This post is a response to the recent posting by rainbowofblood(link to follow) in the Lifeguarding community.
http://community.livejournal.com/l…Apparently my response was too long... (sorry)
I am a veteran Ellis pool & waterpark lifeguard, Aquatic Rescue Professional, as well as YMCA, and all four (Canadian division) of the Royal Lifesaving Society National Lifeguard Service Awards.
I spent years working in the states, and on resorts and cruise lines owned in the states where we were required to be certified in the US system. In the years that I worked there and of the hundred or so guards I worked with I can recall only two who were Americans trained only in the US systems, and they didn't last long.
We were all certified on paper as Ellis, but when the shit hit the fan we were using LS (That is "Lifesaving Society", or "Royal Life Saving Society") training. Bottom line: The American Lifeguard training systems stink, The guards tend to be trained in a minimum amount of time, and focused on one narrow set of techniques. So when things get dicey, or don't fit into that neat (and small) box of techniques they tend to freeze up, and then people tend to die. This has led so-called "experts" in CPR and aquatic rescue to conclude that the standards were too hard, and that they should be made easier.
This is a sad state.
The standards should not be made easier. You as a guard should be trained to perform at the level of a professional, and not disrespected for what you do by being treated like a moron with a lot of standards that are supposed to be simpler, often at the expense of your patient.
The people in charge are too involved with liability, and saving money on training and salary costs. (After all if you can get trained in a weekend then you are cheap, easily replaceable, and they can pay you less.) This is a sad state because Lifeguarding is a noble profession too often kicked around by people who have no clue what it is really about... including the so called "experts" I was speaking of in a previous paragraph.
Here is an example of a decent training schedule, take a look:
www.city.vancouver.bc.ca/parks/rec/lifeguard/lifeguardschoolsched.pdf
If you want to learn to be a crack guard, ready to handle whatever is thrown at you, go take a LS course, or a training camp. (The HR people at Disney know this because their first priority for hiring guards is from Canada, the UK, and Australia.)
The only redeeming aspect of the US systems, that I believe is lacking in others is the Audits. Yes, we all hate them, and I mean HATE!!! (nobody likes to be wet, or feel tricked.) However, I have worked with guards under the LS system who may be well trained but they don't do there jobs because they are lazy or complacent or both. I knew some pretty poorly trained guards down in the states and the Bahamas under Ellis, but you can bet they are paying attention, and at the end of the day if you weren't paying attention... why the hell did you come to work anyway?! So kudos to you guys there.
Now on to the standards.
This is dumb... most of the standard changes are designed to make it simpler, and not out of any really good medical or scientific reason, they just assume you are dumb, and as a lifesaving instructor I have found some of these "dumbing down" methods to actually complicate matters for my students.
1)..back blows (Assuming your patient is standing and unsupported, as most choking victims end up before they crash to the ground like a ton of bricks.) are just plain retarded and I think we can all see why.
2) do what works for YOU and your team doing deep water spinals, if you don't like the tubes, FUCK EM! guard tubes are a tool nothing more, don't be focused on the "correct" way to use the tool, it's for your safety, and if it is in your way, or not working, get rid of it and use another tool.
3) Tying legs together does provide some stabilization, and it is simpler than splinting with real splints... but realistically you will not be transporting your victim anywhere anyway, the ambulance guys do that so it is a waste of your time as they are going to cut your ties off as soon as they arrive. Don't get focused on splinting and neglect the lifesaving priorities. (ABC's)
4)The chest compressions instead of J-thrusts on an obstructed unconscious patient was due to the assertion that you as a rescuer are not smart enough to keep the difference between obstructed airway procedure and CPR straight in your mind. This is the most insulting thing in the new standards. (I find teaching this way has made my trainees way WAY MORE confused, and not less. They don't remeber to sweep when an obstruction is cleared, they do hook and look during CPR, or not at all during obstruction scenarios... I think this one is going to bite someone in the ass when they kill someone forgetting to clear the obstruction, or crack three ribs when a J-thrust would have sufficed.) Good luck with that one.
5) The 30 compressions are the only real scientifically backed change in the standards. Research showed that 15 was about the number of compressions to get all of the blood in the body oxygenated. When the attandent stopped compressions to give breaths, the body cells immediately drained all of the o2 from the blood, and overloaded it with waste products, co2, and lactic acid, both maintaining a state of near cyanosis in the body and raising the blood Ph levels dangerously high. This rise in Co2 and acidity was increasing brain damage in patients that survived. So, in doubling the compressions they found the Co2 and Ph levels in the blood were more normal, and the o2 level was almost unchanged, therefore brain damage goes down, survival goes up, thus the rationale for the change.
Good Change I think.
aggravated