Article

Preparation of lifeguards to Basic Life Support in the drowning

Correspondence / American Journal of Emergency Medicine 36 (2018) 23072335 2335

Atif Bayramoglu, MD?

Engin Kurt, MD

Ataturk University Education and Research Hospital, Department of

Emergency Medicine, Erzurum, Turkey

?Corresponding author.

E-mail address: [email protected] (A. Bayramoglu).

12 April 2018

https://doi.org/10.1016/j.ajem.2018.04.055

Preparation of lifeguards to Basic Life Support in the drowning

Dear Editor,

A lifeguard needs to start cardiopulmonary resuscitation (CPR) in the drowning with breath absence as soon as possible, even before taking them out from water [1]. First Aid/CPR/AED knowledge and skills should be taught during the Lifeguard Candidates (LC) training [2] rather than later on a first aid course or a qualified first aid course (QFAC). Currently in Poland, one can participate in QFAC even several months after com- pleting the lifeguard training [3]. The American Red Cross, lifeguarding training provider in the US requires certified refresher First Aid/CPR/ AED training every two years [4]. Research conducted in New Zealand among Professional Lifeguards (PL) indicates that the effectiveness of CPR training is high within 3 months after its completion [5]. However, Queiroga et al. suggests the first aid refresher once a year before every summer season to improve lifeguard preparation to CPR/AED [6]. In South Korea and Poland, the lifeguard training system in the first aid dif- fers from that in the UK, the Netherlands and Germany – the countries associated with the International life saving Federation (ILS) [7]. Train- ing system requires standardization in all ILS members.

The study aimed to assess knowledge of BLS and BLS for Drowning in the group of LC and PL and analyze the results depending on lifeguard rank, participation in first aid courses and QFAC.

Randomly selected LC who completed lifeguard training but did not

complete the first aid course and PL working at the swimming pools cer- tified with QFAC were enrolled. The survey based on the 2015 European Resuscitation Council (ERC) guidelines standardized by the authors was used. The questionnaire contained 17 questions divided into two groups: knowledge of BLS and BLS for Drowning. The survey was con- ducted from May 1 to September 30, 2017. Pearson’s chi2 test, Mann- Whitney U test, the Spearman rank correlation were used. The level of significance was assumed at p b .050.

99 subjects were enrolled in the study, including: 58 LC after life- guard training, aged 19.9 +- 1.9 years (39 men, 19 women) and 41 PL

aged approx. 32.6 +- 12.3 years (28 men, 13 women).

Analysis of knowledge in the BLS and BLS for Drowning of the whole test showed significant differences between groups, p = .021, p = .047, p = .007. 75.9% of LC group and 53.7% of PL group did not pass the test. We found that the lifeguard’s gender does not have a significant re- lationship with knowledge and other factors such as participation in training or the time that has elapsed since the last training. The higher the lifeguard’s rank, the higher the knowledge r = 0.39, BLS r = 0.29 BLS for Drowning r = 0.39, therefore the higher the lifeguard rank, the better the preparation of lifeguard to conduct CPR in a drowning person. Lifeguards participating in both the first aid course and the

QFAC course had greater knowledge in BLS and BLS for Drowning.

There was a significant difference in knowledge from the whole test p = .0003 and separately in BLS p = .0001 and BLS for Drowning p =

.0007 between participants who attended and did not participate in First Aid/CPR/AED course, the first group passed the test in 97.% and

the latter did not pass the test in 96.7%. First Aid/CPR/AED graduates showed better knowledge in BLS (73.9% of this group) and BLS for Drowning (56.5%). Lack of knowledge in BLS (66.7%) and BLS for Drowning (86.7%) in the subjects without First Aid/CPR/AED course in- dicates necessity of such training.

Significant difference in knowledge from the whole test p = .0002 as well as BLS p = .0160 and BLS for Drowning p = .0000 was found be- tween QFAC graduates and those who have not completed it. The for- mer passed the test in 51.0%, BLS in 73.5% and BLS for Drowning in 67.4%, and persons without QFAC, passed the test in 16%, BLS in 50%, and BLS for Drowning in 20%.

The ERC encourages actions and research to help to reduce mortality and improve resuscitation skills in the drowning [1]. The study proves that LC should take the First Aid/CPR/AED course during the lifeguard training, and not only after its completion (at any time). Due to the signif- icant lack of knowledge in persons who have not completed the first aid training in BLS and BLS for Drowning, such training should be introduced as obligatory for all PL and LC. QFAC graduates are better prepared to per- form BLS for Drowning than those who participated only in the first aid course. Obtaining further lifeguard ranks contributes to increasing the knowledge, experience and good performance of BLS for Drowning.

Financial disclosure statement

The authors have no financial relationships relevant to this article to disclose.

Conflict of interest statement

The authors have no conflicts of interest relevant to this article to disclose.

Jerzy Kiszka* Iwona Tabaczek-Bejster

Institute of Midwifery and Emergency Medicine, Faculty of Medicine, University of Rzeszow, Pigonia 6 Street, 35-310 Rzeszow, Poland

?Corresponding author at: Institute of Obstetrics and Emergency Medicine, Faculty of Medicine, University of Rzeszow, Pigonia 6 Street,

35-310 Rzeszow, Poland.

E-mail address: [email protected] (J. Kiszka).

Katarzyna Walicka-Cuprys Institute of Physiotherapy, Faculty of Medicine, University of Rzeszow, Warszawska 26A Street, 35-205 Rzeszow, Poland

28 July 2018

https://doi.org/10.1016/j.ajem.2018.08.008

References

  1. Truhlar A, Deakin CD, Soar J, Khalifa GEA, Alfonzo A, Bierens JJL, et al. European Resus- citation Council Guidelines for Resuscitation 2015 Section 4. Cardiac arrest in special circumstances. Resuscitation 2015;95:148-201.
  2. American Red Cross. Lifeguarding Manual. The American National Red Cross; 2016.
  3. Tabaczek-Bejster I, Kiszka J, Ozga D. Is the water rescue service in Poland heading in the right direction? Preparing lifeguards to the standards of first aid in Europe. Wil- derness Environ Med 2018. https://doi.org/10.1016/j.wem.2018.01.010.
  4. American Red Cross. n.d. Lifeguard preparation. Become a lifeguard https://www. redcross.org/take-a-class/lifeguarding/lifeguard-preparation (accessed April 19, 2018).
  5. Moran K, Webber J. Surf lifeguard perceptions and practice of Cardiopulmonary Re- suscitation (CPR). Int J Aquat Res Educ 2012;6:24-34.
  6. Queiroga AC, Barcala-Furelos R, Abelairas-Gomez C, Farto-Ramirez O, Prieto-Saborit JA, Rodriguez-Nunez A. Cardiopulmonary Resuscitation quality among lifeguards: self-perception, knowledge, and performance. Am J Emerg Med 2014;32:1429-30. https://doi.org/10.1016/j.ajem.2014.08.077.
  7. Kim KB, Lee JH, Kim SG, Seok KH, Choi YS. Improvement plan on Marine lifesaving ed- ucational course in Korea: comparison with the status of the foreign marine leisure safety education groups. J Coast Res 2017:26-9. https://doi.org/10.2112/SI79-006.1.

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