveillance, you may have specific responsibilities
and Guided based on the facility’s activities or features to help prevent injuries.
Discussion ■ Ask participants to think of specific waterpark features and attractions. Explain to
participants that you will state a responsibility of the lifeguard’s that is intended to
prevent injuries, and they are to identify the waterpark attraction or feature to which
the rule could apply.
Responsibility Feature and Attraction
Enforce maximum height and age requirements. Areas specifically for young children, such as small
slides or water play structures, including sprays,
fountains and dumping buckets
Watch for overcrowding and horseplay Play structures, such as floating obstacle courses or
inflatable structures
Watch patrons as they enter and exit an attraction. Special rides and attractions, such as bowl slides,
multi-person raft rides, uphill water coasters,
high-speed water slides
Have a process or cues for stopping ride usage in the Special rides and attractions, such as bowl slides,
event of an incident requiring your attention. multi-person raft rides, uphill water coasters,
high-speed water slides
Instruct riders how to ride and make sure they are in Water slides, such as open and enclosed slides, drop
the correct position. slides and speed slides
Enforce minimum height requirements. Water slides, such as open and enclosed slides, drop
slides and speed slides
Assist riders who appear off balance or become caught Water slides, such as open and enclosed slides, drop
underwater in the strong downward flow of water in slides and speed slides
the catch pool.
Ensure that patrons enter and exit at designated Winding rivers

locations.
Stand up to get a better view of patrons. Wave pools and winding rivers
Watch for swimmers who are knocked over by Wave pools

the waves or carried into deeper water by the
undercurrent.
LGI_SecD_p175-190.indd 182 12/14/11 8:36 AM

■ Organizations such as day cares or youth camps may bring groups to
waterpark facilities for recreation. These groups may be based out of
your facility and swim regularly or visit one or more times as a field trip.
■ Groups are often supervised by leaders, chaperones or camp counselors.
These supervisors may assist with discipline but do not take the place of
lifeguards. Group leaders may be in the water with the group, on the
deck or shore, or a combination of both. Group leaders should know how
to alert lifeguards in an emergency.
■ In general, when guarding groups, you should:
| Ensure that swimming areas are clearly marked and determined by
swimming abilities.
| Ensure that patrons stay in the sections appropriate for their
swimming abilities.
| Provide U.S. Coast Guard-approved life jackets for weak or
nonswimmers.
| Ensure that chaperones are actively supervising the members of
their group and that the appropriate swimmer-to-chaperone ratio is
being met.
| Signal for additional lifeguard coverage, such as a roving lifeguard, if
you feel you cannot effectively guard your zone.
Emergency Action Plans

Lecture ■ In a waterpark setting there may be additional tasks to perform,
including:
| Stopping the wave generator in a wave pool by pushing the
emergency stop (e-stop) button.
| Stopping the dispatch of riders in an attraction.
| Shutting off the flow of water in a slide, winding river or attraction.
■ Emergency plans may include EMS personnel that are stationed on-site
at the waterpark.
■ Waterparks may have plans designed to address specific situations that
occur at each attraction.
■ Practicing EAPs should be an integral part of the facility’s in-service
training program.
TOPIC: WATERPARK RESCUE SKILLS Time: 10 minutes

PRESENTATION: WATERPARK RESCUE SKILLS
Video Segment ■ Explain that the video segment will demonstrate skills for rescues at waterparks.
■ Show the video segment, “Waterpark Rescue Skills.”
LGI_SecD_p175-190.indd 183 10/21/11 3:02 PM

IN–WATER SKILL SESSION: Time: 1 hour, 30 minutes
WATERPARK RESCUE SKILLS
Skill Practice ■ Explain to participants that during the skill session you will demonstrate the skills
and guide them through practice.
behave as victims.
■ Pair up participants and explain that they will take turns as victim and rescuer for
each skill. For the two-person beach drag, reassign participants into groups of three.
| Walking assist
● Victims: in shallow water about 5 yards from the edge of the pool or zero-
depth area; distressed swimmer
| Beach drag—one person and two person
depth area; face-up passive victim
depth area; face-up passive victim
■ Explain to participants that caring for head, neck and spinal injuries in waterpark
features and attractions require modification of the techniques used for in-line
stabilization learned in the Lifeguarding course.
■ Lead participants through the following skills:
● Victims: face-down in extremely shallow water, approximately one foot
deep, or lying on the deck if simulating the extremely shallow water,
responsive once face-up
| Head splint—moving water (winding river or catch pool)
● Lifeguards: on the edge of a winding river or catch pool
● Victims: face-up in shallow water
■ With participants performing as a team, lead them through the backboarding
procedure and removal from the water for a suspected spinal injury in a speed slide
runout.
| Lifeguards: on the edge of a speed slide runout
| Victims: face-up in shallow water
criteria.
LGI_SecD_p175-190.indd 184 10/21/11 3:02 PM


■ Assemble the participants on the deck and explain they will be practicing rescuing a
backboard, doing a primary assessment and caring for a victim who is not breathing
and does not have a pulse.
■ Explain that the goal of this skill practice is to complete it within 2 minutes. Timing
starts once the lifeguard simulates the EAP. One-rescuer CPR should be performed
for 3 minutes.
for each group. Explain that for each group:
| The rescuing lifeguard, wearing a hip pack with gloves inside, will simulate
| The victim will get into position about 30 feet from the edge and submerge as the
rescuing lifeguard gets near. The rescuing lifeguard will perform a submerged
passive victim rescue.
in removing the victim from the water demonstrating team communication skills
between the lifeguards.
| Once removed from the water, the rescuing lifeguard will do a primary
FINAL WRITTEM EXAM: Time: 25 minutes

■ Tell participants that they will now take a final written exam on the information
covered in the module. They may not use their manual or notes to find the answers.
■ Hand back the exam and review it with participants. Collect all exams as the exam is
for those participants who score less than 80 percent to review the material and re-
take the opposite version of the exam.
LGI_SecD_p175-190.indd 185 10/13/11 12:41 PM

■ Thank all participants for attending the course.

■ Explain the process for how certificates are issued through the Red Cross.
■ Explain that they will receive an American Red Cross certificate indicating Waterpark
Skills that is valid for no more than 2 years. The Waterpark Skills certificate is only
valid when accompanied by a current Lifeguarding/First Aid/CPR/AED certificate.
exam(s) or scenario(s).

ENTRIES
SKILL CHART: RUN-AND-SWIM ENTRY
1. Hold the rescue tube and the excess line and run into the water, lifting your knees high to avoid falling.
2. When you can no longer run, either put the rescue tube across your chest and lean forward or drop the tube to
the side and start swimming, letting the rescue tube trail behind. Do not dive or plunge head-first into the
water; this could cause a serious head, neck or spinal injury.
SKILL ASSESSMENT TOOL: RUN-AND-SWIM ENTRY
Properly position equipment for the ■ Control of the rescue tube is ■ Contact with the rescue tube
entry maintained not maintained
Appropriate entry selected for the Entry is safe for the rescuer, victim Entry causes a safety hazard
Maintain balance while running in Lifts knees high to step over the ■ Fails to lifts knees high enough
the water water to step over the water
■ Loses balance when entering
the water
■ Dives forward when entering
the water
Begin swimming when no longer Leans forward into water with head Does not keep head up while
able to run up to begin swimming swimming toward victim
Maintain focus on the victim Upon entering, focus on the victim Fails to look toward the victim or
or the site where the victim was last site where the victim was last seen
seen is maintained
LGI_SecD_p175-190.indd 186 10/13/11 12:41 PM

SKILL CHART: WALKING ASSIST
1. Place one of the victim’s arms around your neck and across your shoulder.
2. Grasp the wrist of the arm that is across your shoulder. Wrap your free arm around the victim’s back or waist
to provide support.
3. Hold the victim firmly and assist him or her in walking out of the water.
4. Have the victim sit or lie down while you monitor his or her condition.
SKILL ASSESSMENT TOOL: WALKING ASSIST
Communicate with the victim Victim is reassured and told what No attempted verbal
Maintain balance Assumes a sturdy posture and stable Stumbles, falls or knocks victim
Assist victim with balance and ■ Holds victim’s hand securely ■ Fails to hold victim’s hand
bearing weight to walk out of water with arm across shoulders to securely with arm across
bear weight. shoulders
■ Supports victim across the back ■ Fails to support victim’s
for balance and stability. weight
■ Fails to provide balance and
stability to victim while exiting
the water
SKILL CHART: BEACH DRAG
1. Stand behind the victim and grasp him or her under the armpits, supporting the victim’s head as much as
possible with your forearms. Let the rescue tube trail behind, being careful not to trip on the tube or line. If
another lifeguard is available to assist, each of you should grasp the victim under an armpit and support
the head.
2. Walk backward and drag the victim to the shore. Use your legs and not your back.
3. Remove the victim completely from the water then assess his or her condition and provide appropriate care.
SKILL ASSESSMENT TOOL: BEACH DRAG
Securely hold victim Grasps victim securely under the Does not grasp victim securely
armpits under the armpits
Securely hold victim’s head Forearms held close together to ■ Fails to support victim’s head
support victim’s head. securely between forearms
■ Forearms are positioned so
victim’s head falls back
Keep victim’s head above the Mouth and nose of victim Mouth or nose of victim is in the
SKILL CHART: FRONT-AND-BACK CARRY
1. From behind the victim, one lifeguard reaches under the victim’s armpits. This lifeguard grasps the victim’s
right wrist with his or her right hand, and the victim’s left wrist with his or her left hand. Then the lifeguard
crosses the victim’s arms across the victim’s chest.
2. The second lifeguard stands between the victim’s legs, facing the victim’s feet. This lifeguard bends down and
grasps the victim under the knees. On signal, both lifeguards lift the victim and carry him or her out of the
water while walking forward.
LGI_SecD_p175-190.indd 187 10/13/11 12:41 PM

SKILL ASSESSMENT TOOL: FRONT-AND-BACK CARRY
Securely hold victim ■ Lifeguard 1 grasps victim ■ Lifeguards fail to support

securely under the armpits victim under the armpits or
■ Lifeguard 1 grasps wrists knees
■ Lifeguard 2 grasps victim ■ Victim is dropped
securely under the knees
SUSPECTED SPINAL INJURIES
SKILL CHART: HEAD SPLINT—FACE-DOWN IN EXTREMELY SHALLOW WATER
1. Approach the victim from the side. Grasp the victim’s right arm with your right hand and the victim’s left arm
with your left hand, trapping the victim’s head between his or her arms.
2. After the victim’s head is trapped between his or her arms, begin to roll the victim toward you.
3. While rolling the victim, step from the victim’s side toward the victim’s head and begin to turn the victim
face-up.
4. Lower your arm on the victim’s side that is closest to you so that the victim’s arms go over the top of your arm
as you step toward the victim’s head. Maintain arm pressure against the victim’s head, since your hand rotates
during this maneuver. You are now positioned above and behind the victim’s head.
| If the victim is not breathing, immediately remove the victim from the water and give the appropriate
care.
| If the victim is breathing, hold the victim in this position. Place a towel or blanket on the victim to keep
him or her from becoming chilled.
Note: If unable to keep the victim from becoming chilled and there are enough assisting lifeguards, follow the
care steps for Spinal Backboarding Procedure and Removal from Water—Speed Slide.
SKILL ASSESSMENT TOOL: HEAD SPLINT—FACE-DOWN IN EXTREMELY SHALLOW
WATER
Keep victim’s face out of the water ■ Victim’s face does not submerge ■ Victim’s face submerges under
■ Mouth and nose are above water water
under water
Move victim to a safe location to ■ If victim’s condition is life- ■ Does not move victim to a safe
water quickly to perform care as ■ Fails to check victim’s
needed condition
■ Follows facility procedures for
backboarding
LGI_SecD_p175-190.indd 188 10/13/11 12:41 PM

SKILL CHART: HEAD SPLINT—FACE-UP VICTIM IN MOVING WATER
■ Activate the EAP and, if applicable, signal to stop the flow of water and stop sending riders.
■ Keep people or objects away from the rescuer and victim.
1. Approach the victim’s head from behind, or stand behind the victim’s head.
| In shallow water, lower your body so that the water level is at your neck.
2. Grasp the victim’s arms midway between his or her shoulder and elbow. Grasp the victim’s right arm with
your right hand and the victim’s left arm with your left hand. Gently move the victim’s arms up alongside the
head. Position yourself to the victim’s side while trapping the victim’s head with his or her arms.
3. Slowly and carefully squeeze the victim’s arms against his or her head to help hold the head in line with the
body. Do not move the victim any more than necessary.
4. Position the victim’s head close to the crook of your arm, with the head in line with the body.
| If the victim is not breathing, immediately remove the victim from the water using the two-person-
removal-from-the water technique and provide resuscitative care. Do not delay removal from the water
by strapping the victim in or using the head immobilizer device.
| If the victim is breathing, hold the victim with the head in line with and move toward safety until the
backboard arrives.
6. Once in-line stabilization is achieved:
| In a winding river, do not let the current press sideways on the victim or force the victim into a wall. This
would twist the victim’s body. Keep the victim’s head pointed upstream into the current.
| In a catch pool, move the victim to the calmest water if water is still flowing. If there is only one slide, the
calmest water is usually at the center of the catch pool. If several slides empty into the same catch pool,
calmer water is usually between two slides.
SKILL ASSESSMENT TOOL: HEAD SPLINT—FACE-UP VICTIM IN MOVING WATER
Victim’s face remains out of the ■ Victim’s face does not submerge ■ Victim’s face submerges
water ■ Mouth and nose above water underwater
■ Victim’s mouth or nose are
underwater
Move victim to a safe location to ■ Moves victim to an area least ■ Remains in moving water
prepare for backboarding affected by movement or when calmer area is possible
current
Move victim to a safe location to ■ If condition of victim is life- ■ Does not move victim to a safe
water quickly to perform care as ■ Fails to check victim’s level of
needed consciousness and breathing
LGI_SecD_p175-190.indd 189 10/13/11 12:41 PM

SKILL CHART: SPINAL BACKBOARDING PROCEDURE AND REMOVAL FROM
WATER—SPEED SLIDE
1. The primary rescuer performs in-line stabilization by placing his or her hands on both sides of the victim’s
head while the victim is on the slide.
2. Other lifeguards carefully lift the victim and slide the backboard into place from the feet to the head.
3. Lifeguards lower the victim onto the backboard.
4. Lifeguards secure the victim to the backboard and immobilize the head.
5. Lifeguards lift the backboard and victim out of the slide.
SKILL ASSESSMENT TOOL: SPINAL BACKBOARDING PROCEDURE AND
REMOVAL FROM WATER—SPEED SLIDE
Maintain in-line stabilization Lifeguard maintains in-line ■ Loss of in-line stabilization

stabilization while backboard is during the rescue
being positioned ■ Loss of contact with the victim
Victim’s face remains out of the Mouth and nose above water Victim’s mouth or nose are
water underwater
Position the victim on the ■ Victim is lifted and the ■ Victim’s head is not aligned on
backboard backboard is slid in place the backboard’s head space
■ Victim’s body is on the ■ Victim is not aligned and on
backboard the backboard

thighs the strap
■ Hip strap is placed across the ■ Straps are loose and victim
hips with the hands secured can easily slide
underneath the strap
■ Straps are not re-checked for
■ Straps are tight and once all tightness
straps are secured, they are re-
■ Straps are not tightened if
checked
discovered loose
immobilize the victim’s head ■ Head immobilizer is placed
■ Head strap is secured across the and moves victim’s head or
victim’s forehead neck
victim’s forehead
Lifeguards communicate as a team Lifeguards communicate what, how ■ No verbal communication

to remove the victim from the water or when actions happen ■ Communication does not
result in effective actions
Lifeguards remove the backboard ■ Backboard and victim is ■ Backboard is lifted causing the
and victim from the water removed by lifting it out of the victim to move or slide
slide ■ Backboard is jerking or
■ Backboard is steady during rocking from side to side
removal
LGI_SecD_p175-190.indd 190 10/13/11 12:41 PM

SECTION E | LIFEGUARDING FINAL
WRITTEN EXAMS
SECTION 1—CPR/AED FOR THE PROFESSIONAL RESCUER AND

FIRST AID
■ Final Written Exam A
■ Final Written Exam B
SECTION 2—LIFEGUARDING SKILLS

SECTION 2—SHALLOW WATER LIFEGUARDING SKILLS



ANSWER SHEETS
■ Section 1—CPR/AED for the Professional Rescuer and First Aid
■ Section 2—Lifeguarding Skills
■ Section 2—Shallow Water Lifeguarding Skills
■ Waterfront Skills Module
■ Waterpark Skills Module
SECTION E | Lifeguarding Final Written Exams 191
LGI_SecE_p191-252.indd 191 12/16/11 10:42 AM

ANSWER KEYS
■ Answer Key—Final Written Exam A
{ Section 1—CPR/AED for the Professional Rescuer and First Aid
{ Section 2—Lifeguarding Skills
{ Section 2—Shallow Water Lifeguarding Skills
{ Waterfront Skills Module
{ Waterpark Skills Module
■ Answer Key—Final Written Exam B
{ Section 1—CPR/AED for the Professional Rescuer and First Aid
{ Section 2—Lifeguarding Skills
{ Section 2—Shallow Water Lifeguarding Skills
{ Waterfront Skills Module
{ Waterpark Skills Module
LGI_SecE_p191-252.indd 192 12/16/11 10:42 AM

FINAL WRITTEN EXAM: SECTION 1—
CPR/AED FOR THE PROFESSIONAL

LGI_SecE_p191-252.indd 193 10/17/11 12:00 PM

—DO NOT WRITE ON THIS EXAM—
Section 1—CPR/AED for the Professional Rescuer Exam A

and First Aid
IMPORTANT: Read all instructions before beginning the exam.
INSTRUCTIONS: Mark all answers in pencil on a separate answer sheet. Do not write on this exam. The
questions on this exam are multiple choice. Read each question carefully. Then choose the best answer and fill in
that circle on the answer sheet. If you wish to change an answer, erase your first answer completely. Return this
exam to your instructor when you are finished.
EXAMPLE
ANSWER SHEET
xx. a b c
XX. Why does the American Red Cross teach this course?
a. To help people stay calm in emergencies.
b. To help people make appropriate decisions when they are confronted with an emergency.
c. To help people in an emergency keep a victim’s injuries from getting worse until emergency medical
services (EMS) personnel arrive and take over.
d. All of the above
LGI_SecE_p191-252.indd 194 10/17/11 12:00 PM

Section 1—CPR/AED for the Professional Rescuer Exam A

and First Aid
1. How can you best protect yourself from possible 4. You and another lifeguard find an unconscious
bloodborne pathogen transmission when adult on the floor in the locker room. You activate
providing care? your facility’s EAP, size-up the scene and perform
a. Ask the victim first if he or she has any a primary assessment. You find the victim is not
communicable diseases. moving or breathing, but has a pulse. You should
summon EMS personnel, then:
b. Thoroughly wash your hands before
providing care. a. Give 1 rescue breath about every 5 seconds.
c. Use first aid supplies, such as dressings and b. Give back blows and chest thrusts.
bandages, as a barrier when in contact with c. Give quick breaths at the rate of 20 to 40
the victim. a minute.
d. Use personal protective equipment (PPE), d. Perform CPR.
such as disposable gloves and a breathing
barrier, when providing care.
5. You come upon a scene where a patron appears to
2. A 12-year-old boy at a swim meet grabs his chest be injured. Before approaching the victim, which of
and begins to make wheezing noises. After you the following will you not do as you size-up
obtain consent to provide care, his mother informs the scene?
you that he has a history of asthma, but does not a. Use all your senses to determine if the scene
have his inhaler nearby. What care should is safe.
you provide?
b. Determine what happened and how many
a. Give 5 back blows. victims there are.
b. Summon more advanced medical personnel c. Begin the primary assessment.
and place the victim into a position that
d. Put on appropriate PPE.
helps breathing.
c. Tell the victim to use an inhaler borrowed
from a bystander.
6. When providing care during an emergency, which
d. Wait 20 minutes to see if the breathing of the following should you do first?
difficulty goes away.
a. Check for responsiveness.
b. Perform a primary assessment.
3. While having a snack in the concession area, a
c. Size-up the scene.
child suddenly clutches his throat with both hands.
You ask him if he is choking and he frantically nods d. Summon more advanced medical personnel.
yes. You activate your facility’s emergency action
plan (EAP). You identify yourself as a lifeguard and
obtain consent from the parents. What should you 7. As the first lifeguard on the scene, you are
do next? performing CPR on an adult. When performing
a. Check the victim’s carotid pulse and then give chest compressions, how deeply should you
5 back blows and 5 abdominal thrusts. compress the chest?
b. Give 30 chest compressions followed by a. About ½ inch
2 ventilations. b. About 1½ inches
c. Lie the victim down and try to give c. At least 1 inch
2 ventilations. d. At least 2 inches
d. Stand or kneel behind the victim and give
5 back blows and 5 abdominal thrusts.
LGI_SecE_p191-252.indd 195 12/16/11 10:42 AM

8. CPR should be performed on which of the 13. You are performing CPR on a victim and a second
following victims? lifeguard arrives. Which of the following is most
a. One who is conscious and has an appropriate for the second lifeguard to do first?
airway obstruction a. Begin giving ventilations to the victim.
b. One who is experiencing difficulty breathing b. Call for a change in position to assist with CPR.
c. One who is in cardiac arrest c. Check to see whether EMS personnel have
d. One who responds to painful stimuli been called.
d. Have the first lifeguard stop CPR to allow for
victim reassessment.
9. What is the first step of the Cardiac Chain
of Survival?
a. Early CPR 14. Which of the following is most essential to use
when giving ventilations to protect you and the
b. Early defibrillation
victim from disease transmission?
c. Early more advanced medical care
a. CPR breathing barriers
d. Early recognition and access to the emergency
b. Protective clothing
medical services (EMS) system
c. Gowns
d. Protective eye wear
10. You are providing care to a victim having a heart
attack. Which of the following would you do first?
a. Loosen any tight clothing. 15. You are providing care to a facility maintenance
worker who has fallen off the top of a ladder. The
b. Monitor the victim’s appearance.
victim is conscious. Which of the following should
c. Provide comfort to the victim. you do first?
d. Summon EMS personnel. a. Ask the victim what happened when he or
she fell.
b. Check the victim’s pulse.
11. Once you have turned on the automated external
c. Obtain consent from the victim to
defibrillator (AED), you should:
provide care.
a. Apply the pads and allow the AED to analyze
d. Question the victim about any complaints
the heart rhythm.
of pain.
b. Check for breathing.
c. Give abdominal thrusts.
d. Give chest compressions. 16. For which of the following should you summon
EMS personnel?
a. A victim with a minor cut on the forearm that
12. To ensure effective chest compressions during is lightly bleeding
CPR, which of the following is most appropriate? b. A victim with an airway obstruction who is
a. Allowing the chest to fully recoil forcefully coughing
between compressions c. A victim with intermittent abdominal pressure
b. Compressing the chest to a shallow depth d. A victim with an open leg wound with the
c. Placing the victim on a soft, flat surface bone protruding
d. Positioning the hands at the upper part of the
victim’s chest
LGI_SecE_p191-252.indd 196 12/27/11 10:15 AM

17. You pull an unconscious adult from the water who 21. You are preparing to give ventilations to a
is taking infrequent gasps. During the primary 5-year-old boy using a resuscitation mask. You
assessment you find that the victim has a pulse. should give 1 ventilation about every:
Which of the following should you do next? a. 1 second.
a. Begin CPR. b. 2 seconds.
b. Check for severe bleeding. c. 3 seconds.
c. Continue to monitor the victim’s d. 5 seconds.
breathing closely.
d. Give 2 initial ventilations.
22. When compressing a child’s chest during CPR, you
should compress at a rate of at least how many
compressions per minute?
18. If there is a risk of the AED pads touching each
other, such as with a small child or an infant, a. 80
you should: b. 100
a. Place one pad in the middle of the chest and c. 120
the other on the back. d. 140
b. Place one pad on the stomach and one pad on
the chest.
23. An AED has advised that a shock should be given.
c. Place them as usual. It does not matter if the
Which of the following is appropriate?
pads touch each other.
a. Apply new AED pads to the victim’s chest.
d. Reverse the pads’ position on the chest.
b. Begin chest compressions immediately.
c. Cover the AED pads with a blanket.
19. You have sized up the scene and determined d. Tell everyone to stand clear of the victim.
the scene is safe. When performing a primary
assessment, which of the following would you
do next? 24. You are about to apply AED pads to a victim’s chest
when you notice that the victim has several body
a. Check for responsiveness.
piercings with jewelry on his chest. Which of the
b. Summon EMS personnel.
following should you do?
c. Open the victim’s airway.
a. Apply the pads to the chest, making sure to
d. Check for breathing and a pulse. avoid the jewelry.
b. Remove the jewelry before applying the pads.
c. Use one pad, applying it directly over
20. Which of the following statements about the jewelry.
bag-valve-mask resuscitators (BVMs) is
d. Wipe the chest, including the jewelry,
most accurate?
with alcohol.
a. BVMs are readily available at all
emergency scenes.
b. Monitoring the victim for full exhalation is 25. The cycle of chest compressions and ventilations in
not required. two-rescuer CPR for an infant is:
c. Two rescuers need to operate the BVM. a. 15 chest compressions and 1 ventilation.
d. When used by a single rescuer, BVMs allow b. 15 chest compressions and 2 ventilations.
easy coordination with chest compressions. c. 30 chest compressions and 1 ventilation.
d. 30 chest compressions and 2 ventilations.
LGI_SecE_p191-252.indd 197 10/17/11 12:00 PM

26. You are positioned above the child’s head and are 30. When providing care to a conscious infant
using a resuscitation mask to give ventilations. who is choking, which of the following is
After you position the mask, which of the following most appropriate?
should you do next? a. Giving 10 chest thrusts then 10 back blows
a. Blow into the mask. b. Positioning the infant so the head is lower than
b. Lower the mask over the mouth. the chest
c. Open the airway. c. Standing slightly behind the infant with one
d. Seal the mask. arm around the chest
d. Using the heel of your hand to give the
chest thrusts
27. You are providing care to a patron who started
choking on some food. The victim becomes
unconscious. Which of the following should you 31. A person has been injured and is conscious.
do first? You should:
a. Attempt to give ventilations to the victim. a. Have the victim walk with you to the first
b. Lower the victim carefully to the ground and aid station so you can obtain consent and
open his airway. provide care.
c. Give 5 chest compressions. b. Obtain consent, check the victim for

life-threatening conditions and speak with
d. Look inside the victim’s mouth.
the victim to find out what happened.
c. Provide care immediately based on the
victim’s condition.
28. Where should you place your hands when giving
d. Speak with the victim to find out
chest compressions to an infant during CPR?
what happened and check for
a. One hand on the chin and one hand on
non-life-threatening conditions.
the chest
b. One hand on the chin and two or three fingers
on the center of the chest
32. The purpose of the secondary assessment is to:
c. One hand on the forehead and one hand on
a. Determine if the victim is bleeding severely.
the chest
b. Identify and care for conditions that are not
d. One hand on the forehead and two or three
life threatening.
fingers on the center of the chest
c. Look for other victims you may not have
noticed at first.
d. Verify the victim has medical insurance.
29. When giving abdominal thrusts to an adult, where
should you position your fist?
a. In the center of the breastbone
33. An injured patron is conscious and bleeding
b. In the middle of the abdomen, just above severely. After summoning EMS personnel,
the navel obtaining consent and putting on disposable
c. In the middle of the abdomen, just below gloves, what is your next care step?
the navel a. Treat the victim for shock by lying the
d. On the rib cage victim down.
b. Elevate the wound if you can do so without
causing further pain.
c. Let the wound bleed until it stops on its own.
d. Press firmly against the wound with a sterile
dressing and bandage.
LGI_SecE_p191-252.indd 198 12/16/11 10:42 AM

34. A way to remember the questions to ask when 38. When caring for musculoskeletal injuries, what
taking a brief history is to use the acronym does RICE stand for?
SAMPLE. What does the A in SAMPLE stand for? a. Rest, immobilize, cold, elevate
a. Age b. Remove, immobilize, care, elevate
b. Airway c. Rest, ice, care, evaluate
c. Allergies d. Remove, ice, care, evaluate
d. Ankle
39. Signs and symptoms of sudden illness do

35. What is the first step you should take in caring for not include:
a victim with burns? a. Nausea or vomiting.
a. Cool the burned area to stop the burning. b. Loss of vision or blurred vision.
b. Keep the victim comfortable. c. Bruising or rigidness of the abdomen.
c. Remove the victim from the source of d. Changes in skin condition.
the burn.
d. Take steps to minimize shock.
40. When checking a victim during a secondary
assessment you notice changes in her LOC. What
36. If a victim is having a seizure in the water: does the C stand for in LOC?
a. Immediately get him or her out of the water. a. Condition.
b. Immediately move the victim to shallow b. Comprehension.
water until the seizure ends, if the victim is in c. Consciousness.
deep water.
d. Complication.
c. Secure the victim onto a backboard.
d. Support the victim with his or her head above
water until the seizure ends.
37. During a swim meet, the bleachers behind your

guard station suddenly collapse. As you check
the scene, you notice several people who appear
injured. Who should you approach first?
a. A mother holding a crying infant.
b. A man who appears unconscious.
c. A woman who is bleeding lightly from an
injury on her leg.
d. A child who is holding his arm, which appears
to be injured.
LGI_SecE_p191-252.indd 199 12/16/11 10:42 AM

Section 1—CPR/AED for the Professional Rescuer Exam B

and First Aid
EXAMPLE
ANSWER SHEET
xx. a b c
d. All of the above
LGI_SecE_p191-252.indd 200 10/17/11 12:00 PM

Section 1—CPR/AED for the Professional Rescuer Exam B

and First Aid
1. You come upon a scene where someone seems 5. You are providing care to a conscious infant who is
to be hurt. During the primary assessment, you choking. When giving chest thrusts, which of the
should check for all of the following EXCEPT: following would you use?
a. Bleeding. a. Fist of the hand
b. Breathing. b. Heel of the hand
c. Consciousness. c. Two hands
d. Swelling. d. Two or three fingers
2. How can you best protect yourself from possible 6. You determine that a victim is unconscious but
bloodborne pathogen transmission when breathing. While waiting with the victim for EMS
providing care? personnel, you would position the victim:
a. Ask the victim first if he or she has any a. Face-up.
communicable diseases. b. In a modified high arm in endangered spine
b. Thoroughly wash your hands before (H.A.IN.E.S.) recovery position.
providing care. c. On his or her abdomen.
c. Use protective equipment, such as disposable d. On his or her side.
gloves and a breathing barrier, when
providing care.
d. Use first aid supplies, such as dressings and 7. While preparing to use an automated external
bandages, as a barrier when in contact with defibrillator (AED) on a victim, you notice a
the victim. medication patch on the victim’s chest. Which
action is most appropriate?
a. Applying one of the pads directly over
3. Which of the following would you identify as the the patch
universal sign that a conscious person is choking? b. Removing the patch with a gloved hand
a. Clutching the throat c. Placing one pad on the victim’s chest and the
b. Coughing other on his or her back
c. Inability to speak or cry d. Wiping the victim’s chest dry, avoiding
the patch
d. Yelling out “I’m choking”
8. You are giving ventilations to a 5-year-old child

4. As you are giving ventilations with a resuscitation using a resuscitation mask. You should give
mask, the victim vomits. Which of the following 1 ventilation about every:
would you do first?
a. 1 second.
a. Clear the airway of the vomit immediately.
b. 2 seconds.
b. Reposition the victim’s head to reopen
c. 3 seconds.
the airway.
d. 5 seconds.
c. Turn the victim as a unit onto his or her side.
d. Use greater force when ventilating to bypass
the vomit.
LGI_SecE_p191-252.indd 201 10/17/11 12:00 PM

9. Which of the following statements about 13. You are performing CPR on a victim and a second
bag-valve-mask resuscitators (BVMs) is lifeguard arrives. Which of the following is most
most accurate? appropriate for the second lifeguard to do first?
a. BVMs are readily available at all a. Begin giving ventilations to the victim.
emergency scenes. b. Call for a change in position to assist with CPR.
b. Monitoring the victim for full exhalation is c. Check to see whether EMS personnel have
“not required. been called.
c. Two rescuers need to operate the BVM. d. Have the first lifeguard stop CPR to allow for
d. When used by a single rescuer, BVMs allow victim reassessment.
easy coordination with chest compressions.
14. Which of the following findings would lead you to

determine that an infant’s airway is open?
10. When giving chest compressions to an adult, how
a. The infant is crying uncontrollably.
would you position your hands?
b. The infant is not breathing.
a. Side-by-side at the middle of the victim’s chest
c. The infant is unable to speak.
b. Encircling the chest with the thumbs centered
at the nipple line d. The infant’s chest fails to rise and fall.
c. Heel of one hand on the center of the chest
with the other hand on top 15. During a primary assessment, which of the
d. Three fingers of one hand on the chest with the following should you evaluate first?
palm of the other on top a. Airway
b. Breathing
c. Circulation
11. You are performing CPR on a victim and you notice
that the victim’s chest begins to rise and fall. Which d. Check the victim for responsiveness
of the following would you do first?
a. Continue to perform CPR. 16. You are walking on the pool deck when the swim
b. Place the victim face-down to maintain team coach suddenly collapses in front of you.
the airway. During your primary assessment you do not find a
c. Stop chest compressions but pulse, you should:
continue ventilations. a. Suspect he is an unconscious choking victim
d. Stop CPR and monitor the victim’s condition. and give 2 ventilations.
b. Suspect he is in cardiac arrest and immediately
begin CPR.
12. When using a resuscitation mask, which of the c. Suspect he has had a stroke and care for shock
following should you do? and maintain an open airway.
a. Blow into the mask for at least 2 seconds to d. Suspect he may have a head, neck or spinal
give ventilations. injury and send someone to call EMS.
b. Cover the nose completely with the mask with
the bottom edge at the upper lip. 17. Based on which of the following signs and
c. Hold the mask at the one-way valve to seal it. symptoms would you determine that a victim is
d. Place the broad end of the mask between the experiencing respiratory distress?
lower lip and chin. a. Audible high-pitched gurgling
b. Complaints of feeling “really thirsty”
c. Sneezing with watery eyes
d. Yellowish skin
LGI_SecE_p191-252.indd 202 12/16/11 10:42 AM

18. You and another lifeguard find an unconscious 22. You and a fellow lifeguard are giving ventilations
adult on the locker room floor. The other lifeguard using a BVM. You position the mask over the
goes to summon EMS personnel. You complete a victim’s mouth and nose. What should the other
primary assessment and find that the victim has a lifeguard do?
pulse but is not breathing. Which of the following a. Ensure that the mask is sealed.
should you do next?
b. Open the airway with the thumbs.
a. Give 1 ventilation about every 5 seconds.
c. Position fingers behind the jawbone.
b. Give the victim back blows and chest thrusts.
d. Squeeze the bag with both hands.
c. Perform a finger sweep of the victim’s mouth.
d. Perform CPR.
23. You and another lifeguard are preparing for CPR
on an adult who collapsed in the locker room. You
19. As the only lifeguard performing CPR on a determine that there is no breathing or pulse and
7-year-old child, you would perform cycles of: state, “Victim has no pulse. Begin CPR.” Which of
the following should the other lifeguard do next?
a. 15 chest compressions and 1 ventilation.
a. Check for breathing.
b. 20 chest compressions and 1 ventilation.
b. Begin chest compressions.
c. 25 chest compressions and 1 ventilation.
c. Give 2 ventilations.
d. 30 chest compressions and 2 ventilations.
d. Open the airway.
20. An AED indicates that “No shock is advised.”

24. Which of the following is most essential to use
Which of the following is most appropriate to
when giving ventilations to protect you and the
do next?
victim from disease transmission?
a. Monitor the victim’s airway and breathing.
a. CPR breathing barriers
b. Perform CPR for about 2 minutes.
b. Protective clothing
c. Readjust the pad placement on the victim.
c. Gowns
d. Turn off the AED for 5 seconds and try again.
d. Protective eyewear
21. You are providing care to an adult who is 25. Which of the following should you do first when
unconscious and not breathing. You give 1 approaching the scene of an emergency?
ventilation during CPR and notice that the chest
a. Complete a primary assessment.
does not rise. Which of the following should you
do next? b. Obtain the victim’s consent to provide care.
a. Change the position of the mask and then look c. Size-up the scene.
for chest movement. d. Summon EMS personnel.
b. Blow into the mask more forcefully and then
look for the chest to rise.
26. To ensure effective chest compressions during
c. Give 5 back blows and then check the
CPR, which of the following is most appropriate?
victim’s mouth.
a. Allowing the chest to fully recoil
d. Retilt the head and then attempt
between compressions
another ventilation.
b. Compressing the chest to a shallow depth
c. Placing the victim on a soft, flat surface
d. Positioning the hands at the upper part of the
victim’s chest
LGI_SecE_p191-252.indd 203 12/16/11 10:42 AM

27. When using an AED, which of the following should 31. A patron has cut her leg on the edge of the
you do immediately after attaching the AED pads bleachers and is bleeding heavily. You think the
to the victim’s chest? patron is in shock because she:
a. Push the “Analyze” button. a. Becomes restless and irritable.
b. Tell everyone to stand clear. b. Has a red rash.
c. Turn on the AED. c. Has dry skin.
d. Wipe the victim’s chest dry. d. Is calm and quiet.
28. A person has been injured and is conscious.

32. The purpose of a secondary assessment is to:
You obtain consent to check the victim for
a. Determine if the victim is bleeding severely.
life-threatening conditions. What life-threatening
condition would require you to immediately b. Identify and care for conditions that are not
summon EMS personnel? life threatening.
a. Minor cuts and scrapes c. Look for other victims you may not have
noticed at first.
b. Minor headache
d. Verify the victim has medical insurance.
c. Persistent chest pain
d. Swollen ankle
33. An injured patron is conscious and bleeding

29. You and a patron enter the locker room and find an severely. After summoning EMS personnel,
unconscious person lying on the floor. You size-up obtaining consent and putting on disposable
the scene and then you begin performing a primary gloves, what is your next care step?
assessment. The patron asks, “Should we move a. Clean the wound and area of bodily fluids to
him to the first aid room?” What should you minimize contamination.
do next? b. Elevate the wound if you can do so without
a. Help the patron move the victim to the first causing further pain.
aid room. c. Let the wound bleed until it stops on its own.
b. Splash the victim’s face with cold water. d. Press firmly against the wound with a sterile
c. Tell the patron the victim should not be moved dressing and apply bandage.
since there is no immediate danger.
d. Tell the patron to move the victim while you
get other lifeguards to help. 34. When immobilizing an injured patron’s arm:
a. Leave the arm in the position you find it or in
the position the patron is holding it.
30. A 12-year-old boy at a swim meet grabs his chest
b. Loosely apply a sling so the patron can move
and begins to make wheezing noises. After you
the arm around.
obtain consent to provide care, his mother informs
you that he has a history of asthma, but does not c. Secure the injured arm to the patron’s
have his inhaler nearby. What care should you uninjured arm.
provide? d. Straighten the arm and place a folded towel
a. Give 5 back blows. between the injured arm and the patron’s ribs.
b. Summon EMS personnel and place the victim
into a position that helps breathing.
c. Tell the victim to use an inhaler borrowed
from a bystander.
d. Wait 20 minutes to see if the breathing
difficulty goes away.
LGI_SecE_p191-252.indd 204 10/17/11 12:00 PM

35. A way to remember the questions to ask when 38. A victim is having a seizure in the water, what
taking a brief history is to use the acronym should you do?
SAMPLE. What does the S in SAMPLE stand for? a. Immediately get him or her out of the water.
a. Safety techniques b. Immediately move the victim to shallow water
b. Secondary assessment until the seizure ends, if the victim is in
c. Signs and symptoms deep water.
d. Spinal injury assessment c. Secure the victim onto a backboard.
d. Support the victim with his or her head above
water until the seizure ends.
36. A patron seems to be having a diabetic emergency.
You should:
a. Have the victim drink a diet soda. 39. During a swim meet, the bleachers behind your
guard station suddenly collapse. As you check
b. Have the victim drink a fruit juice.
the scene you notice several people who appear
c. Have the victim drink a glass of water. injured. Who should you approach first?
d. Have the victim lie down and cover him or her a. A mother holding a crying infant
with a blanket.
b. A man who appears unconscious
c. A woman who is bleeding lightly from an
injury on her leg
37. A patron has slurred speech, is unable to lift her
right arm level with her left arm and is unable to d. A child who is holding his arm, which appears
smile without one side of her face drooping. You to be injured
make note of the time the symptoms started. These
are symptoms of:
a. A head, neck or spinal injury. 40. When caring for musculoskeletal injuries, what
does RICE stand for?
b. A stroke.
a. Rest, immobilize, cold, elevate
c. Internal bleeding.
b. Remove, immobilize, care, elevate
d. Poisoning.
c. Rest, ice, care, evaluate
d. Remove, ice, care, evaluate
LGI_SecE_p191-252.indd 205 12/16/11 10:42 AM

LIFEGUARDING SKILLS

LGI_SecE_p191-252.indd 206 12/16/11 10:42 AM

Section 2—Lifeguarding Skills Exam A

EXAMPLE
ANSWER SHEET
xx. a b c
d. All of the above
LGI_SecE_p191-252.indd 207 12/16/11 10:42 AM

Section 2—Lifeguarding Skills Exam A

1. You notice a patron that is swimming laps who 4. Which of the following is a primary responsibility
suddenly slips under water without a struggle and of a lifeguard?
does not resurface. This person is probably: a. Enforcing facility rules and regulations and
a. A distressed swimmer who needs help. educating patrons about them
b. A passive victim who needs help. b. Filling out required records and reports on
c. An active victim who needs help. schedule and submitting them to the proper
person or office
d. An intermediate swimmer who does not
need help. c. Monitoring the performance of the other
lifeguards on duty
d. Performing opening duties, closing duties or
2. Primary responsibilities of a lifeguard include: facility safety checks and inspections
a. Fixing the pool rope and lane lines and

ensuring the changing rooms are clean.
5. For a head, neck or spinal injury in deep water:
b. Following the health codes, answering a
patron’s question and making sure patrons a. Minimize movement of the victim’s head and
shower before using the pool. neck using the head splint technique.
c. Inspecting the pool and rescue equipment b. Move the victim directly onto a backboard.
before the facility opens and paying close c. Remove the victim from the water without
attention to patrons in the water by actively wasting time trying to stabilize the victim’s
scanning the assigned area. head and neck until you have the victim out of
d. Passing out the pool rules to all the patrons. the water.
d. Remove your rescue tube and use the head
hold technique.
3. A man is unexpectedly pushed from behind and
falls from the deck into the water and is in distress.
After you activate the emergency action plan 6. While scanning your zone, you notice a person
(EAP), what are included in your next steps. motionless in the water. The steps you follow
a. Clear the pool and alert management of in a water emergency are performed in the
the emergency. following order:
b. Encourage him to stay calm and swim back to a. Perform a secondary assessment, perform
the edge of the pool. a primary assessment, size-up the scene,
activate the emergency action plan (EAP), and
c. Use an ease in entry, approach the victim and
summon EMS personnel.
remove him from the water.
b. Perform a primary assessment, activate the
d. Extend a rescue tube to him while remaining
EAP, summon EMS personnel, perform a
on deck, then provide any additional care.
secondary assessment and size-up the scene.
c. Activate the EAP, enter the water, perform an
appropriate rescue, move the victim to a safe
exit point, remove the victim from the water
and provide emergency care as needed.
d. Size-up the scene, activate the EAP, summon
EMS personnel, perform a primary assessment
and perform a secondary assessment.
LGI_SecE_p191-252.indd 208 12/16/11 10:42 AM

7. While scanning the pool, you witness a patron 11. Working with other lifeguards, facility staff and
struggling while swimming and then go under supervisors as a team is:
water. Which of the following applies? a. A topic that should be covered during an in-
a. You have duty to act and perform the service meeting and new-hire orientation.
appropriate rescue. b. One of the primary responsibilities of
b. You would use the RID factor to determine a lifeguard.
what to do. c. Part of the facility’s EAP.
c. You should continue to scan the pool until d. Solely the role of facility management.
emergency back-up coverage is available.
d. You should notify off duty lifeguards to provide
care for the victim. 12. You are a lifeguard on surveillance duty during a
busy family swim session. It is important to:
8. A lifeguard can no longer see some of the patrons
a. Have a first aid kit, an automated external
at one side of the swimming area from his
defibrillator (AED) and a backboard
station because of glare from the afternoon sun.
immediately available to you on the pool deck
To maintain effective patron surveillance, the
next to your station.
lifeguard should:
b. Scan all areas in your assigned zone of
a. Adjust his position slightly to remove the glare
coverage and carry your rescue tube with you
spot from his surveillance area.
at all times.
b. Document the issue and present it at next
c. Rope off and close all areas of the facility that
month’s staff meeting.
have water over 5-feet deep.
c. Leave the area to find the supervisor
d. Have enough lifejackets on hand and require
for assistance.
all non-swimmers to use them.
d. Stay in the same position since the patrons are
strong swimmers.
13. A head, neck or spinal injury rarely happens:
9. A patron starts running on the deck. You blow your
a. In deep water at a supervised facility.
whistle to get her attention. Next, you enforce the
rules and regulations by: b. When someone strikes a properly inflated
inner tube.
a. Calling your supervisor.
c. In shallow water that is clearly signed
b. Giving her a warning.
No Diving.
c. Telling her she could slip or fall and she must
d. From collisions between swimmers.
walk on the deck.
d. Telling her she might be asked to leave and
demanding she stop it now.
14. Which of the following is true about accidental
fecal releases (AFRs)?
10. When caring for a suspected head, neck or
spinal injury in water, proper manual in-line a. AFRs do not require immediate attention.
stabilization is: b. Managers only need to be concerned
a. Less important than on land due to the with AFRs.
support provided by the water. c. Require water treatment, temporary pool
b. Provided using the head splint technique. closure and immediate lifeguard attention.
c. The only necessary technique needed if EMS d. It is part of the routine daily operation of a
personnel are close by. pool that must be done for safety.
d. Provided by bystanders if the lifeguard needs

to clear the pool.
LGI_SecE_p191-252.indd 209 12/16/11 10:42 AM

15. You are lifeguarding during a family swim session 19. A mother and her son walk over to you; she states
when you notice a swimmer swimming full lengths that he fell on the pool deck and hit his head. You
of the pool under water. What should you do? notice he has blood and fluid running from his ear
a. Activate the facility EAP, clear the pool and and he is feeling dizzy. What steps should you
remove him from the pool. take next?
b. Immediately get the attention of the swimmer a. Have the mother transport him to the
and instruct him to leave the pool for breaking emergency room since he is already walking.
pool rules. b. Bring him to the pool office to sit down and
c. Immediately stop him from continuing the provide manual stabilization.
activity and explain the dangers of the activity. c. Have him lie down on the pool deck until EMS
d. Alert the pool manager of the situation once personnel arrive.
your shift is over and document the event. d. Provide manual stabilization while the other
lifeguards prepare to backboard him.
16. After removing a conscious victim you suspect has

a spinal injury from the water, you should do all 20. The lifeguard supervisor expects the pool to be
the following except: very busy in the afternoon. For effective patron
a. Watch for and care for signs of shock. surveillance, she sets up multiple lifeguard stations
to reduce the number of patrons watched by each
b. Protect the victim from becoming cold.
lifeguard. This type of coverage is called:
c. Dry the victim off and apply the pads of
a. Back-up coverage.
an AED.
b. Rescue coverage.
d. Reassure the victim and perform a
secondary assessment. c. Total coverage.
d. Zone coverage.
17. Two lifeguards are on surveillance duty during a

public swim. You are on a break. One lifeguard 21. To effectively scan, you must:
activates the facility’s EAP for a submerged passive a. Count all the patrons in your zone.
victim and enters the water. Which steps should
b. Focus primarily on blind spots.
you take next to assist in the rescue?
c. Keep your head still but use your eyes to scan
a. Notify the manager to assist.
your area.
b. Bring the backboard to the lifeguard and assist
d. Move your head and eyes as you scan to look
in removing the victim from the water as the
directly at each area rather than staring in a
other lifeguard clears the pool.
fixed direction.
c. Provide emergency total zone coverage while
other lifeguards assist the victim.
22. When providing care to a conscious person you
d. Instruct bystanders how to assist the
suspect of having a head, neck or spinal injury and
lifeguards, document witness accounts and
who was injured from a fall on the pool deck:
provide crowd control.
a. You do not check the scene since the person
needs immediate attention.
18. A lifeguard keeps an eye on the patrons of the pool,
b. Consent is implied because the victim needs
checking the bottom, middle and surface of the
manual stabilization to keep from being
water. He is demonstrating:
further injured.
a. Effective communication.
c. You do not need to do a secondary assessment
b. Effective scanning. since head, neck and spinal injuries are the
c. Implied consent. most serious.
d. The RID factor. d. You do not move the victim unless the scene
becomes unsafe.
LGI_SecE_p191-252.indd 210 12/16/11 10:42 AM

23. A woman collides with another swimmer while 27. Which of the following is true if the manager of
diving into the pool and asks the lifeguard for the facility has assigned you as the only lifeguard
help. Without doing an assessment, the lifeguard conducting patron surveillance?
tells the woman she can continue swimming. a. You have been assigned to total coverage.
The woman leaves the facility and seeks medical
b. You have been assigned to back-up coverage.
attention from a hospital after she begins to feel
tingling sensations in her arms and legs. The c. You have been assigned to zone coverage.
lifeguard may be: d. You have been assigned to a lifeguard station.
a. A Good Samaritan.
b. Following the refusal-of-care principle. 28. Which of the following pieces of equipment need to
c. Negligent. be easily accessible for emergency use:
d. Using the RID factor. a. Rescue tube, manual suction device
b. Backboard, AED
24. During a weather-related power failure at a facility, c. Resuscitation mask, bag-valve-mask
you should: resuscitator
a. Clear everyone from the pool. d. Gloves, first aid kit
b. Let patrons continue swimming.
c. Let patrons sit on the edge with their feet in
29. A technique to minimize movement for a victim
the water.
with a suspected head, neck or spinal injury who is
d. Monitor weather reports while patrons face-down, at the surface and in water less than
continue to swim. 3 feet deep is the:
a. Arm splint technique.
25. During in-service training, lifeguards practice b. Head splint technique.
the steps of recognizing a distressed swimmer, c. Head support technique.
rescuing an active victim, informing management
d. Modified jaw-thrust technique.
and speaking with witnesses. The lifeguards are
practicing parts of a(n):
a. Communication plan. 30. If three lifeguards are on duty, emergency back-up
b. Emergency action plan. coverage takes place:
c. Secondary assessment. a. When a lifeguard is unable to show up to work
d. Staff debriefing. for their shift.
b. Whenever the facility EAP is activated.
c. When a lifeguard enters the water for a rescue.
26. You enter the mechanical room and find a
maintenance worker lying on his back on the d. When the facility has more patrons than its
floor next to a ladder. You check the scene and designed capacity allows.
determine it is safe to enter. During your primary
assessment, you find the victim is unconscious but
breathing. You must leave to get help, what should
you do?
a. Move him into the H.A.IN.E.S. position.
b. Leave him just as he is.
c. Do not leave him since he is breathing,
monitor his condition and wait for additional
help to come.
d. Use a clothes drag to move him to where you
can summon more help.
LGI_SecE_p191-252.indd 211 12/16/11 10:42 AM

31. Which of the following is the least important for a 34. The hazard communication standard includes
safe group visit to a pool? having MSDS information available. What is
a. Knowing how to identify the group’s leaders included in this information?
or chaperones a. Contains information about what first aid and
b. Having appropriate number of lifeguards rescue equipment is required to have on hand
available to cover all zones b. Contains information about what type of
c. Ensuring there are multiple activities planned chemicals are in use at the facility
for the group c. Contains information about areas of the
d. Ensuring that patrons stay in the sections of facility that have unsafe conditions, which
the pool that are appropriate for their require repairs
swim ability d. Contains information that is only important
for the facility manager is required to know
32. While caring for someone with a suspected spinal

injury, you secure the straps on a backboard in the 35. A patron dives into the shallow end of the lap pool.
following order: You suspect she has a head, neck or spinal injury
a. Feet, thighs, arms, head because she has:
b. Hands, legs, upper chest a. An elevated body temperature.
c. Head, upper chest, hands, thighs b. An irregular heartbeat.
d. Upper chest, hips, thighs c. Blood in the ears and nose.
d. Impaired hearing.
33. It is the primary responsibility of facility

management to provide all but which of
the following?
a. Creating and reviewing policy and procedures
b. Addressing unsafe conditions
c. Training staff
d. Educating patrons about and enforcing
facility rules
LGI_SecE_p191-252.indd 212 12/16/11 10:42 AM

Section 2—Lifeguarding Skills Exam B

EXAMPLE
ANSWER SHEET
xx. a b c
d. All of the above
LGI_SecE_p191-252.indd 213 12/16/11 10:42 AM

Section 2—Lifeguarding Skills Exam B

1. During a morning adult lap swim, you notice a 4. If three lifeguards are on duty, emergency back-up
swimmer who slows down and is no longer able to coverage takes place:
make any forward progress. Which of the following a. When a lifeguard is unable to show up to work
is true? for their shift.
a. She has become a passive victim. b. Whenever the facility emergency action plan
b. She is in danger of becoming an active victim if (EAP) is activated.
not assisted. c. When a lifeguard enters the water for a rescue.
c. She is an active victim. d. When the facility has more patrons than its
d. You should continue to scan the pool and designed capacity allows.
watch to see if her condition worsens.
5. A patron comes up to you complaining of neck

2. The hazard communication standard includes pain. He says his hands and feet are tingling. What
having MSDS information available. What is injury might you suspect, and what care would
included in this information? you provide?
a. Contains information about what first aid and a. You should suspect a head, neck or spinal
rescue equipment is required to have on hand. injury. Have the victim move his head in either
b. Contains information about what type of direction to confirm this before applying
chemicals are in use at the facility. manual stabilization.
c. Contains information about areas of the b. You should suspect a head, neck or spinal
facility that have unsafe conditions, which injury. Immediately provide manual
require repairs. stabilization of the victim’s head and neck and
d. Contains information that is only important
for the facility manager to know. c. You should suspect a seizure. Have the victim
lie down immediately.
d. You should suspect a sprained neck. Have
3. For a head, neck or spinal injury in the water: the victim lie down and apply ice to the
affected area.
a. Minimize movement of the victim’s head and
neck using the head splint technique.
b. Move the victim directly onto a backboard
6. Which of the following is the least important for a
using the two person removal from
safe group visit to a pool?
water technique.
a. Knowing how to identify the group’s leaders
c. Remove the victim from the water without
or chaperones
wasting time trying to stabilize the victim’s
head and neck until you have the victim out of b. Having appropriate number of lifeguards
the water. available to cover all zones
d. Remove your rescue tube and use the head c. Ensuring there are multiple activities planned
hold technique. for the group
d. Ensuring that patrons stay in the sections of
the pool that are appropriate for their
swim ability
LGI_SecE_p191-252.indd 214 12/27/11 10:15 AM

7. Which of the following is true about accidental 11. Which of the following pieces of equipment must a
fecal releases (AFRs)? lifeguard have instantly accessible at all times.
a. AFRs do not require immediate attention. a. Rescue tube, bag valve mask, AED
b. Managers only need to be concerned b. Rescue board, ring buoy, resuscitation mask
with AFRs. c. Backboard, first aid supplies, oxygen
c. Require water treatment, temporary pool d. Gloves, resuscitation mask, rescue tube
closure and immediate lifeguard attention.
d. It is part of the routine daily operation of a
pool that must be done for safety. 12. During an in-service training, lifeguards practice
the steps of an emergency action plan, such as:
a. Conducting safety checks before, during and
8. A technique used in the water to minimize after pool hours.
movement of the victim’s head and neck is the:
b. Following rescue procedures, informing
a. Beach drag. management and conducting staff debriefings.
b. Head and body support. c. Getting a patron’s attention, explaining unsafe
c. Head splint. behaviors and discussing safe activities.
d. Rigid splint. d. Telling patrons the rules and regulations.
9. Which of the following is true if the manager of 13. You are lifeguarding during a family swim session
the facility has assigned you as the only lifeguard when you notice a swimmer swimming full lengths
conducting patron surveillance? of the pool under water. What should you do?
a. You have been assigned to total coverage. a. Activate the facility EAP, clear the pool and
b. You have been assigned to back-up coverage. remove him from the pool.
c. You have been assigned to zone coverage. b. Immediately get the attention of the swimmer
and instruct him to leave the pool for breaking
d. You have been assigned to a lifeguard station.
pool rules.
c. Immediately stop him from continuing the
activity and explain the dangers of the activity.
10. You enter the mechanical room and find a
maintenance worker lying on his back on the d. Alert the pool manager of the situation once
floor next to a ladder. You check the scene and your shift is over and document the event.
determine it is safe to enter. During your primary
assessment, you find the victim is unconscious but
breathing. You must leave to get help, what should 14. Which of the following is true of a submerged
you do? unconscious victim in deep water that you suspect
a. Move him into the H.A.IN.E.S. position. has a spinal injury?
b. Leave him just as he is. a. If the victim is not breathing, you would
remove the victim from the water.
monitor his condition and wait for additional b. You must keep your rescue tub e on
help to come. throughout the rescue.
d. Use a clothes drag to move him to where you c. To minimize movement, you should keep them
can summon more help. in the deep end of the pool during the rescue.
d. You should provide in-water ventilations
while other lifeguards strap the victim to
the backboard.
LGI_SecE_p191-252.indd 215 10/17/11 12:00 PM

15. You are walking through the park on your way to 18. A lifeguard keeps an eye on the patrons of the pool,
the pool to report for duty and witness an adult checking the bottom, middle and surface of the
suddenly collapse while playing catch with his son. water. He is demonstrating:
You check the scene to be sure it is safe and then a. Effective communication.
decide to perform CPR on the adult victim. Which
b. Effective scanning.
legal consideration applies?
c. Implied consent.
a. Duty to act
d. The RID factor.
b. Standard of care
c. Good Samaritan law
d. Negligence 19. Signs and symptoms of a person you suspect of a
head, neck, or spinal injury include:
a. Changes in skin color, temperature and feel.
b. Back pain or tingling.
spinal injury in water, proper manual in-line
stabilization is: c. Pressure or pain in the chest.
a. Less important than on land due to the d. Rigid, tender, or bruised abdomen.
support provided by the water.
b. Provided using the head splint technique.
20. A man is unexpectedly pushed from behind and
c. The only necessary technique needed if EMS
falls from the deck into the water and is in distress.
personnel are close by.
After you activate the emergency action plan
d. Provided by bystanders if the lifeguard needs (EAP), what are included in your next steps.
to clear the pool.
a. Clear the pool and alert management of
the emergency.
b. Encourage him to stay calm and swim back to
17. Two lifeguards are on surveillance duty during a
the edge of the pool.
public swim. You are on a break. One lifeguard
activates the facility’s EAP for a submerged passive c. Use an ease in entry, approach the victim and
victim and enters the water. Which steps should remove him from the water.
you take next to assist in the rescue? d. Extend a rescue tube to him while remaining
a. Notify the manager to assist. on deck, then provide any additional care.

in removing the victim from the water as the 21. Before providing care to a conscious person you
other lifeguard clears the pool. suspect of having a head, neck or spinal injury who
c. Provide emergency total zone coverage while is injured from a fall on the pool deck:
other lifeguards assist the victim. a. You do not check the scene since the person
d. Instruct bystanders how to assist the needs immediate attention.
lifeguards, document witness accounts, and b. Consent is implied because the victim needs
provide crowd control. manual stabilization to keep from being
further injured.
since head, neck and spinal injuries are the
most serious.
d. You do not move the victim unless the scene
becomes unsafe.
LGI_SecE_p191-252.indd 216 12/16/11 10:42 AM

22. While scanning your zone, you notice a person 25. While actively scanning the pool, you witness a
motionless in the water. The steps you follow patron struggling while swimming and then go
in a water emergency are performed in the under water. Which of the following applies?
following order: a. You have duty to act and perform the
a. Perform a secondary assessment, perform appropriate rescue.
a primary assessment, size-up the scene, b. You would use the RID factor to determine
activate the emergency action plan (EAP), and what to do.
c. You should continue to scan the pool until
b. Perform a primary assessment, activate the emergency back-up coverage is available.
EAP, summon EMS personnel, perform a
secondary assessment and size-up the scene.
care for the victim.
c. Activate the EAP, enter the water, perform an
appropriate rescue, move the victim to a safe
exit point, remove the victim from the water
26. A lifeguard can no longer see some of the patrons
and provide emergency care as needed.
at one side of the swimming area from his
d. Size-up the scene, activate the EAP, summon station because of glare from the afternoon sun.
EMS personnel, perform a primary assessment To maintain effective patron surveillance, the
and perform a secondary assessment. lifeguard should:
a. Adjust his position slightly to remove the glare
23. A mother and her son walk over to you; she states spot from his surveillance area.
that he fell on the pool deck and hit his head. You b. Document the issue and present it at next
notice he has blood and fluid running from his ear month’s staff meeting.
and he is feeling dizzy. What steps should you c. Leave the area to find the supervisor
take next? for assistance.
a. Have the mother transport him to the d. Stay in the same position since the patrons are
emergency room since he is already walking. strong swimmers.
b. Bring him to the pool office to sit down and
provide manual stabilization.
c. Have him lie down on the pool deck and 27. A large number of patrons are swimming at the
provide manual stabilization until EMS facility. For effective patron surveillance, your
personnel arrive. supervisor decides to add another lifeguard station
d. Provide manual stabilization while the other and tells you to modify the zone coverage based on
lifeguards prepare to backboard him. the new station to:
a. Allow the lifeguards to take turns scanning the
good swimmers.
24. Which of the following is a primary responsibility
b. Allow the lifeguards to take turns walking up
of a lifeguard?
and down the deck.
a. Enforcing facility rules and regulations and
c. Increase the number of patrons watched by
educating patrons about them
each lifeguard.
b. Filling out required records and reports on
d. Reduce the number of patrons watched by
schedule and submitting them to the proper
each lifeguard.
person or office
c. Monitoring the performance of the other
lifeguards on duty
d. Performing opening duties, closing duties or
facility safety checks and inspections
LGI_SecE_p191-252.indd 217 12/16/11 2:05 PM

28. A patron starts running on the deck. You blow your 32. The lifeguard supervisor expects the pool to be
whistle to get her attention. Next, you enforce the very busy in the afternoon. For effective patron
rules and regulations by: surveillance, she sets up multiple lifeguard stations
a. Calling your supervisor. to reduce the number of patrons watched by each
a. Back-up coverage.
walk on the deck. b. Rescue coverage.
d. Telling her she might be asked to leave and c. Total coverage.
demanding she stop it now. d. Zone coverage.
29. A woman collides with another swimmer while 33. You are responsible for a zone of the pool. To
diving into the pool and asks the lifeguard for effectively scan, you must:
help. Without doing an assessment, the lifeguard a. Count all the patrons in your area
tells the woman she can continue swimming. of responsibility.
tingling sensations in her arms and legs. The c. Keep your head still but use your eyes to scan
lifeguard may be: your area.
a. A Good Samaritan d. Move your head and eyes as you scan to look
b. Following the refusal-of-care principle
fixed direction.
c. Negligent
d. Using the FIND model
34. You notice a patron that is swimming laps who
30. During in-service training, lifeguards practice suddenly slips under water without a struggle and
the steps of recognizing a distressed swimmer, does not resurface. This person is probably:
rescuing a victim who is drowning, informing a. A passive victim who needs help.
management and speaking with witnesses. The b. A distressed swimmer who needs help.
lifeguards are practicing parts of a(n):
c. An active victim who needs help.
a. Communication plan.
b. Emergency action plan. need help.
c. Secondary assessment.
d. Staff debriefing.
35. A head, neck or spinal injury rarely happens:
31. In the event of thunder and lightning at an outdoor a. In deep water at a supervised facility.
facility, lifeguards should: b. When someone strikes a properly inflated
a. Clear everyone from the water and send them inner tube.
into the locker room to take showers during c. In shallow water that is clearly signed
the thunderstorm. No Diving.
b. Clear everyone from the water at the first d. From collisions between swimmers.
sound of thunder or first sighting of lightning.
c. Keep watching for lightning strikes near the
facility while patrons continue to swim.
d. Keep watching for more storms and monitor
weather reports while patrons continue
to swim.
LGI_SecE_p191-252.indd 218 12/16/11 10:42 AM

SHALLOW WATER LIFEGUARDING SKILLS

LGI_SecE_p191-252.indd 219 12/16/11 10:42 AM

Section 2—Shallow Water Lifeguarding Skills Exam A

EXAMPLE
ANSWER SHEET
xx. a b c
d. All of the above
LGI_SecE_p191-252.indd 220 12/16/11 10:42 AM

Section 2—Shallow Water Lifeguarding Skills Exam A

1. A child falls backwards from a water play structure 4. A mother walks her son over to you stating that he
in extremely shallow water. She can not stand up. fell on the pool deck and hit his head. You notice
You suspect a head, neck or spinal injury. he has blood and fluid running from his ear, he is
You should: feeling dizzy. What steps should you take next?
a. Wait for other lifeguards to assist in lifting the a. Have the mother transport him to the
child out of the water and onto the pool deck. emergency room since he is already walking.
b. Provide manual in-line stabilization by placing b. Bring him to the pool office to sit down and
your hands on either side of her head until provide manual stabilization.
more help arrives. c. Have him lie down on the pool deck and
c. Use the head splint technique from the victim’s provide manual stabilization until EMS
side and gently move her to deeper water. personnel arrive.
d. Get consent from a parent then quickly d. Provide manual stabilization while the other
backboard her and remove her from the water. lifeguards prepare to backboard him.
5. A patron comes up to you complaining of neck

2. After removing a conscious victim you suspect has
pain. He says his hands and feet are tingling. What
a spinal injury from the water, you should do all
injury might you suspect, and what care would
the following except:
you provide?
a. Watch for and care for signs of shock.
a. You should suspect a head, neck or spinal
b. Protect the victim from becoming cold. injury. Have the victim move his head in either
c. Dry the victim off and apply the automated direction to confirm this before applying
external defibrillator (AED) pads. manual stabilization.
d. Reassure the victim and perform a b. You should suspect a head, neck or spinal
secondary assessment. injury. Immediately provide manual
stabilization of the victim’s head and neck and
3. A large number of patrons are swimming at the c. You should inspect the head, neck and spine
facility. For effective patron surveillance, your for injury. Have the victim move his head in
supervisor decides to add another shallow water either direction to confirm this before applying
lifeguard station and tells you to modify the zone manual stabilization.
coverage based on the new station to: d. You should suspect a sprained neck. Have
a. Allow the lifeguards to take more the victim lie down and apply ice to the
frequent rotations. affected area.
and down the deck.
6. A patron starts running on the deck. You blow your
whistle to get her attention. Next, you enforce the
each lifeguard.
rules and regulations by:
a. Calling your supervisor.
each lifeguard.
walk on the deck.
d. Telling her she might be asked to leave and
demanding she stop it now.
LGI_SecE_p191-252.indd 221 12/16/11 10:42 AM

7. A shallow water lifeguard: 11. A shallow water lifeguard is scanning his zone and
a. Is a part of the lifeguard team and can can no longer see some of the patrons on the other
supervise areas at an aquatic facility that have side of the swimming area from his station because
diving boards, drop slides or other attractions. of the afternoon sun. To maintain effective patron
surveillance, the lifeguard should:
b. Is prepared to recognize and respond to
aquatic emergencies where water is up to a. Adjust his position slightly to remove the glare
5 feet deep. spot from his surveillance area.
c. Is prepared to recognize and respond to b. Document the issue and present it at next
aquatic emergencies at an attraction where the month’s staff meeting.
water is up to 10 feet deep. c. Leave the area to find the supervisor
d. Is separate from the lifeguard team because of for assistance.
his or her different training and skills. d. Stay in the same position since the patrons are
strong swimmers.
8. A shallow water lifeguard keeps an eye on the

patrons of the pool, checking the bottom, middle
and surface of the water. He is demonstrating: 12. A child is in distress and is near the side of the
pool. When using the reaching assist with a rescue
tube to help the child, you should:
a. Extend a rescue tube to the child and pull the
c. Implied consent. child to safety.
d. The RID factor. b. Enter the water and slide the child onto
a backboard.
9. A shallow water lifeguard may expect to have c. Kneel on the pool deck, extend a ring buoy to
total coverage surveillance responsibility the child and pull the child to safety.
assigned when: d. Throw a rescue tube to the child and have the
a. There is a 5-foot plunge slide over 8 feet child swim to safety.
of water.
b. There is only one diving board in use.
c. There is a winding river with a current where 13. A technique to minimize movement for a victim
adults are walking and some children are with a suspected head, neck or spinal injury who is
using lifejackets. face-down, at the surface and in water less than
3 feet deep is the:
d. The lap pool depth varies from 3 feet to 7 feet
in depth. a. Arm splint technique.
b. Head splint technique.
10. A shallow water lifeguard would most likely c. Head support technique.
prevent patron injuries by: d. Anatomical splint technique.
a. Enforcing facility rules and regulations and
educating patrons about them.
b. Filling out required records and reports on
schedule and submitting them to the proper
person or office.
c. Monitoring the performance of the other
lifeguards on duty.
d. Ensuring that the entire assigned zone of
surveillance can be effectively scanned and is
free of hazards.
LGI_SecE_p191-252.indd 222 12/16/11 10:42 AM

14. A woman collides with another swimmer while 17. It is the primary responsibility of the facility
diving into the pool and asks the lifeguard for management to provide all but which of
help. Without doing an assessment, the lifeguard the following?
tells the woman she can continue swimming. a. Creating and reviewing policy and procedures.
b. Addressing unsafe conditions.
tingling sensations in her arms and legs. The c. Training staff.
lifeguard may be: d. Educating patrons about and enforcing
a. A Good Samaritan. facility rules.
b. Following the refusal-of-care principle.

c. Negligent.
18. Primary responsibilities of a shallow water
d. Using the RID factor. lifeguard include:
a. Fixing the pool rope and lane lines and
ensuring the changing rooms are clean.
15. A woman falls off her inner tube when exiting into
b. Following the health codes, answering a
a catch pool and needs help. To use the simple
patron’s question and making sure patrons
assist to help her, you should:
shower before using the pool.
a. Extend a reaching pole to the woman and pull
c. Inspecting the pool and rescue equipment
her to safety.
before the facility opens and paying close
b. Reach across the rescue tube, grasp the woman attention to patrons in the water by actively
under her armpits and help her get her balance scanning the assigned area.
to stand up.
d. Passing out the pool rules to all the patrons.
c. Rest the rescue tube under the woman’s knees,
help her grab onto the side of the deck and lift
her out of the water.
19. While caring for someone with a suspected spinal
d. Throw a rescue tube to the woman and have injury, you secure the straps on a backboard in the
her swim to safety. following order:
a. Feet, thighs, arms, head.
b. Hands, legs, upper chest.
16. While scanning your zone, you notice a person
motionless in the water. The steps you follow c. Head, upper chest, hands, thighs.
in a water emergency are performed in the d. Upper chest, hips, thighs.
following order:
a. Perform a secondary assessment, perform
a primary assessment, size-up the scene, 20. The hazard communication standard includes
activate the emergency action plan (EAP), and having MSDS information available. What is
summon EMS personnel. included in this information?
b. Perform a primary assessment, activate the a. Contains information about what first aid and
EAP, summon EMS personnel, perform a rescue equipment is required to have on hand
secondary assessment and size-up the scene. b. Contains information about what type of
c. Activate the EAP, enter the water, perform an chemicals are in use at the facility
appropriate rescue, move the victim to a safe c. Contains information about areas of the
exit point, remove the victim from the water facility that have unsafe conditions, which
and provide emergency care as needed. require repairs
d. Size-up the scene, activate the EAP, summon d. Contains information that is only important
EMS personnel, perform a primary assessment for the facility manager is required to know
and perform a secondary assessment.
LGI_SecE_p191-252.indd 223 12/16/11 2:05 PM

21. You notice a patron that is swimming laps who 25. When providing care to a conscious person you
suddenly slips under water without a struggle and suspect of a having head, neck or spinal injury and
does not resurface. This person is probably: who was injured from a fall on the pool deck:
a. A distressed swimmer who needs help. a. You do not survey the scene since the person
b. A passive victim who needs help. needs immediate attention.
c. An active victim who needs help. b. Consent is implied because the victim needs
further injured.
need help.
most serious.
22. You recognize that there is an emergency. You
size-up the scene, alert other lifeguards, perform d. You do not move the victim unless the scene
the appropriate rescue, conduct a primary becomes unsafe.
assessment, care for the victim and perform a
secondary assessment. You most likely are:
a. Participating in an in-service training. 26. Which of the following is the least important for a
safe group visit to a pool?
b. Providing a demonstration during a
safety presentation. a. Knowing how to identify the group’s leaders
or chaperones
c. Following the steps of the facility’s EAP.
b. Having appropriate number of lifeguards
d. Preparing to give care to passive victim.
available to cover all zones
c. Ensuring there are multiple activities planned
for the group
23. Three shallow water lifeguards are on duty,
emergency back-up coverage takes place when: d. Ensuring that patrons stay in the sections
of the pool that are appropriate for their
a. A lifeguard is unable to show up to work for
swim ability
their shift.
c. When a lifeguard enters the water for a rescue. 27. Which of the following is true about accidental
d. The facility has more patrons than its designed fecal releases (AFRs)?
capacity allows. a. AFRs do not require immediate attention.
b. Managers only need to be concerned
with AFRs.
c. Require water treatment, temporary pool
spinal injury in water, proper manual in-line
closure and immediate lifeguard attention.
stabilization is:
d. It is part of the routine daily operation of a
a. Less important than on land due to the
pool that must be done for safety.
b. Provided using the head splint technique.
c. The only necessary technique needed if EMS 28. Which of the following is true if the manager of
personnel are close by. the facility has assigned you as the only lifeguard
d. Provided by bystanders if the lifeguard needs conducting patron surveillance?
to clear the pool. a. You have been assigned to total coverage.
c. You have been assigned to zone coverage.
d. You have been assigned to a lifeguard station.
LGI_SecE_p191-252.indd 224 12/27/11 10:17 AM

29. Which of the following pieces of equipment only 33. You are responsible for a part of the kiddie pool for
needs to be easily accessible for emergency use: total zone coverage. To effectively scan, you must:
a. Rescue tube, manual suction device a. Count all the patrons in your area
b. Backboard, AED of responsibility.
c. Resuscitation mask, bag-valve-mask b. Focus primarily on blind spots.
resuscitator c. Keep your head still but use your eyes to scan
d. Gloves, first aid kit your area.
d. Move your head and eyes as you scan to look
30. While actively scanning the pool, you witness a fixed direction.
patron struggling while swimming and then go
under water. Which of the following applies?
a. You have duty to act and perform the 34. You enter the mechanical room and find a
appropriate rescue. maintenance worker lying on his back on the
b. You would use the RID factor to determine floor next to a ladder. You check the scene and
what to do. determine it is safe to enter. During your primary
c. You should continue to scan the pool until assessment, you find the victim is unconscious but
emergency back-up coverage is available. breathing. You must leave to get help, what should
you do?
care for the victim. a. Move him into the H.A.IN.E.S. position.
b. Leave him just as he is.
31. While you are conducting a safety check, you find
monitor his condition and wait for additional
a section of the pool gutter cover is missing.
help to come.
You should:
d. Use a clothes drag to move him to where you
a. Clear the winding river and close for the day.
can summon more help.
b. Close off the area and tell the lifeguard
supervisor right away.
c. Make a note of it or come back to it during 35. You notice a patron in the water whose body
your next break. is diagonal and who is waving to attract your
d. Watch the area closely so nobody gets hurt. attention. The arms and legs are moving to keep
the person’s head above water, but there is no
forward progress. This person
32. Two lifeguards are on surveillance duty during a is probably:
public swim. You are on a break. One lifeguard
a. A distressed swimmer who needs help.
activates the facility’s EAP for a submerged passive
b. A passive victim who needs help.
victim and enters the water. Which steps should
you take next to assist in the rescue? c. An active victim who needs help.
a. Notify the manager to assist. d. An intermediate swimmer who does not
need help.
c. Provide emergency total coverage while the
d. Instruct bystanders how to assist the lifeguard,
document witness accounts and provide
crowd control.
LGI_SecE_p191-252.indd 225 12/20/11 9:13 AM

Section 2—Shallow Water Lifeguarding Skills Exam B

EXAMPLE
ANSWER SHEET
xx. a b c
d. All of the above
LGI_SecE_p191-252.indd 226 12/16/11 10:42 AM

Section 2—Shallow Water Lifeguarding Skills Exam B

1. A child falls backwards from a water play structure 5. A mother walks her son over to you stating that he
in extremely shallow water. She can not stand fell on the pool deck and hit his head. You notice
up. You suspect a head, neck or spinal injury, he has blood and fluid running from his ear and he
you should: is feeling dizzy. What steps should you take next?
a. Wait for other lifeguards to assist in lifting the a. Have the mother transport him to the
child out of the water and onto the pool deck. emergency room since he is already walking.
b. Provide manual stabilization placing your b. Bring him to the pool office to sit down and
hands on either side of her head until more provide manual stabilization.
help arrives. c. Have him lie down on the pool deck and
c. Use the head splint technique from the victim’s provide manual stabilization until EMS
side and gently move her to deeper water. personnel arrive.
d. Get consent from a parent then quickly d. Provide manual stabilization while the other
backboard her and remove her from the water. lifeguards prepare to backboard him.
2. A child is in distress and is near the side of the

6. A shallow water lifeguard may expect to have
pool. When using the reaching assist with a rescue
total coverage surveillance responsibility
tube to help the child, you should:
assigned when:
a. Extend a rescue tube to the child and pull the
a. There is a 5-foot plunge slide over 8 feet
child to safety.
of water.
b. Enter the water and slide the child onto
b. There are diving boards in use.
a backboard.
c. There is a winding river with a current with
c. Kneel on the pool deck, extend a ring buoy to
adults walking and children using lifejackets.
the child and pull the child to safety.
d. The lap pool depth varies from 3 feet to 7 feet
d. Throw a rescue tube to the child and have the
in depth.
child swim to safety.
3. A head, neck or spinal injury rarely happens: 7. A simple assist may be used by a shallow water
a. In deep water at a supervised facility. lifeguard when:
b. When someone strikes a properly inflated a. A passive victim is submerged in 2 feet
inner tube. of water.
c. In shallow water that is clearly signed b. Two victims are clutching each other in 5 feet
No Diving. of water.
d. From collisions between swimmers. c. A child has fallen on the pool deck and is
lightly bleeding from a scraped knee.
d. A second lifeguard is rescuing a passive victim
4. A shallow water lifeguard keeps an eye on the
and requires assistance.
patrons of the pool, checking the bottom, middle
and surface of the water. He is demonstrating:
c. Implied consent.
d. The RID factor.
LGI_SecE_p191-252.indd 227 12/16/11 10:42 AM

8. A technique used for a victim with a suspected 11. In the event of thunder and lightning at an outdoor
head, neck or spinal injury who is face-down, at the facility, lifeguards should:
surface and in water less than 3 feet deep is the: a. Clear everyone from the water and send them
a. Arm splint technique. into the locker room to take showers during
b. Head splint technique. the thunderstorm.
c. Head support technique. b. Clear everyone from the water at the first
sound of thunder or first sighting of lightning.
d. Anatomical splint technique.
c. Keep watching for lightning strikes near the
facility while patrons continue to swim.
9. During an in-service training, lifeguards practice d. Keep watching for more storms and monitor
the steps of an emergency action plan, such as: weather reports while patrons continue
to swim.
a. Conducting safety checks before, during and
after pool hours.
b. Following rescue procedures, informing
12. It is the primary responsibility of the facility
management and conducting staff debriefings.
management to provide all but which of
c. Getting a patron’s attention, explaining unsafe the following?
behaviors and discussing safe activities.
a. Creating and reviewing policy and procedures
d. Telling patrons the rules and regulations.
b. Addressing unsafe conditions
c. Training staff
10. While scanning your zone, you notice a person d. Educating patrons about and enforcing
motionless in the water. The steps you follow in a facility rules
water emergency are performed in the following
order:
a. Perform a secondary assessment, perform 13. One of the primary responsibilities of a shallow
a primary assessment, size-up the scene, water lifeguard includes:
activate the emergency action plan (EAP), and a. Filling out required records and reports on
summon EMS personnel. schedule and submitting them to the proper
b. Perform a primary assessment, activate the person or office.
EAP, summon EMS personnel, perform a b. Working with other lifeguards, facility staff
secondary assessment and size-up the scene. and supervisors as a team.
c. Activate the EAP, enter the water, perform an c. Monitoring the performance of the other
appropriate rescue, move the victim to a safe lifeguards on duty.
exit point, remove the victim from the water d. Performing maintenance or other tasks
and provide emergency care as needed. assigned by his or her supervisor.
d. Size-up the scene, activate the EAP, summon
EMS personnel, perform a primary assessment
and perform a secondary assessment. 14. While caring for someone with a suspected spinal
injury, you secure the straps on a backboard in the
following order:
a. Feet, thighs, arms, head.
b. Hands, legs, upper chest.
c. Head, upper chest, hands, thighs.
d. Upper chest, hips, thighs.
LGI_SecE_p191-252.indd 228 12/16/11 10:42 AM

15. Signs and symptoms of a person you suspect of a 19. When performing patron surveillance at a pool
head, neck or spinal injury include: with play structures:
a. Changes in skin color, temperature and feel. a. It is necessary to have at least one lifeguard for
b. Back pain or tingling. every three slides.
c. Pressure or pain in the chest. b. It is not necessary to wear your rescue tube.
d. Rigid, tender, or bruised abdomen. c. Pay close attention to nonswimmers or
weak swimmers.
d. Pay less attention to sprays and fountains.
16. The failure to recognize a victim who is drowning,
the intrusion of secondary duties on a lifeguard’s
primary responsibility of patron surveillance and 20. When providing care to a conscious person you
the distraction from patron surveillance duties are suspect of having a head, neck or spinal injury and
elements of: who was injured from a fall on the pool deck:
a. A policies and procedures manual. a. You do not survey the scene since the person
b. An aquatic safety team. needs immediate attention.
c. The FIND model. b. Consent is implied because the victim needs
d. The RID factor.
further injured.
17. Three shallow water lifeguards are on duty,
most serious.
emergency back-up coverage takes place:
d. You do not move the victim unless the scene
a. When a lifeguard is unable to show up to work
becomes unsafe.
for their shift.
c. When a lifeguard enters the water for a rescue. 21. Which of the following is the least important for a
d. When the facility has more patrons than its safe group visit to a pool?
designed capacity allows. a. Knowing how to identify the group’s leaders
or chaperones
b. Having appropriate number of lifeguards
18. When caring for a suspected head, neck or spinal available to cover all zones
injury in water, proper manual in-line
c. Ensuring there are multiple activities planned
stabilization is:
for the group
a. Less important than on land due to the
d. Ensuring that patrons stay in the sections
of the pool that are appropriate for their
b. Provided using the head splint technique. swim ability
c. Is only necessary if EMS personnel are not
close by.
d. Provided by bystanders if the lifeguard needs 22. Which of the following is true if the manager of
to clear the pool. the facility has assigned you as the only lifeguard
conducting patron surveillance?
a. You have been assigned to total coverage.
c. You have been assigned to zone coverage.
d. You have been assigned to an elevated
lifeguard station.
LGI_SecE_p191-252.indd 229 12/27/11 10:17 AM

23. Which of the following pieces of equipment must a 27. Two lifeguards are on surveillance duty during a
lifeguard have instantly accessible at all times. public swim. You are on a break. One lifeguard
a. Rescue tube, bag-valve-mask resuscitator, an activates the facility’s EAP for a submerged passive
automated external defibrillator (AED) victim and enters the water. Which steps should
you take next to assist in the rescue?
b. Rescue board, ring buoy, resuscitation mask
a. Notify the manager to assist.
c. Backboard, first aid supplies, oxygen
d. Gloves, resuscitation mask, rescue tube
c. Provide emergency back-up coverage while the
24. While performing patron surveillance during a
beginner swim class, you would prevent patron
injuries by: d. Instruct bystanders how to assist the
lifeguards, document witness accounts, and
a. Helping the instructor teach the class when the
provide crowd control.
students practice floating skills.
b. Monitoring only the students who are at a
distance from the side of the pool.
28. You are assigned zone coverage of a shallow
c. Scanning the students in your area water attraction. To provide adequate patron
of responsibility. surveillance, you should:
d. Showing the students the simple assist skill. a. Follow the facility’s EAP.
b. Make sure that other lifeguards have total
coverage of the area.
25. While actively scanning the pool, you witness a
c. Check patrons in all areas of the facility during
patron struggling while swimming and then go
your rotation.
under water. Which of the following applies?
d. Provide effective scanning of your
a. You have duty to act and perform the
assigned zone.
appropriate rescue.
b. You would use the RID factor to determine
what to do.
29. You are responsible for a part of the pool that can
c. You should continue to scan the pool until be easily viewed from your lifeguard station. To
emergency back-up coverage is available. effectively scan, you must:
d. You should notify off duty lifeguards to provide a. Count all the patrons in your area
care for the victim. of responsibility.
c. Keep your head still but use your eyes to scan
26. While you are conducting a safety check, you find
your area.
a section of the pool gutter cover is missing.
You should: d. Move your head and eyes as you scan to look
a. Clear the winding river and close for the day.
fixed direction.
b. Close off the area and tell the lifeguard
c. Make a note of it or come back to it during
your next break.
d. Watch the area closely so nobody gets hurt.
LGI_SecE_p191-252.indd 230 12/16/11 10:42 AM

30. You are the lifeguard on duty at the spa therapy 33. You enter the mechanical room and find a
pool when you notice a patron holding her breath maintenance worker lying on his back on the floor
repeatedly for extended periods of time. What next to a ladder. During your primary assessment,
should you do? you find the victim unconscious but breathing. You
a. Activate the facility EAP, clear the area and must leave to get help, what should you do?
remove her from the pool. a. Move him into the H.A.IN.E.S. position.
b. Immediately get the attention of the patron b. Leave him just as he is.
and instruct her to leave the pool for breaking c. Do not leave him since he is breathing,
pool rules. monitor his condition and wait for additional
c. Immediately stop her from continuing the help to come.
activity and explain the dangers of the activity. d. Use a clothes drag to move him to where you
d. Alert the pool manager of the situation once can summon more help.
your shift is over and document the event.
34. You find a patron lying on the locker room floor.

31. You are walking through the park on your way to You suspect she has a head, neck or spinal injury
the pool to report for duty and witness an adult because she has:
suddenly collapse while playing catch with his son. a. An elevated body temperature.
You survey the scene to be sure it is safe and then
b. An irregular heartbeat.
decide to perform CPR on the adult victim. Which
legal consideration applies? c. Blood in the ears and nose.
a. Duty to act d. Impaired hearing.
b. Standard of care
c. Good Samaritan law
35. You notice a patron who is swimming laps
d. Negligence suddenly slips underwater without a struggle and
does not resurface. This person is probably:
a. A passive victim who needs help.
32. You can remain alert and reduce fatigue during
b. A distressed swimmer who needs help.
your shift by:
c. An active victim who needs help.
a. Practicing entries and rescue approaches while
on surveillance duty. d. An intermediate swimmer who does not
need help.
b. Practicing risk-management techniques.
c. Rotating from station to station.
d. Staying at one station.
LGI_SecE_p191-252.indd 231 12/16/11 10:42 AM

FINAL WRITTEN EXAM: WATERFRONT
SKILLS MODULE

LGI_SecE_p191-252.indd 232 10/17/11 12:00 PM

Waterfront Skills Module Exam A
EXAMPLE
ANSWER SHEET
xx. a b c
d. All of the above
LGI_SecE_p191-252.indd 233 10/17/11 12:00 PM

Waterfront Skills Module Exam A
1. You are a lifeguard on duty at a waterfront facility 5. Lifeguards are conducting a deep-water line search
and notice a swimmer in distress 100 feet outside to locate a submerged victim. To see more clearly
the designated swim area. You should: and cover more distance with less effort, the
a. Ignore distractions that are outside the lifeguards should:
designated swim area and your assigned zone a. Ask patrons to participate in the search.
of coverage. b. Use a watercraft.
b. Initiate the facility EAP and use the available c. Use extra oars and paddles.
rowboat to rescue the distressed swimmer.
d. Wear a mask and fins.
c. Alert other nearby lifeguards and monitor
the situation.
6. At a summer youth camp, lifeguards may use swim
d. Prepare to use the available backboard for
classifications as an injury-prevention strategy to:
a two-person removal from the water and
initiate the facility EAP. a. Allow campers to only enter areas appropriate
to their swimming capability.
b. Familiarize campers with water safety rules
2. Which of the following is not a strategy to be used and regulations prior to in-water activities.
while on duty at a waterfront facility?
c. Pair camp participants with different
a. Assigning buddy pairs and calling for periodic swimming abilities.
buddy checks
d. Teach campers to continuously monitor
b. Monitoring water and weather conditions their partners.
c. Classifying swimmers and designating
swimming areas based on swimmer abilities
7. During a safety check at a waterfront facility, you
d. Clearing the facility for frequent facility find an area with a large amount of debris in the
safety checks water. You should close off the area, inform your
supervisor and:
a. Alert patrons by using signs, buoys and
3. A lifeguard at a waterfront needs to have which of
safety announcements.
the following pieces of equipment only accessible
to him or her while on duty? b. Expect the other lifeguards in the area to tell
the patrons.
a. Mask, snorkel, and fins
c. Move your lifeguard station away from
b. Whistle, rescue tube and resuscitation mask
the area.
c. Rescue tube, gloves and emergency oxygen
d. Wait to see if any patrons swim in the area
d. Gloves, resuscitation mask and an automated
before alerting the patrons.
external defibrillator
8. During a safety check, you determine the water

4. A lifeguard on duty should keep which of the temperature of the lake is very cold due to a recent
following in mind when working at a rain. You should:
waterfront area: a. Alert patrons to the cold water and watch for
a. The in-water stabilization care for head, neck signs of hypothermia.
and spinal injuries is significantly modified. b. Expect the other lifeguards to warn patrons.
b. The RID factor. c. Focus on water depth since the water
c. Specialized rescue equipment may be present. temperature is safe.
d. There are not a maximum number of people in d. Wait to see if any swimmers notice the water
his/her assigned zone of coverage. temperature before alerting the other patrons.
LGI_SecE_p191-252.indd 234 10/17/11 12:00 PM

9. At a summer youth camp, lifeguards use 13. While you are conducting a safety check, you find
injury-prevention strategies, such as: several nails sticking out from the pier. You should:
a. Back-up coverage. a. Clear the lake and close the entire swimming
b. Buddy pairs. area for the day.
c. The FIND model. b. Close off the area and tell the lifeguard
d. The RID factor.
c. Make a note of it or come back to it during
your next break.
10. High winds are creating large waves and impairing d. Watch the area closely so nobody gets hurt.
visibility at a waterfront facility. You should:
a. Clear the patrons from the waterfront and
move indoors. 14. You see a distressed swimmer in the outer
boundaries of a swimming area. To approach the
b. Let patrons continue swimming.
victim using a motorized watercraft, you should:
c. Let patrons sit on the edge of the floating
a. Approach quickly to reach the victim promptly.
platform with their feet in the water.
b. Point the bow toward the victim.
d. Monitor weather reports while patrons
continue to swim. c. Approach from downwind and down current.
d. Approach the victim from the side with the
engine in neutral and at idle.
11. When you are performing patron surveillance at
the outer edge of a waterfront swimming area, you
may be watching swimmers from a: 15. When launching a rescue board, you should:
a. Ground-level position. a. Climb on just behind the middle of the rescue
b. Rescue tube. board and lie down.
c. Rescue watercraft. b. Hold the rescue board in the air until the water
reaches your waist.
d. An elevated station.
c. Lay the rescue board on the shoreline and
push it forward before you enter the water.
12. While performing patron surveillance at a d. Straddle the end of the rescue board and
waterfront facility during a summer youth camp, remain in a seated position.
you would prevent patron injuries by:
a. Helping the staff organize a swimming game
when the campers move to deep water.
b. Monitoring only the campers who are not
wearing life jackets.
c. Scanning the campers in your area
of responsibility.
d. Showing the campers the simple assist skill.
LGI_SecE_p191-252.indd 235 10/17/11 12:00 PM

Waterfront Skills Module Exam B
EXAMPLE
ANSWER SHEET
xx. a b c
d. All of the above
LGI_SecE_p191-252.indd 236 10/17/11 12:00 PM

Waterfront Skills Module Exam B
1. Which of the following statements is true for 4. As you are lifeguarding a youth group using the
waterfront lifeguarding? buddy system, one of the youth tells you his buddy
a. Water and weather conditions usually change is missing. You should:
slowly and only need to be checked at the a. Initiate the facility EAP and immediately
beginning of the day. perform a deep-water line search.
b. Motorized watercraft, rowboats and rescue b. Signal for a buddy check.
boards are available at most waterfront c. Initiate the facility EAP and perform a passive
facilities for emergency use. victim rescue.
c. Lifeguards need specialized training during d. Clear the area and perform a facility
orientation and in-service training on the use safety check.
of equipment and procedures specific to
the facility.
d. Patrons at waterfronts tend to be 5. Which of the following is not a strategy to be used
generally better swimmers than those at while on duty at a waterfront facility?
swimming pools.
a. Assigning buddy pairs and calling
buddy checks
b. Monitoring water and weather conditions
2. You are on duty at a waterfront facility and notice
lightning in approaching storm clouds. You should: c. Classifying swimmers and designating
swimming areas based on abilities
a. Immediately locate and inform the waterfront
director of the situation and wait for d. Clearing the facility for frequent facility
further instruction. safety checks
b. Initiate the facility EAP, clear the area and

direct participants to areas of safety indoors.
6. A lifeguard at a waterfront needs to have which of
c. Alert other staff, monitor the situation, wait
the following pieces of equipment only accessible
until you hear thunder or see lightening to
to him or her while on duty?
clear the area.
a. Whistle, rescue tube, and resuscitation mask
d. Initiate the facility EAP, post signs stating
lifeguards are no longer on duty and inform b. Rescue tube, gloves, and backboard
patrons that they may continue to swim at c. Mask, snorkel, and fins
their own risk. d. Gloves, rescue board, AED
3. You approach a patron standing still in waist-deep 7. An item of special concern at a waterfront that a
water at a waterfront facility. The victim is shaking, lifeguard should consider is:
not speaking clearly and has blue lips. You should
a. The in-water care for head, neck and spinal
most likely care for:
injuries is significantly modified.
a. Seizure.
b. The RID factor.
b. Choking.
c. Specialized rescue equipment may be present.
c. Hypothermia.
d. There are not a maximum number of people in
d. Stroke. his/her assigned zone of coverage.
LGI_SecE_p191-252.indd 237 12/16/11 2:05 PM

8. Lifeguards are conducting a deep-water line search 12. To enter the water with a mask and fins, it is
to locate a submerged victim. To see more clearly important to:
and cover more distance with less effort, the a. Put both hands over the mask and keep your
lifeguards should: elbows away from your chest.
a. Ask patrons to participate in the search. b. Put one hand over the mask and keep your
b. Use a watercraft. elbow close to your chest.
c. Use extra oars and paddles. c. Step out and lean forward over the water.
d. Wear a mask and fins. d. Swim, keeping your arms extended and your
face above water.
9. A man starts to fish in the swimming area. You

blow your whistle to get his attention. Next, you 13. To take a cross bearing, two lifeguards should:
enforce the rules and regulations by: a. Ask bystanders to swim toward the victim
a. Calling your supervisor. along their sight lines.
b. Giving him a warning. b. Swim toward the victim based on where
c. Telling him he cannot fish in the swimming bystanders last remember seeing the victim
area and suggesting other areas where he from one angle.
can fish. c. Take a sighting on the spot where the victim
d. Telling him he might be asked to leave the was last seen based on who was closest to
campground and demanding he stop it now. the victim.
d. Take a sighting from two different angles on
the spot where the victim was last seen
10. If the water is murky during a deep-water line going underwater.
search, you should:
a. Check the bottom by sweeping your hands
back and forth in front of you, making sure to 14. You are searching for a missing swimmer in
cover the entire area. shallow water, but cannot see the bottom.
You should:
b. Move the search to shallow water.
a. Conduct a deep-water line search.
c. Perform a different surface dive than the
lifeguard next to you and increase the number b. Conduct a shallow-water line search.
of swimming strokes. c. Move to water that is greater than chest depth.
d. Return to the surface at an angle. d. Wear a mask and fins.
11. Several lifeguards start a deep-water line search for 15. When launching a rescue board, you should:
a missing swimmer in a lake. The first step is to: a. Climb on just behind the middle of the rescue
a. Form a straight line an arm’s length from each board and lie down.
other, wearing masks and fins. b. Hold the rescue board in the air until the water
b. Have a lifeguard on a watercraft search reaches your waist.
the area. c. Lay the rescue board on the shoreline and
c. Take turns diving in different directions. push it forward before you enter the water.
d. Take turns diving to the bottom and returning d. Straddle the end of the rescue board and
to the surface at a 90-degree angle. remain in a seated position.
LGI_SecE_p191-252.indd 238 10/17/11 12:00 PM

FINAL WRITTEN EXAM: WATERPARK
SKILLS MODULE

LGI_SecE_p191-252.indd 239 10/17/11 12:00 PM

Waterpark Skills Module Exam A
EXAMPLE
ANSWER SHEET
xx. a b c
d. All of the above
LGI_SecE_p191-252.indd 240 10/17/11 12:00 PM

Waterpark Skills Module Exam A
1. A safety check at a waterpark may include which of 4. Which statement is true about rules at
the following? a waterpark?
a. Unusual noises, missing pieces or mildewed a. Rules do not need to be posted when
safety netting announced over a public address system.
b. Checking the facility grounds for a lost child b. Rules should only be posted in the changing
c. Posting rules and closing attractions because room since that is the one place
of a shortage of lifeguards everyone visits.
d. Checking to confirm a patron meets height c. There should be limited number of rules
restrictions for an attraction posted so visitors will take the time to
read them.
d. Rules should be posted near each attraction
2. When assigned to roving station on the zero-depth providing specific information about
area of a wave pool, a lifeguard should: that attraction.
a. Use the head and chin support for manual in-

line stabilization for a suspected neck injury in
extremely shallow water. 5. Every waterpark lifeguard should have which of
the following equipment immediately available to
b. Use a run-and-swim entry during a rescue.
them at all times?
c. Be assigned to total coverage for a large
a. A rescue tube, gloves and resuscitation mask
number of patrons.
b. Personal protective equipment, bodily fluid
d. Assist non-swimmers with the proper fitting of
cleanup and first aid supplies
lifejackets provided by the waterpark.
c. Radio, rescue tube and bag-valve-mask
resuscitator
3. Some of the unique challenges of a waterpark d. An automated external defibrillator,

facility compared with other aquatic facilities are: emergency oxygen and manual
suction device
a. The number of patrons visiting and their ages.
b. The types of rescue equipment and
supplies required.
6. A person is lying in the run out area of a speed
c. The variety and number of attractions and slide and does not sit up. You approach the victim
features at the facility. and he states that his toes, feet and legs are
d. The availability of concessions stands tingling. You should:
provides greater chance of food and drinks a. Have him rest in place and see if the
on the pool deck. condition changes.
b. Notify the dispatch lifeguard and have staff
proceed with a safety check of the attraction.
c. Prepare to care for the victim for a head, neck
or spinal injury.
d. Ask him for consent to help and immediately
perform a secondary assessment.
LGI_SecE_p191-252.indd 241 10/17/11 12:00 PM

7. You are assigned a zone at the deep end of a 10. A lifeguard starts to rescue a patron in the deep-
crowded wave pool. You see an active adult victim water section of a wave pool. For effective patron
in your zone. You should: surveillance, the other lifeguards should stand in
a. Activate the facility’s emergency action plan their chairs and adjust their zone coverage to:
(EAP), wait for all the wave action to stop and a. Decrease the number of lifeguards
enter the water. with fatigue.
b. Time your entry for the trough of the next b. Exclude the rescuing lifeguard’s area
wave, rescue the victim and signal other of responsibility.
lifeguards for assistance if needed. c. Include the rescuing lifeguard’s area
c. Activate the facility’s EAP, motion to other of responsibility.
lifeguards the victim’s location and toss the d. Increase the number of safety checks at
victim a ring buoy. each attraction.
d. Activate the facility’s EAP, time you entry for
the crest of the next wave, use a compact jump
entry and make the appropriate rescue. 11. A man exits from a drop-off slide into the catch
pool. He surfaces and is in distress. You activate
the EAP and then extend a rescue tube to the man.
8. A lifeguard is responsible for the splash down area The next steps include:
of a waterslide. She notices an adult patron exit the a. Completing a report and discussing the
slide and collide with a child patron moving toward emergency with bystanders.
the slide exit. Both victims are now submerged.
b. Completing a report and talking to the media.
The lifeguard might:
c. Pulling him to safety and checking the rescue
a. Expect the child to have a head, neck or
tube for damage.
spinal injury.
d. Pulling him to safety and providing
b. Activate the facility’s EAP, retrieve the
additional care.
backboard and request assistance.
c. Activate the facility’s EAP, approach the
victims and perform a multiple victim rescue.
12. You are responsible for a part of the wave pool that
d. Monitor the victims to see if they appear to be can be easily viewed from your lifeguard station.
injured or need assistance prior to taking any To effectively scan, you must:
other action.
a. Count all the patrons in your area
of responsibility.
9. A large number of patrons are swimming in the
wave pool. For effective patron surveillance, your c. Keep your head still but use your eyes to scan
supervisor decides to add another lifeguard station your area.
and tells you to modify the zone coverage based on d. Move your head and eyes as you scan to look
the new station to: directly at each area rather than staring in a
a. Allow the lifeguards to take turns scanning the fixed direction.
good swimmers.
and down the deck.
each lifeguard.
each lifeguard.
LGI_SecE_p191-252.indd 242 12/16/11 10:42 AM

13. You are the dispatch lifeguard on a slide at a 15. At a waterpark, one step of an EAP may include:
waterpark and notice the handrail has become a. Assisting with in-service trainings.
detached. Which of the following statements
b. Monitoring the water chemistry.
is true?
c. Opening the facility.
a. You should close the attraction as soon as
those currently in line have had their turn. d. Stopping the slide dispatch.
b. You should immediately close the attraction

and notify the facility management.
c. You can ignore the issue since it will be
corrected during the next facility safety check.
d. You should use signs and ropes to alert
patrons of the hazard and continue operating
the attraction.
14. During an in-service training, which of the

following would not be part of a facility’s EAP?
a. Stopping the wave machine by pushing the
emergency stop button.
b. Stopping the dispatch of riders on a slide.
c. Stopping the flow of water creating a current
in a winding river.
d. Stopping patrons from exiting the wave pool.
LGI_SecE_p191-252.indd 243 10/17/11 12:00 PM

Waterpark Skills Module Exam B
EXAMPLE
ANSWER SHEET
xx. a b c
d. All of the above
LGI_SecE_p191-252.indd 244 10/17/11 12:00 PM

Waterpark Skills Module Exam B
1. A person is lying in the run out area of a speed 4. When assigned to a roving station on the zero
slide and does not sit up. You approach the victim depth area of a wave pool a lifeguard should:
and he states that his toes, feet and legs are a. Use the head and chin support for manual in-
tingling. You should: line stabilization for a suspected neck injury in
a. Have him rest in place and see if the extremely shallow water.
condition changes. b. Use a run-and-swim entry during a rescue.
b. Notify the dispatch lifeguard and have staff c. Be assigned to total coverage for a large
proceed with a safety check of the attraction. number of patrons.
c. Prepare to care for the victim for a head, neck d. Assist non-swimmers with the proper fitting of
or spinal injury. lifejackets provided by the waterpark.
d. Ask him for consent to help and immediately
perform a secondary assessment.
5. You are assigned a zone at the deep end of a
crowded wave pool. You see an active adult victim
2. During an in-service training, which of the in your zone. You should:
following would not be part of a facility’s a. Activate the facility’s emergency action plan
emergency action plan (EAP)? (EAP), wait for all the wave action to stop and
a. Stopping the wave machine by pushing the enter the water.
emergency stop button b. Time you entry for the trough of the next wave,
b. Stopping the dispatch of riders on a slide rescue the victim and signal other lifeguards
c. Stopping the flow of water creating a current for assistance if needed.
in a winding river c. Activate the facility’s EAP, motion to other
d. Stopping patrons from exiting the wave pool lifeguards the victim’s location and toss the
victim a ring buoy.
d. Activate the facility’s EAP, time your entry for
3. You are the dispatch lifeguard on a slide at a the crest of the next wave, use a compact jump
waterpark and notice the handrail has become entry and make the appropriate rescue.
detached. Which of the following statements
is true?
a. You should close the attraction as soon as 6. A lifeguard is responsible for the splash down area
those currently in line have had their turn. of a waterslide. She notices an adult patron exit the
slide and collide with a child patron moving toward
b. You should immediately close the attraction
the slide exit. Both victims are now submerged.
and notify the facility management.
The lifeguard might:
c. You can ignore the issue since it will be
a. Activate the facility’s EAP, retrieve the
corrected during the next facility safety check.
backboard, and request assistance.
d. You should use signs and ropes to alert
b. Activate the facility’s EAP, approach the
patrons of the hazard and continue operating
victims and perform a multiple victim rescue.
the attraction.
c. Monitor the victims to see if they appear to be
injured or need assistance prior to taking any
other action.
d. Expect the child to have a head, neck or
spinal injury.
LGI_SecE_p191-252.indd 245 12/16/11 10:42 AM

7. A conscious patron needs help getting out of a 11. At a waterpark, one step of an EAP may include:
pool that has a zero-depth exit. He does not have a a. Assisting with in-service trainings.
head, neck or spinal injury. To effectively remove
b. Monitoring the water chemistry.
the patron from the water, you should:
c. Opening the facility.
a. Have the patron swim to the closest railing.
d. Stopping the slide dispatch.
b. Perform the head and chin support.
c. Slide the patron onto a backboard.
12. During a weather-related power failure, you hear
d. Use the walking assist.
thunder in the distance you should:
a. Clear everyone from the water and move them
to a safe area.
8. A lifeguard starts to rescue a patron in a shallow-
water attraction at a waterpark. For effective b. Let patrons continue swimming.
patron surveillance, the lifeguard nearby should: c. Let patrons sit on the edge with their feet in
a. Cover both his or her area of responsibility and the water.
the rescuing lifeguard’s area of responsibility. d. Monitor weather reports while patrons
b. Focus only on the rescuing lifeguard’s area continue to swim.
of responsibility.
c. Leave his or her area of responsibility and find 13. The lifeguard supervisor expects the wave pool to
other lifeguards to assist with the rescue. be very busy in the afternoon. For effective patron
d. Signal the other lifeguards to rotate stations. surveillance, she sets up multiple lifeguard stations
to reduce the number of patrons watched by each
9. A man exits from a drop-off slide into the catch a. Back-up coverage.
pool. He surfaces and is in distress. You activate b. Rescue coverage.
the EAP and then extend a rescue tube to the man. c. Total coverage.
The next steps include:
d. Zone coverage.
a. Completing a report and discussing the
emergency with bystanders.
14. When performing patron surveillance at a child
b. Completing a report and talking to the media.
play structure at a waterpark:
c. Pulling him to safety and checking the rescue
a. It is necessary to have at least one lifeguard for
tube for damage.
every three slides.
d. Pulling him to safety and providing
b. It is not necessary to wear your rescue tube.
additional care.
c. You should pay close attention to non-
swimmers or weak swimmers.
d. Pay less attention to sprays and fountains.
10. At a waterpark, lifeguards can remain alert and
reduce fatigue during their shift by:
a. Completing records and reports at their 15. While you are conducting a safety check, you find
lifeguard stations a section of the pool gutter cover is missing. You
b. Performing light cleaning tasks when stationed should:
in the water for surveillance duty a. Close the entire facility for the day.
c. Rotating through different attractions or b. Close off the area and tell the lifeguard
positions at an attraction supervisor right away.
d. Staying at one station or position at c. Make a note of it or come back to it during
an attraction your next break.
d. Watch the area closely so nobody gets hurt.
LGI_SecE_p191-252.indd 246 10/17/11 12:00 PM

ANSWER SHEET: CPR/AED for the Professional Rescuer and
First Aid
Name: ______________________________________________ Date: __________
Exam A B
1. a b c d 15. a b c d 28. a b c d
2. a b c d 16. a b c d 29. a b c d
3. a b c d 17. a b c d 30. a b c d
4. a b c d 18. a b c d 31. a b c d
5. a b c d 19. a b c d 32. a b c d
6. a b c d 20. a b c d 33. a b c d
7. a b c d 21. a b c d 34. a b c d
8. a b c d 22. a b c d 35. a b c d
9. a b c d 23. a b c d 36. a b c d
10. a b c d 24. a b c d 37. a b c d
11. a b c d 25. a b c d 38. a b c d
12. a b c d 26. a b c d 39. a b c d
13. a b c d 27. a b c d 40. a b c d
14. a b c d
LGI_SecE_p191-252.indd 247 10/17/11 12:00 PM

ANSWER SHEET: Lifeguarding Skills
Name: ______________________________________________ Date: __________
Exam A B
1. a b c d 13. a b c d 25. a b c d
2. a b c d 14. a b c d 26. a b c d
3. a b c d 15. a b c d 27. a b c d
4. a b c d 16. a b c d 28. a b c d
5. a b c d 17. a b c d 29. a b c d
6. a b c d 18. a b c d 30. a b c d
7. a b c d 19. a b c d 31. a b c d
8. a b c d 20. a b c d 32. a b c d
9. a b c d 21. a b c d 33. a b c d
10. a b c d 22. a b c d 34. a b c d
11. a b c d 23. a b c d 35. a b c d
12. a b c d 24. a b c d
LGI_SecE_p191-252.indd 248 12/27/11 10:18 AM

ANSWER SHEET: Shallow Water Lifeguarding Skills
Name: ______________________________________________ Date: __________
Exam A B
1. a b c d 13. a b c d 25. a b c d
2. a b c d 14. a b c d 26. a b c d
3. a b c d 15. a b c d 27. a b c d
4. a b c d 16. a b c d 28. a b c d
5. a b c d 17. a b c d 29. a b c d
6. a b c d 18. a b c d 30. a b c d
7. a b c d 19. a b c d 31. a b c d
8. a b c d 20. a b c d 32. a b c d
9. a b c d 21. a b c d 33. a b c d
10. a b c d 22. a b c d 34. a b c d
11. a b c d 23. a b c d 35. a b c d
12. a b c d 24. a b c d
LGI_SecE_p191-252.indd 249 12/27/11 1:16 PM

ANSWER SHEET: Waterfront Skills Module
Name: ______________________________________________ Date: __________
Exam A B
1. a b c d
2. a b c d
3. a b c d
4. a b c d
5. a b c d
6. a b c d
7. a b c d
8. a b c d
9. a b c d
10. a b c d
11. a b c d
12. a b c d
13. a b c d
14. a b c d
15. a b c d
LGI_SecE_p191-252.indd 250 10/17/11 12:00 PM

ANSWER SHEET: Waterpark Skills Module
Name: ______________________________________________ Date: __________
Exam A B
1. a b c d
2. a b c d
3. a b c d
4. a b c d
5. a b c d
6. a b c d
7. a b c d
8. a b c d
9. a b c d
10. a b c d
11. a b c d
12. a b c d
13. a b c d
14. a b c d
15. a b c d
LGI_SecE_p191-252.indd 251 10/17/11 12:00 PM

LGI_SecE_p191-252.indd 252 10/17/11 12:00 PM
INDEX
A Burns, 118, 123

Active victim rescues, 66–70, 77–78, 143, 173
C
Activities, 3–4
Activity worksheets, 6, 145–150 Cardiac arrest, 50, 100, 103
Adults Cardiac Chain of Survival, 99–100
choking by, 87–90, 96, 97 Cardiac emergencies, 16, 21, 99–113
CPR on, 101–102, 108–109 Certificates, awarding completion, 11
giving ventilations to, 86 Certification prerequisite, 155, 176, 179
primary assessment of, 82, 90–91 Chest compressions, 101
AED. See Automated external defibrillator (AED) Children
Age prerequisite, 27 choking by, 87–89, 96, 97
Agonal gasps, 50, 81 CPR on, 101–102, 108–109
Airway obstructions, 87–89, 96–98 giving ventilations to, 86
American Red Cross Lifeguarding program, 1–11 primary assessment of, 82–83, 91
courses, 6 Choking, 87–89, 96–98
refresher program, 6 Classroom space, 7
reporting procedures, 11 Class safety, 8–9
retail products, 6 Class size, 7, 152, 176
American Red Cross Universal Certificate, 10, 33 Co-instructors, 8
Americans with Disabilities Act (ADA) Accommodation Cold water, 159
Resource Guide, 8, 9 Communication systems, 162
Approaches, 43–44, 47 Compact jump, 44, 46
Aquatic facilities Continuing education units, 11
rules and regulations of, 41–43, 49, 145–147 Continuous swim, 30
See also specific types of facilities Course length, 7, 152, 176
Aquatic sports, 57 Course presentation, 5–6
Aspirin in cardiac emergencies, 100 CPR, 101–102
Assignments, 4 final written exam for, 193–209
Assisting and Co-Instructors, 8 skill assessment tool for, 109–110
Asthma, 85 skill chart for, 108–109, 110–111
Automated external defibrillator (AED), 16, 21 two-rescuer, 102–103, 110–111
activity worksheet, 150
maintenance of, 105–106 D
precautions with, 105–106 Decision making, 35
skill assessment tool, 112 Defibrillation, 103
skill chart for, 111–112 Diabetes, 121
use of, 103–106, 111–112 Disease transmission, 79–80
written exam for, 193–209 Disposable gloves, removal of, 80, 90
Distraction, 53
B Distressed swimmers, characteristics of, 51–52
Backboards, 134–136 Diving areas, rules and regulations of, 42–43, 146
Bag-valve-mask (BVM) resuscitator, 87, 95–96 Drowning process, 50
Beach drag, 163, 167–168, 187 Drowning response behaviors, 51–52
Bites, 118
Bleeding, control of, 116–117, 128 E
Blind spots, 53 EAPs. See Emergency action plans (EAPs)
Bloodborne pathogens, 80 Effective surveillance, 51–54, 156, 180
Bloodborne Pathogens Standard, 49 Emergencies
Body substance isolation (BSI), 80 breathing, 15–16, 20–21, 84–85, 87–89
Bone injuries, 120 cardiac, 99–113
Breastbone injuries, 129 cold-related, 119, 159
Breathing emergencies, 15–16, 20–21, 84–85, 87–89 on land, 80–81
Buddy systems, 161–162 Emergency action plans (EAPs), 43, 64–65, 162–163, 183
Index 253
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Emergency medical services (EMS), 1, 83 recovery position for, 93
Emphysema, 85 Injuries
Entries, 43–44, 46–47, 163, 166–167, 170, 186 common, 117–118
Equipment, 5, 6, 153, 177 foot, 129
Escapes, 131–132 hand and finger, 129
Exams. See Final written exams head, neck and spinal, 17, 22, 123–124, 129–131, 133–
140, 143
F leg, 129
Face-up position, 93 muscle, bone, and joint, 120
Facility responding to, 116–120
safety, 13–14, 18–19, 39–40, 48–49, 157–160, 180–182 rib and breastbone, 129
management of, 48–49 Injury prevention, 14, 19, 35
FAST, 122 strategies for, 54–56
Fatigue, 53 at waterfront facilities, 161–162
Final In-Water Skill Scenarios, 4, 143 at waterpark facilities, 182–183
Final written exams, 4, 10, 18, 23 In-service training, 37, 45
answer sheets and keys for, 262–285 Instructional classes, 57
for CPR/AED for the professional rescuer, 133, 141, Instructor aids, 8–9
193–209 Instructors
for first aid, 133, 141, 193–209 resources and materials for, 3–6
for head, neck and spinal injuries, 142, 210–243 responsibilities, 2
for lifeguarding skills, 210–243 video segments for training of, 4
security of, 11 Instructor’s Corner, 6
for Waterfront Skills module, 166, 244–252 Internet Association of Continuing Education and
for Waterpark Skills module, 185, 253–261 Training (IACET), 11
Final written exam answer sheets and In-water skills scenarios, 10–11, 18,
keys, 262–285, A1–A20 142–143
Finger injuries, 129 In-water skills sessions
Fins, 164, 170–171 breathing emergency, 89
First aid, 17, 22, 114–132 drowning victim, 107–108
final written exam for, 193–209 entries and approaches, 43–44
scenarios, 120–123 head, neck and spinal injuries, 135–137
Foot injuries, 129 lifeguard rotations, 60–61
Front-and-back carry, 163, 168, 187–188 rescue skills, 73–74, 89, 125–126
scanning, 60–61
G skills review, 60, 125–126, 142
Glare, 53, 54 waterfront rescue skills, 163–165
Group visits, 62–64, 149, 161–162, 183 waterpark rescue skills, 184
for when things do not go as practiced, 124–125
H In-water ventilations, 125
Hand injuries, 129
Hazard Communication Standard, 49 J
Head-hold escape, 125, 131 Jaw-thrust (with head extension) maneuver, 94
Head injuries Jaw-thrust (without head extension) maneuver, 94
caring for, 123–124, 129–131, 133–140 Joint injuries, 120
final written exam for, 210–243
in-water scenario for, 143 L
Head splints, 136–138, 164, 168–169, 188–189 Labor laws, 49
Health precautions, 9 Laryngospasm, 50
Heart attack, 99–100 Lecture points, 3
Heat, 53 Legal considerations, 35–36
Heat cramps, 119 Leg injuries, 129
Heat stroke, 119 Lessons
Hot tubs, rules and regulations of, 43, 147 objectives, 3
Human-knot activity, 38 plans, 3–4
Hypothermia, 119, 159 See also individual topics
Hypoxia, 84 Lifeguard evaluations, 37
Lifeguarding
I organized groups, 62–64, 149, 161–162, 183
IACET. See Internet Association of Continuing Education special attractions, 58–59, 148
and Training (IACET) variety of activities, 56–57
Illnesses waterfront, 156–163
heat-related, 119 waterpark, 180–183
sudden, 116 Lifeguarding course
Infants completion criteria, 10–11
choking by, 88, 89, 96–98 design of, 3–6
CPR on, 102, 103, 109–111 introduction to, 32–33
giving ventilations to, 86 objectives of, 1
primary assessment of, 82, 83, 91 outline, 13–18
LGI_Index_p253-258.indd 254 11/2/11 9:30 AM

participants in, 1–2 age prerequisite verification, 27
precourse session, 25–26 counseling after, 29
purpose of, 1 introduction to, 25–26
setting up and running, 7–9 swimming skills evaluation, 27–29
swimming skills evaluation, 27 wrap-up, 29
written exam for, 210–226 Prerequisite skills, 25–26, 30–31,
Lifeguarding DVD Set, 4 154–155, 176
Lifeguarding Instructor’s Manual, 3–4 Primary assessments, 81–83, 90–92
Lifeguarding Manual, 3 Professionalism, 34, 45
Lifeguard rotations, 60–61 Professional lifeguards, 13, 18–19, 33–35
Life-threatening conditions, 54, 81–83 characteristics of, 33–34
Lightning, 40, 55–56 continuation of training for, 36–37
responsibilities of, 34, 45
M
Masks, 164, 170–171 R
Materials, equipment and supplies Recovery positions, 93
for the class, 5 Recreational swimming, 56
for the instructor, 5 Rescue boards, 165, 173–174
for participants, 5 Rescue equipment, 39
Material Safety Data Sheet (MSDS), 49, 118 Rescues
Medical history, 126–127, 128 active victim front, 66, 68, 70
Modified H.A.IN.E.S. recovery position, 93 active victim rear, 66, 69–70
Monotony, 53 in cold water, 159
Mouth injuries, 118, 123 deep water, 75, 76, 164, 172–174
MSDS. See Material Safety Data Sheet (MSDS) multiple-rescuer response, 107–108, 113
Multiple-rescuer response, 107–108, 113 multiple victim, 71
Multiple victim rescues, 71 at or near surface, 65–69
Murky water, 53 passive victim, 69, 70, 76, 143, 173–174
Muscle injuries, 120 simple assist, 68
submerged victim, 73–76, 160–161
N two-person removals, 74, 77–78
Neck injuries Rescue skills, 14–15, 19–20
caring for, 123–124, 129–131, 133–140 in-water skill session for, 65–67, 73–74, 125–126
in-water scenario for, 143 waterfront, 163–165
written exam for, 210–243 waterpark, 183–184
Negligence, 36 Rescue tube, 39
Non-life-threatening conditions, 54–55 Rescue Tube Relay, 61
Nosebleeds, 118 Respiratory arrest, 85
Respiratory distress, 85
O
Resuscitation masks, using, 83, 94–95
Objectives, testing, 8 Rib injuries, 129
Occupational Safety and Health Administration (OSHA), Rides and attractions, 59
49, 80 Rip currents, 159–160
Open swimming, 56 Risk behaviors, 55
Organized activities, 56 Risk management, 54
Orientation sessions, 36–37 Round Robin Brick Drill, 61
Oxygen, 85 Rules and regulations, 41–43, 181–182
P Run-and-swim entries, 163, 166–167, 186
Participants S
course evaluation form, 11 Safety orientation, for organized groups, 63–64
with disabilities and special health considerations, 9 Scanning, 52–53, 60–61, 160–161
health precautions for, 9 Scenarios, 4
resources for, 3, 6 Scene size-up, 81
Passive victim rescues, 69–70, 76, 143, 173–174 Searches, 164, 169, 172
Patron loads Secondary assessment, 115, 126–127
heavy, 53, 54 Seizures, 122
low, 53 Shallow Water Lifeguarding course
Patrons, communication with, 55 introduction to, 32–33
Patron surveillance, 14, 19, 50–54, 160–161, outline, 18–23
180, 182 precourse session, 25–26
Personal protective equipment (PPE), 80 prerequisite skills, 26
Physical structures, in water, 157 purpose of, 1
Play structures, 58 rescue skills, 74
Poison Control Center, 118 swimming skills evaluation, 28–29
Poisoning, 118–119 written exam for, 227–243
Policies and procedures manual, 37 Shock, 117
Power failures, 40 Skill charts and assessment tools
Precourse session, 13, 18, 25–31 active victim front and rear rescues, 68–69
Index 255

Skill charts and assessment tools (cont) Stabilization, in-line, 137, 138
approaches, 47 Standard precautions, 79–80
assessment tools, 4 Stings, 121
assists, 68 Stride jump, 44, 46
beach drag, 167–168, 187 Submerged victim rescues, 73–76,
checking conscious person, 127 160–161
choking, 96, 98 Supplies, 5, 153, 177
compact jump, 46 Surface distortion, 53
control of bleeding, 128 Surface dives, 76–77, 170–171
CPR, 108–111 Surveillance, 160–161
disposal glove removal, 90 Surveillance skills, 72, 114–115, 156, 180
entries, 46–47 Swim lessons, 57
escapes, 132 Swimming approach, 47
foot injuries, 129 Swimming prerequisites, 154–155, 176, 178
front-and-back carry, 168, 187–188 Swimming skills evaluation, 27–29, 155–156, 179
giving ventilations, 95–96 Swim tests, 161
hand and finger injuries, 129
head, neck and spinal injuries, 129–131 T
head-hold escape, 131 Team-building activity, 38
head splints, 137–138, 168, 188–189 Teeth injuries, 118, 123
in-water ventilations, 132 Therapy pools, rules and regulations of, 43, 147
jaw-thrust (with head extension) maneuver, 94 Thunderstorms, 40
jaw-thrust (without head extension) maneuver, 94 Timed event, 31, 155, 179
leg injuries, 129 Training equipment, 6
masks and fins, 170–171 Tread water, 30, 155, 179
medical history, 128
multiple-victim rescues, 71 U
passive victim rescues, 69, 70 Underwater hazards, 157
primary assessment, 90–92 Underwater swim event, 31, 156
reaching assist from deck, 68
V
recovery positions, 93
rescues at or near surface, 69 Ventilations
rescue board use, 173–174 giving, 86–87, 95–96
resuscitation masks, 94, 95 in-water, 125, 132
rib and breastbone injuries, 129 Ventricular fibrillation (V-fib), 103
run-and-swim entry, 166, 167, 186 Ventricular tachycardia (V-tach), 103
searches, 169, 172 Victim assessment, 15, 20
secondary assessment, 126–127 Victim recognition, 51–52, 60–61
simple assist, 68 Victims, moving, 84
slide-in entry, 46 Video segments, 4
spinal backboarding, 138–140, 190
W
splinting, 129
stride jump, 46 Walking approach, 47
submerged victim rescues, 75, 76 Walking assists, 163, 167, 187
surface dives, 76–77, 170–171 Water conditions, 157–158
swimming approach, 47 Watercraft, 161
two-person removals, 77–78 Water currents, 158
using an AED, 111–112 Water depth, 158
walking approach, 47 Water exercise classes, 57
walking assist, 167, 187 Waterfront facilities
Skill drills, 4 rules and regulations of, 41–42, 145–146
Skills practice safety issues, 157–160
entries and approaches, 43–44 Waterfront lifeguarding, unique aspects of, 156–163
in-water, 4, 8 Waterfront skills
land-based, 4, 8 deep water searches, 164
setting up and running, 7–8 rescue, 163–165
Slide-in entry, 43–44, 46 rescue board use, 165
Spas, rules and regulations of, 43, 147 skill drill, 165
Special attractions, 58–59, 148 verification of, 155–156
Spinal backboarding, 134–135, 138–140, 190 Waterfront Skills module
Spinal injuries class size for, 152
caring for, 123–124, 129–131, 133–140 facility requirements for, 153
final written exam for, 210–243 final written exam for, 166, 244–252
in-water scenario for, 143 introduction to, 154–155
suspected, 168–169, 188–190 length of, 152
Splinting, 120, 129 lesson plan for, 154–174

materials, equipment and supplies for, 153 introduction to, 178
outline of, 151 length of, 176
prerequisites for, 26, 152, 176 lesson plan for, 178–190
purpose of, 1, 152, 156 materials, equipment, and supplies for, 177
skill charts and assessment tools for, 166–174 outline of, 175
swimming skills evaluation for, 28 prerequisites for, 25, 178, 179
testing and certificates for, 153 purpose of, 1, 176
Water movement, 53 skill charts and assessment tools for, 186–190
Waterpark facilities swimming skills evaluation for, 27, 179
group visits to, 183 testing and certificates for, 177
injury prevention at, 182–183 Water quality, 158
rules and regulations of, 42, 146, 181–182 Water slides, 59, 181, 190
safety issues at, 180–182 Wave pools, 59
types of features in, 180 Weather conditions, 40
Waterpark lifeguarding, unique aspects of, 180–183 Whistle blowing, 55
Waterpark rescue skills, 183–184 Winding rivers, 59, 181
final written exam for, 185
skill drill, 185 Y
verification of, 179 Youth camps, 161–162
Waterpark Skills module
class size for, 176 Z
facility requirements for, 177 Zones of surveillance responsibility, 54
final written exam for, 253–261
Index 257

ANSWER KEY: CPR/AED for the Professional Rescuer and
First Aid
Exam A
1. a b c d 15. a b c d 28. a b c d
2. a b c d 16. a b c d 29. a b c d
3. a b c d 17. a b c d 30. a b c d
4. a b c d 18. a b c d 31. a b c d
5. a b c d 19. a b c d 32. a b c d
6. a b c d 20. a b c d 33. a b c d
7. a b c d 21. a b c d 34. a b c d
8. a b c d 22. a b c d 35. a b c d
9. a b c d 23. a b c d 36. a b c d
10. a b c d 24. a b c d 37. a b c d
11. a b c d 25. a b c d 38. a b c d
12. a b c d 26. a b c d 39. a b c d
13. a b c d 27. a b c d 40. a b c d
14. a b c d
LGI_SecE_Ans_Key_A-1-A-20.indd A-1 10/17/11 12:47 PM

ANSWER KEY: CPR/AED for the Professional Rescuer and
First Aid
Exam B
1. a b c d 15. a b c d 28. a b c d
2. a b c d 16. a b c d 29. a b c d
3. a b c d 17. a b c d 30. a b c d
4. a b c d 18. a b c d 31. a b c d
5. a b c d 19. a b c d 32. a b c d
6. a b c d 20. a b c d 33. a b c d
7. a b c d 21. a b c d 34. a b c d
8. a b c d 22. a b c d 35. a b c d
9. a b c d 23. a b c d 36. a b c d
10. a b c d 24. a b c d 37. a b c d
11. a b c d 25. a b c d 38. a b c d
12. a b c d 26. a b c d 39. a b c d
13. a b c d 27. a b c d 40. a b c d
14. a b c d

ANSWER KEY: Lifeguarding Skills
Exam A
1. a b c d 13. a b c d 25. a b c d
2. a b c d 14. a b c d 26. a b c d
3. a b c d 15. a b c d 27. a b c d
4. a b c d 16. a b c d 28. a b c d
5. a b c d 17. a b c d 29. a b c d
6. a b c d 18. a b c d 30. a b c d
7. a b c d 19. a b c d 31. a b c d
8. a b c d 20. a b c d 32. a b c d
9. a b c d 21. a b c d 33. a b c d
10. a b c d 22. a b c d 34. a b c d
11. a b c d 23. a b c d 35. a b c d
12. a b c d 24. a b c d
LGI_SecE_Ans_Key_A-1-A-20.indd A-5 12/16/11 9:52 AM

ANSWER KEY: Lifeguarding Skills
Exam B
1. a b c d 13. a b c d 25. a b c d
2. a b c d 14. a b c d 26. a b c d
3. a b c d 15. a b c d 27. a b c d
4. a b c d 16. a b c d 28. a b c d
5. a b c d 17. a b c d 29. a b c d
6. a b c d 18. a b c d 30. a b c d
7. a b c d 19. a b c d 31. a b c d
8. a b c d 20. a b c d 32. a b c d
9. a b c d 21. a b c d 33. a b c d
10. a b c d 22. a b c d 34. a b c d
11. a b c d 23. a b c d 35. a b c d
12. a b c d 24. a b c d

ANSWER KEY: Shallow Water Lifeguarding Skills
Exam A
1. a b c d 13. a b c d 25. a b c d
2. a b c d 14. a b c d 26. a b c d
3. a b c d 15. a b c d 27. a b c d
4. a b c d 16. a b c d 28. a b c d
5. a b c d 17. a b c d 29. a b c d
6. a b c d 18. a b c d 30. a b c d
7. a b c d 19. a b c d 31. a b c d
8. a b c d 20. a b c d 32. a b c d
9. a b c d 21. a b c d 33. a b c d
10. a b c d 22. a b c d 34. a b c d
11. a b c d 23. a b c d 35. a b c d
12. a b c d 24. a b c d

ANSWER KEY: Shallow Water Lifeguarding Skills
Exam B
1. a b c d 13. a b c d 25. a b c d
2. a b c d 14. a b c d 26. a b c d
3. a b c d 15. a b c d 27. a b c d
4. a b c d 16. a b c d 28. a b c d
5. a b c d 17. a b c d 29. a b c d
6. a b c d 18. a b c d 30. a b c d
7. a b c d 19. a b c d 31. a b c d
8. a b c d 20. a b c d 32. a b c d
9. a b c d 21. a b c d 33. a b c d
10. a b c d 22. a b c d 34. a b c d
11. a b c d 23. a b c d 35. a b c d
12. a b c d 24. a b c d

ANSWER KEY: Waterfront Skills Module
Exam A
1. a b c d
2. a b c d
3. a b c d
4. a b c d
5. a b c d
6. a b c d
7. a b c d
8. a b c d
9. a b c d
10. a b c d
11. a b c d
12. a b c d
13. a b c d
14. a b c d
15. a b c d

ANSWER KEY: Waterfront Skills Module
Exam B
1. a b c d
2. a b c d
3. a b c d
4. a b c d
5. a b c d
6. a b c d
7. a b c d
8. a b c d
9. a b c d
10. a b c d
11. a b c d
12. a b c d
13. a b c d
14. a b c d
15. a b c d

ANSWER KEY: Waterpark Skills Module
Exam A
1. a b c d
2. a b c d
3. a b c d
4. a b c d
5. a b c d
6. a b c d
7. a b c d
8. a b c d
9. a b c d
10. a b c d
11. a b c d
12. a b c d
13. a b c d
14. a b c d
15 a b c d

ANSWER KEY: Waterpark Skills Module
Exam B
1. a b c d
2. a b c d
3. a b c d
4. a b c d
5. a b c d
6. a b c d
7. a b c d
8. a b c d
9. a b c d
10. a b c d
11. a b c d
12. a b c d
13. a b c d
14. a b c d
15. a b c d

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PLEASE READ THE FOLLOWING TERMS AND CONDITIONS BEFORE AGREEING

■■ The recipient is prohibited from selling electronic versions of the materials.

© 2012 American National Red Cross. ALL RIGHTS RESERVED.

Published by Krames StayWell Strategic Partnerships Division.

Printed in the United States of America.

The American Red Cross team for this edition included:

The following individuals provided guidance and support:

LGI_FM_pi-x.indd iii 12/13/11 1:13 PM

The Sounding Board for this edition included:

iv Lifeguarding Instructor’s Manual

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The following individuals provided external review:

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CHAPTER 1 INTRODUCTION _____________________________________________________________ 1

CHAPTER 2 COURSE DESIGN____________________________________________________________ 3

CHAPTER 3 SETTING UP AND RUNNING THIS COURSE ____________________________________ 7

CHAPTER 4 REQUIREMENTS FOR SUCCESSFUL COURSE COMPLETION ____________________ 11

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SECTION B | THE LIFEGUARDING AND SHALLOW WATER

Lifeguarding Course Outline _________________________________________________ 13

SECTION C | WATERFRONT SKILLS

Module Outline ____________________________________________________________ 151

SECTION D | WATERPARK SKILLS

Module Outline ____________________________________________________________ 175

SECTION E | LIFEGUARDING FINAL WRITTEN EXAMS

viii Lifeguarding Instructor’s Manual

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2 Lifeguarding Instructor’s Manual

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4 Lifeguarding Instructor’s Manual

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ADDITIONAL RESOURCES FOR INSTRUCTORS

6 Lifeguarding Instructor’s Manual

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RECOMMENDED CLASS SIZE

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SETTING UP AND RUNNING SKILL SESSIONS

8 Lifeguarding Instructor’s Manual

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HEALTH PRECAUTIONS FOR COURSE PARTICIPANTS

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10 Lifeguarding Instructor’s Manual

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CRITERIA FOR COURSE COMPLETION

FINAL WRITTEN EXAMS

FINAL IN-WATER SKILLS SCENARIO

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PARTICIPANT COURSE EVALUATION

CONTINUING EDUCATION UNITS FOR PROFESSIONALS

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LIFEGUARDING COURSE OUTLINE

LESSON 1—THE PROFESSIONAL LIFEGUARD AND

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LESSON 2—FACILITY SAFETY, PATRON SURVEILLANCE

LESSON 3—INJURY PREVENTION AND RESCUE SKILLS,