Lifeguard Responsibilities and Procedures, Exams of Medicine

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American Red Cross Lifeguarding Exam with 100% correct Answers What is the primary responsibility of a lifeguard? - Correct answer To prevent drowning and other injuries from occurring at their aquatic facility Examples of fulfilling primary responsibilities - Correct answer - Monitoring activities in and near the water through patron surveillance - Preventing injuries by minimizing or eliminating hazardous 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, including using an ARD and, of trained, administering emergency oxygen when needed - Working as a team with other lifeguards, facility staff, and management Examples of secondary responsibilities that should never interfere with patron surveillance - Correct answer - Testing the pool water chemistry - Assist patrons by performing safety orientations, administering swim tests, fitting life jackets, and other duties - Cleaning or performing maintenance - Completing records and reports - Performing opening duties, closing duties, or facility safety checks and inspections Characteristics of a professional lifeguard - Correct answer - Knowledgeable and skilled - Reliable - Mature - Courteous and consistent - Positive - Professional - Healthy and fit (exercise, eat/hydrate properly, rest adequately, protect yourself from sun exposure) Legal considerations - Correct answer 1. Duty to Act 2. Standard of Care 3. Negligence 4. Abandonment 5. Confidentiality 6. Documentation 7. Consent 8. Refusal of care How to obtain consent - Correct answer 1. Name 2. Level of training 3. Ask if you may help 4. Explain that you would like to assess them to find out what you think may be wrong or what you can do to help 5. Explain what you plan to do Why is it important to attend a pre-season orientation and training? - Correct answer To ensure that lifeguards understand their responsibilities and know how to perform their job, to get practice with their facility's safety and rescue equipment and EAP, to ensure lifeguards understand codes, rules, and regulations of the facility 1. EAP 2. Why is it important for lifeguards and other team members to understand and practice the EAP? - Correct answer 1. Emergency Action Plan 2. You will learn how staff members work together in a variety of circumstances, gives teammates a chance to work on different responder roles together, so everyone knows their responsibilities and can perform them effectively In-service training - Correct answer Takes place while you are employed as a lifeguard and is designed to help you maintain your knowledge and skills at a professional level. It also gives you a chance to practice with other lifeguards at your facility and help you efficiently respond as a team in an emergency What is the best practice for the frequency of in-service training participation at well-managed aquatic facilities? - Correct answer At least 4 hours of in-service training each month Common rules at aquatic facilities - Correct answer - Swim only when a lifeguard is on duty - Swim diapers are required for small children or people with incontinence - No swimming with open or infected wounds - Obey lifeguard instructions at all times - No running, pushing, or rough play - No hyperventilating before swimming underwater or breath-holding contests - No sitting or playing near or with drains or suction fittings - Dive only in designated areas - No glass containers in the pool area and locker rooms - No alcoholic beverages or drug use Rules for facility equipment and structures - Correct answer - One person at a time on a ladder - Do not sir 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 As a lifeguard, you are responsible for- - Correct answer Consistently enforcing your facility's rules and regulations Laryngospasm - Correct answer A sudden closure of the larynx of windpipe. Air cannot reach the lungs, victim is unable to breathe but may swallow large quantities of water into the stomach How long does it take cardiac arrest to occur? Brain damage/death? (After drowning) - Correct answer Cardiac arrest: 3 minutes Brain damage/death: 4-6 minutes A weak swimmer or nonswimmer characteristics - Correct answer - Bobbing in or near water over their head - Crawling hand-over-hand along a pool wall - Beyond arm's reach of a supervising adult, even if wearing a flotation aid - Clinging to something or struggling to grab something to stay afloat - Wearing a life jacket improperly Swimmer who may become a victim characteristics - Correct answer - 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 Drowning Victim-Active - Correct answer - May not be able to call out for help because their efforts are focused on getting a breath - Works to keep their face above water in an effort to breathe - May be in a horizontal face-down position during the struggle because they are unable to life their face out of the water - Has extended their arms to the side or front, pressing down for support - Is positioned vertically in the water with an ineffective kick, young child may tip into a horizontal face-down position - Might continue to struggle underwater once submerged - Eventually will lose consciousness and stop moving Drowning Victim-Passive - Correct answer - Does not struggle - Suddenly slips underwater due to a medical condition or another cause - Might float face-down at or near the surface of might sink to the bottom - May be limp or have slight convulsive-like movements - May have no defined arm or leg actions, no locomotion, and no breathing - May appear to be floating, if at the surface of the water - May be face-downC on one side or face-up, if at the bottom Swimmers in Ditress - Correct answer - Makes little or no forward progress and may be unable to reach safety without assistance - Able to keep their face out of the water - Able to call for help - Able to wave for help - Horizontal, vertical, or diagonal, depending on what they use to support themselves - Floating, sculling, or treading water - Generally able to reach for a rescue device A lifeguard on duty should be able to recognize and reach a drowning victim within - Correct answer 30 seconds RID - Correct answer - RID factor is set of causes due to an active victim drowning while a lifeguard is on duty - Recognition, Intrusion (performing other duties while conducting patron surveillance), Distraction 3 types of coverage - Correct answer - Zone coverage - Total coverage - Emergency back-up coverage Roving Stations - Correct answer Good to use with a crowded zone Elevated Stations - Correct answer Ideal for a single guard facility Ground-Level Stations - Correct answer Puts you close to the patrons to easily make assists Floating stations - Correct answer Used in waterfront facilities to patrol the outer edge of a swimming area The size of a zone should allow for a lifeguard to recognize an emergency, reach the victims extricate and provide ventilations within _______. - Correct answer 1 1/2 mins to 2 mins Lifeguards should be actively ________ their zones - Correct answer Searching Rotations: Incoming lifeguard Outgoing lifeguard - Correct answer 1. Search the zone and be aware of the activity level in the zone you will be guarding. Search your zone as you are walking toward your station, checking all areas of the water from bottom to surface 2. Should inform you of any situations that need special attention. Confirm and signal that the zone is clear and transfer responsibility for the zone. Should continue scanning as they are walking toward the next station ___________, which can be described as 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. If you see these dangerous activities, you must intervene. - Correct answer Hyperventilating 4. Correct any improper wearing or use 5. Remove any extra empty life jackets from the water. An empty life jacket in the water should be a signal that something is wrong Examples of situation based EAPs - Correct answer - Water emergency: Drowning victim- active or passive - Water emergency: spinal injury victim or missing person - Land emergency: injury or illness Other situations requiring an EAP - Correct answer - Evacuations - Sheltering in place - Severe weather - Chemical spills or leaks - Power failures - Violence - Thefts in progress Why should every aquatic facility have its own specific set of EAPs? - Correct answer The unique characteristics at each facility. The facility's layout, number of staff on duty at a time, location of backup lifeguards and other safety team members, equipment used, and typical responses times of the local emergency medical services system. EAP actions in order for a situation where the victim is responsive and does not require additional care - Correct answer 1. Signal 2. Rescue 3. Report, advise, release 4. Equipment check/corrective action 5. Return to duty Actions of other lifeguards during a rescue where the victim is unresponsive and requires additional emergency care - Correct answer - Back up surveillance coverage 1, The water or land rescue and providing emergency care 2. back-up zone coverage or clearing the area Actions of additional safety team members during a rescue where the victim is unresponsive and requires additional emergency care - Correct answer - Clearing the zone of area if no additional certified lifeguards available for patron surveillance 1. Summoning EMS personnel 2. Bringing additional equipment 3. Clearing the area of facility 4. Controlling the crowd 5. Meeting EMS personnel When completing a report, you should - Correct answer Collect all factual info about what was seen, heard, and the actions taken Who should deal with questions from the media after an incident? Why? - Correct answer - The facility manager or the company spokesperson - Your doing so may lead to legal action Why might a supervisor choose NOT to re-open a facility that was closed during an emergency? - Correct answer The decision may depend on safety issues, such as whether enough lifeguards are ready to return to surveillance duty, all of the required equipment is in place or spills involving blood or other potentially infectious materials have been cleaned up. Members of the safety team, including non-lifeguard personnel should be: - Correct answer Trained and certified in first aid and CPR/AED at the same level of the lifeguard team Explain: 1. Report 2. Advise 3. Release - Correct answer 1. Complete the appropriate incident report as soon as possible after providing care. Collect the required information about the victim (name, address, contact info) 2. Give the victim safety instructions to prevent a similar incident from recurring or recommend that the person follow up with a health care provider 3. A victim may be released only when the rescue and emergency care provided by you and your safety team is complete. Release the victim to their own care, a parent, guardian, etc, or EMS personnel You must be prepared to respond to emergencies that are outside of the immediate aquatic environment and not part of your zone of responsibility. Examples: - Correct answer - Locker rooms - Concession areas - Entrance and lobby areas - Mechanical rooms - Playgrounds and play areas - Parking lots List the general procedures, in order, for situations involving a water rescue - Correct answer 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? - Correct answer 1. The depth of the water 2. The height and position of the lifeguard station 3. Obstacles in the water 4. The location and condition of the victim 5. The type of rescue equipment 6. The design of the facility Slide in Entry - Correct answer The slide-in entry is slower than other entries, but it is the safest in most conditions. This technique is useful in shallow water, crowded pools, of when a victim with a head, neck, or spinal injury is close to the side of the pool or pier Stride jump - Correct answer Use the stride jump only if the water is at least 5 feet deep and you are no more than 3 feet above the water Compact jump - Correct answer You can use the compact jump to enter water from the deck or from a height, depending on the depth of the water. If jumping from a height (when you are more than 3 feet above the water, such as on a lifeguard stand or pier), the water must be at least 5 feet deep Run-and-swim Entry - Correct answer To enter the water from a gradual slope—zero-depth area, such as a shoreline or wave pool—use the run and swim entry 5. Form an initial impression that may indicate a life-threatening emergency, including unresponsiveness or severe bleeding 6. Determine what additional resources may be needed When should you move an injured victim on land? - Correct answer 1. You are faced with immediate danger 2. You need to get to other victims who have more serious injuries or illnesses 3. It is necessary to provide appropriate care If you are alone when responding to someone who is ill, you must decide whether to Call First or Care First. When should you call first? When should you Care First? - Correct answer Call First: - Any adult or child about 12 years of age of older who is unresponsive - A child or an infant whom you witnessed suddenly collapse - An unresponsive child or infant known to have heart problems Care First: - An unresponsive child whom you did not see collapse - Any victim suspected of drowning How do you tell the difference between an adult, a child, and an infant? - Correct answer Adult: Age of 12 or older Child: Between ages 1 and 12 Infant: Someone younger than 1 year of age During the primary assessment, you find the victim is not breathing and has no pulse. When would you give 2 ventilations before starting CPR? - Correct answer 1. Not breathing and no pulse: begin CPR with chest compressions 2. Unresponsive and not breathing and no pulse as a result of drowning: 2 ventilations before starting compressions AVPU (to help determine level of consciousness) - Correct answer Alert: fully awake, but may still be confused Verbal: responds to verbal stimuli Painful: responds to painful stimuli Unresponsive: does not respond Ventilations for an adult and child/infant - Correct answer Adult: 1 ventilation about every 5-6 seconds Child/infant: 1 ventilation every 3 seconds Respiratory distress - Correct answer A victim who is having difficulty breathing Respiratory arrest - Correct answer A victim who has stopped breathing but has a pulse Possible causes of respiratory distress - Correct answer 1. A partially obstructed airway 2. Illness 3. Chronic conditions, such as asthma, emphysema, and congestive heart failure 4. Electrocution, including lightning strikes 5. Heart attack 6. Injury to the head, chest, lungs, or abdomen 7. Allergic reactions 8. Drug overdose 9. Poisoning 10. Emotional distress 11. Anaphylactic shock When caring for a person in respiratory distress - Correct answer Maintain an open airway and summon EMS personnel Possible causes of respiratory arrest - Correct answer 1. Drowning 2. Obstructed airway (choking) 3. Injury to the head, chest, lungs, or abdomen 4. Illness, such as pneumonia 5. Respiratory conditions, such as emphysema or asthma 6. Congestive heart failure 7. Heart attack 8. Coronary heart disease (such as angina) 9. Allergic reactions (food or insect stings) 10. Electrocution, including lightning strikes 11. Shock 12. Poisoning 13. Drug overdose 14. Emotional distress When checking to see if someone is breathing: - Correct answer - Look to see if the victim's chest clearly rises and falls - Check for breathing and a pulse simultaneously - Listen and feel for air against the side of your face The normal breathing rate for an adult is between __ and __ breaths per minute - Correct answer 12 and 20 What is the lifeguards objective when caring for a drowning victim who is not breathing? - Correct answer Get the victim's mouth and nose out of the water, open the airway, and give ventilations as quickly as possible When giving ventilations to an adult who is not breathing but has a definite pulse, you should give ventilations - Correct answer 1 every 5-6 seconds When giving ventilations to a child who is not breathing but has a definite pulse, you should give ventilations: - Correct answer 1 every 3 seconds What should you do if you are giving ventilations and the victim's chest does not rise after the first breath? - Correct answer Reopen the airway, make a seal and try a second breath. If the breath is not successful, move to compressions and check the airway for an obstruction before attempting subsequent ventilations. If an obstruction is found, remove it and attempt ventilations. However, never perform a blind finger sweep Continue giving ventilations until: - Correct answer 1. The victim begins to breathe on their own 2. Another trained rescuer takes over 3. More advanced medical personnel take over 4. The victim has no pulse, in which case you should begin CPR and use an AED if one is available and ready to use 5. The scene becomes unsafe If a conscious choking victim becomes unresponsive, what should you do? - Correct answer 1. Carefully lower the victim to a firm, flat surface 2. Send someone to get an ARD and summon EMS if you have not already done so SAMPLE - Correct answer Signs and symptoms Allergies Medications Pertinent past medical history Last oral intake Events leading up to the incident Symptoms of sudden illness - Correct answer 1. Changes in LOC 2. Nausea or vomiting 3. Difficulty speaking or slurred speech 4. Numbness or weakness 5. Loss of vision or blurred vision 6. Changes in breathing; the person may have trouble breathing or may not be breathing normally 7. Changes in skin color 8. Sweating 9. Persistent pressure or pain 10. Diarrhea 11. Paralysis of an inability to move 12. Severe headache General precautions for injury or sudden illness on land - Correct answer 1. Care for any life-threatening conditions first 2. Monitor the victim's condition and watch for changes in LOC 3. Keep the victim comfortable and reassure them 4. Keep the victim from getting chilled or overheated 5. Do not give the victim 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, such as vomiting How should you provide care for a victim experiencing a diabetic emergency? - Correct answer Give sugar if the person is awake and can safely swallow and follow simple commands Summon EMS if the person is - Correct answer 1. unresponsive 2. responsive but not fully awake and unable to swallow 3. person does not feel better within about 10-15 minutes of taking sugar or gets worse 4. or a form of sugar cannot be found immediately Why you should summon EMS personnel for a victim who is having, or had a seizure - Correct answer 1. The seizure occurs in the water 2. This is the person's first seizure 3. The seizure lasts more than 5 minutes 4. The person has repeated seizures with no lucid period 5. The person appears to be injured 6. The cause of the seizure is unknown 7. The person is pregnant 8. The person is known to have diabetes 9. The person fails to regain consciousness after the seizure 10. The person is elderly and may have suffered a stroke You are lifeguarding at a crowded facility and recognize a patron in the water who appears to be having a seizure. What is your response? - Correct answer 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 What does FAST stand for? When would you use it? - Correct answer Face Arm Speech Time - To identify and care for a victim of a stroke What are a lifeguard's objectives while waiting for EMS personnel to arrive? - Correct answer 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 - Correct answer 1. Restlessness or irritability 2. Altered LOC 3. Pale, ashen, cool or moist skin 4. Nausea or vomiting 5. Rapid breathing and pulse 6. Excessive thirst ____ _____ is a life-threatening condition that occurs when the body's systems are overwhelmed by heat and stop functioning - Correct answer Heat stroke Heat stroke signs and symptoms - Correct answer 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 5. Seizures 6. Vomiting 7. Rapid and shallow breathing 8. Rapid and weak pulse 9. Lack of sweating Head, neck or spinal injuries often are caused by high-impact/high-risk activities. What are examples of those activities in an aquatic environment? - Correct answer 1. Entering head-first into shallow water 2. Falling from greater than a standing height 3. Entering the water from a height, such as a diving board, water slide, embankment, cliff, or tower 4. Receiving a blow to the head 5. Striking a submerged or floating object 6. Colliding with another swimmer 7. Striking the water with high impact, such as falling white water skiing or surfing General rescue procedures for caring for a head, neck, or spinal injury in the water in order - Correct answer 1. Activate the EAP 2. Safely enter the water 3. Perform the rescue providing manual in-line stabilization 4. Check for responsiveness and breathing 5. Remove the victim from the water using the appropriate spinal backboarding procedure 6. Re-assess the victim's condition and provide appropriate care