Canadian Lifesaving Manual 9780920326466
Canadian Lifesaving Manual 9780920326466
Canadian Lifesaving Manual 9780920326466
Published by the Lifesaving Society. First Printing, December 1994. Twenty-second Printing, September 2017.
Copyright, 1994 by the Royal Life Saving Society Canada. Reproduction, by any means, of materials con-
tained in this book is prohibited unless authorized by the publisher. Requests should be directed to the Na
tional office of the Society (see inside back cover for address).
The Lifesaving Society is Canada's lifeguarding expert. The Society works to prevent drowning and
water-related injury through its training programs, Water Smart® public education initiatives, drowning
prevention research, aquatic safety management services and lifesaving sport.
Annually, over 1,000,000 Canadians participate in the Society's swimming, lifesaving, lifeguard and
leadership training programs. The Society sets the standard for aquatic safety in Canada and certifies
Canada's National Lifeguards.
The Society is an independent, charitable organization educating Canadian lifesavers since the first
Lifesaving Society Bronze Medallion Award was earned in 1896.
The Society represents Canada internationally as an active member of the Commonwealth Royal Life
Saving Society and the International Life Saving Federation. The Society is the Canadian governing
body for lifesaving sport - a sport recognized by the International Olympic Committee and the
Commonwealth Games Federation.
Note: The Lifesaving Society® is the simplified style of the Royal Life Saving Society Canada (RLSSC). Both
styles may be found in this publication until a new edition is released.
i Lifesaving Society
Foreword
Lifesaving Society
Contents
1.1 Introduction
As a lifesaver, you can make a difference. You can help other
people or even save them from drowning, and you can be very
influential in helping others be Water Smart in, on, and around
water.
0 Males are far more likely to drown than females. About four
out of every five people who drown in Canada are male. City 6oy Saved from
0 Swimmers and non-swimmers drown. Knowing how to Drowning
By Peter Smith a nd
swim is ,wt enough to protect against drowning. Kevin Martin
Ca lgary Sun
What Activities Are Involved? CALGARY - Two Ca lgary
0 About two-thirds of the people who drown are near the l ifeg uards saved a you ng
water but do ,wt intend to go in. boy's l ife yesterday.
0 Two-thirds of water-related deaths occur during recreational Matthew Brown, 7, of
activities in, on, or near the water. Fishing, powerboating, northeast Calgary, had
and swimming are the leading activities involved in water been taking swi m m i ng
related deaths occurring during recreational activity. Other l essons with a day-care
g roup. "After their l essons
significant activities are playing or walking near water,
had ft n ished, they had
canoeing, and snowmobiling. a spe l l of free swi m m ing
0 About 50 people drown every year in bathtubs. time, and the boy was
seen on the bott-om in
1 ° metres of water," said
Average Number of Water-related Deaths per Year Const. Larry Lafreniere.
in Canada, 2001-2005, by Recreational Activity
Ken Schaffer, of the
100 Emergency Medica l
85 Services, said t h e boy
wasn't breathi ng when he
rll 80 was taken from 'the water.
68
-
tlS "By the time paramed ics
cu a rrived, the boy was
0 60 53
0
conscious, alert a nd was
doing wel l," said Schaffer.
31 "We would l ike to g ive a
28
pat on the back to the
19 l ifeguards for a job wel l
20 10 done. Their promptness
a nd professional care
saved a you ng l ife."
Fishing Power- Swimming Playing Walking Canoeing Snow-
boating near near mobiling
Water Water
Recreational Activity
Source: Lifesaving Society Canada drowning research.
Young Explorers
These are children between 5 and 12 who are playing near
lakes, rivers, streams, and private pools, often without adult
supervision.
Risk Takers
These are males aged 18 to 34 who powerboat, fish, swim,
canoe, and snowmobile. Risk takers often party with friends,
drinking alcohol and wearing neither a lifejacket nor a PFD.
Unsuspecting Seniors
These include males and females over 65. They are often alone
when they drown, and they are at risk while walking near
water or taking baths because they cannot rescue themselves.
1 -4 Lifesaving Society
Be a Hero: You Can Make a Difference!
Program Education
Program education refers to the formal training in swimming,
lifesaving, lifeguarding and leadership provided by the Society.
The Society reviews and revises its programs on a regular basis.
Public Education
Public education refers to the Society's efforts to ensure that
all Canadians are "Water Smart." Being Water Smart involves
acting safely near water and avoiding water-related hazards.
The Society creates Water-Smart messages featuring personal
lifesaving tips for people involved in unsupervised activities
in, on, or near water. These messages are directed at Canadians
who do not emol in aquatic training programs. These people are
not exposed to information on self-rescue and the prevention
of aquatic accidents and may not know how to cope with aquatic
emergencies involving others. The Society's public-education
efforts reach millions of Canadians every year.
Research
Each year, the Society conducts research that profiles drownings and
other water-related deaths in Canada. This research is presented in
national drowning reports that identify the key
factors contributing to these incidents. Education initiatives are
developed from this research. The Society also holds
symposiums on key lifesaving and public- ----------------
education topics each year. In addition, the Father and Son Rescued from
Society investigates issues that affect the Cap5ized Boat
development and technical excellence of its Kim Richardson completed her Bronze
programs and services. Medal lion course at Centennial Pool in Hope,
British Columbia, on August 11, 1991 . Six
days later she found herself employing those
Partnerships skills she had learned when she was faced
The Society works in co-operation and consul with a real l ife and death situation.
tation with national, provincial, regional, and
community agencies, governments, and organi She a nd her husband were camping on Gil l is
zations in the areas of prevention, education, Lake. About 6:00 p.m. Kim heard a l oud
safe boating, and aquatic safety. splash accompanied by an ear-piercing cry.
Looking out onto the lake she saw a capsized
Consu ltation boat with one person in the water and one
The Society provides advice to education, hanging onto the craft.
recreation, health, and government agencies that
oversee aquatic recreation in Canada. In addition, Kim's husband Bob went for hel p and
Kim rowed her rubber dinghy out to the
Society representatives act as expert witnesses at overturned boat. As she approached the
coroner's inquests and in court cases. victims, the father, who was beginning to
submerge because of his heavy clothes,
How Can You Get Involved? cal led desperately to his son. Suddenly, his
The Society has Branches, volunteers, and staff son let go o f the overturned boat and bega n
serving every province and territory in Canada. to swim towards his drowning father. Both
men began to submerge. Kim cal led to them,
At the national level, the Society is governed by encouraging them to roll onto their backs.
a volunteer Board of Directors. The Board is
responsible for policy development and stra Using her paddle, Kim pulled the son to her
boat a nd held onto him. Just then, a small
tegic management of the Society. The Society's motor boat arrived and helped the father.
national office is in Ottawa.
2.1 Introduction
Being a lifesaver is of course about rescuing others
from danger around water. But it's also about drowning
prevention and self-rescue. These two topics are so
important that each has its own chapter in this book.
This chapter covers drowning prevention, and Chapter 3
discusses self-rescue.
"JITI
they can give way suddenly. Path Path
r-1-l�
,/ When swimming, be aware of
<G••db& · �
and avoid nearby boats. Subm
,I To avoid drifting too far from �
the swimming area, choose
and refer regularly to a Lateral � Lateral
specific landmark.
� - · . ?Rz
Current RIP � Current
,/ Watch for and avoid water
�7F??p;7 __�
toys (surfboards, balls, etc.).
They can be hazardous even
·• · :- ·: . ·•• . . . : • . • . . • 1 - . ' • • . . • . . . . . • . ·: . . . .. .
when abandoned. : . . • • · :·:_- ·. -;·
,/ Never rely on inflatable ·: · · Beach · .
cushions, air mattresses, Swimming path across current
water toys, etc., for the
support of non-swimmers.
Supervised Pools, Waterparks, and Watezfronts
,/ Read and abide by all rules and instructions.
,/ Co-operate with those in charge (lifeguards, supervisors, etc.) - they're there to keep the area
safe for you and others.
,/ Take responsibility for your own safety - don't assume lifeguards or others can do it all for
you.
,/ Ensure that toddlers and young children are supervised at close range.
,/ Check any depth markings to determine which areas are shallow and deep and where drop-
off or transition zones are.
,/ Stay out of deep water unless you can swim well.
,I Always WALK on pool decks, in shower or locker rooms, or on docks.
Unsupervised Pools and Waterfronts
Do as for supervised pools, waterparks, and waterfronts, but add the following:
,/ Make sure there's a phone right at the water 's edge - that way, you can answer the phone
and keep supervising activity. Keep the phone line open in case there's an emergency.
,/ Post emergency numbers near the phone.
,I Have rescue equipment and a first aid kit.
,/ Never let anyone swim alone.
,I Avoid diving in backyard pools - they rarely have the depth or distance required for safe
diving.
,I Secure access to pool areas from both yard and home - it prevents small children from
entering when they shouldn't. Install a fence and a locking gate.
,/ Use unbreakable containers near the water.
Warm-water spas and hot tubs (40 ° Celsius) are not recom
mended for those with heart or circulatory problems, the very
young, the elderly, and pregnant women. Do NOT use these
facilities if you have any open sores or infections. And if you
are receiving medical treatment, consult your doctor about the
use of warm-water spas and tubs.
Here are some tips on how to avoid getting into trouble in warm
water:
.I Stay in warm water for less than 15 minutes .
.I Always have someone nearby who can help in an
emergency- never use a spa or hot tub alone .
.I Consult your doctor if you're unsure about using warm-water
spas and tubs.
3.1 Introduction
Chapter 2 discussed how to be Water
Smart and prevent aquatic accidents. But
even the best prevention is not always
enough. Despite taking Water-Smart
precautions, you might someday get into
trouble in, on, or around the water. For
example, the canoe you are in might
capsize if the water suddenly becomes very
rough. Or you might slip and fall from a Self-rescue: You never know when
dock when you're alone. you'll be put to the test!
Recognize
.I Recognize that you are in trouble and that you must rescue
yourself.
What'ei EMS?
The Emerg ency Medical
.I Recognize that aspects of the situation, such as your
System ( E M S) is a condition, water conditions, and weather conditions, may be
com m u n ity-wide system changing.
for respond ing to
emergencies. It consists Assess
of pol ice, fi re, a nd .I What self-rescue skills do you (and those with you) have?
ambula nce services. To .I What is your physical condition? Are you injured? Which of
fi nd these numbers i n your injuries are the most important? How fit are you?
your com m u nity, check .I Where is the closest point of safety?
the front pag es of the
.I What are the water and weather conditions? How will they
tel ephone book.
affect your options?
.I What equipment do you have that might be useful in a self-
rescue?
.I What is the lowest-risk way of rescuing yourself?
.I Are there bystanders? How can they help?
Act
.I Do the things you decided to do in your assessment.
.I Watch for changes that make reassessment necessary .
.I Direct bystanders as needed.
.I Contact the Emergency Medical System (EMS) if you need it.
(See page 3-3.)
.I Contact the authorities if the incident should be reported.
3-2 Lifesaving Society
Self-rescue
Calling EMS
After removing the victim from the water, direct him or her to a suitable location. Ask if
the victim has friends or family he or she would like to call. If the victim is unconscious,
ask if anyone knows the victim. Shout this if you have to!
After calling EMS, give a responsible person the job of meeting it and directing the
emergency-response team to the victim. If you're alone, give EMS detailed instructions
about your location.
When the EMS team arrives, the team assumes responsibility for the care of the victim.
In some cases, emergency-response teams won't assume responsibility for the victim of
an aquatic accident until he or she has been removed from the water. Offer help as
needed, and provide information as you are asked for it (EMS teams follow their own
action plans, and they ask for information as it is needed).
Swimming
Here are some tips on using swimming as a self-rescue skill:
.I If you have a watercraft or boat, decide if you will use it as a
swimming assist.
.I If there are currents, winds, or tides you can use to your
advantage, consider them in planning your swimming route.
.I If there is a buoyant object that will help keep you afloat, use
it.
.I PFDs or lifejackets make swimming a bit more difficult, but
DON'T discard them.
.I Swim with your head up unless you're in warm water .
.I Don't swim too fast. Pace yourself, and keep your breathing
relaxed and controlled. If you're in warm water or are
wearing a PFD, you can rest if you feel fatigue in your
muscles or breathing becomes difficult; otherwise, keep
moving, but with reduced effort.
Treading Water
You can use one of the following
kicks when treading water. You
may also alternate among these
kicks to reduce fatigue:
.I modified whip kick. This is the
most common choice in
treading water. Instead of
finishing the kick by bringing
the legs together, make a
wide and continuous rotary
motion to give yourself more
consistent support.
.I scissor kick, modified so that
the legs never fully close. Treading water with
.I slow eggbeater kick. slow eggbeater kick
For arm action, use either a wide sculling action or a modified
finning action. Technique for these leg and arm actions is
presented in detail in Chapter 9.
Motionless Floating
In a motionless float, you need to find a position that keeps your
nose and mouth above the water. You also need to keep your
lungs as full as possible (this is especially important if you tend
to sink easily). Hold your breath when you float motionless-
blowing out makes you sink.
Vertical float
Front float
together, and interlock arms (one arm over and the other
arm under a partner's). If the water is calm and currents
aren't strong, it may be easier and more efficient to use
HELP. But if these conditions are not present or there are
children in the group, the Huddle Position is preferable
(children in the middle). This position keeps the group
together, and it can also boost morale .
.I If you fall through ice, call for help. Use any
combination of kicking, clawing, crawling, and breaking
loose ice to find solid support. Move your feet and legs -
into a swimming position. Try to push yourself forward
on your stomach onto the unbroken ice. DON'T stand
up. Roll away from the break until you find solid ice.
.I If you fell into cold water from a car or truck, try to
escape while the vehicle is still floating. The most
practical escape hatches are the windows; water and ..._......,
ice pressure make it very hard to open the doors of a Ice self-rescue: Keeping low,
submerging vehicle. push forward on your stomach
Lateral (side) currents often feed into rip currents. Lateral currents
can be dangerous because they can carry unsuspecting bathers
out of their depth, into a hazardous area or even into a rip
current. Too often, people don't recognize that they're travelling
in a lateral current. All swimmers, body surfers, and waders
should periodically confirm their location relative to onshore
landmarks. Because lateral currents usually flow parallel to
shore, self-rescue consists of swimming either toward or away
from shore.
OR
• try to move to shore along the face of the dam. This might
work, but only if the shore is close enough and someone
is there to help you over the dam's vertical wall or onto
shore.
4.1 Introduction
Rescues involving others can be physically and emotionally
demanding for both rescuer and victim. This chapter
covers the skills needed to perform safe, effective, and
efficient rescues. The recurring theme is the rescue Recognize
process, which involves the following three elements:
./ Recognize Assess
./ Assess
./ Act.
Act
The rescue process is used in self-rescue, the rescue of
others, and first aid. The three elements are the same in
every kind of rescue or first aid situation, but the
element details are different. See Chapter 3 for how the
process applies to self-rescue, Chapter 6 for how it
applies to first aid.
Recognize
.I Recognize that someone is in trouble, and that you must
perform a rescue.
,I Recognize that aspects of the situation, such as your
condition, the victim's condition, or water and weather
conditions, may change .
.I Recognize hazards, the cause of the incident, and the number
of victims and their condition.
Lifesavers are trained in what to do, but the situations they find
themselves in can vary greatly. The environment, equipment, and available
personnel are not plannable in a lifesaving situation.
�4:-
While there are variations from person to person, the keys to
recognizing distressed swimmers are the following:
0 Their body position approaches the vertical.
0 They are making little forward progress.
0 Distress is obvious on their face.
0 They are breathing, and so they may call or wave for help.
0 If they are injured or ill, they might be holding the affected
area of the body.
0 They may be facing a point they consider "safety," such as the
shore, a raft, a boat, or a dock.
( ',) Drowning victims are unable to support themselves at the surface.
Distressed swimmer They are not always non-swimmers, and they may or may not
struggle against drowning. Many factors can prevent people from
==-== struggling- illness, injury (a blow to the head, for instance),
alcohol or other intoxicants, hyperventilation (people who
hyperventilate become unconscious without a struggle),
fatigue, or unconsciousness.
,r
Pr= Throw Re� c � e .
ll 1// .I If the victim 1s a short distance from shore and a
'I·
A' suitable buoyant object is available, throw the
object so the victim can grasp it for support .
.I Be careful not to hit the victim on the head when
throwing the object.
.I Encourage the victim verbally, and direct him or her toward
----" safety .
.I Remember that wind and waves make it harder to throw
with accuracy.
r� D Reach Rescue
JR/�-
.I If you can find a
suitable rescue
#3 1/ assist, extend it,
1
1/ and pull the victim
If) to safety.
.I If the victim is close enough,
a towel might do the trick.
For victims farther away, a .,.���
�� �� �� �� �
------.;-
pole or a branch works well.
you can reach even farther
if a rope is attached to the buoyant object.
.I Buoyant objects are usually best, because they support
victims in the water. This means you don't have to lift and
pull.
.I Keep your centre of gravity as low as possible. Anchor
yourself by holding onto a solid object such as a tree root,
ladder, or dock with your free hand. This will help prevent
you from being pulled into the water.
H �'7
·
Row Rescue
ffl i This rescue involves greater risk because you do it in It's a g ood idea to l ea rn
#s . 0_ ;
I open water from a small boat (rowboat, canoe, etc.). how to operate sma l l
/6;/
ff] /!J
P �ge 4-8 summarizes _ the pros and cons of using
d1fferent small boats m rescues.
boats. I f you use the m i n
a rescue, you'l l need to
know the provincial or
.I Try to manoeuvre the boat so that you approach the victim territoria l regulations
with wind in your face. This reduces the chances of the boat and com ply with them .
being pushed into the victim and injuring him or her. But if
you're alone in a strong wind, you may need to approach
from the windward side.
lf:-==fllSwim Rescue
The following circumstances may make it necessary for
# 6/i�'11
JI .1// you to e�te� the wate� _dunng a rescue:
!!J/
6/,! 0 The ':-ct
1/
0 The �' � condition gets worse. _ _
VIchm 1s too far away to reach with a throwmg
assist.
0 You've tried to throw an assist but haven't succeeded.
0 No small craft is available.
In a swim rescue,
.I enter the water with a buoyant assist, and swim to the
victim .
.I minimize your personal risk by pushing the assist to the
victim from the ready position (see page 4-19). Avoid even
indirect contact with the victim .
.I back up in a ready position, maintain eye contact, and
encourage the victim to safety.
Tow Rescue
# 7 fJ!!_w tl7
/ . / If you've tried a swim rescue and the victim cannot
/2 / move to safety while holding an assist, pull from the
1/ other end of the assist and tow the victim to safety.
This indirect contact with the victim brings you very close to
him or her, and it increases your personal risk. To ensure your
own safety, be ready to move away quickly at any time.
#s
f=,TJ Cany Rescue
&=�=w
J,r{8/; Direct contact between rescuer and victim may be
required _ w�en
./
the victim cannot support his or her head above
uJ - 7Jj the surface while holding an assist
./ no assist is available, and the victim is not responding to
verbal encouragement
./ the victim is unconscious.
Use the Rescuer 's Checklist to answer the first question. The
Rescuer' s Checklist is a guide to action. Wherever you are on the
ladder, use the checklist to review your options on that rung and
choose the appropriate option.
'How the Ladder Approach and Rescuer's Checklist Work Together "'
The chart below shows the relationship between the Rescuer's Checklist and the Ladder
Approach. It shows, for example, that removing hazards is part of every rescue. Similarly,
follow-up must happen in every rescue. But reverse, ready, and reassess occurs only in swim,
tow, and carry rescues.
ti'
Checklist in detail.
4.6 Hazards
In any rescue situation, there may be hazards in the
environment that could endanger you or cause further
danger to the victim. Either remove such hazards from the
area or remove the victim from the hazards.
Possible Assists
Possible assists include the following:
0 lif ejackets an.d PFDs. Because of their buoyancy, lifejackets
and PFDs are excellent assists.
0 kickboards. Kickboards (flutterboards) are used as assists in
many facilities because they are so widely available. They
are, however, hard to throw and tend to blow away.
0 improvised buoyant assists. Buoyant objects such as plastic
bottles (for example, bleach containers), plastic coolers,
gasoline containers, oars, paddles, boards, and branches can
all be used in rescues. Poles, oars, paddles, and sticks make
excellent extensions because they are usually light and
strong and can be extended with accuracy.
0 reaching poles. Reaching poles are used when the victim is
within reaching distance. These poles vary in length and are
made of various materials. Some models are very light, and
some are electrically insulated. Reaching poles that are
hooked are called "shepherd's hooks."
0 ring buoys. Ring buoys are required at public pools and
beaches by regulation in many regions in Canada. They are
also found at many docks and marinas. A length of rope
allows them to be thrown to someone at a distance.
0 rescue cans. Rescue cans (torpedo buoys) come with a length
of rope and a strap that slips over the rescuer's shoulder.
Cans are rigid and easy to hold onto; they can be used as
reaching assists or as assists to tow or carry distressed
swimmers or drowning victims.
0 rescue tubes. Rescue tubes are similar in shape to rescue cans,
but they are made of soft foam with a waterproof coating.
They have an attached shoulder loop and line at one end, a
snap at the other. The tube can be wrapped around a victim
and secured with the snap. Because they have no handles,
rescue tubes can be hard for victims to hold onto.
0 throw bags. Throw bags are generally a white-water assist.
They consist of a bag with a length of rope. The rope comes
out of the bag while it is in "flight." With practice, you can
throw these bags both far and accurately.
Choosing an Assist
When choosing an assist, consider
,I availability. The assist must be readily available.
,I buoyancy. Floating objects support victims higher in the
water and allow you to rest as needed.
.r-dJ
you can carry and use the assist 0 Use c l othes to
>-iV
effectively. If you don't, you tow a calm,
could be putting yourself in passive victim . =-
==-""'
�
t;:;o:. i 0) �{
F ro � behind the
danger.
· ./ your immediate surroundings. The
_
v1ct1 m, pass the �£ ---
�__s .V:-,. __,,.� , ·
C:::.i_;. �-
legs or sl eeves •- • --5
assist you choose should "fit" u nder his or her arms a nd back over h is or her shoulders.
the surroundings. While a (You are using clothes m uch as you u se you r arm s in a
reaching pole is long, for mod ified body carry (see page 4-23).) Hold both l egs or
example, it's harder to man sl eeves i n one ha nd d u ring the tow, and use your other
oeuvre if there are people a rm to scu l l or fin.
nearby. It's also harder to
manoeuvre if there's a fence or
wall close to the water's edge-
you can't pull a long pole in all
the way. A smaller or shorter
object is more suitable when the
victim is close to shore.
If the victim is just out of reach, you can lie down to stretch out
as far as possible:
� Lie down at an angle of about 45 ° to the side of the dock or
pool with your legs spread. This position is most stable,
because your centre of gravity is as low as possible. The
angled position places one shoulder over the edge of the
dock or pool, allowing freedom of movement and offering
the longest reach.
,.I'
in emergencies.
4.8 Entries
Emergency situations can require a rapid entry into the water
for searches and rescues in varying circumstances. You need to
know different ways of entering the water - that way, you can
choose the best one for the situation.
Possible Entries
0 Wading or running
0 Slip-in entry
0 Stride jump
0 Head-up dive
0 Shallow dive
0 Compact jump
0 Modified compact jump
Wading or Running
If the water is shallow but you aren't sure of the water
conditions in the area,
./ consider keeping your shoes on
./ wade in slowly and carefully
./ go to the victim by sliding your feet along the bottom,
testing the depth with a reaching assist, stick, or pole
./ test the bottom for firmness and underwater obstructions
before transferring your weight to the front foot.
Slip-in Entry
If the water is deep and you're unsure of the water conditions,
use a slip-in entry. Any other entry is extremely dangerous. You
can also use this entry if you want to minimize movement (for
example, when approaching injured victims) . Here's how to do
this entry:
,,/ Place one or both hands at the point
of entry, and use your arms to lower
yourself slowly and deliberately,
Stride Jump
The goal of this entry is to jump as far as possible while looking
at the victim. Your head does not go under the water. This is
NOT an entry for unknown or shallow water or for heights
greater than 1 metre.
Head-up Dive
This dive is faster than the stride jump, because you enter the
water in a position that lets you start swimming earlier. This
dive also allows you to keep victims in your sight. Because of
the head-up position on entry, this dive is used only from a
very limited height (15 centimetres or less). This is NOT an
entry for unknown or shallow water.
Shallow Dive
The depth of water required for a safe shallow dive depends on
your skill in shallow dives. A minimum of 1 metre (3 feet) is
recommended for skilled divers. Under stress, however, your
judgment about whether the depth is safe may be affected.
There are documented cases of spinal injuries in which skilled
divers dove into water between 3 and 4 feet deep.
Compact Jump
This jump is used to enter the water from a great height, such
as from a wharf. This is NOT an entry for unknown or shallow
water.
.I Cross the legs, and keep the arms close to the body.
.I Cross the arms across the chest, placing one hand over the
mouth and nose.
.I Once underwater, use the arms and legs to stop downward
motion
.I Surface, and swim to the victim.
....----
Modified Compact Jump
This entry is used from an intermediate height- 1 to l1/2
metres. This entry is useful when victims are close to the edge
of a pool, dock, or boat or when they are in the deep end of a
wave pool. This entry keeps your head above the surface, and
you always see the victim. Since the jump' s vertical descent
eliminates the forward motion of the stride jump, the entry
doesn't swamp victims. This is NOT an entry for unknown or
' \ shallow water.
l
.I Start from a standing position at the edge of a pool, dock,
deck, etc.
.I The legs are straddled, the knees are slightly bent, and the
upper body is straight.
.I Step off the edge, and drop straight down.
.I Do a whip kick on contact with the water.
.I Reduce downward pressure by pressing on the water with
the hands and arms.
-� .I Move to a horizontal position, and swim to the victim.
Choosing an Entry
Consider the following when choosing your entry:
0 the victim's condition and location
0 your abilities
0 your condition and location
0 water conditions (depth, currents, waves, temperature,
pollution, etc.)
0 the condition of the bottom
0 the speed with which you need to get to the victim
0 the need to keep the victim in sight
0 the assists available for use
0 your familiarity with the area.
When you are 2 to 3 metres from the victim, stop, reverse your
direction, assume a "ready" position, and talk to him or her.
This position allows you to swim away quickly if you
think you'll be grabbed.
"Sit" in the water with one leg bent in front and the
foot at the surface. Face the victim, and maintain your
stability with a sculling action (see page 9-13). If
necessary, use your bent leg to push the victim away,
or swim away until he or she is calm.
While in your ready position, assess your original plan again. Ready position
Circumstances may have changed:
0 The victim's condition may have changed, or your
assessment of the victim may have changed:
• The victim may have become tired.
• A conscious victim may have become unconscious.
• A distressed victim may have become a drowning victim.
0 The victim may be larger or smaller than you had originally
thought.
0 The victim may have injuries or disabilities you weren't
aware of.
0 The victim may not accept a buoyant assist.
0 The water may have become rougher or calmer.
ti'
or by using a tow or carry.
Possible Carries
0 Assistive carries. These carries provide you with the most
safety but the least control over victims. They allow victims
to help while being pulled to safety. Assistive carries are
used mainly with victims who are
• weak
• tired
• injured below the waist.
0 Control carries. These carries put you at greatest risk but give
you maximum control over victims. In all such carries, keep
the victim's head out of the water. Control carries are used
mainly with victims who are
• non-swimmers
• in rough water conditions
• distressed
• injured above or below the waist
• unconscious.
Assistive Carries
Any carry that allows the victim to help and provides the most
safety for the rescuer can be considered an assistive carry. Some
examples are provided below.
0 Elbow or wrist carry
0 Clothes carry
0 Underarm carry
0 Single-chin carry
victim.
Contro l Carries
Any carry that allows you to hold the victim's head out of the
water can be considered a control carry. Some examples are
provided below.
0 Head carry
0 Double-chin carry
0 Modified body carry
0 Cross-chest carry
=�-�
- ---��-= �
l��
' - · :!/_ ·//7 /_
-
.. �;; o
V
O
., 0 o __.-\ \
head by gently squeezing with your
forearms. Alternatively, put his or her head
on your chest.
Choosing a Carry
./ When choosing a carry, consider both your swim
ming skills and the circumstances of the rescue.
./ Choose a carry that is efficient, one that
• always keeps the victim's mouth above the surface
• gives you freedom of movement
• provides maximum safety with conscious victims
• lets you conserve energy, given the water conditions
and the distance to safety.
You might want to change from one carry to another. You might
be tired, the victim's condition might have changed, the water
conditions might have changed, etc. Maintain full support and
control of the victim throughout the change-over. With conscious
victims, explain what you will be doing, why it must be done,
and how you will do it. Don't change carries until you and the
t/'
victim are ready for it.
4.12 Removals
Remove victims from the water as soon as possible, and use the
removal method with the least risk for you and the victim .
Underarm Lift
This removal works well for removing a victim to a deck or
dock:
.I Hold the victim in a stable position in which he or she faces
away from you.
.I Reach from behind, and hold the victim securely under the
armpits. Place your hands securely on the victim's chest.
.I Lift the victim vertically until he or she is above the surface
you're standing on (deck, dock, etc.). Make sure you don't
scrape the victim's back.
.I Step back gently, and lower the victim to a secure sitting
position on the surface you're standing on. The victim
should be far enough from the edge that he or she can't fall
back into the water.
Cradle Lift
This removal works best for removing victims from
shallow water to a dock or deck:
./ The victim is at the surface, cradled in your
outstretched arms and parallel to the lip or edge
of a pool, deck, dock, etc.
./ Hook one arm under the victim's thighs and the
other under his or her neck.
./ Lift the victim, and place him or her gently on
the deck, dock, etc.
Wa lk Out
This removal is especially useful at a beach or in other open
water situations:
./ If the victim is conscious and exhausted and you' re both in
shallow water, pause there briefly.
./ Supporting the victim, walk out of the water. Put one arm
around the victim's waist; the victim's arm is over your
shoulder.
One-Rescuer Drag
This technique is useful if you are
alone, the victim is unconscious, and
you need to move him or her a short
distance fast. It is also useful at a
beach or in other open-water
situations:
./ From behind the victim, reach
under his or her armpits, and grab
his or her wrists.
./ Pull the victim out of the water,
heels dragging.
./ Place the victim in a position
suitable for treatment.
Firefighter's CarnJ
This removal requires either a small-sized victim or a rescuer
with a high level of strength and power. It is quite useful at a
beach or in other open-water situations. This is a useful removal
method when you're alone:
.t' In shallow water, face the victim .
.t' Pick up the victim in one of two ways:
• Grab the victim's nearer upper arm with one hand.
Place your other hand on the inside of the victim's
nearer leg and just above the knee. Submerge beneath
the victim in a squatting position, keeping your chin
tucked close to your chest. Roll the victim over, and
stand up with the victim draped over your shoulders
as you do so. With one hand, clasp the victim's lower
arm and lower leg against your body. Balance with
the other hand while walking to shore.
• Kneel down, and draw one of the victim's arms across
your shoulders. Slip your own arm between the
victim's legs. As you turn your back to the victim,
support him or her across your shoulders .
With practice, you will know when to start this carry to ensure
that the victim's head is always clear of the water.
Over-One-Shoulder Carry
This removal requires either a small-sized victim or a rescuer
with a high level of strength and power. It is quite useful at a
beach or in other open-water situations. This carry is used when
no help is available:
./ Lift the victim over one of your shoulders so that he or she
pikes at the waist.
./ Grasp the victim's dangling legs .
./ Transport the victim to safety slowly and deliberately. (Vvalking
hurriedly can cause victims to vomit, especially if they've eaten
recently or swallowed water during their near-drowning.)
t/"
water conditions, and the height of the deck, dock, or shoreline.
4.13 Follow-up
Once the victim has been removed from the water, evaluate his
or her condition, and start follow-up procedures. If possible, get
help moving the victim to a more comfortable environment (see
page 4-2 for how to use bystanders in a rescue). Call EMS if
necessary, and decide whether the incident should be formally
reported to an authority.
For the Assess element of the rescue process, use the Ladder
Approach as your evaluation tool; for the Act element, use the
Rescuer's Checklist.
5.1 Introduction
Chapter 4 described the fundamental skills needed to perform
safe, effective, and efficient rescues of others. Those key skills
make up the rescue process, and they're usually all you need to
use in a rescue.
5.2 Avoidance
Avoidance is a primary goal for all rescuers. With distressed
swimmers and drowning victims, you need to minimize the risk
of being grabbed during a rescue. Here are some tips on how to
avoid victims to ensure your own safety:
,/ Watch the victim.
,I Be attentive to the victim's body movements and intentions.
,I Be watchful about the possibility of being grabbed.
,I Use the Ladder Approach to choose the safest rescue
method, given the situation (see pages 4-4 to 4-9 for
information on the Ladder Approach) .
,/ If the victim tries to grab you, either swim away or
submerge (see below
for information on
defences) .
d,__
,I Resume a ready position. � -""-..--�
,/ Talk to the victim to
explain that he or she
mustn't try to hold onto
you. --..___,..._____.
,I Repeat the rescue
approach if and when you
and the victim are ready.
Rescuer in ready
5.3 Defences position
Arm Block
,/ Extend one arm, and press forcefully against the victim's
upper body to move away.
,/ This is the highest risk block, and you should avoid it if at all
possible.
,/ Return to the reverse and ready position, and make sure
there's enough distance between you and the victim.
5.4 Releases
You may be grabbed by a victim during a rescue. This might
happen if the victim's condition changes (getting tired or
confused, for example) or if you don't plan effectively for
your own safety. Because of panic, the intensity of the victim's
strength and power are often intensified. Releases can be used in
such situations.
It is not at all certain that releases will succeed if a victim grabs
you. That's why this section does not include specific release
techniques -it could give the impression there are sequential
steps to success in such situations. Instead, release principles are
listed, with the warning they are guidelines for these potentially
life-threatening situations.
Release Principles
If you have to use a release, remember the following:
0 This is a life-threatening situation for you.
0 Submerge the victim if possible.
0 The next option is to submerge yourself and the victim if he or
she is still holding onto you.
0 Try to use quick, high-velocity movements.
0 Orient yourself to water surface and depth. Resurface in the
reverse and ready position a safe distance from the victim.
0 If you are grabbed around the neck, tuck your chin.
0 Do not further endanger yourself. Consider a low-risk rescue,
and remember self-rescue principles.
��)
�,
Push up on
elbow and
back on head Push victim away
•
_. I
wider the grid pattern can be . L _ _ _,
./ Searchers should be able to easily see one
another underwater. 5
./ The depth of the search will depend on the
clarity of water. Searchers need to swim Landmarking and grid pattern,
at a depth where they can clearly see the overhead view
bottom.
-�-
quently to avoid getting tired.
Searchers tire quickly if they try
Foot-first surface dive to cover too large an area all at
once.
� ·- ,/ If there are three or more
--�-- rescuers and the victim is not
known to be in the water, one
G person should conduct a land
search while the best swimmers
conduct a water search.
,/ Skin-diving equipment can in
crease the efficiency of under
water searches (Section 5.6 des
cribes this equipment and its
use).
-- -- -- - ",,t
should scan the water
while other rescuers start
a search of shower rooms, f CJ
locker rooms, and all other
possible areas (including
I '
lockers).
,/ If the water being -- -- � - - -
----
searched is cloudy, use
---- _,
the techniques presented I
- t
above for deep-water I
searches. I �
\ D ../
Face Masks
To test a face mask for proper fit, hold it in place, and inhale
through the nose. When you remove your hand, the mask
should stay in position on your face.
One of the first skills to learn is how to clear the mask when
it fills with water. There are three ways to do this, and each
involves displacing water by exhaling through the nose. The
three methods are Testing for proper fit
0 doing a horizontal roll
0 doing a vertical tilt
0 using the mask's purge valve.
Vertical tilt
With practice, you can learn to clear your mask and your
snorkel with one breath.
Fins
Fins are easier to put on if your feet are wet. Here are some tips
on choosing fins:
0 It's important that fins fit your feet. Fins that are
too large cause sores and blisters; fins that are
too tight can cause poor blood circulation and
even muscle cramps.
0 Fins should be rigid enough to stay still during
downward leg movement.
f O The larger the surface area, the more energy it
takes to kick.
0 Fins with an inclined blade provide maximum
propulsion.
While the ABCs are listed fourth in the sequence, they are
still the priority. This means you must do the first three steps
efficiently so that the ABC priorities can be assessed, treated,
and monitored.
Approach
,/ Slip into the water.
,/ Approach the victim
carefully to minimize
water movement.
,I Do not jump or dive into
the water near the victim.
Technique is as follows:
.I Stand on either side of the victim .
.I Grasp the victim's arms midway between the
elbow and the shoulder - your right hand on
the victim' s right arm, your left hand on the
victim's left arm .
. .I Gently float the victim's arms up alongside his
or her head, parallel to the water surface .
.I Position the victim's arms so that they
extend against his or her head .
.I Apply pressure to the arms with your
fingers while placing your thumbs on
the back of the victim's head to eliminate
back-and-forth movement of his or her
head .
.I Lower your body to chest depth, and
move the victim slowly forward and to
a horizontal position, gliding the victim' s
body to the surface .
.I As the victim becomes horizontal in the
water, keep moving forward slowly and
rotating the victim toward you until he
or she is face up .
.I Rest the victim' s head in the crook of
your arm .
.I Assess the victim's breathing.
Technique is as follows:
,/ Stand beside the victim, facing his or her head.
,/ Place your hands between the victim's arms and
torso.
,/ Reach in front of the victim's shoulders with
your hands (your right hand to the victim's
right shoulder, your left hand to the victim's left
shoulder).
,I Gently move your arms forward until your hands
reach the sides of the victim's head. Your hands
are open with the thumb behind the ear and the
fingers in front. The base of each hand is along
the jawline. Do not apply pressure yet.
,I Squeeze your elbows into the victim's body, and
then apply pressure with your forearms and
hands.
,/ Lower your body, and place your head beside
the victim.
,/ Turn the victim face up, keeping your hands in
position on either side of the head with your
elbows secured. Rotate the victim toward you
while you submerge yourself.
,/ Carefully roll under the victim while turning him or her over in
the water. Both you and the victim are face up when you surface
on the other side.
,I Move slowly to avoid twisting the victim's body.
,/ The second rescuer assesses and monitors breathing and
circulation.
ABCs
Checking for breathing does not always require rolling the
victim onto his or her back. A cry of pain, chest movement,
or the sound of breathing tells you the victim is breathing.
Here are the key points about the ABCs as they relate to
spinal injuries (for a detailed description of the ABCs,
see Chapter 7) .
Airway
While airway is always a high priority, you need to modify
what you do when you
suspect a spinal injury:
,/ If the victim is
breathing, monitor
breathing closely.
,I To assess the airway
or to perform rescue
breaths, attempt to
open the airway
using a jaw thrust
technique. If the jaw thrust does not work (i.e., rescue
breaths do not go in), use the head-tilt / chin-lift technique.
Breathing
./ Perform a quick, visual check (5 sec.) for
absent or abnormal breathing. Look for chest
movement and listen for breathing. Abnormal
breathing can include noisy and gasping
(agonal) breaths.
Circulation
If the victim is breathing, assume effective circulation.
If the victim is not breathing, or not breathing
effectively (gasping), perform CPR. If the victim is
found on land, start CPR with chest compressions. If
found in the water, start with 2 rescue breaths.
./ Hip straps are secured with the victim's arms at his or her sides .
./ The victim's head is secured on both sides. If the board has a
head harness, it is used. Sandbags, rolled towels, etc., may also
be used. The head should not be moved while being secured .
./ All remaining straps are secured at the thighs and feet.
Trapezius Squeeze
./ usually used to transfer from the vice grip or modified
body
./ place your hands and forearms alongside the victim's
ears
./ place your tumbs on the victim's collarbone or
trapezius muscle and your fingers below the
shoulders
./ squeeze your forearms together to splint the head and
neck
Reverse Canadian
,/ usually used to transfer from the Canadian
immobilization technique
,/ grasp the victim's arms as close to the ears as
possible
,/ gently squeeze the victim's arms together to
maintain the immobilization
Removal
Whenever possible, a person with a suspected spinal injury
EMS transport and should be removed from shallow water. Removal requires at
spineboarde least two rescuers if a spinal board is involved, and having three
Spineboard s, a l so or four rescuers is preferred.
known as backboard s,
are often used to
remove a suspected There are many techniques for removing victims from the water.
spinal-inj ured victim But you risk injury, especially to the back, if you don't use safe
from the water. E MS lifting techniques (see page 4-24). Any removal procedure that
may d ecide to remove allows for efficient, careful removal is appropriate. For example:
the spineboard when ,/ Rescuers check that their grip is secure.
preparing to transport ,/ If the victim is in a pool, the board is positioned at right
the victim. angles to its side.
,/ The board is removed head-first.
,/ The board is kept horizontal for as long as possible while
being removed.
,/ Bystanders can help by smoothly lifting and sliding the board.
,/ The rescuer at the victim's head should direct the removal
by instructing all other rescuers to lift at an agreed-on signal.
For instance, rescuers might agree to lift on the count
of 3 in "1 . . . 2 . . .3."
Further Treatment
./ Monitor vital signs .
./ Do a secondary assessment, including a head-to-toe
examination (see pages 6-5 to 6-7) .
./ Treat injuries.
6.1 Introduction
./ Preserve life .
./ Prevent further injury.
./ Promote recovery.
The first P is the most important. In first aid, you need to take
care of life-threatening emergencies first. This chapter covers
the rescue process for dealing with such emergencies. The
elements in this process are as follows:
./ Recognize .
./ Assess .
./ Act.
Recognize
,I Recognize that the victim is in trouble and that help is needed.
,I Recognize signs of danger to you at or near the emergency scene.
,I Recognize clues about what happened to the victim.
,I Recognize that aspects of the situation, such as the victim's
condition, your condition, or the environment, may have
changed.
Much of this recognizing happens before you reach the victim. Use
all your senses as you approach him or her. Rely on what you feel,
smell, and hear, not just on what you see.
Assess
There are four different assessments you must do in the rescue
process. You must also do these assessments in order:
1 Assess the rescue environment, and remove hazards.
2 Conduct the primary assessment.
3 Get a history of the victim and the emergency.
4 Conduct the secondary assessment .
Act
As a result of your assessment, you take action. Here are some of
the actions you'll take:
./ Treat the lifesaving priorities. (See Chapter 7 for a full
description.)
./ Treat other conditions. (See Chapter 8 for specific descriptions of
signs, symptoms, and treatments.)
./ Contact EMS if the victim' s condition is serious or life
threatening (see page 3-3) .
Head-to-Toe Examination
Scalp
Ci bumps
Ci bleeding Eyes
Ci swelling Ci pupils - equal, responsive
Ci bruises Ci bruising around eyes
Ears
Nose and Mouth
Ci fluids
Ci breathing - presence
Ci bruises
and quality
Base Ci bleeding
Ci odors - alcohol, poisons
Ci fluid of Collarbone and Shoulders
Ci bleeding Skull Ci bruises
Ci bumps Ci bumps
Ci bruises Ci symmetry
Ci necklace
identifying a
medical
condition Ribs
Ci ability to
Arms expand 1 ungs
Ci bruises Ci bruises
Ci burnps Abdomen
Ci burnps
Ci symmetry Ci rigidity
Ci symmetry
Wrists Ci bruising
0 bracelet identifying a Ci distension Spine
medical condition Ci bruises
Ci bruises Ci burnps
O bumps
O symmetry
Hands
Ci bruises
Fingers
Ci bumps
Ci return of blood
Ci symmetry
when squeezed
Ci strength or bowel control
Ci bruises
Ci reaction to Ci bleeding
Ci bumps
pain
Ci temperature
Ci color
Legs
Ci bruises
Cibumps
Ci symmetry
Ci ability ot move
Feet
Ci reaction to pain
Ci strength
Ci bruises
Toes O bumps
Ci return of color Ci anklet identifying
when squeezed a medical condition
O bruises O symmetry
O bumps O color
Ci temperature Ci temperature
•• •••
Contents of a First Aid Kit
••
Q Basic:
Attendant scissors
•
Tweezers
Surgical gloves Cotton-tip applicators
• ••
Antiseptic towelettes Wound closures (e.g., Steristrips)
Sterile telfa pads (individually Absorbent pads (unscented sanitary
•
wrapped 25 X 10 cm)
••
napkins)
Sterile gauze pads individually Adhesive tape (2 cm)
wrapped 10 X 10 cm) Adhesive tape 5( cm)
Bandage strips or assorted adhesive Cloth triangular bandages, at least 3
•
dressings
••
Crepe bandages (2)
••
Q Advanced:
••
Parrafin-impregnated gauze dressing Cloth triangular bandages, at least 7
e.g., Jelonet individually wrapped) Ice, ice pack, or instant cold pack
Metal splints (4) Sandbags/head rolls
Spinal board
••
ASA tablets (e.g., Aspirin)
•
Q Extras:
••
••
• Razor and blades Additional cloth triangular bandages
Thermometers (oral and rectal ranging Blood pressure cuff and stethoscope
from 32Q to 45Q Celsius) Large syringe
Additional rolls adhesive tape (2 cm) Pressure dressing
Waterproof, air-permeable dressing ASA tablets (e.g., Aspirin)
(e.g., Jelonet individually wrapped)
Q Luxuries:
e Penlight
• Finger splints
•• Sterile saline solution
Forearm tendonitis splints
7.1 Introduction
As a lifesaver, you may be faced with life-threatening emer Age of victim
gencies that occur in, on, or near the water. For example, a U n less s peciflca l ly
picnicker at a beach might have a heart attack, or someone n oted, the tec h n iques
might fall on the dock at the cottage and injure himself or descri bed in t h i s c h a p
herself. ter a re fo r a d u lts.
Use the fo l l owi n g
When emergencies involve the ABCs - Airway, Breathing, or age g u id e l i n es wh e n
Circulation - you must act fast. If victims don't receive treat se lecti ng tec h n iques:
0 Ad u lt - 8 yea rs
ment, their chances of survival drop quickly as time passes.
a nd older
0 C h i ld - 1 to 8 yea rs
This chapter describes the procedures to follow when dealing 0 I nfa nt - b i rth to 1
with _A BC priorities. It shows how to handle possible com yea r
plications in airway management and choking, discusses when
and how to use rescue breathing, and presents detailed infor
mation on cardiopulmonary resuscitation (CPR) .
Breathing
Breathing is the exchange of air between the lungs and the atmosphere. The air passages consist
of the nose, mouth, pharynx, larynx, trachea, bronchi, and bronchioles. These passages lead to
the true lung tissues, or alveoli, the clusters of air spaces at the end of the bronchioles. In the
alveoli, oxygen and carbon dioxide pass between the atmosphere and the blood. Because of the
microscopic distances involved, this exchange is almost instantaneous.
Nose -
Mouth--> ........
Pharynx-__,k--_
Larynx
Trachea ----#-----\11
Bronchi --+.,.._-1,,__�
Bronchioles ---t--+-+,1----::.,11
The air-containing lungs are elastic. When you breathe in, your lungs inflate - the diaphragm
moves down, the lower ribs swing outward to increase the width of the chest, and the upper
ribs and breastbone move outward to increase the front-to-back diameter. Breathing out happens
passively, as the muscles relax.
About 21 % of room air consists of oxygen. About 16% of exhaled air consists of oxygen. This
difference shows that there is plenty of oxygen in exhaled air for use in rescue breathing to
rescue a non-breathing victim.
Circulation
The circulatory system is a closed "plumbing" system of heart, arteries, capillaries, and veins
through which blood flows continuously. Its purpose is to transport oxygen and other materials
to the cells of the body and to remove wastes, including carbon dioxide.
Lungs
0 The circulatory system conducts blood through a simple circuit powered by two pumps
working simultaneously. The pumps are the right and left ventricles of the heart.
0 Darker venous blood, having given up some of its oxygen to the cells, flows centrally
through veins back to the heart, where it is pumped to the lungs for oxygenation. The blood
returns from the lungs to the heart and is pumped throughout the body through the aorta
and arteries.
0 The blood flow then divides into many pulmonary capillaries, where blood is re-oxygenated
after it releases its carbon dioxide.
0 The aorta and larger arteries stretch with each ventricular beat. When the circulatory system
is functioning properly, all tissues in the body receive a full supply of blood -and with it
oxygen.
Airway Obstruction
Airway obstruction (choking) can occur in conscious or
unconscious victims. If the conscious victim does not receive
prompt treatment, he or she will quickly become unconscious.
Airway obstruction is most often caused by food or other
objects getting stuck in the throat.
making the chest rise. Watch the chest rise and allow
Rescue breathing rate
exhalation between the breaths.
• Pinch the nose, and seal the victim's mouth with your Rescue breathing alone
mouth. With small children and infants, you might have is performed at a rate of
1 breath every 5 seconds
to seal the mouth and nose with your mouth because for adults; 1 breath every
their faces are small. Also, extend their neck gently. 3 seconds for children
and infants.
Rescue Breathing in Water
General Recommendations
.I Ensure your own safety and that of the victim .
.I Call EMS .
.I Start rescue breathing as soon as you and the victim are in a
stable position .
.I When you are doing rescue breathing in the water, only the
head-tilt manoeuvre may be possible .
.I Keep the victim's nose pinched throughout rescue breathing
in the water.
.I Get out of cold water as soon as possible if you started
rescue breathing in water. ---�
��-� 1"
.I Strong currents make it harder to control the victim. So move =-=---= ___ 4P - ·
away from them, or work with currents, not against them.
Rescue Breathing in Shallow Water
.I Find a secure location where
• slips and submersion will not occur
• complications can be treated if they occur
• other rescuers can come to help
• removal is possible.
Rescue Breathing in Deep Water
0 Deep-water rescue breathing is an advanced lifesaving skill
(see page 5-23). It can be very tiring, and you risk injury
when you do it.
0 Consider deep-water rescue breathing only if you have a
reaching assist and can stabilize yourself and the victim. Rescue breathing in
0 Deep-water rescue breathing should generally be avoided shallow water
because it is hard to maintain an airway and nearly im
possible to perform if the victim vomits.
-
neck. Perform rescue breathing using the stoma. Observe the
chest rise to see that air goes in.
--
Mouth-to-stoma rescue breathing
0 mouth-to-mask rescue breathing.
Handkerchiefs and
tissues are not effective
Mouthpieces, face masks, and face shields
barriers and d o not
are barriers that offer protection against
decrease the risk of disease in rescue breathing. Those who
cross-contamination are expected to routinely provide
from bodily fl uids (from first aid are advised to keep
bacteria and viruses, for such a barrier handy in a first Face mask barrier
instance) . aid kit. Follow the manufacturer's
instructions to learn how to use barriers properly.
If a child victim is small, do not let the pads touch each other. If
necessary, place one pad on the centre of the chest and the other on the
back between the shoulder blades.
r--,
prior to the application of the AED pads. Apply the pads
properly as required for adults and children.
M
9 Do not touch the victim while the AED is 1
,' l
a nalyzing for a heart rhythm or during a
SHOCK sequence. After a "shock" or "no-
shock" prompt, perform 2 minutes of CPR
r�
unless the � �
·J ::t' (-
victim shows
signs of life. � - , '/ � ( .· � '/ _ · ,.
\� j � ·- ( , , · ' 1-handed child CPR
�- �
Adult/child landmarking and adult/child CPR
All the pa rts that come into contact with a i r m ust fi rst be clea ned with
brushes in soapy water (d ishwashing liquid is recom mended). The pa rts
a re then left to soa k for 10 minutes in a disinfecting solution made up of
60 m i l l i l itres of household bleach such a s Javex to 4 litres of tap water.
The l u ngs blown into must be disposable and must be discard ed prom ptly
after use.
6. Continue cycles of 30 compressions and 2 ventilations until EMS takes over treatment, the
AED arrives on the scene, or the victim begins to move. If the victim begins to move, reassess
ABCs and treat appropriately.
7 Two-rescuer CPR options may include:
• 2 rescuers take turns doing one-rescuer CPR.
• 1 rescuer does chest compressions while other does rescue breathing; switch roles about
every 5 cycles of 30:2 (about 2 minutes).
8 When the AED arrives on the scene, turn on the power and follow the prompts.
9 Expose the chest and if necessary, shave and dry the skin prior to applying AED pads
properly as required for adults and children.
10 Avoid touching the victim while the AED is analyzing for a heart rhythm or during a shock
sequence. After a "shock" or "no-shock" prompt, perform 2 minutes of CPR unless the victim
shows signs of life.
8.2 Shock
Shock is a depression of the body's circulatory system. Shock
It is your responsibi l ity
as a rescuer to assess
occurs when the body is responding to a stress such as physical
risk in an emergency. If illness or injury or to emotional or psychological distress. f,xpect
you a re in doubt, cal l shock in anyone requiring rescue or first aid.
the Emergency Medica l
System (E MS), a nd get Shock can be mild, with few signs and symptoms, or very
directions from them . serious, with life-threatening signs and symptoms. The extent
But remem ber- not of shock is usually related to the severity of the stress on the
a l l emergencies require body.
EMS.
Signs and Symptoms
,I Pale, cool, clammy skin
,/ Restlessness, weakness
,I Fear, anxiety
,I Confusion, disorientation
,I Weak, rapid pulse
,I Shallow, rapid respiration
,I Blue-colored lips and fingernails (cyanosis)
Treatment
The way to remember treatment for shock is the word WARTS:
1 Warmth. Maintain body temperature. If the victim is in the
sun, provide shade. If the victim's body is cool, maintain
heat.
2 ABCs:
• Airway- Maintain an open airway
• Breathing - assess the victim's breathing and start CPR if
needed
• Circulation-Monitor responsiveness and breathing. Start
CPR if needed.
3 Rest and assurance. Reassure the victim, and make sure he or
she rests. Pursed-lip breathing (see page 8-4) is a technique
you can use to calm the victim. Talk calmly, positively, and
personally to the victim. Make eye contact when you talk to
him or her, and use a gentle, confident touch. Maintain your
calm - your ability to cope with stress directly affects the
victim, and that's your priority.
4 Treatment. Treat the cause of the stress - the cut, for example,
or the heart attack.
5 Semi-prone (recovery) position. This is the position
of choice for victims. But if the illness or
injury indicates that another position would
be better, the victim should get into that
position. For example, a semi-sitting position
is recommended with heart attacks, and spinal
victims should be on their back with their head
immobilized.
Asthma
Asthma is a breathing disorder in which the airway' s sensitivity
is increased. This sensitivity results in spasms of the muscles
of the airway (and therefore a narrowing of the airway) and
increased production of mucus (and therefore a blockage of the
airway) .
Pu rsed - Li p B reath i ng People with asthma are likely to have specific "triggers" to
Asthmatics have the condition. Common triggers include allergies, emotional
trouble getting air out.
distress, and extreme temperatures.
P ursed-lip breathing
occurs when the lips are
in a "pucker" position
Signs and Symptoms
and the victim actively .I Difficulty breathing
blows the air out in a .I Anxiety
slow, steady stream. .I Wheezing
You and the victim can
do this together. I nhale Treatment
through the nose, ex 1 Assist the victim to a comfortable position. This often
hale through the pursed involves sitting and leaning forward slightly or standing and
lips, and focus on get leaning forward with the arms resting on some object.
ting air out. 2 Help the victim take any medication he or she has.
3 Loosen tight-fitting clothing around the neck or chest.
4 Assist or encourage the victim in pursed-lip breathing.
5 Treat for shock.
6 If the asthma attack continues or is severe, arrange for
transportation to hospital by contacting EMS .
Hyperventilation
Hyperventilation, sometimes called overbreathing, occurs when
breathing is faster or deeper than necessary. Hyperventilation
decreases the level of carbon dioxide in the blood, causing the
body to depress the breathing centre in the brain. This can
result in loss of consciousness.
Treatment
1 Assess responsiveness, maintain an open airway and assess
the victim's breathing. Start CPR if needed.
2 Assist or encourage pursed-lip breathing.
3 Treat for shock.
4 Arrange for transportation to hospital if breathing problems
are severe or ongoing or there is a decreased level of con
sciousness.
Respiratory Distress
Several unrelated medical conditions can cause respiratory
distress. Conditions causing this distress include emphysema
and chronic bronchitis (chronic obstructive lung diseases),
pneumothorax (abnormal pressure in the lungs), and collapsed
lungs.
--------
� The Canadian Lifesaving Manual 8-5
Chapter 8
Treatment
Treatment is as for hyperventilation, above:
1 Assess responsiveness, maintain an open airway and assess
the victim's breathing. Start CPR if needed.
2 Assist or encourage pursed-lip breathing.
3 Treat for shock.
4 Arrange for transportation to hospital if breathing problems are
severe or ongoing or there is a decreased level of consciousness.
Treatment
1 Assess responsiveness, maintain an open airway and assess
the victim's breathing. Start CPR if needed.
2 Contact EMS.
3 Assist the victim into a comfortable position. This is often a
semi-sitting position.
4 Help the victim take his or her angina medication as per the
physician's directions. Encourage the victim to chew 1 adult or
2 low dose ASA (e.g., Aspirin), unless the victim is allergic to
ASA or has been advised by a doctor not to take ASA tablets.
5 Loosen tight clothing around the neck and chest.
6 Treat for shock.
Semi-sitting position
7 Give oxygen if you are trained to do so and it is both
medically necessary and available.
Heart Attack
Heart attack, sometimes called myocardial infarction, is a
medical condition where the circulation of blood to the heart
is severely affected. The severity of the heart attack and the
damage to the heart muscle depend on the duration of the
interruption in blood flow to the heart and the extent of the
muscle affected.
Treatment
1 Assess responsiveness, maintain an open airway and assess the
victim' s breathing. Start CPR if needed.
2 Contact EMS.
3 Assist the victim into a comfortable position. This is often a semi
sitting position.
4 Help the victim take his or her angina medication as per the
physician's directions. Encourage the victim to chew 1 adult or 2
low dose ASA (e.g., Aspirin), unless the victim is allergic to ASA
or has been advised by a doctor not to take ASA tablets.
5 Loosen tight clothing around the neck and chest.
6 Treat for shock.
7 Give oxygen if you are trained to do so and it is both medically
necessary and available.
Cardiac Arrest
"Cardiac arrest'' means the heart has stopped beating. The evidence is
absent or abnormal breathing (gasping) and other signs of circulation
such as skin colour or a pulse. Blood stops carrying oxygen to the
brain, heart, lungs, and vital organs, and tissue damage begins. Tissue
damage becomes significant after about four minutes.
Treatment
1 Contact EMS.
2 Initiate CPR immediately (see pages 7-1 3 to 7-1 5) .
3 Treat for shock.
4 Give oxygen if you are trained to do so and it is both medically
necessary and available.
Stroke
Strokes, also known as cerebrovascular accidents (CVAs), occur when
part of the brain has an insufficient supply of blood. Causes of this
interruption in supply include blockage or bleeding.
The Canadian Lifesaving Manual 8-7
Chapter 8
Deep cuts and wounds may require stitches for tissue to heal.
Cuts and wounds that involve bleeding from larger veins and
arteries are more serious, and EMS must be called promptly.
The more blood the victim loses, the greater the extent of the
shock.
Signs and Symptoms
.I Blood
.I Pain
.I Distress, anxiety
.I Shock
Treatment
Minor wounds
For superficial wounds and abrasions, gently clean affected area
by flushing with clean water (e.g., tap water) over the wound
and apply an antibiotic ointment to promote healing. Apply a
sterile dressing (e.g., adhesive bandage strip). Treatment of bleeding
Severe bleeding
1 One way to remember the treatment of severe bleeding Bandaging Notes
is the 2 Ps:
• Position: have the victim lay down to prevent further
injury should he or she become unresponsive.
• Pressure: apply firm, direct pressure over the wound with
the cleanest material available (a bandage, for example).
Direct pressure is the most important factor in stopping
blood flow. Secure direct pressure with a tied bandage. If
blood starts to seep through the bandaging material, place
a second bandage on top of the first. Do NOT lift the
bandage- it interrupts the clotting of blood and increases Q When securing
bleeding. ba ndages, tie the knot
2 Treat for shock. securely over the wound.
3 Contact EMS if there is a lot of blood loss, if you cannot Q Signs that a ba ndage is
control the bleeding, or if moderate to severe shock becomes t o o tig ht incl ude
a factor. When direct pressure fails to control life-threatening the part beyond the
external limb bleeding, apply a tourniquet. bandage getting cool,
becom ing pale, or
Applying a tourniquet lacking a pulse.
A com mercial tourniquet consists of a wide Velcro band and one-ha nded a When there is a foreig n
cra n k system used to tig hten the ba nd a round the circumference of the object in the wou nd, d o
wou nd. Place the ba nd j u st above the wou nd, turn the cra n k u ntil bleeding N OT rem ove the object.
stops. a nd secure Apply pressu re a round
the c ra n k into the the object to avoid
l ocking position of the pushing it in d eeper. The
tourniquet. If necessa ry, priority is to stop the
i m provise a tourniquet bleeding.
by tig htening a bandage
(e.g ., i n sert a pen or
stick i nto the knot and
twist) u ntil bleeding Appl y and tighten Secure crank rod in
stops. tourniquet locked position
The Canadian Lifesaving Manual 8-9
Chapter 8
Nosebleeds
Nosebleeds can be caused by trauma to the nose, or they can
start spontaneously. Nosebleeds often look serious because of
the amount of blood lost, but they usually respond promptly to
treatment. Nosebleeds that last for more than a few minutes or
recur in a short period of time may require medical attention.
Sign and Symptoms
,/ Blood from the nose
,/ Pain associated with the trauma (being hit, for instance)
,/ Anxiety
,/ Shock
Treatment
1 Pinch the nose where the
soft nostril meets cartilage.
2 Treat for shock.
3 Tilt head slightly forward.
This helps any blood drain
from the nose or mouth
instead of back into the
throat.
4 Contact EMS if the nose
bleed lasts more than a few
minutes, if it recurs, or if
the victim is in moderate to severe shock.
Treatment
1 Immobilize the head and neck in the position found unless
breathing cannot be assessed.
2 Assess responsiveness, maintain an open airway and assess the
victim's breathing. Start CPR if needed.
3 Contact EMS.
4 Treat the area of trauma for bleeding, bruising, or swelling.
5 Treat for shock.
6 Give oxygen if you are trained to do so and it is both medically
necessary and available.
Spinal Injuries
Spinal injuries occur when trauma Spinal lnjurie6
affects the nerves in the spinal column. Here are som e com mon
Spinal injuries of the upper neck are causes of spinal injuries:
often associated with head trauma and Q diving head -fi rst into
head injuries. shallow water and
hitting the bottom
Most of the injury to the spinal cord 0 being thrown into the
occurs at the time of impact. Never water
theless, caution is essential to minimize Q diving into a sandbar
further damage. Q making aggressive
contact in water polo
Q falls
The part of the body affected depends
Q severe head injuries
on the level of the injury. N eek (or Q car accidents
cervical) spinal injuries can affect the
�==:.��;:===::::;;;:-
Q bicycle accidents.
ability to swallow, breathe, or use the
arms. Chest (or thoracic) spinal injuries
can affect breathing, the chest wall, or
Spinal rollover and
internal organs. Low-back (or lumbar)
immobilization
spinal injuries can affect the bowel, bladder, or legs.
Chest Wounds
Chest wounds include injuries to the chest wall or
ribs. These injuries can include bruising, fractures,
and bleeding wounds. Common causes include falls,
collisions, and blows from blunt objects.
Signs and Symptoms
./ Trauma at the site of the injury (swelling, bruising, or
bleeding)
./ Pain at the site of the injury
./ Difficulty in breathing
./ Cyanosis of the lips and fingernails
./ Shock
Treatment
1 Assess responsiveness, maintain an open airway and assess
the victim's breathing. Start CPR if needed.
2 Apply a non-occlusive dressing - a special type of non
adhering dressing that allows liquids or air to pass through
preventing further complications. If the dressing becomes
blood soaked, change it immediately to avoid complications.
Apply direct pressure if there is massive external bleeding.
3 Contact EMS.
4 Protect and support the injured area.
5 Treat for shock.
6 Give oxygen if you are trained to do so and it is both
medically necessary and available.
Treatment
1 Leave the object in place.
2 Control bleeding, stabilize
the object to prevent further
damage, and bandage the
wound.
3 Contact EMS.
4 Treat for shock.
5 If the embedding is
superficial, remove
the object with a clean
instrument (a needle or
tweezers, for example),
and treat the wound for
bleeding (see Section 8.5) or
other local injury.
Bites
Bites by humans, animals, and insects often require first aid .
I f the victim has an allergy or sensitivity t o the specific type
of bite, anaphylaxis may be an issue (see page 8-3) . For most
bites, treatment of the injury site is the primary issue.
Treatment
(for localized injunJ due to bites)
1 Control bleeding.
2 Seek medical assistance (to have the risk of infection and
immunization needs evaluated) .
3 Treat for shock.
Eye Injuries
Because of the sensitive nature of the eye, you must take
special care when treating injuries to or around the eye. The
injury could be due to a foreign object such as chemicals in
the eye.
Treatment
1 Treat for shock.
2 Do not remove a foreign object manually or take
any action that would embed an object deeper.
3 If a foreign object is floating in the eye, try
flushing the eye with water.
4 If chemicals are the cause of the eye injury, flush
the eye with running water for a long time - 1 5
to 20 minutes.
5 Contact EMS if there is an object in the eye or
vision is affected.
6 If the eye area is wounded, treat the injury (for
instance, a cut).
7 Bandage the injured eye by placing a patch
bandage over it and securing the bandage.
8.7 Burns
Causes of burns include heat, chemicals, and
electricity. Burns are classified in several ways. This
section classifies them in terms of the depth of the skin Chemical Burns
affected: first-degree burns, second-degree bums, and Q Do not touch chem ical prod ucts or
third-degree burns. First-degree burns are the least the container they a re i n .
serious, third-degree burns the most serious. Q Brush dry chemicals careful ly to
avoid a chemical cloud that can be
Burns to small children and infants are considered inha led.
more serious because of the greater risk of shock. Burns Q Since clothes can a bsorb chem ica ls,
to the neck and face require special attention because of they should be removed or fl ushed
the possible effect on breathing function. with water.
Q Remove the victi m's shoes a nd
socks -they ca n act as reservoirs
First-De gree Burns for chemicals.
First-degree burns are those in which damage is a Use larg e volumes of water to fl ush
restricted to the surface of the skin. First-degree burns these burns.
can be quite painful; in cases such as sunburn, these
burns can also be widespread.
Treatment
1 Assess responsiveness, maintain an open airway and assess the
victim's breathing. Start CPR if needed.
2 Flush the burned area with cool, dean water or apply rold (not ice).
3 Repeat the flushing until the victim notes that the heat in the
affected area has subsided.
Second-Degree Burns
Second-degree burns affect the upper layers of skin. These
burns are characterized by blisters, redness, pain, and swelling.
Treatment
1 Assess responsiveness, maintain an open airway and
assess the victim's breathing. Start CPR if needed.
2 Flush the burned area with cool, dean water or apply cold
(not ice).
3 Repeat the flushing until any heat in the affected area
subsides.
4 Apply a dry sterile dressing to the wound.
5 If the hands and feet are affected, separate the fingers
or toes with dressings.
6 Treat for shock.
7 Contact EMS if the area burned is large, the face and
neck are affected, the victim is a small child or infant,
or moderate to severe shock is a factor.
Third-Degree Bums
Third-degree burns (also called "full-thickness burns") affect all
the layers of tissue. Because the burn goes through the skin, the
muscles, nerves and bones in the area may also be affected.
Treatment
1 Assess responsiveness, maintain an open airway and assess the
victim's breathing. Start CPR if needed.
2 Contact EMS.
3 Flush the burned area with cool, clean water or apply cold
(not ice).
4 Repeat the flushing until any heat in the affected area subsides.
5 Apply a dry sterile dressing to the wound.
6 If the hands and feet are affected, separate the fingers or toes
with dressings.
7 Treat for shock.
Electrical 13urns
Separating burned
E lectrica l burns ca n occur in one of two ways: when a
short circuit ca uses a spa rk or when a n el ectrical cur
fingers
rent passes th roug h the body (el ectrification) . Elec
trica l c u rrents can cause death (electrocution). With
these burns,
Q make sure the cu rrent is O F F before touching the
victim or the electrica l source
Q sta nd i n a d ry a rea
Q if the cu rrent ca nnot be turned off, use a l ong, dry,
non-cond ucti ng object (wood or plastic, for ex
a m p l e) to sepa rate the victi m from the current
Q look for wou nds where e lectricity entered a nd exited
the body.
Seizure Disorders
Seizures occur when there is abnormal electrical activity in the
brain. Seizures can be associated with the medical disorder
epilepsy, with high fevers, and with drug intoxication.
Treatment
1 If the victim is in water, get his or her head out of water; after
the seizure, remove the victim from the water.
2 If the victim is on land, clear objects from the surrounding
area to prevent him or her from striking them and getting
injured.
Treatment
1 Assess responsiveness, maintain an open airway and assess
the victim's breathing. Start CPR if needed.
2 Contact EMS.
3 Treat for shock.
Fainting
Fainting is a temporary loss of consciousness. It is associated
with several medical disorders, stress, fatigue, and shock.
Poisoning Treatment
Poisoning can also occur in 1 Assess responsiveness, maintain an open airway and assess
these three ways: the victim's breathing. Start CPR if needed.
0 inhalation. Inhaled 2 Identify and control the cause of the fainting.
poisons include chlorine 3 Treat for shock.
gas, chemical product
powders and vapors,
and car bon monoxide.
Poisoning
See pages 8-5 and This section refers to ingested, or swallowed, poisons. Ingested
8-6, on respiratory poisons include spoiled or contaminated food, medications or
distress; for infor drugs, cleaning agents, and plants.
mation on chlorine gas,
see page 8-21. Rescuers should avoid contact with caustic agents. When
0 contact and absorp assessing whether to induce vomiting, consider the poison.
tion. Contacted and Read the instructions on the original container's label-it will
absorbed poisons provide directions for treatment. Caustic poisons that burn the
include chemicals used passages to the lungs and stomach when swallowed probably
for pool-water main
do the same during vomiting; in such cases, do NOT induce
tenance. Insecticides,
herbicides, fertilizers,
vomiting.
and plants (poison
oak and poison ivy, for Signs and Symptoms
example). Treat this .I Abdominal pain or cramps
form of poisoning as a .I Reduced level of consciousness
burn (see Section 8.7) . .I Cyanosis of the lips and fingernails
0 injection. I njected .I Coughing, difficulty breathing
poisons include stings .I Vomiting
and bites (from insects .I Rash, blisters
or marine life, for .I Changes in behavior, hallucinations, agitation, drowsiness
example), medication,
.I Headache
or non-prescription
drugs. See page
8 -14 for information on
how to treat bites.
Treatment
1 Assess responsiveness, maintain an open airway and assess
the victim's breathing. Start CPR if needed.
2 Contact EMS.
3 Contact the Poison Information Centre for assistance. (Check
the front pages of your telephone book for the local number.)
4 Induce vomiting if the original product label recommends it.
5 Treat for shock.
6 Give oxygen if you are trained to do so and it is both
medically necessary and available.
7 If hazardous material has been spilled, call the fire
department.
8 Whenever possible, put the poison and its container in a
clear plastic bag. Note the name of the poison, and give that
information and the poison container to EMS.
Treatment
1 Remove the victim from the hot environment.
2 Give the victim cool water or a sport drink (e.g., Gatorade) if
available.
3 Stretch the cramp.
4 Advise the victim to eat well to restore the depleted body salt.
5 Treat for shock.
Heat Exhaustion
Heat exhaustion can occur when a person is exposed to high
temperatures for a long time. Water loss occurs through
perspiration and can result in mineral and salt loss.
Heatstroke
Heatstroke is a rare but serious condition in which the body' s
cooling mechanism stops working. The body's core temperature
starts to rise, and the body organs are at risk of tissue damage,
convulsions (tonic-clonic seizures; see page 8-1 8), and cardiac
arrhythmia. Those most likely to suffer heatstroke are young
children and infants, the elderly, and cardiac patients.
Treatment
1 Assess responsiveness, maintain an open airway and assess the
victim' s breathing. Start CPR if needed.
2 Contact EMS.
3 Remove the victim from the hot environment.
4 Remove the outer layer of the victim's clothing.
5 Cool the victim's body core (head, neck, chest, back and groin)
by wrapping him or her in wet sheets or fanning the body. If the
victim is alert, walk him or her into cool water up to the knees.
Ask the victim to sit down so he or she is immersed up to the
shoulders.
6 Treat for shock.
Be Sun Smart
Overexpm:;ure to the sun can be extremely dangerous. I n the short run.
unprotected exposure can cause moderate to severe su n burn. I n the
long run, the skin and eyes can be damaged. The risk of skin cancer and
cataracts i ncreases with exposure.
Reflections from water, sand, and concrete can intensify the effect of
the sun's rays. Even on overcast days, sunscreen is necessary, because
the sun's ultraviolet ( UV) radiation is still present. Eve ryone doing
aquatic activities outdoors should take Sun-Smart precautions:
,I Wear clothing that covers exposed skin.
,I Wear a hat that protects the face and the back of the neck.
,I U se sunscreen with a sun protection fa ctor (SP F) of at least 30.
,/ Apply sunscreen and lip bal m to protect exposed skin. Apply and
reapply sunscreen according to the manufacturer's directions.
,I Wear protective sunglasses.
,/ If ap propriate, wear a wetsuit or other protective clothing to prevent
sunbu rn or wind chill. Chemical Warmer6
,I Monitor UV ratings and forecasts in weather reports. Do not apply chemical
warmers (e.g., pocket
Frostbite warmers) directly on
Frostbite is freezing that occurs in external tissue. The tissue most frostbitten tissue.
at risk is exposed skin (usually the ears and face), fingers, and toes. The high temperatures
produced from chemical
warmers can cause more
Signs and Symptoms
harm, potentially burning
.I Pain
the injured tissue .
.I Altered sensation (burning sensation, pins and needles, numbness)
.I White area on the skin
...
Treatment
1 Remove the victim from the cold environment.
1
2 Reheat the affected area with body heat (for instance, put
;p;,G
'
frostbitten fingers under the armpits, or cup the frostbitten face "---.:::J
-'
or ears in the hands) or immerse the affected body part in warm L
water - ideally 37° to 40 ° Celsius - for 20-30 minutes. "'
Hypothermia
Hypothermia refers to a dropping of the body's core tempera
ture. This medically serious condition can occur with exposure
to cold water or air. Most of Canada's lakes, streams, rivers, and
oceans are cold year-round; hypothermia can therefore happen
So What /Jo You Mean
any time of year. (For more information on hypothermia, see
by Cold Water?
M a ny factors affect how
page 2-6.)
you r body responds to
cold water. Here a re som e
Signs and Symptoms
o f them : .I Shivering, feeling cold
Cl l e ngth of ti m e in the ,/ Loss of muscular co-ordination
water .I Decreased consciousness, confusion, disorientation,
Cl water tem peratu re unconsciousness
Cl a m ou nt of body fat ,/ Fatigue
Cl a m ou nt of the body ,/ Shock
that is submerged
Cl whether c l oth i ng or a Treatment
l ifejacket is worn 1 Assess responsivenss, maintain an open airway and assess
Cl body positio n
Cl a g e .
the victim's breathing. Start CPR if needed.
2 Contact EMS.
Water tem peratures as
3 Remove the victim from the cold environment.
°
wa rm as 20 Celsius are 4 Warm the victim's body core (head, neck, chest, back, and
considered a risk for groin) by giving warm beverages if the victim is alert,
hypotherm i a . wrapping him or her in warm blankets, or getting into the
huddle position.
5 Treat for shock.
6 Give oxygen if you are trained to do so and it is both
medically necessary and available.
Treatment
1 Ice the injured part for 1 0 to 1 5 minutes every hour until the
swelling subsides.
��n
.I Discoloration (bruising)
.I Difficulty moving the affected area
Treatment
1 The way to remember treatment of sprains and strains is the ,,,,- �
: <fl .:.
word RICE: ' I
'
I '
• Rest. Rest the injured part.
''' ''•
I
Closed Fractures
Oosed fractures are breaks in a bone. Undisplaced closed Closed
fractures are like a crack in a teacup - there's a break in the undisplaced ____...,,
surface but not in alignment. Undisplaced fractures can be fracture
distinguished from sprains and strains only on X-rays. Displaced
fractures are fractures in which there' s a break in the surface and
in alignment.
Treatment
1 The way to remember treatment of simple fractures is the
word RICE:
• Rest. Rest the injured part.
Im mobilization • Immobilize. Immobilize the
.I To immobi l ize a hand, injured part in a comfortable
wrist, a rm, elbow, or
position - don 't move it!
shoulder, you can
• Cold. Ice the injured part for
use a n arm sling.
.I To i m m obil ize a wrist, 1 0 -1 5 minutes every hour until
a n kl e, or foot, you the swelling subsides. Icing is
ca n use a pil l ow or the most important component of
towel t o spl int. treatment.
• Elevate. Elevate the injured,
splinted part (it helps control
swelling) but not if it increases
pain, discomfort or harm.
2 Contact EMS.
.I To im mobil ize 3 Treat for shock .
joints, you can 4 Assess the pulse and movement
use air spl ints, beyond the site of the injury. For
wooden spl ints, instance, assess the pulse and
or splints made movement in the ankle if the leg
out of card board is broken.
or rol l ed newspaper.
� Treatment
1 Rest the affected part, and immobilize it as you found it. Do
not attempt realignment.
2 Place a clean bandage over the exposed bone.
3 Ice the injury for 1 0 to 1 5 minutes. Avoid wetting the open
wound.
4 Contact EMS.
5 Treat for shock.
Dislocations
A dislocation is an injury in which the bones at a joint
are displaced from their usual alignment. The joints most
commonly dislocated are shoulders, fingers, and toes.
Treatment
1 Rest the injured part. Immobilize it in a comfortable
position- don 't move it!
2 Ice the injured part for 1 0 to 1 5 minutes every hour.
3 Support the injured part in a position of comfort.
4 Contact EMS.
5 Treat for shock.
Muscle Cramps
Muscle cramps (sometimes called charley horses) are spasms
in the muscle. They can occur because of loss of body salt (see
the information on heat cramps on pages 8-21 and 8-22) or as
a reaction to cold air or water. Not warming up enough before
activity can also lead to muscle cramps .
Treatment
1 Stretch the muscle (slowly lengthen the muscle fibres) .
2 Gently massage along the length of the muscle.
3 Apply mild heat (warm shower or warm, wet cloth).
Squeezes
Squeezes result from the increasing pressure water exerts on
a body as it descends. Water exerts pressure on air spaces in
the body: ears, sinuses, cavities, and lungs. Water also exerts
pressure on equipment such as masks.
Treatment
1 Ascend for a short distance, and try to equalize pressure.
2 With mask squeezes, blow gently through the nose.
3 If the squeeze occurs during a dive, initiate your established
procedures for ending the dive.
4 If the pain persists, contact EMS.
Equalizing pressure
Air Embolism
An air embolism is an air bubble in the bloodstream. Holding
the breath or ascending faster than its bubbles are rising may
lead to this condition. Air bubbles may escape from the lungs,
block small arteries and capillaries, and prevent blood flow to
the heart or brain.
Treatment
1 Assess responsiveness, maintain an open airway and assess
the victim's breathing. Start CPR if needed.
2 Give oxygen if you are trained to do so and it is both medi
cally necessary and available.
3 Treat for shock.
4 Call EMS, advise them that the emergency is related to scuba
diving or skin diving, and make arrangements for transport
to a decompression chamber.
Decompression S ickness
In decompression sickness, also known as "the bends," small
pockets of nitrogen form in the body tissues and blood. This
condition is most likely to occur after a long, deep dive -
deeper than you can do in most pools. Decompression sickness
is also associated with surfacing too fast.
Signs and Symptoms
.I Pain
.I When nitrogen bubbles go to the brain
• blindness, dizziness
• paralysis, convulsions
• unconsciousness
.I When nitrogen bubbles go to the joints, muscles, or bones
• pain
• blocked circulation
.I When nitrogen bubbles go to the spinal cord
• paralysis
• loss of feeling
.I When nitrogen bubbles go to the lungs
• labored breathing
• coughing
• burning chest pain
.I When nitrogen bubbles go to the skin
• itch, rash
Treatment
1 Assess responsiveness, maintain an open airway and assess
the victim's breathing. Start CPR if needed.
2 Call EMS, advise them that the emergency is related to scuba
diving or skin diving, and make arrangements for transport
to a decompression chamber.
3 Treat for shock.
9.1 Introduction
Lifesavers use swimming in self-rescue and the rescue of
others. As a rescuer, you need to apply swimming prin
ciples and adapt stroke technique to your needs . This
chapter presents strokes and skills as lifesavers would use
them. Strokes and skills are both described in terms of
maximum efficiency: how to get the most out of them
with the least amount of energy.
Front Crawl
Front crawl is the most efficient stroke. It keeps the body level
at the surface. It also creates little frontal resistance, because the
kick is shallow and the arms recover above the water. The long
bent-arm pull of front crawl provides continuous propulsion.
Leg Action
.I The flutter kick balances and
stabilizes the rolling swimmer.
For many swimmers, this kick
also levels the body. Those with
proportionally stronger kicks
can maintain good propulsion
throughout the kick.
.I The kick used depends on your
need for stability. It may be a
regular kick (for example, 3
downward beats to 1 arm pull).
Or it may be an irregular or
periodic kick. Choose a flutter
kick that maintains body posi
tion and prevents side-to-side
swaying.
.I Kick the legs rhythmically, up and down, from the hips.
Relax the legs so that the knees are slightly bent. The feet
should be loose and relaxed.
Arm Action
./ One arm pulls underwater while the other recovers above
the surface. Try to alternate the arms continuously. The arms
provide most of the forward movement in front crawl.
Breathing
./ Exhale below the surface through the mouth and
nose. Finish exhaling as the mouth clears the
surface.
./ Roll the head with the body, turning sideways just
enough to allow inhalation. Inhale through the
mouth or mouth and nose.
./ Do not lift the head out of the water to breathe in
or out.
./ Breathing follows a regular pattern. You may
breathe after every 2, 3, 4, or more strokes. Choose
the breathing pattern that is most comfortable for
you. (This pattern will depend on such things as
what the water conditions are and how far you
have to swim.)
Co-ordination
./ Since the recovery takes less time than the drive, one arm
should enter as the other is about halfway through the drive.
Individual variations may occur. These variations will
depend on such factors as your swimming speed and your
swimming background (sprinter or distance swimmer).
./ Timing of the leg action should occur naturally. Tempo varies
with the arm action.
./ Maintain the kick's tempo even when your arms get tired.
While the stroke is almost the same as regular front crawl, there
are the following differences:
./ The head is held up to provide an unrestricted view ahead.
This causes the feet to sink.
./ Use the breathing rhythm that is most comfortable for you.
./ The knees are more bent in the kick, which is more vigorous
than in regular front crawl. These changes compensate for
the feet sinking .
./ The arm stroke includes a downward push while pulling to
help raise the head and keep it above water.
Back Crawl
Like the front crawl, back crawl uses an alternating
arm action with recovery over the water, combined
with a flutter kick.
---=
Leg Action
The flutter kick is more important in back crawl than in front
crawl. In addition to being needed for stability, this kick is
..,.... _____
needed for lift and propulsion. Here are the important features -��
of flutter kick for back crawl:
'1' The knees flex more, but the kick still starts in the hips.
�------
'1' The kick is done in a regular cycle (usually 3 upward beats
to every arm pull). -�
'1' The toes- but no part of the leg- just break the surface. ..;
'1' The ankles are relaxed, and the feet turn slightly inward.
'1' The upward beat of the kick is the driving part of the kick. - . � )-
• ..r
Arm Action
Drive. Drive in the arm action is as follows:
'1' The hand leads the extended arm into the water above and
beside the head. Try to have the little finger enter the water
first.
.I The body rolls toward the extended arm. This pushes the
hand below the surface. As the hand starts to pull, the elbow
bends.
.I The bent elbow points downward to the bottom (not to the
feet). The elbow bend increases to at most 90 ° as the hand
passes the shoulder.
.I The hand pushes down and back in a curved or elongated S
shaped path. The elbow straightens near the end of the push.
Water pressure is felt on the palm and the inner surface of
the arm.
.I The hand finishes with a vigorous push, palm downward.
This starts a body roll away from that arm as the other arm
enters the water.
Breathing
.I Breathing presents few problems, since the face is always
above water.
.I The breathing pattern should be regular.
Co-ordination
.I As one arm finishes the drive, the other arm is ready to start
the next propulsive phase.
Breaststroke
Breaststroke is very useful in lifesaving because
,/ you can approach victims quickly and see
· - - � ;e ;.:szs
-�---
well
,/ it is a survival skill in self-rescue
,/ you can easily adapt it for underwater swim
ming
,/ most swimmers find it a less tiring stroke
than front crawl for long distances.
Leg Action
,/ In the position of full extension, the legs are extended, in
line with the trunk, and just below the surface. The toes are
pointed, the ankles relaxed.
Arm Action
Drive. Drive in the arm action is as follows:
./ The pull starts with the arms pressing downward and
outward in a diagonal motion. The
hands are held at a 45 ° angle with the -
�
palms outward. The body and arms
outline the letter "Y." · C1C.>
./ The hands accelerate toward the centre
line of the body. They are at a 45 ° angle
with the palms inward .
./ The elbows stay high until the hands
finish the inward movement.
./ The hands pull to the shoulder, but not
past it.
Breathing
./ Take a breath on every stroke as the
arms start to move outward .
./ Exhale below the surface.
./ Extend the neck early in the arm stroke.
./ Return the face to the water by the
middle of the arm pull.
Co-ordination
Here's a sequence you can use to co-ordinate
movement in this stroke:
./ Pull.
./ Breathe.
./ Kick.
./ Stretch.
Head-up Breaststroke
The head-up version of breaststroke is used to maintain eye
contact while approaching victims in rescue situations. The
head-up position gives you a clear view and reduces heat loss
in cold water. While slower than head-up front crawl, this
stroke is often less tiring over long distances. While the stroke
is very similar to regular breaststroke, there are some
differences:
./ The head is held high enough to
stay above the water at all times
and to allow the eyes a clear for
ward view .
./ Because of the raised head, the legs
are slightly deeper.
./ The arm motion is modified to
include pulling down to help raise the head and keep it
above water.
Lifesaving Kicks
Lifesavers use various kicks to tow or carry victims to safety.
You can also use these kicks to support yourself vertically, or
you can modify them for use in underwater swims. Because of
their uses in rescues, you need to practise these kicks without
using your arms. These are the kicks:
0 eggbeater kick
0 whip kick
0 scissor kick
0 inverted scissor kick.
Eggbeater Kick
Eggbeater kick provides steady and powerful
propulsion, and it is the most useful lifesaving
kick for vertical support. Because it provides
smooth propulsion, eggbeater is also the most
useful kick for transporting victims with spinal
injuries. It may be used with a variety of carries
(see pages 4-20 to 4-24). In demanding water
conditions, lifesavers often find they get "bounced
around" with eggbeater, making kicks such as
whip kick or scissor kick more useful in such
situations.
Whip Kick
The whip kick is a powerful lifesaving kick. Because it provides
a stop-start type of forward propulsion, it is less useful than
eggbeater for vertical support or for transporting victims with
spinal injuries. Whip kick may also be used with a variety of
carries (see pages 4-20 to 4-24). It is especially effective with
large or heavy victims and in adverse water conditions.
Body and Head Position. Start on the back with the hips at or
just below the surface. Let the water support the head in line
with the body.
Scissor Kick
Lifesavers who have trouble with eggbeater or whip kick do
have alternatives. Scissor kick may be preferable for lifesavers
with knee problems. Its forward movement is not continuous,
and it can create a lot of frontal resistance in the recovery phase.
It is therefore not as useful for vertical support or transporting
victims with spinal injuries. Rescuers using the scissor kick
during carries must make a conscious effort to avoid or
minimize kicking victims.
3 ,/ Start the kick by bending at the hips and knees with the legs
-�
�3 �- and feet together.
, ,/ Recover the legs together, and keep them in front of the
-=
trunk to reduce resistance. Some leg separation may be
necessary to avoid kicking victims.
,/ Extend the top leg forward with the ankle flexed (toes drawn
up toward the shin) until the legs are straight.
,/ Extend the bottom leg backward with the toes pointed.
Technique is as follows :
Body and Head Position.
,/ The trunk is stretched out on its back. The hips are turned so
�-====-3
�-- =� that the legs are on their side. The body is in a streamlined
position, as horizontal as possible.
,/ The back of the head is cradled by the water in a position of
maximum buoyancy.
��:-._,--=---.,Jg
• �
o •
its _.,,,,,-,�
--'
Surface Dives
When practising surface Surface dives enable rescuers to move quickly and efficiently
dives. you need to from the surface to the desired depth underwater. To start an
understa nd the dangers underwater swim for a search, victim recovery, or rescue
of hyperventilation. See approach, you need to be able to do surface dives.
page 17 of this chapter.
Foot-first Surface Dive
When you do not know the water or the area might have
underwater hazards, you should do a foot-first surface dive:
.I From a swimming position, raise the head and tuck the
knees toward the chest to stop forward motion and to rotate
into an upright position.
When you use this dive .I Press the arms vigorously downward to the thigh. At the
as a defence, do NOf same time, give a vigorous whip or scissor kick with the
ra ise the trunk out of
legs. These actions raise the trunk out of the water, which
the water before sub
merg i ng . A victim could eases the descent phase.
easily g ra b you. .I At the highest point in the ascent, take a breath. The body is
streamlined, the arms at the sides, the legs straight and
together, and the feet pointed to the bottom .
.I You sink. When the head is below the surface, rotate the
hands so that the palms are turned out and up .
.I With the elbows bent, push vigorously up. Keep the legs
extended in a streamlined position. These actions aid the
descent.
� -�
One way is to tuck the knees toward the chest
and extend the arms and head forward. Another
way is to arch the back during the descent and �
bend the legs at the knees. This produces a
levelling action at the desired depth, with the =
action depending on the amount of arch and knee
bend.
-���
Head-first Surface Dive
You can do head-first surface dives using a pike or a lii
tuck position. Most surface dives are preceded by head-up
·-v_�__,.,;- ��
sw1mmmg.
-----
makes the body descend rapidly.
De5cent
0 You r ears may h u rt whi l e descend ing. You can rel ieve the pai n by
closing you r mouth, holding your nose. a nd gently blowi ng.
0 If you r ea rs sti l l h u rt, return to th e surface, a nd do not keep d iving .
A5cent
0 Ascend sl owly. Fol l ow your bubbles to the surface.
0 DON'T HOLD YOU R BREATH ! Exhal e slowly whi l e ascend ing.
0 Rotate through 360 ° when sea rc h i ng i n unknown water - it helps
you see haza rds more effectively.
0 Extend an a rm above your head, a nd l ook up!
Ann Action
Drive. Drive in the arm action is as follows:
.I Flex the wrists and elbows as the arms are pulled backward
and upward. When the arms pass a 90 ° angle to the trunk,
draw the elbows in to the sides.
Leg Action
,/ Use a whip, scissor, or flutter kick.
Co-ordination
,/ If using a whip or scissor kick, hold the body �--
streamlined following the arm pull.
,I Recover the legs as the arms recover. �- -� .
c__..._ • • • .,_ •
,/ Drive with the legs as you bring the arms to full
extension.
,/ Drive with the arms right after finishing the kick. While the
arm pull is occurring, do a vigorous dolphin kick.
,I A pause or glide can be very effective if you have a powerful
whip kick.
Hyperventi lation does not increase the OxYgen l evel i n the body m u ch, a nd so it does not provide a ny
adva nta g e to the swi m m e r. It does, however, g reatly decrease the l evel of ca rbon dioxide i n the body.
Th is is dang erous, because the carbon-d ioxide l evel ca uses the bra i n to sig n a l the body to breathe.
Whe n overbreath i ng is fol l owed by exercise, oxyg en is used u p, a n d the ca rbon-dioxide l evel is slow to
rise. The oxyg en l evel may d rop so fa r that the swi m m er l oses consciousness before fee l i ng the need to
ta ke a b reath .
The swi m m er's l oss of consc iou sness may be hard to d etect, as he or she may swi m for a few seconds
afterwa rd . Or the swi m m e r may s u rface when cl ose to l os i ng consciou sness - but lack the stre ngth to
l ift the head to b reathe.
10.1 Introduction
Thousands of articles and books have been written about
physical fitness. Researchers have found that fitness reduces the
risk of many diseases, helps people feel better and work more
effectively, and increases people's overall sense of well-being.
Body Composition
Body composition refers to how your body is made up: for
example, the amount of fat compared with the amount of
muscle in your body or your height relative to your weight.
There are three basic body types:
0 ectomorphs- bodies with light frames, low percentage of
body fat, and long, thin, muscles
0 mesomorphs - bodies with medium frames, medium
percentage of body fat, and well-developed muscles
0 endomorphs - bodies with heavy frames, higher percentage
of body fat, and a higher capacity for good muscular
development.
Flexibility
FlexibilihJ refers to your ability to move easily
within your normal range of motion. If you
have good flexibility, you can- if
necessary- move to the very end of this
range of motion without pain or injury.
Muscular Endurance
Muscular endurance refers to your muscles' ability to keep
producing force for a moderate amount of time.
Aerobic Fitness
Aerobic fitness refers to your body's ability to perform tasks for
an extended period of time. This kind of fitness is also called
cardiorespiraton; fitness or cardiovascular fitness. Aerobic fitness is
often described as the most important component of fitness.
The greater your aerobic fitness, the longer you can work at a
given level of intensity.
The chart on pages 10-8 and 10-9 shows how to do this for all
five components of fitness. Here are some tips on using this
chart:
,/ First, evaluate where you are on each component. If you feel
you need to take specific tests, consult a certified fitness
appraiser (see page 1 0-9). ---------------------..
Choo6e Activitie6 and Location6 You Enjoy
./ Before you start any new activity, ask
,I Do land or water a ctivities - or both!!
Yourself if there's any health reason
,/ If you l i ke to exercise alone, consider swi m m ing,
for you not to do it. If you have any wa l king, cycl i ng, or run n i ng . Or do exercises a"t
d oubts at all, you may want to con- home. perhaps with exercise videos. You m ig ht even
suit your doctor. do weig ht tra i n i ng at home .
./ Next, decide how to develop and ,/ If you l ike exercising with oth ers, fi nd c lasses, c l u bs,
maintain each component. When or teams that i nterest you .
you're making this decision, choose ,/ If you prefer team activity, how a bout tennis,
activities and locations you enjoy basketbal l , vol l eybal l , or water pol o?
- it'll keep you motivated. ./ Remem ber that there a re as m a ny ways to d evelop
,/ Start from where you are now. For fitness as there a re people. The possibil ities a re
example, use your current level of end l ess - just use your creativity!
participation as a base. This is much
better for your health than suddenly and dramatically
increasing your activity level. But it'll also motivate you,
because setting unrealistic goals can discourage you if you
don't reach them.
,/ Exercise at a moderate level of intensity. Make sure you can
pass the "talk test" - talk at your normal volume and pace,
without gasping - while you exercise. If you can't do this,
you could be working your heart and lungs too much.
--=-=-1!��--�-=!�!'!.""-
,/ Increase your activity gradually - it reduces the risk of
injury, and it'll keep you motivated. 0
./ Watch out for signs you're doing too much. Feeling fatigue
' •
in your muscles is normal. But some muscle aches indicate
overtraining or potential injury . Any sharp pain in your
muscles or joints is a sign the activity isn't appropriate.
"'
Choose activities you enjoy
A Word of Caution
I Lowe�Limit Up�Limit Age-Pndlcted �- Hurt Rate
I
The heart rates presented in the training-zone chart are guidelines. There are no absolutes in this
area, and many factors go into determining your training zone:
0 There is great individual variation in resting and exercise heart rates. Two equally fit people
can have different resting and exercise heart rates. By knowing and keeping track of your
heart rate, you can apply the chart to yourself.
0 Many factors can raise or lower your heart rate. For example, being tired or sick can affect it.
So can gaining weight or exercising in difficult weather conditions (heat and humidity, for
instance). Be sure to take this into account when you use the chart.
0 The chart refers to exercise on land. There is evidence that exercising in the water results in a
lower heart rate than exercising at the same intensity on land. Some research suggests this
difference in heart rates is about 10%. While this research is still inconclusive, you need to
account for the existence of this difference when using the chart for aquatic exercise.
•
volume and intensity of • do shoulder and gluteal
the muscle's resistance. stretches before removals
,I After working on your do back and leg stretches before
•
flexibility for a few dives, surface dives, or front-
weeks, see if you can roll entries
stretch farther. If you do arm and leg stretches before
can, your flexibility has endurance swims.
improved.
/' "I
How to Develop and Maintain Physical Fitness (cont'd)
How to Evaluate How to Develop and Maintain
Component This Component This Component
Muscular Endurance .,/ Do as many repetitions .,/ Do 5 to 10 repetitions at mild to
[the ability to keep of an activity as you moderate intensity. Rest enough
producing force for a can in 1 to 2 minutes. between repetitions that you can
moderate amount of .,/ Push-ups, chin-ups, do the activity again at the original
time] and sit-ups can all be level of resistance. For instance,
used to test muscular • tread water for 1 minute 5 to 10
endurance, as can the times
number of pool-side • swim 5 lengths of the pool 5
pull-ups you can do in times
1 minute. • do 5 to 10 removals
• do 5 to 10 pull-ups from the
side of the pool.
Note: Intensity is specific to the
individual, and it is affected by your
age, size, and skill level.
Aerobic Fitness .,/ Take the Canadian .,/ To improve your aerobic fitness,
[the ability to perform Standardized Test of you need to do 15 to 20 minutes of
tasks for an extended Fitness (see page 10-11) exercise three times a week with
period of time] from a certified fitness your heart rate in its training zone
appraiser2 or other (see page 10-7).
fitness tests as recom- ./ Swimming, cycling, walking,
mended by your local running, and dancing are all
recreation centre. aerobic activities.
.,/ Step tests and treadmill
tests should be con-
ducted and admin-
istered by certified
'-..
fitness appraisers. �
Notes:
1. For the long sitting test (see page 10-10), measure the number of centimetres between
the fingers and foot placement. A negative score is obtained if the fingertips do not
reach the foot placement, and a positive score is obtained if the fingertips reach beyond
the feet.
2. If you feel you need to take specific tests for any component, consult a certified fitness
appraiser. Local pools, recreation centres, YMCA-YWCAs, and many fitness centres
have such appraisers on staff.
Stretching Exercises
Stretching
quadriceps
Stretching
pectorals
:::::-:::r-]-
Stretching
gluteals
r �
After a Critical Incident: Some Do's and Don'ts
Do Don 't
,/ Expect the incident to bother )( Deny your reactions, for
you example, by drinking or
,/ Follow a good diet taking drugs
,/ Exercise )( Withdraw from family,
,/ Take time for leisure activi friends, and co-workers
ties )( Automatically avoid work
,/ Remind yourself that your )( Use off-duty time for training
reactions are normal immediately after the
,/ Learn as much as you can incident
about critical incident stress )( Look for easy answers to
syndrome explain why the incident
,/ Spend time with family, happened
friends, and co-workers )( Think you're crazy
,/ Find someone you're com )( Have unrealistic expectations
fortable with, and share for recovery
your feelings about the
incident with him or her
,/ Realize that it can take
months or years to deal with
all aspects of an incident
'-,/ Get extra help if necessary
A -2 Lifesaving Society �
Appendix B
The Society's Policy Guidelines
on Rescue Breathing Practice
The Society does not require direct contact with another person
in rescue breathing to achieve a Society award. Instructors and
Examiners should respect candidates' preference to
demonstrate rescue breathing with a partner of their choice
(with or without direct contact) or manikin or suitable device.
Introduction
To develop efficient strokes, you need to apply certain swim
ming principles. These principles are about what happens in
water:
0 flotation - what makes you float or sink
0 propulsion- what makes you move
0 resistance - what holds you back
0 levers- what helps you move loads.
Flotation Principles
The principle of flotation is about what makes you float or sink
in water. Flotation is affected by
0 water pressure
0 water displacement
0 density
0 specific gravity
0 body type
0 balance.
Water Pressure
Water exerts pressure equally in all directions on Try Thie;/ Water Pree;e;ure
anything submerged in it. This pressure increases To Bee how water exertB preBBu re that
with the depth of the water. While the water's increaBeB with depth,
pressure is equal on the sides of the body, water Q ta ke a n i nflated ba l l oo n to the
pressure under the body is greater than that above it, bottom of a pool or lake. What
because the bottom of the body is deeper. The result ha ppenB to it'?
is an upward force, called buoyancy or buoyant force. Cl try it aga in, but Burface Bl owly thiB
The larger a body is, the greater its buoyant force. ti m e . What h a ppenB to the ba l loon aB
"Effective" buoyancy occurs whenever the weight of you get c l oBer to th e Burface'?
a body in water is less than the weight of the water
it displaces.
Specific Gravity
Buoyancy is often measured in terms of specific gravity. The
specific gravity of a body is its weight divided by the weight of
the water it displaces when completely submerged:
Body Type
The human body contains muscle, bone, and fat. The specific
gravity of muscle and bone is greater than 1. The specific
gravity of fat is less than 1 . This is how body type affects whether
you float:
0 People with a high percentage of body fat (endomorphs)
usually have a specific gravity less than 1. So they tend to
float.
0 People with a low percentage of body fat and light bone
density (ectomorphs) usually have a specific gravity less than
1 . They tend to float.
Balance
People keep their balance on land by Try Thi5/ Balance
maintaining support under their centre T ry fl oati ng in d ifferent positions without moving:
of gravity. This is the point in the body 0 T ry to float on you r ba ck with you r a rm s at you r
around which its mass is evenly sides. Ca n you h o l d you r position without sinki ng'?
balanced. When the body isn't sup 0 T ry floati ng on you r back with you r a rms extended
ported at this point, the body moves i n the water a bove your head . )s it ea sier o r
ha rder'?
until the centre of gravity is as low as
0 Try fl oating vertical ly, with o n ly you r face out of the
possible. For example, if you lean over
water. Does you r body stay sta bl e, or do you " l ose
too far, you'll fall to the ground! you r ba l ance"'?
0 What other positions can you fl oat in without
Swimmers must also keep their balance m ovi ng'?
in water. They can do this by keeping
their centre of gravity directly below
their centre of buoyanetJ (which is near
the lungs).
Propulsion Principles
The force that pushes you through the water is called propulsion.
Propulsion is affected by several aspects of motion:
0 inertia
0 acceleration
0 action and reaction.
Inertia
Try Thiel Inertia
The principle of inertia says that
0 Swi m a poo l - l ength of breaststroke. How m a ny
0 bodies at rest tend to stay at rest until strokes did it ta ke'?
acted upon by an outside force 0 Swi m the same d i stance aga i n, but let you r body
0 bodies in motion tend to stay in come to a complete stop between strokes. Did it
motion until acted upon by an ta ke more or fewer strokes to cover the same
outside force. d istance'?
Acceleration
Acceleration is an increase in speed. The principle of acceleration
says that when a force is applied to a body, the body's accele
ration
0 increases as the force does
0 is less for heavier bodies.
Resistance Principles
The force that holds you back in the water
is called resistance. This is caused by
water's density. While you can use Try This! Resistance
resistance positively to move forward Get a fl utterboa rd or PFD, a nd swi m some lengths of
(action and reaction), negative resistance fl utter kick or whip kick with it i n d ifferent positions:
can force you to work harder. Cl Hold the fl utterboard or P F D l i ke a portrait,
perpend icular to the water. with a bout 20
centi m etres of it submerg ed .
The main types of resistance are Cl H o l d the fl utterboard o r P F D l i ke a la ndsca pe.
0 frontal resistance again perpendicular to the water, with a bout 20
0 eddy resistance. centi m etres submerg ed .
Eddy Resistance
As a body moves through water, water flows around the body.
The result is eddy resistance, or drag. Eddy resistance increases
when you fishtail- move too much from side to side- rather
than travel in a straight line. Streamlining the body reduces the
effect of eddy drag.
�--
Ii) •
Good streamlining
Poor
streamlining ./ use a body position as close to the horizontal as
possible. (Some adjustments will be needed for
whip kick.)
./ don't submerge the head completely. Instead, let
the water support it .
./ travel in a straight line. (Keeping your eyes open
Cradling the head will help you travel in a straight line.) Make
sure you apply force in the right direction
(opposite the line of travel). In addition, travel at
constant speed throughout the distance being
travelled.
Straight-line travel
./ minimize the force of movements that oppose
forward motion. For example, recover the legs
slowly on the whip kick and drive them quickly
and hard.
Minimizing forces
'
C-6 Lifesaving Society �
Swimm ing Principles
Bent-arm pull
snorkels 5-8 rescue strokes 9-2 to 9-9 victim priority 5-1 1, 6-3
snowmobiling on ice 1 -5, 2-6 rescuer's abilities 9-1 victims
spas self-rescue 3-4 to 3-5, 3-6 choking 7-6 to 7-7
dangers 2-6 to 2-7 skills 3-1 drowning
self-rescue from 3-9 underwater 9-16 to 9-1 7 airway management 7-3
spinal boards 5-19 to 5-21 swimming ability, and drown4lg approaching 4--9
spinal injuries 1 -3 getting their consent 4-4
signs 6-4, 7-3, 8-12 swimming pools multiple 5-11 to 5-12
treatment 5-1 8 to 5-19, 8-12 to safety tips 2-5 panicking 5-2
8--13 searches in 5-6 reassessing 4--9 to 4--10
spinal injury victims symptoms, defined 6-5 recognizing 4-3 to 4-4
ABCs 5-1 8 to 5-19 removing from water 4--24
approaching 5-14 T to 4--28
in deep water 5-1 7 unconscious 4-4
talk rescue
removals 5-22 with disabilities 5-14
defined 4--5
reporting to EMS 5-1 3 injured, see also first aid 4-4,
when and how 4-6
rollover and immobilization 4--16, 4--20, 5-13 to 5-23
talking
5-14 to 5-1 7 changes in condition 6-3
to drowning victim 4-19, 4--20
shock 5-22 recognizing 6-2
to injured victim 6-4
stabilization 5-19 to 5-21 unconscious 6-3, 7-9
telephones, in emergencies 3-3
spittle, rescuer safety 6-6 vomit, rescuer safety 6-6
temperature
sprains, signs and treatment 8--25 vomiting, during or after rescue
as hazard 4--1 1
squeezes 7-9
of victim's skin 6-5
w
preventing 5-10 throw bags, as assists 4-12
signs and treatment 8--28 throw rescue
stabilization, spinal injury victims defined 4--5 wade rescue
5-19 to 5-21 when and how 4-6 defined 4--5
stings, signs and treatment 8--14 tonic-clonic seizures 8-1 8 to 8--1 9 when and how 4-7
strains, signs and treatment 8-25 torpedo buoys, as assists 4-12 wading, to enter rescue area 4--15
streams, safety tips 2-5 tow rescue walk out removal 4--26
strength, of lifesavers 1 0-4, 10-8 to defined 4--5 warm water
1 0-9 when and how 4-9 dangers 2-6 to 2-7
stress, see also Appendix A towels, as assists 4--14 self-rescue from 3-4
rescuer 4-11 towing water
victim 4--11 two or more victims 5-12 cold see cold water
stretching exercises 10-10 using back crawl 9-6 deep see deep water
stride jump, skin-diving entry using eggbeater kick 9-10 hot see warm water
5-10 when and how 4--20 moving, self-rescue 3-10 to 3-11
stroke, signs and treatment 8-7 to training programs 1-1 shallow see shallow water
8-8
training zone (heart rate) 10..7 warm see warm water
sun safety 8--23 treading water, self-rescue 3-4, 3-6 water hazards
sunburn tree branches, checking for 2-5 checking for 2-4, 2-5
risk factors 8--23
u
types 4--11
signs and treatment 8--15 fo 8--16 water intoxication
supervision
underarm carry 4--21 signs 8--1 9
by lifeguards 2-4
underarm lift 4--24 to 4--25 treatment 8-20
of children 2-4
undertows water safety
surface dives importance 2-1
foot-first 9-14 to 9-15 defined 3-10
self-rescue from 3-10 public education 1-6 to 1 -7
head-first 9-15 to 9-16 tips 2-2
safety 9-16 underwater swimming, how to do
9-16 to 9-1 7 water scooters, for rescue 4--8
swim rescue Water Smart see water safety
defined 4--5 undisplaced fractures 8--25
water toys, safety tips 2-5
when and how 4-8 waterfronts, safety tips 2-5
swimmers, distressed 4--3 to 4-4 V waterparks, safety tips 2-5
swimming, see also Appendix C vehicle, under ice 3-9 weeds, checking for 2-5
buddy system 1-4, 2-2, 2-4 vertical float 3-7 whip kicks, how to do 9-10 to 9-1 1
learning how 2-2 vertical tilt 5-7 wind, self-rescue 3-6
references 9-1 8 vice grip rollover and wrist carry 4-21
rescue skills 9-9 to 9-1 7 immobilization technique 5-1 6