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As the only lifeguard performing CPR on a & year old child, you would perform cycles of:
30 chest compressions and 2 ventilations
Which of the following would you identify as the universal sign that a conscious person is choking?
Clutching the throat
The patron asks, “Should we move them to the first aid room?” What should you do next?
Tell the patron the victim should not be moved since there is no immediate danger.
How can you best protect yourself from possible bloodborne pathogen transmission when providing care?
Use protective equipment, such as disposable gloves and a breathing barrier, when providing care.
A patron has slurred speech, is unable to lift their right arm level with their left arm and is unable to smile without one side of their face drooping. These are symptoms of:
You are walking on the pool deck when the swim team coach suddenly collapses in front of you. During your primary assessment, you find that the victim doesn’t have a pulse. You should:
Immediately begin CPR using cycles of 30 compressions followed by 2 ventilations.
Which of the following is most essential to use when giving ventilations to protect you and the victim from disease transmission?
You are giving ventilations to a 5 year old child using a resuscitation mask. You should give 1 ventilation about every:
You are providing care to an adult who is unresponsive and not breathing as a result of a drowning. You give your first ventilation before performing CPR and notice that the chest doesn’t rise. Which of the following should you do next?
Re-tilt the victim’s head and then attempt another ventilation.
A patron seems to be having a diabetic emergency. You should:
Give them a glucose tablets.
Wile preparing to use an AED on a victim, you notice a medication patch on the victim’s chest. Which action is appropriate?
Removing the patch with a gloved hand.
Which of the following statements about BVMs is most accurate?
Ventilations are more effective when 2 rescuers operate the BVM.
…complete a primary assessment and find that the victim has a pulse but is not breathing. Which of the following should you do next?
give ventilations at a rate of 1 about every 5-6 seconds
You and another lifeguard are preparing for CPR on an adult who collapsed in the locker room. You determine that there is no breathing or pulse and state, “Victim has no pulse. Begin CPR.” Which of the following should the other lifeguard do next?
begin chest compressions
A patron has cut their leg on the edge of the bleachers and is bleeding heavily. You think the patron is in shock because they:
Become reckless and irritable.
A person has been injured and is responsive. You obtain consent to check the victim for life threatening conditions. What life-threatening conditions would require you to immediately summon EMS personnel?
persistent chest pain
You determine that a victim is unresponsive but breathing. While waiting with the victim for EMS personnel, you would position the victim:
in a recovery position
An AED indicates that “no shock is advised”. Which of the following is most appropriate to do next ?
Perform CPR for about 2 minutes.
If a victim is having a seizure in the water:
Support the victim with their head above water until the seizure ends.
You arrive on a scene where someone seems to be hurt. During the primary assessment, you should check for all of the following EXCEPT:
When using an AED, which of the following should you do immediately after attaching the AED pads to the victim’s chest?
Tell everyone to stand clear.
Which of the following should you do first when approaching the scene of an emergency?
Size-up the scene while forming an initial impression.
You are providing care to a conscious infant who is choking. When giving chest thrusts, which of the following would you see?
2 or 3 fingers
During a primary assessment, which of the following should you check first?
You are performing CPR on a victim and an assisting responder arrives. Which of the following is most appropriate for the assisting responder to do first?
Check to see whether EMS personnel have been called.
When giving abdominal thrusts to an adult who is chocking, where should you position your fist?
In the middle of the abdomen, just above the navel.
Your initial impression reveals severe life threatening bleeding in an adult victim who appears to be unresponsive. YOur next step should be:
Control the bleeding with any available resources.
An injured patron is responsive and bleeding. After summoning EMS personnel, obtaining consent and putting on disposable gloves, what is your next care step?
Press firmly against the wound w/ a sterile dressing and bamdage.
Let the wound bleed until it stops on its own.
check for responsiveness.
What is the 1 step your should take in caring for a victim with burns?
Remove the victim from the source of the burn.
You are providing care to a patron who started chocking on some food. The victim becomes unresponsive. Which of the following should you do first?
Lower the victim to the ground and begin CPR starting w/ chest compressions.
AS you are giving ventilations with a resuscitation mask, the victim vomits. Which of the following would you do first?
Turn the victim onto their side and clear the airway of the vomit immediately.
Based on which of the following signs and symptoms would you determine that a victim is experiencing respiratory distress?
Gasping for breath
A way to remember the questions to ask when taking a brief history is to use the acronym SAMPLE. What does the S in SAMPLE stand for?
signs and symptoms
Which of the following statements about performing CPR w/ 2 or more rescuers is true?
To redue rescuer fatigue, rescuers should switch positions about every 2 minutes or when the AED is analyzing.
You and a fellow lifeguard are giving ventilations using a BVM. You position the mask over the victims’s mouth and nose. What should the other lifeguard do?
Squeeze the bag with both hands.
To ensure high- quality CPR and high- quality chest compressions, you should:
Expose the victim’s chest to ensure proper hand placement and full chest recoil.
Which of the following finding would lead you to determine that an infant’s airway is open and not obstructed?
The infant is crying uncontrollably.
When giving chest compressions to an adult, how would you position your hands?
Heel of one hand on the center of the chest with the other hand on top
A 12 yr old child at a swim meet grabs their chest and begins to make wheezing noises. After you obtain consent to provide care, the child’s parent informs you that the child has a history of asthma, but doesn;t have an inhaler nearby. What care should you provide?
Summon more advanced medical personnel and place the victim into a position that helps breathing.
How can you best protect yourself from possible
bloodborne pathogen transmission when
d. Use personal protective equipment (PPE),
such as disposable gloves and a breathing
barrier, when providing care.
A 12-year-old boy at a swim meet grabs his chest
and begins to make wheezing noises. After you
obtain consent to provide care, his mother informs
you that he has a history of asthma, but does not
have his inhaler nearby. What care should
b. Summon more advanced medical personnel
and place the victim into a position that
While having a snack in the concession area, a
child suddenly clutches his throat with both hands.
You ask him if he is choking and he frantically nods
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
d. Stand or kneel behind the victim and give
5 back blows and 5 abdominal thrusts.
You and another lifeguard find an unconscious
adult on the floor in the locker room. You activate
your facility’s EAP, size-up the scene and perform
a primary assessment. You find the victim is not
moving or breathing, but has a pulse. You should
summon EMS personnel, then:
a. Give 1 rescue breath about every 5 seconds.
You come upon a scene where a patron appears to
be injured. Before approaching the victim, which of
the following will you not do as you size-up
c. Begin the primary assessment.
When providing care during an emergency, which
of the following should you do first?
c. Size-up the scene.
As the first lifeguard on the scene, you are
performing CPR on an adult. When performing
chest compressions, how deeply should you
compress the chest?
d. At least 2 inches
CPR should be performed on which of the
c. One who is in cardiac arrest
What is the first step of the Cardiac Chain
d. Early recognition and access to the emergency medical services (EMS) system
You are providing care to a victim having a heart
attack. Which of the following would you do first?
d. Summon EMS personnel.
Once you have turned on the automated external defibrillator (AED), you should:
a. Apply the pads and allow the AED to analyze
the heart rhythm.
To ensure effective chest compressions during
CPR, which of the following is most appropriate?
a. Allowing the chest to fully recoil
You are performing CPR on a victim and a second
lifeguard arrives. Which of the following is most
appropriate for the second lifeguard to do first?
c. Check to see whether EMS personnel have
Which of the following is most essential to use
when giving ventilations to protect you and the
victim from disease transmission?
a. CPR breathing barriers
You are providing care to a facility maintenance
worker who has fallen off the top of a ladder. The
victim is conscious. Which of the following should
you do first?
c. Obtain consent from the victim to
For which of the following should you summon
d. A victim with an open leg wound with the
You pull an unconscious adult from the water who is taking infrequent gasps. During the primary assessment you find that the victim has a pulse. What should you do next?
d. Give 2 initial ventilations.
If there is a risk of the AED pads touching each
other, such as with a small child or an infant, you should:
a. Place one pad in the middle of the chest and
the other on the back.
You have sized up the scene and determined
the scene is safe. When performing a primary
assessment, which of the following would you
a. Check for responsiveness
Which of the following statements about
bag-valve-mask resuscitators (BVMs) is
c. Two rescuers need to operate the BVM.
You are preparing to give ventilations to a
5-year-old boy using a resuscitation mask. You
should give 1 ventilation about every:
c. 3 seconds
When compressing a child’s chest during CPR, you
should compress at a rate of at least how many
compressions per minute?
An AED has advised that a shock should be given.
Which of the following is appropriate?
d. Tell everyone to stand clear of the victim.
You are about to apply AED pads to a victim’s chest
when you notice that the victim has several body
piercings with jewelry on his chest. Which of the
following should you do?
a. Apply the pads to the chest, making sure to
avoid the jewelry.
The cycle of chest compressions and ventilations in
two-rescuer CPR for an infant is:
b. 15 chest compressions and 2 ventilations.
You are positioned above the child’s head and are using a resuscitation mask to give ventilations. After you position the mask, which of the following
should you do next?
d. Seal the mask.
You are providing care to a patron who started
choking on some food. The victim becomes
unconscious. Which of the following should you
b. Lower the victim carefully to the ground and
open his airway.
Where should you place your hands when giving
chest compressions to an infant during CPR?
c. One hand on the forehead and one hand on
When giving abdominal thrusts to an adult, where should you position your fist?
d. On the rib cage
When providing care to a conscious infant
who is choking, which of the following is
Positioning the infant so the head is lower than
A person has been injured and is conscious.
b. Obtain consent, check the victim for
life-threatening conditions and speak with
the victim to find out what happened.
The purpose of the secondary assessment is to:
b. Identify and care for conditions that are not
An injured patron is conscious and bleeding
severely. After summoning EMS personnel,
obtaining consent and putting on disposable
gloves, what is your next care step?
d. Press firmly against the wound with a sterile
dressing and bandage.
A way to remember the questions to ask when
taking a brief history is to use the acronym
SAMPLE. What does the A in SAMPLE stand for?
What is the first step you should take in caring for a victim with burns?
c. Remove the victim from the source of
If a victim is having a seizure in the water:
d. Support the victim with his or her head above
water until the seizure ends.
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?
b. A man who appears unconscious.
When caring for musculoskeletal injuries, what
does RICE stand for?
a. Rest, immobilize, cold, elevate
Signs and symptoms of sudden illness do
c. Bruising or rigidness of the abdomen.
What does the C stand for in LOC?
You notice a patron that is swimming laps who
suddenly slips under water without a struggle and does not resurface. This person is probably:
b. A passive victim who needs help.
Primary responsibilities of a lifeguard include:
c. Inspecting the pool and rescue equipment
before the facility opens and paying close
attention to patrons in the water by actively
scanning the assigned area. b. Move the victim directly onto a backboard.
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 (EAP), what are included in your next steps.
d. Extend a rescue tube to him while remaining
on deck, then provide any additional care.
Which of the following is a primary responsibility of a lifeguard?
a. Enforcing facility rules and regulations and
educating patrons about them
5. For a head, neck or spinal injury in deep water:
a. Minimize movement of the victim’s head and
neck using the head splint technique.
While scanning your zone, you notice a person
motionless in the water. The steps you follow
in a water emergency are performed in the
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.
7. While scanning the pool, you witness a patron
struggling while swimming and then go under
water. Which of the following applies?
a. You have duty to act and perform the
A lifeguard can no longer see some of the patrons at one side of the swimming area from his station because of glare from the afternoon sun. To maintain effective patron surveillance, the lifeguard should:
a. Adjust his position slightly to remove the glare
spot from his surveillance area.
A patron starts running on the deck. You blow your whistle to get her attention. Next, you enforce the rules and regulations by:
c. Telling her she could slip or fall and she must
walk on the deck.
When caring for a suspected head, neck or
spinal injury in water, proper manual in-line
b. Provided using the head splint technique.
Working with other lifeguards, facility staff and
supervisors as a team is:
b. One of the primary responsibilities of
You are a lifeguard on surveillance duty during a
busy family swim session. It is important to:
b. Scan all areas in your assigned zone of
coverage and carry your rescue tube with you
at all times.
13. A head, neck or spinal injury rarely happens:
a. In deep water at a supervised facility.
Which of the following is true about accidental
fecal releases (AFRs)?
c. Require water treatment, temporary pool
closure and immediate lifeguard attention.
You are lifeguarding during a family swim session when you notice a swimmer swimming full lengths of the pool under water. What should you do?
c. Immediately stop him from continuing the
activity and explain the dangers of the activity.
After removing a conscious victim you suspect has a spinal injury from the water, you should do all the following except:
c. Dry the victim off and apply the pads of
17. Two lifeguards are on surveillance duty during a public swim. You are on a break. One lifeguard activates the facility’s EAP for a submerged passive victim and enters the water. Which steps should you take next to assist in the rescue?
b. Bring the backboard to the lifeguard and assist
in removing the victim from the water as the
other lifeguard clears the pool.
A lifeguard keeps an eye on the patrons of the pool, checking the bottom, middle and surface of the water. He is demonstrating:
b. Effective scanning.
A mother and her son walk over to you; she states that he fell on the pool deck and hit his head. You notice he has blood and fluid running from his ear and he is feeling dizzy. What steps should you take next?
d. Provide manual stabilization while the other
lifeguards prepare to backboard him.
The lifeguard supervisor expects the pool to be
very busy in the afternoon. For effective patron
surveillance, she sets up multiple lifeguard stations to reduce the number of patrons watched by each lifeguard. This type of coverage is called:
d. Zone coverage.
To effectively scan, you must:
d. Move your head and eyes as you scan to look
directly at each area rather than staring in a
When providing care to a conscious person you
suspect of having a head, neck or spinal injury and who was injured from a fall on the pool deck:
d. You do not move the victim unless the scene
A woman collides with another swimmer while
diving into the pool and asks the lifeguard for
help. Without doing an assessment, the lifeguard tells the woman she can continue swimming. The woman leaves the facility and seeks medical attention from a hospital after she begins to feel tingling sensations in her arms and legs. The lifeguard may be:
During a weather-related power failure at a facility, you should:
a. Clear everyone from the pool.
During in-service training, lifeguards practice
the steps of recognizing a distressed swimmer,
rescuing an active victim, informing management and speaking with witnesses. The lifeguards are practicing parts of a(n):
b. Emergency action plan.
You enter the mechanical room and find a
maintenance worker lying on his back on the
floor next to a ladder. You check the scene and
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
a. Move him into the H.A.IN.E.S. position.
Which of the following is true if the manager of
the facility has assigned you as the only lifeguard conducting patron surveillance?
a. You have been assigned to total coverage.
Which of the following pieces of equipment need to be easily accessible for emergency use:
b. Backboard, AED
A technique to minimize movement for a victim
with a suspected head, neck or spinal injury who is face-down, at the surface and in water less than 3 feet deep is the:
b. Head splint technique.
If three lifeguards are on duty, emergency back-up coverage takes place:
c. When a lifeguard enters the water for a rescue.
Which of the following is the least important for a safe group visit to a pool?
c. Ensuring there are multiple activities planned
for the group
While caring for someone with a suspected spinal injury, you secure the straps on a backboard in the following order:
d. Upper chest, hips, thighs
It is the primary responsibility of facility
management to provide all but which of
d. Educating patrons about and enforcing
The hazard communication standard includes
having MSDS information available. What is
included in this information?
b. Contains information about what type of
chemicals are in use at the facility
A patron dives into the shallow end of the lap pool. You suspect she has a head, neck or spinal injury because she has:
c. Blood in the ears and nose.
what is the primary responsibility of a lifeguard
to prevent drowning and other injuries from occurring at their aquatic facility
provide three examples of how lifeguards fulfill their primary responsibility
1. monitoring activities in and out of the water
2. eliminating hazardous situations/behaviors
3. recognizing and responding to all emergencies
list five examples of secondary responsibilities that should never interfere with patron surveillance
1. completing records and reports
2. pool maintenance
3. giving swim tests
4. giving swim lessons
5. testing pool water/chlorine levels
list five characteristics of a professional lifeguard
a. keep a cell phone in their hip packs at all times, in case of an emergency
b. stay alert by eating at the lifeguard stand
c. always be attentive and sit or stand upright while on duty
d. assist patrons with swim testing when on duty
a lifeguard is texting while on duty and fails to recognize a swimmer in distress. What legal principle could be a problem for this lifeguard?
list the five steps that a lifeguard should take when obtaining consent from an injured or ill person before providing first aid or emergency care:
1. state your name
2. state your level of training
3. ask if you can help
4. explain that you’d like to help them
5. explain what you plan to do
why is it important to attend a pre-season orientation and training?
a. to ensure that lifeguards understand their responsibilities and know how to perform their job
b. to ensure that lifeguards get practice with their facility’s safety and rescue equipment and EAP
c. to ensure lifeguards understand codes, rules and regulations of the facility
d. all of the above
what does EAP stand for?
Emergency Action Plan
why is it important for lifeguards and other team members to understand and practice the EAP?
because everyone needs to know their responsibility and how to perform it effectively
what is the best practice for the frequency of in-service training participation at well-managed aquatic facilities?
at least 4 hours of in-service training each month
what does FIND stand for?
F – figure out the problem
I – identify possible solutions
N – name the pros + cons for each solution
D – decide which solution is best than act on it
what items are considered to be personal protective equipment for a lifeguard?
– protective eyewear
– resuscitation mask
what equipment should be worn or carried by a lifeguard at all times while on duty? List 2 and include reasons why.
1) rescue tube – can keep multiple victims afloat
2) hip-pack with gloves and resuscitation mask – needs to be instantly available incase of an emergency
what safety equipment/items should be easily accessible for a lifeguard? list at least 2 and describe how/when each item is used.
1) backboard – removes victim from water when they can’t do it themselves
2) AED – helps heart reestablish an affective rhythm
As a lifeguard you are responsible for:
consistently enforcing your facility’s rules and regulations
list 5 common rules often posted at an aquatic facility.
1. swim only when lifeguard is on duty
2. no swimming with open or infected wounds
3. no running, pushing, or rough play
4. obey lifeguard instruction
5. dive only in designated areas
explain what it means to be “equipped and rescue-ready”
equipped and rescue-ready means that you are wearing or carrying the appropriate rescue equipment and ready to enter water for rescue
active victim front rescue
1. approach the victim from the front
2. grab rescue tube from under your arms and push the tube in front of you
3. thrust rescue tube slightly under water and into the victim’s chest
4. keep kicking with your arms fully extended
in general there are three types of swimmer in distress or drowning victims. list each type with three observable characteristics for each.
– head above water
– floating or treading water
– trying to support self by holding or clinging to a lane line or safety line
Drowning victim – active:
– tilted head back with face looking up
– struggling to keep or get the head above the surface of the water
– no forward progress
Drowning victim – passive:
– Face up or facedown in the water or submerged
– not breathing
[Limp floating at the surface or sinking/submerged at the bottom
good to use with a crowded zone
ideal for a single-guard facility
puts you close to the patrons to easily make assists
used in waterfront facilities to patrol the outer edge of a swimming area
a lifeguard on duty should be able to recognize and reach a drowning victim within…
the size of a zone should allow for a lifeguard to recognize an emergency, reach the victim, extricate and provide ventilations within _______. Explain why.
1.5 – 2 minutes
to ensure you can get there quickly enough to save them
what is the difference between total and zone coverage
total coverage: you are the only lifeguard conducting surveillance
zone coverage: the swimming area is divided into separate zones with one zone for each lifeguard station
lifeguards should be actively _____ their zones. Why?
searching – to make sure they don’t miss anything that’s happening like someone drowning or in distress
you are guarding a lap swim with only two patrons. All of the following will help you deal with monotony EXCEPT for which?
a. stay fully engaged and do not let attention drift
b. change body position and posture periodically
c. swing whistle lanyard
d. sit upright and slightly forward
The glare of the lights on the water and the water movements are making it hard to see all areas of your zone. Circle all acceptable options.
A. Wear polarized sunglasses.
B. Adjust your body position; stand up to look around and through the glare spots.
C. Reposition the lifeguard station with the permission of your supervisor
D. Be aware of the normal appearance of the bottom of the pool; know the appearance of drains, colored tiles or painted depth markings
E. Do not change your position as a lifeguard stations are placed to be aesthetically pleasing
A, B, C, D
it is very hot in your facility and you are starting to doze on the stand. All of the following can help you stay alert except for which?
a. stay in a cooler area during breaks
b. stay hydrated while drinking plenty of water
c. rotate more frequently
d. jump in the pool while on surveillance duty to cool off
why is it important for lifeguard managers to conduct drills to test zones?
to make sure they’re appropriate for adequate patron surveillance and response time to victims in water
rapid, deep breathing, is a dangerous technique used by some swimmers to try to swim long distances underwater or to hold their breath for an extended period while submerged in one place
RID stands for:
R – recognition (a swimmer in a distress or a person who is drowning)
I – intrusion (don’t let secondary duties get in the way or your main job)
D – distraction (don’t let other people distract you from your job)
active victim rear rescue
1. approach from behind
2. reach under the victim’s armpits and grasp shoulders firmly. tell victim you are there to help and reassure them.
3. squeeze rescue tube between your chest and the victim’s back
4. lean back and pull victim onto the tube
passive victim front rescue
1. reach right arm out toward the victims right arm and grab the victims wrist while grabbing the rescue tube with your other hand
2. pull and twist the arm toward your opposite shoulder to turn victim onto their back
3. as you pull and twist, thrust the rescue tube under their back as they turn over
4. place tube below their shoulders
5. reach one arm over the victim’s shoulder and grasp the rescue tube
passive victim rear rescue
1. with both arms, reach under the victim’s armpits and grasp shoulders firmly.
3. squeeze the rescue tube between your chest and the victim’s back
4. roll the victim over by dipping your shoulder and rolling onto your back
5. reach one arm over the victim’s shoulder and grasp the rescue tube
submerged victim in shallow water
1. reach down to grab the victim under the armpits
2. roll victim face-up when they reach the surface
3. keep holding onto victim’s arms and position rescue tube under victim’s shoulders
(do same thing for victim at or near surface in shallow water)
multiple victim rescue
1. approach victim (that’s underwater) from behind
2. do active victim rear rescue
3. support both victims until other lifeguards arrive
slide in entry
Used in shallow water
When a victim is suspected to have a head, neck or spinal injury
Use the stride jump only if they water is at least 5 feet deep and you are no more than 3 feet above the water
Use to enter water from the deck or when you are more than 3 feet above the water such as on a lifeguard stand) and water must be at least 5 feet deep.
run and swim entry
To enter the water from a wave pool or shoreline
list the three major strategies a lifeguard can use to help prevent injuries at an acqatic facility
1. inform and educate patrons
2. enforce rules
3. use and read nonverbal communication
list three things that can help determine if a life jacket is appropriate for use
1. U.S. coastguard approved
2. no shrinkage of bouyant material
3. buckles and straps in good working condition
4. no rips, tears, or holes
many facilities have unique challenges that demand different kinds of surveillance. For each situation listed below, list 2 guidelines you should keep in mind when providing surveillance for patrons
1. guarding areas for young children
2. play structures
guarding young children:
1. watch for children becoming too hot or cold
2. toddlers may fall and not be able to right themselves in shallow waterplay structures:
1. do not allow patrons to swim underneath structures
2. pay close attention to moving water as it can take people by surprise
identify three strategies for ensuring safe group visits
1. classification of swimming abilities (swim test)
2. safety orientation
3. identification of group leaders/chaperones
why is it important to educate your patrons about safety in, on, and around the water
to keep them safe and make sure they know the facility policies
describe the swim test steps:
1. enter the water and completely submerge
2. return to the surface and remain there for at least 1 minute
3. rotate 360 degree and orient towards the exit
4. swim on front or back for at least 25 yards
5. exit water
why should an EAP be facility specific
– different layouts
– different EMS response times
– different emergencies require different responses
provide three examples of situation-based EAPs
1. land emergency – injury or illness
2. water emergency – drowning victim – passive
3. water emergency – drowning victim – active
place the following EAP actions in order for a situation where the victim is responsive and doesn’t require additional care:
Equipment check/corrective action
return to duty
report, advise, release
3. report, advise, release
4. equipment check/corrective action
5. return to duty
what should other lifeguards do during a rescue where the victim is unresponsive and requires addtional care
1. back-up surviellance
2. water or land rescues and provide emergency care
3. clear area
what should additional safety team members do during a rescue where the victim is unresponsive and requires addtional care
1. clear the zone
2. summon EMS personnel
3. bringing additional equipment
4. controlling the crowd
5. meeting EMS personnel
when completing a report, you should:
collect only factual information about what seen, heard, and done
who should deal with questions from the media after an incident?
the facility manager and company spokesperson
why might a supervisor chose not to re-open a facility that was closed during an emergency
– contaminated surfaces (blood)
– missing or damaged equipment (EMS takes backboard)
members of the safety team, including non-lifeguard personnel, should be:
trained and certified in first aid and CPR/AED at the same level of the lifeguard team
after an emergency has been resolved, there are still three important tasks to complete. explain them.
*Report:* the person who made the rescue must complete the form recording only factual information of what was seen, heard, or done
*Advise:* safety instructions to prevent similar incident from recurring, recommend that they go to the doctor
*Release:* victim may be released after emergency care is provided or release care to EMS personnel
describe three places emergencies could occur besides the pool and the pool deck
– locker room
– parking lot
touching soiled dressings that are contaminated with potentially infectious material is an example of:
a. indirect contact
b. direct contact
c. droplet contact
d. vector-borne contact
examples of work practice controls (methods of working that reduce likely hood of an exposure)
a. disposing of sharp items in a puncture resistant, leak-proof, labeled container
b. removal and proper disposal of soiled protective clothing as soon as possible
c. cleaning/disinfecting all equipment and work surfaces possibly soiled by blood or other potentially infectious material
d. all of the above
the OSHA recommened solution to use for disinfecting contaminated or soiled equipment and surfaces is:
a. 4 cups of bleach per gallon of water
b. 1 cup of ammonia per gallon of water
c. 1/4 cup of antibacterial soap per gallon of water
d. 1 part bleach per 9 parts of water
describe six actions you should take or determinations that you should make while performing a scene size-up
1. check for hazards that could present a danger to you or the victim
2. use appropriate PPE
3. determine number of injured or ill victims
4. determine nature of illness or what caused injury
5. form an initial impression like whether or not it’s life-threatening
6. determine what additional resources may be needed
place the following general procedures for injury or sudden illness on land in order:
perform a primary assessment
provide care for conditions found
summon EMS, if needed and not already done
size up the scene
report, advise, and release
perform a secondary assessment
1. size up the scene
2. perform a primary assessment
3. summon EMS, if needed and not already done
4. perform a secondary assessment
5. provide care for conditions found
6. report, advise, and release
when should you move a victim who is on land
– faced with immediate danger
– need to get other victims who have more serious injuries or illnesses
– it is necessary in order to provide appropriate care
When should you call first vs. care first when you are ALONE
– patron 12 years or older is unresponsive
– child or infant suddenly collapses
– unresponsive child or infant known to have heart problems
(call first mainly during cardiac situations)
– unresponsive child or infant you did not see collapse
– victim suspected of drowning
how do you tell the difference between an adult, child, and infant?
adult: 12 years or older
child: 1 – onset of puberty (breast growth or underarm hair)
infant: under the age of 1 year
during primary assessment, you find the victim is not breathing and has no pulse. would you give two ventilations before starting CPR?
normally start CPR with chest compressions unless it is a drowning situation which then you should start by giving two ventilations
if the victim is not breathing but has a pulse give ventilations. How do you give ventilations for adult, child, infant?
adult: 1 ventilation every 5-6 seconds
child and infant: 1 ventilation every 3 seconds
if the victim id not breathing and has no pulse, what should you do?
begin CPR starting with compressions (unless it was a drowning emergency)
describe the two types of respiratory emergencies:
1. respiratory distress
2. respiratory arrest
distress – breathing becomes difficult
arrest – breathing stops
list 5 possible causes of respiratory distress
1. partially obstructed airway
3. heart attack
4. allergic reactions
when caring for a person in respiratory distress:
A. Ask the victim to stand and lean back to make breathing easier.
B. Determine the exact cause of respiratory distress before providing initial care.
C. Do not allow the victim to take their prescribed medication.
D. Maintain an open airway and summon EMS personnel.
list 5 possible causes of respiratory arrest
2. obstructed airway (choking)
3. heart attack
5. emotional distress
When checking to see if someone is breathing (pick all that apply)
A. Look to see if the victims chest clearly rises and falls.
B. Check for breathing before checking for a pulse.
C. Check for breathing and a pulse simultaneously.
D. Look away from the victims chest.
E. Keep the victims mouth closed.
F. Listen and feel for air against the side of your face.
A, C, F
the normal breathing rate for an adult is between ____ and ____ breaths per minute
12 and 20
what is a lifeguard’s objective when caring for a drowning victim who is not breathing?
get their face and mouth out of the water and begin giving ventilations
what should you do if you are giving ventilations and the victim’s chest does not rise after the first breath
re-tilt head and try again. if it’s not successful move to compressions
All of the following describe appropriate care for a conscious person with an airway obstruction except:
A. Check the victim for breathing and a pulse for no more than 10 seconds
B. Perform a combination of five back blows performed by five abdominal thrusts
C. Obtain consent; if the victim is a child get consent from a parent or guardian
D. If the victim cannot cough speak or breathe activate the EAP and have someone summon EMS
if a conscious choking victim becomes unresponsive, what should you do?
– lay them down on a flat surface
– begin CPR starting with compressions
– after each set of compressions look in mouth for object before starting ventilations
describe the five links in the Cardiac chain of survival for adults
-recognize emergency and call 911
-advanced life support
-integrated post-cardiac arrest care
How much does the victim’s chance of survival decrease each minute?
What is the pediatric cardiac chain of survival?
1. injury prevention and safety
2. early CPR
3. early emergency care
4. pediatric advanced life support
5. integrated post-cardiac arrest care
what should you do if you think someone is having a heart attack
– summon EMS personnel
– have victim stop activity and rest in comfortable position
– loosen tight clothing
– closely monitor victim until EMS arrives
– comfort victim
– be prepared for CPR and use of AED
signs of cardiac arrest include:
a. sudden collapse
c. no pulse
e. rapid pulse
A, C, D
what is the objective of CPR?
to perform a combination of effective chest compressions and ventilations to circulate blood that contains oxygen to the victim’s brain and other vital organs
compressions given at the correct rate are at least ___ per minute to a maximum of ___ per minute
what is the appropriate compression depth when providing CPR on an adult
at least 2 inches but no more than 2.4 inches
when providing two rescuer CPR, when should rescuers change positions?
a. at least every 2 minutes
b. after 5 cycles of 30 compressions and 2 ventilations
c. during the analysis of the AED
d. all of the above
you arrive on the scene when another lifeguard is performing CPR, what should you do first?
ask if EMS was summoned. if not, call 911
two-rescuer CPR modifications for infants:
compression to ventilation ratio:
encircling thumbs technique
three examples why a lifeguard could or should stop CPR:
1. obvious sign of life
2. AED is ready to analyze
3. scene becomes unsafe
4. EMS takes over
True r False: it is not appropriate to use an AED on a victim who is pregnant. why?
False – fetus has best chance of survival if mother survives. Use AED same way you would normally
compression depth for child
about 2 inches
compression depth for infant
CPR cycles for one rescuer
30:2 (30 chest compressions to 2 ventilations)
CPR cycles for two rescuers
child and infant: 15:2
how long should you give ventilations for before you reassess for breathing and pulse
list the general procedures in order for situations involving a water rescue
1. activate the EAP
2. enter the water if necessary
3. perform an appropriate rescue
4. move the victim to a safe exit point
5. remove the victim from the water
6. provide emergency care as needed
7. report, advise, release
what are some factors that should be considered when deciding how to enter the water?
a. location of the victim
b. location of other swimmers
c. size of the victim
d. condition of the victim
e. water temperature
f. your location
g. facility design/set-up
h. type of equipment used
A, B, D, F, G, H
what are the two most common assists and when should each be used?
1. simple assist – used in shallow water to help a person stand or rescue a submerged victim in shallow water that is within reach
2. reaching assist – assist a distressed swimmer who is close to the side of the pool or a pier (extend tube out to them)
You are approaching a victim who is vertical in the water, near the surface in 4 feet
of water. The victim is facing you and appears to be unconscious. Which rescue should you use?
passive victim front rescue
You are approaching a child who is facing away from you and struggling to keep
their head above water.
active victim rear rescue
You are approaching a victim from behind who appears to be unconscious
passive victim rear rescue followed by extrication using backboard
a victim in the water is not breathing. what should you do?
remove victim from water as soon as possible / if doing so will delay care, provide in-water ventilations
what are four core objectives in any rescue situation
1. ensure the safety of the victim, yourself and others in the vicinity. This includes the entry, approach, rescue, removal and care provided
2. use a rescue technique that is appropriate and effective for the situation
3. provide an appropriate assessment, always treating life-threatening conditions first
4. handle the rescue with a sense of urgency
when completing a secondary assessment, lifeguards use SAMPLE to gather a brief history of the responsive victim. What does the mnemonic SAMPLE stand for?
S – signs and symptoms
A – allergies
M – medications
P – pertinent past medical history
L – last oral intake
E – events leading up to the incident
list five symptoms of sudden illnesses
1. nausea or vomiting
3. severe headache
4. changes in skin color
5. difficulty speaking or slurred speech
list the general precautions for injury or sudden illness on land
1. care for any life-threatening conditions
2. monitor their condition and watch for changes in LOC
3. keep the victim comfortable and reassure them
4. keep victim from getting chilled or overheated
5. don’t give them anything to eat or drink, unless the victim is awake, able to swallow and follow simple commands and intake is indicated based on the treatment recommendations
6. care for any other problems that develop
how should you provide care for a victim experiencing a diabetic emergency
if the person is awake and can safely swallow and follow simple commands, give them sugar (glucose tablets – 15 to 20 grams).
if not available 15 to 20 grams of sugar can be given from several sources including glucose – candies, jelly beans, orange juice, or whole milk
when should you summon EMS personnel for a victim of a diabetic emergency. Provide 2 examples
– the person is unresponsive
– the person is responsive but not fully awake and is unable to swallow
– the person does not feel better within 10 – 15 minutes after taking sugar, or they get worse
– a form of sugar cannot be found immediately
list three reasons why you should summon EMS personnel for a victim who is having, or had a seizure
– seizure occurs in the water
– seizure lasts more than 5 minutes
– cause of seizure is unknown
place the following response and care steps in order for a rescuing a patron in the water having a seizure
remove the person from the water
perform a primary assessment
support the person with their head above water until the seizure ends
summon EMS personnel
if breathing normally, position the victim on their side and monitor airway and breathing
1. summon EMS personnel
2. support the person with their head above water until the seizure ends
3. remove the person from the water
4. perform a primary assessment
5. if breathing normally, position the victim on their side and monitor airway and breathing
you are conducting a secondary assessment on an adult patron who lost their balance on the pool deck. the patron is slurring his speech while explaining that his arm is feeling numb. what sudden illness could this patron be experiencing
a. cardiac arrest
b. diabetic emergency
What does FAST stand for? when would you use it?
F = face – weakness on one side of the face
A = arm – weakness or numbness in one arm
S = speech – slurred speech or trouble speaking
T = time – summon EMS personnel if any of these signs or symptoms are seen
what are a lifeguard’s objectives while waiting for EMS personnel to arrive
1. Care for any life-threatening conditions first
2. Help the victim rest in a comfortable position and reassure them
3. Monitor the victim’s condition, and watch for any changes in LOC
4. Keep the victim from getting chilled
5. Care for other problems that develop, such as vomiting
the following are signs and symptoms of shock, EXCLUDING
a. altered level of consciousness
b. warm or dry skin
c. restlessness or irritability
d. nausea or vomiting
fill in the blank – ______________ is a life-threatening condition that occurs when the body’s systems are overwhelmed by heat and stop functioning. list three signs and symptoms of the condition described above.
1. Changes in LOC
2. Skin that is hot to the touch
3. Skin that is wet or dry or appears red or pale
4. Vision disturbances
Head, neck or spinal injuries often are caused by high-impact/high-risk activities. What are examples of those activities in an aquatic environment?
– entering head-first into shallow water
– falling from greater than standing height
– entering the water from a height, such as a diving board, water slide, embankment, cliff, or tower
– receiving a blow to the head
– colliding with another swimmer
General rescue procedures for caring for a head, neck, or spinal injury in the water in order:
check for responsiveness and breathing
activate the EAP
perform a rescue providing manual in-line stabilization
re-assess the victim’s condition and provide appropriate care
safely enter the water
remove the victim from the water using appropriate spinal back boarding procedure
1. activate the EAP
2. safely enter the water
3. perform a rescue providing manual in-line stabilization
4. check for responsiveness and breathing
5. remove the victim from the water using appropriate spinal back boarding procedure
6. re-assess the victim’s condition and provide appropriate care
the ____________ technique is used for performing manual in-line stabilization for victims in the water
backboards are a standard piece of rescue equipment used at aquatic facilities for immobilizing and removing the victim from the water. Backboards work best when they are equipped with:
– a chest strap to secure the victim onto the board
– a head immobilizer device that can be attached to the top, or head-end , of the board
you enter the water to rescue a victim with a suspected spinal injury. You determine that the victim is not breathing. What should you do next?
a. remove the victim from the water using the passive victim extrication technique
b. remove the victim from the water using the spinal back boarding procedure
c. remove the victim from the water using a modified spinal back boarding procedure
d. delay removal from the water and provide 2 minutes of in-water ventilations
the following statements describe appropriate rescue techniques for a victim with a suspected spinal injury, EXCEPT:
a. if the victim is in shallow water, you do not need to use a rescue tube to support yourself
b. if the victim is in shallow water, you should not use the rescue tube when submerging and bringing the victim to the surface
c. if the victim is small and is in shallow water, you do not need to use a backboard to extricate the victim
d. if the victim is at the surface in deep water, you may need a rescue tube to support yourself and the victim
when rescuing a victim of a suspected head, neck or spinal injury using the spinal back boarding procedure , communication with the victim is important. what should lifeguards tell the victim?
– let the victim know what you are doing and reassure them
– tell the victim not to nod or shake their head but instead answer with “Yes” or “No”
describe four ways that additional lifeguards can help during spinal back boarding and extrication from the water
– helping to submerge, position and stabilize the backboard from the deck
– supporting the in-water rescuer in deep water
– communicating and reassuring the victim
– removing the backboard from the water
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