Development of in-water-intervention (IWI) in a lifeguard protocol with analysis of rescue history

This paper discusses the development and effectiveness of a protocol for lifeguards in enclosed aquatic facilities with special emphasis on scanning, rapid rescue, and applying a resuscitation procedure in the water immediately after contacting a drowning victim. We call this set of procedures In-The-Water-Intervention (IWI). Testing showed abdominal thrusts (ATs) adapted for the protocol were the most effective IWI that could reliably be performed in deep water by 16-18 year-old lifeguards. Data analysis was done on a waterpark attendance of 63,800,000 with 56,000 rescues and 32 respiratory failures including four deaths. This paper concludes that this lifeguard protocol is effective for the environment described in this study. The lifeguard protocol’s fatality rate (0.0063 per 100K) is 1.09% of the year 2000 CDC fatality rate for all US pools. Only IWI was required to restore spontaneous respiration in 14 (43.75%) of the 32 cases involving loss of spontaneous respiration. In an additional 2 (6.25%) of the 32 cases involving loss of spontaneous respiration, ATs delivered out of the water were all that was required to restore spontaneous respiration.