Lifesaving

(As described by the Commonwealth and Royal Lifesaving Society)

Lifesaving is both a sport and a service, and will be integrated into the next Commonwealth games. The Royal Lifesaving Society has a simple programme through which students and adults may obtain qualifications and training in lifesaving. Basic Rescue is a programme set up for 13-14 year olds which teaches how to recognise situations, assess situations and help a little.
Bronze Star adds onto the knowledge gained in Basic Rescue and includes basic rescue techniques, but emphasises getting help, rather than helping.
Bronze Medallion is the beginning of rescue training. Towing of victims, EAR (expired air resucitation) and aftercare are introduced. The Bronze Medallion student (aged 15+) must be able to competently assess a situation given by an examiner and safely stabilise a spinal victim and rescue in-water victims. A pass in a theory test on respiration, lifesaving techniques and the heart is also required, along with a basic first aid pass.
Bronze Cross builds on previous knowledge and introduces very little new theory.
Award of Merit is a large step up. It involves not only rescuing any person given in an examination, but teaching first aid, EAR, CPR, search patterns and rescue of a spinal victim to untrained bystanders.
Distinction involves a lot of training, skills must be polished, students must react quickly and effectively to situations. A thorough knowledge of the entire lifesaving manual is necessary to pass the theory examination.
Diploma is a difficult and highly respected award. The candidate is put in high pressure situations, and must act perfectly, and know the lifesaving manual inside out.
In an examination rescue, the candidates must be able to answer, having rescued their victims, why they acted as they did, with the examiners second-guessing them.

Basic Theory of Lifesaving

This will apply through all awards, but will cover all knowledge up to Bronze Medallion (after that, a lifesaving manual is required)

Types of Victims

A weak swimmer will be on an angle, facing shore, trying to swim.
A non-swimmer will be straight up, facing away from the shore, splashing.
An injured swimmer will hold their injured part, and wave the other (free) hand, and will face the shore.
An unconcious victim will generally be face down in the water, and unmoving.

What is self preservation?

The rescue should not endanger you (the rescuer) in any way. Help if you can, but make sure you do not over-estimate your abilities. Assess your fitness, skills and ability. If you are injured trying to rescue another person, then there could be two drownings instead of one! If you doubt your abilities, or the situation is unsafe, do not enter the water. Remember - your safety comes first.

Six Rescue Methods

(These are in the order that you should use when attempting a rescue, and are ranked from least dangerous for rescuer to most dangerous):
  1. Reach - reach out with a hand, or extend out with an object. Lie on your stomach for maximum stability.
  2. Throw - throw an aid or rope to the victim.
  3. Wade - wade out to near the victim, talking to them. Talk them in, if possible.
  4. Row - row a boat out to victim and pull them in.
  5. Swim - swim out to where the victim is, but stop at least 4m away (a victim on adrenaline can launch 4m). Talk victim into shore.
  6. Tow - having none of the above options, it will be necessary to tow the victim. A non-contact tow (kickboard, T-shirt etc) is preferable to a contact tow (holding onto victim).

Things to think about when you are going to rescue someone

Injuries (spinal?), your skill, water depth, how much help is available to you, what can you tow with, where are you going to exit and enter the water?... can you land a person here?, assistance of others e.g. bystanders, strength of the current, are you clothes too heavy for you to swim properly?, how are you going to rescue the person?, will the rescue put you in danger, and have you properly assessed the situation for dangers?, are there hazards in the water, and how far away is the victim?
Spend 30 seconds thinking about these things if possible. Your safety is the most important thing.

How can a bystander help you with the rescue?

They can go for help (always say "and come back after you’ve done that", so you know that they actually did do it!), help in the rescue and help in the aftercare. Be polite in asking for help from bystanders.

Swiming Out to a Victim

You have decided to swim out to help a victim... what can you take as an aid? Towel, T-Shirt, clothes, anything buoyant... lifejackets, chillybin lids, kick-boards... plastic containers, rope, an oar, stick, inner tubing, a lilo... basically anything that you think will help you when towing in a victim.

What order do you rescue victims?

Get the weak swimmer first, and help them by giving them something buoyant to hold. Next, get the non swimmer, then the injured swimmer. Lastly, get any unconscious swimmers. This system may seem cruel, but it is assessing the situation on the likelihood of survival. You may spend a long time rescuing the unconcious victim at the expense of the other victims, and end up with the rescued victim dying anyway...

When you get close to the victims...

Use the defence position (come in a sitting position with your legs in front of you so that you can use these or your arms to push the victim away if they try to grab you and tow you under), and talk. Reassure the victim as much as possible, and explain what you are going to do. Keep saying helpful and enthusiastic comments to put them at ease, and comfort them.

Aftercare in order:

ABC (airway, breathing, cardio)
First Aid
Treat for shock
Get medical assistance

How to treat...

  • A blue-bottle jellyfish sting - methylated spirits, watch for shock and allergic reaction... get medical help.
  • Sunburn - Lie the victim flat in a cool, shady place, bathe with cold water and give cold water to drink. It also helps to put cold wet cloths on sunburnt areas if possible.
  • Bleeding - Two easy steps... PE. This is pressure (tie a bandage or piece of cloth reasonably tight around the wound) and elevation (put the injured area above the heart, so that not as much blood will be pumped there). If the first bandage is soaked through, add another on top, and keep adding them until bleeding is controlled. Do not remove the original bandage.

Some Possible Causes of Non-Breathing:

(It is important to consider these whilst considering a rescue... if it's an electrocution, do you really want to get in that water?)
Near drowning, heart attack, stroke, electrocution, head injury, drug overdoses.
You know they aren’t breathing if there is no rising in the chest, and you can’t feel any breath coming from them if you hold your cheek over their mouth and nose area.

Resuscitation:

Check the area for danger to you and the victim.
Ask the victim if they’re OK (they could be sleeping!). Shake gently... no response.
Get a passer-by to get help and come back and tell you when they have done that (signal for help).
Put the patient on their back, with their arms at their sides and you are kneeling next to their head. Have the pistol grip (or any grip that ensures their mouth is closed and your fingers are not blocking their airway) on their chin, a hand on their forehead, and tilt the head back (chin up) to open the airway.
Check for breathing. Look, listen, feel.
Do two full breaths (mouth to nose), check pulse, while looking at chest. Make sure you have blocked the patient’s mouth!
Start breathing every five seconds... in between each breath, look, listen, feel, pulse...
Patient is about to vomit? Turn patient away from you onto their side. Check their mouth is clear (don’t let them choke on it!). If not, use two fingers to scrape out anything blocking their airway.
Resume the resuscitation position, and continue mouth to mouth.
They’re breathing? Put them in the recovery position.

Recovery Position:

Taken from victim on their back with you kneeling so you are facing their chest
  1. Cross victim’s far leg over the near one.
  2. Place the near arm under their back.
  3. Grasp hips and shoulders, roll them towards you.
  4. Place upper hand under head, with the head tilted back to open their airway.
  5. Pull other arm behind victim’s back.
There are advantages to this type of resuscitation (EAR), as there is no chance of damaging the internal organs of the victim, and you might help save their life by keeping their body supplied with oxygen until a professional arrives. Take care with their head when rolling them. This position was also used (recently by a child near where I live) to save the life of a person with alcohol poisoning.

Shock and Aftercare

Shock is serious, and comes after or during an accident. This can actually kill someone. You must stop bleeding, and dress burns (if possible). Lay the victim flat, but with their legs raised. Don’t lower the head. Make sure they are not hot or cold. Cover with rug, if needed. Don’t give them anything to eat or drink (yes, this includes water, even if victim is dehydrated... get professional help), as if anaesthetic is needed at a hospital, this will not help. Talk, and reassure all the time, and make sure you handle the victim with care.

Lifesaving is a useful and rewarding study, and I strongly reccommend it. It teaches life skills that can be applied in any situation, and you never know what life will throw at you... may as well be prepared!

mirv adds: I learned that one should always dive if a drowning victim tries to drag you down: If he doesn't see you as a float, he won't try to grab you.
June is when Finns crowd their lakesides for midsummer and corpses wash ashore for days. It's a good time to review amateur life-saving, as taught by professionals to my local Red Cross team. Posmella explains above how the pro version melds dozens of factors into fascinating coreography, but anyone without that skill should focus on a simple idea:

Doing this unthinkingly will get you killed.

An online stranger's recollections will hardly cause thinking, but may show you what you're in for.

Anyone breathing water will be in a state of panic. Panicked people have been lost in burning airplanes because they didn't think of unbuckling their seatbelts to escape. In the water, they'll latch onto anything and will not let go. Look into it: you may find that drownings in your area tend to occur in pairs.

The smart rescuer still has options. The most common order of action (says Google) is throw, row, tow, go. That is, throw the victim a life ring, a personal flotation device or frankly anything that floats since there's nothing to lose; reach the victim in a nice boat for latching on and hauling onto; provide a rope, an oar or other item to pull him in; and enter the water.

"Enter the water" is the nightmare option. Do not enter the water if you can't swim. Do not enter the water if the current and waves trouble you. Do not enter the water unless you have an item that you can use to tow the victim at a safe distance, for his hands unmake all things. Swim out to meet the victim, always keeping the item between him and you. The step is sometimes given as "don't go" or "go for help," which seems to be for children: first aid tends to start with calling 911, having someone else call 911, or screaming for someone to come over and call 911. Bare hands are really very limited tools.

Our practical training was diverse. Life rings proved to be difficult to aim, and it was good to build a habit of checking around my feet before throwing a rope. Most of it was still dedicated to meeting the victim in the water. Stop a couple meters from the victim. Before closing bring your legs forward, ready to escape, and extend the arm or arms holding the tool that you're still keeping between you and him. If he makes a grab at you, abort and flee. If you are caught, push the victim forwards and upwards and try to dive underwater - aka the last place a drowning person is going to follow you. Should you be able to free yourself, abort and flee.

If rescue works, moving the victim is doable by a person of ordinary physical ability, as is lifting one onto a pier or to a poolside if there's a helper. There are a few tricks that are difficult to put into words. Once the victim's environment is no longer trying to kill him, the hard part's over! A promptly EMS'd victim has an excellent chance, and in the meantime CPR and treating for hypothermia or shock are done normally. He must still be seen at a hospital: water in the lungs can lead to progressive damage and a fun effect where the victim makes a full recovery and drowns on dry land the following week.

If rescue doesn't work and no option is available, bystanders are to stand by and let the victim drown. Diving after anyone is also forbidden, at least in these murky Northern waters. I asked the pros how strong drowning three-year-olds are. Apparently quite strong enough. Plus those things climb like monkeys.

The Red Cross plays defensively: Hold what you've got. The first priority at any accident scene is to avoid increasing the number of casualties. By placing numbers above heroics, it preserves life impartially.

Its approach makes perfect sense and is, in fact, the only rational option.

Goddammit.


Things to remember:

  • Have a cell phone instead of a landline when you watch your kids at the pool.
  • If drunk, try to swim along the shore.
  • It's even called a life jacket.

Life"-sav`ing (?), a.

That saves life, or is suited to save life, esp. from drowning; as, the life-saving service; a life-saving station.

 

© Webster 1913.

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