Submerged Victim at a Crowded Pool
You are lifeguarding at a busy outdoor pool on a Saturday afternoon. There are about 75 people in the water and on the deck. You are positioned at the deep-end stand, which covers the area from the 5-foot mark to the 12-foot diving well. The pool has a slight glare from the sun. You scan your zone and notice a swimmer who was previously holding onto the wall near the 12-foot mark is no longer there. You see a faint shadow below the surface near the drain. You blow your whistle and signal to the other guard to watch your zone. You enter the water with a compact jump, surface dive, and bring the victim to the surface. The victim is unresponsive and not breathing. You are about 15 yards from the nearest wall. The other guard is clearing the pool and calling 911.
1. What should you do first after bringing the victim to the surface, and why?
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After bringing the victim to the surface, the first priority is to get the victim to the side of the pool as quickly and safely as possible while maintaining an open airway. Since the victim is unresponsive and not breathing, you need to remove them from the water to begin CPR. The nearest wall is 15 yards away, so you should use a rear rescue or a front rescue depending on the situation, but you must keep the victim's face out of the water. You should call for assistance from the other guard or a bystander to help pull the victim out. Do not delay extrication to check for a pulse in the water; the priority is to get the victim on a firm, flat surface to start CPR. Once at the wall, use a two-person extrication if possible, or a single-person technique like the beach drag or ladder lift if you have help. The goal is to minimize time in the water and begin CPR immediately.
2. After extrication, the victim is on the deck. You check for breathing and a pulse and find none. What is your next action, and how does the presence of other people affect your decision?
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After extrication, if the victim is unresponsive, not breathing, and has no pulse, you should immediately begin CPR with chest compressions. The presence of other people is crucial: you should direct someone to call 911 if not already done, and send someone to retrieve the AED. You should also ask for someone to help with rescue breaths if available, but if alone, you should perform compression-only CPR until help arrives. The other guard is already clearing the pool and calling 911, so you can focus on CPR. If an AED arrives, apply it as soon as possible and follow the prompts. The key is to minimize interruptions in chest compressions and use the AED as soon as it is available.