## Duty of Care

• As a lifeguard, you have a legal obligation to avoid causing harm to others. This is known as your Duty of Care.
• It arises when a lifeguard-patron relationship is established, meaning you are responsible for the safety of pool users.
• The standard of care expected is that of a reasonably competent lifeguard acting in similar circumstances, using the skills and knowledge from your NPLQ training.

## Negligence

• Negligence is a failure to meet the required standard of care, resulting in harm to another person.
• To prove negligence, four elements must be present:
• A Duty of Care was owed.
• There was a Breach of Duty (you failed to act as a reasonably competent lifeguard).
• Causation: The breach directly caused the harm.
• Damage/Harm: The person suffered injury or loss.
• Consequences can range from civil claims for compensation to, in severe cases, criminal charges.

## Health and Safety Legislation

• The Health and Safety at Work Act 1974 (HSWA) places duties on employers to ensure, so far as is reasonably practicable, the health, safety, and welfare of their employees and others affected by their work. Employees also have duties to take reasonable care for their own safety and that of others.
• The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR) requires employers to report specific serious work-related incidents, including deaths, major injuries, and certain dangerous occurrences, to the Health and Safety Executive (HSE).

## Consent and Confidentiality

• Consent is permission for treatment or intervention. It must be informed, voluntary, and given by someone with the capacity to do so. For minor first aid, consent is often implied, but for more invasive procedures, express consent is needed. Always explain what you are doing.
• Confidentiality means keeping personal information private. You should only share information on a strict 'need to know' basis, respecting data protection laws such as the General Data Protection Regulation (GDPR).

## Record Keeping

• Accurate and timely record keeping is crucial for legal defence, incident analysis, and continuous improvement of safety procedures.
• This includes incident reports, accident forms, training records, and daily operating procedures. Records must be factual, objective, and completed promptly after an incident.

## Swimming Pool Supervision: Key Principles

Effective swimming pool supervision is the cornerstone of bather safety, aiming to prevent accidents, detect emergencies early, and intervene promptly. Lifeguards are the primary safety personnel, responsible for maintaining constant vigilance over their designated area.

## Supervision Techniques

The 10/20 Rule is fundamental: a lifeguard should be able to reach any part of their zone within 10 seconds of identifying an incident, and then be able to assess the situation and initiate a rescue within 20 seconds. This requires optimal positioning and constant, systematic scanning.

• Systematic Scanning: Involves a methodical visual sweep of the entire zone, paying attention to the bottom, middle, and surface of the water, as well as the poolside. Avoid fixed gazes or 'head counting' and actively look for changes in behaviour or distress.
• Supervision Positions: Lifeguards rotate between elevated positions (offering a wide view and reducing glare), poolside positions (closer to bathers, good for communication), and roving positions (allowing closer inspection of specific areas or activities). Regular rotation helps maintain vigilance, combat fatigue, and vary perspective.
• Zone Supervision: Pools are divided into specific supervision zones, each assigned to a lifeguard. Zones may overlap to ensure comprehensive coverage and allow for effective communication and teamwork, especially during busy periods or complex activities.

## Factors Affecting Supervision

Many factors can impact a lifeguard's ability to supervise effectively:

• Bather Load: High numbers increase complexity.
• Water Clarity: Poor visibility hinders detection.
• Glare and Lighting: Can create blind spots or obscure views.
• Pool Design: Features like flumes, diving boards, or pillars can obstruct lines of sight.
• Distractions: Both internal (fatigue, personal thoughts) and external (noise, other staff, public interaction) must be managed.
• Type of Activity: Different activities (e.g., lessons, public swimming, inflatables) require varied focus.

## Lifeguard Responsibilities and Professional Conduct

Lifeguards must always be attentive and vigilant. This includes:

• Knowing and following the facility's Normal Operating Procedures (NOP) and Emergency Action Plan (EAP).
• Maintaining physical fitness and rescue skills.
• Wearing the correct uniform and being clearly identifiable.
• Using standard whistle signals to communicate effectively with bathers and other staff (e.g., one short blast for attention, two short for attention of another lifeguard, three short for danger/clear the pool, one long for emergency/clear the pool).
• Avoiding all forms of distraction, including mobile phones or engaging in prolonged conversations. Professionalism ensures public trust and effective safety management.

## Intervention and Rescue

Effective intervention and rescue are core to a lifeguard's role, requiring quick recognition, appropriate action, and safe casualty management. Understanding the Emergency Action Plan (EAP) and mastering rescue techniques are paramount.

## Recognising an Emergency

Lifeguards must be vigilant for signs of distress. A weak swimmer may show signs of fatigue, struggling to stay afloat. A non-swimmer will typically be vertical in the water, unable to make progress, often with a panicked expression. An unconscious casualty will be motionless, either floating face down or submerged.

Active drowning involves a person struggling at the surface, often unable to call for help, with arms thrashing or pushing down on the water. Passive drowning occurs when a person slips silently beneath the surface, often due to a medical condition or sudden incapacitation.

## Emergency Action Plan (EAP) and Whistle Signals

Every pool has a specific Emergency Action Plan (EAP), detailing procedures for various incidents. Lifeguards must know their site's EAP thoroughly. Whistle signals are crucial for communication:

• One short blast: Attract attention of a pool user.
• Two short blasts: Attract attention of another lifeguard.
• Three short blasts: Lifeguard taking action/entering the water.
• One long blast: Clear the pool.
• Multiple short blasts: Major emergency.

## Entry Methods and Rescue Aids

Choosing the correct entry method is vital:

• Stride entry: For shallow water (up to 1.5m), keeping casualty in sight.
• Step-in entry: For very shallow water, or when unsure of depth.
• Shallow dive: For deep water, when speed is essential and no obstructions.
• Compact jump: For deep water, when unsure of depth or from a height.
• Slide-in entry: For suspected spinal injuries or when maintaining eye contact is paramount.

Rescue aids extend reach and provide support:

• Shepherd's crook: Reaching aid for conscious casualties near the edge.
• Rescue buoy/throw bag: Throwing aid for conscious casualties further from the edge.
• Torso support: Wading aid for shallow water.

## In-Water Rescues and Tows

Contact rescues are used when the casualty is conscious and cooperative. Non-contact rescues (using an aid) are preferred for conscious casualties to maintain a safe distance. For conscious casualties, common tows include:

• Head tow: Good for cooperative casualties, keeps their face clear.
• Armpit tow: Provides good support, useful for larger casualties.
• Cross chest tow: Secure, good for uncooperative or struggling casualties.

For unconscious casualties, priority is to open the airway and provide rescue breaths (EAR) in the water. Tows like the head tow or armpit tow can be used once the airway is open and breaths are being given.

## Spinal Injury Management

If a spinal injury is suspected (e.g., fall, dive, collision), immediate in-water stabilisation is crucial. Use a vice grip or head splint to maintain inline stabilisation of the head and neck. The casualty should be extracted using a spinal board with trained assistance.

## Post-Rescue Care

After extraction, assess the casualty and provide appropriate first aid. Ensure the EAP is followed, including contacting emergency services if necessary, and completing an incident report.

## Emergency Action Plan (EAP)

The Emergency Action Plan (EAP) is a vital written document detailing the specific procedures to be followed in the event of an emergency within a swimming pool environment. Its primary purpose is to ensure a swift, effective, and coordinated response, minimising risk to life and property. As a lifeguard, you must have a comprehensive understanding of your facility's EAP and be proficient in your role for each scenario.

Key Components of an EAP

A robust EAP covers a range of potential emergencies. While specific details vary between facilities, common sections include:

• Pool Rescue: Procedures for rescuing casualties, including conscious and unconscious individuals, and those with suspected spinal injuries. This often involves specific signals, rescue techniques, and post-rescue care.
• Spinal Injury: Detailed steps for immobilisation, safe removal from the water, and summoning advanced medical help.
• Missing Person: Protocols for searching the facility, securing exits, and contacting management and, if necessary, the police.
• Bomb Threat: Clear instructions for evacuation, communication with authorities, and potential search procedures.
• Fire: Procedures for activating alarms, evacuating the building to designated assembly points, and conducting a roll call.
• Chemical Incident: Steps for containing spills, ensuring public safety through evacuation, and contacting specialist services.
• Power Failure: Guidance on maintaining safety, emergency lighting, communication, and potential evacuation.
• Serious Injury/Illness: Protocols for administering first aid and summoning appropriate medical assistance.

Lifeguard Responsibilities

Your responsibilities include:

• Knowing the EAP: You must be familiar with every section and your specific duties within each emergency.
• Activating the EAP: Be prepared to initiate the plan immediately upon identifying an emergency, often using whistles, alarms, or direct communication.
• Communication: Effectively communicate with colleagues, management, and emergency services as per the EAP.
• Practice: Participate in regular EAP training, drills, and simulations to maintain proficiency and identify areas for improvement.

The EAP is a living document, regularly reviewed and updated, and its effectiveness relies on the consistent training and preparedness of all staff.

## Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillator (AED)

CPR and AED are vital life-saving skills for any lifeguard. They are used when a casualty is unresponsive and not breathing normally. Rapid intervention significantly increases the chance of survival from cardiac arrest.

## When to Start CPR

Always follow the DRSABCD action plan:

• Danger: Ensure safety for yourself, the casualty, and others.
• Response: Check for a response (shout, gentle shake).
• Shout for help: Alert others, call 999/112.
• Airway: Open the airway using head tilt/chin lift.
• Breathing: Check for normal breathing for no more than 10 seconds. If not breathing normally (e.g., agonal gasps), start CPR.
• CPR: Commence chest compressions and rescue breaths.
• Defibrillation: Use an AED as soon as available.

## CPR Technique (Adult)

• Hand Placement: Place the heel of one hand in the centre of the casualty's chest, on the lower half of the sternum. Place the heel of your other hand on top, interlocking fingers.
• Compressions: Keep arms straight, elbows locked, and use your body weight to press down.
• Depth: At least 5cm but no more than 6cm.
• Rate: 100-120 compressions per minute.
• Ratio: Perform 30 chest compressions followed by 2 rescue breaths.
• Minimise Interruptions: Continue CPR until paramedics arrive, the casualty starts breathing normally, or you become exhausted.

## Rescue Breaths

After 30 compressions:

1. Re-open the airway using head tilt/chin lift.

2. Pinch the casualty's nose.

3. Take a normal breath and seal your lips around their mouth.

4. Blow steadily for about 1 second, watching for the chest to rise.

5. Allow the chest to fall, then give a second breath.

6. Return immediately to chest compressions.

## Automated External Defibrillator (AED)

An AED delivers an electrical shock to correct an abnormal heart rhythm.

1. Switch on the AED and follow its voice prompts.

2. Attach pads: Place one pad on the upper right side of the chest, and the other on the lower left side below the armpit. Ensure good skin contact.

3. Analyse: The AED will analyse the heart rhythm. Ensure no one touches the casualty during this time.

4. Shock: If a shock is advised, ensure everyone is CLEAR before pressing the shock button (if semi-automatic) or allowing the AED to deliver it automatically.

5. Continue CPR: Immediately resume CPR for 2 minutes after a shock (or if no shock is advised).

6. Children: Use attenuated (child) pads for children aged 1-8 years or under 25kg. If not available, use adult pads, ensuring they don't touch.

## Key Safety Points

• Always ensure the casualty's chest is as dry as possible before applying AED pads.
• Remove excessive chest hair if it impedes pad adhesion.
• Do not touch the casualty during AED analysis or shock delivery.

## The Lifeguard's Role in First Aid

As a lifeguard, your primary role in first aid is to provide immediate, effective care to casualties until professional medical help arrives. This involves assessing the situation, performing life-saving interventions, and managing the scene. Always prioritise your own safety, ensuring the environment is safe before approaching.

## Primary Survey: DRSABCD

The Primary Survey is a systematic approach to assess and manage a casualty, focusing on life-threatening conditions. It guides your initial actions:

• Danger: Check for any dangers to yourself, the casualty, or bystanders. Make the area safe.
• Response: Check for a response (e.g., AVPU scale - Alert, Voice, Pain, Unresponsive). Gently shake shoulders and ask "Are you alright?".
• Send for help: If unresponsive or seriously injured, call 999/112 immediately and activate your EAP (Emergency Action Plan).
• Airway: Open the airway using a head tilt, chin lift (or jaw thrust for suspected spinal injury). Check for foreign objects.
• Breathing: Look, listen, and feel for normal breathing for no more than 10 seconds. Agonal gasps are not normal breathing.
• CPR: If not breathing normally, start Cardiopulmonary Resuscitation immediately.
• Defibrillation: Attach and use an Automated External Defibrillator (AED) as soon as available.

## CPR and AED Use

Cardiopulmonary Resuscitation (CPR) is vital for casualties who are unresponsive and not breathing normally.

• Adult CPR: 30 chest compressions to 2 rescue breaths (30:2). Compressions should be 5-6 cm deep at a rate of 100-120 per minute, allowing full chest recoil.
• Child/Infant CPR: Start with 5 initial rescue breaths, then 30 compressions to 2 rescue breaths (30:2). Compressions are about 1/3 depth of the chest.
• AED: An AED delivers an electrical shock to restart the heart. Follow its clear voice prompts. Continue CPR until the AED is ready, after a shock, or until professional help takes over. Do not interrupt CPR for longer than 10 seconds.

## Choking

Choking occurs when an object blocks the airway.

• Mild Choking: Encourage the casualty to cough forcefully.
• Severe Choking (Conscious): Deliver 5 sharp back blows between the shoulder blades. If unsuccessful, deliver 5 abdominal thrusts (Heimlich manoeuvre). Alternate 5 back blows and 5 abdominal thrusts until the obstruction clears or the casualty becomes unconscious.
• Severe Choking (Unconscious): Start CPR immediately, checking the mouth for obstruction before each rescue breath.

## Bleeding and Shock

• Severe Bleeding: Apply direct pressure to the wound, elevate the injured limb (if no fracture), and apply a sterile dressing. If bleeding soaks through, add more dressings. Monitor for signs of shock.
• Shock: A life-threatening condition where the body's organs don't get enough blood flow. Signs include pale, cold, clammy skin, rapid weak pulse, rapid shallow breathing, and confusion/anxiety. Manage by lying the casualty down, raising legs (if no injury prevents it), maintaining body temperature, and reassuring them.

## Other Common Emergencies

• Seizures: Protect the casualty from injury, especially their head. Do not restrain them or put anything in their mouth. Time the seizure. Once it stops, place them in the recovery position if unconscious.
• Spinal Injury: Suspect a spinal injury if there's a fall from height, diving incident, or direct trauma to the back/neck. Minimise movement of the head and neck. Maintain an open airway using a jaw thrust if necessary.
• Burns: Cool the burn immediately with cool running water for at least 10-20 minutes. Cover with a loose, non-stick dressing.

## Recognising a Suspected Spinal Injury

Recognising a suspected spinal injury is crucial. Always consider the mechanism of injury – did the incident involve a fall from height, a dive into shallow water, a collision, or a direct blow to the head, neck, or back? Key signs and symptoms include:

• Pain: In the neck or back, often severe.
• Numbness, tingling, or weakness: In the limbs.
• Paralysis: Inability to move limbs.
• Altered consciousness: Dizziness, confusion, or loss of consciousness.
• Deformity: Visible bruising or swelling along the spine.
• Headache: Especially if severe or sudden.
• Difficulty breathing: If the injury is high on the spine.

Always suspect a spinal injury if the mechanism suggests it, even if the casualty doesn't immediately report pain. Err on the side of caution.

## Initial Actions and Stabilisation

Your immediate priorities are to immobilise the casualty, alert other lifeguards, and call Emergency Medical Services (EMS). The primary technique for in-water stabilisation is Manual In-Line Stabilisation (MILS).

• MILS: This involves manually holding the casualty's head, keeping it in line with their spine, to prevent any further movement. For a conscious casualty, you can often instruct them to hold their own head while you support them. For an unconscious casualty, MILS must be established immediately by the lifeguard.
• Alerting: Use your whistle or call for assistance from other lifeguards to prepare for a team rescue.
• EMS: Instruct a colleague to call 999/112, providing a clear and concise report of the situation.

## In-Water Rescue and Spinal Board Application

Maintaining MILS is paramount throughout the entire rescue process. The goal is to move the casualty from the water onto a long spinal board (LSB) with minimal movement.

• Team Approach: A minimum of three lifeguards is required for a safe spinal board rescue: one maintaining MILS, and two others positioning the board and securing the casualty.
• Positioning the Board: The LSB is carefully slid under the casualty while MILS is maintained. The casualty is then gently floated onto the board.
• Securing the Casualty: Once on the board, the casualty is secured using straps across the chest, hips, and legs. Head immobilisers (blocks) are then applied to prevent head movement, and a head strap is used to further secure the head to the board.
• Extraction: The casualty is then carefully extracted from the water, usually by lifting the board, ensuring the head and spine remain stable.

## Out-of-Water Management

Once out of the water:

• Maintain MILS: Continue MILS until EMS personnel take over, even if the casualty is fully secured to the board.
• Monitor ABCDE: Continuously assess the casualty's Airway, Breathing, Circulation, Disability (level of consciousness), and Exposure (treat for shock/hypothermia).
• Reassurance: Keep the casualty calm and informed.
• Handover: Provide a clear and detailed handover to EMS, including mechanism of injury, signs/symptoms, and actions taken.

## Pool Water Testing and Management

Maintaining correct pool water chemistry is crucial for the health and safety of bathers, the longevity of pool equipment, and overall bather comfort. Lifeguards play a vital role in routine testing and reporting.

Why Test Pool Water?

• Prevent illness: Incorrect levels of disinfectants can allow harmful bacteria and viruses to thrive.
• Protect equipment: Imbalanced water can corrode or scale pipes and plant.
• Bather comfort: Incorrect pH or high chlorine can cause skin and eye irritation.
• Legal compliance: Adhering to Health and Safety at Work Act 1974 and COSHH regulations.

Key Water Parameters and Ideal Ranges

The main parameters lifeguards typically test are:

• Free Chlorine (Disinfectant): Measures active chlorine available to kill germs.
• Ideal Range: 1-3 mg/l (ppm) for indoor pools; 1-5 mg/l (ppm) for outdoor pools.
• pH (Acidity/Alkalinity): Indicates how acidic or alkaline the water is. Affects chlorine efficiency and bather comfort.
• Ideal Range: 7.2 - 7.4 (absolute maximum 7.6).
• Combined Chlorine (Chloramines): Formed when free chlorine reacts with bather waste. Causes strong chlorine smell and irritation.
• Ideal Range: < 0.5 mg/l (ppm).
• Total Alkalinity: Buffers pH, preventing rapid fluctuations.
• Ideal Range: 80 - 150 mg/l (ppm).
• Calcium Hardness: Prevents corrosion or scaling.
• Ideal Range: 180 - 250 mg/l (ppm).
• Cyanuric Acid (Stabiliser): Used in outdoor pools to protect chlorine from UV degradation.
• Ideal Range: 30 - 50 mg/l (ppm). Maximum 100 mg/l.
• Water Temperature: Affects bather comfort and chemical reactions.
• Ideal Range: 28-30°C for general use.

Testing Procedures

• Frequency: Typically 2-3 times per day, or more frequently during busy periods or if issues arise.
• Methods: Comparator kits (colour matching), test strips, or digital meters. Always follow manufacturer instructions.
• Sample Collection: Collect water sample away from inlets/outlets, elbow deep.
• Record Keeping: All results must be accurately recorded in a logbook, along with any actions taken. This is a legal requirement.

Actions for Out-of-Range Results

• Report: Immediately inform the pool operator/supervisor.
• Adjustments: Chemical adjustments are usually made by trained plant operators.
• Pool Closure: If levels pose an immediate risk (e.g., very low disinfectant, extreme pH), the pool may need to be closed until rectified.

Chemical Safety (COSHH)

Always handle pool chemicals with extreme care. Wear appropriate Personal Protective Equipment (PPE), understand Material Safety Data Sheets (MSDS), and follow Control of Substances Hazardous to Health (COSHH) regulations. Store chemicals securely and separately.